WorldWideScience

Sample records for current management practices

  1. Fever management: Evidence vs current practice.

    Science.gov (United States)

    El-Radhi, A Sahib Mehdi

    2012-12-08

    Fever is a very common complaint in children and is the single most common non-trauma-related reason for a visit to the emergency department. Parents are concerned about fever and it's potential complications. The biological value of fever (i.e., whether it is beneficial or harmful) is disputed and it is being vigorously treated with the belief of preventing complications such as brain injury and febrile seizures. The practice of alternating antipyretics has become widespread at home and on paediatric wards without supporting scientific evidence. There is still a significant contrast between the current concept and practice, and the scientific evidence. Why is that the case in such a common complaint like fever The article will discuss the significant contrast between the current concepts and practice of fever management on one hand, and the scientific evidence against such concepts and practice.

  2. Current practice for diagnosis and management of silent atrial fibrillation

    DEFF Research Database (Denmark)

    Dobreanu, Dan; Svendsen, Jesper Hastrup; Lewalter, Thorsten

    2013-01-01

    Although it is well known that silent atrial fibrillation (AF) is associated with morbidity and mortality rates similar to those of symptomatic AF, no specific strategy for screening and management of this form of AF has been advocated. The purpose of this survey was to identify current practices...... for the diagnosis and management of silent AF. This survey is based on an electronic questionnaire sent to the European Heart Rhythm Association Research Network partners. Responses were received from 33 centres in 16 countries. The preferred screening methods for silent AF in patients with rhythm control...... episode of silent AF was documented, without recommending further investigations. The results of this survey have confirmed that there is currently no consensus regarding the screening and management of patients with silent AF and that clinical practice is not always consistent with the few existing...

  3. Asthma in children: gaps between current management and best practice.

    Science.gov (United States)

    Haby, M M; Powell, C V E; Oberklaid, F; Waters, E B; Robertson, C F

    2002-06-01

    To determine the extent to which steps three to six of the Australian six-step asthma management plan are being implemented in the community and to identify barriers to the adoption of best practice asthma management. A cross-sectional descriptive study was conducted at the Royal Children's Hospital and Sunshine Hospital, Melbourne. Two hundred and thirty-one 2-5-year old children who visited the emergency department for asthma were enrolled in the study. Main outcome measures were frequency of asthma management practices and barriers, as measured by parent-completed questionnaire. Gaps: 51% of parents do not feel they have enough information about asthma triggers, more than 60% of children with persistent or frequent episodic asthma are not using regular preventive medication, 48% do not have a written action plan, 39% have not had their asthma reviewed in the last 6 months, and 38% of parents do not feel that they have enough information about their child's asthma. Areas where current practice was close to best practice: 83% of doctors had talked to parents about what causes or 'triggers' their child's asthma, less than 1% of children are using puffers without a spacer, 83% of parents who had an action plan used it for the current visit to the emergency department. Large gaps still exist between current management and best practice in this group of emergency department attenders. Improvements in asthma management could be achieved if the child's asthma doctor requested review visits for asthma, provided an action plan and followed best practice in relation to asthma medications.

  4. Individual Performance Management: A Review of Current Practices

    Directory of Open Access Journals (Sweden)

    Ian O’ Boyle

    2013-05-01

    Full Text Available This paper provides a review of current practice in relation to individual performance management systems and process within the traditional business environment. There is a consensus that the role of the individual is central to the overall performance of any organization and how individual performances are managed and evaluated can have significant impacts on overall organizational success. Many organizations employ the traditional performance appraisal in order to monitor and assess individual employee performances. However, new approaches, such as 360-degree feedback have also become commonplace within the business environment. An analysis of each approach including benefits and challenges associated with each process is presented within this paper.

  5. Current UK practices in the management of subacromial impingement

    Science.gov (United States)

    Drury, Colin; Tait, Gavin R

    2015-01-01

    Background 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. Methods BESS members were invited to complete a questionnaire and responses were received from 157 consultant shoulder surgeons. Results 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. Conclusions 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. PMID:27582972

  6. Current Credit Risk Management Practices in Chinese Banking Industry

    OpenAIRE

    Zheng, Hao

    2008-01-01

    ABSTRACT Bank loans can be characterized as the engine of the Chinese economy as the economy is almost financed by bank loans. As a result, Credit risk management in Chinese banks is not only the issue to those banks, but it is also essential to the stability of the whole economy. Inadequate credit risk management practices can create an unforeseeable disaster to China in the future, especially with a significant increase in credit expansion. In the last decade, the government has tried ha...

  7. Current practice in out-of-hospital cardiac arrest management

    DEFF Research Database (Denmark)

    Proclemer, Alessandro; Dobreanu, Dan; Pison, Laurent

    2012-01-01

    AIMS: The purpose of this EP wire is to examine clinical practice in the field of out-of-hospital cardiac arrest (OHCA) management, with special focus on in-hospital diagnostic and therapeutic strategies. METHODS AND RESULTS: Fifty-three European centres, all members of the EHRA-EP Research network...... management strategy, including coronary angiography/PCI and implantable cardioverter defibrillator therapy, while therapeutic hypothermia appears to be underused....

  8. Targeted temperature management: Current evidence and practices in critical care

    Directory of Open Access Journals (Sweden)

    Saurabh Saigal

    2015-01-01

    Full Text Available Targeted temperature management (TTM in today′s modern era, especially in intensive care units represents a promising multifaceted therapy for a variety of conditions. Though hypothermia is being used since Hippocratic era, the renewed interest of late has been since early 21 st century. There have been multiple advancements in this field and varieties of cooling devices are available at present. TTM requires careful titration of its depth, duration and rewarming as it is associated with side-effects. The purpose of this review is to find out the best evidence-based clinical practice criteria of therapeutic hypothermia in critical care settings. TTM is an unique therapeutic modality for salvaging neurological tissue viability in critically ill patients viz. Post-cardiac arrest, traumatic brain injury (TBI, meningitis, acute liver failure and stroke. TTM is standard of care in post-cardiac arrest situations; there has been a lot of controversy of late regarding temperature ranges to be used for the same. In patients with TBI, it reduces intracranial pressure, but has not shown any favorable neurologic outcome. Hypothermia is generally accepted treatment for hypoxic ischemic encephalopathy in newborns. The current available technology to induce and maintain hypothermia allows for precise temperature control. Future studies should focus on optimizing hypothermic treatment to full benefit of our patients and its application in other clinical scenarios.

  9. Employee Internet management: current business practices and outcomes.

    Science.gov (United States)

    Case, Carl J; Young, Kimberly S

    2002-08-01

    This paper empirically examines emergent business practices that attempt to reduce and control employee Internet misuse and abuse. Over a 6-month period, 52 web-administered surveys were collected. Respondents ranged from human resource managers to company presidents. Data were stored in a database management system and analyzed utilizing statistical measures. Monitoring efforts and policy development issues are examined against critical incidents of employee Internet abuse. The analysis also includes a rank ordering of the types of Internet applications that were perceived as most problematic or abused. Types of applications abused include electronic mail, adult web sites, online gaming, chat rooms, stock trading, and so on. Moreover, company size and years online are examined. Overall, this research will assist organizations in implementing effective corporate initiatives to improve employee Internet management practices.

  10. Managing the Services Supply Chain in the Department of Defense: Empirical Study of the Current Management Practices in the Army

    Science.gov (United States)

    2009-09-21

    Managing the Services Supply Chain in the Department of Defense: Empirical Study of the Current Management Practices in the Army 21 September...Managing the Services Supply Chain in the Department of Defense: Empirical Study of the Current Management Practices in the Army 5a. CONTRACT NUMBER 5b...Service Supply Chain , Services Acquisition, Service Lifecycle, Contract Management, Project Management, Program Management = = ^Åèìáëáíáçå=oÉëÉ~êÅÜ

  11. Challenges of Environmental Management Accounting - Current Accounting Practices

    National Research Council Canada - National Science Library

    Prof. Ph.D. Gheorghe Popescu; Prof. Ph.D. Adriana Popescu; Univ. Junior Assistant, PhD Attendant Cristina Raluca Popescu

    2008-01-01

    ...).Environmental Management Accounting is a relatively new tool in environmental management definedas the identification, collection, estimation, analysis, internal reporting, and use of materials...

  12. Challenges of Environmental Management Accounting ?- Current Accounting Practices

    OpenAIRE

    Prof. Ph. D. Gheorghe Popescu; Prof. Ph.D . Adriana Popescu; Univ.Junior Assistant, PhD Attendant Cristina Raluca Popescu

    2008-01-01

    The goal of our paper is to reduce some of the international confusion generated on such an important topic by providing a general framework and set of definitions for Environmental Management Accounting (EMA). Environmental Management Accounting is a relatively new tool in environmental management defined as the identification, collection, estimation, analysis, internal reporting, and use of materials and energy flow information, environmental cost information, and other cost information for...

  13. Challenges of Environmental Management Accounting –- Current Accounting Practices

    Directory of Open Access Journals (Sweden)

    Prof. Ph.D. Gheorghe Popescu

    2008-12-01

    Full Text Available The goal of our paper is to reduce some of the international confusion generated on such animportant topic by providing a general framework and set of definitions for Environmental ManagementAccounting (EMA.Environmental Management Accounting is a relatively new tool in environmental management definedas the identification, collection, estimation, analysis, internal reporting, and use of materials and energyflow information, environmental cost information, and other cost information for both conventionaland environmental decision-making within an organization.Due to their special role, accountants, since they are the ones with access to the important monetarydata and information systems needed for management accounting activities, must to improve both theirability to verify the quality of such information and the skills to use that information for decision making.

  14. Pediatric airway management: current practices and future directions.

    Science.gov (United States)

    Sunder, Rani A; Haile, Dawit T; Farrell, Patrick T; Sharma, Anshuman

    2012-10-01

    Management of a pediatric airway can be a challenge, especially for the non-pediatric anesthesiologists. Structured algorithms for an unexpected difficult pediatric airway have been missing so far. A recent step wise algorithm, based on the Difficult Airway society (DAS) adult protocol, is a step in the right direction. There have been some exciting advances in development of pediatric extra-glottic devices for maintaining ventilation, and introduction of pediatric versions of new 'non line of sight' laryngoscopes and optical stylets. The exact role of these devices in routine and emergent situations is still evolving. Recent advances in simulation technology has become a valuable tool in imparting psychomotor and procedural skills to trainees and allied healthcare workers. Moving toward the goal of eliminating serious adverse events during the management of routine and difficult pediatric airway, authors propose that institutions develop a dedicated Difficult Airway Service comprising of a team of experts in advanced airway management. © 2012 Blackwell Publishing Ltd.

  15. Physical Activity in Clinical Pediatric Weight Management Programs: Current Practices and Recommendations.

    Science.gov (United States)

    Kist, Christopher; Gier, Amanda; Tucker, Jared; Barbieri, Teresa F; Johnson-Branch, Sonya; Moore, Lindy; Picard, Sarah; Lukasiewicz, Gloria; Coleman, Nailah

    2016-11-01

    Physical activity (PA) is essential for youth weight management. FOCUS on a Fitter Future (FFF), a group of health care professionals from 25 children's hospitals, sponsored by the Children's Hospital Association, examined current care practices for overweight and obese youth with the goal of building consensus on outcome measurements and quality improvement for pediatric weight management programs (WMPs). WMPs completed a survey regarding PA practices, including testing, assessment and intervention. Consistency in general treatment practices was noted with variability in implementation. All programs included PA assessment and counseling. A majority of programs measured aerobic fitness, and more than half evaluated muscular fitness. Most offered group exercise sessions. Programs differed in availability of resources, assessment tools, interventions and outcome measures. Based on current practice and research, the FFF PA subgroup recommends key components for inclusion in a pediatric WMP: exercise testing, body composition assessment, PA and sedentary behaviors measures, individual exercise counseling, and group exercise programming. © The Author(s) 2015.

  16. Management of tinnitus in English NHS audiology departments: an evaluation of current practice.

    Science.gov (United States)

    Hoare, Derek J; Gander, Phillip E; Collins, Luke; Smith, Sandra; Hall, Deborah A

    2012-04-01

    In 2009, the UK Department of Health formalized recommended National Health Service practices for the management of tinnitus from primary care onwards. It is timely therefore to evaluate the perceived practicality, utility and impact of those guidelines in the context of current practice. We surveyed current practice by posting a 36-item questionnaire to all audiology and hearing therapy staff that we were able to identify as being involved in tinnitus patient care in England. In total, 138 out of 351 clinicians responded (39% response rate). The findings indicate a consensus opinion that management should be tailored to individual symptom profiles but that there is little standardization of assessment procedures or tools in use. While the lack of standardized practice might provide flexibility to meet local demand, it has drawbacks. It makes it difficult to ascertain key standards of best practice, it complicates the process of clinical audit, it implies unequal patient access to care, and it limits the implementation of translational research outcomes. We recommend that core elements of practice should be standardized, including use of a validated tinnitus questionnaires and an agreed pathway for decision making to better understand the rationale for management strategies offered. © 2010 Blackwell Publishing Ltd.

  17. Cancer pain management in China: current status and practice implications based on the ACHEON survey.

    Science.gov (United States)

    Xia, Zhongjun

    2017-01-01

    Cancer pain can seriously impact the quality of life (QoL) of patients, and optimal management practices are therefore of paramount importance. The ACHEON survey queried physicians and patients from 10 Asian countries/regions to assess current clinical practices in cancer pain management in Asia. This study presents the data obtained for cancer pain management in mainland China, with an emphasis on practices related to opioid drugs. In several tertiary hospitals across China, 250 patients experiencing cancer pain and 100 physicians were surveyed on questions designed to assess current cancer pain management practices and cancer pain impact on QoL. The patient survey showed that 88% of patients reported moderate-to-severe cancer pain, with a median duration of 6 months. The physician survey showed that medical school/residency training with regard to cancer pain management was inadequate in ~80% of physicians. A total of 80% of physicians and 67.2% of patients reported that pain scale was used during pain assessment; 84% of physicians expressed that physician-perceived pain severity was not completely consistent with actual pain the patient experienced. Of the 147 patients who recalled the medication received, 83.7% were administered opioid prescriptions. Of the 240 patients who received treatment, 43.8% perceived the inadequacy of controlling pain. The primary barriers from physicians perceived to optimal pain management included patients' fear of side effects (58%), patients' fear of addiction (53%), patients' reluctance to report pain (43%), physicians' reluctance to prescribe (29%), physicians' inadequacy of pain assessment (27%) and excessive regulation of opioid analgesics (47%). Knowledge of cancer pain management should be strengthened among physicians. Quantitative pain assessment and principle-based pain management should be combined to achieve pain relief. Misconceptions about opioids in patients and physicians and poor report about pain should be

  18. Practice management.

    Science.gov (United States)

    Althausen, Peter L; Mead, Lisa

    2014-07-01

    The practicing orthopaedic traumatologist must have a sound knowledge of business fundamentals to be successful in the changing healthcare environment. Practice management encompasses multiple topics including governance, the financial aspects of billing and coding, physician extender management, ancillary service development, information technology, transcription utilization, and marketing. Some of these are universal, but several of these areas may be most applicable to the private practice of medicine. Attention to each component is vital to develop an understanding of the intricacies of practice management.

  19. Current practice with regard to short-term incentive schemes for middle managers

    Directory of Open Access Journals (Sweden)

    Chrisilla Grigoiadis

    2007-01-01

    Full Text Available This study aimed to determine what the current practice is with regard to short-term incentive schemes for middle managers. This was done by means of a quantitative study through a structured research survey completed by a sample of forty-eight organisations. The design elements, performance measures and payout practices of the various schemes in use were surveyed, as well as the participants’ view on the perceived effectiveness of their short-term incentive schemes. Evidence shows that the majority of organisations have a short-term incentive scheme in place for middle managers, and that the type of scheme used in most of the organisations is a performance-related bonus scheme, introduced mainly to drive business performance and reward superior performance.

  20. A Survey on Current Practice of Management of Early Onset Neonatal Sepsis.

    Science.gov (United States)

    Dey, A C; Hossain, M I; Afroze, S; Dey, S K; Mannan, M A; Shahidullah, M

    2016-04-01

    It was a survey type of cross sectional study where the participants were from different teaching/referral hospital across the country and was done to gather information regarding current practice of management of neonatal sepsis among paediatricians and neonatologists and was conducted on the spot during a national conference of Bangladesh Perinatal Society in December 2013. Specialists in neonatology, paediatrics, and some other disciplines working in different institutes across the country were requested to respond. Out of 150 physicians, 92 (61.33%) were neonatologists. Physicians suspected early onset neonatal sepsis (EONS) when there is history suggestive of prolonged rupture of membrane (74.77%), prolonged labour (9.33%), chorioamnionitis (7.33%) and maternal fever (2%). Clinical sepsis is found commonly (53.33%) which is later proved by laboratory evidences such as Hb%, TC, DC PBF (peripheral blood film), C-reactive protein, chest X-ray etc. Injection Ampicillin and Gentamycin are still the first choice of antibiotics (61.3%). Preferred route was intravenous (95.3%). Antibiotics were given for 7-10 days by most of the physicians (48.77%). However there is lack of uniformity among the participants in regard to taking decision about antibiotics, the choice of first line and the subsequent options of antibiotics. So, neonatal sepsis is the most important cause of neonatal mortality in the community. Therefore a standard protocolized approach for diagnosis and management of Early Onset Neonatal Sepsis may prove critical which is currently not in practice uniformly.

  1. Management of obstetric postpartum hemorrhage: a national service evaluation of current practice in the UK

    Directory of Open Access Journals (Sweden)

    Al Wattar BH

    2017-01-01

    Full Text Available Bassel H Al Wattar,1,* Jennifer A Tamblyn,2,* William Parry-Smith,2,* Mathew Prior,3,* Helen Van Der Nelson4,* On behalf of UK Audit and Research trainee Collaborative in Obstetrics and Gynaecology (UKARCOG 1Women’s Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University London, London, UK; 2Institute of Metabolism and Systems Research (IMSR, University of Birmingham, Birmingham, UK; 3Division of Child Health, Obstetrics & Gynaecology, School of Medicine, University of Nottingham, Nottingham, UK; 4Academic Centre for Women’s Health, North Bristol NHS Trust, Bristol, UK *UKARCOG Background: Postpartum hemorrhage (PPH continues to be one of the major causes of maternal mortality and morbidity in obstetrics. Variations in practice often lead to adverse maternity outcomes following PPH. Our objective was to assess the current practice in managing PPH in the UK.Methods: We performed a national multicenter prospective service evaluation study over one calendar month and compared the current performance to national standards for managing PPH. We used a standardized data collection tool and collected data on patients’ demographics, incidence of PPH, estimated blood loss (EBL, prophylactic and treatment measures, onset of labor, and mode of delivery.Results: We collected data from 98 obstetric units, including 3663 cases of primary PPH. Fifty percent of cases were minor PPH (EBL 500–1000 mL, n=1900/3613, 52.6% and the remaining were moderate PPH (EBL >1000 to <2000 mL, n=1424/3613, 39.4% and severe PPH (EBL >2000 mL, n=289/3613, 8%. The majority of women received active management of the third stage of labor (3504/3613, 97% most commonly with Syntometrine intramuscular (1479/3613, 40.9%. More than half required one additional uterotonic agent (2364/3613, 65.4% most commonly with Syntocinon intravenous infusion (1155/2364, 48.8%. There was a poor involvement of consultant obstetricians and anesthetists in

  2. Developing a Knowledge Management Framework to Assist With Current USMC Information Management Practices

    Science.gov (United States)

    2010-09-01

    23 Figure 8. AFKN Build Learning Communities (from AFMC Briefing...the goals. Figure 8. AFKN Build Learning Communities (from AFMC Briefing, 2001) 41 HQ AFMC/A5BK provides expertise in management of information

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

    Directory of Open Access Journals (Sweden)

    Marie Ludlow

    2017-06-01

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

  4. Rural domestic waste management in Zhejiang Province, China: Characteristics, current practices, and an improved strategy.

    Science.gov (United States)

    Guan, Yidong; Zhang, Yuan; Zhao, Dongye; Huang, Xiaofeng; Li, Haini

    2015-06-01

    Lack of access to adequate sanitation facilities has serious health implications for rural dwellers and can degrade the ecosystems. This study offers a systemantic and quantitative overview of historical data on rural domestic waste (RDW) production and past and current management practices in a prototype region in China, where rural areas are undergoing rapid urbanization and are confronted with great environmental challenges associated with poor RDW management practices. The results indicate that RDW is characterized with a large fraction of kitchen waste (42.9%) and high water content (53.4%). The RDW generation (RDWG) per capita between 2012 and 2020 is estimated to increase from 0.68 to 1.01 kg/d-cap. The Hill 1 model is able to adequately simulate/project the population growth in a rural area from 1993 to 2020. The annual RDWG in the region is estimated to double from 6,033,000 tons/year in 2008 to 12,030,000 tons/year by 2020. By comparing three RDW management scenarios based on the life-cycle inventory approach and cost-benefit analysis, it is strongly recommended that the present Scenario 2 (sanitary landfill treatment) be upgraded to Scenario 3 (source separation followed by composting and landfill of RDW) to significantly reduce the ecological footprint and to improve the cost-effectiveness and long-term sustainability. Rural domestic waste (RDW) is affecting 720 million people in China and more than 3221 million people worldwide. Consequently, handling and disposal of RDW have serious health implications to rural dwellers and the ecosystems. This study offers a systemantic and quantitative overview and analysis of historical data on RDW production and management practices in a prototype region in China, which is confronted with great environmental challenges associated with RDW. Then we predict future production of RDW and propose a sustainable RDW management strategy, which holds the promise of greatly mitigating the mounting environmental pressure

  5. Respiratory management of motor neurone disease: a review of current practice and new developments.

    Science.gov (United States)

    Rafiq, Muhammad Khizar; Proctor, Alison Ruth; McDermott, Christopher J; Shaw, Pamela J

    2012-06-01

    Motor neurone disease is a neurodegenerative condition with a significant morbidity and shortened life expectancy. Hypoventilatory respiratory failure is the most common cause of death and respiratory function significantly predicts both survival and quality of life in patients with motor neurone disease. Accordingly, supporting and maintaining respiratory function is important in caring for these patients. The most significant advance in motor neurone disease care of recent years has been the domiciliary provision of non-invasive ventilation for treating respiratory failure. Neuromuscular respiratory weakness also leads to ineffective cough and retained airways secretions, predisposing to recurrent chest infections. In this review, we discuss current practice and recent developments in the respiratory management of motor neurone disease, in terms of ventilatory support and cough augmentation.

  6. Medication therapy management services in North Carolina community pharmacies: current practice patterns and projected demand.

    Science.gov (United States)

    Hansen, Richard A; Roth, Mary T; Brouwer, Emily S; Herndon, Susan; Christensen, Dale B

    2006-01-01

    To evaluate the types of cognitive services offered and the number of patients being served in community pharmacies, determine the number of pharmacies that plan to offer medication therapy management (MTM) services under the Medicare Part D prescription drug benefit, and assess whether current and expected practices will meet the potential needs of enrollees. Cross-sectional study. North Carolina in January 2005. 1,593 community pharmacy managers. Survey using a Web-based tool. Provision of cognitive services and number of patients for whom services are provided. A total of 262 (16%) pharmacy managers provided usable responses. Approximately 42% of respondents (n = 110) indicated that they provide some type of cognitive service. Comprehensive MTM services, or services consistent with the professionwide consensus definition, were provided by 31% of respondents (n = 81). Independent pharmacies were more likely to offer some type of service compared with chain pharmacies (58% versus 31%, respectively; P Pharmacy managers with a doctor of pharmacy degree were less likely than pharmacy managers with a bachelor's degree to offer services in their pharmacies (P = .02), and pharmacies with pharmacists on staff who had received certificate training were more likely to offer cognitive services (P = .03). Of all respondents, 28% (n = 73) indicated that they planned to offer MTM services under the Medicare Part D prescription drug benefit. Comparing these results with those of a 1999 survey of North Carolina pharmacists that used some of the same items, the percentage of community pharmacies that provide cognitive services has increased in the intervening years but remains low. Among the services being offered in 2005, most were focused on patient education and training, coordinating and integrating care, and medication regimen reviews. Implementation of MTM services under the Medicare Part D prescription drug benefit should hasten the development and offering of these

  7. Practice Patterns and Opinions on Current Clinical Practice Guidelines Regarding the Management of Delirium in the Intensive Care Unit.

    Science.gov (United States)

    Mo, Yoonsun; Zimmermann, Anthony E; Thomas, Michael C

    2017-04-01

    The aim of this study was to determine current delirium practices in the intensive care unit (ICU) setting and evaluate awareness and adoption of the 2013 Pain, Agitation, and Delirium (PAD) guidelines with emphasis on delirium management. A large-scale, multidisciplinary, online survey was administered to physician, pharmacist, nurse, and mid-level practitioner members of the Society of Critical Care Medicine (SCCM) between September 2014 and October 2014. A total of 635 respondents completed the survey. Nonpharmacologic interventions such as early mobilization were used in most ICUs (83%) for prevention of delirium. A majority of respondents (97%) reported using pharmacologic agents to treat hyperactive delirium. Ninety percent of the respondents answered that they were aware of the 2013 PAD guidelines, and 75% of respondents felt that their delirium practices have been changed as a result of the new guidelines. In addition, logistic regression analysis of this study showed that respondents who use delirium screening tools were twice more likely to be fully aware of key components of the updated guidelines (odds ratio [OR] = 2.07, 95% confidence interval [CI] = 1.20-3.60). Most critical care practitioners are fully aware and knowledgeable of key recommendations in the new guidelines and have changed their delirium practices accordingly.

  8. Managing caries: the need to close the gap between the evidence base and current practice.

    Science.gov (United States)

    Schwendicke, F; Doméjean, S; Ricketts, D; Peters, M

    2015-11-13

    Underpinned by a changing knowledge of the aetiology of caries and its sequelae, and assisted by established and advancing dental materials, there is growing evidence supporting less invasive management of dental caries based on the principles of minimal intervention dentistry. This narrative review assesses both the evidence and the adoption of less invasive caries management strategies and describes ways in which the gap between evidence and practice might be overcome. While there is increasing data supporting less invasive management of carious lesions, these are not standard in most dental practices worldwide. Usually, clinical studies focused on efficacy as outcome, and did not take into consideration the views and priorities of other stakeholders, such as primary care dentists, educators, patients and those financing services. Involving these stakeholders into study design and demonstrating the broader advantages of new management strategies might improve translation of research into practice. In theory, clinical dentists can rely on a growing evidence in cariology regarding less invasive management options. In practice, further factors seem to impede adoption of these strategies. Future research should address these factors by involving major stakeholders and investigating their prioritised outcomes to narrow or close the evidence gap.

  9. Management of septic arthritis following anterior cruciate ligament reconstruction: a review of current practices and recommendations.

    Science.gov (United States)

    Cadet, Edwin R; Makhni, Eric C; Mehran, Nima; Schulz, Brian M

    2013-11-01

    Septic arthritis following anterior cruciate ligament reconstruction is a rare and potentially devastating complication that often leads to articular destruction and adverse clinical outcomes. Because of its rare occurrence, best practices for diagnosis and management have yet to be established. However, graft retention and favorable outcomes are possible with early diagnosis, surgical intervention, and appropriate antibiotic management. Clinicians must be familiar with the diagnostic criteria and management options for septic arthritis. Most patients require multiple procedures to effectively eradicate infection. When the original reconstructed graft cannot be salvaged, a staged anterior cruciate ligament reconstruction revision is required.

  10. Individualized Anesthetic Management for Patients Undergoing Electroconvulsive Therapy: A Review of Current Practice.

    Science.gov (United States)

    Bryson, Ethan O; Aloysi, Amy S; Farber, Kate G; Kellner, Charles H

    2017-06-01

    Electroconvulsive therapy (ECT) remains an indispensable treatment for severe psychiatric illness. It is practiced extensively in the United States and around the world, yet there is little guidance for anesthesiologists involved with this common practice. Communication between the anesthesiologist and the proceduralist is particularly important for ECT, because the choice of anesthetic and management of physiologic sequelae of the therapeutic seizure can directly impact both the efficacy and safety of the treatment. In this review, we examine the literature on anesthetic management for ECT. A casual or "one-size-fits-all" approach may lead to less-than-optimal outcomes; customizing the anesthetic management for each patient is essential and can significantly increase treatment success rate and patient satisfaction.

  11. Managing the services supply chain in the Department of Defense: an empirical study of current management practices / by Aruna U. Apte, Uday M. Apte, and Rene G. Rendon.

    OpenAIRE

    Apte, Aruna U.; Uday M. Apte; Rendon, Rene G.

    2009-01-01

    This paper presents the results of our ongoing research on the management of services acquisition in the Department of Defense. In this empirical study we developed and used a web-based survey to collect data on the acquisition strategy, procurement methods, and contract types used at Air Force and Navy installations. Specifically, we studied the current management practices in such areas as life cycle approach, project management, organization/management structure, and training provided to s...

  12. Perioperative management of haemophilia B: A critical appraisal of the evidence and current practices.

    Science.gov (United States)

    Neufeld, E J; Solimeno, L; Quon, D; Walsh, C; Seremetis, S; Cooper, D; Iyer, N N; Hoxer, C S; Giangrande, P

    2017-07-27

    While there is substantial literature addressing the principles of general management of haemophilia, literature on perioperative management of haemostasis is scarce. The aim of this study was to better understand perioperative management among congenital haemophilia B patients (without inhibitors) and to gain insights into real-world surgical practices. A systematic literature review, with an emphasis on haemophilia B, was conducted using EMBASE(®) , Medline(®) and the Cochrane Library. Studies from 1974 to June 2015 were accessed, and 132 studies were eligible for the full-study review. An international expert panel with five haematologists and one surgeon reviewed the resulting literature and provided further insights. The literature review revealed that documented experience in the perioperative management of bleeding risk in haemophilia B patients is relatively scarce. Therefore, the review was amended to provide a comprehensive overview of the perioperative management for haemophilia A and B patients; the expert panel applied a particular focus to haemophilia B. Several gaps were identified in the literature including the lack of consensus on defining surgery in terms of bleeding risk, optimal factor levels during surgery and lack of robust evidence on surgical outcomes. The ensuing discussions with the expert panel provided validation of some of the results from the systematic literature review and proposed future directions for perioperative management. Suggestions included collaboration with haemophilia treatment centres (HTCs) to collect real-world data on perioperative management, establishing the need for optimal factor level monitoring practice, and the appropriate adoption of extended half-life products in clinical settings. © 2017 John Wiley & Sons Ltd.

  13. 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...... influences them. The objective of this paper is two-fold: First, based on a literature review and industry focus group discussions, we introduce a new model for describing portfolio-level risks. It consists of three types of risks (escalated risks, common cause risks, and cascading risks) based on 9 types...... of interdependencies in PD project portfolios (Technology, Budget, Objectives and Requirements, Infrastructure and Equipment, Skillset and Human Resources, Process and Schedule, Supplier, Legal and Regulatory, and finally Market and Customer). Second, we investigate how risk management on the portfolio level...

  14. Offshore produced water management: A review of current practice and challenges in harsh/Arctic environments.

    Science.gov (United States)

    Zheng, Jisi; Chen, Bing; Thanyamanta, Worakanok; Hawboldt, Kelly; Zhang, Baiyu; Liu, Bo

    2016-03-15

    Increasing offshore oil and gas exploration and development in harsh/Arctic environments require more effective offshore produced water management, as these environments are much more sensitive to changes in water quality than more temperate climates. However, the number and scope of studies of offshore produced water management in harsh/Arctic environments are limited. This paper reviews the current state of offshore produced water management, impacts, and policies, as well as the vulnerability, implications and operational challenges in harsh/Arctic environments. The findings show that the primary contaminant(s) of concern are contained in both the dissolved oil and the dispersed oil. The application of emerging technologies that can tackle this issue is significantly limited by the challenges of offshore operations in harsh/Arctic environments. Therefore, there is a need to develop more efficient and suitable management systems since more stringent policies are being implemented due to the increased vulnerability of harsh/Arctic environments.

  15. Physiotherapy management of patients undergoing thoracotomy procedure: A survey of current practice in Gauteng

    Directory of Open Access Journals (Sweden)

    Liezel Schwellnus

    2017-02-01

    Full Text Available Background: Physiotherapy is included in the management of patients undergoing thoracic surgery. The aim of this study was to describe physiotherapy practice in the management of patients who undergo an open thoracotomy.Methods: A cross-sectional study using convenience sampling was undertaken. An electronic self-administered questionnaire was distributed via SurveyMonkey to 1389 physiotherapists registered with the South African Society of Physiotherapy in Gauteng. The data collection period was August and September 2014 and data were analysed descriptively.Results: A total of 323 physiotherapists (23.3% responded to the survey and 141 (10.2% indicated that they treated patients with open thoracotomies. Preoperative treatment was done by 65 (41.6% and consisted of teaching supported coughing (92.3%; n = 60, sustained maximal inspiration (70.8%; n = 46 and the active cycle of breathing technique (69.2%; n = 45. One hundred and sixteen (82.3% respondents treated patients during their hospital stay. Deep breathing exercises (97.6%; n = 83, coughing (95.3%; n = 81, early mobilisation (95.3%; n = 81, upper limb mobility exercises (91.8%; n = 78, chest wall vibrations (88.2%; n = 75 and trunk mobility exercises (85.9%; n = 73 were done frequently. Pain management modalities were less common, for example transcutaneous electrical nerve stimulation (12.9%; n = 11. Post hospital physiotherapy management was uncommon (32.6%; n = 46.Conclusion: Physiotherapy related to early mobilisation in hospital is in line with evidence-based practice, but further education is needed regarding the need for physiotherapy post hospital discharge and pain management.

  16. Engineering change management report 2012: Survey results on causes and effects, current practice, problems, and strategies in Brazil

    DEFF Research Database (Denmark)

    Chucholowski, Nepomuk; Langer, Stefan; Ferreira, Marcelo Gitirana Gomes

    management of engineering changes is a crucial precondition for Brazilian companies to successfully compete not only on the fast growing Brazilian market, but also on the world market which becomes more interesting due to the rising industrial power of Brazil. To achieve improvements in engineering change...... management practice, industry and universities need to work together. In this report the main findings of our study on Engineering Change Management (ECM) in Brazilian companies are presented, which indicate possible solution strategies and further research needs. Our survey aimed on the investigation...... of current practice, the biggest challenges and potential strategies of engineering change management. A total of 55 Brazilian companies from a broad range of industry sectors and company sizes participated from December 2011 until January 2012 in the survey which was elaborated and conducted by members...

  17. Physiotherapy management of patients with coronary artery disease: a report on current practice in South Africa

    Directory of Open Access Journals (Sweden)

    R. Roos

    2011-02-01

    Full Text Available Coronary artery disease (CAD is a worldwide health problem with  an  increased  prevalence  in  sub-Saharan  Africa.  Physiotherapists  inter-nationally  are  involved  in  the  care  of  these  patients  from  the  acute  stage following  a  cardiac  event  until  phase  III  cardiac  rehabilitation  is  completed.  The  purpose  of  this  study  was  to  determine  the  current  physiotherapy management  of  patients  with  CAD  in  South  Africa.  An  observational  cross-sectional  study  was  conducted  over  two  months  with  a  questionnaire  that  was  sent  to  the  government  and  private  health  care  sectors.  Results  showed  that  more  cardiopulmonary  physiotherapists  provided  care  (62%  than  those who  didn’t  (38%.  Care  was  mostly  provided  in  a  hospital  setting  (81%  and  out- patient phase III cardiac rehabilitation was lacking (11%. In-hospital physiotherapy treatment was mostly provided once daily. Deep breathing exercises (99%, circulatory exercises (95% and manual chest clearance techniques (88% were mostly used during physiotherapy. Evidence based practice was consistent regarding early mobilization but was inconsistent with regards to the use of manual chest clearance techniques.

  18. Waste management in the Irkutsk Region, Siberia, Russia: Environmental assessment of current practice focusing on landfilling

    DEFF Research Database (Denmark)

    Starostina, Vlada; Damgaard, Anders; Rechberger, Helmut

    2014-01-01

    The municipal waste management system of the region of Irkutsk is described and a life cycle assessment (LCA) performed to assess the environmental performance of the system. Annually about 500 000 tons of waste are managed. The waste originates from three sources: household waste (27%), commercial...... waste (23%) and office & institutional waste (44%). Other waste of unknown composition constitutes 6%. Only 3% of the waste is recycled; 97% of the municipal waste is disposed of at the old Alexandrovsky landfill. The environmental impact from the current system is dominated by the landfill, which has...... years, the LCA modelling showed that introduction of a new and modern landfill with gas and leachate collection could improve the performance of the waste management system significantly. Collection of landfill gas and utilization for 30 years for electricity production (gas turbine) would reduce...

  19. Environmental assessment of waste management in Greenland: current practice and potential future developments.

    Science.gov (United States)

    Eisted, Rasmus; Christensen, Thomas H

    2013-05-01

    The majority of the waste in Greenland is disposed of in open dumps or incinerated in simple small-scale incinerators. There are relatively few environmental regulations that control the emissions of leachate, landfill gas and/or flue gases from incineration. Only some scrap metal and hazardous waste are collected separately and exported to Europe. The impacts from the current waste management system were modelled from a life-cycle perspective using the LCA-waste model EASEWASTE. Impacts with regard to global warming, acidification, etc. are small (a few hundred person-equivalents (PE) for a system serving 56 000 inhabitants), but significant environmental loads are caused by air emissions from the incinerators and leachate from the landfills. Several alternative management scenarios were modelled and results show that increased use of incineration, full utilization of the heat production for district heating and separation of hazardous waste probably could improve Greenland's waste management system. Segregation of recyclable materials as paper, cardboard and biowaste will do little to environmentally improve the waste management system due to loss of energy recovery from incineration and the long transport of the recyclables to markets. Export of waste to Denmark for incineration at modern waste incinerators with advanced flue gas cleaning could also be considered as a means to achieve better environmental performance of the waste management system.

  20. Current practice in Europe

    DEFF Research Database (Denmark)

    Proclemer, Alessandro; Dagres, Nikolaos; Marinskis, Germanas

    2013-01-01

    The purpose of the EP wire is to examine the clinical practice in the management of sustained ventricular tachycardia (VT), with special focus on diagnostic and therapeutic strategies. Forty-five European centres, all members of the EHRA-EP Research network completed the questions of the survey...

  1. The trophy hunting of African lions: scale, current management practices and factors undermining sustainability.

    Directory of Open Access Journals (Sweden)

    Peter Andrew Lindsey

    Full Text Available The trophy hunting of lions Panthera leo is contentious due to uncertainty concerning conservation impacts and because of highly polarised opinions about the practice. African lions are hunted across at least ~558,000 km(2, which comprises 27-32% of the lion range in countries where trophy hunting of the species is permitted. Consequently, trophy hunting has potential to impart significant positive or negative impacts on lions. Several studies have demonstrated that excessive trophy harvests have driven lion population declines. There have been several attempts by protectionist non-governmental organisations to reduce or preclude trophy hunting via restrictions on the import and export of lion trophies. We document the management of lion hunting in Africa and highlight challenges which need addressing to achieve sustainability. Problems include: unscientific bases for quota setting; excessive quotas and off-takes in some countries; fixed quotas which encourage over-harvest; and lack of restrictions on the age of lions that can be hunted. Key interventions needed to make lion hunting more sustainable, include implementation of: enforced age restrictions; improved trophy monitoring; adaptive management of quotas and a minimum length of lion hunts of at least 21 days. Some range states have made important steps towards implementing such improved management and off-takes have fallen steeply in recent years. For example age restrictions have been introduced in Tanzania and in Niassa in Mozambique, and are being considered for Benin and Zimbabwe, several states have reduced quotas, and Zimbabwe is implementing trophy monitoring. However, further reforms are needed to ensure sustainability and reduce conservation problems associated with the practice while allowing retention of associated financial incentives for conservation.

  2. The Trophy Hunting of African Lions: Scale, Current Management Practices and Factors Undermining Sustainability

    Science.gov (United States)

    Lindsey, Peter Andrew; Balme, Guy Andrew; Funston, Paul; Henschel, Philipp; Hunter, Luke; Madzikanda, Hilary; Midlane, Neil; Nyirenda, Vincent

    2013-01-01

    The trophy hunting of lions Panthera leo is contentious due to uncertainty concerning conservation impacts and because of highly polarised opinions about the practice. African lions are hunted across at least ∼558,000 km2, which comprises 27–32% of the lion range in countries where trophy hunting of the species is permitted. Consequently, trophy hunting has potential to impart significant positive or negative impacts on lions. Several studies have demonstrated that excessive trophy harvests have driven lion population declines. There have been several attempts by protectionist non-governmental organisations to reduce or preclude trophy hunting via restrictions on the import and export of lion trophies. We document the management of lion hunting in Africa and highlight challenges which need addressing to achieve sustainability. Problems include: unscientific bases for quota setting; excessive quotas and off-takes in some countries; fixed quotas which encourage over-harvest; and lack of restrictions on the age of lions that can be hunted. Key interventions needed to make lion hunting more sustainable, include implementation of: enforced age restrictions; improved trophy monitoring; adaptive management of quotas and a minimum length of lion hunts of at least 21 days. Some range states have made important steps towards implementing such improved management and off-takes have fallen steeply in recent years. For example age restrictions have been introduced in Tanzania and in Niassa in Mozambique, and are being considered for Benin and Zimbabwe, several states have reduced quotas, and Zimbabwe is implementing trophy monitoring. However, further reforms are needed to ensure sustainability and reduce conservation problems associated with the practice while allowing retention of associated financial incentives for conservation. PMID:24058491

  3. The trophy hunting of African lions: scale, current management practices and factors undermining sustainability.

    Science.gov (United States)

    Lindsey, Peter Andrew; Balme, Guy Andrew; Funston, Paul; Henschel, Philipp; Hunter, Luke; Madzikanda, Hilary; Midlane, Neil; Nyirenda, Vincent

    2013-01-01

    The trophy hunting of lions Panthera leo is contentious due to uncertainty concerning conservation impacts and because of highly polarised opinions about the practice. African lions are hunted across at least ~558,000 km(2), which comprises 27-32% of the lion range in countries where trophy hunting of the species is permitted. Consequently, trophy hunting has potential to impart significant positive or negative impacts on lions. Several studies have demonstrated that excessive trophy harvests have driven lion population declines. There have been several attempts by protectionist non-governmental organisations to reduce or preclude trophy hunting via restrictions on the import and export of lion trophies. We document the management of lion hunting in Africa and highlight challenges which need addressing to achieve sustainability. Problems include: unscientific bases for quota setting; excessive quotas and off-takes in some countries; fixed quotas which encourage over-harvest; and lack of restrictions on the age of lions that can be hunted. Key interventions needed to make lion hunting more sustainable, include implementation of: enforced age restrictions; improved trophy monitoring; adaptive management of quotas and a minimum length of lion hunts of at least 21 days. Some range states have made important steps towards implementing such improved management and off-takes have fallen steeply in recent years. For example age restrictions have been introduced in Tanzania and in Niassa in Mozambique, and are being considered for Benin and Zimbabwe, several states have reduced quotas, and Zimbabwe is implementing trophy monitoring. However, further reforms are needed to ensure sustainability and reduce conservation problems associated with the practice while allowing retention of associated financial incentives for conservation.

  4. Management of blunt extracranial traumatic cerebrovascular injury: a multidisciplinary survey of current practice

    Directory of Open Access Journals (Sweden)

    Cava Luis P

    2011-04-01

    Full Text Available Abstract Background Extracranial traumatic cerebrovascular injury (TCVI is present in 1-3% of all blunt force trauma patients. Although options for the management of patients with these lesions include anticoagulation, antiplatelet agents, and endovascular treatment, the optimal management strategy for patients with these lesions is not yet established. Objective Multidisciplinary survey of clinicians about current management of TCVI. Methods A six-item multiple-choice survey was sent by electronic mail to a total of 11,784 neurosurgeons, trauma surgeons, stroke neurologists, and interventional radiologists. The survey included questions about their choice of imaging, medical management, and the use of endovascular techniques. Survey responses were analyzed according to stated specialty. Results Seven hundred eighty-five (6.7% responses were received. Overall, a total of 325 (42.8% respondents favored anticoagulation (heparin and/or warfarin, 247 (32.5% favored antiplatelet drugs, 130 (17.1% preferred both anticoagulation and antiplatelet drugs, and 57 (7.5% preferred stenting and/or embolization. Anticoagulation was the most commonly preferred treatment among vascular surgeons (56.9%, neurologists (50.2% and neurosurgeons (40.7%, whereas antiplatelet agents were the most common preferred treatment among trauma surgeons (41.5%. Overall, 158 (20.7% of respondents recommended treatment of asymptomatic dissections and traumatic aneurysms, 211 (27.7% did not recommend it, and 39.4% recommended endovascular treatment only if there is worsening of the lesion on follow-up imaging. Conclusions These data demonstrate the wide variability of physicians' management of traumatic cerebrovascular injury, both on an individual basis, and between specialties. These findings underscore the need for multicenter, randomized trials in this field.

  5. Decompression illness secondary to occupational diving: recommended management based current legistation and practice in Malaysia.

    Science.gov (United States)

    Rozali, A; Khairuddin, H; Sherina, M S; Zin, B Mohd; Sulaiman, A

    2008-06-01

    Occupational divers are exposed to hazards which contribute to the risk of developing decompression illnesses (DCI). DCI consists of Type I decompression sickness (DCS), Type II DCS and arterial gas embolism (AGE), developed from formation of bubbles in the tissues or circulation as a result of inadequate elimination of inert gas (nitrogen) after a dive. In Malaysia, DCI is one of the significant contributions to mortality and permanent residual morbidity in diving accidents. This is a case of a diver who suffered from Type II DCS with neurological complications due to an occupational diving activity. This article mentions the clinical management of the case and makes several recommendations based on current legislations and practise implemented in Malaysia in order to educate medical and health practitioners on the current management of DCI from the occupational perspective. By following these recommendations, hopefully diving accidents mainly DCI and its sequalae among occupational divers can be minimized and prevented, while divers who become injured receive the proper compensation for their disabilities.

  6. Current issues in dental practice management. Part 1. The importance of shared values.

    Science.gov (United States)

    Newsome, Philip R H

    2003-04-01

    There can be few who would argue with the notion that the nature of dental practice in the United Kingdom has changed dramatically over the last couple of decades. A variety of factors, including new clinical techniques, growing consumerism, a much greater awareness of health-related and well-being issues in the public at large, as well as a marked deregulation within the dental profession, the development of vocational training and recently mandatory lifelong learning, the growing number of females working in the profession, and an increasing reluctance of young dentists to finance dental practices have all combined to create an environment which has enabled and encouraged a move away from traditional forms of dental care delivery. Instead, there has been considerable growth in independently-funded practice and a commensurate growth in the number of practices operating under a corporate body umbrella of one form or another. Currently there are 27 corporate bodies registered with the General Dental Council (GDC) with the likelihood of more in the future given the proposed GDC review. This will no doubt take into consideration European law, under which the restriction within the Dentist's Act on the number of corporate bodies is likely to be untenable. Although they still have only a small share of the dental market--with 4% of all dentists in the UK in 1999--they have expanded rapidly from a small base. The data available at the time the paper was written indicate that the global total of fees earned from dentistry in the UK in the financial year 2001/2002 was almost 3 billion Pounds, of which 1.9 billion Pounds (64%) came from NHS fees and 1.1 billion Pounds (36%) from private fees. Of this 1.9 billion Pounds received in NHS fees in 2001/2002, 0.55 billion Pounds were paid by patients who were not exempt from charges, bringing the total amount actually paid out of patients' pockets for dental treatment to 1.65 billion Pounds. Compare these figures with 1996

  7. Diagnosis and management of growth disorders in Gulf Cooperation Council (GCC countries: Current procedures and key recommendations for best practice

    Directory of Open Access Journals (Sweden)

    Abdullah S. Al Herbish

    2016-09-01

    Full Text Available Diagnosis and management of growth disorders comprises an important area of pediatric practice. Current procedures in the different stages of the identification, referral, investigation, and treatment of growth disorders in the Gulf Cooperation Council (GCC countries have been summarized. Evidence-based procedures, relating specifically to height screening for identification of short stature, auxological criteria for patient referral from primary to secondary pediatric care, and general and endocrine investigations and diagnosis have been discussed and outlined. The management issues related to key disorders that are licensed for growth hormone (hGH therapy, namely GH deficiency, Turner syndrome, short stature related to birth size small for gestational age (SGA, and idiopathic short stature are discussed with recommendations described for best practice. Finally, two key components of short stature management, namely transitional care for the transfer of patients from pediatric to adult endocrinology services and adherence to recommended therapy with hGH, have been addressed with current practice outlines and recommendations presented.

  8. Current practices in the diagnosis and management of gestational diabetes mellitus in India (WINGS-5)

    Science.gov (United States)

    Mahalakshmi, Manni Mohanraj; Bhavadharini, Balaji; Maheswari, Kumar; Anjana, Ranjit Mohan; Jebarani, Saravanan; Ninov, Lyudmil; Kayal, Arivudainambi; Malanda, Belma; Belton, Anne; Uma, Ram; Mohan, Viswanathan; Unnikrishnan, Ranjit

    2016-01-01

    Aim: To obtain information on existing practices in the diagnosis and management of gestational diabetes mellitus (GDM) among physicians/diabetologists/endocrinologists and obstetricians/gynecologists (OB/GYNs) in India. Methods: Details regarding diagnostic criteria used, screening methods, management strategies, and the postpartum follow-up of GDM were obtained from physicians/diabetologists/endocrinologists and OB/GYNs across 24 states of India using online/in-person surveys using a structured questionnaire. Results: A total of 3841 doctors participated in the survey of whom 68.6% worked in private clinics. Majority of OB/GYNs (84.9%) preferred universal screening for GDM, and screening in the first trimester was performed by 67% of them. Among the OB/GYNs, 600 (36.7%) reported using the nonfasting 2 h criteria for diagnosing GDM whereas 560 (29.4%) of the diabetologists/endocrinologists reported using the same. However, further questioning on the type of blood sample collected and the glucose load used revealed that, in reality, only 208 (12.7%) and 72 (3.8%), respectively, used these criteria properly. The survey also revealed that the International Association of Diabetes and Pregnancy Study Groups criteria was followed properly by 299 (18.3%) of OB/GYNs and 376 (19.7%) of physicians/diabetologists/endocrinologists. Postpartum oral glucose tolerance testing was advised by 56% of diabetologists and 71.6% of OB/GYNs. Conclusion: More than half of the physicians/diabetologists/endocrinologists and OB/GYNs in India do not follow any of the recommended guidelines for the diagnosis of GDM. This emphasizes the need for increased awareness about screening and diagnosis of GDM both among physicians/diabetologists/endocrinologists and OB/GYNs in India. PMID:27186555

  9. Current practices in the diagnosis and management of gestational diabetes mellitus in India (WINGS-5

    Directory of Open Access Journals (Sweden)

    Manni Mohanraj Mahalakshmi

    2016-01-01

    Full Text Available Aim: To obtain information on existing practices in the diagnosis and management of gestational diabetes mellitus (GDM among physicians/diabetologists/endocrinologists and obstetricians/gynecologists (OB/GYNs in India. Methods: Details regarding diagnostic criteria used, screening methods, management strategies, and the postpartum follow-up of GDM were obtained from physicians/diabetologists/endocrinologists and OB/GYNs across 24 states of India using online/in-person surveys using a structured questionnaire. Results: A total of 3841 doctors participated in the survey of whom 68.6% worked in private clinics. Majority of OB/GYNs (84.9% preferred universal screening for GDM, and screening in the first trimester was performed by 67% of them. Among the OB/GYNs, 600 (36.7% reported using the nonfasting 2 h criteria for diagnosing GDM whereas 560 (29.4% of the diabetologists/endocrinologists reported using the same. However, further questioning on the type of blood sample collected and the glucose load used revealed that, in reality, only 208 (12.7% and 72 (3.8%, respectively, used these criteria properly. The survey also revealed that the International Association of Diabetes and Pregnancy Study Groups criteria was followed properly by 299 (18.3% of OB/GYNs and 376 (19.7% of physicians/diabetologists/endocrinologists. Postpartum oral glucose tolerance testing was advised by 56% of diabetologists and 71.6% of OB/GYNs. Conclusion: More than half of the physicians/diabetologists/endocrinologists and OB/GYNs in India do not follow any of the recommended guidelines for the diagnosis of GDM. This emphasizes the need for increased awareness about screening and diagnosis of GDM both among physicians/diabetologists/endocrinologists and OB/GYNs in India.

  10. A comparative analysis of current microbial water quality risk assessment and management practices in British Columbia and Ontario, Canada.

    Science.gov (United States)

    Dunn, Gemma; Harris, Leila; Cook, Christina; Prystajecky, Natalie

    2014-01-15

    Bacteria, protozoa and viruses are ubiquitous in aquatic environments and may pose threats to water quality for both human and ecosystem health. Microbial risk assessment and management in the water sector is a focus of governmental regulation and scientific inquiry; however, stark gaps remain in their application and interpretation. This paper evaluates how water managers practice microbial risk assessment and management in two Canadian provinces (BC and Ontario). We assess three types of entities engaged in water management along the source-to-tap spectrum (watershed agencies, water utilities, and public health authorities). We analyze and compare the approaches used by these agencies to assess and manage microbial risk (including scope, frequency, and tools). We evaluate key similarities and differences, and situate them with respect to international best practices derived from literatures related to microbial risk assessment and management. We find considerable variability in microbial risk assessment frameworks and management tools in that approaches 1) vary between provinces; 2) vary within provinces and between similar types of agencies; 3) have limited focus on microbial risk assessment for ecosystem health and 4) diverge considerably from the literature on best practices. We find that risk assessments that are formalized, routine and applied system-wide (i.e. from source-to-tap) are limited. We identify key limitations of current testing methodologies and looking forward consider the outcomes of this research within the context of new developments in microbial water quality monitoring such as tests derived from genomics and metagenomics based research. © 2013 Elsevier B.V. All rights reserved.

  11. Imaging and image management: A survey on current outlook and awareness in pathology practice

    Directory of Open Access Journals (Sweden)

    M Indu

    2015-01-01

    Full Text Available Background: Flexibility of digital photography enables it to be an integral part of pathology practice. An assessment of guidelines of imaging is essential for proper usage of photographs. Objectives: The purpose of the study was to assess awareness of oral pathologists about various aspects of medical photography. Methods: Questionnaire based on the availability of facilities, usage, technical details and ethical issues of medical photography was sent to postgraduate students and teaching faculties of Oral Pathology in various localities in India. Results: Photographs were taken mostly for the purposes of publication, medical documentation and education. Significant number of postgraduate students and faculties of Oral Pathology didn′t receive any training or hadn′t gone through any publications/books (P = 0.000 about medical photography. Consent for patient photography was taken by significant number of respondents (P = 0.000 but in a verbal form. Majority of people used image editing software, but 19.0% of faculties and 21.1% of postgraduate students were unaware of deleterious effect of image editing. Firm and sensible instructions concerning image storage, sharing and accessibility were not yet created. Conclusion: This survey drew attention towards lack of proper understanding about the technical details, medical protocols and ethical issues related to medical photography. These findings recommend implementation of basic training for medical photography and policy for image management for students and faculties in every health care institution.

  12. Medication management policy, practice and research in Australian residential aged care: Current and future directions.

    Science.gov (United States)

    Sluggett, Janet K; Ilomäki, Jenni; Seaman, Karla L; Corlis, Megan; Bell, J Simon

    2017-02-01

    Eight percent of Australians aged 65 years and over receive residential aged care each year. Residents are increasingly older, frailer and have complex care needs on entry to residential aged care. Up to 63% of Australian residents of aged care facilities take nine or more medications regularly. Together, these factors place residents at high risk of adverse drug events. This paper reviews medication-related policies, practices and research in Australian residential aged care. Complex processes underpin prescribing, supply and administration of medications in aged care facilities. A broad range of policies and resources are available to assist health professionals, aged care facilities and residents to optimise medication management. These include national guiding principles, a standardised national medication chart, clinical medication reviews and facility accreditation standards. Recent Australian interventions have improved medication use in residential aged care facilities. Generating evidence for prescribing and deprescribing that is specific to residential aged care, health workforce reform, medication-related quality indicators and inter-professional education in aged care are important steps toward optimising medication use in this setting.

  13. Scrap automotive electronics: A mini-review of current management practices.

    Science.gov (United States)

    Cucchiella, Federica; D'Adamo, Idiano; Rosa, Paolo; Terzi, Sergio

    2016-01-01

    End-of-life vehicles, together with waste from electric and electronic equipment, are known as an important source of secondary raw materials. For many years, their recovery has allowed the restoring of great amounts of metals for new cars production. This article provides a comprehensive mini-review on the end-of-life vehicles recycling topic between 2000 and 2014, with a particular focus on automotive electronics recycling. In fact, in the last years, experts focused their attention on a better exploitation of automotive shredder residue fraction, but not sufficiently on eventual electronic scraps embedded in it. Hence, studies assessing the value embedded in these scraps are rarely available in literature, causing an important gap in both recycling policies and research. The fact that, at present, the management of electronic control units (the most valuable component among automotive electronic equipment) is, as yet, off the radar in both end-of-life vehicles and waste from electric and electronic equipment Directives demonstrates the theory. Of course, their recycling would not contribute in a relevant way to reach the weighted-based recycling and recovery targets characterising current regulations, but would be very important under a critical raw materials recovery view. Results coming from the literature analysis confirm these assumptions.

  14. Inpatient management of sickle cell pain: a 'snapshot' of current practice.

    Science.gov (United States)

    Miller, Scott T; Kim, Hae-Young; Weiner, Debra; Wager, Carrie G; Gallagher, Dianne; Styles, Lori; Dampier, Carlton D

    2012-03-01

    The Sickle Cell Disease Clinical Research Network (SCDCRN) designed the PROACTIVE Feasibility Study (ClinicalTrials.gov NCT00951808) to determine whether elevated serum levels of secretory phospholipase A2 (sPLA2) during hospitalization for pain would permit preemptive therapy of sickle cell acute chest syndrome (ACS) by blood transfusion. While PROACTIVE was not designed to assess pain management and was terminated early due to inadequate patient accrual, collection of clinical data allowed a "snapshot" of current care by expert providers. Nearly half the patients admitted for pain were taking hydroxyurea; hydroxyurea did not affect length of stay. Providers commonly administered parenteral opioid analgesia, usually morphine or hydromorphone, to adults and children, generally by patient-controlled analgesia (PCA). Adult providers were more likely to prescribe hydromorphone and did so at substantially higher morphine equivalent doses than were given to adults receiving morphine; the latter received doses similar to children who received either medication. All subjects treated with PCA received higher daily doses of opioids than those treated by time-contingent dosing. Physicians often restricted intravenous fluids to less than a maintenance rate and underutilized incentive spirometry, which reduces ACS in patients hospitalized for pain.

  15. Physiotherapy management of patients with coronary artery disease: a report on current practice in South Africa

    OpenAIRE

    2011-01-01

    Coronary artery disease (CAD) is a worldwide health problem with  an  increased  prevalence  in  sub-Saharan  Africa.  Physiotherapists  inter-nationally  are  involved  in  the  care  of  these  patients  from  the  acute  stage following  a  cardiac  event  until  phase  III  cardiac  rehabilitation  is  completed.  The  purpose  of  this  study  was  to  determine  the  current  physiotherapy management  of  patients  with  CAD  in  South  Africa.  An  observational  cross-sectional  study...

  16. Current practices in the management of malignant pleural effusions: a survey among members of the European Society of Thoracic Surgeons.

    Science.gov (United States)

    Scarci, Marco; Caruana, Edward; Bertolaccini, Luca; Bedetti, Benedetta; Brunelli, Alessandro; Varela, Gonzalo; Papagiannopoulos, Kostas; Kuzdzal, Jaroslaw; Massard, Gilbert; Ruffini, Enrico; Falcoz, Pierre Emmanuel; Opitz, Isabelle; Batirel, Hasan; Toker, Alper; Rocco, Gaetano

    2017-03-01

    Malignant pleural effusion (MPE) commonly complicates advanced malignancy and their exact management is still undefined. We undertook a survey to determine the current practice among members of the European Society of Thoracic Surgeons (ESTS). A cross-sectional survey focused on the current practice of management of MPE was developed by the authors. The questions were outlined after a review of the literature and circulated in an Internet-based survey format. Computed tomography (125, 92%) and chest X-ray (106, 78%) are the most common imaging modalities performed in the initial evaluation. Video-assisted thoracoscopic surgery for washout and pleurodesis (93, 68%) was reported as the preferred approach to patients with uncomplicated MPE. Sixty-one (45%) of the responding colleagues routinely use large bore chest tubes for draining malignant effusions. Forty-nine (35%) surgeons would not apply suction to the drainage system, whilst 50 (37%) would use -2 kPa or less. Talc (124, 91%) is the most commonly used sclerosing agent for pleurodesis in the context of malignant pleural effusion. The practice of 76 (56%) of the respondents is not informed by any clinical guidelines, whilst 60 (44%) reported adhering to the 2010 British Thoracic Society Pleural Disease Guideline. Seventy-one (52%) declared that the guidance was in need of updating or revision. This survey demonstrates the lacking adoption of the existing clinical guidance in this field, as well as the need for more contemporary guidelines for a better-informed practice. The ESTS Working Group on the management of MPE has been established for this purpose.

  17. A Case Analysis to Increase Awareness of Current USMC Knowledge Management (KM) Practices

    Science.gov (United States)

    2013-09-01

    communities” (p. 63; Virtanen, 2013, p. 119)  Capeda- Carrion (2006) states KM to be “the formalized, integrated approach of managing an enterprise’s...management and intellectual capital research,” Knowledge and Process Management,15(4): 235–246. doi:10.1002/kpm.314 Capeda- Carrion , G. (2006). Competitive

  18. Managing player load in professional rugby union: a review of current knowledge and practices.

    Science.gov (United States)

    Quarrie, Kenneth L; Raftery, Martin; Blackie, Josh; Cook, Christian J; Fuller, Colin W; Gabbett, Tim J; Gray, Andrew J; Gill, Nicholas; Hennessy, Liam; Kemp, Simon; Lambert, Mike; Nichol, Rob; Mellalieu, Stephen D; Piscione, Julien; Stadelmann, Jörg; Tucker, Ross

    2017-03-01

    The loads to which professional rugby players are subjected has been identified as a concern by coaches, players and administrators. In November 2014, World Rugby commissioned an expert group to identify the physical demands and non-physical load issues associated with participation in professional rugby. To describe the current state of knowledge about the loads encountered by professional rugby players and the implications for their physical and mental health. The group defined 'load' as it relates to professional rugby players as the total stressors and demands applied to the players. In the 2013-2014 seasons, 40% of professional players appeared in 20 matches or more, and 5% of players appeared in 30 matches or more. Matches account for ∼5-11% of exposure to rugby-related activities (matches, team and individual training sessions) during professional competitions. The match injury rate is about 27 times higher than that in training. The working group surmised that players entering a new level of play, players with unresolved previous injuries, players who are relatively older and players who are subjected to rapid increases in load are probably at increased risk of injury. A mix of 'objective' and 'subjective' measures in conjunction with effective communication among team staff and between staff and players was held to be the best approach to monitoring and managing player loads. While comprehensive monitoring holds promise for individually addressing player loads, it brings with it ethical and legal responsibilities that rugby organisations need to address to ensure that players' personal information is adequately protected. Administrators, broadcasters, team owners, team staff and the players themselves have important roles in balancing the desire to have the 'best players' on the field with the ongoing health of players. In contrast, the coaching, fitness and medical staff exert significant control over the activities, duration and intensity of training

  19. Multi-criteria decision making to support waste management: A critical review of current practices and methods.

    Science.gov (United States)

    Goulart Coelho, Lineker M; Lange, Liséte C; Coelho, Hosmanny Mg

    2017-01-01

    Solid waste management is a complex domain involving the interaction of several dimensions; thus, its analysis and control impose continuous challenges for decision makers. In this context, multi-criteria decision-making models have become important and convenient supporting tools for solid waste management because they can handle problems involving multiple dimensions and conflicting criteria. However, the selection of the multi-criteria decision-making method is a hard task since there are several multi-criteria decision-making approaches, each one with a large number of variants whose applicability depends on information availability and the aim of the study. Therefore, to support researchers and decision makers, the objectives of this article are to present a literature review of multi-criteria decision-making applications used in solid waste management, offer a critical assessment of the current practices, and provide suggestions for future works. A brief review of fundamental concepts on this topic is first provided, followed by the analysis of 260 articles related to the application of multi-criteria decision making in solid waste management. These studies were investigated in terms of the methodology, including specific steps such as normalisation, weighting, and sensitivity analysis. In addition, information related to waste type, the study objective, and aspects considered was recorded. From the articles analysed it is noted that studies using multi-criteria decision making in solid waste management are predominantly addressed to problems related to municipal solid waste involving facility location or management strategy.

  20. An audit of current practice and management of metastatic spinal cord compression at a regional cancer centre.

    LENUS (Irish Health Repository)

    Sui, J

    2012-02-01

    Metastatic spinal cord compression (MSCC) is an oncological emergency requiring prompt recognition and management to preserve neurological function and mobility. We performed an audit to assess current practice of MSCC against current best practice as outlined by NICE. Our retrospective audit identified 10 patients from January to December 2009 with confirmed MSCC. The most common primary tumours were prostate 3 (30%), breast 3 (30%) and lung 2 (20%). Pain was the main presenting symptom 9 (90%), followed by weakness 7 (70%) and sensory changes 1 (10%). 5 (50%) had MRI within 24 hours and only 6 (60%) underwent full MRI scan. 8 (80%) had corticosteroids before MRI scan. 6 (60%) received radiotherapy within 24 hours. Only 4 (40%) were referred to orthopaedics and none of these patients had been recommended surgery. Up 14 days following radiological confirmation of MSCC, the number of patients who were unable to walk increased by 20%. Only 5 (50%) were discharged during this period of study. Our audit reported a number of variances in management compared to NICE guideline. These can be improved by following a\\'fast track\\' referral pathway and regular education for junior doctors and primary care doctors.

  1. AN HISTORICAL PERSPECTIVE ON LIFE CYCLE MANAGEMENT AND CURRENT PRACTICES WORLDWIDE

    Science.gov (United States)

    Environmental life cycle management looks at products, processes, and activities by recognizing all the "cradle to grave" stages that are involved and identifying where potential environmental and economic impacts occur. Government, industry and non-governmental organizations can...

  2. AN HISTORICAL PERSPECTIVE ON LIFE CYCLE MANAGEMENT AND CURRENT PRACTICES WORLDWIDE

    Science.gov (United States)

    Environmental life cycle management looks at products, processes, and activities by recognizing all the "cradle to grave" stages that are involved and identifying where potential environmental and economic impacts occur. Government, industry and non-governmental organizations can...

  3. Challenges and Strength of Current Industrial Energy Efficiency Management Practices in Steam Industries

    Science.gov (United States)

    Nkosi, S. B.; Pretorius, J. H. C.

    2017-07-01

    The aim of this study is to achieve greater output by examining the existing way of coordinating the determined attempts of Steam Industries in South Africa to successfully reach a sustainable industrial development by using energy source adequately in a more competent way. Furthermore into the study we look at obstacles that prevent and those that leads to maximum utilization of energy management measures and also highlights the effects of implementing cheap available energy source in South Africa. The investigation and analysis have shown that energy is not well managed in Steam Industries and that the use of energy is minimized and not fully utilized due to poor management and lack of knowledge. Another detection was that lack of government structured and strategic measures of implementing and motivating the use of energy effectively. The effective and rational use of available power by Steam Industries in South Africa is a key player in developing a sustainable industrial development. The use of energy efficiency management strategies has contributed an increase in economic and improve environmentally friendly in the industrial sector. The slow pace adoption of energy saving and cost effective management programmes are negatively impacting on the benefits to Steam Industries in South Africa. In conclusion the study finds that the economy can be boosted by implementing energy efficiency management programmes and environmentally friendly. These will also stabilize the negative impact of energy raising prices.

  4. Municipal solid waste management in Tehran: current practices, opportunities and challenges.

    Science.gov (United States)

    Damghani, Abdolmajid Mahdavi; Savarypour, Gholamreza; Zand, Eskandar; Deihimfard, Reza

    2008-01-01

    Tehran, the capital city of Iran and a metropolis with a population of 8.2 million and containing 2.4 million households, generated 2,626,519 tons of solid waste in 2005. The present study is aimed at evaluating the generation, characteristics and management of solid waste in Tehran. Municipal solid waste comprises more than 97% of Tehran's solid waste, while three other types of solid waste comprise less than 3% of it, namely hospital waste (1.0%), industrial waste (0.6%) and construction and demolition waste (0.5%). The contribution of household solid waste to total municipal solid waste is about 62.5%. The municipality of Tehran is responsible for the solid waste management of the city; the waste is mainly landfilled in three centers in Tehran, with a small part of it usually recycled or processed as compost. However, an informal sector is also active in collecting recyclable materials from solid waste. The municipality has recently initiated some activities to mechanize solid waste management and reduce waste generation. There remain important challenges in solid waste management in Tehran which include: the proper collection and management of hospital waste; public education aimed at reducing and separating household waste and educating municipal workers in order to optimize the waste collection system; and the participation of other related organizations and the private sector in solid waste management.

  5. An Assessment of Research Supervision: A Leadership Model Enhancing Current Practices in Business and Management

    Science.gov (United States)

    Morrison, James L.; Oladunjoye, Ganiyu T.; Onyefulu, Cynthia

    2007-01-01

    Students enrolled in business and management assessed the research supervisory process less favorably when compared with their counterparts. In this article, the authors found that there was considerable dissatisfaction with the interaction and relationships that students had with their supervisors, especially within the business program. As a…

  6. Differential diagnosis and clinical management of diastolic heart failure: current best practice

    OpenAIRE

    Gelzinis, Theresa A.; Tawil,Justin

    2016-01-01

    Justin Tawil,1 Theresa A Gelzinis2 1Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, WI, 2Department of Anesthesiology, University of Pittsburgh, Pittsburgh, PA, USA Abstract: As the population ages, the prevalence of diastolic dysfunction and heart failure with preserved ejection fraction is rising. The presentation and management of these patients is increasing in frequency and requires an understanding of its pathophysiology, diagnostic methodology, as well as modern ...

  7. [Risk Management of Teratogenic Drugs ~The Current States of Practice in Europe, US and Japan~].

    Science.gov (United States)

    Takagi, Tatsuya; van Bennekom, Carla; Amann, Steffen; Hattori, Chizuko; Shirakuni, Yuko; Sato, Tsugumichi; Nasu, Masao

    2015-01-01

    Thalidomide was approved for the treatment of multiple myeloma in Japan under a risk management program, named TERMS, in 2008. Since then, we have been conducting a survey of the stakeholders to assess the effectiveness of TERMS. These surveys showed patients had enough knowledge of the risks of thalidomide. In the USA, legislation in 2007 granted its U.S. Food and Drug Administration (FDA) the authority to require Risk Evaluation and Mitigation Strategies (REMS) when necessary to ensure that a drug's benefits outweigh its risks. As of 2015, more than 70 drugs, including thalidomide, have REMS programs. In Germany, in the early 1960s, over 5000 children were born with deformities. Therefore, the safety regulations in Germany go far beyond the European Medicines Agency (EMA) safety regulations at the time of thalidomide re-approval; thalidomide can be prescribed by a special prescribing form, including both proof of the patients' awareness of information about the risks, and participation in a pregnancy prevention program. While Japan has taken similar safety measures, a portion of thalidomide is still privately imported there. By March 2013, 594 patients have been registered to Japan's Safety Management System for Unapproved Drugs (SMUD), which was introduced by the Ministry of Health, Labour and Welfare (MHLW) in 2009. The number of females of child bearing potential (FCBPs) was 33 and the fraction (33/594=5.6%) was higher than that (48/7370=0.7%) in the case of TERMS. Risk management of thalidomide is described in this review.

  8. Current Practices Regarding Perioperative Management of Patients With Fracture on Antiplatelet Therapy: A Survey of Orthopedic Surgeons.

    Science.gov (United States)

    Pean, Christian A; Goch, Abraham; Christiano, Anthony; Konda, Sanjit; Egol, Kenneth

    2015-12-01

    There continues to be controversy over whether operative delay is necessary for patients on antiplatelet therapy, particularly for elderly patients with hip fractures. This study sought to assess current clinical practices of orthopedic surgeons regarding perioperative management of these patients. A 12-question, Web-based survey was distributed to orthopedic surgeons via e-mail. Questions regarding timing of surgery assumed patients were on antiplatelet therapy and assessed attitudes toward emergent and nonemergent orthopedic cases as well as operative delay for specific closed fracture types. Responses were compared using unpaired, 2-tailed Student t tests for continuous variables and Pearson chi-square tests with odds ratios (ORs) and 95% confidence intervals (CIs) for categorical variables. Statistical significance was defined as a P value antiplatelet therapy with closed hip fractures did not require operative delay. Surgeons who opted for surgical delay in hip fractures were more likely to delay surgery in other lower extremity fracture types (OR = 16.4, 95% CI 4.48-60.61, P antiplatelet therapy. Over a quarter of surgeons continue to opt for surgical delay in patients with hip fracture. This survey highlights the need to formulate and better disseminate practice management guidelines for patients with fracture on antiplatelet therapy, particularly given the aging population in the United States.

  9. Australian survey of current practice and guideline use in adult cancer pain assessment and management: The community nurse perspective.

    Science.gov (United States)

    Phillips, Jane L; Lovell, Melanie; Luckett, Tim; Agar, Meera; Green, Anna; Davidson, Patricia

    2015-01-01

    Cancer pain remains a major public health concern. Despite effective treatments being available to manage the majority of cancer pain, this debilitating symptom is frequently under treated. As cancer has becomes a chronic disease a range of health professionals, including community nurses in Australia are increasingly caring for people living with cancer related pain. Yet, little is known about community nurses capacity to assess and manage cancer pain in accordance with best available evidence. This study aimed to: identify the barriers and facilitators to adult cancer pain assessment and management as perceived by Australian health professionals; identify if cancer pain guidelines are currently used; identify barriers and facilitators to guideline use; and establish the need for Australian cancer pain guidelines. This article reports on community nurses' perceptions of managing cancer pain in the community setting. A cross-sectional survey was administered online. Invitations were circulated via peak bodies and clinical leaders seeking the views and experiences of health professionals involved in caring for people living with cancer pain. Descriptive statistics were used to summarise the quantitative data, and thematic content analysis were used to describe the qualitative data. Sixty-two community nurses responded to the survey, representing 29% of the total sample. These participants reported high levels of adherence to accepted cancer pain management practices in their workplace, with 71% nominating the Palliative Care Therapeutic Guideline V.3 as being most frequently used to manage community patients' cancer related pain. Key barriers to effective cancer pain management in the community were: difficulties accessing non-pharmacological interventions (89%), lack of coordination by multiple providers (89%), and impact of distance on ability to access pain-related services for patients (86%). A range of system, health professional and consumer barriers limit

  10. Current best practice in the management of patients after pituitary surgery

    Science.gov (United States)

    Prete, Alessandro; Corsello, Salvatore Maria; Salvatori, Roberto

    2017-01-01

    Sellar and parasellar masses are a common finding, and most of them are treated surgically via transsphenoidal approach. This type of surgery has revolutionized the approach to several hypothalamic-pituitary diseases and is usually effective, and well-tolerated by the patient. However, given the complex anatomy and high density of glandular, neurological and vascular structures in a confined space, transsphenoidal surgery harbors a substantial risk of complications. Hypopituitarism is one of the most frequent sequelae, with central adrenal insufficiency being the deficit that requires a timely diagnosis and treatment. The perioperative management of AI is influenced by the preoperative status of the hypothalamic–pituitary–adrenal axis. Disorders of water metabolism are another common complication, and they can span from diabetes insipidus, to the syndrome of inappropriate antidiuretic hormone secretion, up to the rare cerebral salt-wasting syndrome. These abnormalities are often transient, but require careful monitoring and management in order to avoid abrupt variations of blood sodium levels. Cerebrospinal fluid leaks, damage to neurological structures such as the optic chiasm, and vascular complications can worsen the postoperative course after transsphenoidal surgery as well. Finally, long-term follow up after surgery varies depending on the underlying pathology, and is most challenging in patients with acromegaly and Cushing disease, in whom failure of primary pituitary surgery is a major concern. When these pituitary functioning adenomas persist or relapse after neurosurgery other treatment options are considered, including repeated surgery, radiotherapy, and medical therapy. PMID:28377801

  11. Managing the Services Supply Chain in the Department of Defense: An Empirical Study of Current Management Practices

    Science.gov (United States)

    2008-04-23

    of services and the increasing importance of services acquisition offer a unique and significant opportunity for conducting research in the management of the service supply chain in the Department of Defense.

  12. Adaptive Comanagement in the Venice Lagoon? An Analysis of Current Water and Environmental Management Practices and Prospects for Change

    Directory of Open Access Journals (Sweden)

    Stefania Munaretto

    2012-06-01

    Full Text Available Adaptive comanagement (ACM is often suggested as a way of handling the modern challenges of environmental governance, which include uncertainty and complexity. ACM is a novel combination of the learning dimension of adaptive management and the linkage dimension of comanagement. As has been suggested, there is a need for more insight on enabling policy environments for ACM success and failure. Picking up on this agenda we provide a case study of the world famous Venice lagoon in Italy. We address the following questions: first, to what extent are four institutional prescriptions typically associated with ACM currently practiced in the Venice system? Second, to what extent is learning taking place in the Venice system? Third, how is learning related to the implementation or nonimplementation of the prescriptions of ACM in the Venice system? Our analysis is based on interviews with stakeholders, participatory observation, and archive data. This paper demonstrates that the prescriptions of ACM are hardly followed in the Venice lagoon, but some levels of cognitive learning do take place, albeit very much within established management paradigms. Normative and relational learning are much rarer and when they do occur, they seem to have a relatively opportunistic reason. We propose that in particular the low levels of collaboration, because the governance system was deliberately set up in a hierarchical and mono-centric way, and the limited possibilities for stakeholder participation are implicated in this finding because they cause low levels of social capital and an incapacity to handle disagreements and uncertainty very well.

  13. The effect of current military maintenance practices and regulations on the implementation of Integrated Vehicle Health Management technology

    OpenAIRE

    Esperon Miguez, Manuel; John, Philip; Ian K. Jennions

    2012-01-01

    Health monitoring tools can be used to diagnose failures and estimate the remaining useful life of certain components, generating information that can be used to improve the management of logistics and maintenance activities in what is known as Integrated Vehicle Health Management (IVHM). The work presented here analyzes the effect of military practices and regulations on the benefits that can be expected from installing health monitoring tools on military aircraft. The findings on the impact...

  14. Practical colour management

    Science.gov (United States)

    Williams, Susan

    2006-06-01

    Spectrophotometers have been successfully used for colour measurement. This paper addresses digital imaging as a complementary and alternative method of colour measurement and appearance and an effective communication tool as part of a practical colour management programme within the supply chain of a textile retailer. The specific needs—to measure and communicate textured dyed material and printed fabric—are discussed, as well as the colour specification and quality control (QC) of currently un-measurable fabrics and accessories. A unique method of using digital imaging for the assessment of colour fastness will also be discussed.

  15. Dental Practice Management

    OpenAIRE

    Gheorghe Raftu

    2016-01-01

    the population. Private dental practices in Romania require personnel specialized in dental management. Success in dentistry depends, on the one hand, on the management of clinical aspects, and equallyon the efficient management of the dental practice. Patient satisfaction is influenced by factors related to the communication between the physicianand the patient, technical competence and by the environment provided by dental practice. The realization of the paper followed a review...

  16. Soil sustainability and indigenous soil management practices ...

    African Journals Online (AJOL)

    Soil sustainability and indigenous soil management practices among food crop farmers in Ogun State, Nigeria. ... Journal of Environmental Extension ... describe and analyse the current soil management practices among food crop farmers in ...

  17. Risk Management Practices and Accounting Requirements.

    Science.gov (United States)

    Cheng, Rita Hartung; Yahr, Robert B.

    1989-01-01

    Reviews current school district risk management practices and the related accounting requirements. Summarizes the Governmental Accounting Standards Board's proposed accounting standards and the impact of these on school districts' risk management practices and on their financial statements. (11 references) (MLF)

  18. Engineering change management report 2012: Survey results on causes and effects, current practice, problems, and strategies in Brazil

    DEFF Research Database (Denmark)

    Chucholowski, Nepomuk; Langer, Stefan; Ferreira, Marcelo Gitirana Gomes

    Engineering changes (ECs) are well known for generating additional costs and decreasing de-velopment efficiency. Yet, they are a fundamental part of product and service development and they are necessary to keep up with, for example, competitors, market trends or new technolo-gies. The effective...... management of engineering changes is a crucial precondition for Brazilian companies to successfully compete not only on the fast growing Brazilian market, but also on the world market which becomes more interesting due to the rising industrial power of Brazil. To achieve improvements in engineering change...... management practice, industry and universities need to work together. In this report the main findings of our study on Engineering Change Management (ECM) in Brazilian companies are presented, which indicate possible solution strategies and further research needs. Our survey aimed on the investigation...

  19. practice managers in Scotland

    Directory of Open Access Journals (Sweden)

    Lisa Hanna

    2011-03-01

    Conclusion Practice managers are likely to play a central role in the introduction of new consultation/ communication technologies within general practice. They hold varying views on the appropriateness of these technologies, influenced by a complex mix of contextual characteristics.Managers from areas in which the ethos of the practice prioritises personalised care in service delivery are less enthusiastic about the adoption of remote consultation/ communication technologies.

  20. Australian survey of current practice and guideline use in adult cancer pain assessment and management: perspectives of oncologists.

    Science.gov (United States)

    Luckett, Tim; Davidson, Patricia Mary; Boyle, Frances; Liauw, Winston; Agar, Meera; Green, Anna; Lovell, Melanie

    2014-06-01

    Cancer pain continues to be undertreated in up to half of cases, despite the availability of evidence-based guidelines. This study aimed to: (i) identify barriers and facilitators to adult cancer pain assessment and management, as perceived by Australian health professionals; (ii) establish the perceived need for new Australian guidelines and implementation strategy; (iii) identify which guidelines are used; (iv) identify barriers and facilitators to guideline use. This article focuses on the perceptions of responding oncologists. A cross-sectional survey was administered online. Invitations were circulated via peak bodies and clinical leaders. Comments were coded independently by two researchers. In all 76 oncologists self-reported high concordance with evidence-based recommendations, except validated pain scales. Perceived barriers to pain management included insufficient non-pharmacological interventions, access to /coordination between services, and time. Only 22 percent of respondents reported using pain guidelines. Perceived barriers to guideline use included lack of access, awareness and any single standard. Respondents were generally supportive of new Australian guidelines and especially an implementation strategy. Barriers to evidence-based practice and guideline use identified by our survey might be addressed via a clinical pathway that gives step-by-step guidance on evidence-based practice along with a framework for evaluation. Particular attention should be paid to promoting use of validated scales, patient education and non-pharmacological interventions, training of an appropriately skilled workforce and improving care coordination. Challenges are discussed. © 2012 Wiley Publishing Asia Pty Ltd.

  1. Neurogenic bladder evaluation and management after spinal cord injury: Current practice among urologists working in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Waleed Al Taweel

    2011-01-01

    Full Text Available Aim: The aim of this study is to determine the current trends in the management and surveillance of the NB population secondary to spinal cord injury (SCI or myelomeningocele by certified urologist working in Saudi Arabia and to compare it to the current guidelines. Materials and Methods: A cross-sectional study was conducted using a 12-points questionnaire distributed to urologists working in Saudi Arabia and registered at the Saudi medical association. The assessment and follow-up of upper and lower urinary tract function in neurogenic bladder patients, their optimal frequency and management of related infections were the topics of inquiry. Results: Of the 272 urologists surveyed, 105 responded, yielding a response rate of 38%. Eighty-nine percent of respondents said that ultrasound was their diagnostic tool of choice for upper tract evaluation. Sixty-one percent of respondents said that they would follow their patients with a multichannel urodynamic study. Forty percent of urologists stated that they would treat asymptomatic bacteriuria. Clean intermittent catheterization (CIC was the most common modality chosen for the management of neurogenic bladder in patients with emptying difficulties. Conclusion: This study confirms that most urologists in Saudi Arabia involved with neurogenic bladder management. However, more than one third of the urologists do not have urodynamic machine and only two of the reporting practitioners has a videourodynamic machine. The results emphasize the need for clear guidelines in this field of urology in Saudi Arabia. Highly specialized rehabilitation centers for neurogenic bladder secondary to SCI are required for optimal care and urologist teaching.

  2. Brain abscess: Current management

    Science.gov (United States)

    Alvis Miranda, Hernando; Castellar-Leones, Sandra Milena; Elzain, Mohammed Awad; Moscote-Salazar, Luis Rafael

    2013-01-01

    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. PMID:24174804

  3. 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.

  4. [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.

  5. Current management of liver metastases from gastric cancer: what is common practice? New challenge of EORTC and JCOG.

    Science.gov (United States)

    Kataoka, Kozo; Kinoshita, Takahiro; Moehler, Markus; Mauer, Murielle; Shitara, Kohei; Wagner, Anna Dorothea; Schrauwen, Stefanie; Yoshikawa, Takaki; Roviello, Franco; Tokunaga, Masanori; Boku, Narikazu; Ducreux, Michel; Terashima, Masanori; Lordick, Florian

    2017-02-01

    The role of multidisciplinary treatment including surgery for liver metastases from gastric cancer (LMGC) is controversial. Studies to answer this clinical question are increasing in number, but all published data thus far are based on retrospective analyses with limited sample sizes. Thus, the European Organisation for Research and Treatment of Cancer (EORTC) Gastrointestinal Tract Cancer Group (GITCG) and the Japan Clinical Oncology Group (JCOG) Stomach Cancer Study Group (SCSG) initiated a collaboration to develop an optimal treatment strategy for LMGC. Before planning a prospective study, a questionnaire was sent out to the network members of both groups in June 2016 to clarify current common practice in each region. Sixty-seven sites from 17 countries in the EORTC network and 55 sites from Japan responded. According to the survey, for patients with resectable LMGC without extrahepatic metastases, preoperative chemotherapy followed by resection of both primary (if still in place) and liver lesions was the preferred option for both the synchronous and the metachronous setting. For patients with unresectable LMGC, most of the sites recommended chemotherapy only. In this article, the detailed results of this survey are reported, shedding light on current community practice, and a joint EORTC-JCOG strategy of investigation is delineated.

  6. Control and management of congenital Chagas disease in Europe and other non-endemic countries: current policies and practices.

    Science.gov (United States)

    Soriano-Arandes, Antoni; Angheben, Andrea; Serre-Delcor, Nuria; Treviño-Maruri, Begoña; Gómez I Prat, Jordi; Jackson, Yves

    2016-05-01

    Identifying pregnant women infected with Trypanosoma cruzi is one of the major challenges for preventing and controlling Chagas disease (CD) in non-endemic countries. The aim of this paper was to perform a policy evaluation of the current practices of congenital Chagas disease (CCD) control in non-endemic countries and to propose specific targets for enhanced interventions to tackle this emerging health problem outside the endemic areas of Latin America. We conducted a mixed method review of CCD policy strategies by searching the literature in the PubMed, Google Scholar and the World Health Organization (WHO) databases using the key terms 'CCD', 'paediatric Chagas disease' and 'non-endemic countries'; as free text and combined as one phrase to increase the search sensitivity. Reviews, recommendations, guidelines and control/surveillance programme reports were included. Of 427 CCD papers identified in non-endemic countries, 44 matched the inclusion. Although local programmes were launched in different countries with large numbers of Latin American immigrants, there were considerable disparities in terms of the programmes' distribution, delivery, integration and appropriated CCD control strategies. Moreover, Catalonia, Spain is the only region/country with an established systematic monitoring of CCD in pregnant women from Latin American countries. Given the worldwide dissemination of CD, the nature of its vertical transmission, and the gaps of the current strategies in non-endemic countries, there is an urgent need to standardise, expand and reinforce the control measures against CCD transmission. © 2016 John Wiley & Sons Ltd.

  7. Current Practices in Home Management of Nasogastric Tube Placement in Pediatric Patients: A Survey of Parents and Homecare Providers.

    Science.gov (United States)

    Northington, LaDonna; Lyman, Beth; Guenter, Peggi; Irving, Sharon Y; Duesing, Lori

    Enteral feeding tubes are used in pediatric patients to deliver nutrition, fluids or medications. The literature related to short-term feeding tube (nasogastric [NG], hereafter known as NGT, or orogastric [OGT],) use in pediatric homecare patients is sparse. This descriptive study sought to gather baseline information about these children and how their feeding tubes are managed at home. Specifically, we sought to better understand how the tubes are placed and the method(s) used for tube placement verification. Two surveys were distributed: one to parents and one to homecare providers who have direct patient contact. Responses were obtained from 144 parents and 66 homecare providers. Over half of the children were 12months of age or younger and had a 6 Fr feeding tube. Over 75% (108) had an NGT for 1year or less. Predominantly parents replaced the NGT but a few children self-inserted their tubes. Feeding tube placement was verified by auscultation (44%) or measurement of gastric pH (25%) in the parent's survey. Twenty-six percent of parents indicated they had misplaced an NGT at least once and 35 parents described symptoms of pulmonary misplacement. The homecare provider data indicated auscultation (39%) and pH measurement of gastric contents (28%) to verify NG tube placement location. Study results confirms a need for consistency of practice among health care professionals and in parent education for those children who require NGTs at home. It is troubling that auscultation is still widely used for NGT location confirmation despite practice alerts that warn against its use. Copyright © 2017 Elsevier Inc. All rights reserved.

  8. Exploring the cost-utility of stratified primary care management for low back pain compared with current best practice within risk-defined subgroups.

    Science.gov (United States)

    Whitehurst, David G T; Bryan, Stirling; Lewis, Martyn; Hill, Jonathan; Hay, Elaine M

    2012-11-01

    Stratified management for low back pain according to patients' prognosis and matched care pathways has been shown to be an effective treatment approach in primary care. The aim of this within-trial study was to determine the economic implications of providing such an intervention, compared with non-stratified current best practice, within specific risk-defined subgroups (low-risk, medium-risk and high-risk). Within a cost-utility framework, the base-case analysis estimated the incremental healthcare cost per additional quality-adjusted life year (QALY), using the EQ-5D to generate QALYs, for each risk-defined subgroup. Uncertainty was explored with cost-utility planes and acceptability curves. Sensitivity analyses were performed to consider alternative costing methodologies, including the assessment of societal loss relating to work absence and the incorporation of generic (ie, non-back pain) healthcare utilisation. The stratified management approach was a cost-effective treatment strategy compared with current best practice within each risk-defined subgroup, exhibiting dominance (greater benefit and lower costs) for medium-risk patients and acceptable incremental cost to utility ratios for low-risk and high-risk patients. The likelihood that stratified care provides a cost-effective use of resources exceeds 90% at willingness-to-pay thresholds of £4000 (≈ 4500; $6500) per additional QALY for the medium-risk and high-risk groups. Patients receiving stratified care also reported fewer back pain-related days off work in all three subgroups. Compared with current best practice, stratified primary care management for low back pain provides a highly cost-effective use of resources across all risk-defined subgroups.

  9. Municipal asset management or mismanagement? A six ‘Whats’ perspective on current practices and challenges in Ethiopia’s urban water sector

    Directory of Open Access Journals (Sweden)

    Tendayi GONDO

    2010-06-01

    Full Text Available Effective systems of asset management can strengthen the performance of a local economy and community significantly. Despite the existence of new and interactive technologies for recording and communicating assets and asset management, many local authorities across the developing world have not taken advantage of the emerging revolutionary ways in which technologies may benefit municipal asset management. The analysis reviews the current practices, challenges and policy options for Ethiopian cities with regard to the state of the art technology for Municipal Asset Management (MAM in the water and sanitation sector. Empirical evidence relate to a number of independent studies carried out in a sample of Ethiopian cities and towns. The pooling together of these findings was achieved through the Comparative Studies framework. In addition, data was also solicited from a panel of experts dealing with water and sanitation issues. The overall analysis was done within the context of the six Whats? Framework. Results indicate that, the water sector has gone through a number of reforms that have not cascaded into improved infrastructure asset management. Lack of financial resources, human resource expertise and appropriate organizational strategy has constrained the adoption and application of system software for effective asset management.

  10. Management practice: phenomenological approach

    Directory of Open Access Journals (Sweden)

    Myriam Siqueira da Cunha

    2005-01-01

    Full Text Available This work has the aim of understanding the lived experiences by managers in relation to organizational changes in an enterprise in the food area, located in the State of Rio Grande do Sul, Brazil. The role of managers has been constantly evaluated and their capacity of continuous learning and also the ability of transforming the learning in good organizational results is reacquired every instant. In this work, my intention is to show, using an interpretative analysis, real and practical situations, from lived experiences. The methodological way followed was the hermeneutic phenomenological approach, trying to give a global and a contextual treatment to the theme. The results achieved offer subsides for a new look over the management practice and point out the importance of the study of what is lived, as an inspiration source for the strategic decisions in the enterprises.

  11. Current practice for pulmonary hypertension

    Institute of Scientific and Technical Information of China (English)

    Toru Satoh

    2014-01-01

    Objective To investigate the current practice of pulmonary hypertension including current epidemiology,diagnosis and treatment.Data sources The review was based on data obtained from the published articles and guidelines.Study selection Articles with high level of evidence or current best evidence in each issue were selected to be reviewed.Results Overall prevalence of pulmonary hypertension was 0.3% to 6% with left heart disease occupying the most proportion,followed by pulmonary disease,pulmonary arterial hypertension and chronic thromboembolic pulmonary hypertension.In diagnosis,a flow diagram of diagnosis of pulmonary hypertension,differential diagnosis of pulmonary hypertension and how to determine the severity of pulmonary hypertension are explained including recent development of magnetic resonance imaging and gene abnormality study on bone morphogenetic protein receptor Ⅱ.In treatment,newlydeveloped pulmonary vasodilators and the way to use them are shown to treat pulmonary hypertension.Conclusion Safer and more effective treatment algorithm and basic researches and clinical trials are warranted to be explored.

  12. Best Practices in Project Management

    OpenAIRE

    Liviu ILIES; Emil CRISAN; Ioana Natalia MURESAN

    2010-01-01

    Project management has evolved over time, becoming the principal mean of dealing with change in modern organizations. Best practices have occurred as a result of business evolution and of practicing project management at a global level. Best practices in project management, if followed, increase the chances of success in achieving goals when dealing with projects. In this article we present the concept of best practice, the advantages of using best practices in project management, which are t...

  13. A case of thoracic giant cell tumor of bone and discussion of radiological features and current management practices

    Directory of Open Access Journals (Sweden)

    Deirdre Kelly, MBBCh

    2016-09-01

    Full Text Available Giant cell tumor of bone (GCTB is a rare condition with distinct radiological features that aid diagnosis. We present the case of an adult female patient, with locally invasive GCTB and review important radiological and management principles. Specific radiological features include locally aggressive, lytic radiolucent lesions, which can demonstrate cortical thinning and expansile remodeling of bone and typically involve the epiphysis and metaphysis. Management is primarily surgical, and denosumab has a role in the advanced setting.

  14. Current management of presbyopia

    Directory of Open Access Journals (Sweden)

    Pandelis A Papadopoulos

    2014-01-01

    Full Text Available Presbyopia is a physiologic inevitability that causes gradual loss of accommodation during the fifth decade of life. The correction of presbyopia and the restoration of accommodation are considered the final frontier of refractive surgery. Different approaches on the cornea, the crystalline lens and the sclera are being pursued to achieve surgical correction of this disability. There are however, a number of limitations and considerations that have prevented widespread acceptance of surgical correction for presbyopia. The quality of vision, optical and visual distortions, regression of effect, complications such as corneal ectasia and haze, anisometropia after monovision correction, impaired distance vision and the invasive nature of the currently techniques have limited the utilization of presbyopia surgery. The purpose of this paper is to provide an update of current procedures available for presbyopia correction and their limitations.

  15. Practice Management: The Game Changer.

    Science.gov (United States)

    Pessis, Paul

    2016-11-01

    The reimbursement landscape is undergoing significant changes. Practice management, which encompasses reimbursement, is becoming increasingly more important in securing business success. Each practitioner within a facility is responsible for fortifying the practice through thoughtful business protocols. Knowing legislation that impacts health care along with understanding the foundational components of reimbursement is key for keeping a practice financially healthy. Change is good, but making the changes is what counts! Legislation such as the Medicare Access and Chip Reauthorization Act defines the new payment models. Correcting current business practices might seem difficult on the surface, but implementing change is rewarding and an obligation of the practitioners within a facility to their patients. Financial stability for a practice occurs when sound business practices are routine. Today's audiologist must not only be proficient at performing his or her scope of practice, but must also accept that performing best business practices is part of the job. In the end, the patients seeking the services of the audiologist benefit most when a practice has the financial stability to be best in its class.

  16. Management Advisory Services by CPA’s. A Survey of Current Expansion of Sole Proprietor Professional Practice Units.

    Science.gov (United States)

    1981-12-01

    text. tial andl existing managerial talent; of National Affains. executive responibility desuiphios: 1974). Chs 1.2,14.15. ree of ex~ecutive performance...W.; Laurence , Paul R.; and Lorsch, Jay W. Organizational Structure and Desin. Homewood, IL: Irwin, 1970. Drucker, Peter F. Managing for Results

  17. Pain management in trauma patients in (pre)hospital based emergency care: current practice versus new guideline

    NARCIS (Netherlands)

    Scholten, A.C.; Berben, S.A.A.; Westmaas, A.H.; Grunsven, P.M.; Vaal, de E.T.; Rood, Pleunie P.M.; Hoogerwerf, N.; Doggen, C.J.M.; Schoonhoven, L.

    2015-01-01

    Introduction Acute pain in trauma patients in emergency care is still undertreated. Early pain treatment is assumed to effectively reduce pain in patients and improve long-term outcomes. In order to improve pain management in the chain of emergency care, a national evidence-based guideline was devel

  18. Pain management in trauma patients in (pre)hospital based emergency care: Current practice versus new guideline

    NARCIS (Netherlands)

    A.C. Scholten (Annemieke); S.A.A. Berben (Sivera); A.H. Westmaas (Alvin H); P.M. van Grunsven (Pierre); E.T. de Vaal; P.P.M. Rood (Pleunie); N. Hoogerwerf (N.); C.J.M. Doggen (Carine); R. van Schoonhoven (Renee)

    2015-01-01

    textabstractIntroduction Acute pain in trauma patients in emergency care is still undertreated. Early pain treatment is assumed to effectively reduce pain in patients and improve long-term outcomes. In order to improve pain management in the chain of emergency care, a national evidence-based guideli

  19. Pain management in trauma patients in (pre)hospital based emergency care: current practice versus new guideline

    NARCIS (Netherlands)

    Scholten, A.C.; Berben, S.A.A.; Westmaas, A.H.; Grunsven, P.M. van; Vaal, E.T. de; Hoogerwerf, N.; Doggen, C.J.; Schoonhoven, L.

    2015-01-01

    INTRODUCTION: Acute pain in trauma patients in emergency care is still undertreated. Early pain treatment is assumed to effectively reduce pain in patients and improve long-term outcomes. In order to improve pain management in the chain of emergency care, a national evidence-based guideline was deve

  20. Identifying enabling management practices for employee engagement

    Directory of Open Access Journals (Sweden)

    Marius Joubert

    2011-12-01

    Full Text Available Orientation: A currently emerging viewpoint is that today's management practices no longer add value to organisations. The focus of this article is to conduct a systematic review of the scholarly literature on management practices that could be related to employee engagement. Research purpose: This study searched for evidence in support of the notion of a management value chain, and enabling management practices within each value chain component that could relate to employee engagement. Motivation for the study: An alternative management value chain model could contribute towards a better understanding of which management practices may potentially impact employee engagement. Research design, approach, and method: This is a non-empirical (theoretical study, based on a systematic, in-depth literature review to identify the key management components and enabling practices within this proposed management value chain. Scholarly research databases were sourced for relevant peer reviewed research conducted since 1990, not excluding important contributions prior to 1990. The literature was systematically searched, selected, studied, and contextualized within this study. Main findings: Support was found for the notion of a management value chain, for enabling management practices within each proposed management value chain component, and it was also established these management practices indeed have an impact on employee engagement. Practical/managerial/implications: The possibility that management work can be presented as a generic management value chain allows managers to approach engaging management practices more systematically. Contribution/value-add: This study highlights the importance of some management practices that have never been seen as part of management work.

  1. Current practice in managing patients on anticoagulants and/or antiplatelet agents around the time of gastrointestinal endoscopy -- a nation-wide survey in Germany.

    Science.gov (United States)

    Mosler, P; Mergener, K; Denzer, U; Kiesslich, R; Galle, P R; Kanzler, S

    2004-11-01

    Anticoagulants and antiplatelet agents are widely used in the prophylaxis and management of thromboembolic and cardiovascular diseases. Gastrointestinal bleeding is a well-known complication of these agents. Modification of anticoagulant and antiplatelet therapy is often required in patients undergoing surgical procedures and specific recommendations for the perioperative period have been issued. Fewer data exist with regard to the use of these agents around the time of endoscopic procedures. A survey of the American Society for Gastrointestinal Endoscopy (ASGE), performed several years ago, showed a wide variation between endoscopists in the management of anticoagulants and antiplatelet agents in the periendoscopic period. Subsequently, guidelines have been proposed by the ASGE as well as the German Society for Gastroenterology (DGVS). The aim of this study was to investigate the current practices among German endoscopists regarding the use of these medications in patients undergoing endoscopic procedures and to assess their adherence to published guidelines. Our data demonstrate that, in spite of the dissemination of guidelines, there is still a wide variation in the periendoscopic management of patients who are at increased risk for bleeding due to anticoagulants, especially in patients taking antiplatelet agents.

  2. Waste dumping sites as a potential source of POPs and associated health risks in perspective of current waste management practices in Lahore city, Pakistan.

    Science.gov (United States)

    Hafeez, Saba; Mahmood, Adeel; Syed, Jabir Hussain; Li, Jun; Ali, Usman; Malik, Riffat Naseem; Zhang, Gan

    2016-08-15

    Persistent organic pollutants (POPs) including polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) and dechloran plus (DP) were analyzed in air, dust, soil and water samples from waste dump site, Lahore, Pakistan. It was revealed that PCB levels were detected higher in all matrices than PBDEs and DPs. Principal Component Analysis (PCA) showed higher usage of BDE-47, -99 and di-CBs, tri-CBs, tetra-CBs and penta-CBs. Health risk assessment of PCBs and PBDEs from soil and dust indicated low to moderate risk to the local population via different exposure pathways. It is recommended to improve current waste management practices in order to avoid emissions of contaminants and open dumping grounds should be modified into sanitary landfill.

  3. Factors in Sustainable Development: Current and Innovative Livestock and Range Management Practices as Perceived by Cattle-Producing Ejidatarios and Private Cattle Ranchers of Sonora, Mexico. A Summary Report of Research. Department Information Bulletin 99-4.

    Science.gov (United States)

    Hamlett, Peggy J.

    A study was conducted to identify and compare livestock production and range management practices currently in use in the Texas/Mexico border corridor, and to determine the acceptance of selected innovative practices among cattle ranchers in the State of Sonora, Mexico. Information was collected from private livestock producers who were members of…

  4. Assessment and applicability of evaluation tools: Current practice in a sample of European countries and steps towards a state-of-the-art approach. Road Infrastructure Safety Management Evaluation Tools (RISMET), Deliverables No. 4 and 5.

    NARCIS (Netherlands)

    Elvik, R.

    2014-01-01

    This report surveys current practice in a sample of European countries with respect to the use of ten different tools for safety management of road systems. The report also proposes steps that can be taken to bring the use of these management tools closer to their state-of-the-art versions. These to

  5. The effects of farm management practices on liver fluke prevalence and the current internal parasite control measures employed on Irish dairy farms.

    Science.gov (United States)

    Selemetas, Nikolaos; Phelan, Paul; O'Kiely, Padraig; de Waal, Theo

    2015-01-30

    Fasciolosis caused by Fasciola hepatica is responsible for major production losses in cattle farms. The objectives of this study were to assess the effect of farm management practices on liver fluke prevalence on Irish dairy farms and to document the current control measures against parasitic diseases. In total, 369 dairy farms throughout Ireland were sampled from October to December 2013, each providing a single bulk tank milk (BTM) sample for liver fluke antibody-detection ELISA testing and completing a questionnaire on their farm management. The analysis of samples showed that cows on 78% (n=288) of dairy farms had been exposed to liver fluke. There was a difference (P0.05) between positive and negative farms in (a) the grazing of dry cows together with replacement cows, (b) whether or not grazed grassland was mowed for conservation, (c) the type of drinking water provision system, (d) spreading of cattle manure on grassland or (e) for grazing season length (GSL; mean=262.5 days). Also, there were differences (Pcontrol strategy.

  6. Current practice in the diagnosis and management of IBD-associated anaemia and iron deficiency in Germany: the German AnaemIBD Study.

    Science.gov (United States)

    Blumenstein, Irina; Dignass, Axel; Vollmer, Stephan; Klemm, Wolfgang; Weber-Mangal, Susanne; Stein, Juergen

    2014-10-01

    Anaemia is a common complication in inflammatory bowel disease (IBD), frequently resulting from iron deficiency. IBD guidelines advocate intravenous iron administration although some patients respond to oral supplementation. This non-interventional study investigates the current status of anaemia management in German IBD patients. Baseline data on pre-study treatment for anaemia were retrospectively analysed in IBD patients with anaemia participating in a prospective trial of the efficacy and safety of ferric carboxymaltose. Data were collected from 55 German gastroenterological centres up to August 2010. Subjects had received care at their centre for at least 12 months prior to baseline. 193 cases of IBD-associated anaemia (115 Crohn's disease, 77 ulcerative colitis) were analysed (mean age: 39 years (18-83), 79 (41%) males). Anaemia and iron status were usually assessed by haemoglobin (100%), serum ferritin (97%), and transferrin saturation (82%). In the previous 6 months, only 84 patients (43.5%) had been treated for anaemia: 47 (56%) with oral iron, 13 (15%) parenteral iron, 16 (19%) oral plus parenteral iron and 8 (10%) transfusions. No patients received erythropoietin stimulating agents. Although intravenous iron supplementation is recommended in IBD patients, current German practice still relies on oral therapy, even in severe anaemia. The high incidence of severe anaemia in this cohort reflects inadequate iron replacement and status monitoring. While the proportion of IBD patients with inadequately treated anaemia/iron deficiency is unknown, greater awareness of existing guidelines for iron deficiency management in IBD patients appears necessary. Copyright © 2014 European Crohn's and Colitis Organisation. Published by Elsevier B.V. All rights reserved.

  7. Current management of oral cancer

    Institute of Scientific and Technical Information of China (English)

    Robert Ord

    2008-01-01

    @@ This presentation will summarize some of the current areas of interest in the management of oral cancer. The presentation will be divided into a brief review of epidemiology and diagnosis, with a more extensive discussion regarding the controversial areas in surgery and a review of the adjuvant roles of radiation and chemotherapy.

  8. Current management of wound healing

    DEFF Research Database (Denmark)

    Gottrup, F; Karlsmark, T

    2009-01-01

    in the next decade. It is the hope that increasing parts of the new knowledge from basic wound healing research will be implemented in daily clinical practice. The development of new treatment products will also continue, and especially new technologies with combined types of dressing materials or dressing...... containing active substances will be accentuated. Further developments in the management structure and education will also continue and consensus of treatment guidelines, recommendations and organization models will hopefully be achieved....

  9. Post-trauma support in the workplace: the current status and practice of critical incident stress management (CISM) and psychological debriefing (PD) within organizations in the UK.

    Science.gov (United States)

    Regel, Stephen

    2007-09-01

    Employers' duties of care under both common and statute law include the need to take reasonable care of the health and safety of the workforce. This includes both the moral and legal duties to consider the psychological needs of personnel following exposure to traumatic events related to the workplace. While this has been recognized within many high-risk occupations such the police, fire and rescue services and the military, there is also evidence that post-trauma support in the workplace is increasingly commonly provided not only among health and social services agencies, but within many private sector organizations. Over the past decade, however, there has been considerable controversy over the provision of early psychological support to personnel in the form of critical incident stress management (CISM) processes. In particular, one aspect of CISM, the use of psychological debriefing (PD) has come under scrutiny and criticism as two studies indicated that PD was ineffective and had the potential to do harm. Inevitably, this has provoked much uncertainty and confusion among some organizations as what should be the most appropriate support. It has also led to misconceptions and misunderstandings as to the aims and purpose of PD, together with inaccuracies of terminology, for example describing PD as 'counselling'. Despite the controversy, both CISM and PD continue to be provided on a widespread basis, often utilizing a framework of voluntary peer group support. This paper intends to (i) present a review of the current status of CISM practices, including the use of PD within various organizations in the UK and (ii) provide a clear framework and understanding of the main issues and to clarify conceptual misunderstandings. The history, principles and background of the use of post-trauma support in the workplace, charting trends over the past two decades, previous research, problems with the evidence base and current thinking and practice in the field are reviewed

  10. Current practice in transvenous lead extraction

    DEFF Research Database (Denmark)

    Bongiorni, Maria Grazia; Blomström-Lundqvist, Carina; Kennergren, Charles

    2012-01-01

    AIM: Current practice with regard to transvenous lead extraction among European implanting centres was analysed by this survey. METHODS AND RESULTS: Among all contacted centres, 164, from 30 countries, declared that they perform transvenous lead extraction and answered 58 questions...... with a compliance rate of 99.9%. Data from the survey show that there seems to be an overall increasing experience of managing various techniques of lead extraction and a widespread involvement of cardiac centres in this treatment. Results and complication rates seem comparable with those of main international...... registries. CONCLUSION: This survey gives an interesting snapshot of lead extraction in Europe today and gives some clues for future research and prospective European registries....

  11. Building new WDM regulations for the Namibian tourism sector on factors influencing current water-management practices at the enterprise level

    Science.gov (United States)

    Schachtschneider, Klaudia

    Namibia’s aridity is forcing its water sector to resort to new water resource management approaches, including water demand management (WDM). Such a change in management approach is facilitated through the country’s opportunity at independence to rewrite and adapt its old policies, including those for water and tourism. Legal support for WDM through the Water Act and other sector-specific Acts is crucial to plan the practical implementation of WDM throughout the different water use sectors of Namibia. In order to be able to put the policy into practice, it is imperative to understand which factors motivate people to adopt WDM initiatives. Within the Namibian tourism industry three main factors have been identified which influence the water-management approaches at tourist facilities. This paper discusses how the water and tourism decision makers can consider these factors when developing new regulations to introduce WDM in the tourism sector.

  12. An essay on agile project management practices

    OpenAIRE

    Gouveia, Daniel Rabasquinho

    2015-01-01

    The main goals for the current dissertation is to research on how practices and concepts from Agile Project Management can be applied in a non-IT context and to discover which aspects should be considered when deciding if whether an Agile approach should be implemented or not. Previous studies reflect on the adoption for the identified context. However, the recognition of these practices and concepts by the Project Management field of studies still remains unresolved. The adoption of Agile...

  13. Waste dumping sites as a potential source of POPs and associated health risks in perspective of current waste management practices in Lahore city, Pakistan

    Energy Technology Data Exchange (ETDEWEB)

    Hafeez, Saba [Environmental Biology and Ecotoxicology Laboratory, Department of Environmental Sciences, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320 (Pakistan); Mahmood, Adeel [Department of Biosciences, COMSATS Institute of Information Technology, Islamabad PO: 45550 (Pakistan); State Key Laboratory of Organic Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640 (China); Syed, Jabir Hussain; Li, Jun [State Key Laboratory of Organic Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640 (China); Ali, Usman [Environmental Biology and Ecotoxicology Laboratory, Department of Environmental Sciences, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320 (Pakistan); Malik, Riffat Naseem, E-mail: r_n_malik2000@yahoo.co.uk [Environmental Biology and Ecotoxicology Laboratory, Department of Environmental Sciences, Faculty of Biological Sciences, Quaid-i-Azam University, Islamabad 45320 (Pakistan); Zhang, Gan [State Key Laboratory of Organic Geochemistry, Guangzhou Institute of Geochemistry, Chinese Academy of Sciences, Guangzhou 510640 (China)

    2016-08-15

    Persistent organic pollutants (POPs) including polychlorinated biphenyls (PCBs), polybrominated diphenyl ethers (PBDEs) and dechloran plus (DP) were analyzed in air, dust, soil and water samples from waste dump site, Lahore, Pakistan. It was revealed that PCB levels were detected higher in all matrices than PBDEs and DPs. Principal Component Analysis (PCA) showed higher usage of BDE-47, -99 and di-CBs, tri-CBs, tetra-CBs and penta-CBs. Health risk assessment of PCBs and PBDEs from soil and dust indicated low to moderate risk to the local population via different exposure pathways. It is recommended to improve current waste management practices in order to avoid emissions of contaminants and open dumping grounds should be modified into sanitary landfill. - Highlights: • The pioneer study provides the baseline data from waste dumping site from Lahore. • Dump site of Lahore is the potential source of PCBs, PBDEs and DPs in nearby environment. • Fugacity fractions indicated air to soil deposition of PCBs and PBDEs.

  14. Current Challenges in Social Media Management

    DEFF Research Database (Denmark)

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

    2015-01-01

    Social media management is an emerging field of academic research and organizational practice. It is concerned with the operational issues, managerial challenges, and comparative advantages that ensue from the adoption and use of social media platforms for organizational functions such as marketing...... 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......®, PANDORA®, Novo Nordisk®, and Carlsberg®). Empirical findings uncover the prevailing perceptions about social media amongst the managers, typical managerial challenges tied directly to coordinating social media productions, and uncertainty about the return of investment on social media activities....

  15. Current challenges in social media management

    DEFF Research Database (Denmark)

    Tørning, Kristian; Jaffari, Zeshan; Vatrapu, Ravi

    2015-01-01

    Social media management is an emerging field of academic research and organizational practice. It is concerned with the operational issues, managerial challenges, and comparative advantages that ensue from the adoption and use of social media platforms for organizational functions such as marketing...... 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......®, PANDORA®, Novo Nordisk®, and Carlsberg®). Empirical findings uncover the prevailing perceptions about social media amongst the managers, typical managerial challenges tied directly to coordinating social media productions, and uncertainty about the return of investment on social media activities....

  16. Current challenges in social media management

    DEFF Research Database (Denmark)

    Tørning, Kristian; Jaffari, Zeshan; Vatrapu, Ravi

    2015-01-01

    Social media management is an emerging field of academic research and organizational practice. It is concerned with the operational issues, managerial challenges, and comparative advantages that ensue from the adoption and use of social media platforms for organizational functions such as marketing...... 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......®, PANDORA®, Novo Nordisk®, and Carlsberg®). Empirical findings uncover the prevailing perceptions about social media amongst the managers, typical managerial challenges tied directly to coordinating social media productions, and uncertainty about the return of investment on social media activities....

  17. Employability management practices in the Polish ICT sector

    NARCIS (Netherlands)

    Marzec, I.; van der Heijden, B.I.J.M.; Scholarios, D.; van der Schoot, E.; Jędrzejowicz, P.; Bozionelos, N.; Epitropaki, O.; Knauth, P.; Mikkelsen, A.; van der Heijde, C.

    2009-01-01

    This article examines current career thinking and employability management practices within the Polish Information and Communication Technology (ICT) sector. The aim of this contribution is to identify career management problems and to determine obstacles for implementing employability management pr

  18. Interaction of ice storms and management practices on current carbon sequestration in forests with potential mitigation under future CO2 atmosphere

    Science.gov (United States)

    Heather R. McCarthy; Ram Oren; Hyun-Seok Kim; Kurt H. Johnsen; Chris Maier; Seth G. Pritchard; Michael A. Davis

    2006-01-01

    Ice storms are disturbance events with potential impacts on carbon sequestration. Common forest management practices, such as fertilization and thinning, can change wood and stand properties and thus may change vulnerability to ice storm damage. At the same time, increasing atmospheric CO2 levels may also influence ice storm vulnerability. Here...

  19. Dental Practice Management

    Directory of Open Access Journals (Sweden)

    Gheorghe Raftu

    2016-01-01

    The realization of the paper followed a review of specialty literature, through which the mainaspects of dental office management have been analyzed, rendering the management solutionsavailable to all of those interested from an economic, deontological point of view, as well asmethods of managing human resources in order to obtain the best feedback possible from patients.

  20. Educational Management: Theory and Practice.

    Science.gov (United States)

    Bush, Tony

    This document is a chapter in "The Principles and Practice of Educational Management," which aims to provide a systematic and analytical introduction to the study of educational management. The structure of the book reflects the main substantive areas of educational leadership and management, and most of the major themes are covered in the…

  1. Educational Management: Theory and Practice.

    Science.gov (United States)

    Bush, Tony

    This document is a chapter in "The Principles and Practice of Educational Management," which aims to provide a systematic and analytical introduction to the study of educational management. The structure of the book reflects the main substantive areas of educational leadership and management, and most of the major themes are covered in the…

  2. Overview of current chelation practices

    Directory of Open Access Journals (Sweden)

    Y. Aydinok

    2011-12-01

    , should provide long-term survival and quality of life for patients with iron loading anemias. The goal of this review is to summarize current concepts in iron chelation therapies based on the considerable amount of prospective data obtained by clinical studies. 去铁胺 (DFO)是自20世纪80年以来输血引起铁过载的参考标准疗法。 虽然它是一种高效的铁螯合剂,但是去铁胺皮下给药的遵从性问题依旧是主要问题。 口服螯合剂去铁酮(DFP)在北美没有销售许可证,但是,它在1994年获得印度许可,1999年欧洲联盟(EU)批准授予去铁酮销售许可证,特别是当去铁胺不足、无法忍受或无法接受时,去铁酮可用于重型地中海贫血患者。 还可获得关于在6岁至10岁之间的儿童身上使用去铁酮的有限数据,但是没有关于在6岁以下儿童身上使用去铁酮的数据。 随后美国食品和药品管理局(FDA)和欧洲药品管理局(EMA)分别在2005年和2006年批准口服螯合剂去铁酮作为第一疗法来治疗2岁以上输血引起铁过载的患者。 铁螯合的主要目的是将身体铁维持在安全水平,但一旦铁累积起来,铁螯合的目标是把组织铁降低到安全级别,这是一个缓慢的过程。 确定螯合剂的螯合方案、剂量和频率管理的主要依据是身体铁负担、心肌铁的状态和输血铁负载速率。 适当监控螯合对测量特殊方案的反应速率和提供计量调整来加强螯合效果和避免毒效尤其重要。 由于一些因素,诸如:螯合剂的吸收和代谢,螯合方案的效果可能呈现个别变化。 耐受性和遵从性也是影响螯合反应的个别变量。 了解螯合剂的优点和局限性,准确确定铁过载患者的螯合需求以及设计毒效更小但效果更优的个性化螯合方案,可以向铁过载贫血患者提供长期的生存和生活质量。 此次调研的目的是在临床研究获得的相当数

  3. Rotator cuff rehabilitation: current theories and practice.

    Science.gov (United States)

    Osborne, Jeffrey D; Gowda, Ashok L; Wiater, Brett; Wiater, J Michael

    2016-01-01

    A fully functioning, painless shoulder joint is essential to maintain a healthy, normal quality of life. Disease of the rotator cuff tendons (RCTs) is a common issue that affects the population, increasing with age, and can lead to significant disability and social and health costs. RCT injuries can affect younger, healthy patients and the elderly alike, and may be the result of trauma or occur as a result of chronic degeneration. They can be acutely painful, limited to certain activities or completely asymptomatic and incidental findings. A wide variety of treatment options exists ranging from conservative local and systemic pain modalities, to surgical fixation. Regardless of management ultimately chosen, physiotherapy of the RCT, rotator cuff muscles and surrounding shoulder girdle plays an essential role in proper treatment. Length of treatment, types of therapy and timing may vary if therapy is definitive care or part of a postoperative protocol. Allowing time for adequate RCT healing must always be considered when implementing ROM and strengthening after surgery. With current rehabilitation methods, patients with all spectrums of RCT pathology can improve their function, pain and quality of life. This manuscript reviews current theories and practice involving rehabilitation for RCT injuries.

  4. Practical management of hyperthyroidism

    Energy Technology Data Exchange (ETDEWEB)

    Houston, M.S.; Hay, I.D. (Mayo Clinic, Rochester, MN (USA))

    1990-03-01

    There are several causes of hyperthyroidism, and correct diagnosis is essential for management. Graves' disease is most commonly managed with radioactive iodine therapy ({sup 131}I), antithyroid drugs or surgery. Toxic adenomas (single or multiple) may be treated with {sup 131}I or surgery. Most types of thyroiditis are managed expectantly. Pregnant women, children and the elderly deserve special consideration. Follow-up is vital to identify the later development of hypothyroidism.18 references.

  5. Management Accounting in Denmark; Theory and Practice

    DEFF Research Database (Denmark)

    Israelsen, Poul; Andersen, Michael; Rohde, Carsten

    1996-01-01

    The article describes the present state of cost and management accounting in Denmark within “mainstream accounting”, both as regards theory and practice. In the case of theory, there has been a gradual convergence of views. The essence of these views is briefly described. Concerning practice......, the main results of two new empirical studies are presented one on product costing and the other on identifying the adoption of “modern cost management techniques” in Denmark. The article places both current theory and practice in their historical context. In the former, this is done through an outline...

  6. Current american practice in color measurement.

    Science.gov (United States)

    Billmeyer, F W

    1969-04-01

    Current Aimerienn practice in color measurement is reviewed from the standpoint of instrumentation practice, measurement concepts, and computational methods. Instrumentation practice is described for spectrophotometers, abridged spectrophotometers, and tristimulus colorimeters. Measurement variables discussed include photometric and wavelength scales, standards and standardization, illuminating and viewing geometry, and instrument sources simulating standard illuminants. Computation-methods practiced for obtaining color coordinates and color differences are discussed. Topics indirectly related to the measurement step, such as the basis of colorimetry, color mixing laws, and computer color matching, are specifically excluded from this paper.

  7. Contemporary management of pericardial effusion: practical aspects for clinical practice.

    Science.gov (United States)

    Imazio, Massimo; Gaido, Luca; Battaglia, Alberto; Gaita, Fiorenzo

    2017-03-01

    A pericardial effusion (PE) is a relatively common finding in clinical practice. It may be either isolated or associated with pericarditis with or without an underlying disease. The aetiology is varied and may be either infectious (especially tuberculosis as the most common cause in developing countries) or non-infectious (cancer, systemic inflammatory diseases). The management is essentially guided by the hemodynamic effect (presence or absence of cardiac tamponade), the presence of concomitant pericarditis or underlying disease, and its size and duration. The present paper reviews the current knowledge on the aetiology, classification, diagnosis, management, therapy, and prognosis of PE in clinical practice.

  8. Current guidelines for the evaluation and management of atopic dermatitis: A comparison of the Joint Task Force Practice Parameter and American Academy of Dermatology guidelines.

    Science.gov (United States)

    Eichenfield, Lawrence F; Ahluwalia, Jusleen; Waldman, Andrea; Borok, Jenna; Udkoff, Jeremy; Boguniewicz, Mark

    2017-04-01

    Atopic dermatitis (AD) is a chronic pruritic inflammatory disease that commonly presents in the pediatric population. Although definitions and diagnosis of AD have largely been agreed upon, allergists and dermatologists have similar and divergent approaches to the management of AD. This review facilitated integration of the American Academy of Allergy, Asthma & Immunology/American College of Allergy, Asthma & Immunology Joint Task Force 2012 AD Practice Parameter and the 2014 American Academy of Dermatology guidelines to highlight the basic principles of AD management and discuss therapies and management of AD from the distinct perspectives of the allergist and dermatologist. Copyright © 2017 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  9. Provenance Management in Practice

    NARCIS (Netherlands)

    Ooms, M.J.

    2009-01-01

    Scientific Workflow Managements Systems (SWfMSs), such as our own research prototype e-BioFlow, are being used by bioinformaticians to design and run data-intensive experiments, connecting local and remote (Web) services and tools. Preserving data, for later inspection or reuse, determine the quali

  10. Canonical discrimination of the effect of a new broiler production facility on soil chemical profiles as related to current management practices.

    Directory of Open Access Journals (Sweden)

    Cynthia L Sheffield

    Full Text Available The effect dirt-floored broiler houses have on the underlying native soil, and the potential for contamination of the ground water by leaching under the foundation, is an understudied area. This study examines alterations in fifteen quantitative soil parameters (Ca, Cu, electrical conductivity, Fe, K, Mg, Mn, Na, NO3, organic matter, P, pH, S, soil moisture and Zn in the underlayment of a newly constructed dirt-floored broiler house over the first two years of production (Native through Flock 11. The experiment was conducted near NW Robertson County, Texas, where the native soil is a fine, smectitic thermic Udertic Paleustalfs and the slopes range from zero to three percent. Multiple samples were collected from under each of three water and three feed lines the length of the house, in a longitudinal study during February 2008 through August 2010. To better define the relationship between the soil parameters and sampling times, a canonical discriminant analysis approach was used. The soil profiles assembled into five distinctive clusters corresponding to time and management practices. Results of this work revealed that the majority of parameters increased over time. The management practices of partial and total house clean-outs markedly altered soil profiles the house underlayment, thus reducing the risk of infiltration into the ground water near the farm. This is important as most broiler farms consist of several houses within a small area, so the cumulative ecological impact could be substantial if not properly managed.

  11. Canonical discrimination of the effect of a new broiler production facility on soil chemical profiles as related to current management practices.

    Science.gov (United States)

    Sheffield, Cynthia L; Crippen, Tawni L; Byrd, J Allen; Beier, Ross C; Yeater, Kathleen

    2015-01-01

    The effect dirt-floored broiler houses have on the underlying native soil, and the potential for contamination of the ground water by leaching under the foundation, is an understudied area. This study examines alterations in fifteen quantitative soil parameters (Ca, Cu, electrical conductivity, Fe, K, Mg, Mn, Na, NO3, organic matter, P, pH, S, soil moisture and Zn) in the underlayment of a newly constructed dirt-floored broiler house over the first two years of production (Native through Flock 11). The experiment was conducted near NW Robertson County, Texas, where the native soil is a fine, smectitic thermic Udertic Paleustalfs and the slopes range from zero to three percent. Multiple samples were collected from under each of three water and three feed lines the length of the house, in a longitudinal study during February 2008 through August 2010. To better define the relationship between the soil parameters and sampling times, a canonical discriminant analysis approach was used. The soil profiles assembled into five distinctive clusters corresponding to time and management practices. Results of this work revealed that the majority of parameters increased over time. The management practices of partial and total house clean-outs markedly altered soil profiles the house underlayment, thus reducing the risk of infiltration into the ground water near the farm. This is important as most broiler farms consist of several houses within a small area, so the cumulative ecological impact could be substantial if not properly managed.

  12. E-waste: Environmental Problems and Current Management

    National Research Council Canada - National Science Library

    D. Aktsoglou; K. Angelakoglou; G. Gaidajis

    2010-01-01

    ..., 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...

  13. Best management practices for airport deicing stormwater.

    Science.gov (United States)

    Switzenbaum, M S; Veltman, S; Mericas, D; Wagoner, B; Schoenberg, T

    2001-06-01

    With the advent of new regulations concerning aircraft deicing and management of spent aircraft deicing fluids (ADFs), many airports now face the dual challenges of simultaneously maintaining public safety and protecting the environment. This paper provides a theoretical assessment of the potential environmental impact of stormwater runoff and offers detailed current information on alternative deicing fluid application methods and materials, collection and treatment practices.

  14. Management of the bladder in traumatic injuries of the spinal cord during the First World War and its implications for the current practice of urology.

    Science.gov (United States)

    Silver, John R

    2011-08-01

    What's known on the subject? and What does the study add? Prior to the First World War, traumatic injuries to the spinal cord rapidly led to death from severe infections of the bladder. During the Second World War, Ludwig Guttmann resurrected the use of intermittent catheterisation at Stoke Mandeville Hospital, by meticulous attention to detail and was so successful, that this method was introduced into general urological practice. Historical review of the management of the bladder in patients with spinal injuries. Spinal injury patients--literature review--personal experience at Stoke Mandeville Hospital. Review of the different methods of catheterisation from the 19th century to today. Methods learned from the management of the bladder of spinal injuries patients were adopted into mainstream urology.

  15. Multidisciplinary management of clear-cell renal cell carcinoma in Africa and the Middle East: current practice and recommendations for improvement.

    Science.gov (United States)

    Zekri, Jamal; Dreosti, Lydia M; Ghosn, Marwan; Hamada, Emad; Jaloudi, Mohamed; Khorshid, Ola; Larbaoui, Blaha

    2015-01-01

    The management of renal cell carcinoma (RCC) has evolved considerably in recent years. This report represents the consensus of 22 relevant medical specialists from Africa and the Middle East region engaged in the management of RCC. Partial or radical nephrectomy is the standard of care for most patients with localized RCC. It is essential that patients are followed up appropriately after surgery to enable local and distant relapses to be identified and treated promptly. The treatment of advanced/metastatic disease has changed dramatically with the introduction of targeted therapies. Follow-up of these patients enables therapy optimization and assessment of response to treatment. There was universal agreement on the importance of management of RCC by a multidisciplinary team supported by a multidisciplinary tumor board. Barriers hindering this approach were identified. These included lack of awareness of the benefits of multidisciplinary team role, poor communication among relevant disciplines, time constraints, and specifics of private practice. Other challenges include shortage of expert specialists as urologists and oncologists and lack of local management guidelines in some countries. Solutions were proposed and discussed. Medical educational initiatives and awareness activities were highlighted as keys to encouraging cooperation between specialties to improve patients' outcome. Establishing combined genitourinary cancer clinics and formal referral systems should encourage a culture of effective communication. Joining forces with professionals in peripheral areas and the private sector is likely to help standardize care. Sustained action will be required to ensure that all patients with RCC in the region benefit from up-to-date care.

  16. Current Practices in Resident Assistant Training

    Science.gov (United States)

    Koch, Virginia Albaneso

    2016-01-01

    Developing resident assistant (RA) training is a challenge for most housing and residence life staff. Grounded in the author's doctoral research on the curricular design of RA training programs, this study summarizes current practices in three types of RA training programs--preservice training, in-service training, and academic courses--and…

  17. Teaching Math Online: Current Practices in Turkey

    Science.gov (United States)

    Akdemir, Omur

    2011-01-01

    Changing nature of student population, developments in technology, and insufficient number of traditional universities have made online courses popular around the globe. This study was designed to investigate the current practices of teaching mathematics online in Turkish Universities through a qualitative inquiry. The snowball sampling method was…

  18. Current Practices in Resident Assistant Training

    Science.gov (United States)

    Koch, Virginia Albaneso

    2016-01-01

    Developing resident assistant (RA) training is a challenge for most housing and residence life staff. Grounded in the author's doctoral research on the curricular design of RA training programs, this study summarizes current practices in three types of RA training programs--preservice training, in-service training, and academic courses--and…

  19. Curating research data a handbook of current practice

    CERN Document Server

    Johnston, Lisa R

    2017-01-01

    Curating Research Data, Volume Two: A Handbook of Current Practice guides you across the data lifecycle through the practical strategies and techniques for curating research data in a digital repository setting. The data curation steps for receiving, appraising, selecting, ingesting, transforming, describing, contextualizing, disseminating, and preserving digital research data are each explored, and then supplemented with detailed case studies written by more than forty international practitioners from national, disciplinary, and institutional data repositories. The steps in this volume detail the sequential actions that you might take to curate a data set from receiving the data (Step 1) to eventual reuse (Step 8). Data curators, archivists, research data management specialists, subject librarians, institutional repository managers, and digital library staff will benefit from these current and practical approaches to data curation.

  20. Physician Asthma Management Practices in Canada

    Directory of Open Access Journals (Sweden)

    Robert Jin

    2000-01-01

    Full Text Available OBJECTIVES: To establish national baseline information on asthma management practices of physicians, to compare the reported practices with the Canadian Consensus recommendations and to identify results potentially useful for interventions that improve physician asthma management practices.

  1. Environmental management as situated practice

    DEFF Research Database (Denmark)

    Lippert, Ingmar; Krause, Franz; Hartmann, Niklas Klaus

    2015-01-01

    We propose an analysis of environmental management (EM) as work and as practical activity. This approach enables empirical studies of the diverse ways in which professionals, scientists, NGO staffers, and activists achieve the partial manageability of specific “environments”. In this introduction......, we sketch the debates in Human Geography, Management Studies, and Science and Technology Studies to which this special issue contributes. We identify the limits of understanding EM though the framework of ecological modernisation, and show how political ecology and work-place studies provide...

  2. Environmental management as situated practice

    DEFF Research Database (Denmark)

    Lippert, Ingmar; Krause, Franz; Hartmann, Niklas Klaus

    2015-01-01

    We propose an analysis of environmental management (EM) as work and as practical activity. This approach enables empirical studies of the diverse ways in which professionals, scientists, NGO staffers, and activists achieve the partial manageability of specific “environments”. In this introduction......, we sketch the debates in Human Geography, Management Studies, and Science and Technology Studies to which this special issue contributes. We identify the limits of understanding EM though the framework of ecological modernisation, and show how political ecology and work-place studies provide...

  3. Knowledge management systems in practice

    DEFF Research Database (Denmark)

    Tørning, Kristian

    which has the strategy of working with knowledge in the form of "best practices" meant to boost performance. The thesis explores the situation that workers are in, since they are meant to share and develop "best practices" knowledge in a portal based Knowledge Management System (KMS). The study...... is to directly seek to change the user's behavior, i.e., persuading more knowledge sharing. The main contribution is an indication of an anomaly with regards to the strategic approach towards knowledge management, where knowledge sharing is seen as an effort by which companies can gain a competitive advantage...... by working with knowledge in a structured fashion. The issue is that the descriptions found in literature on strategic knowledge management do not address the many issues uncovered when conducting prolonged fieldwork among workers who engage in the activities that the literature seemingly takes for granted...

  4. Current management of fungal infections.

    NARCIS (Netherlands)

    Meis, J.F.G.M.; Verweij, P.E.

    2001-01-01

    The management of superficial fungal infections differs significantly from the management of systemic fungal infections. Most superficial infections are treated with topical antifungal agents, the choice of agent being determined by the site and extent of the infection and by the causative organism,

  5. E-waste: Environmental Problems and Current Management

    Directory of Open Access Journals (Sweden)

    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.

  6. Multidisciplinary management of clear-cell renal cell carcinoma in Africa and the Middle East: current practice and recommendations for improvement

    Directory of Open Access Journals (Sweden)

    Zekri J

    2015-07-01

    Full Text Available Jamal Zekri,1 Lydia M Dreosti,2 Marwan Ghosn,3 Emad Hamada,4 Mohamed Jaloudi,5 Ola Khorshid,6 Blaha Larbaoui7 1College of Medicine, King Faisal Specialist Hospital and Research Centre, Alfaisal University, Jeddah, Saudi Arabia; 2Department of Medical Oncology, University of Pretoria, Pretoria, South Africa; 3Faculty of Medicine Hematology, Oncology Department, Saint Joseph University, Beirut, Lebanon; 4Faculty of Medicine, Cairo University, Kasr Alainy, Cairo, Egypt; 5Oncology Hematology Department, Tawam Hospital, Al Ain, Abu Dhabi, United Arab Emirates; 6National Cancer Institute, Cairo University, Kasr El Ainy, Cairo, Egypt; 7Oncology Service, Université Djillali Liabés, Sidi Bel Abbés, Algeria Abstract: The management of renal cell carcinoma (RCC has evolved considerably in recent years. This report represents the consensus of 22 relevant medical specialists from Africa and the Middle East region engaged in the management of RCC. Partial or radical nephrectomy is the standard of care for most patients with localized RCC. It is essential that patients are followed up appropriately after surgery to enable local and distant relapses to be identified and treated promptly. The treatment of advanced/metastatic disease has changed dramatically with the introduction of targeted therapies. Follow-up of these patients enables therapy optimization and assessment of response to treatment. There was universal agreement on the importance of management of RCC by a multidisciplinary team supported by a multidisciplinary tumor board. Barriers hindering this approach were identified. These included lack of awareness of the benefits of multidisciplinary team role, poor communication among relevant disciplines, time constraints, and specifics of private practice. Other challenges include shortage of expert specialists as urologists and oncologists and lack of local management guidelines in some countries. Solutions were proposed and discussed. Medical

  7. Revisiting current “barefoot doctors” in border areas of China: system of services, financial issue and clinical practice prior to introducing integrated management of childhood illness (IMCI

    Directory of Open Access Journals (Sweden)

    Li Xiuyun

    2012-08-01

    Full Text Available Abstract Background Under-5-years child mortality remains high in rural China. Integrated management of childhood illness (IMCI was introduced to China in 1998, but only a few rural areas have been included. This study aimed at assessing the current situation of the health system of rural health care and evaluating the clinical competency of village doctors in management of childhood illnesses prior to implementing IMCI programme in remote border rural areas. Methods The study was carried out in the border areas of Puer prefecture of Yunnan province. There were 182 village doctors in the list of the health bureau in these border areas. Of these, 154 (84.6% were recruited into the study. The local health system components were investigated using a qualitative approach and analyzed with triangulation of information from different sources. The clinical component was assessed objectively and quantitatively presented using descriptive statistics. Results The study found that the New Rural Cooperative Medical Scheme (NRCMS coordinated the health insurance system and the provider service through 3 tiers: village doctor, township and county hospitals. The 30 RMB per person per year premium did not cover the referral cost, and thereby decreased the number of referrals. In contrast to available treatment facilities and drug supply, the level of basic medical education of village doctors and township doctors was low. Discontent among village doctors was common, especially concerning low rates of return from the service, exceptions being procedures such as injections, which in fact may create moral hazards to the patients. Direct observation on the assessment and management of paediatric patients by village doctors revealed inadequate history taking and physical examination, inability to detect potentially serious complications, overprescription of injection and antibiotics, and underprescription of oral rehydration salts and poor quality of counseling

  8. Current management options for tyrosinemia

    Directory of Open Access Journals (Sweden)

    El-Shabrawi MH

    2013-03-01

    Full Text Available Mortada Hassan El-Shabrawi, Naglaa Mohamed KamalPediatric Hepatology, Faculty of Medicine, Cairo University, Cairo, EgyptAbstract: Hypertyrosinemia is observed in three inherited disorders of tyrosine metabolism. Hereditary Tyrosinemia Type I (HTT-I, or hepatorenal tyrosinemia, is an autosomal recessive disorder caused by mutation in the fumarylacetoacetate hydrolase (FAH gene. HTT-I is associated with severe involvement of the liver, kidneys, and central nervous system, and is due to toxic accumulation of metabolites of tyrosine, such as succinylacetone. HTT-I is the inborn error with the highest incidence of progression to hepatocellular carcinoma. Elevated succinylacetone, in dried filter paper blood samples, or in plasma or urine, is pathognomonic and diagnostic for HTT-I and is the most reliable neonatal screening method. Liver transplantation is the definitive management, but the need for this is markedly decreased by the combined dietary and drug management. A diet low in tyrosine and phenylalanine, plus nitisinone (2-[2-nitro-4-trifluoromethylbenzoyl]-1,3-cyclohexanedione (NCTB are considered the gold standard management options. Carnitine and 1,25-OH-vitamin D are adjuvant therapy. Strict follow up with succinylacetone level for monitoring of treatment should be done. Abdominal ultrasonography and abdominal computerized tomography scan or magnetic resonance imaging should also be done for surveillance of the possible development of hepatocellular carcinoma.Keywords: tyrosinemia, management, NTBC, hepatocellular carcinoma

  9. IMPROVING SITE MANAGEMENT PRACTICES IN THE NIGERIAN ...

    African Journals Online (AJOL)

    Osondu

    technological methods adopted and huge consumption of ... challenging engineering and management problems that occur on .... Communication: Formal lines of communication ..... practices through knowledge management,. Construction.

  10. Toolkit - South Africa's good waste management practices: lessons learned

    CSIR Research Space (South Africa)

    Afrika, M

    2010-02-01

    Full Text Available practices are to be found. This paper reports on the development of a Toolkit for municipal waste management service delivery, based on some of the good waste management practices currently implemented in different municipalities across all the categories...

  11. Current management of wound healing

    DEFF Research Database (Denmark)

    Gottrup, F; Karlsmark, T

    2009-01-01

    in the next decade. It is the hope that increasing parts of the new knowledge from basic wound healing research will be implemented in daily clinical practice. The development of new treatment products will also continue, and especially new technologies with combined types of dressing materials or dressing......While the understanding of wound pathophysiology has progressed considerably over the past decades the improvements in clinical treatment has occurred to a minor degree. During the last years, however, new trends and initiatives have been launched, and we will continue to attain new information...

  12. The Role of Management Practices in Closing the Productivity Gap

    CERN Document Server

    Siebers, Peer-Olaf; Battisti, Giuliana; Celia, Helen; Clegg, Christopher; Fu, Xu; De Hoyos, Raphael; Iona, Alfonsiana; Petrescu, Alina; Adriano, Peixoto

    2008-01-01

    There is no doubt that management practices are linked to the productivity and performance of a company. However, research findings are mixed. This paper provides a multi-disciplinary review of the current evidence of such a relationship and offers suggestions for further exploration. We provide an extensive review of the literature in terms of research findings from studies that have been trying to measure and understand the impact that individual management practices and clusters of management practices have on productivity at different levels of analysis. We focus our review on Operations Management (om) and Human Resource Management (hrm) practices as well as joint applications of these practices. In conclusion, we can say that taken as a whole, the research findings are equivocal. Some studies have found a positive relationship between the adoption of management practices and productivity, some negative and some no association whatsoever. We believe that the lack of universal consensus on the effect of t...

  13. Managing Hypertriglyceridemia in Daily Practice

    Directory of Open Access Journals (Sweden)

    Laurentius A Pramono

    2015-07-01

    Full Text Available Hypertriglyceridemia is a form of dyslipidemia, which usually occurs in combination with hypercholesterolemia, high-LDL or low-HDL cholesterol level. Most studies suggest that hypertriglyceridemia is associated with many metabolic disorders such as metabolic syndrome, diabetes, obesity, and also cardio-cerebrovascular diseases. Treatment of  hypertriglyceridemia is often not comprehensively addressed by many physicians, who usually only include prescribing drugs without encouraging patients to perform physical activity, to take a true healthy diet for dyslipidemia and to stop smoking. This review article discusses evaluation, diagnosis and a comprehensive, yet simple management of hypertriglyceridemia, which can be easily pplied in daily clinical practice. Key words: hypertriglyceridemia, dyslipidemia, management, clinical guidelines.

  14. Managing Hypertriglyceridemia in Daily Practice.

    Science.gov (United States)

    Pramono, Laurentius A; Harbuwono, Dante S

    2015-07-01

    Hypertriglyceridemia is a form of dyslipidemia, which usually occurs in combination with hypercholesterolemia, high-LDL or low-HDL cholesterol level. Most studies suggest that hypertriglyceridemia is associated with many metabolic disorders such as metabolic syndrome, diabetes, obesity, and also cardio-cerebrovascular diseases. Treatment of hypertriglyceridemia is often not comprehensively addressed by many physicians, who usually only include prescribing drugs without encouraging patients to perform physical activity, to take a true healthy diet for dyslipidemia and to stop smoking. This review article discusses evaluation, diagnosis and a comprehensive, yet simple management of hypertriglyceridemia, which can be easily applied in daily clinical practice.

  15. Orofacial pain management: current perspectives.

    Science.gov (United States)

    Romero-Reyes, Marcela; Uyanik, James M

    2014-01-01

    Some of the most prevalent and debilitating pain conditions arise from the structures innervated by the trigeminal system (head, face, masticatory musculature, temporomandibular joint and associated structures). Orofacial pain (OFP) can arise from different regions and etiologies. Temporomandibular disorders (TMD) are the most prevalent orofacial pain conditions for which patients seek treatment. Temporomandibular disorders include a number of clinical problems that involve the masticatory musculature, the temporomandibular joint (TMJ) or both. Trigeminal neuropathic pain conditions can arise from injury secondary to dental procedures, infection, neoplasias, or disease or dysfunction of the peripheral and/or central nervous system. Neurovascular disorders, such as primary headaches, can present as chronic orofacial pain, such as in the case of facial migraine, where the pain is localized in the second and third division of the trigeminal nerve. Together, these disorders of the trigeminal system impact the quality of life of the sufferer dramatically. A multidisciplinary pain management approach should be considered for the optimal treatment of orofacial pain disorders including both non-pharmacological and pharmacological modalities.

  16. Orofacial pain management: current perspectives

    Science.gov (United States)

    Romero-Reyes, Marcela; Uyanik, James M

    2014-01-01

    Some of the most prevalent and debilitating pain conditions arise from the structures innervated by the trigeminal system (head, face, masticatory musculature, temporomandibular joint and associated structures). Orofacial pain (OFP) can arise from different regions and etiologies. Temporomandibular disorders (TMD) are the most prevalent orofacial pain conditions for which patients seek treatment. Temporomandibular disorders include a number of clinical problems that involve the masticatory musculature, the temporomandibular joint (TMJ) or both. Trigeminal neuropathic pain conditions can arise from injury secondary to dental procedures, infection, neoplasias, or disease or dysfunction of the peripheral and/or central nervous system. Neurovascular disorders, such as primary headaches, can present as chronic orofacial pain, such as in the case of facial migraine, where the pain is localized in the second and third division of the trigeminal nerve. Together, these disorders of the trigeminal system impact the quality of life of the sufferer dramatically. A multidisciplinary pain management approach should be considered for the optimal treatment of orofacial pain disorders including both non-pharmacological and pharmacological modalities. PMID:24591846

  17. Orofacial pain management: current perspectives

    Directory of Open Access Journals (Sweden)

    Romero-Reyes M

    2014-02-01

    Full Text Available Marcela Romero-Reyes, James M Uyanik Orofacial and Head Pain Service, Department of Oral and Maxillofacial Pathology Radiology and Medicine, New York University College of Dentistry, New York, NY, USA Abstract: Some of the most prevalent and debilitating pain conditions arise from the structures innervated by the trigeminal system (head, face, masticatory musculature, temporomandibular joint and associated structures. Orofacial pain (OFP can arise from different regions and etiologies. Temporomandibular disorders (TMD are the most prevalent orofacial pain conditions for which patients seek treatment. Temporomandibular disorders include a number of clinical problems that involve the masticatory musculature, the temporomandibular joint (TMJ or both. Trigeminal neuropathic pain conditions can arise from injury secondary to dental procedures, infection, neoplasias, or disease or dysfunction of the peripheral and/or central nervous system. Neurovascular disorders, such as primary headaches, can present as chronic orofacial pain, such as in the case of facial migraine, where the pain is localized in the second and third division of the trigeminal nerve. Together, these disorders of the trigeminal system impact the quality of life of the sufferer dramatically. A multidisciplinary pain management approach should be considered for the optimal treatment of orofacial pain disorders including both non-pharmacological and pharmacological modalities. Keywords: pain, orofacial, neuropathic, TMD, trigeminal, headache

  18. Massive transfusion protocols: current best practice

    Directory of Open Access Journals (Sweden)

    Hsu YM

    2016-03-01

    Full Text Available Yen-Michael S Hsu,1 Thorsten Haas,2 Melissa M Cushing1 1Department of Pathology and Laboratory Medicine, Weill Cornell Medical College, New York, NY, USA; 2Department of Anesthesia, University Children's Hospital Zurich, Zurich, Switzerland Abstract: Massive transfusion protocols (MTPs are established to provide rapid blood replacement in a setting of severe hemorrhage. Early optimal blood transfusion is essential to sustain organ perfusion and oxygenation. There are many variables to consider when establishing an MTP, and studies have prospectively evaluated different scenarios and patient populations to establish the best practices to attain improved patient outcomes. The establishment and utilization of an optimal MTP is challenging given the ever-changing patient status during resuscitation efforts. Much of the MTP literature comes from the trauma population, due to the fact that massive hemorrhage is the leading cause of preventable trauma-related death. As we come to further understand the positive and negative clinical impacts of transfusion-related factors, massive transfusion practice can be further refined. This article will first discuss specific MTPs targeting different patient populations and current relevant international guidelines. Then, we will examine a wide selection of therapeutic products to support MTPs, including newly available products and the most suitable of the traditional products. Lastly, we will discuss the best design for an MTP, including ratio-based MTPs and MTPs based on the use of point-of-care coagulation diagnostic tools. Keywords: hemorrhage, MTP, antifibrinolytics, coagulopathy, trauma, ratio, logistics, guidelines, hemostatic

  19. Telehealth: current practices and future directions

    Science.gov (United States)

    David, Yadin B.

    1996-02-01

    When we review the positive impact that the integration of ostensibly independent patient-care services have on the efficient management of quality care, education, and collaborative research, it is not surprising that telehealth deployment is on the rise. The forces that drive this phenomenon include: the need to manage the entire disease episode; the desire for wider geographically-distributed quality health care; the escalation of customer expectations; globalization of healthcare and its support services; an increase in patient and provider convenience; and the acceptance of the present technological community. At the Telehealth Center at the Texas Children's Hospital, current classifications of clinical applications are listed: (1) initial urgent evaluation of patients, (2) triage decisions and pretransfer arrangements, (3) medical and surgical follow-up and medication review, (4) consultation for primary care encounters, (5) real-time subspecialty care consultation and planning, (6) management of chronic diseases and conditions, (7) extended diagnostic work-ups, (8) review of diagnostic images, and (9) preventive medicine and patient education. The delivery of such services is associated with challenges and opportunities. As we move forward from limited data processing to an integrated communication system, from centralized main frame functions to personalized and location-independent workstations, and from hospitals to clinics and homecare, an increase in the minimum features provided by the equipment and the communication systems must accompany the widening variety of clinical applications. Future expansion of telehealth systems stands to revolutionize the delivery of services to the benefits of providers' networks, our economy, and patients through integration.

  20. Current practice of gastric cancer treatment

    Institute of Scientific and Technical Information of China (English)

    Yoon Young Choi; Ji Yeong An; Hyung-Il Kim; Jae-Ho Cheong; Woo Jin Hyung; Sung Hoon Noh

    2014-01-01

    Objective The aim of this review was to overview the current practice of gastric cancer treatment including surgery and other adjuvant modalities.Data sources The review was based on data obtained from the published articles and main guidelines in the East and West.Study selection Articles with high level of evidence or current best evidence in each issue were selected to be reviewed.Results Although varied adjuvant modalities have been proved to be benefit for treating gastric cancer,surgery is still the most important treatment strategy against gastric cancer.Actively adapting to new technology is important but it should be balanced with an effort to establish sound scientific rationale that adheres to oncologic principles.Conclusions Future treatment of gastric cancer will be focused on tailored,personalized therapy.For achieving it,collaboration across disciplines is essential.Also the philosophy of caring for the patients with gastric cancer should be rooted in the realization of true patient benefit regardless of who is providing the care.With these philosophies,we can shift the scientific and technological advances toward triumph over gastric cancer.

  1. CURRENT AND FUTURE USE OF MANAGEMENT TOOLS

    National Research Council Canada - National Science Library

    Zlatko Nedelko; Vojko Pototcan; Marina Dabic

    2015-01-01

    .... The authors developed and tested a model for predicting the future use of management tools based on the current use of tools by employees in organizations, underlying assumptions of the theory...

  2. Urine drug testing: current recommendations and best practices.

    Science.gov (United States)

    Owen, Graves T; Burton, Allen W; Schade, Cristy M; Passik, Steve

    2012-07-01

    The precise role of urine drug testing (UDT) in the practice of pain medicine is currently being defined. Confusion exists as to best practices, and even to what constitutes standard of care. A member survey by our state pain society revealed variability in practice and a lack of consensus. The authors sought to further clarify the importance of routine UDT as an important part of an overall treatment plan that includes chronic opioid prescribing. Further, we wish to clarify best practices based on consensus and data where available. A 20-item membership survey was sent to Texas Pain Society members. A group of chronic pain experts from the Texas Pain Society undertook an effort to review the best practices in the literature. The rationale for current UDT practices is clarified, with risk management strategies outlined, and recommendations for UDT outlined in detail. A detailed insight into the limitations of point-of-care (enzyme-linked immunosorbent assay, test cups, test strips) versus the more sensitive and specific laboratory methods is provided. Our membership survey was of a limited sample size in one geographic area in the United States and may not represent national patterns. Finally, there is limited data as to the efficacy of UDT practices in improving compliance and curtailing overall medication misuse. UDT must be done routinely as part of an overall best practice program in order to prescribe chronic opioid therapy. This program may include risk stratification; baseline and periodic UDT; behavioral monitoring; and prescription monitoring programs as the best available tools to monitor chronic opioid compliance.

  3. Principles and practices of sustainable water management

    Institute of Scientific and Technical Information of China (English)

    Bixia Xu

    2010-01-01

    Literature related to sustainable water management is reviewed to illustrate the relationship among water management, sustainability (sustainable development), and sustainable water management. This review begins with the explanation on the definition of sustainable water management, followed by a discussion of sustainable water management principles and practices.

  4. Business and Practice Management Knowledge Deficiencies in Graduating Orthopedic Residents.

    Science.gov (United States)

    Miller, D Joshua; Throckmorton, Thomas W; Azar, Frederick M; Beaty, James H; Canale, S Terry; Richardson, David R

    2015-10-01

    We conducted a study to determine the general level of knowledge that orthopedic residents have on business and practice management topics at graduation and to evaluate the level of knowledge that practicing orthopedic surgeons need in order to function effectively in a medical practice. Residency graduates from a single training program were asked to complete a survey that gathered demographic information and had surgeons rate their understanding of 9 general business and practice management skills and the importance of these skills in their current practice situation. The amount of necessary business knowledge they lacked at graduation was defined as a functional knowledge deficiency (FKD) and was calculated as the difference between the reported importance of a topic in current practice and the level of understanding of that topic at graduation (larger FKD indicates greater deficiency). Those in physician-managed practices reported significantly higher levels of understanding of economic analytical tools than those in nonphysician-managed practices. There were no other statistically significant differences among groups. Hospital-employed physicians had the lowest overall FKD (4.0), followed by those in academic practices (5.1) and private practices (5.9). Graduating orthopedic surgeons appear to be inadequately prepared to effectively manage business issues in their practices, as evidenced by the low overall knowledge levels and high FKDs.

  5. Fundamentals of Value Based Management in practice of Quality management

    Directory of Open Access Journals (Sweden)

    Katarzyna Szczepańska

    2010-03-01

    Full Text Available The article discusses the practical aspects of using the theory of value management in quality management. Presents the essence of value based management (VBM as a background of reflection on its links with quality management. Coherence of the concept in practice, been reviewed in the author’s own studies. The discovery of absence of sufficient procedural structure of the metrics of an economic – financial, to measure the value of the quality management system, points to a gap between the theoretical and practical considerations in managing the value of the company quality management system.  

  6. Module Technology: Current Practice and Issues (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Wohlgemuth, J.

    2010-10-05

    PV modules must provide mechanical support for the cells, protect the world from the voltages inside, protect the cells, diodes and interconnects from the weather outside, couple as much light as possible into the PV cells and minimize the temperature increase of the cells. The package must continue to serve these functions for at least 25 years as that is the typical module warranty period today. Furthermore the package must do all this for as low a cost as possible since the key to large scale PV growth is a reduction in cost while retaining excellent module reliability and durability. This paper will review current module construction practices for both crystalline silicon and thin film PV with emphasis on explaining why the present designs and materials have been selected. Possible long term issues with today's designs and materials will be discussed. Several proposed solutions to these issues will be presented, highlighting the research efforts that will be necessary in order to verify that they can cost effectively solve the identified issues.

  7. 21 CFR 226.1 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Current good manufacturing practice. 226.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR TYPE A MEDICATED ARTICLES General Provisions § 226.1 Current good manufacturing practice. (a) The criteria in §§ 226.10 through 226.115,...

  8. 21 CFR 225.1 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Current good manufacturing practice. 225.1 Section...) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR MEDICATED FEEDS General Provisions § 225.1 Current good manufacturing practice. (a) Section 501(a)(2)(B) of the Federal Food, Drug, and Cosmetic...

  9. 21 CFR 110.5 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 110.5 Section...) FOOD FOR HUMAN CONSUMPTION CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PACKING, OR HOLDING HUMAN FOOD General Provisions § 110.5 Current good manufacturing practice. (a) The criteria...

  10. Workplace road safety risk management: An investigation into Australian practices.

    Science.gov (United States)

    Warmerdam, Amanda; Newnam, Sharon; Sheppard, Dianne; Griffin, Mark; Stevenson, Mark

    2017-01-01

    In Australia, more than 30% of the traffic volume can be attributed to work-related vehicles. Although work-related driver safety has been given increasing attention in the scientific literature, it is uncertain how well this knowledge has been translated into practice in industry. It is also unclear how current practice in industry can inform scientific knowledge. The aim of the research was to use a benchmarking tool developed by the National Road Safety Partnership Program to assess industry maturity in relation to risk management practices. A total of 83 managers from a range of small, medium and large organisations were recruited through the Victorian Work Authority. Semi-structured interviews aimed at eliciting information on current organisational practices, as well as policy and procedures around work-related driving were conducted and the data mapped onto the benchmarking tool. Overall, the results demonstrated varying levels of maturity of risk management practices across organisations, highlighting the need to build accountability within organisations, improve communication practices, improve journey management, reduce vehicle-related risk, improve driver competency through an effective workplace road safety management program and review organisational incident and infringement management. The findings of the study have important implications for industry and highlight the need to review current risk management practices.

  11. Pain Assessment of Elderly Patients with Cognitive Impairment in the Emergency Department: Implications for Pain Management-A Narrative Review of Current Practices.

    Science.gov (United States)

    Jones, Joshua; Sim, Tin Fei; Hughes, Jeff

    2017-06-01

    Elderly people are susceptible to both falls and cognitive impairment making them a particularly vulnerable group of patients when it comes to pain assessment and management in the emergency department (ED). Pain assessment is often difficult in patients who present to the ED with a cognitive impairment as they are frequently unable to self-report their level of pain, which can have a negative impact on pain management. This paper aims to review how cognitive impairment influences pain assessment in elderly adults who present to the ED with an injury due to a fall. A literature search of EMBASE, ProQuest, PubMed, Science Direct, SciFinder and the Curtin University Library database was conducted using keyword searches to generate lists of articles which were then screened for relevance by title and then abstract to give a final list of articles for full-text review. Further articles were identified by snowballing from the reference lists of the full-text articles. The literature reports that ED staff commonly use visual or verbal analogue scales to assess pain, but resort to their own intuition or physiological parameters rather than using standardised observational pain assessment tools when self-report of pain is not attainable due to cognitive impairment. While studies have found that the use of pain assessment tools improves the recognition and management of pain, pain scores are often not recorded for elderly patients with a cognitive impairment in the ED, leading to poorer pain management in this patient group in terms of time to analgesic administration and the use of strong opioids. All healthcare professionals involved in the care of such patients, including pharmacists, need to be aware of this and strive to ensure analgesic use is guided by appropriate and accurate pain assessment in the ED.

  12. Sustainability in facilities management: an overview of current research

    DEFF Research Database (Denmark)

    Nielsen, Susanne Balslev; Sarasoja, Anna-Liisa; Ramskov Galamba, Kirsten

    2016-01-01

    the emerging sub-discipline of sustainable facilities management (SFM) on research, an overview of current studies is needed. The purpose of this literature review is to provide exactly this overview. Design/methodology/approach: This article identifies and examines current research studies on SFM through...... indicated that the current research varies in focus, methodology and application of theory, and it was concluded that the current research primary addresses environmental sustainability, whereas the current research which takes an integrated strategic approach to SFM is limited. The article includes lists...... of reviewed journals and articles to support the further development of SFM in research and practice. Research limitations/implications: The literature review includes literature from 2007 to 2012, to manage the analytical process within the project period. However, with the current categorisation...

  13. Problem and Preferred Management Practices Identification Workshop

    Energy Technology Data Exchange (ETDEWEB)

    Patchen, Douglas G.

    2003-03-10

    The goals for this workshop were: to introduce key players in the Appalachian basin oil industry to DOE's new Preferred Upstream Management Practices (PUMP) program; to explain the various elements of our two-year project in detail; to transfer technology through a series of short, invited talks; to identify technical problems and best management practices; and to recruit members for our Preferred Management Practices (PMP) Council.

  14. Outcome of a new patient pathway for managing B3 breast lesions by vacuum-assisted biopsy: time to change current UK practice?

    Science.gov (United States)

    Strachan, C; Horgan, K; Millican-Slater, R A; Shaaban, A M; Sharma, N

    2016-03-01

    B3 lesions of the breast represent a difficult management dilemma. The umbrella term 'B3' incorporates lesions with little associated malignancy risk as well as lesions with significant risk of concurrent neoplasia. Diagnosis of B3 lesions in screening populations is largely made on needle core biopsy, which provides little tissue to adequately diagnose pathologically diverse lesions. The advent of vacuum-assisted biopsy (VAB) provides the multidisciplinary team with a more representative pathology sample to direct management. In this unit, in 2009, a pathway to guide management of B3 lesions detected on needle core biopsy in screening patients was implemented to assess whether VAB was a safe and viable alternative to surgery in selected cases.Here we present the 5-year follow-up results of this pathway. 398 patients with B3 lesions were suitable for this pathway, of which 321 went on to have second-line VAB. 24% of these patients subsequently required surgery for malignancy or ongoing concerns, and thus 245 avoided surgery being subsequently referred for 5-year mammographic surveillance or back to screening. Median follow-up was 3 years (IQR 2), and no cancers were detected at the original B3 site during follow-up. We have demonstrated here that with large volume tissue sampling for indeterminate lesions of the breast surgery can be safely avoided in selected B3 lesions with and without atypia. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. Implications of Risk Management Practices on Financial ...

    African Journals Online (AJOL)

    Implications of Risk Management Practices on Financial Performance of Sugar ... is that risk management is an integral part of the decision-making process and ... can proactively help in overcoming the possibilities of the business failures.

  16. The Effectiveness of Human Resource Management Practices

    National Research Council Canada - National Science Library

    Eric Ng Chee Hong; Lam Zheng Hao; Ramesh Kumar; Charles Ramendran; Vimala Kadiresan

    2012-01-01

    An effective human resource management practices namely employee empowerment, training and development, appraisal system compensation are the main factor for the success of a firm on employee retention...

  17. Management of Uncomplicated Malaria in Underfives in Private and Public Health Facilities in South-Eastern Nigeria: A Clinical Audit of Current Practices

    Directory of Open Access Journals (Sweden)

    Ekong Udoh

    2013-01-01

    Full Text Available Malaria remains a leading cause of underfive morbidity and mortality in sub-Saharan Africa. Effective case management is a strategy recommended by the World Health Organization for its control. A clinical audit of case management of uncomplicated malaria in underfives in health facilities in Cross River State, Nigeria, was conducted from January to March 2012. Data was extracted from patients’ case records by trained medical personnel using pretested data extraction forms. Of the 463 case records reviewed, age, gender, and weight were reported in 98.1%, 97.3%, and 49.7% of the children, respectively. A history of fever was obtained in 89.6% and a record of temperature in 74.1% of the children. General examination was performed in 203 (43.8% children. Malaria parasite test was requested in 132 (28.5% while Packed cell volume or haemoglobin was requested in 107 (23.1% children. Appropriate dose of Artemisinin Combination Therapy (ACT was instituted in 300 (64.8%, wrong dose in 109 (23.5%, and inappropriate treatment in 41 (8.9%. The utilization of ACTs for treating uncomplicated malaria in the State has improved but clinical assessment of patients and laboratory confirmation of diagnosis are suboptimum.

  18. Best Practices for Managing Organizational Diversity

    Energy Technology Data Exchange (ETDEWEB)

    Kreitz, Patricia; /SLAC

    2007-10-15

    Organizations with increasingly diverse workforces and customer populations face challenges in reaping diversity's benefits while managing its potentially disruptive effects. This article defines workplace diversity and identifies best practices supporting planned and positive diversity management. It explores how academic libraries can apply diversity management best practices and provides a reading list for leaders and human resource managers wishing to optimize their organization's approach to diversity.

  19. Nurse managers describe their practice environments.

    Science.gov (United States)

    Warshawsky, Nora E; Lake, Sharon W; Brandford, Arica

    2013-01-01

    Hospital work environments that support the professional practice of nurses are critical to patient safety. Nurse managers are responsible for creating these professional practice environments for staff nurses, yet little is known about the environments needed to support nurse managers. Domains of nurse managers' practice environment have recently been defined. This is a secondary analysis of 2 cross-sectional studies of organizational characteristics that influence nurse manager practice. Content analysis of the free text comments from 127 nurse managers was used to illustrate the 8 domains of nurse managers' practice environments. Nurse managers valued time spent with their staff; therefore, workloads must permit meaningful interaction. Directors demonstrated trust when they empowered nurse managers to make decisions. Administrative leaders should build patient safety cultures on the basis of shared accountability and mutual respect among the health care team. The expectations of nurse managers have greatly expanded in the volume and complexity of direct reports, patient care areas, and job functions. The nurse managers in this analysis reported characteristics of their practice environments that limit their role effectiveness and may negatively impact organizational performance. Further research is needed to understand the effects of nurse managers' practice environments on staff and patient outcomes.

  20. Best practice of nurse managers in risk management

    Directory of Open Access Journals (Sweden)

    Veridiana Tavares Costa

    2013-09-01

    Full Text Available OBJECTIVE: to identify the actions, undertaken by nurse managers in a risk management program, considered as best practice. METHOD: a case study undertaken in a private hospital in the south of Brazil. A risk manager and nurse managers working in a risk management program participated in this study. The data was collected between May and September 2011 through analysis of documents, semi-structured interviews and non-participant observation. Based on the triangulation, the data was analyzed through practical measures. RESULTS: educational actions, the critical analysis of the context, and the multiple dimensions of the management were evidenced as best practice. CONCLUSIONS: the broadening of understanding regarding risk management best practice offers further support for nurse managers to achieve excellence in their actions and thus provide safe and quality care.

  1. Best practice of nurse managers in risk management.

    Science.gov (United States)

    Costa, Veridiana Tavares; Meirelles, Betina Hörner Schlindwein; Erdmann, Alacoque Lorenzini

    2013-01-01

    To identify the actions, undertaken by nurse managers in a risk management program, considered as best practice. A case study undertaken in a private hospital in the south of Brazil. A risk manager and nurse managers working in a risk management program participated in this study. The data was collected between May and September 2011 through analysis of documents, semi-structured interviews and non-participant observation. Based on the triangulation, the data was analyzed through practical measures. Educational actions, the critical analysis of the context, and the multiple dimensions of the management were evidenced as best practice. The broadening of understanding regarding risk management best practice offers further support for nurse managers to achieve excellence in their actions and thus provide safe and quality care.

  2. Videoing and ways of seeing management practices

    OpenAIRE

    Mason, Katy

    2015-01-01

    This paper uses social practice theory to explore the potential of video to generate new ‘ways of seeing’ organising and management practices. The ontological assumptions of social practice theory are invoked to suggest how organisational researchers should practice the videoing, analysing and representing of videography-based research. Examples are drawn from visual anthropology, film theory and film studies to show how inserting the camera into ordinary everyday research practices is likely...

  3. RISK MANAGEMENT APPROACHES AND PRACTICES IN IT PROJECTS

    Directory of Open Access Journals (Sweden)

    BRANDAS Claudiu

    2012-07-01

    Full Text Available Risk is identified in project management literature as an important factor influencing IT projects success, and it is relevant for both academic and practitionersn#8217; communities. The paper presents the past and current approaches to risk management in IT projects. The objective of this paper is to compare the different approaches and relate them to existing practices. Project management literature and practice have brought different approaches to risk management, and as a result, many projects ended in failure. We present how risk management is considered in the literature, and we compare the main two approaches: the evaluation approach and the management approach. The contingency approach does not consider risk management to be a specific process as it is an embedded process in the other project management processes. Then, we present the main practices in risk management. The methodology applied is based on documentary study review and analysis of the concepts used by the literature. We analyzed the literature published between 1978 and 2011 from the main journals for IT project management and found out that the essence of project management is risk management. The risk management practices have a considerable influence on stakeholdersn#8217; perception of project success. But, regardless of the chosen approach, a standard method for identifying, assessing, and responding to risks should be included in any project as this influences the outcome of the project.

  4. 21 CFR 129.1 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 129.1 Section... Current good manufacturing practice. The applicable criteria in part 110 of this chapter, as well as the... manufacturing practice to assure that bottled drinking water is safe and that it has been processed,...

  5. Operative Time, Airway Management, Need for Blood Transfusions, and In-Hospital Stay for Bimaxillary, Intranasal, and Osseous Genioplasty Surgery: Current Clinical Practices.

    Science.gov (United States)

    Posnick, Jeffrey C; Choi, Elbert; Chavda, Anish

    2016-03-01

    The purpose of this study was to assess operative time, perioperative airway management, early postoperative cardiopulmonary health, need for blood transfusion, and in-hospital stay associated with simultaneous bimaxillary, intranasal, and osseous genioplasty surgery. The authors executed a retrospective cohort study derived from patients treated by 1 surgeon at a single institution from 2009 through 2014. The sample consisted of a consecutive series of patients with symptomatic chronic obstructed nasal breathing and a dentofacial deformity (DFD). All underwent at least a Le Fort I osteotomy, sagittal ramus osteotomies, septoplasty, inferior turbinate reduction, and osseous genioplasty. For each patient, the design of the osteotomies and the fixation techniques were consistent. The outcome variables included need for blood transfusion, operating time, success of nasotracheal intubation, time and place of extubation, early postoperative cardiopulmonary health, length of in-hospital stay, and need for readmission after surgery. For the 166 patients studied, the average age was 25 years (range, 13 to 65 yr; 87 female patients [52%]). The primary patterns of presenting DFD included long face (43 of 166, 26%), maxillary deficiency (41 of 166, 25%), asymmetric mandibular excess (37 of 166, 22%), short face (28 of 166, 17%), and mandibular deficiency (15 of 166, 9%). Forty-two patients (25%) were confirmed to have symptomatic obstructive sleep apnea. The open wound operating time averaged 2 hours 59 minutes (standard deviation, 32 minutes). Only 3 of the 166 patients (1.8%) received blood transfusions. All patients underwent successful nasotracheal intubation. Ninety-six percent of patients were extubated in the operating room and the remaining 4% were extubated in the recovery room. No patients required reintubation or tracheostomy. One hundred thirty-seven patients (83%) were discharged after a 1- or 2-night in-hospital stay. Twenty-five (15%) required a 3-night stay

  6. Understanding management practices in business incubators

    NARCIS (Netherlands)

    Blok, Vincent; Thijssen, Sander; Pascucci, Stefano

    2017-01-01

    Following the call for process-oriented research on business incubation processes, this paper investigates the process of business incubation (BI) via an understanding of management practices and interactions. Based on a comprehensive literature review and empirical evidence of management practices

  7. Theory and Practice of Marine Regional Management in China

    Institute of Scientific and Technical Information of China (English)

    Shangjie; JI; Qunzhen; QU

    2014-01-01

    With the development of marine economy in coastal provinces and cities,there comes a series of environmental problems. Marine regional management,as a completely new marine management mode,transforms traditional management mode and can protect marine ecosystem. Thus,the marine regional management is feasible and applicable in China. This paper firstly discussed connotation and development of the marine regional management in China and pointed that the marine regional management is integrated management of a certain marine region. Next,it summarized characteristics of the marine regional management at current stage,for example,land-based pollution of trans-geographic system and marine management under regional government cooperative mechanism. Finally,it came up with recommendations including combining theory and practice of the marine regional management,and establishing marine regional management system as soon as possible,to realize benign interaction and sustainable development of marine economy and ecological environment.

  8. Soil Quality Impacts of Current South American Agricultural Practices

    Directory of Open Access Journals (Sweden)

    Ana B. Wingeyer

    2015-02-01

    Full Text Available Increasing global demand for oil seeds and cereals during the past 50 years has caused an expansion in the cultivated areas and resulted in major soil management and crop production changes throughout Bolivia, Paraguay, Uruguay, Argentina and southern Brazil. Unprecedented adoption of no-tillage as well as improved soil fertility and plant genetics have increased yields, but the use of purchased inputs, monocropping i.e., continuous soybean (Glycine max (L. Merr., and marginal land cultivation have also increased. These changes have significantly altered the global food and feed supply role of these countries, but they have also resulted in various levels of soil degradation through wind and water erosion, soil compaction, soil organic matter (SOM depletion, and nutrient losses. Sustainability is dependent upon local interactions between soil, climate, landscape characteristics, and production systems. This review examines the region’s current soil and crop conditions and summarizes several research studies designed to reduce or prevent soil degradation. Although the region has both environmental and soil resources that can sustain current agricultural production levels, increasing population, greater urbanization, and more available income will continue to increase the pressure on South American croplands. A better understanding of regional soil differences and quantifying potential consequences of current production practices on various soil resources is needed to ensure that scientific, educational, and regulatory programs result in land management recommendations that support intensification of agriculture without additional soil degradation or other unintended environmental consequences.

  9. Current and Future Parts Management at NASA

    Science.gov (United States)

    Sampson, Michael J.

    2011-01-01

    This presentation provides a high level view of current and future electronic parts management at NASA. It describes a current perspective of the new human space flight direction that NASA is beginning to take and how that could influence parts management in the future. It provides an overview of current NASA electronic parts policy and how that is implemented at the NASA flight Centers. It also describes some of the technical challenges that lie ahead and suggests approaches for their mitigation. These challenges include: advanced packaging, obsolescence and counterfeits, the global supply chain and Commercial Crew, a new direction by which NASA will utilize commercial launch vehicles to get astronauts to the International Space Station.

  10. Current trends in management of pediatric asthma.

    Science.gov (United States)

    Kercsmar, Carolyn M

    2003-03-01

    Though asthma cannot be cured, it can be effectively controlled with existing treatments. Management strategies for acute and chronic asthma often vary substantially within and among medical facilities and practices, often driven by physician preference and familiarity rather than by data. The use of carefully designed care paths can improve quality of care and decrease management costs of acute asthma in both the emergency department and in-patient setting. Using newer beta agonists and attention to proper inhalation delivery systems may also improve outcomes and patient satisfaction. Assessment-driven care paths can be safely and effectively administered by respiratory therapists and nurses. The major controversies in the management of chronic asthma center on what to do for the patient who fails to respond to low or moderate doses of inhaled corticosteroids. The addition of a long-acting beta agonist or a leukotriene receptor antagonist may be beneficial.

  11. Impoverishment of practice: analysis of effects of economic discourses in home care case management practice.

    Science.gov (United States)

    Ceci, Christine

    2006-03-01

    Home care is a health sector under increasing pressure. Demand is often said to be outstripping capacity, with constant change and retrenchment distinguishing features of the current context. This paper takes a reading of the current conditions of home care using data gathered during a field study of home care case management practices conducted in 2004. As economic discourses become increasingly influential in determining responses to client situations, case managers (and their managers) find themselves with limited capacity to exercise control over their practices. A growing gap between professionally influenced discourses--those presumably intended to guide practice--and organizational priorities creates a dissonance for case managers as the political-ethical dimensions of their practices are displaced by budget "realities." For front-line workers, such displacement cannot be sustained in their face-to-face encounters with clients, leading to a growing sense of frustration and powerlessness among these highly skilled practitioners.

  12. Current clinical practice in atopic dermatitis.

    Science.gov (United States)

    Odedra, Katy Mara

    2014-08-12

    Atopic dermatitis affects both children and adults, and often presents in early life as itchy, dry skin primarily located on the face, trunk and limbs. There is usually a history of family or personal atopic disease and an increased blood level of the allergic antibody immunoglobulin E. The mainstays of treatment are emollients and corticosteroid ointments and/or creams. Other therapies include immunomodulators and management of any associated infections. Caring for a patient with atopic dermatitis requires skilled assessment, effective education and the ability to involve and support patients and carers in the management of this condition.

  13. Best Management Practice Fact Sheet. 12, Filtering Practices

    OpenAIRE

    2013-01-01

    This fact sheet is one of a 15-part series on urban stormwater management practices. This fact sheet discusses filtering practices, what they are, where they are used, how they work, maintenance, limitations, performance, expected costs and includes a glossary of terms.

  14. Best practice of nurse managers in risk management

    OpenAIRE

    2013-01-01

    OBJECTIVE: to identify the actions, undertaken by nurse managers in a risk management program, considered as best practice. METHOD: a case study undertaken in a private hospital in the south of Brazil. A risk manager and nurse managers working in a risk management program participated in this study. The data was collected between May and September 2011 through analysis of documents, semi-structured interviews and non-participant observation. Based on the triangulation, the data was analy...

  15. The Impact of Knowledge Management Capability, Organizational Learning, and Supply Chain Management Practices on Organizational Performance

    Directory of Open Access Journals (Sweden)

    Ingy Essam Eldin Salama

    2017-03-01

    Full Text Available The focus of this research is developing and examining a conceptual framework relating resource-based organizational capabilities and inter-organizational practices with organizational performance. Specifically, it investigates the relationship between knowledge management capability, organizational learning, supply chain management practices and organizational performance. Such a study is important as it contributes to the growing body of literature that links organizational capabilities and practices with organizational performance. In addition, it also contributes to empirical knowledge by applying the proposed conceptual framework in the Egyptian context, which is currently under-researched. The research approach adopted in this research includes empirical examination of the hypothesized relationships among research variables applied on 63 factories with more than 100 employees located at New Borg Al-Arab industrial city using self-administrated questionnaires. The findings of this research provide evidence that knowledge management capability has an impact on organizational learning as well as on supply chain management practices. However, none of the research variables; i.e. knowledge management capability, organizational learning and supply chain management practices have an impact on organizational performance. The main conclusion drawn from this study is that knowledge management capability may be useful to managers for predicting organizational learning and coordinating supply chain management practices between supply chain members. In addition, it could be concluded that organizational performance, in the factories under study, is affected by variables other than knowledge management capability, organizational learning and supply chain management practices.

  16. Microalgal bioremediation : Current practices and perspectives

    OpenAIRE

    BISWAJIT RATH

    2011-01-01

    During last two decades, extensive attention has been paid on the management of environmental pollution caused by hazardous materials. A number of methods has been developed for removal of such substances like precipitation, evaporation, ion-exchange etc. However these methods have several disadvantages. This review highlights the alternative biological agent abundantly present in nature i.e Microalgae as a potential sink for removal of such toxic substances from the surrounding. Microalgal b...

  17. Evaluating Water Management Practice for Sustainable Mining

    Directory of Open Access Journals (Sweden)

    Xiangfeng Zhang

    2014-02-01

    Full Text Available To move towards sustainable development, the mining industry needs to identify better mine water management practices for reducing raw water use, increasing water use efficiency, and eliminating environmental impacts in a precondition of securing mining production. However, the selection of optimal mine water management practices is technically challenging due to the lack of scientific tools to comprehensively evaluate management options against a set of conflicting criteria. This work has provided a solution to aid the identification of more sustainable mine water management practices. The solution includes a conceptual framework for forming a decision hierarchy; an evaluation method for assessing mine water management practices; and a sensitivity analysis in view of different preferences of stakeholders or managers. The solution is applied to a case study of the evaluation of sustainable water management practices in 16 mines located in the Bowen Basin in Queensland, Australia. The evaluation results illustrate the usefulness of the proposed solution. A sensitivity analysis is performed according to preference weights of stakeholders or managers. Some measures are provided for assessing sensitivity of strategy ranking outcomes if the weight of an indicator changes. Finally, some advice is given to improve the mine water management in some mines.

  18. Endocrinopathies: The current and changing perspectives in anesthesia practice

    Directory of Open Access Journals (Sweden)

    Sukhminder Jit Singh Bajwa

    2015-01-01

    Full Text Available The gateways to advancements in medical fields have always been accessed through the coalition between various specialties. It is almost impossible for any specialty to make rapid strides of its own. However, the understanding of deeper perspectives of each specialty or super specialty is essential to take initiatives for the progress of the other specialty. Endocrinology and anesthesiology are two such examples which have made rapid progress in the last three decades. Somehow the interaction and relationship among these medical streams have been only scarcely studied. Diabetes and thyroid pathophysiologies have been the most researched endocrine disorders so far in anesthesia practice but even their management strategies have undergone significant metamorphosis over the last three decades. As such, anesthesia practice has been influenced vastly by these advancements in endocrinology. However, a comprehensive understanding of the relationship between these two partially related specialties is considered to be an essential cornerstone for further progress in anesthesia and surgical sciences. The current review is an attempt to imbibe the current and the changing perspectives so as to make the understanding of the relationship between these two medical streams a little simple and clearer.

  19. Endocrinopathies: The current and changing perspectives in anesthesia practice

    Science.gov (United States)

    Bajwa, Sukhminder Jit Singh; Kaur, Gurpreet

    2015-01-01

    The gateways to advancements in medical fields have always been accessed through the coalition between various specialties. It is almost impossible for any specialty to make rapid strides of its own. However, the understanding of deeper perspectives of each specialty or super specialty is essential to take initiatives for the progress of the other specialty. Endocrinology and anesthesiology are two such examples which have made rapid progress in the last three decades. Somehow the interaction and relationship among these medical streams have been only scarcely studied. Diabetes and thyroid pathophysiologies have been the most researched endocrine disorders so far in anesthesia practice but even their management strategies have undergone significant metamorphosis over the last three decades. As such, anesthesia practice has been influenced vastly by these advancements in endocrinology. However, a comprehensive understanding of the relationship between these two partially related specialties is considered to be an essential cornerstone for further progress in anesthesia and surgical sciences. The current review is an attempt to imbibe the current and the changing perspectives so as to make the understanding of the relationship between these two medical streams a little simple and clearer. PMID:26180760

  20. Current management strategy of hepatocellular carcinoma

    Institute of Scientific and Technical Information of China (English)

    Bernardino Rampone; Beniamino Schiavone; Antonio Martino; Carmine Viviano; Giuseppe Confuorto

    2009-01-01

    Hepatocellular carcinoma (HCC) still remains a considerable challenge for surgeons. Surgery, including liver transplantation, is the most important therapeutic approach for patients with this disease. HCC is frequently diagnosed at advanced stages and has a poor prognosis with a high mortality rate even when surgical resection has been considered potentially curative. This brief report summarizes the current status of the management of this malignancy and includes a short description of new pharmacological approaches in HCC treatment.

  1. Hospital administrative characteristics and volunteer resource management practices.

    Science.gov (United States)

    Intindola, Melissa; Rogers, Sean; Flinchbaugh, Carol; Della Pietra, Doug

    2016-05-16

    Purpose - The purpose of this paper is to explore the links between various characteristics of hospital administration and the utilization of classes of volunteer resource management (VRM) practices. Design/methodology/approach - This paper uses original data collected via surveys of volunteer directors in 122 hospitals in five Northeastern and Southern US states. Findings - Structural equation modeling results suggest that number of paid volunteer management staff, scope of responsibility of the primary volunteer administrator, and hospital size are positively associated with increased usage of certain VRM practices. Research limitations/implications - First, the authors begin the exploration of VRM antecedents, and encourage others to continue this line of inquiry; and second, the authors assess dimensionality of practices, allowing future researchers to consider whether specific dimensions have a differential impact on key individual and organizational outcomes. Practical implications - Based on the findings of a relationship between administrative characteristics and the on-the-ground execution of VRM practice, a baseline audit comparing current practices to those VRM practices presented here might be useful in determining what next steps may be taken to focus investments in VRM that can ultimately drive practice utilization. Originality/value - The exploration of the dimensionality of volunteer management adds a novel perspective to both the academic study, and practice, of volunteer management. To the authors' knowledge, this is the first empirical categorization of VRM practices.

  2. Benchmarking management practices in Australian public healthcare.

    Science.gov (United States)

    Agarwal, Renu; Green, Roy; Agarwal, Neeru; Randhawa, Krithika

    2016-01-01

    The purpose of this paper is to investigate the quality of management practices of public hospitals in the Australian healthcare system, specifically those in the state-managed health systems of Queensland and New South Wales (NSW). Further, the authors assess the management practices of Queensland and NSW public hospitals jointly and globally benchmark against those in the health systems of seven other countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. In this study, the authors adapt the unique and globally deployed Bloom et al. (2009) survey instrument that uses a "double blind, double scored" methodology and an interview-based scoring grid to measure and internationally benchmark the management practices in Queensland and NSW public hospitals based on 21 management dimensions across four broad areas of management - operations, performance monitoring, targets and people management. The findings reveal the areas of strength and potential areas of improvement in the Queensland and NSW Health hospital management practices when compared with public hospitals in seven countries, namely, USA, UK, Sweden, France, Germany, Italy and Canada. Together, Queensland and NSW Health hospitals perform best in operations management followed by performance monitoring. While target management presents scope for improvement, people management is the sphere where these Australian hospitals lag the most. This paper is of interest to both hospital administrators and health care policy-makers aiming to lift management quality at the hospital level as well as at the institutional level, as a vehicle to consistently deliver sustainable high-quality health services. This study provides the first internationally comparable robust measure of management capability in Australian public hospitals, where hospitals are run independently by the state-run healthcare systems. Additionally, this research study contributes to the empirical evidence base on the quality of

  3. Incident Management: Process into Practice

    Science.gov (United States)

    Isaac, Gayle; Moore, Brian

    2011-01-01

    Tornados, shootings, fires--these are emergencies that require fast action by school district personnel, but they are not the only incidents that require risk management. The authors have introduced the National Incident Management System (NIMS) and the Incident Command System (ICS) and assured that these systems can help educators plan for and…

  4. 21 CFR 113.5 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 113.5 Section 113.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... CONTAINERS General Provisions § 113.5 Current good manufacturing practice. The criteria in §§ 113.10,...

  5. 21 CFR 120.5 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 120.5 Section 120.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... Provisions § 120.5 Current good manufacturing practice. Part 110 of this chapter applies in...

  6. Retention practices in education human resources management ...

    African Journals Online (AJOL)

    The review of retention practices for teachers is premised on the principles of quality ... of business principles and public service management principles based on legal and statutory provision. An increase in customer satisfaction is necessary.

  7. Moving Design from Metaphor to Management Practice

    OpenAIRE

    Jeanne Liedtka; Bidhan Parmar

    2012-01-01

    Despite the centrality of “design” to the field of organizational science, we argue that its use has remained at the level of metaphor rather than practice. Donald Schon’s concept of “reflection in action” addresses this gap by describing how managers can practice designing by generating problem frames as hypotheses, and then testing and refining those hypotheses in the situation. Much of management theory has focused on stable and predictable situations where problem framing is less importan...

  8. Knowledge Management. Synergy between Theory and Practice

    OpenAIRE

    Craciun Bucur Matei

    2011-01-01

    There are, however, not much time, work to provide the reader synergies between theory and practice. The objective of this paper is to bring them closer to the reader the foundation and direction of knowledge management and aspects of it, because later this knowledge to develop the example of Best Practice and to be enhanced. It consists of two models of strategies in relation to the implementation of knowledge management, with special traits, oriented consultancy. The economic areas and the ...

  9. The Role of Top Management in Supply Chain Management Practices

    OpenAIRE

    Sandberg, Erik

    2007-01-01

    Supply chain management (SCM) has been discussed by researchers as well as business practitioners for more than two decades now, but still surprisingly little of this philosophy can be seen in today’s business practices. One important enabler for taking the SCM philosophy from theory into practice that is often mentioned, but not investigated in-depth, is top management support. The role top management plays in a company’s SCM practices could be an important piece of research that is not yet ...

  10. Practice management: observations, issues, and empirical evidence.

    Science.gov (United States)

    Wong, H M; Braithwaite, J

    2001-02-01

    The primary objective of this study is to provide objective, empirical, evidence-based practice management information. This is a hitherto under-researched area of considerable interest for both the practitioner and educator. A questionnaire eliciting a mix of structured and free text responses was administered to a random sample of 480 practitioners who are members of the American Academy of Periodontology. Potential respondents not in private practice were excluded and the next listed person substituted. The results provide demographic and descriptive information about some of the main issues and problems facing practice managers, central to which are information technology (IT), financial, people management, and marketing. Human resource and marketing management appear to represent the biggest challenges. Periodontists running practices would prefer more information, development, and support in dealing with IT, finance, marketing, and people management. The empirical evidence reported here suggests that although tailored educational programs on key management issues at both undergraduate and postgraduate levels have become ubiquitous, nevertheless some respondents seek further training opportunities. Evidence-based practice management information will be invaluable to the clinician considering strategic and marketing planning, and also for those responsible for the design and conduct of predoctoral and postdoctoral programs.

  11. 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.

  12. Sleep bruxism: Current knowledge and contemporary management

    Directory of Open Access Journals (Sweden)

    Adrian U.J. Yap

    2016-01-01

    Full Text Available 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.

  13. Current Diagnosis and Management of Thyroid Nodules

    Directory of Open Access Journals (Sweden)

    Tjokorda Gde Dalem Pemayun

    2016-11-01

    Full Text Available Thyroid nodules are frequently found. Although they are often palpable, many are found incidentally during unrelated radiographic studies. Ten to 15% of thyroid nodules represents thyroid malignancy. Clinician suc as an internist/endocrinologist have to  classify the nodule, stratify the risk of thyroid cancer, performed a diagnostic work-up, provide medical / non-surgical therapy, select candidates for surgery and provide appropriate follow-up that should last a lifetime. This article provide an up-date review of diagnostic approach and management of thyroid nodules, focusing on current algorithm in lights of the most recent published American Thyroid Association thyroid nodule and differentiated thyroid cancer management guidelines.

  14. 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

  15. Best Practices for Managing Organizational Diversity

    Science.gov (United States)

    Kreitz, Patricia A.

    2008-01-01

    Organizations with increasingly diverse workforces and customer populations face challenges in reaping diversity's benefits while managing its potentially disruptive effects. This article defines workplace diversity and identifies best practices supporting planned and positive diversity management. It explores how academic libraries can apply…

  16. Best Practices for Managing Organizational Diversity

    Science.gov (United States)

    Kreitz, Patricia A.

    2008-01-01

    Organizations with increasingly diverse workforces and customer populations face challenges in reaping diversity's benefits while managing its potentially disruptive effects. This article defines workplace diversity and identifies best practices supporting planned and positive diversity management. It explores how academic libraries can apply…

  17. Classroom Management, Bullying, and Teacher Practices

    Science.gov (United States)

    Allen, Kathleen P.

    2010-01-01

    While bullying in schools has begun to receive attention, little is known about the relationship between classroom management and bullying in the classroom. The process for exploring this relationship will be a review of research and literature related to bullying in the school environment, classroom management, teacher practices, and student…

  18. Evidence-Based Practice: Management of Vertigo

    OpenAIRE

    Nguyen-Huynh, Anh T.

    2012-01-01

    The article focuses on the evidence basis for the management of benign paroxysmal positional vertigo (BPPV), the most common diagnosis of vertigo in both primary care and subspecialty settings. Like all articles in this compilation of evidence-based practice, an overview is presented along with evidence based clinical assessment, diagnosis, and management. Summaries of differential diagnosis of vertigo and outcomes are presented.

  19. Blurred Boundaries in Wildlife Management Practices

    NARCIS (Netherlands)

    Boonman-Berson, S.H.

    2016-01-01

    Human-wildlife conflicts have been increasing at alarming rates over the last few decades. Wildlife management practices deal with preventing and disentangling these conflicts. However, which approach should be taken is widely disputed in research, policy, in-the-field-wildlife management and local

  20. Blurred Boundaries in Wildlife Management Practices

    NARCIS (Netherlands)

    Boonman-Berson, S.H.

    2016-01-01

    Human-wildlife conflicts have been increasing at alarming rates over the last few decades. Wildlife management practices deal with preventing and disentangling these conflicts. However, which approach should be taken is widely disputed in research, policy, in-the-field-wildlife management and local

  1. Stadium Alcohol Management: A Best Practices Approach

    Directory of Open Access Journals (Sweden)

    Richard Filce

    2016-03-01

    Full Text Available Sport managers have expressed the concern that the largest threat to fan safety emanates from alcohol overuse. A Turnkey Sports & Entertainment (2009 study asked 1,100 senior sport executives in the United States to rank various threats to fan safety. Alcohol abuse by unruly fans was listed by 62% of respondents, easily outpacing the next highest response of terrorism (18.73%. Previous studies have also identified an increase in violence and criminal activity relating to alcohol consumption at sporting events (Erickson et al., 2011; Menaker & Chaney, 2014. Intoxicated fans have been the source of numerous documented tort claims against vendors and facility owners (Bearman, 1983; Verni, 2006. Despite the known tort liability risk, administrators continue to make decisions without real evidence due to a lack of literature on alcohol policies at sporting events (Oster-Aaland & Neighbors, 2007. This paper will document the problems associated with alcohol consumption at sporting events, review current alcohol policies and barriers to the implementation of stricter policies, and conclude with research-based suggestions for best practices in stadium alcohol management relative to: policy and training, sales and marketing, tailgating, and detection and enforcement.

  2. The problem of current toxic chemicals management.

    Science.gov (United States)

    Tickner, Joel; Geiser, Ken

    2004-01-01

    In this article, we explore the limitations of current chemicals management policies worldwide and the evolution of new European, International and U.S. policies to address the problem of toxic chemicals control. It is becoming increasingly apparent that current chemicals management policies in Europe and the United States are inadequate. There is a general lack of toxicity and exposure information on chemicals in commerce and the vast majority of chemicals were considered safe until proven guilty in legislation. Governments must then prove each chemical is dangerous through a slow and resource-intensive risk assessment process. For more than a decade, Nordic countries, such as Denmark and Sweden, have actively promoted integrated chemicals policies to address contamination of critical waterways. They have successfully used a variety of voluntary and mandatory policy tools, such as education, procurement, lists of chemicals of concern, eco-labeling, research and development on safer substitutes, and chemical phase-out requirements, to encourage companies using chemicals to reduce their reliance on harmful substances and to develop safer substitutes. While previously isolated to particular countries, innovative and exciting European-wide policies to promote sustainable chemicals management are now moving forward, including the recently published draft Registration, Evaluation and Authorization of CHemicals (REACH) policy of the European Union. A sweeping change in chemicals management policies in Europe is inevitable and it will ultimately affect manufacturers in the U.S. and globally. The European movement provides an opportunity to initiate a discussion on integrated chemicals policy in the U.S. where some innovative initiatives already are underway.

  3. 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.

  4. Current Soil Nutrient Status of Intensively Managed Greenhouses

    Institute of Scientific and Technical Information of China (English)

    HU Yun-Cai; SONG Zhi-Wen; LU Wen-Long; C.POSCHENRIEDER; U.SCHMIDHALTER

    2012-01-01

    Nine districts covering the main greenhouse vegetable areas in Tianjin Municipality of the North China Plain were selected for the soil investigation in 2010 to survey the current soil nutrient status (soil available N,P and K),acidification and salinization due to excessive input of fertilizers in greenhouses in Tianjin. The study showed that,in particular,soil available P content increased with the age of greenhouses.In contrast,our results did not reveal higher K accumulation and lowered pH in the greenhouse soils compared with cultivation in open fields.Over-fertilization,causing high NO3- accumulation,most likely resulted in salinity problems in the greenhouses.Ninety percent of the investigated greenhouse soils had electrical conductivity values of saturated paste extracts of 2-10 d S m-1,which might affect the yields of vegetable crops like green bean,pepper,cabbage,carrot,eggplant,lettuce,spinach,celery,cucumber and tomato. The findings of our survey of the current fertility and salinity problems in greenhouse soils suggest that there is an urgent need to improve the farmers' practices and strategies in fertilization management in greenhouses of China.Because education and the agricultural technical extension services may play a more important role in avoiding overuse of fertilizers,we suggest that current nutrient management practices should be improved in the near future through training of local farmers in farmers' schools and through strengthening the agricultural extension services with practical techniques.

  5. Current clinical management of brainstem cavernomas.

    Science.gov (United States)

    Bozinov, Oliver; Hatano, Taketo; Sarnthein, Johannes; Burkhardt, Jan-Karl; Bertalanffy, Helmut

    2010-11-26

    Over the last two decades a favourable course for treated or nontreated brainstem cavernomas has become possible with enhanced diagnostic tools and clinical experience, as well as minimally invasive microsurgical improvements. Currently, brainstem cavernoma can be treated microsurgically with excellent results and an acceptable morbidity rate. The preferred surgical route has progressively shifted from a dorsal to a lateral approach, but this remains dependent on the location of the lesion in the brainstem. Surgical evaluation and management of all cases of this rare disease should be performed by experienced teams from the outset.

  6. Overview of current and alternative slaughter practices

    Directory of Open Access Journals (Sweden)

    Troeger K.

    2004-01-01

    Full Text Available The conventional cattle slaughtering process includes some critical stages where a dissemination of Specified Risk Material (SRM: brain, spinal cord within or onto the carcass and within the slaughterhouse environment can occur. These processes are captive bolt stunning, removal of the head and first of all carcass splitting (sawing the spine lengthways. Captive bolt (CB stunning results in massive brain tissue damage with bleeding, and in some cases brain tissue also emerges from the CB hole. As the heart is still functioning, there is a risk of brain tissue particles being transferred v i a the blood flow to heart and lungs or even in the whole carcass. This contamination risk is actually assessed to be low, but a continuing leakage of Central Nervous System (CNS material from the captive bolt aperture in the further slaughter process may lead to direct and indirect contamination of carcass, meat and equipment. Therefore alternative stunning methods like electrical stunning or concussion stunning are discussed. A further critical point is the treatment of the head. When the head is removed, the spinal cord is cut with a knife. There is a danger of cross contamination due to spinal protein that may adhere to the knife and because of liquid cerebralis, which leaks from the foramen occipitale magnum. Further head cleaning with hand-held hoses following skinning also includes the danger of cross contamination from cleaning water or aerosol. Therefore measures regarding the safe handling of head and harvesting of head meat are proposed. The most critical point in terms of contamination of the meat surface with SRM is the currently common practise of sawing the spine vertically in the middle with hand-guided belt-type saws. A m i x t u r e of sawing residues and rinsing water (“sawing sludge” collects in the housing of the saw, and if it contains infectious material this leads to contamination of the subsequent carcasses. The most promising

  7. Quality management in a radiological practice

    Energy Technology Data Exchange (ETDEWEB)

    Kirsch, Michael, E-mail: kirschm@uni-greifswald.d [Department of Radiology, Universitaetsklinikum Greifswald der Ernst-Moritz-Arndt-Universitaet Greifswald AOR, Ferdinand-Sauerbruch-Strasse, 17487 Greifswald (Germany); Vogg, Ingrid, E-mail: ivmobil2@medimpuls.d [Stapelfelder Strasse 84, 22143 Hamburg (Germany); Hosten, Norbert, E-mail: hosten@uni-greifswald.d [Department of Radiology, Universitaetsklinikum Greifswald der Ernst-Moritz-Arndt-Universitaet Greifswald AOR, Ferdinand-Sauerbruch-Strasse, 17487 Greifswald (Germany); Flessa, Steffen, E-mail: Steffen.Flessa@uni-greifswald.d [General Business Studies and Health Management, Friedrich-Loeffler-Strasse 70, 17487 Greifswald (Germany)

    2010-07-15

    This paper describes the introduction of a total quality management system in a radiological practice. Certification was based on DIN EN ISO 9001:2000. The implementation of the quality management system had to overcome a number of barriers, for instance, legal obligations of a partnership association, leadership problems, and the fear to loose all hindered implementation. The knowledge of these barriers induces a faster and cheaper implementation of a quality management system in a radiological practice as a foundation of improved quality and competitiveness.

  8. Multi-Agent Simulation and Management Practices

    CERN Document Server

    Siebers, Peer-Olaf; Celia, Helen; Clegg, Chris

    2010-01-01

    Intelligent agents offer a new and exciting way of understanding the world of work. Agent-Based Simulation (ABS), one way of using intelligent agents, carries great potential for progressing our understanding of management practices and how they link to retail performance. We have developed simulation models based on research by a multi-disciplinary team of economists, work psychologists and computer scientists. We will discuss our experiences of implementing these concepts working with a well-known retail department store. There is no doubt that management practices are linked to the performance of an organisation (Reynolds et al., 2005; Wall & Wood, 2005). Best practices have been developed, but when it comes down to the actual application of these guidelines considerable ambiguity remains regarding their effectiveness within particular contexts (Siebers et al., forthcoming a). Most Operational Research (OR) methods can only be used as analysis tools once management practices have been implemented. Ofte...

  9. Information management competencies for practicing nurses and new graduates

    Directory of Open Access Journals (Sweden)

    Corina Saratan

    2015-09-01

    Full Text Available Nursing informatics skills are required at all levels of nursing practice. Of those basic skills, management of information through the electronic health record (EHR is paramount. Previous research has explored computer literacy of nurses but has not investigated the competencies that relate specifically to information management. The purpose of this research study was to gather practicing nurses’ views of current information management competencies published by the Technology Informatics Guiding Education Reform (TIGER initiative, as they pertain to new graduates. A convenience sample of members from the InspireNet online user group was surveyed. The results suggest that overall, nurses tend to agree with the information management competencies; however, informatics education is most needed for those who have been practicing nursing for longer, rather than for novice nurses.

  10. Knowledge management (KM) processes in organizations theoretical foundations and practice

    CERN Document Server

    McInerney, Claire R

    2011-01-01

    Knowledge Management (KM) is an effort to increase useful knowledge in the organization. It is a natural outgrowth of late twentieth century movements to make organizational management and operations more effective, of higher quality, and more responsive to constituents in a rapidly changing global environment. This document traces the evolution of KM in organizations, summarizing the most influential research and literature in the field. It also presents an overview of selected common and current practices in knowledge management, including the relationship between knowledge management and de

  11. Social media best practices in emergency management.

    Science.gov (United States)

    Siskey, Ashley; Islam, Tanveer

    2016-01-01

    Social media platforms have become popular as means of communications in emergency management. Many people use social media sites such as Facebook and Twitter on a daily basis including during disaster events. Emergency management agencies (EMAs) need to recognize the value of not only having a presence on social media but also actively engaging stakeholders and the public on these sites. However, identifying best practices for the use of social media in emergency management is still in its infancy. The objective of this article is to begin to create or further define best practices for emergency managers to use social media sites particularly Facebook and Twitter in four key areas: 1) implementation, 2) education, 3) collaboration, and 4) communication. A list of recommendations of best practices is formulated for each key area and results from a nationwide survey on the use of social media by county EMAs are discussed in this article.

  12. Pediatricians' weight assessment and obesity management practices.

    Science.gov (United States)

    Huang, Jeannie S; Donohue, Michael; Golnari, Golnaz; Fernandez, Susan; Walker-Gallego, Edward; Galvan, Kate; Briones, Christina; Tamai, Jennifer; Becerra, Karen

    2009-03-05

    Clinician adherence to obesity screening guidelines from United States health agencies remains suboptimal. This study explored how personal and career demographics influence pediatricians' weight assessment and management practices. A web-based survey was distributed to U.S. pediatricians. Respondents were asked to identify the weight status of photographed children and about their weight assessment and management practices. Associations between career and personal demographic variables and pediatricians' weight perceptions, weight assessment and management practices were evaluated using univariate and multivariate modeling. 3,633 pediatric medical providers correctly identified the weight status of children at a median rate of 58%. The majority of pediatric clinicians were white, female, and of normal weight status with more than 10 years clinical experience. Experienced pediatric medical providers were less likely than younger colleagues to correctly identify the weight status of pictured children and were also less likely to know and use BMI criteria for assessing weight status. General pediatricians were more likely than subspecialty practitioners to provide diverse interventions for weight management. Non-white and Hispanic general practitioners were more likely than counterparts to consider cultural approaches to weight management. Pediatricians' perceptions of children's weight and their weight assessment and management practices are influenced by career and personal characteristics. Objective criteria and clinical guidelines should be uniformly applied by pediatricians to screen for and manage pediatric obesity.

  13. Intimate Partner Violence Risk Assessment and Management:Understanding the Current Practice in Hong Kong%香港亲密伴侣暴力危机评估与控制的实践经验和启示

    Institute of Scientific and Technical Information of China (English)

    王玲; 吴清禄; 蔡兆欣

    2016-01-01

    Through the introduction of the theory and practice of risk assessment and controlof intimate part-ner violence in HKSAR,experience will be offered to the prevention of domestic violence in Mainland China and assist the frontline staff in dealing with cases of intimate partner violence.The main content covers intro-duction of risk assessment definition,categorization and current risk assessment practice in Hong Kong;dis-cuss risk management and mode of cross-professional cooperation and propose advice for optimizing the pro-cedures of handling intimate partner violence cases:first,clarify the disposal and intervention process of government departments regarding cases of intimate partner violence;second,building the information net-work for domestic violence;third,strengthening the risk appraisal and control abilities of frontline workers;fourth,multi-department cooperation to promote support and referral service to violence victims and their children;fifth,offering counseling to abusers to help them stop violence;sixth,police should make out standard procedures for the handling of intimate partner violence;seventh,evaluation of current procedures for domestic violence prevention and treatment and its service quality by the social work academics and pro-posing measures for improvement.%通过介绍中国香港特区危机评估的概念、分类和实务,探讨了危机控制、专业跨界别合作模式等方面的内容,提出完善内地亲密伴侣暴力个案防治工作的建议。一是明确政府职能部门对亲密伴侣暴力事件的处置及介入程序;二是建立家庭暴力信息系统;三是加强一线工作人员危机评估和控制的专业能力;四是多部门协作推进对受暴者及其子女的支援和转介服务;五是对施暴者提供辅导服务,助其停止暴力行为;六是警务人员应制定出处理亲密伴侣暴力的标准程序;七是社会工作学术界对现行的防治家庭暴力程序及服务

  14. Pediatric enteric neuropathies: diagnosis and current management.

    Science.gov (United States)

    Westfal, Maggie L; Goldstein, Allan M

    2017-06-01

    Neurointestinal diseases are increasingly recognized as causes of significant gastrointestinal morbidity in children. This review highlights the most common pediatric enteric neuropathies and their diagnosis and management, emphasizing insights and discoveries from the most recent literature available. The embryologic and histopathologic causes of enteric neuropathies are varied. They range from congenital aganglionosis in Hirschsprung disease, to autoimmune-mediated loss of neuronal subtypes in esophageal achalasia and Chagas disease, to degenerative neuropathies in some cases of chronic intestinal pseudo-obstruction and gastroparesis. Increased awareness of the clinical presentation and diagnostic evaluation of these conditions is essential as it allows for earlier initiation of treatment and improved outcomes. Most current therapies, which include medical management, neurostimulation, and operative intervention, aim to minimize the symptoms caused by these conditions. The evidence base for many of these treatments in children is poor, and multiinstitutional prospective studies are needed. An innovative therapy on the horizon involves using neuronal stem cell transplantation to treat the underlying disorder by replacing the missing or damaged neurons in these diseases. Although recent advances in basic and clinical neurogastroenterology have significantly improved our awareness and understanding of enteric neuropathies, the efficacy of current treatment approaches is limited. The development of novel therapies, including pharmacologic modulators of neurointestinal function, neurostimulation to enhance gut motility, and neuronal cell-based therapies, is essential to improve the long-term outcomes in children with these disorders.

  15. Management of asthma: the current US and European guidelines.

    Science.gov (United States)

    Reddy, Ashwini P; Gupta, Meera R

    2014-01-01

    Asthma management guidelines aim to improve the implementation of current knowledge into daily clinical practice by establishing a consensus of scientific practices for the management of asthma. Initial guidelines were based on consensus of expert opinion in order to employ a severity-based classification system as a guide to treatment. However, advances in asthma research led to the development of evidence-based guidelines and a major paradigm shift to control-based asthma management. Control-based management is central to the published guidelines developed by The National Heart, Lung, and Blood Institute (NHLBI), The Global Initiative for Asthma (GINA), and The British Thoracic Society (BTS), each one using the same volume of evidence but emphasizing aspects particular to their specific patient populations and socioeconomic needs. This chapter summarizes the evolution of these guidelines and summarizes the key points and evidence used in the recommendations for the assessment, monitoring, and management of asthma in all ages, with particular emphasis on the NHLBI guidelines.

  16. Clinical practice guidelines in patient management

    Directory of Open Access Journals (Sweden)

    Santosh Kumar

    2001-01-01

    Full Text Available Efforts have always been made to evolve certain prin-ciples to reduce the variability in the management of patients and make medical care more appropriate. These efforts have become almost a movement since 1980s as evidenced in the development of clinical practice guide-lines in all medical disciplines. This article describes the need for clinical practice guidelines and their de-velopment methods and qualities. Advantages and limi-tations of clinical practice guidelines are enumerated. The salient features of various available clinical prac-tice guidelines in urology are also described.

  17. REVIEW OF CURRENT PRACTICE IN CHARACTERIZATION AND MONITORING

    Energy Technology Data Exchange (ETDEWEB)

    M.A.Ebadian, Ph.D.

    2001-01-01

    Characterization and monitoring are important parts of environmental remediation of contaminated sites by the Department of Energy--Office of Environmental Management (DOE-EM). The actual remediation process often cannot begin or even be planned until characterization is complete. Monitoring is essential to verify the progress of remediation and of the waste stream. However, some contaminated sites are difficult, costly, or have a high exposure risk to personnel to characterize or monitor using the baseline technology or current practice. Therefore, development of new characterization and monitoring technologies is time-critical to remediate these sites. The main task of the Characterization, Monitoring, and Sensor Technology Crosscutting Program (CMST-CP) is to develop and deploy innovative characterization and monitoring technologies that improve performance and reduce personnel exposure, cost, and detection limits. However, to evaluate different proposals for new technologies to decide which ones to develop or deploy, it is necessary to compare their cost and performance to the baseline technology. The goal of this project is to facilitate the direct comparison of new technologies to the baseline technology by documenting the current practices for site characterization and monitoring at DOE sites and by presenting the information in an easy-to-use, concise database. The database will assist the CMST-CP and others in evaluating or designing new technologies by identifying the baseline technologies and describing their performance and cost. The purpose of this document is to report on the completion of this project and to describe the database. Section 2.0 describes the data assessment methodology. Section 3.0 presents the database and serves as a user manual. Section 4.0 lists the references used for each baseline technology in the database. The full references can be found in the Appendix.

  18. Construction quality management principles and good practice

    CERN Document Server

    Watson, Paul

    2011-01-01

    Quality management is essential for facilitating the competitiveness of modern day commercial organizations. Excellence in quality management is a requisite for construction organizations who seek to remain competitive and successful. The challenges presented by competitive construction markets and large projects that are dynamic and complex necessitate the adoption and application of quality management approaches. This textbook is written in line with the ISO 9001:2008 standard and provides a comprehensive evaluation of quality management systems and tools. Their effectiveness in achieving project objectives is explored, as well as applications in corporate performance enhancement. Both the strategic and operational dimensions of quality assurance are addressed by focusing on providing models of best practice. The reader is supported throughout by concise and clear explanations and with self-assessment questions. Practical case study examples show how various evaluative-based quality management systems and t...

  19. 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

  20. 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

  1. Crystallization screening: the influence of history on current practice.

    Science.gov (United States)

    Luft, Joseph R; Newman, Janet; Snell, Edward H

    2014-07-01

    While crystallization historically predates crystallography, it is a critical step for the crystallographic process. The rich history of crystallization and how that history influences current practices is described. The tremendous impact of crystallization screens on the field is discussed.

  2. Teacher's current practices of teaching reading and grade four ...

    African Journals Online (AJOL)

    Teacher's current practices of teaching reading and grade four students' reading ... of teaching reading strategies and assessment in Dona Berber Primary School. ... random sampling technique and an English teacher and a school supervisor ...

  3. Management of infection control in dental practice.

    Science.gov (United States)

    Smith, A; Creanor, S; Hurrell, D; Bagg, J; McCowan, M

    2009-04-01

    This was an observational study in which the management policies and procedures associated with infection control and instrument decontamination were examined in 179 dental surgeries by a team of trained surveyors. Information relating to the management of a wide range of infection control procedures, in particular the decontamination of dental instruments, was collected by interview and by examination of practice documentation. This study found that although the majority of surgeries (70%) claimed to have a management policy on infection control, only 50% of these were documented. For infection control policies, 79% of surgeries had access to the British Dental Association Advice Sheet A12. Infection control policies were claimed to be present in 89% of surgeries, of which 62% were documented. Seventy-seven per cent of staff claimed to have received specific infection control training, but for instrument decontamination this was provided mainly by demonstration (97%) or observed practice (88%). Many dental nurses (74%) and dental practitioners (57%) did not recognise the symbol used to designate a single-use device. Audit of infection control or decontamination activities was undertaken in 11% of surgeries. The majority of surgeries have policies and procedures for the management of infection control in dental practice, but in many instances these are not documented. The training of staff in infection control and its documentation is poorly managed and consideration should be given to development of quality management systems for use in dental practice.

  4. Current Practices in the Delivery of Undergraduate Exercise Physiology Content

    Science.gov (United States)

    Fisher, Michele M.

    2013-01-01

    The purpose of this study was to identify current practices for the delivery of exercise physiology content at the undergraduate level. An anonymous 22-item survey was sent to instructors of exercise physiology to collect information concerning the structure of course offerings and instructional practices. One hundred ten instructors responded to…

  5. 21 CFR 123.5 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 123.5 Section 123.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED... manufacturing practice. (a) Part 110 of this chapter applies in determining whether the facilities,...

  6. A summarized discussion of current good manufacturing practice regulations.

    Science.gov (United States)

    Allen, Loyd V

    2013-01-01

    In light of recent events and discussions of compounding pharmacy, it is important to discuss and understand the purpose of good manufacturing practices. This article provides a summary of the current Good Manufacturing Practice Regulations which were established by the U.S. Food and Drug Administration.

  7. Sustainable practices in medicinal chemistry: current state and future directions.

    Science.gov (United States)

    Bryan, Marian C; Dillon, Barry; Hamann, Lawrence G; Hughes, Gregory J; Kopach, Michael E; Peterson, Emily A; Pourashraf, Mehrnaz; Raheem, Izzat; Richardson, Paul; Richter, Daniel; Sneddon, Helen F

    2013-08-08

    The medicinal chemistry subgroup of the American Chemical Society's Green Chemistry Institute Pharmaceutical Roundtable (ACS GCI PR) offers a perspective on the current state of environmentally sustainable practices in medicinal chemistry with the aim of sharing best practices more widely and highlighting some potential future developments.

  8. Integrative learning for practicing adaptive resource management

    Directory of Open Access Journals (Sweden)

    Craig A. McLoughlin

    2015-03-01

    Full Text Available Adaptive resource management is a learning-by-doing approach to natural resource management. Its effective practice involves the activation, completion, and regeneration of the "adaptive management cycle" while working toward achieving a flexible set of collaboratively identified objectives. This iterative process requires application of single-, double-, and triple-loop learning, to strategically modify inputs, outputs, assumptions, and hypotheses linked to improving policies, management strategies, and actions, along with transforming governance. Obtaining an appropriate balance between these three modes of learning has been difficult to achieve in practice and building capacity in this area can be achieved through an emphasis on reflexive learning, by employing adaptive feedback systems. A heuristic reflexive learning framework for adaptive resource management is presented in this manuscript. It is built on the conceptual pillars of the following: stakeholder driven adaptive feedback systems; strategic adaptive management (SAM; and hierarchy theory. The SAM Reflexive Learning Framework (SRLF emphasizes the types, roles, and transfer of information within a reflexive learning context. Its adaptive feedback systems enhance the facilitation of single-, double-, and triple-loop learning. Focus on the reflexive learning process is further fostered by streamlining objectives within and across all governance levels; incorporating multiple interlinked adaptive management cycles; having learning as an ongoing, nested process; recognizing when and where to employ the three-modes of learning; distinguishing initiating conditions for this learning; and contemplating practitioner mandates for this learning across governance levels. The SRLF is a key enabler for implementing the "adaptive management cycle," and thereby translating the theory of adaptive resource management into practice. It promotes the heuristics of adaptive management within a cohesive

  9. Practice Management Training in the PGY1 Residency Year: Best Practices From Two Nationwide Surveys.

    Science.gov (United States)

    Doligalski, Christina; Verbosky, Michael; Alexander, Earnest; Kotis, Desi; Powell, Michael

    2014-03-01

    The development of future pharmacy leaders is vital to the advancement of our profession. Postgraduate year 1 (PGY1) residency training requires residents to exercise leadership and practice management skills. Two national surveys were conducted to describe the current state of practice management experiences and elucidate best practice recommendations. The surveys, online multiple choice and free response, queried American Society of Health-System Pharmacists (ASHP)-accredited residency program practice management preceptors (survey 1) and PGY1 residents (survey 2) and were distributed via the ASHP residency program directors' listserv. Responses were reviewed and analyzed by members of the University HealthSystem Consortium Pharmacy Council Strategic Initiatives and Programming Committee. Survey 1, completed by 240 institutions, identified that a combination of concentrated and longitudinal practice management experiences were used most frequently (47%), followed by concentrated alone (33%). Universally noted activities included meeting attendance (98%), projects (94%), and committee involvement (92%). Sixty-seven percent of the programs changed the experience in the previous 3 years, with 43% planning changes in the coming year. Survey 2 was completed by 58 PGY1 residents from 42 programs. Most (80%) residents stated they had enough time with their preceptors, and 55% rated their enjoyment of the rotation as 4 or 5 on a 1 to 5 scale (5 = most enjoyed). Our findings suggest that there is not a best practice for the structure or content of the PGY1 practice management experience. These results highlight key recommendations, including the need for practice management-specific preceptor development, incorporation of longitudinal experiences, and more practice management and leadership activities.

  10. Applying Dairy Cow Behavior in Management Practice

    Institute of Scientific and Technical Information of China (English)

    YUAN Kai; LIU Zongping; WANG Zongyuan

    2009-01-01

    Applying dairy cow behavior in management practice is an effective way of improving cow health, welfare and performance. This paper first reviewed daily time budget and normal patterns of dairy cow behavior, and then discussed the influence of major management conditions and practices (such as competitive environments, stocking density, grouping strategies) on cow's feeding, lying and social behavior. Finally, new findings of using feeding behavior to predict disorders in transition period were addressed. It was suggested that dairy researchers and farmers should take advantage of related knowledge of dairy cow behavior to improve dairy cow health and welfare. More research is required to further study dairy cow behavior so as to better apply it in practical management and meet the needs of production.

  11. Management of infantile hemangiomas: Current trends

    Directory of Open Access Journals (Sweden)

    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.

  12. Neutralized current acid waste consolidation management plan

    Energy Technology Data Exchange (ETDEWEB)

    Powell, W.J.; Brown, R.G.; Galbraith, J.; Jensen, C.; Place, D.E.; Reddick, G.W.; Zuroff, W. [Westinghouse Hanford Co., Richland, WA (United States); Brothers, A.J. [Pacific Northwest National Lab., Richland, WA (United States)

    1996-01-01

    The scope of this evaluation is to recommend a management plan for the high-heat tank waste, including neutralized current acid waste (NCAW) in AY and AZ Tank Farms, and tank C-106 waste. The movement of solids, liquids and salt cake in the designated tank farms is included. Decision analysis techniques were used to determine a recommended alternative. The recommended course of action was replacement of a 75-hp mixer pump in tank AY-102 and in-tank concentration of tank AZ-102 supernate. The alternative includes transfer fo tank C-106 sludge to tank AY-102, then transfer to tank AY-102 and tank C-106 sludge to tank AZ-101 using the new 75-hp mixer pump installed in tank AY-102. Tank AZ-101 becomes a storage tank for high-level waste (HLW) sludge, with the capacity to mix and transfer sludge as desired.

  13. Catastrophic antiphospholipid syndrome: The current management approach.

    Science.gov (United States)

    Rodriguez-Pintó, Ignasi; Espinosa, Gerard; Cervera, Ricard

    2016-04-01

    The current recommendation for catastrophic antiphospholipid syndrome (CAPS) management is the standard triple therapy with anticoagulation (AC), glucocorticoids (GCs), plasma exchange (PE), and/or intravenous immunoglobulins (IVIGs). Of note, only AC has a significant effect on the prognosis of these patients. However, from the experimental or basic point of view, there is only indirect evidence to advocate the use of these immunomodulatory therapies (GC, PE, and IVIG) in CAPS. Recently, there have been reports of severe or refractory CAPS patients treated with the monoclonal antibodies rituximab and eculizumab. The first blocks CD20, a surface protein expressed on the cytoplasmic membrane of B cells, and decreases the generation of pathogenic autoantibodies such as antiphospholipid (aPL) antibodies. The second binds with high affinity to C5 complement protein, inhibiting its cleavage and thus preventing the generation of C5b-C9 complex. Copyright © 2016 Elsevier Ltd. All rights reserved.

  14. Current diagnosis and management of achalasia.

    Science.gov (United States)

    Moonen, An; Boeckxstaens, Guy

    2014-07-01

    Achalasia is the best characterized primary esophageal motility disorder of the esophagus and typically presents with absent peristalsis of the esophageal body and a failure of the lower esophageal sphincter to relax upon swallowing on manometry, associated with progressively severe dysphagia, regurgitation, aspiration, chest pain, and weight loss. The diagnosis is suggested by barium swallow and endoscopy, and confirmed by manometry. As there is no curative treatment for achalasia, treatment is confined to disruption of the lower esophageal sphincter to improve bolus passage. Treatment modalities available for this purpose include pneumatic dilation, laparoscopic Heller myotomy and since recently peroral endoscopic myotomy or POEM. In this review, we will discuss the current diagnosis, management, and treatment options of achalasia.

  15. Current management of patients with hepatocellularcarcinoma

    Institute of Scientific and Technical Information of China (English)

    2015-01-01

    The current management therapies for hepatocellularcarcinoma (HCC) patients are discussed in this review.Despite the development of new therapies, HCCremains a "difficult to treat" cancer because HCCtypically occurs in advanced liver disease or hepaticcirrhosis. The progression of multistep and multicentricHCC hampers the prevention of the recurrence of HCC.Many HCC patients are treated with surgical resectionand radiofrequencyablation (RFA), although thesemodalities should be considered in only selected caseswith a certain HCC number and size. Although there is ashortage of grafts, liver transplantation has the highestsurvival rates for HCC. Several modalities are salvagetreatments; however, intensive care in combinationwith other modalities or in combination with surgicalresection or RFA might offer a better prognosis. Sorafenibis useful for patients with advanced HCC. In the nearfuture, HCC treatment will include stronger moleculartargeted drugs, which will have greater potency andfewer adverse events. Further studies will be ongoing.

  16. Current Trends in the Management of Retinoblastoma

    Directory of Open Access Journals (Sweden)

    Hayyam Kıratlı

    2014-09-01

    Full Text Available Retinoblastoma is the most common primary intraocular malignant tumor of early childhood, and 95% of all cases are diagnosed before the age of 5 years. Tumors are evaluated and classified based on laterality, genetic features, the number, location and size of foci. Currently, systemic and intaarterial chemotherapy are the most commonly used management options worldwide. Group A tumors are treated with focal techniques including transpupillary thermotherapy, cryotherapy, or laser photocoagulation. Groups B and C tumors are managed with systemic chemotherapy and focal consolidation techniques. Group D lesions are best treated with systemic chemotherapy, subtenon carboplatin injection or external beam radiotherapy. Alternatively, groups B, C and D tumors can be primarily treated with intraarterial chemotherapy. Intravitreal melphalan injection can be an alternative treatment for eyes with recurrent or persistent vitreous seeding. Group E eyes are often enucleated, however, depending on the fellow eye, systemic or intraarterial chemotherapy may be administered. Systemic chemotherapy is also mandatory if high-risk histopathological features are found after enucleation. (Turk J Ophthalmol 2014; 44: Supplement 22-8

  17. Peripartum cardiomyopathy: current management and future perspectives

    Science.gov (United States)

    Hilfiker-Kleiner, Denise; Haghikia, Arash; Nonhoff, Justus; Bauersachs, Johann

    2015-01-01

    Pregnancy is associated with marked physiological changes challenging the cardiovascular system. Among the more severe pregnancy associated cardiovascular complications, peripartum cardiomyopathy (PPCM) is a potentially life-threatening heart disease emerging towards the end of pregnancy or in the first postpartal months in previously healthy women. A major challenge is to distinguish the peripartum discomforts in healthy women (fatigue, shortness of breath, and oedema) from the pathological symptoms of PPCM. Moreover, pregnancy-related pathologies such as preeclampsia, myocarditis, or underlying genetic disease show overlapping symptoms with PPCM. Difficulties in diagnosis and the discrimination from other pathological conditions in pregnancy may explain why PPCM is still underestimated. Additionally, underlying pathophysiologies are poorly understood, biomarkers are scarce and treatment options in general limited. Experience in long-term prognosis and management including subsequent pregnancies is just beginning to emerge. This review focuses on novel aspects of physiological and pathophysiological changes of the maternal cardiovascular system by comparing normal conditions, hypertensive complications, genetic aspects, and infectious disease in PPCM-pregnancies. It also presents clinical and basic science data on the current state of knowledge on PPCM and brings them in context thereby highlighting promising new insights in diagnostic tools and therapeutic approaches and management. PMID:25636745

  18. Intrahepatic cholangiocarcinoma: current management and emerging therapies.

    Science.gov (United States)

    Rahnemai-Azar, Amir A; Weisbrod, Allison B; Dillhoff, Mary; Schmidt, Carl; Pawlik, Timothy M

    2017-05-01

    Intrahepatic cholangiocarcinoma (iCCA) is a malignancy with an increasing incidence and a high-case fatality. While surgery offers the best hope at long-term survival, only one-third of tumors are amenable to surgical resection at the time of the diagnosis. Unfortunately, conventional chemotherapy offers limited survival benefit in the management of unresectable or metastatic disease. Recent advances in understanding the molecular pathogenesis of iCCA and the use of next-generation sequencing techniques have provided a chance to identify 'target-able' molecular aberrations. These novel molecular therapies offer the promise to personalize therapy for patients with iCCA and, in turn, improve the outcomes of patients. Area covered: We herein review the current management options for iCCA with a focus on defining both established and emerging therapies. Expert commentary: Surgical resection remains as an only hope for cure in iCCA patients. However, frequently the diagnosis is delayed till advanced stages when surgery cannot be offered; signifying the urge for specific diagnostic tumor biomarkers and targeted therapies. New advances in genomic profiling have contributed to a better understanding of the landscape of molecular alterations in iCCA and offer hope for the development of novel diagnostic biomarkers and targeted therapies.

  19. Current management of obsessive and phobic states.

    Science.gov (United States)

    Goljevscek, Serena; Carvalho, Livia A

    2011-01-01

    Obsessional states show an average point prevalence of 1%-3% and a lifetime prevalence of 2%-2.5%. Most treatment-seeking patients with obsessions continue to experience significant symptoms after 2 years of prospective follow-up. A significant burden of impairment, distress, and comorbidity characterize the course of the illness, leading to an increased need for a better understanding of the nature and management of this condition. This review aims to give a representation of the current pharmacological and psychotherapeutic strategies used in the treatment of obsessive-compulsive disorder. Antidepressants (clomipramine and selective serotonin reuptake inhibitors) are generally the first-line choice used to handle obsessional states, showing good response rates and long-term positive outcomes. About 40% of patients fail to respond to selective serotonin reuptake inhibitors. So far, additional pharmacological treatment strategies have been shown to be effective, ie, administration of high doses of selective serotonin reuptake inhibitors, as well as combinations of different drugs, such as dopamine antagonists, are considered efficacious and well tolerated strategies in terms of symptom remission and side effects. Psychotherapy also plays an important role in the management of obsessive-compulsive disorder, being effective for a wide range of symptoms, and many studies have assessed its long-term efficacy, especially when added to appropriate pharmacotherapy. In this paper, we also give a description of the clinical and psychological features likely to characterize patients refractory to treatment for this illness, with the aim of highlighting the need for greater attention to more patient-oriented management of the disease.

  20. Current management of obsessive and phobic states

    Directory of Open Access Journals (Sweden)

    Goljevscek S

    2011-09-01

    Full Text Available Serena Goljevscek1, Livia A Carvalho21Psychiatric Clinic, University of Udine, Udine, Italy; 2Health Science Research Centre, Department of Life Sciences, Roehampton University, London, UKAbstract: Obsessional states show an average point prevalence of 1%–3% and a lifetime prevalence of 2%–2.5%. Most treatment-seeking patients with obsessions continue to experience significant symptoms after 2 years of prospective follow-up. A significant burden of impairment, distress, and comorbidity characterize the course of the illness, leading to an increased need for a better understanding of the nature and management of this condition. This review aims to give a representation of the current pharmacological and psychotherapeutic strategies used in the treatment of obsessive-compulsive disorder. Antidepressants (clomipramine and selective serotonin reuptake inhibitors are generally the first-line choice used to handle obsessional states, showing good response rates and long-term positive outcomes. About 40% of patients fail to respond to selective serotonin reuptake inhibitors. So far, additional pharmacological treatment strategies have been shown to be effective, ie, administration of high doses of selective serotonin reuptake inhibitors, as well as combinations of different drugs, such as dopamine antagonists, are considered efficacious and well tolerated strategies in terms of symptom remission and side effects. Psychotherapy also plays an important role in the management of obsessive-compulsive disorder, being effective for a wide range of symptoms, and many studies have assessed its long-term efficacy, especially when added to appropriate pharmacotherapy. In this paper, we also give a description of the clinical and psychological features likely to characterize patients refractory to treatment for this illness, with the aim of highlighting the need for greater attention to more patient-oriented management of the disease.Keywords: obsessive

  1. Total quality management in orthodontic practice.

    Science.gov (United States)

    Atta, A E

    1999-12-01

    Quality is the buzz word for the new Millennium. Patients demand it, and we must serve it. Yet one must identify it. Quality is not imaging or public relations; it is a business process. This short article presents quality as a balance of three critical notions: core clinical competence, perceived values that our patients seek and want, and the cost of quality. Customer satisfaction is a variable that must be identified for each practice. In my practice, patients perceive quality as communication and time, be it treatment or waiting time. Time is a value and cost that must be managed effectively. Total quality management is a business function; it involves diagnosis, design, implementation, and measurement of the process, the people, and the service. Kazien is a function that reduces value services, eliminates waste, and manages time and cost in the process. Total quality management is a total commitment for continuous improvement.

  2. APM Best Practices Realizing Application Performance Management

    CERN Document Server

    Sydor, Michael J

    2011-01-01

    The objective of APM Best Practices: Realizing Application Performance Management is to establish reliable application performance management (APM) practices - to demonstrate value, to do it quickly, and to adapt to the client circumstances. It's important to balance long-term goals with short-term deliverables, but without compromising usefulness or correctness. The successful strategy is to establish a few reasonable goals, achieve them quickly, and then iterate over the same topics two more times, with each successive iteration expanding the skills and capabilities of the APM team. This str

  3. Risk management practices in the airline industry

    OpenAIRE

    Fernando, Sharon Perpetua Anasta

    2006-01-01

    This paper reviews the use of financial derivative instruments by non-financial entities to manage risk exposure. It provides the main objectives of a non-financial corporation to enter into derivative contracts with a counterparty and the scope of usage of these instruments. It is evident that most companies use derivative instruments to preserve cash flows and firm value as opposed to taking positions in contracts for speculative purposes. The paper focuses on the risk management practices ...

  4. Evidence-Based Practice: Management of Vertigo

    Science.gov (United States)

    Nguyen-Huynh, Anh T.

    2012-01-01

    Synopsis The article focuses on the evidence basis for the management of benign paroxysmal positional vertigo (BPPV), the most common diagnosis of vertigo in both primary care and subspecialty settings. Like all articles in this compilation of evidence-based practice, an overview is presented along with evidence based clinical assessment, diagnosis, and management. Summaries of differential diagnosis of vertigo and outcomes are presented. PMID:22980676

  5. 21 CFR 114.5 - Current good manufacturing practice.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 2 2010-04-01 2010-04-01 false Current good manufacturing practice. 114.5 Section 114.5 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) FOOD FOR HUMAN CONSUMPTION ACIDIFIED FOODS General Provisions § 114.5 Current good...

  6. Cough management: a practical approach.

    Science.gov (United States)

    De Blasio, Francesco; Virchow, Johann C; Polverino, Mario; Zanasi, Alessandro; Behrakis, Panagiotis K; Kilinç, Gunsely; Balsamo, Rossella; De Danieli, Gianluca; Lanata, Luigi

    2011-10-10

    Cough is one of the most common symptoms for which patients seek medical attention from primary care physicians and pulmonologists. Cough is an important defensive reflex that enhances the clearance of secretions and particles from the airways and protects the lower airways from the aspiration of foreign materials. Therapeutic suppression of cough may be either disease-specific or symptom related. The potential benefits of an early treatment of cough could include the prevention of the vicious cycle of cough. There has been a long tradition in acute cough, which is frequently due to upper respiratory tract infections, to use symptom-related anti-tussives. Suppression of cough (during chronic cough) may be achieved by disease-specific therapies, but in many patients it is often necessary to use symptomatic anti-tussives, too. According to the current guidelines of the American College of Chest Physician on "Cough Suppressants and Pharmacologic Protussive Therapy" and additional clinical trials on the most frequent anti-tussive drugs, it should be possible to diagnose and treat cough successfully in a majority of cases. Among drugs used for the symptomatic treatment of cough, peripherally acting anti-tussives such as levodropropizine and moguisteine show the highest level of benefit and should be recommended especially in children. By improving our understanding of the specific effects of these anti-tussive agents, the therapeutic use of these drugs may be refined. The present review provides a summary of the most clinically relevant anti-tussive drugs in addition to their potential mechanism of action.

  7. Managing climate change in conservation practice: an exploration of the science-management interface in beech forest management.

    Science.gov (United States)

    de Koning, Jessica; Turnhout, Esther; Winkel, Georg; Blondet, Marieke; Borras, Lars; Ferranti, Francesca; Geitzenauer, Maria; Sotirov, Metodi; Jump, Alistair

    Scientific studies reveal significant consequences of climate change for nature, from ecosystems to individual species. Such studies are important factors in policy decisions on forest conservation and management in Europe. However, while research has shown that climate change research start to impact on European conservation policies like Natura 2000, climate change information has yet to translate into management practices. This article contributes to the on-going debates about science-society relations and knowledge utilization by exploring and analysing the interface between scientific knowledge and forest management practice. We focus specifically on climate change debates in conservation policy and on how managers of forest areas in Europe perceive and use climate change ecology. Our findings show that forest managers do not necessarily deny the potential importance of climate change for their management practices, at least in the future, but have reservations about the current usefulness of available knowledge for their own areas and circumstances. This suggests that the science-management interface is not as politicized as current policy debates about climate change and that the use of climate change ecology is situated in practice. We conclude the article by discussing what forms of knowledge may enable responsible and future oriented management in practice focusing specifically on the role of reflexive experimentation and monitoring.

  8. Urban air quality management - current issues

    Energy Technology Data Exchange (ETDEWEB)

    Chaplin, N. [Sheffield City Council, Sheffield (United Kingdom). Environment and Regulatory Services; Virtanen, T. [Helsinki Metropolitan Area Council, Helsinki (Finland); Mladonicky, P. [National Centre of Health Promotion, Bratislava (Slovakia)

    2002-07-01

    In 1996 the EC adopted the Ambient Air Quality and Assessment Directive, which is designed to provide a comprehensive strategy for the management of air quality in Member States, linking controls on emissions with the attainment of air quality objectives. The subsequent Daughter Directives provide limit values, based on health effects, for specified pollutants. In essence Member States have to monitor and assess air quality and where necessary draw up air pollution minimisation plans. This paper explores the practical issues facing three European cities, Sheffield, Helsinki and Bratislava as they face the challenge of implementing action necessary to bring about improvements in air quality by 2010. There are very different problems to resolve due to each City's particular characteristics, although they all share the same cause of the problem - road traffic. Although the technical solutions appear to be relatively straight forward each city faces the problems of trying to educate its citizens, to bring about changes in individual behaviour so that everyone can benefit from better air quality. Sheffield now faces an added level of complexity as its economic performance is below the European average and it has attained Objective 1 status which will introduce a huge investment to kick start the economy and make sure it continues to thrive. (orig.)

  9. Postoperative delirium in elderly citizens and current practice

    Directory of Open Access Journals (Sweden)

    Siddareddygari Velayudha Reddy

    2017-01-01

    Full Text Available Postoperative delirium (POD represents an acute brain dysfunction in the postsurgical period. Perioperative physicians caring for the older adults are familiar with the care of dysfunction of organs such as lungs, heart, liver, or kidney in the perioperative setting, but they are less familiar with management of brain dysfunction. As early detection and prompt treatment of inciting factors are utmost important to prevent or minimize the deleterious outcomes of delirium. The purpose of this review is to prepare perioperative physicians with a set of current clinical practice recommendations to provide optimal perioperative care of older adults, with a special focus on specific perioperative interventions that have been shown to prevent POD. On literature search in EMBASE, CINAHL, and PUBMED between January 2000 and September 2015 using search words delirium, POD, acute postoperative confusion, and brain dysfunction resulted in 9710 articles. Among them, 73 articles were chosen for review, in addition, National Institute for Health and Clinical Excellence guidelines, American Geriatric Society guidelines, hospital elderly life program-confusion assessment method training manual, New York geriatric nursing protocols, World Health Organization's International Classification of Diseases, 10th Revision classification of mental disorders, Food and Drug Administration requests boxed warnings on older class of antipsychotic drugs 2008 and delirium in Miller's text book of anesthesia were reviewed and relevant information presented in this article.

  10. Endoscopy Practice Management, Fee Structures, and Marketing.

    Science.gov (United States)

    Divers, Stephen J

    2015-09-01

    Although our knowledge and appreciation of endoscopic procedures in exotic pets is extensive, associated management practices, including equipment preferences and fee structures, have rarely been discussed. This short article highlights the results of a small survey of 35 experienced exotic animal endoscopists and details their equipment ownership/preferences and fee structures. The importance of marketing is also emphasized.

  11. Understanding Management Students' Reflective Practice through Blogging

    Science.gov (United States)

    Osman, Gihan; Koh, Joyce Hwee Ling

    2013-01-01

    The paper discusses the results of a study on the use of blogging to encourage students to engage in the making of theory-practice linkages and critical thinking within the context of a graduate management course. Sixty-five students participated in collaborative blogging for a period of five weeks. The transcripts of these blogs were analyzed…

  12. Practice management skills for the nurse practitioner.

    Science.gov (United States)

    Sportsman, S; Hawley, L J; Pollock, S; Varnell, G

    2001-01-01

    The faculties of three schools of nursing involved in a collaborative family nurse practitioner (FNP) program designed a study to address issues involved in preparing the nurse practitioner for the challenges of practice management in the clinical environment. The purposes of the study were to (1) identify business concepts necessary to successfully manage a primary care practice; (2) determine which of these concepts should be incorporated into an FNP curriculum; and (3) clarify information to be taught regarding each identified concept. Fifty-four business concepts related to primary care were identified from a literature review. A survey was then developed to assess the extent to which the identified concepts were necessary for an FNP to effectively manage a practice. Seven experts and five FNP faculty responded to the survey. The Content Validity Index (CVI) defined by Lynn (1986) was applied and 20 concepts necessary for an FNP to effectively manage a practice were identified. A focus group that included nurse practitioners (both faculty and nonfaculty) from the three collaborative sites connected by interactive telecommunications determined that all 20 of the identified concepts should be included in an FNP curriculum. Additionally, the focus group clarified relevant information to be taught regarding each identified concept.

  13. STORMWATER BEST MANAGEMENT PRACTICES TEST FACILITY - SWALES

    Science.gov (United States)

    The NRMRL swale evaluation is part of a larger collection of long-term research projects that evaluates many Best Management Practices. EPA has ongoing research examining the performance of constructed wet lands, and detention and retention ponds. Other projects will evaluate ra...

  14. Effective maintenance practices to manage system aging

    Science.gov (United States)

    Chockie, Alan; Bjorkelo, Kenneth

    A study for the Nuclear Regulatory Commission was recently undertaken to identify effective maintenance practices that could be adapted by the nuclear industry in the United States to assist in managing the aging degradation of plant systems and components. Four organizations were examined to assess the influence of maintenance programs on addressing the system and component aging degradation issues. An effective maintenance program was found to be essential to the management of system and component aging. Four key elements of an effective maintenance program that are important to an aging management were identified: (1) the selection of critical systems and components; (2) the development of an understanding of aging through the collection and analysis of equipment performance information; (3) the development of appropriate preventive and predictive maintenance tasks to manage equipment and system aging degradation; and (4) the use of feedback mechanisms to continuously improve the management of aging systems and components. These elements were found to be common to all four organizations.

  15. Practice management education during surgical residency.

    Science.gov (United States)

    Jones, Kory; Lebron, Ricardo A; Mangram, Alicia; Dunn, Ernest

    2008-12-01

    Surgical education has undergone radical changes in the past decade. The introductions of laparoscopic surgery and endovascular techniques have required program directors to alter surgical training. The 6 competencies are now in place. One issue that still needs to be addressed is the business aspect of surgical practice. Often residents complete their training with minimal or no knowledge on coding of charges or basic aspects on how to set up a practice. We present our program, which has been in place over the past 2 years and is designed to teach the residents practice management. The program begins with a series of 10 lectures given monthly beginning in August. Topics include an introduction to types of practices available, negotiating a contract, managed care, and marketing the practice. Both medical and surgical residents attend these conferences. In addition, the surgical residents meet monthly with the business office to discuss billing and coding issues. These are didactic sessions combined with in-house chart reviews of surgical coding. The third phase of the practice management plan has the coding team along with the program director attend the outpatient clinic to review in real time the evaluation and management coding of clinic visits. Resident evaluations were completed for each of the practice management lectures. The responses were recorded on a Likert scale. The scores ranged from 4.1 to 4.8 (average, 4.3). Highest scores were given to lectures concerning negotiating employee agreements, recruiting contracts, malpractice insurance, and risk management. The medical education department has tracked resident coding compliance over the past 2 years. Surgical coding compliance increased from 36% to 88% over a 12-month period. The program director who participated in the educational process increased his accuracy from 50% to 90% over the same time period. When residents finish their surgical training they need to be ready to enter the world of business

  16. Current investigation and management of patients with syncope

    DEFF Research Database (Denmark)

    Dagres, Nikolaos; Bongiorni, Maria Grazia; Dobreanu, Dan

    2013-01-01

    for neurally mediated syncope. Physical manoeuvres were the most widely (93%) applied standard treatment for this syncope form. The results of this survey suggest that there are significant differences in the management of patients with syncope across Europe, specifically with respect to hospitalization rates......The aim of this European Heart Rhythm Association (EHRA) survey was to provide an insight into the current practice of work-up and management of patients with syncope among members of the EHRA electrophysiology research network. Responses were received from 43 centres. The majority of respondents...... (74%) had no specific syncope unit and only 42% used a standardized assessment protocol or algorithm. Hospitalization rates varied from 10% to 25% (56% of the centres) to >50% (21% of the centres). The leading reasons for hospitalization were features suggesting arrhythmogenic syncope (85...

  17. Current Pharmacological Management of Gastroesophageal Reflux Disease

    Directory of Open Access Journals (Sweden)

    Yao-Kuang Wang

    2013-01-01

    Full Text Available Gastroesophageal reflux disease (GERD, a common disorder with troublesome symptoms caused by reflux of gastric contents into the esophagus, has adverse impact on quality of life. A variety of medications have been used in GERD treatment, and acid suppression therapy is the mainstay of treatment for GERD. Although proton pump inhibitor is the most potent acid suppressant and provides good efficacy in esophagitis healing and symptom relief, about one-third of patients with GERD still have persistent symptoms with poor response to standard dose PPI. Antacids, alginate, histamine type-2 receptor antagonists, and prokinetic agents are usually used as add-on therapy to PPI in clinical practice. Development of novel therapeutic agents has focused on the underlying mechanisms of GERD, such as transient lower esophageal sphincter relaxation, motility disorder, mucosal protection, and esophageal hypersensitivity. Newer formulations of PPI with faster and longer duration of action and potassium-competitive acid blocker, a newer acid suppressant, have also been investigated in clinical trials. In this review, we summarize the current and developing therapeutic agents for GERD treatment.

  18. Data management practices for collaborative research

    Directory of Open Access Journals (Sweden)

    Charles eSchmitt

    2011-07-01

    Full Text Available The success of research in the field of maternal-infant health, or in any scientific field, relies on the adoption of best practices for data and knowledge management. Prior work by our group and others has identified evidence-based solutions to many of the data management challenges that exist, including cost-effective practices for ensuring high-quality data entry and proper construction and maintenance of data standards and ontologies. Quality assurance practices for data entry and processing are necessary to ensure that data are not denigrated during processing, but the use of these practices has not been widely adopted in the fields of psychology and biology. Furthermore, collaborative research is becoming more common. Collaborative research often involves multiple laboratories, different scientific disciplines, numerous data sources, large data sets, and data sets from public and commercial sources. These factors present new challenges for data and knowledge management. Data security and privacy concerns are increased as data may be accessed by investigators affiliated with different institutions. Collaborative groups must address the challenges associated with federating data access between the data-collecting sites and a centralized data management site. The merging of ontologies between different data sets can become formidable, especially in fields with evolving ontologies. The increased use of automated data acquisition can yield more data, but it can also increase the risk of introducing error or systematic biases into data. In addition, the integration of data collected from different assay types often requires the development of new tools to analyze the data. All of these challenges act to increase the costs and time spent on data management for a given project, and they increase the likelihood of decreasing the quality of the data. In this paper, we review these issues and discuss theoretical and practical approaches for

  19. Management of refractory ischemic priapism: current perspectives.

    Science.gov (United States)

    Capece, Marco; Gillo, Arianna; Cocci, Andrea; Garaffa, Giulio; Timpano, Massimiliano; Falcone, Marco

    2017-01-01

    The aim of the present manuscript is to review the current literature on priapism, focusing on the state-of-the-art knowledge of both the diagnosis and the treatment of the refractory ischemic priapism (IP). Pubmed and EMBASE search engines were used to search for words "priapism", "refractory priapism", "penile prosthesis", "diagnosis priapism", "priapism treatment", "penile fibrosis", "priapism therapy". All the studies were carefully examined by the authors and then included in the review. First-line treatment involves ejaculation, physical exercise and cold shower followed by corporal blood aspiration and injection of α-adrenoceptor agonists. Subsequently, a distal or proximal shunt may be considered. If none of the treatment is effective or the priapism episode lasts >48 hours penile prosthesis implantation could be the only option to solve the priapism and treat the ongoing erectile dysfunction. The management of IP is to achieve detumescence of persistent penile erection and to preserve erectile function after resolution of the priapic episode. On the other hand, penile fibrosis and following shortening should be prevented. Early penile prosthesis implantation in patients with refractory IP is able to solve both the priapic episode and prevent the otherwise certain penile shortening. Penile prosthesis implantation is the actual gold standard of care in cases of refractory IP.

  20. Optimal management of genital herpes: current perspectives

    Directory of Open Access Journals (Sweden)

    Sauerbrei A

    2016-06-01

    Full Text Available Andreas Sauerbrei Institute of Virology and Antiviral Therapy, German Consulting Laboratory for Herpes Simplex Virus and Varicella-Zoster Virus, Jena University Hospital, Friedrich-Schiller University of Jena, Jena, Germany Abstract: As one of the most common sexually transmitted diseases, genital herpes is a global medical problem with significant physical and psychological morbidity. Genital herpes is caused by herpes simplex virus type 1 or type 2 and can manifest as primary and/or recurrent infection. This manuscript provides an overview about the fundamental knowledge on the virus, its epidemiology, and infection. Furthermore, the current possibilities of antiviral therapeutic interventions and laboratory diagnosis of genital herpes as well as the present situation and perspectives for the treatment by novel antivirals and prevention of disease by vaccination are presented. Since the medical management of patients with genital herpes simplex virus infection is often unsatisfactory, this review aims at all physicians and health professionals who are involved in the care of patients with genital herpes. The information provided would help to improve the counseling of affected patients and to optimize the diagnosis, treatment, and prevention of this particular disease. Keywords: herpes simplex virus, epidemiology, infection, antiviral therapy, laboratory diagnosis, prevention

  1. Nurses in Australian general practice: implications for chronic disease management.

    Science.gov (United States)

    Halcomb, Elizabeth J; Davidson, Patricia M; Salamonson, Yenna; Ollerton, Richard; Griffiths, Rhonda

    2008-03-01

    The purpose of this study was to describe the demographic and employment characteristics of Australian practice nurses and explore the relationship between these characteristics and the nurses' role. Nursing in general practice is an integral component of primary care and chronic disease management in the United Kingdom and New Zealand, but in Australia it is an emerging specialty and there is limited data on the workforce and role. National postal survey embedded in a sequential mixed method design. 284 practice nurses completed a postal survey during 2003-2004. Descriptive statistics and factor analysis were utilized to analyse the data. Most participants were female (99%), Registered Nurses (86%), employed part-time in a group practice, with a mean age of 45.8 years, and had a hospital nursing certificate as their highest qualification (63%). The tasks currently undertaken by participants and those requiring further education were inversely related (R2 = -0.779). Conversely, tasks perceived to be appropriate for a practice nurse and those currently undertaken by participants were positively related (R2 = 0.8996). There was a mismatch between the number of participants who perceived that a particular task was appropriate and those who undertook the task. This disparity was not completely explained by demographic or employment characteristics. Extrinsic factors such as legal and funding issues, lack of space and general practitioner attitudes were identified as barriers to role expansion. Practice nurses are a clinically experienced workforce whose skills are not optimally harnessed to improve the care of the growing number of people with chronic and complex conditions. Relevance to clinical practice. Study data reveal a need to overcome the funding, regulatory and interprofessional barriers that currently constrain the practice nurse role. Expansion of the practice nurse role is clearly a useful adjunct to specialist management of chronic and complex disease

  2. Scleral Lens Prescription and Management Practices: The SCOPE Study.

    Science.gov (United States)

    Harthan, Jennifer; Nau, Cherie B; Barr, Joseph; Nau, Amy; Shorter, Ellen; Chimato, Nicolette T; Hodge, David O; Schornack, Muriel M

    2017-04-06

    To assess current scleral lens prescription and management practices by conducting an international online survey of eye care providers. The SCOPE (Scleral Lenses in Current Ophthalmic Practice: an Evaluation) study group designed and administered an online survey regarding current scleral lens prescription and management practices. The survey was open from January 15 to March 31, 2015, and generated 723 responses from individuals who had fit at least 5 patients with scleral lenses. Respondents (n=663) prescribed scleral lenses that ranged from 15 to 17 mm in diameter (65%), smaller than 15 mm (18%), and larger than 18 mm (17%). More than 50 lens designs were identified. Average daily wearing time of 11.8 hr was consistent across 651 respondents, and 475/651 (73%) recommended midday removal on some, most, or all days. Most respondents recommended nonpreserved saline to fill the bowl of the lens before application (single-use vials, 392/653 [60%]; bottled products, 372/653 [57%]). A hydrogen peroxide-based disinfection system was the most commonly recommended care product (397/651 [61%]). A reasonable degree of consensus exists regarding some aspects of scleral lens prescription and management (average lens diameter, daily wearing time, and use of nonpreserved products for lens application). Further study is needed to develop evidence-based guidelines for scleral lens prescription and management.

  3. Best Practices for Managing Organizational Diversity

    Energy Technology Data Exchange (ETDEWEB)

    Kreitz, Patricia A.; /SLAC

    2007-05-18

    should human resource specialists play in creating and managing diverse organizations? What are the best practices they should apply? The purpose of this review is to define workplace diversity, to identify best practices, and to identify how diversity management best practices can be applied in academic libraries. Finally, this review will provide a resource list for HR managers and leaders to learn more about those best practices with the goal of optimizing their organization's approach to diversity.

  4. Managing reservoir sedimentation by venting turbidity currents:A review

    Institute of Scientific and Technical Information of China (English)

    Sabine Chamoun; Giovanni De Cesare; Anton J. Schleiss

    2016-01-01

    Reservoir sedimentation is an issue that dam operators are increasingly facing as dams are aging. Not only does it reduce a reservoir's capacity but it also affects its outlet structures such as bottom outlets and powerhouse intakes. Sedimentation may also impoverish downstream ecosystems. For these reasons, several strategies for sediment management are being investigated and applied worldwide. Among these methods, venting of turbidity currents reaching the dam can be very beneficial and economical. This measure helps in preserving a certain continuity of sediment transport in rivers obstructed by dams. However, several practical but also theoretical challenges hamper this technique, rendering its use less common and its aspects rela-tively unknown. The present paper aims to gather the actual state-of-the-art concerning turbidity currents venting and to present an outlook for future development and research in this field.

  5. Managing image collections a practical guide

    CERN Document Server

    Note, Margot

    2011-01-01

    This book explores issues surrounding all aspects of visual collection management, taken from real-world experience in creating management systems and digitizing core content. Readers will gain the knowledge to manage the digitization process from beginning to end, assess and define the needs of their particular project, and evaluate digitization options. Additionally, they will select strategies which best meet current and future needs, acquire the knowledge to select the best images for digitization, and understand the legal issues surrounding digitization of visual collections.<

  6. Soil management practices under organic farming

    Science.gov (United States)

    Aly, Adel; Chami Ziad, Al; Hamdy, Atef

    2015-04-01

    Organic farming methods combine scientific knowledge of ecology and modern technology with traditional farming practices based on naturally occurring biological processes. Soil building practices such as crop rotations, intercropping, symbiotic associations, cover crops, organic fertilizers and minimum tillage are central to organic practices. Those practices encourage soil formation and structure and creating more stable systems. In farm nutrient and energy cycling is increased and the retentive abilities of the soil for nutrients and water are enhanced. Such management techniques also play an important role in soil erosion control. The length of time that the soil is exposed to erosive forces is decreased, soil biodiversity is increased, and nutrient losses are reduced, helping to maintain and enhance soil productivity. Organic farming as systematized and certifiable approach for agriculture, there is no surprise that it faces some challenges among both farmers and public sector. This can be clearly demonstrated particularly in the absence of the essential conditions needed to implement successfully the soil management practices like green manure and composting to improve soil fertility including crop rotation, cover cropping and reduced tillage. Those issues beside others will be fully discussed highlighting their beneficial impact on the environmental soil characteristics. Keywords: soil fertility, organic matter, plant nutrition

  7. Management of refractory ischemic priapism: current perspectives

    Directory of Open Access Journals (Sweden)

    Capece M

    2017-08-01

    Full Text Available Marco Capece,1 Arianna Gillo,2 Andrea Cocci,3 Giulio Garaffa,1 Massimiliano Timpano,4 Marco Falcone4 1The Institute of Urology, University College of London Hospital (UCLH, London, UK; 2Department of Urology, “Umberto Parini” Hospital, Aosta, 3Department of Urology, Careggi Hospital, Firenze, 4Department of Urology, University of Turin, Città della Salute e della Scienza, Turin, Italy Objectives: The aim of the present manuscript is to review the current literature on priapism, focusing on the state-of-the-art knowledge of both the diagnosis and the treatment of the refractory ischemic priapism (IP.Methods: Pubmed and EMBASE search engines were used to search for words “priapism”, “refractory priapism”, “penile prosthesis”, “diagnosis priapism”, “priapism treatment”, “penile fibrosis”, “priapism therapy”. All the studies were carefully examined by the authors and then included in the review.Results: First-line treatment involves ejaculation, physical exercise and cold shower followed by corporal blood aspiration and injection of α-adrenoceptor agonists. Subsequently, a distal or proximal shunt may be considered. If none of the treatment is effective or the priapism episode lasts >48 hours penile prosthesis implantation could be the only option to solve the priapism and treat the ongoing erectile dysfunction.Conclusion: The management of IP is to achieve detumescence of persistent penile erection and to preserve erectile function after resolution of the priapic episode. On the other hand, penile fibrosis and following shortening should be prevented. Early penile prosthesis implantation in patients with refractory IP is able to solve both the priapic episode and prevent the otherwise certain penile shortening. Penile prosthesis implantation is the actual gold standard of care in cases of refractory IP. Keywords: priapism, ischemic priapism, penile fibrosis, penile prosthesis, shunt 

  8. Management by objectives in medical group practice.

    Science.gov (United States)

    Bozis, D E

    1986-01-01

    When the concept of management by objectives first emerged, it was heralded by many as the long-sought secret to employee motivation. The MBO technique, involving the three primary functions of objective setting, objective using, and employee involvement, is described here in terms of both theory and practice. Although it does have its pitfalls and is certainly not the "ultimate answer," MBO in medical group practice does have its merits when properly introduced. It is much more than a purely academic concept, and its major strength lies in its recognition of the importance of human resources in getting the job done.

  9. Management of Periprocedural Anticoagulation: A Survey of Contemporary Practice.

    Science.gov (United States)

    Flaker, Greg C; Theriot, Paul; Binder, Lea G; Dobesh, Paul P; Cuker, Adam; Doherty, John U

    2016-07-12

    Interruption of oral anticoagulation (AC) for surgery or an invasive procedure is a complicated process. Practice guidelines provide only general recommendations, and care of such patients occurs across multiple specialties. The availability of direct oral anticoagulants further complicates decision making and guidance here is limited. To evaluate current practice patterns in the United States for bridging AC, a survey was developed by the American College of Cardiology Anticoagulation Work Group. The goal of the survey was to assess how general and subspecialty cardiologists, internists, gastroenterologists, and orthopedic surgeons currently manage patients who receive AC and undergo surgery or an invasive procedure. The survey was completed by 945 physicians involved in the periprocedural management of AC. The results provide a template for educational and research projects geared toward the development of clinical pathways and point-of-care tools to improve this area of health care. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. Practical Methods for Information Security Risk Management

    Directory of Open Access Journals (Sweden)

    Cristian AMANCEI

    2011-01-01

    Full Text Available The purpose of this paper is to present some directions to perform the risk man-agement for information security. The article follows to practical methods through question-naire that asses the internal control, and through evaluation based on existing controls as part of vulnerability assessment. The methods presented contains all the key elements that concurs in risk management, through the elements proposed for evaluation questionnaire, list of threats, resource classification and evaluation, correlation between risks and controls and residual risk computation.

  11. Practical Risk Management for the CIO

    CERN Document Server

    Scherling, Mark

    2007-01-01

    The growing complexity of today's interconnected systems has not only increased the need for improved information security, but also helped to move information from the IT backroom to the executive boardroom as a strategic asset. And, just like the tip of an iceberg is all you see until you run into it, the risks to your information are mostly invisible until disaster strikes. Detailing procedures that will help your team perform better risk assessments and aggregate results into more meaningful metrics, Practical Risk Management for the CIO approaches information risk management through impro

  12. IP Address Management Principles and Practice

    CERN Document Server

    Rooney, Timothy

    2010-01-01

    This book will be the first covering the subject of IP address management (IPAM). The practice of IPAM includes the application of network management disciplines to IP address space and associated network services, namely DHCP (Dynamic Host Configuration Protocol) and DNS (Domain Name System). The consequence of inaccurately configuring DHCP is that end users may not be able to obtain IP addresses to access the network. Without proper DNS configuration, usability of the network will greatly suffer as the name-to-address lookup process may fail. Imagine having to navigate to a website or send a

  13. Solid waste management. Principles and practice

    Energy Technology Data Exchange (ETDEWEB)

    Chandrappa, Ramesha [Karnataka State Pollution Control Board, Biomedical Waste, Bangalore (India); Bhusan Das, Diganta [Loughborough Univ. of Technology (United Kingdom). Dept. of Chemical Engineering

    2012-11-01

    Solid waste was already a problem long before water and air pollution issues attracted public attention. Historically the problem associated with solid waste can be dated back to prehistoric days. Due to the invention of new products, technologies and services the quantity and quality of the waste have changed over the years. Waste characteristics not only depend on income, culture and geography but also on a society's economy and, situations like disasters that affect that economy. There was tremendous industrial activity in Europe during the industrial revolution. The twentieth century is recognized as the American Century and the twenty-first century is recognized as the Asian Century in which everyone wants to earn 'as much as possible'. After Asia the currently developing Africa could next take the center stage. With transitions in their economies many countries have also witnessed an explosion of waste quantities. Solid waste problems and approaches to tackling them vary from country to country. For example, while efforts are made to collect and dispose hospital waste through separate mechanisms in India it is burnt together with municipal solid waste in Sweden. While trans-boundary movement of waste has been addressed in numerous international agreements, it still reaches developing countries in many forms. While thousands of people depend on waste for their lively hood throughout the world, many others face problems due to poor waste management. In this context solid waste has not remained an issue to be tackled by the local urban bodies alone. It has become a subject of importance for engineers as well as doctors, psychologist, economists, and climate scientists and any others. There are huge changes in waste management in different parts of the world at different times in history. To address these issues, an effort has been made by the authors to combine their experience and bring together a new text book on the theory and practice of the

  14. Best practice in workplace hazardous substances management.

    Science.gov (United States)

    Winder, C

    1995-09-01

    Chemical-induced injury and disease remains a significant problem in workers in industry. As a result of this problem, a number of national and international initiatives have recommended the development of conventions, regulations, and codes of practice to attempt to deal with the problems of hazardous substances at work. Within Australia, workplace hazardous substances regulations are in development which will impose legal obligations and responsibilities on the suppliers of hazardous substances and on the employers who use them. At the same time, internationally consistent ISO standards are in use, or are being developed, for quality systems, environmental management, and occupational health and safety. These standards outline a model for the management of quality, environment, or safety, and the processes involved are applicable to the management of hazardous substances. This process includes: obtaining commitment from senior management; instituting consultative mechanisms; developing a hazardous substances policy; identifying components of the hazardous substances management program; resourcing, implementing, and reviewing the program; and integrating the program into the organisation's strategic plan. Only by blending in a specific management program for hazardous substances into the overall planning of an organization will they be managed effectively and efficiently.

  15. Chondral Rib Fractures in Professional American Football: Two Cases and Current Practice Patterns Among NFL Team Physicians

    National Research Council Canada - National Science Library

    McAdams, Timothy R; Deimel, Jay F; Ferguson, Jeff; Beamer, Brandon S; Beaulieu, Christopher F

    2016-01-01

    ...: To present 2 cases of chondral rib injuries in the National Football League (NFL) and discuss the current practice patterns for management of these injuries among the NFL team physicians. Study Design: Case series...

  16. European Communication Monitor: Current developments, issues and tendencies of the professional practice of public relations in Europe

    NARCIS (Netherlands)

    Moreno, A.; Zerfass, A.; Tench, R.; Verčič, D.; Verhoeven, P.

    2009-01-01

    The European Communication Monitor (ECM) research explores the current developments for communications disciplines, practices and instruments. It is an extensive research project to monitor trends in communication management, analyse the changing framework for the profession driven by European integ

  17. European Communication Monitor: Current developments, issues and tendencies of the professional practice of public relations in Europe

    NARCIS (Netherlands)

    Moreno, A.; Zerfass, A.; Tench, R.; Verčič, D.; Verhoeven, P.

    2009-01-01

    The European Communication Monitor (ECM) research explores the current developments for communications disciplines, practices and instruments. It is an extensive research project to monitor trends in communication management, analyse the changing framework for the profession driven by European

  18. Narrative, Poststructuralism, and Social Justice: Current Practices in Narrative Therapy

    Science.gov (United States)

    Combs, Gene; Freedman, Jill

    2012-01-01

    This paper is a review of current practice in narrative therapy with a focus on how it is attractive and useful for therapists who wish to work for social justice. The authors describe narrative therapy's roots in poststructuralist philosophy and social science. They illustrate its major theoretical constructs, including the "narrative metaphor,"…

  19. Cardioversion for atrial fibrillation in current European practice

    DEFF Research Database (Denmark)

    Hernández-Madrid, Antonio; Svendsen, Jesper Hastrup; Lip, Gregory Y.H.

    2013-01-01

    This survey was conducted to provide an insight into the current clinical practice regarding the use of cardioversion for atrial fibrillation (AF) in Europe. Responses were received from 57 centres across Europe, 71.9% of which were university hospitals. For electrical cardioversion, general anae...

  20. Autism Spectrum Disorders: Neurobiology and Current Assessment Practices

    Science.gov (United States)

    Allen, Ryan A.; Robins, Diana L.; Decker, Scott L.

    2008-01-01

    This study reviews recent research related to the neurobiology of Autism Spectrum Disorders (ASDs) an provides an empirical analysis of current assessment practices. Data were collected through a survey of 117 school psychologists. The Childhood Autism Rating Scale (CARS), Gilliam Autism Rating Scale (GARS), and Gilliam Asperger's Disorder Scale…

  1. Current Practice and Infrastructures for Campus Centers of Community Engagement

    Science.gov (United States)

    Welch, Marshall; Saltmarsh, John

    2013-01-01

    This article provides an overview of current practice and essential infrastructure of campus community engagement centers in their efforts to establish and advance community engagement as part of the college experience. The authors identified key characteristics and the prevalence of activities of community engagement centers at engaged campuses…

  2. Crystallization screening: the influence of history on current practice

    Science.gov (United States)

    Luft, Joseph R.; Newman, Janet; Snell, Edward H.

    2014-01-01

    While crystallization historically predates crystallography, it is a critical step for the crystallographic process. The rich history of crystallization and how that history influences current practices is described. The tremendous impact of crystallization screens on the field is discussed. PMID:25005076

  3. Paying research participants: a study of current practices in Australia.

    Science.gov (United States)

    Fry, C L; Ritter, A; Baldwin, S; Bowen, K J; Gardiner, P; Holt, T; Jenkinson, R; Johnston, J

    2005-09-01

    To examine current research payment practices and to inform development of clearer guidelines for researchers and ethics committees. Exploratory email based questionnaire study of current research participant reimbursement practices. A diverse sample of organisations and individuals were targeted. Australia. Contacts in 84 key research organisations and select electronic listservers across Australia. A total of 100 completed questionnaires were received with representations from a variety of research areas (for example, market, alcohol and drug, medical, pharmaceutical and social research). Open-ended and fixed alternative questions about type of research agency; type of research; type of population under study; whether payment is standard; amounts and mechanisms of payment; factors taken into account when deciding on payment practices; and whether payment policies exist. Reimbursement practice is highly variable. Where it occurs (most commonly for drug dependent rather than health professional or general population samples) it is largely monetary and is for time and out-of-pocket expenses. Ethics committees were reported to be often involved in decision making around reimbursement. Research subject payment practices vary in Australia. Researchers who do provide payments to research participants generally do so without written policy and procedures. Ethics committees have an important role in developing guidelines in this area. Specific guidelines are needed considering existing local policies and procedures; payment models and their application in diverse settings; case study examples of types and levels of reimbursement; applied definitions of incentive and inducement; and the rationale for diverse payment practices in different settings.

  4. RISK MANAGEMENT TOOLS PRACTICED IN TUNISIAN COMMERCIAL BANKS

    OpenAIRE

    Monki Rim Ben Selma; Echchabi Abdelghani; Mohamed Taher Rajhi

    2013-01-01

    The main purpose of this study is to explore the current risk management practices and techniques used by Tunisian banks. A questionnaire was developed and surveyed to 16 commercial banks operating in Tunisia. This paper attempts to ascertain the perceptions of Tunisian bankers about the importance of transparency and public disclosure and the understanding of the bank’s risk profile. Among others, the results indicate that the Tunisian bankers are aware of the importance and the role of effe...

  5. Practical management measures for patients with recurrent herpes labialis.

    Science.gov (United States)

    St Pierre, S A; Bartlett, B L; Schlosser, B J

    2009-01-01

    Recurrent herpes labialis (RHL) is a common condition associated with the formation of vesicles around the mouth, often preceded by prodromal symptoms including tingling and burning. Treatment is targeted toward individual episodes, but in severe cases, suppressive therapy may be indicated. At present, no cure exists for this troublesome condition. The purpose of this article is to serve as a practical guide in the management of RHL by summarizing current treatments and discussing potential new therapies.

  6. Practical Approach to Endoscopic Management for Bleeding Gastric Varices

    Energy Technology Data Exchange (ETDEWEB)

    Lim, Young Suk [Asan Medical Center, University of Ulsan College of Medicine, Seoul (Korea, Republic of)

    2012-02-15

    Bleeding from gastric varices is generally more severe than bleeding from esophageal varices, although it occurs less frequently. Recently, new endoscopic treatment options and interventional radiological procedures have broadened the therapeutic armamentarium for gastric varices. This review provides an overview of the classification and pathophysiology of gastric varices, an introduction to current endoscopic and interventional radiological management options for gastric varices, and details of a practical approach to endoscopic variceal obturation using N-butyl-2-cyanoacrylate.

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

    Science.gov (United States)

    Stanton, Marietta P; Barnett Lammon, Carol Ann

    2008-01-01

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

  8. Shifting currents: Progress, setbacks, and shifts in policy and practice

    Science.gov (United States)

    ,; Dunning, Charles; Robertson, Dale

    2016-01-01

    The Wisconsin Academy’s initial Waters of Wisconsin project (WOW I) facilitated a statewide conversation between 2000 and 2003 around one main question: How can we ensure healthy aquatic ecosystems and clean, abundant water supplies for tomorrow’s Wisconsin? Robust participation in this conversation underscored the important role citizens have in the stewardship of our waters, and we found enthusiastic support for farsighted policies—based on sound science—to manage our water legacy. Overall, we found that Wisconsinites cherish water and see our waters as essential to our way of life in Wisconsin. Nationally, our state ranks 25th in land area but has the fourth-highest area covered by water. Wisconsin is 20th in population but is second only to Florida in the number of fishing licenses sold each year. Clean water supports billions of dollars’ worth of economic activity through tourism, agriculture, and industry. From the Northwoods cabin to the Port of Milwaukee to the Wisconsin Dells, water shapes our state’s identity. Our tradition of safeguarding Wisconsin’s waters is grounded in values such as responsibility to family and future generations, respect for land and wildlife, protecting public health and safety, and caring for water as a common good, as articulated in the state’s Public Trust Doctrine (see page 9). These deeply held values have also shaped a conservation ethic, and its legacy has served many generations who depend upon and enjoy the waters of the state. Through WOW I, we identified the need to overcome the institutional and disciplinary separation of science, policy, and management protocols through a more integrated approach to water management. WOW also affirmed that the Wisconsin Department of Natural Resources (DNR) and other public agencies play a critical role in sound scientific application, citizen participation, and the practical implementation of policy while balancing public and private interests toward the goal of a

  9. Management of psychosis in Australian general practice.

    Science.gov (United States)

    Charles, Janice; Miller, Graeme; Ng, Anthea

    2006-03-01

    The BEACH program, a continuous national study of general practice activity in Australia, gives us an overview of consultations involving the management of psychoses. In this analysis we have included schizophrenia, affective disorders/bipolar, organic psychoses, and senile psychoses, with undefined psychosis and chronic brain syndrome grouped as 'other'. This synopsis provides a backdrop against which the theme articles in this issue of Australian Family Physician can be further considered.

  10. Clinical Practice Guidelines for Convulsive Condition Management

    Directory of Open Access Journals (Sweden)

    Victor Rene Navarro Machado

    2009-03-01

    Full Text Available Clinical Practice Guidelines for Convulsive Condition Management. It has been redefined as the occurrence of two or more successive convulsions without conscience recuperation between them; or the occurrence of convulsive uninterrupted activity for more than 5 minutes, including focal crisis. This document includes a review and update of conceptual, etiological and classification aspects for diagnosis and treatment, stressing the various therapy trends. It includes assessment guidelines focused on the most important aspects to be accomplished.

  11. Clinical Practice Guidelines for Potential Donors Management

    Directory of Open Access Journals (Sweden)

    José Roque Nodal Arruebarrena

    2009-03-01

    Full Text Available Clinical Practice Guidelines for Potential Donors Management. It has been defined as the patient in Glasgow coma with scale higher or equal to 8 who doesn´t present contradictions for transplant (possible donor and who has been diagnosed of encephalic death. This document reviews and updates concepts, lists indications and contraindications for different organs donation, clinical assessment of the donor and its treatment. It includes assessment guidelines focused on the most important aspects to be accomplished.

  12. Process-oriented performance indicators for measuring ecodesign management practices

    DEFF Research Database (Denmark)

    Rodrigues, Vinicius Picanco; Pigosso, Daniela Cristina Antelmi; McAloone, Tim C.

    2016-01-01

    In order to support ecodesign performance measurement from a business perspective, this paper performs an exploration of available process-oriented indicators to be applied to ecodesign management practices. With the Ecodesign Maturity Model as a background framework, a systematic literature review...... coupled with a cross-content analysis was carried out to assign proper indicators to the practices. Results show that the currently available indicators do not fully reflect the characteristics of ecodesign and there is significant room for improving the development of tailor-made indicators....

  13. Enhancing nurses' empowerment: the role of supervisors' empowering management practices.

    Science.gov (United States)

    Montani, Francesco; Courcy, François; Giorgi, Gabriele; Boilard, Amélie

    2015-09-01

    This study tests a theoretical model where: (a) nurses' dispositional resistance to change is indirectly negatively related to behavioural empowerment through the mediating role of psychological empowerment; and (b) supervisors' empowering management practices buffer both the negative relationship between dispositional resistance to change and psychological empowerment and the indirect negative relationship between resistance to change and behavioural empowerment via psychological empowerment. Promoting a high level of empowerment among nursing personnel is important to ensure their effectiveness in the context of organizational change. It is thus essential to advance our current understanding of the factors that hamper nurses' psychological and behavioural expressions of empowerment and to clarify supervisor practices that can overcome such barriers. A cross-sectional research design. We collected survey data during 2012 from a sample of 197 nurses from a Canadian hospital undergoing a major organizational change. Results from moderated mediation analyses provided evidence for an indirect negative relationship between dispositional resistance to change and behavioural empowerment through psychological empowerment, and for a moderating (buffering) effect of supervisors' empowering management practices on this mediated relationship. These findings provided support for our hypotheses. Supervisors' empowering management practices represent an important contextual buffer against the negative effects of dispositional resistance to change on nurses' empowerment. Organizations should develop empowering management skills among nurses' supervisors to counteract the detrimental effects of dispositional resistance to change and to sustain an empowered nursing workforce. © 2015 John Wiley & Sons Ltd.

  14. Integrating leadership into a practice management curriculum for dental students.

    Science.gov (United States)

    Kalenderian, Elsbeth; Skoulas, Angelique; Timothé, Peggy; Friedland, Bernard

    2010-05-01

    Curriculum evaluations by recent graduates of the Harvard School of Dental Medicine suggested the need for additional coursework in practice management. Given the complex challenges facing practitioners, the course design was expanded beyond the suggested practice management to include leadership theory and skills. Students were able to distinguish and assess their level of various leadership skills at the end of the course. The course received an overall rating of 4.23 on a scale of 1 (poor) to 5 (excellent), with 84 percent of responding students indicating that their interest-specifically in the areas of clinical efficiency, practice management, reducing medical errors, communication, business, team building, leadership, and access to care-was enhanced. The responding students assessed their current leadership skills overall at 3.84. They assessed themselves best at "Integrity" (4.48) and worst at "Managing Conflict" (3.12). They felt that "Ability to Build Trust with Others" is the most beneficial skill for a dentist, while "Ability to Influence" is the least beneficial. Eighty-eight percent of students responding indicated that it is "Very Likely" they will continue to practice developing their leadership skills. Qualitative feedback was overwhelmingly positive and indicated that students found the course life-altering and highly valued its breadth of topics.

  15. Medical management of paediatric burn injuries: best practice.

    Science.gov (United States)

    Kim, Leo K P; Martin, Hugh C O; Holland, Andrew J A

    2012-04-01

    Burns commonly occur in children and their first aid remains inadequate despite burn prevention programmes. While scald injuries predominate, contact and flame burns remain common. Although typically less severe injuries overall than those in adults, hypertrophic scarring complicating both the burn wound and even donor sites occur more frequently in children. The heterogeneous nature of burn wounds, coupled with the difficulties associated with the early clinical assessment of burn depth, has stimulated the application of novel technologies to predict burn wound outcome. This review explores current best practice in the management of paediatric burns, with a focus on prevention, optimal first aid, resuscitation, burn wound prediction and wound management strategies.

  16. Management of upper dyspepsia in general practice

    DEFF Research Database (Denmark)

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

     Aim: To compare the effect of two strategies for management of dyspepsia. Evaluation based on GP's assessment after two weeks and patients assessment after three months.   Design: Prospective randomised controlled trial in general practice   Methods: 357 patients with dyspepsia where the general......) for two weeks. If symptoms were unchanged after to weeks => referral to endoscopy. Later recurrence of symptoms => endoscopy (> 45 year) or management strategy according to helicobacter pylori status and/or clinical reflux (measures......)   Conclusion In management of dyspepsia therapy does have a better short term effect than endoscopy concerning symptom relief, but after 3 months the endoscopy strategy had a better effect than PPI concerning symptom relief  ...

  17. 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.

  18. Challenges for municipal solid waste management practices in Vietnam

    Directory of Open Access Journals (Sweden)

    Nguyen Duc Luong

    2013-11-01

    Full Text Available Municipal solid waste (MSW management is currently one of the major environmental problems facing by Vietnam. Improper management of MSW has caused adverse impacts on the environment, community health, and social-economic development. This study attempts to provide a review of the generation and characterization, disposal and treatment technologies of MSW to evaluate the current status and identify the problems of MSW management practices in Vietnam. Finally, this study is concluded with fruitful recommendations which may be useful in encouraging the responsible agencies to work towards the further improvement of the existing MSW management system.Doi: http://dx.doi.org/10.12777/wastech.1.1.17-21Citation:  Luong, N.D., Giang, H.M., Thanh, B.X. and Hung, N.T.  2013. Challenges for municipal solid waste management practices in Vietnam. Waste Technology 1(1:6-9.Doi: http://dx.doi.org/10.12777/wastech.1.1.17-21

  19. Digitally Controllable Current Amplifier and Current Conveyors in Practical Application of Controllable Frequency Filter

    Science.gov (United States)

    Polak, Josef; Jerabek, Jan; Langhammer, Lukas; Sotner, Roman; Dvorak, Jan; Panek, David

    2016-07-01

    This paper presents the simulations results in comparison with the measured results of the practical realization of the multifunctional second order frequency filter with a Digitally Adjustable Current Amplifier (DACA) and two Dual-Output Controllable Current Conveyors (CCCII +/-). This filter is designed for use in current mode. The filter was designed of the single input multiple outputs (SIMO) type, therefore it has only one input and three outputs with individual filtering functions. DACA element used in a newly proposed circuit is present in form of an integrated chip and the current conveyors are implemented using the Universal Current Conveyor (UCC) chip with designation UCC-N1B. Proposed frequency filter enables independent control of the pole frequency using parameters of two current conveyors and also independent control of the quality factor by change of a current gain of DACA.

  20. Polycystic ovary syndrome: current infertility management.

    Science.gov (United States)

    Aubuchon, Mira; Legro, Richard S

    2011-12-01

    This review summarizes the diagnosis of polycystic ovary syndrome and management of associated infertility. The goal is to guide clinicians through basic evaluation, initial treatment, and briefly describe more complex therapies.

  1. The current management of urolithiasis during pregnancy.

    Science.gov (United States)

    Loughlin, Kevin R; Ker, Lindsey A

    2002-08-01

    The management of urolithiasis in pregnancy can present complex challenges to the urologist. However, if the principles discussed above are followed, these difficult clinical problems can be approached in a rational manner.

  2. Facilities Management Practices in Malaysia: A Literature Review

    Directory of Open Access Journals (Sweden)

    Isa Nordiana Mohd

    2016-01-01

    Full Text Available Facilities management in Malaysia has been practiced for decades. The development of its formal practice parallels the improvement of the built environment in the nation. Involvement of the public and private sectors teaming up in arranging the National Asset and Facilities Management (NAFAM in demonstrates the vital collaboration in the facilities management area in Malaysia. Facilities management is seen distinctively as indicated by diverse geographical locations, interests and schools of thought. Facilities management is delegated a service-based industry which gives proficient counsel and administration of clients’ building facilities including residential, commercial, industrial, airports terminals and offices. The aim of this paper is to review the gaps that exist, especially on how FM is being practice in comparison with the published FM body of knowledge. Very relying upon literature, this paper discovered a gap that is an unclear description of current FM applications. This research aims to give new bits of knowledge to upgrade comprehension of FM execution in Malaysia.

  3. Current management options for recurrent adrenocortical carcinoma

    Directory of Open Access Journals (Sweden)

    Glover AR

    2013-06-01

    Full Text Available Anthony R Glover,1 Julian C Y Ip,1 Jing Ting Zhao,1 Patsy S H Soon,1,4 Bruce G Robinson,1,3 Stan B Sidhu1,2 1Kolling Institute of Medical Research, Cancer Genetics Laboratory, 2Endocrine Surgical Unit, 3Department of Endocrinology, Royal North Shore Hospital and University of Sydney, St Leonards, 4Department of Surgery, Bankstown Hospital and University of New South Wales, Bankstown, NSW, Australia Abstract: Adrenal cortical carcinoma (ACC is a rare cancer that poses a number of management challenges due to the limited number of effective systemic treatments. Complete surgical resection offers the best chance of long-term survival. However, despite complete resection, ACC is associated with high recurrence rates. This review will discuss the management of recurrent ACC in adults following complete surgical resection. Management should take place in a specialist center and treatment decisions must consider the individual tumor biology of each case of recurrence. Given the fact that ACC commonly recurs, management to prevent recurrence should be considered from initial diagnosis with the use of adjuvant mitotane. Close follow up with clinical examination and imaging is important for early detection of recurrent disease. Locoregional recurrence may be isolated, and repeat surgical resection should be considered along with mitotane. The use of radiotherapy in ACC remains controversial. Systemic recurrence most often involves liver, pulmonary, and bone metastasis and is usually managed with mitotane, with or without combination chemotherapy. There is a limited role for surgical resection in systemic recurrence in selected patients. In all patients with recurrent disease, control of excessive hormone production is an important part of management. Despite intensive management of recurrent ACC, treatment failure is common and the use of clinical trials and novel treatment is an important part of management. Keywords: recurrence, surgery, chemotherapy

  4. Risk Management Techniques and Practice Workshop Workshop Report

    Energy Technology Data Exchange (ETDEWEB)

    Quinn, T; Zosel, M

    2008-12-02

    At the request of the Department of Energy (DOE) Office of Science (SC), Lawrence Livermore National Laboratory (LLNL) hosted a two-day Risk Management Techniques and Practice (RMTAP) workshop held September 18-19 at the Hotel Nikko in San Francisco. The purpose of the workshop, which was sponsored by the SC/Advanced Scientific Computing Research (ASCR) program and the National Nuclear Security Administration (NNSA)/Advanced Simulation and Computing (ASC) program, was to assess current and emerging techniques, practices, and lessons learned for effectively identifying, understanding, managing, and mitigating the risks associated with acquiring leading-edge computing systems at high-performance computing centers (HPCCs). Representatives from fifteen high-performance computing (HPC) organizations, four HPC vendor partners, and three government agencies attended the workshop. The overall workshop findings were: (1) Standard risk management techniques and tools are in the aggregate applicable to projects at HPCCs and are commonly employed by the HPC community; (2) HPC projects have characteristics that necessitate a tailoring of the standard risk management practices; (3) All HPCC acquisition projects can benefit by employing risk management, but the specific choice of risk management processes and tools is less important to the success of the project; (4) The special relationship between the HPCCs and HPC vendors must be reflected in the risk management strategy; (5) Best practices findings include developing a prioritized risk register with special attention to the top risks, establishing a practice of regular meetings and status updates with the platform partner, supporting regular and open reviews that engage the interests and expertise of a wide range of staff and stakeholders, and documenting and sharing the acquisition/build/deployment experience; and (6) Top risk categories include system scaling issues, request for proposal/contract and acceptance testing, and

  5. Practical IT service management a concise guide for busy executives

    CERN Document Server

    Thejendra, BS

    2008-01-01

    Practical IT Service Management is a clear, concise and to the point guide to implementing IT service management (ITSM). It is based on ITIL Version 3, one of the most widely accepted best-practice approaches to ITSM

  6. Current trends in endodontic practice: emergency treatments and technological armamentarium.

    Science.gov (United States)

    Lee, Michelle; Winkler, Johnathon; Hartwell, Gary; Stewart, Jeffrey; Caine, Rufus

    2009-01-01

    The current clinical practice of endodontics includes the utilization of a variety of new technological advances and materials. The last comprehensive survey that compared treatment modalities used in endodontic practices was conducted in 1990. The purpose of the current survey was to determine the frequency with which these new endodontic technologies and materials are being used in endodontic practices today. An e-mail questionnaire was sent to the 636 active diplomates of the American Board of Endodontics with current e-mail addresses. Two hundred thirty-two diplomates responded for a response rate of 35%. Calcium hydroxide was found to be the most frequently used intracanal medicament for all cases diagnosed with necrotic pulps. Ibuprofen was the most frequently prescribed medication for pain, and penicillin was the most frequently prescribed antibiotic when an active infection was present. Eighty-two percent of the respondents are still incorporating hand files in some fashion during the cleansing and shaping phase of treatment. Lateral condensation and continuous wave were the most common methods used for obturation. Digital radiography was reported as being used by 72.5% of the respondents, whereas 45.3% reported using the microscope greater than 75% of the patient treatment. Ultrasonics was used by 97.8% of the respondents. It appears from the results that new endodontic technology is currently being used in the endodontic offices of those who responded to the survey.

  7. Innovative Soil Management Practices (SMP) Assessment in Europe and China

    Science.gov (United States)

    Barão, Lúcia

    2017-04-01

    The growing world population poses a major challenge to global agricultural food and feed production through the pressure to increase agricultural outputs either by increasing the land area dedicated to agriculture or by productivity increases. Whether in developed or developing regions, agricultural intensification based on conventional approaches has resulted in severe environmental impacts and innovative soil management practices are needed to halter ongoing soil degradation and promote sustainable land management capable to produce more from less. The iSQAPER project - Interactive Soil Quality Assessment in Europe and China for Agricultural Productivity and Environmental Resilience - aims to develop a Soil Quality app (SQAPP) linking soil and agricultural management practices to soil quality indicators. This easy friendly tool will provide a direct and convenient way to advise farmers and other suitable actors in this area, regarding the best management practices to be adopted in very specific and local conditions. In this particular study from iSQAPER, we aimed to identify the most promising innovative soil management practices (SMP) currently used and its geographical distribution along different pedo-climatic regions in Europe (Boreal, Atlantic, Mediterranean Temperate, Mediterranean Semi-Arid, Southern Sub-Continental and Northern Sub-Continental) and China (Middle Temperate, Warm temperate and Central Asia Tropical). So far we have identified 155 farms where innovative SMP's are used, distributed along 4 study site regions located in China (Qiyang, Suining, Zhifanggou and Gongzhuling) and 10 study site regions located in Europe (The Netherlands, France, Portugal, Spain, Greece, Slovenia, Hungary, Romania, Poland and Estonia) and covering the major pedo-climatic regions. From this identification we concluded that the most used innovative SMP's in the study site regions in Europe are Manuring & Composting (14%), Min-till (14%), Crop rotation (12

  8. Distributed Database Management Systems A Practical Approach

    CERN Document Server

    Rahimi, Saeed K

    2010-01-01

    This book addresses issues related to managing data across a distributed database system. It is unique because it covers traditional database theory and current research, explaining the difficulties in providing a unified user interface and global data dictionary. The book gives implementers guidance on hiding discrepancies across systems and creating the illusion of a single repository for users. It also includes three sample frameworksâ€"implemented using J2SE with JMS, J2EE, and Microsoft .Netâ€"that readers can use to learn how to implement a distributed database management system. IT and

  9. [Management of stroke in sub-Saharan Africa: current issues].

    Science.gov (United States)

    Adoukonou, T A; Vallat, J-M; Joubert, J; Macian, F; Kabore, R; Magy, L; Houinato, D; Preux, P-M

    2010-11-01

    In sub-Saharan Africa, stroke is likely to present an increasingly important public health problem with a larger relative share of overall morbidity and mortality. Overall, sub-Saharan Health Care is characterized by a lack of human resources, lack of facilities for special investigations, and especially an absence of specific programs addressing the prevention of cardiovascular conditions. Current data on the epidemiology of stroke in sub-Saharan Africa, although sparse and fragmentary, indicate a comparatively high incidence of cerebral hemorrhage associated with high blood pressure, while ischemic stroke in black Africans still appears to be related primarily to small artery disease, HIV infection, and sickle cell disease. With urbanization, the role of large-vessel atherosclerosis is increasing. It is thus essential to coordinate government funding, health care professionals and development agencies to address this rising health problem. Access to health care needs to be better structured, and screening programs should be developed in order to identify and treat vascular risk factors. Improved training of health care professionals is also required in the areas of prevention, diagnosis and management of stroke. Implementation of best-practice recommendations for the management of stroke adapted to the specificities and resources of African countries would help rationalize the scarce resources currently available. Copyright © 2010 Elsevier Masson SAS. All rights reserved.

  10. Cutaneous Scar Prevention and Management; Overview of current therapies

    Directory of Open Access Journals (Sweden)

    Sultan Al-Shaqsi

    2016-02-01

    Full Text Available Cutaneous scarring is common after trauma, surgery and infection and occurs when normal skin tissue is replaced by fibroblastic tissue during the healing process. The pathophysiology of scar formation is not yet fully understood, although the degree of tension across the wound edges and the speed of cell growth are believed to play central roles. Prevention of scars is essential and can be achieved by attention to surgical techniques and the use of measures to reduce cell growth. Grading and classifying scars is important to determine available treatment strategies. This article presents an overview of the current therapies available for the prevention and treatment of scars. It is intended to be a practical guide for surgeons and other health professionals involved with and interested in scar management.

  11. Cutaneous Scar Prevention and Management: Overview of current therapies.

    Science.gov (United States)

    Al-Shaqsi, Sultan; Al-Bulushi, Taimoor

    2016-02-01

    Cutaneous scarring is common after trauma, surgery and infection and occurs when normal skin tissue is replaced by fibroblastic tissue during the healing process. The pathophysiology of scar formation is not yet fully understood, although the degree of tension across the wound edges and the speed of cell growth are believed to play central roles. Prevention of scars is essential and can be achieved by attention to surgical techniques and the use of measures to reduce cell growth. Grading and classifying scars is important to determine available treatment strategies. This article presents an overview of the current therapies available for the prevention and treatment of scars. It is intended to be a practical guide for surgeons and other health professionals involved with and interested in scar management.

  12. Flecainide: Current status and perspectives in arrhythmia management

    Institute of Scientific and Technical Information of China (English)

    George; K; Andrikopoulos; Sokratis; Pastromas; Stylianos; Tzeis

    2015-01-01

    Flecainide acetate is a class IC antiarrhythmic agent and its clinical efficacy has been confirmed by the results of several clinical trials. Nowadays, flecainide is recommended as one of the first line therapies for pharmacological conversion as well as maintenance of sinus rhythm in patients with atrial fibrillation and/or supraventricular tachycardias. Based on the Cardiac Arrhythmia Suppression Trial study results, flecainide is not recommended in patients with structural heart disease due to high proarrhythmic risk. Recent data support the role of flecainide in preventing ventricular tachyarrhythmias in patients with catecholaminergic polymorphic ventricular tachycardia associated both with ryanodine receptor and calsequestrin mutations. We herein review the current clinical data related to flecainide use in clinical practice and some concerns about its role in the management of patients with coronary artery disease.

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

    African Journals Online (AJOL)

    Obesity in Nigeria: Current trends and management. ... The objective of the study is to review the current knowledge on the problems associated with obesity, ... of obesity, its epidemiology, risk factors, clinical complications and treatment ...

  14. Data issues for practical asset management

    Energy Technology Data Exchange (ETDEWEB)

    Bergman, W.; Meehan, J. [PowerNex Associates Inc., Toronto, ON (Canada)

    2007-07-01

    This paper presented opportunities for improvement of an electric utility's asset management processes, with particular reference to transmission utilities. The objective was to offer support for future maintenance and reinvestment decisions for assets such as disconnect switches and protection systems. Several recommendations were presented to help utilities quantify the state of assets and the risk to transmission system performance. Issues dealing with data gathering and condition assessment were considered. The basic approach to asset management decisions for disconnect switches and protection systems included a best practice survey; an infrared survey; a review of criticality criteria; maintenance practices; and, the possibility of refurbishment. It was noted that although there is minimal information on the performance or condition of switches, much is known about switch deficiencies. Therefore, data can be gathered to identify poor designs and substantiate changes to switch specifications and maintenance practices. Performance is the key driver for protection equipment. As such, a complete analysis of each protection operation is needed in order to understand the actual protection reliability and success. 1 tab., 1 fig.

  15. Gender Perspective to Vedic Education: Current Practices in Nepal

    Directory of Open Access Journals (Sweden)

    Rajendra Raj Timilsina

    2016-10-01

    Full Text Available Vedic civilization has seen changes in its history- from Satya Yug to current Kali Yug. There were equal rights and duties of both men and women at the beginning. Interpretations of Veda, brought out of the Puranas and externalities made the status unequal. Sanatan Dharma, which is still mainstream of Hinduism, has been challenged by reformist Arya Samaj. As a result, there are interpretive differences as well as practices. Such differences can be seen in contemporary Nepal for the last 130 years. Continuing the differences, classicism has been reviving in the education. This revival also commenced with the same dualism. In this qualitative approach of exploration, two different gurukuls of girls have been observed and analyzed from the field for the purpose of exploring the recent practices. The observation was based on respective scriptures as well as experts' interviews. These data have analyzed the confronting practices on gender in Veda and rooted ideas in contemporary Nepal.

  16. Current marketing practices in the nursing home sector.

    Science.gov (United States)

    Calhoun, Judith G; Banaszak-Holl, Jane; Hearld, Larry R

    2006-01-01

    Marketing is widely recognized as an essential business function across all industries, including healthcare. While many long-term care facilities adopted basic healthcare marketing practices and hired marketing staff by the early 1990s, a paucity of research on nursing home marketing exists in the literature. This study examines the extent to which nursing homes have developed more formulated marketing and related communication and promotional strategies as market competition has increased in this sector during the past two decades. In addition, we explored managers' perceptions of their control over marketing decision making, the impact of competition on the use of marketing practices, and areas for enhanced competitive positioning. Administrators from 230 nursing homes in 18 Southeastern Michigan counties were surveyed regarding (1) the adoption level of approximately 40 literature-based, best-practice marketing strategies; (2) the types of staff involved with the marketing function; and (3) their perception of their level of control over marketing functions and of local competition. Results from 101 (44 percent) survey participants revealed that although respondents viewed their markets as highly competitive, their marketing practices remained focused on traditional and relatively constrained practices. In relation to the importance of customer relationship management, the majority of the administrators reported intensive efforts being focused on residents and their families, referrers, and staff, with minimal efforts being extended to insurers and other types of payers. A significant positive relation was found between the intensity of marketing initiatives and the size of the facility (number of beds), whereas significant negative correlations were revealed in relation to occupancy and the perceived level of control over the function.

  17. Current management of locally recurrent rectal cancer

    DEFF Research Database (Denmark)

    Nielsen, Mette Bak; Laurberg, Søren; Holm, Thorbjörn

    2011-01-01

    ABSTRACT Objective: A review of the literature was undertaken to provide an overview of the surgical management of locally recurrent rectal cancer (LRRC) after the introduction of total mesorectal excision (TME). Method: A systematic literature search was undertaken using PubMed, Embase, Web...

  18. Current Research on Effective Classroom Management.

    Science.gov (United States)

    Emmer, Edmund T.

    This presentation provides an overview of research on classroom management, emphasizing results from a program of research conducted at the Research and Development Center for Teacher Education (University of Texas) during the last 5 years. These studies, along with others, provide a basis for describing important dimensions of teacher behavior…

  19. Pediatric asthma self-management: current concepts.

    Science.gov (United States)

    Robinson, L. D.

    1999-01-01

    The concept of asthma self-management began in asthma camps in the 1970s. Today all asthma camps are required to provide an educational asthma self-management program. The interaction between children and educators is brief, and if the children do not continue in an associated program after camp, the benefits may be lost. Open Airways, the first program developed specifically for minority children, has been the prototype for community asthma self-management. School-based intervention programs have incorporated asthma education into the health curriculum. Some asthma education programs include an emphasis on the environment. Another approach is to develop intervention projects with parents, as in the Head Start program. This program has been very effective in increasing early recognition of asthma and decreasing recidivism in a high-risk population. Another type of project addressed the reading ability and reading comprehension of asthmatic children. Improvement in reading skills resulted in a 47% decrease in asthma recidivism. After 18 months, there were only two hospitalizations among the enrolled participants. Asthma self-management programs that are most effective for inner-city children provide an interactive, culturally relevant form of asthma education and address issues such as literacy and continuity. PMID:12653391

  20. Aneurysmal disease – current management concepts

    African Journals Online (AJOL)

    an increase in diameter of ≥50% than that of the 'normal' undilated ... Professor Van Marle has a special interest in the endovascular management of peripheral ... balance the risk of intervention against ... Backache. Leg pain. Ureter obstruction (due to retroperitoneal. Hydro-ureter ... Open surgery is an effective procedure.

  1. Kidney Failure and Liver Allocation: Current Practices and Potential Improvements.

    Science.gov (United States)

    Saxena, Varun; Lai, Jennifer C

    2015-09-01

    In February 2002, the United Network for Organ Sharing implemented a system for prioritizing candidates for liver transplantation that was based on the risk of 90-day mortality as determined by the Model for End-Stage Liver Disease (MELD) score. As the MELD score is driven in part by serum creatinine as a marker of kidney function, the prevalence of kidney dysfunction and failure in patients with end-stage liver disease at the time of listing and at transplantation has steadily risen. In this review, we discuss current practices in liver transplantation in patients with kidney dysfunction focusing briefly on the decision to perform simultaneous liver-kidney transplantation. We then discuss pitfalls to the current practices of liver transplantation in patients with kidney dysfunction. We conclude by discussing potential improvements to current practices including the use of the MELD-Na score, alternatives to creatinine and creatinine-based equation for estimating kidney function, and the use of intraoperative kidney replacement therapy during liver transplantation.

  2. Management of upper dyspepsia in general practice

    DEFF Research Database (Denmark)

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

    of dyspepsia, dyspeptic episodes, main symptom, previous contact to general practice, previous gastroscopia, use of antacids or NSAID's, Helicobacter Pylori status and mental/physical well being (SF-36 measurement scale) (Table 1). After two weeks the GPs assessed 46 % of the patients to be free of symptoms...... Aim: To compare the effect of two strategies for management of dyspepsia. Evaluation based on GP's assessment after two weeks and patients assessment after three months.   Design: Prospective randomised controlled trial in general practice   Methods: 357 patients with dyspepsia where the general...... after 3 months.   Results: Response rate GPs after two weeks were 92% (330/357). Response rate patients after three months were 71% (252/357). There were no significant difference between the groups randomised to strategy 1(PPI group) and strategy 2 (endoscopy group) concerning, age, gender, duration...

  3. Practical Implementation of Sustainable Urban Management Tools

    DEFF Research Database (Denmark)

    Nielsen, Susanne Balslev; Jensen, Jesper Ole; Hoffmann, Birgitte

    2006-01-01

    The paper discusses how to promote the use of decision support tools for urban sustainable development. The interest in decision support tools based on indicators is increasing among practitioners and researchers. The research has so far focused on indicator types and systems of indicators...... of intermediary actors. The paper is based on the Danish part of the PETUS-project (Practical Evaluation of Urban Sustainability) and the INTERMEDIARY-project (New intermediary services and the transformation of urban water supply and waste water disposal systems in Europe). Further the paper draws on Danish...... experiences with urban sustainable management tools. The experiences rank from simple approaches of municipalities publishing indicators or green accounts, to more advanced approaches of urban sustainability integrated in environmental management systems....

  4. Practical Management of Anaesthesia in the Elderly

    DEFF Research Database (Denmark)

    Strøm, Camilla; Rasmussen, Lars Simon; Steinmetz, Jacob

    2016-01-01

    The elderly population is rapidly growing and particularly diverse. Ageing leads to reduced organ function and a decline in physiologic reserve. Elderly patients are characterised by great inter-individual variability in physiological function with a high prevalence of chronic disease. In general......, older patients have a higher risk of postoperative adverse outcomes, and frailty is a very important risk factor. This review article aims to provide a practical guide to anaesthetic management of the elderly surgical patient. To optimise care, clinicians should be familiar with the typical physiologic...... changes related to ageing and the implications for anaesthetic management. All anaesthetic techniques, methods and agents can be applied, if tailored to the patient's physiologic and pathologic changes. The elderly are more sensitive to anaesthetics, meaning that desired sedative and analgesic effects...

  5. Management of professionals in school practices

    DEFF Research Database (Denmark)

    Jacobsen, Alice Juel; Buch, Anders

    2016-01-01

    This article investigates organizational reform changes as they are con-structed in the interaction between managers and teachers in a school context. The empirical basis is comprised of case studies carried out in Danish upper secondary schools. An ethnographic approach and a concept of paradox...... related to an under-standing of professionals are used to investigate the practices involved in the change processes. The article argues that the ambiguity of a primus inter pares management position among professionals leads to several paradoxes, deadlocks, and detours, all of which affect the work...... for change in the schools. Significant paradoxes are identi-fied on the basis of the empirical material, and methodological advantages of a pro-posed paradox perspective, are demonstrated....

  6. Green Human Resource Management: Policies and practices

    Directory of Open Access Journals (Sweden)

    Shoeb Ahmad

    2015-12-01

    Full Text Available Recently, there has been observed an increasing awareness within business communities on the significance of going green and adopting various environment management techniques. As the corporate world is going global, the business is experiencing a shift from a conventional financial structure to a modern capacity-based economy which is ready to explore green economic facets of business. Today, Green Human Resource Management (GHRM has become a key business strategy for the significant organizations where Human Resource Departments play an active part in going green at the office. The paper largely focuses upon the various Green Human Resource Practices pursued by the organizations all over the world and, explains the simplified meaning of GHRM. The study also adds to the extant literature by discussing future direction of some GHRM functions. Finally, the paper suggests some potentially prolific HR initiatives for Green organizations.

  7. Supply Chain Management Practices Impact on the Healthcare Perceived Organizational Performance in Malaysia

    Directory of Open Access Journals (Sweden)

    Meisam Karami

    2014-04-01

    Full Text Available The structure of the current study is based on to the prior studies on supply chain management practices and perceived organizational performance. The objective of the current study is to create a conceptual framework to investigating the link between supply chain management practices and healthcare’s perceived organizational performance that indicates the mediating impact of alliance integrated network in Malaysia. Dimensions of supply chain management practices such as demand management, information and technology management capacity and resource management, customer relationship management, supplier relationship management are determined to have a positive and significant relationship with perceived organizational performance. Furthermore, alliance network have the mediation impact on the direct relationship. The proposed research framework applies to a Malaysian health care industry which has limited studies.

  8. Records Management Practices in the Zambian Pension Industry ...

    African Journals Online (AJOL)

    Records Management Practices in the Zambian Pension Industry. ... pension industry face numerous challenges in as far as records management is concerned. ... some benefits of records management such as reduced time and effort spent to ...

  9. A review of sustainable facilities management knowledge and practice

    Directory of Open Access Journals (Sweden)

    Baaki Timothy Kurannen

    2016-01-01

    Full Text Available Sustainability is seen as a far-reaching issue now, and one which the facilities management [FM] profession cannot overlook. This paper explores current sustainable facilities management [SFM] knowledge and practice with specific focus on performance as part of a research focus toward proposing a sustainable FM performance management framework for sustainable healthcare waste management in Malaysia. This paper utilized a review of extant literature on the subject of SFM, FM performance and FM development in Malaysia as source of information. Findings reflect the increasing recognition of the need for the strategic FM function, and how facilities managers are best positioned to drive organizations’ sustainability agendas. In Malaysian context, this recognition is barely evident as findings show FM practice is still immature and predominantly operational. Unlike developed FM markets, FM relevance in Malaysia is being driven by the public sector. Also findings show a disharmony between organizations’ sustainability priority areas and the responsibilities for facilities managers to execute them where the sustainability policy of organizations prioritize one FM service and the facilities managers’ responsibilities prioritize another. As most of SFM implementation is driven by legislation this seems to strengthen the position that, organizations continue to view support services as non-value-adding, as unavoidable liabilities. The implication of this is the pressure on the FM function to continually express its strategic relevance to organizations by tangible value-adding performance output. This creates a new perspective to measuring and managing facilities performance. This paper therefore elevates the importance of FM performance management in SFM context taking into account the peculiar position of the facilities manager. This is seen as a way forward for FM to better express its value to the organization

  10. 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

  11. Organizational change and current trends in management

    Directory of Open Access Journals (Sweden)

    Lect. Dr. Chirimbu Sebastian

    2011-05-01

    Full Text Available The challenge is to manage the organization's culture so that you can tap the company's strenghts to chieve superior performance and identify it's weaknesses in time to overcome them before they cause serious damage." Successful adaptation to change is as crucial within an organization as it is in the natural world. Just like plants and animals, organizations and the individuals in them inevitably encounter changing conditions that they are powerless to control.

  12. Current management of the short bowel syndrome.

    Science.gov (United States)

    Thompson, Jon S; Weseman, Rebecca; Rochling, Fedja A; Mercer, David F

    2011-06-01

    Short bowel syndrome is a challenging clinical problem that benefits from a multidisciplinary approach. Much progress has recently been made in all aspects of management. Medical intestinal rehabilitation should be the initial treatment focus, and several new potential pharmacologic agents are being investigated. Surgical rehabilitation using nontransplant procedures in selected patients may further improve intestinal function. Intestinal lengthening procedures are particularly promising. Intestinal transplantation has increasingly been used with improving success in patients with life-threatening complications of intestinal failure.

  13. 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.

  14. Airway management in pierre robin sequence: patterns of practice.

    Science.gov (United States)

    Collins, Benjamin; Powitzky, Rosser; Robledo, Candace; Rose, Christopher; Glade, Robert

    2014-05-01

    Objectives : To report survey results from American Cleft Palate-Craniofacial Association members on the practice patterns of airway obstruction management in patients with Pierre Robin sequence. Design : A 10-question online survey was sent and the data were reviewed. Setting : Online survey of members of the American Cleft Palate-Craniofacial Association. Patients : Surveys assessed management patterns of patients with Pierre Robin sequence whom a surgeon member of the American Cleft Palate-Craniofacial Association treated for airway obstruction. Interventions : The survey comprised data on management strategies for airway obstruction in Pierre Robin sequence, including tracheostomy, tongue-lip adhesion, mandibular distraction, and treatments that falls in the "other" category. Results : A total of 87 American Cleft Palate-Craniofacial Association members completed the survey. Respondents' results were analyzed as a whole and by individual subspecialty: plastic surgery (n = 33), oromaxillofacial surgery (n = 21), and otolaryngology (n = 29). Although most of the surgeons were trained to manage airway obstruction in Pierre Robin sequence patients using tracheostomy (47%, n = 39) and tongue-lip adhesion (31%, n = 26), 48% reported a current preference for mandibular distraction (n = 40). Of surgeons who preferred to manage Pierre Robin sequence with tongue-lip adhesion (n = 23), 65% were trained to do so (n = 15). Surgeons preferring mandibular distraction (n = 40) and tracheostomy (n = 14) more often reported they were trained to manage Pierre Robin sequence with tracheostomy. Conclusions : Currently there are various practice patterns for the management of airway obstruction in Pierre Robin sequence. Training habits and subspecialty category may influence a surgeon's preference in patients who fail conservative therapy. Treatment guidelines are lacking and may require significant collaboration among centers and subspecialties to develop a more standardized

  15. The role of management in an in vitro fertilization practice.

    Science.gov (United States)

    Masler, Steve; Strickland, Robert R

    2013-05-01

    An in vitro fertilization (IVF) practice is an enterprise. Like any enterprise, it has management that plays a major role, forming the structure, framework, and components that make the practice viable. Management of an IVF practice consists of two key teams: the fertility team and the management team. Management activities of the teams fall into eight core areas: business operations, financial, human resources, information technology, organizational governance, risk management, patient care systems, and quality management. Shady Grove Fertility Centers and Huntington Reproductive Center are two examples of professionally managed large fertility practices, one managed mostly centrally and the other largely managed in a decentralized way. Management is what takes a physician's IVF practice and converts it to a professional enterprise.

  16. Current Models and Innovative Strategies in Management Education in China.

    Science.gov (United States)

    Wang, Zhong-Ming

    1999-01-01

    Current models of management education in China include national training, on-the-job technical training, and the national master's of business administration supervisory committee. Effective strategies being used include teamwork, process skills, action learning, cross-cultural management learning, and competency-based management development. (SK)

  17. Managing hospital doctors and their practice: what can we learn about human resource management from non-healthcare organisations?

    OpenAIRE

    Trebble, Timothy M.; Heyworth, Nicola; Clarke, Nicholas; Powell, Timothy; Hockey, Peter M

    2014-01-01

    Background Improved management of clinicians’ time and practice is advocated to address increasing demands on healthcare provision in the UK National Health Service (NHS). Human resource management (HRM) is associated with improvements in organisational performance and outcomes within and outside of healthcare, but with limited use in managing individual clinicians. This may reflect the absence of effective and transferrable models. Methods The current systems of managing the performance of i...

  18. A best practices approach to caries management.

    Science.gov (United States)

    Hurlbutt, Michelle; Young, Douglas A

    2014-06-01

    Caries management by risk assessment represents best practices and is an evidence-based model that focuses on treating and preventing disease at the patient level rather than a surgical/restorative approach at the tooth level. Dental caries is a multifactorial, biofilm and pH mediated disease that affects people of all ages and disproportionally affects certain populations at epidemic proportions. Simply restoring cavitated teeth does nothing to resolve the disease. At the heart of the CAMBRA philosophy is identifying the patient's unique risk level for future caries disease. This can be done by completing a caries risk assessment (CRA). Several easy to use CRA questionnaires are available. Once the patient's unique risk level has been determined, preventive and therapeutic interventions, based on the specific risk level, can then be implemented. Landmark publications, original research, and systematic reviews are analyzed and reviewed to form the basis for this shift in patient care related to caries disease. Caries management by risk assessment has emerged as the new paradigm in patient care and represents an evidence-based, best practices approach with the potential for significant advantages over traditional methods. Copyright © 2014 Elsevier Inc. All rights reserved.

  19. Employment of people with disabilities: Implications for HR management practices

    Directory of Open Access Journals (Sweden)

    P. Gida

    2007-12-01

    Full Text Available Purpose: The purpose of this paper is to, firstly, present the findings of an empirical study in which the human resource management practices associated with the employment of people with disabilities were investigated. The human resource management challenges related to employment of people with disabilities were also identified in the empirical study and are presented in this paper. A further purpose of this paper is to propose a number of recommendations focused on human resource management practices and principles aimed at assisting managers and human resource management specialists in their endeavours to effectively deal with the employment of people with disabilities. Design/Methodology/Approach: This paper is based on an empirical study in which interviews were conducted with respondents from 19 different organisations identified in the Financial Mail's 'Top 100 Organisations in South Africa' list. Findings: The findings from the empirical study suggest that very few organisations are dealing with the employment of people with disabilities as a priority in their equity strategies. Where attention is being given to this issue, respondents seem to either address it as a legal compliance issue or a social responsibility 'project'. Furthermore, very little has been done to review current human resource management practices to determine whether they are discriminatory towards people with disabilities. Based on the insights gained from these findings and in line with best practice principles identified in the relevant literature, a number of recommendations focusing on human resource management practices and principles in relation to the employment of people with disabilities are proposed. Implications: This paper provides a number of practical steps to consider as part of an organisation's response to equity strategies related to the employment of people with disabilities.Originality/Value: In the Employment Equity Commission's Annual Report

  20. Clinical practice guideline for the management of intracranial aneurysms.

    Science.gov (United States)

    Jeong, Hae Woong; Seo, Jung Hwa; Kim, Sung Tae; Jung, Cheol Kyu; Suh, Sang-Il

    2014-09-01

    An intracranial aneurysm, with or without subarachnoid hemorrhage (SAH), is a relevant health problem. The rupture of an intracranial aneurysm is a critical concern for individual health; even an unruptured intracranial aneurysm is an anxious condition for the individual. The aim of this guideline is to present current and comprehensive recommendations for the management of intracranial aneurysms, with or without rupture. We performed an extensive literature search, using Medline. We met in person to discuss recommendations. This document is reviewed by the Task Force Team of the Korean Society of Interventional Neuroradiology (KSIN). We divided the current guideline for ruptured intracranial aneurysms (RIAs) and unruptured intracranial aneurysms (UIAs). The guideline for RIAs focuses on diagnosis and treatment. And the guideline for UIAs focuses on the definition of a high-risk patient, screening, principle for treatment and selection of treatment method. This guideline provides practical, evidence-based advice for the management of patients with an intracranial aneurysm, with or without rupture.

  1. Optimal management of chronic osteomyelitis: current perspectives

    Directory of Open Access Journals (Sweden)

    Pande KC

    2015-08-01

    Full Text Available Ketan C Pande Raja Isteri Pengiran Anak Saleha Hospital, Bandar Seri Begawan, BruneiAbstract: Chronic osteomyelitis is a challenging condition to treat. It is seen mostly after open fractures or in implant-related infections following treatment of fractures and prosthetic joint replacements. Recurrence of infection is well known, and successful treatment requires a multidisciplinary team approach with surgical debridement and appropriate antimicrobial therapy as the cornerstone of treatment. Staging of the disease and identification of the causative microorganism is essential before initiation of treatment. Important surgical steps include radical debridement of necrotic and devitalized tissue, removal of implants, management of resultant dead space, soft-tissue coverage, and skeletal stabilization or management of skeletal defects. The route of administration and duration of antimicrobial therapy continues to be debated. The role of biofilm is now clearly established in the chronicity of bone infection, and newer modalities are being developed to address various issues related to biofilm formation. The present review addresses various aspects of chronic osteomyelitis of long bones seen in adults, with a review of recent developments. Keywords: osteomyelitis, infection, biofilm, bone, therapy, treatment

  2. The current management of Turner Syndrome.

    Science.gov (United States)

    Kriksciuniene, Ruta; Zilaitiene, Birute; Verkauskiene, Rasa

    2016-03-01

    Turner Syndrome (TS) is a rare disease, with the incidence of 1 of 2500 life born females. Characteristic features are: growth retardation, gonadal dysgenesis and impairment, congenital and acquired cardiovascular disorders. New management possibilities in Turner Syndrome are coming along with the new scientific evidence on the pathogenesis of TS developmental, metabolic, cardiovascular and reproductive issues. Attitude to the growth retardation treatment and hormone replacement therapy is changing. The effectiveness of additional androgen doses for growth improvement and low estrogen doses in the early childhood for better puberty induction and metabolic outcomes has been demonstrated recently. There are some new concerns about pregnancy induced progression of cardiovascular pathology in TS. Inadequate follow-up despite strict and clear guidelines of TS patients is still an issue in the health care system in many countries. This rare disorder requires multidiscipline approach of experienced professionals. The aim of this review is to overview recent studies evaluating TS, to focus on the possibilities to avoid crucial outcomes of this disorder and to improve management and follow-up.

  3. Reflection as a strategy to improve management practice: Insights from management education

    Directory of Open Access Journals (Sweden)

    Linda Ronnie

    2016-03-01

    Full Text Available Orientation: This study examines the role of reflection as a learning strategy for management students and how this process can contribute to developing a cadre of useful and effective managers.Research purpose: Using data from MBA student work, the aim of the study was to explore reflection as a pedagogical strategy to enhance management practice within an emerging market context.Motivation for the study: The development of more rigorous, thoughtful and decision-focussed management is among the challenges facing organisations in South Africa. Within management education, reflection is seen as a potential strategy to address this issue.Research approach, design and method: This qualitative study sampled 513 students’ reflective assignments. Students were given an individual task as a deliberate strategy to reflect on their own learning and provide insight on the benefits and challenges of the process. Coding was conducted along thematic lines.Main findings: The findings showed that students gained self-awareness and insight into their own management and organisational practices. Their application of concepts, tools and techniques was also enhanced, as was their understanding of working with others.Practical implications: Personal growth, transformation and development in terms of current and future management roles were all outcomes of the reflective process. Skills such as probing, analysing and synthesis – all essential to managers – are encouraged through a reflective mindset.Contribution: The findings of this study indicated that a deeper understanding and improved clarity of management and organisational practices ensued as an outcome of the reflective process.

  4. LIQUIDITY MANAGING A CURRENT JOB OF BANKING MANAGEMENT

    Directory of Open Access Journals (Sweden)

    MEDAR LUCIAN-ION

    2014-02-01

    Full Text Available A credit institution liquidity managing, concerns on currency flows and operative funding needs, for customer satisfaction. Correlating bank liabilities and assets reflects the overall picture of the liquidity situation. The purpose of an efficient management of bank liquidity is to ensure the normal course of banking intermediation, to protect the interests of customers on one side and of the shareholders on the other side. Through an efficient bank liquidity management, are ensured reserve requirements and especially reasonable banking capacity of deposits reimbursement to customers, correlated with period in which they are or there are not returned to the credit institution, investments in the loans and other assets.

  5. Electronics waste management: Indian practices and guidelines

    Energy Technology Data Exchange (ETDEWEB)

    Bandyopadhyay, Amitava [Department of Chemical Engineering. University of Calcutta, 92, A.P.C.Road. Kolkata 700 009 (India)

    2010-07-01

    Electronic waste or e-waste or waste electrical and electronic equipment (WEEE) is a popular, informal name for discarded electrical and electronic equipment (EEE) with all of their peripherals at their end-of-life. WEEE constitutes 8% of municipal waste and is one of the fastest growing waste streams. The fraction of precious and other metals in e-waste is over 60%, while pollutants comprise a meager 2.70%. Given the volume of WEEE generated containing toxic materials, it emerges as a risk to the society. Considering the high toxicity of these pollutants especially when burned or recycled in uncontrolled environments, the Basel Convention has identified e-waste as hazardous, and developed a framework for controls on transboundary movement of such waste. In contrast, WEEE can offer a tremendous business opportunity if it would treat in proper manner. The management of the WEEE has thus become a global challenge in today's world. Several nations across the globe have implemented or are about to implement WEEE regulations based on the principle of Extended Producer Responsibility (EPR). Both existing and proposed solutions are implemented with various degrees of centralization. Practical implementations however, can give rise to absurd organizational outcomes. In the light of these findings, the present paper deals with the Indian initiatives on the WEEE management keeping pace with the international scenario. Initially, this paper aims to draw an overview on the basics of WEEE. Next, the international legislative practices followed by Indian initiatives intended to help manage these growing quantities of this waste stream are discussed.

  6. Electronics waste management: Indian practices and guidelines

    Directory of Open Access Journals (Sweden)

    Amitava Bandyopadhyay

    2010-09-01

    Full Text Available Electronic waste or e-waste or waste electrical and electronic equipment (WEEE is a popular, informal name for discarded electrical and electronic equipment (EEE with all of their peripherals at their end-of-life. WEEE constitutes 8% of municipal waste and is one of the fastest growing waste streams. The fraction of precious and other metals in e-waste is over 60%, while pollutants comprise a meager 2.70%. Given the volume of WEEE generated containing toxic materials, it emerges as a risk to the society. Considering the high toxicity of these pollutants especially when burned or recycled in uncontrolled environments, the Basel Convention has identified e-waste as hazardous, and developed a framework for controls on transboundary movement of such waste. In contrast, WEEE can offer a tremendous business opportunity if it would treat in proper manner. The management of the WEEE has thus become a global challenge in today’s world. Several nations across the globe have implemented or are about to implement WEEE regulations based on the principle of Extended Producer Responsibility (EPR. Both existing and proposed solutions are implemented with various degrees of centralization. Practical implementations however, can give rise to absurd organizational outcomes. In the light of these findings, the present paper deals with the Indian initiatives on the WEEE management keeping pace with the international scenario. Initially, this paper aims to draw an overview on the basics of WEEE. Next, the international legislative practices followed by Indian initiatives intended to help manage these growing quantities of this waste stream are discussed.

  7. The presentation, pathology, and current management strategies of cutaneous metastasis

    Directory of Open Access Journals (Sweden)

    Christina Yin Bin Wong

    2013-01-01

    Full Text Available Skin metastases are rare in the routine clinical practice of dermatology, but are of major clinical significance because they usually indicate advanced disease. We reviewed the literature on skin metastasis regarding recent trends in clinical presentation and diagnosis of the most common cutaneous lesions. An extensive literature review was conducted using PubMed from May 26, 2011 to July 16, 2013 relating cutaneous metastases. Articles chosen for reference were queried with the following prompts: "Cutaneous metastases", "clinical presentation", "histological features", and "immunohistochemistry". Further searches included "treatment" and "management" options for "metastatic breast", "metastatic colorectal", "metastatic melanoma", "metastatic lung", and "hematologic cancers." We also reviewed the literature on the current management of melanoma as a model for all cutaneous metastatic disease. Our own clinical findings are presented and compared to the literature. Additionally, we highlight the most useful immunohistochemical studies that aid in diagnoses. Several novel therapies and combination therapies such as electrochemotherapy, vemurafenib, and imiquimod will be discussed for palliative treatment of cancers that have been found to improve cutaneous lesions. We review these notable findings and developments regarding skin metastases for the general dermatologist.

  8. Current and emerging treatment options in the management of lupus

    Directory of Open Access Journals (Sweden)

    Jordan N

    2016-03-01

    Full Text Available Natasha Jordan,1 David D’Cruz2 1Department of Rheumatology, Cambridge University Hospitals NHS Foundation Trust, Cambridge, 2Louise Coote Lupus Unit, Guy’s and St Thomas’ Hospital NHS Foundation Trust, London, UK Abstract: Systemic lupus erythematosus (SLE is a complex autoimmune disease with variable clinical manifestations. While the clearest guidelines for the treatment of SLE exist in the context of lupus nephritis, patients with other lupus manifestations such as neuropsychiatric, hematologic, musculoskeletal, and severe cutaneous lupus frequently require immunosuppression and/or biologic therapy. Conventional immunosuppressive agents such as mycophenolate mofetil, azathioprine, and cyclophosphamide are widely used in the management of SLE with current more rationalized treatment regimens optimizing the use of these agents while minimizing potential toxicity. The advent of biologic therapies has advanced the treatment of SLE particularly in patients with refractory disease. The CD20 monoclonal antibody rituximab and the anti-BLyS agent belimumab are now widely in use in clinical practice. Several other biologic agents are in ongoing clinical trials. While immunosuppressive and biologic agents are the foundation of inflammatory disease control in SLE, the importance of managing comorbidities such as cardiovascular risk factors, bone health, and minimizing susceptibility to infection should not be neglected. Keywords: hydroxychloroquine, mycophenolate mofetil, azathioprine, cyclophosphamide, rituximab, belimumab

  9. Current and emerging treatment options in the management of lupus.

    Science.gov (United States)

    Jordan, Natasha; D'Cruz, David

    2016-01-01

    Systemic lupus erythematosus (SLE) is a complex autoimmune disease with variable clinical manifestations. While the clearest guidelines for the treatment of SLE exist in the context of lupus nephritis, patients with other lupus manifestations such as neuropsychiatric, hematologic, musculoskeletal, and severe cutaneous lupus frequently require immunosuppression and/or biologic therapy. Conventional immunosuppressive agents such as mycophenolate mofetil, azathioprine, and cyclophosphamide are widely used in the management of SLE with current more rationalized treatment regimens optimizing the use of these agents while minimizing potential toxicity. The advent of biologic therapies has advanced the treatment of SLE particularly in patients with refractory disease. The CD20 monoclonal antibody rituximab and the anti-BLyS agent belimumab are now widely in use in clinical practice. Several other biologic agents are in ongoing clinical trials. While immunosuppressive and biologic agents are the foundation of inflammatory disease control in SLE, the importance of managing comorbidities such as cardiovascular risk factors, bone health, and minimizing susceptibility to infection should not be neglected.

  10. Bimodal Programming: A Survey of Current Clinical Practice.

    Science.gov (United States)

    Siburt, Hannah W; Holmes, Alice E

    2015-06-01

    The purpose of this study was to determine the current clinical practice in approaches to bimodal programming in the United States. To be specific, if clinicians are recommending bimodal stimulation, who programs the hearing aid in the bimodal condition, and what method is used for programming the hearing aid? An 11-question online survey was created and sent via email to a comprehensive list of cochlear implant programming centers in the United States. The survey was sent to 360 recipients. Respondents in this study represented a diverse group of clinical settings (response rate: 26%). Results indicate little agreement about who programs the hearing aids, when they are programmed, and how they are programmed in the bimodal condition. Analysis of small versus large implant centers indicated small centers are less likely to add a device to the contralateral ear. Although a growing number of cochlear implant recipients choose to wear a hearing aid on the contralateral ear, there is inconsistency in the current clinical approach to bimodal programming. These survey results provide evidence of large variability in the current bimodal programming practices and indicate a need for more structured clinical recommendations and programming approaches.

  11. Current Diagnosis and Management of Gastrojejunocolic Fistula

    Directory of Open Access Journals (Sweden)

    Can Kece

    2010-05-01

    Full Text Available We herein report the case of a 51-year-old man with gastrojejunocolic fistula. It is one of the late severe complications of gastrectomy and gastrojejunostomy and is considered to be induced by a stomal ulcer due to inadequate resection of the stomach and incompleteness of vagotomy. The main clinical presentation of this condition is chronic abdominal pain, weight loss, diarrhea, gastrointestinal bleeding and fecal vomiting. The diagnostic workup should include barium enema, gastroscopy and sometimes colonoscopy and abdominal tomography for excluding and ruling out the possibility of malignant extraluminal disease. The historical approach of the treatment of this rare entity was 2–3-phased operations which included colostomy. However today, medical management has recently been recommended as the first-line therapy, with parenteral and enteral support treatments. The preferred surgical approach is single-stage gastrocolic resection and anastomosis and this has been favored to minimize mortality.

  12. Theoretical and Practical Aspects of Logistic Quality Management System Documentation Development Process

    Directory of Open Access Journals (Sweden)

    Linas Šaulinskas

    2013-12-01

    Full Text Available This paper addresses aspects of logistics quality management system documentation development and suggests models for quality management system documentation development, documentation hierarchical systems and authorization approval. It also identifies logistic processes and a responsibilities model and a detailed document development and approval process that can be practically applied. Our results are based upon an analysis of advanced Lithuanian and foreign corporate business practices, a review of current literature and recommendations for quality management system standards.

  13. Current management of surgical oncologic emergencies.

    Directory of Open Access Journals (Sweden)

    Marianne R F Bosscher

    Full Text Available For some oncologic emergencies, surgical interventions are necessary for dissolution or temporary relieve. In the absence of guidelines, the most optimal method for decision making would be in a multidisciplinary cancer conference (MCC. In an acute setting, the opportunity for multidisciplinary discussion is often not available. In this study, the management and short term outcome of patients after surgical oncologic emergency consultation was analyzed.A prospective registration and follow up of adult patients with surgical oncologic emergencies between 01-11-2013 and 30-04-2014. The follow up period was 30 days.In total, 207 patients with surgical oncologic emergencies were included. Postoperative wound infections, malignant obstruction, and clinical deterioration due to progressive disease were the most frequent conditions for surgical oncologic emergency consultation. During the follow up period, 40% of patients underwent surgery. The median number of involved medical specialties was two. Only 30% of all patients were discussed in a MCC within 30 days after emergency consultation, and only 41% of the patients who underwent surgery were discussed in a MCC. For 79% of these patients, the surgical procedure was performed before the MCC. Mortality within 30 days was 13%.In most cases, surgery occurred without discussing the patient in a MCC, regardless of the fact that multiple medical specialties were involved in the treatment process. There is a need for prognostic aids and acute oncology pathways with structural multidisciplinary management. These will provide in faster institution of the most appropriate personalized cancer care, and prevent unnecessary investigations or invasive therapy.

  14. Operation And Maintenance In Facilities Management Practices: A Gap Analysis In Malaysia

    Directory of Open Access Journals (Sweden)

    Zawawi Zuraihana Ahmad

    2016-01-01

    Full Text Available Facilities management in Malaysia has started as early as 1990s during the development of mega projects such as Putrajaya in 1999 [8, 9]. During this period, Malaysia was introduced to an integrated property management and maintenance services known as facilities management. However, its implementation according to the standard practice is still being disputed. The purpose of facilities management standard practices is to provide the facility management profession with a leading reference on facilities management activities and standards. Therefore, the determination of how far the gap in FM current practice is essential to help our FM industry. Thus, the aim of this study is to establish the gap between the current practices and the standard practices and also how far the gap should be satisfied. A set of questionnaire was designed upon literature and previous research done to gather the required information. The study is subjected to FM organizations in private sectors and only the personnel at management level are assessed. There were certified that most of the practices that assessed by means of gap analysis had an acceptable result which the gap between the current practices and the standard practices are not too far.

  15. Harvest managements and cultural practices in sugarcane

    Directory of Open Access Journals (Sweden)

    Sérgio Gustavo Quassi de Castro

    2014-02-01

    Full Text Available The presence of trash from the mechanical harvest of green cane on sugarcane plantations promotes changes in the agricultural management, for example, in the mechanical cultural practices of ratoon cane in-between the rows and nitrogen (N fertilization. The goal of this study was to evaluate the performance of sugarcane in different harvest systems, associated to the mechanical cultural practices in interrows and N rates. The study was carried out on a sugarcane plantation in Sales Oliveira, São Paulo, Brazil, with the sugarcane variety SP81-3250, on soil classified as Acrudox, in a randomized block design with split-split plots and four replications. The main treatments consisted of harvest systems (harvesting green cane or burnt cane, the secondary treatment consisted of the mechanical cultural practices in the interrows and the tertiary treatments were N rates (0, 30, 60, 90, 120 and 160 kg ha-1, using ammonium nitrate (33 % N as N source. The harvest systems did not differ in sugarcane yield (tons of cane per hectare - TCH, but in burnt cane, the pol percent and total sugar recovery (TSR were higher. This could be explained by the higher quantity of plant impurities in the harvested raw material in the system without burning, which reduces the processing quality. Mechanical cultural practices in the interrows after harvest had no effect on cane yield and sugar quality, indicating that this operation can be omitted in areas with mechanical harvesting. The application of N fertilizer at rates of 88 and 144 kg ha-1 N, respectively, increased stalk height and TCH quadratically to the highest values for these variables. For the sugar yield per hectare (in pol %, N fertilization induced a linear increase.

  16. Self-Assessment in Librarianship: Current Practices and Future Possibilities

    Directory of Open Access Journals (Sweden)

    Ania Dymarz

    2015-07-01

    Full Text Available The authors of this qualitative study set out to investigate self-assessment practices within the library profession. The researchers conducted semi-structured interviews with a purposeful sample of nine librarians coming from a range of library settings and possessing a diversity of library experience. Interviews were then transcribed and coded in NVIVO to identify emergent themes. This paper details some of the results of that study, highlighting motivations, limitations, and strategies with regard to self-assessment. The findings present a summary of a range of approaches to the practice of assessment as reported by the interviewees. One area of possible growth for our profession, as highlighted by the findings, is in the development of peer networks as a support for the individual practice of self-assessment. While the results of this small case study cannot be generalized, the authors hope these preliminary findings can open up the conversation around self-assessment both for individual librarians and for those librarians and managers working to shape their workplace culture.

  17. Pathogen reduction co-benefits of nutrient best management practices

    Directory of Open Access Journals (Sweden)

    Jennifer Richkus

    2016-11-01

    Full Text Available Background Many of the practices currently underway to reduce nitrogen, phosphorus, and sediment loads entering the Chesapeake Bay have also been observed to support reduction of disease-causing pathogen loadings. We quantify how implementation of these practices, proposed to meet the nutrient and sediment caps prescribed by the Total Maximum Daily Load (TMDL, could reduce pathogen loadings and provide public health co-benefits within the Chesapeake Bay system. Methods We used published data on the pathogen reduction potential of management practices and baseline fecal coliform loadings estimated as part of prior modeling to estimate the reduction in pathogen loadings to the mainstem Potomac River and Chesapeake Bay attributable to practices implemented as part of the TMDL. We then compare the estimates with the baseline loadings of fecal coliform loadings to estimate the total pathogen reduction potential of the TMDL. Results We estimate that the TMDL practices have the potential to decrease disease-causing pathogen loads from all point and non-point sources to the mainstem Potomac River and the entire Chesapeake Bay watershed by 19% and 27%, respectively. These numbers are likely to be underestimates due to data limitations that forced us to omit some practices from analysis. Discussion Based on known impairments and disease incidence rates, we conclude that efforts to reduce nutrients may create substantial health co-benefits by improving the safety of water-contact recreation and seafood consumption.

  18. Current assessment practice, personality measurement, and rorschach usage by psychologists.

    Science.gov (United States)

    Musewicz, John; Marczyk, Geoffrey; Knauss, Linda; York, David

    2009-09-01

    In this study, we investigated current personality assessment practice and attitudes toward Rorschach (Exner, 2003) usage by 215 psychologists. We administered an Internet survey to members of the Society for Personality Assessment (SPA) and the American Psychological Association. Results were similar to those of past surveys, but the importance of using tests with strong psychometric properties was greater in this study. The majority of respondents reported using the Rorschach and supporting efforts to standardize and psychometrically validate the test. However, SPA members agreed more strongly than non-SPA members that the Rorschach is an effective test. Implications and directions for future research are discussed.

  19. Current Practice of Thermoregulation During the Transport of Combat Wounded

    Science.gov (United States)

    2010-07-01

    ORIGINAL ARTICLE Current Practice of Thermoregulation During the Transport of Combat Wounded Michael Nesbitt , DSc, PA-C, Paul Allen, DSc, PA-C, Alec...reprints: Mike Nesbitt , PA-C, 4511 Star Grove, San Antonio, TX 78259; email: mike.nesbitt@us.army.mil. DOI: 10.1097/TA.0b013e3181e45b83 S162 The Journal...ELEMENT NUMBER 6. AUTHOR(S) Nesbitt M., Allen P., Beekley A., Butler F., Eastridge B., Blackbourne L. H., 5d. PROJECT NUMBER 5e. TASK NUMBER 5f

  20. 76 FR 47593 - Guidance for Small Business Entities on Current Good Manufacturing Practice for Positron Emission...

    Science.gov (United States)

    2011-08-05

    ... a guidance for small business entities entitled ``PET Drugs--Current Good Manufacturing Practice... entitled ``PET Drugs--Current Good Manufacturing Practice (CGMP); Small Entity Compliance Guide.'' This... Manufacturing Practice for Positron Emission Tomography Drugs; Availability AGENCY: Food and Drug...

  1. Current management of heparin-induced thrombocytopenia.

    Science.gov (United States)

    Cosmi, Benilde

    2015-12-01

    Heparin-induced thrombocytopenia (HIT) is an immune adverse reaction to heparin (both unfractionated and low-molecular-weight), which is mediated by the formation of IgG antibodies against platelet factor 4-heparin complexes. The IgG/platelet factor 4 immunocomplexes activate platelets with resulting thrombocytopenia, which is not associated with bleeding, but with paradoxical life-threatening thrombotic complications, for coagulation activation. HIT diagnosis requires the assessment of pre-test clinical probability in combination with the measurement of platelet activating antibodies against platelet factor 4-heparin complexes with immunological and functional assays. When HIT is diagnosed, any form of heparin should be stopped and a non-heparin alternative anticoagulant should be started. Argatroban and danaparoid are currently the only drugs licensed for HIT, with different country availability. Bivalirudin is an option in cardiac surgery and procedures in HIT patients.

  2. Neuroimaging in refractory epilepsy. Current practice and evolving trends

    Energy Technology Data Exchange (ETDEWEB)

    Ramli, N. [Department of Biomedical Imaging, University Malaya Research Imaging Centre (Malaysia); Rahmat, K., E-mail: katt_xr2000@yahoo.com [Department of Biomedical Imaging, University Malaya Research Imaging Centre (Malaysia); Lim, K.S.; Tan, C.T. [Neurology Unit, Department of Medicine, University Malaya, Kuala Lumpur (Malaysia)

    2015-09-15

    Highlights: • Neuroimaging is imperative in diagnostic work up and therapeutic assessment of refractory epilepsy. • Identification of epileptogenic zone on EEG, MRI and functional imaging improves the success of surgery. • High performance MRI greatly enhanced metabolic information and elucidate brain functions. • Optimisation of epilepsy protocols in structural and functional MRI are presented in this article. - Abstract: Identification of the epileptogenic zone is of paramount importance in refractory epilepsy as the success of surgical treatment depends on complete resection of the epileptogenic zone. Imaging plays an important role in the locating and defining anatomic epileptogenic abnormalities in patients with medically refractory epilepsy. The aim of this article is to present an overview of the current MRI sequences used in epilepsy imaging with special emphasis of lesion seen in our practices. Optimisation of epilepsy imaging protocols are addressed and current trends in functional MRI sequences including MR spectroscopy, diffusion tensor imaging and fusion MR with PET and SPECT are discussed.

  3. Autopsy in Islam and current practice in Arab Muslim countries.

    Science.gov (United States)

    Mohammed, Madadin; Kharoshah, Magdy A

    2014-03-01

    Autopsy, or post-mortem examination, is the dissection of a dead body. It is performed for many reasons. Attitudes toward dead bodies vary with religious beliefs and cultural and geographical backgrounds. We have carried out an extensive literature review to determine the Islamic view and current practice of Autopsy, in at least four Arab countries which published their experiences. Several research articles have studied the history of Islamic Autopsy as well as the current situation and legal debates about it. The overwhelming conclusion is that data is lacking. More must be published from Arabic Muslim countries and more research done to correct misconceptions. We also recommend more application of non-invasive Autopsy.

  4. Best Practice of Construction Waste Management and Minimization

    OpenAIRE

    Khor Jie Cheng; Md Azree Othuman Mydin

    2014-01-01

    Material management is an important issue as seen in construction waste management. Best practice of material management is accompanied by various benefits which are acknowledged by several studies. The site layout has particular effects on both materials and their waste through effective waste management practice. Ignoring the benefits of material management could result in a daily reduction in productivity of up to 40% by material wastage. Thus, the benefits of effectiv...

  5. The current management of septic shock.

    Science.gov (United States)

    Russel, J A

    2008-10-01

    This is a review of the management of septic shock that suggests an approach to treatment (ABCDEF: Airway, Breathing, Circulation, Drugs, Evaluate the source of sepsis, Fix the source of sepsis) for clinicians. The incidence of septic shock is increasing and mortality ranges from 30% to 70%. The commonest sources of infection are lung (25%), abdomen (25%), and other sources. Septic shock occurs because of highly complex interactions between the infecting microorganism(s) and the responses of the human host. The innate immune response is rapidly followed by the more specific adaptive immune response. Septic shock is characterized by alterations in the coagulant/anticoagulant balance such that there is a more pro-coagulant phenotype. Lung protective ventilation (which means the use of relatively low tidal volumes of 4 -6 mL/kg ideal body weight) is recommended for treatment of patients who have septic shock. Rivers early goal-directed therapy is recommended because it showed a significant increase in survival. Surviving Sepsis guidelines recommend resuscitation of septic shock with either crystalloid or colloid. Patients who have septic shock should be treated with intravenous broad-spectrum antibiotics as rapidly as possible and certainly within one hour. Activated protein C (APC) is a vitamin K dependent serine protease that is an anticoagulant and is also cytoprotective and anti-inflammatory. APC (24 mg/kg/hour infusion for 96 hours) decreased mortality (APC 25% vs placebo 31%, relative risk 0.81P=0.005) and improved organ dysfunction in patients at high risk of death (e.g. APACHE II >25 [APC 31% vs placebo 44%]). APC is not recommended to treat surgical patients who have one organ system dysfunction. In 2006, the European regulatory authority indicated that there must be another randomized placebo-controlled trial of APC to further establish efficacy as assessed by mortality reduction. Vasopressin is a key stress hormone in response to hypotension. The VASST

  6. Current surgical management of carotid body tumors.

    Science.gov (United States)

    Davila, Victor J; Chang, James M; Stone, William M; Fowl, Richard J; Bower, Thomas C; Hinni, Michael L; Money, Samuel R

    2016-12-01

    Carotid body tumors (CBTs) are rare. Management guidelines may include genetic testing for succinate dehydrogenase (SDH) mutations. We performed an institutional review of the surgical management of CBT. A retrospective analysis (1994-2015) of CBT excisions at our institution was performed. Data obtained included demographics, genetic testing (if performed), intraoperative details, postoperative morbidity, and long-term outcomes. Data from the first CBT excision were included in patients with bilateral tumors. Genetic testing was routinely offered in patients with a family history of CBT or multiple paragangliomas. A total of 183 CBTs (124 female [67.7%]) were excised. A neck mass was present in 106 patients (57.9%), 24 patients (12.1%) presented with tenderness or neck pain, and 3 (1.6%) presented with cranial nerve dysfunction. Computed tomography (57.9%) or magnetic resonance imaging (51.3%) were the most commonly used imaging modalities. Preoperative angiography was performed in 73 patients (39.8%), and 62 of them (84.5%) underwent embolization or internal carotid balloon occlusion testing, or both. Mean tumor diameter was 3.2 cm (range, 0.6-7.2 cm). There were 71 (38.8%), 75 (41%), and 37 (20.2%) Shamblin type 1, 2, and 3 tumors, respectively. Average operating time was 224 minutes (range, 52-696 minutes). Average blood loss was 143.9 mL (range, 10-2000 mL). Arterial reconstruction with an interposition graft was required in 10, and patch angioplasty was performed in four. Cranial nerve injury was permanent in 10 (5.5%), and the rate of stroke was 1% (n = 2). A total of 382 lymph nodes were excised, and all were benign. There were no deaths ≤30 days. Only one patient presented with malignant disease 2 years after CBT excision, and this patient did not undergo genetic testing. Thirty-four (18.6%) had a family history of CBT. SDH testing was performed in 18 patients, and 17 tested positive. Positive genetic testing had a correlation with earlier age

  7. Assessment of current practices in creating and using passwords as a control mechanism for information access

    Directory of Open Access Journals (Sweden)

    P. L. Wessels

    2007-11-01

    Full Text Available One of the critical issues in managing information within an organization is to ensure that proper controls exist and are applied in allowing people access to information. Passwords are used extensively as the main control mechanism to identify users wanting access to systems, applications, data files, network servers or personal information. In this article, the issues involved in selecting and using passwords are discussed and the current practices employed by users in creating and storing passwords to gain access to sensitive information are assessed. The results of this survey conclude that information managers cannot rely only on users to employ proper password control in order to protect sensitive information.

  8. Therapeutic management of inflammatory bowel disease in real-life practice in the current era of anti-TNF agents: analysis of the French administrative health databases 2009-2014.

    Science.gov (United States)

    Kirchgesner, J; Lemaitre, M; Rudnichi, A; Racine, A; Zureik, M; Carbonnel, F; Dray-Spira, R

    2017-01-01

    Management of inflammatory bowel disease (IBD) has evolved in the last decade. To assess IBD therapeutic management, including treatment withdrawal and early treatment use in the current era of anti-TNF agents (anti-TNFs). All patients affiliated to the French national health insurance diagnosed with IBD were included from 2009 to 2013 and followed up until 31 December 2014. Medication uses, treatment sequences after introduction of thiopurine or anti-TNF monotherapies or both (combination therapy), surgical procedures and hospitalisations were assessed. A total of 210 001 patients were diagnosed with IBD [Crohn's disease (CD), 100 112; ulcerative colitis (UC), 109 889]. Five years after diagnosis, cumulative probabilities of anti-TNF monotherapy and combination therapy exposures were 33.8% and 18.3% in CD patients and 12.9% and 7.4% in UC patients, respectively. Among incident patients who received thiopurines or anti-TNFs, the first treatment was thiopurine in 69.1% of CD and 78.2% of UC patients. Among patients treated with anti-TNFs, 45.2% and 54.5% of CD patients and 38.2% and 39.9% of UC patients started monotherapy and combination therapy within 3 months after diagnosis, respectively; 31.3% of CD and 27.1% of UC incident patients withdrew from thiopurine or anti-TNFs for more than 3 months after their first course of treatment. Five years after diagnosis, the cumulative risks of first intestinal resection in CD patients and colectomy in UC patients were 11.9% and 5.7%, respectively. Step-up approach remains the predominant strategy, while exposure to anti-TNFs is high. Surgery rates are low. Treatment withdrawal in IBD is more common than expected. © 2016 John Wiley & Sons Ltd.

  9. Figures in clinical trial reports: current practice & scope for improvement

    Directory of Open Access Journals (Sweden)

    Travison Thomas G

    2007-11-01

    Full Text Available Abstract Background Most clinical trial publications include figures, but there is little guidance on what results should be displayed as figures and how. Purpose To evaluate the current use of figures in Trial reports, and to make constructive suggestions for future practice. Methods We surveyed all 77 reports of randomised controlled trials in five general medical journals during November 2006 to January 2007. The numbers and types of figures were determined, and then each Figure was assessed for its style, content, clarity and suitability. As a consequence, guidelines are developed for presenting figures, both in general and for each specific common type of Figure. Results Most trial reports contained one to three figures, mean 2.3 per article. The four main types were flow diagram, Kaplan Meier plot, Forest plot (for subgroup analyses and repeated measures over time: these accounted for 92% of all figures published. For each type of figure there is a considerable diversity of practice in both style and content which we illustrate with selected examples of both good and bad practice. Some pointers on what to do, and what to avoid, are derived from our critical evaluation of these articles' use of figures. Conclusion There is considerable scope for authors to improve their use of figures in clinical trial reports, as regards which figures to choose, their style of presentation and labelling, and their specific content. Particular improvements are needed for the four main types of figures commonly used.

  10. Best practices in specialty pharmacy management.

    Science.gov (United States)

    Patterson, Courtney J

    2013-01-01

    Specialty pharmacy is a growing area of research, utilization, and cost. Because of the unique nature of the diseases treated by specialty pharmaceuticals, such as cancer and rheumatoid arthritis, novel management approaches are needed. Advocate Physician Partners (APP) is an entity within the Advocate Health Care Health System in the Chicago and the central Illinois area. It coordinates the care management and managed care contracting between the Advocate Health Care System and more than 4,000 physicians on the medical staffs of Advocate hospitals. APP has experienced a per-member-per-month (PMPM) increase of less than  3% in oncology intravenous medications spend in 2012. This spend refers to the intravenous medications covered under the medical benefits for APP's health maintenance organization (HMO) population. The spend has consistently been less than national projections, and we believe this is tied to the adoption of several key best practices. Prior to instituting the best practices, the yearly percentage increases for oncology spending were 5.52% (2007 to 2008), 9.39% (2008 to 2009), and 5.29% (2009 to 2010). After instituting best practices during the first quarter of 2011, the increases in PMPM were 3.11% (2010 to 2011) and 2.11% (2011 to 2012), which were below previous years. To describe the best practices of specialty pharmacy management adopted by APP, specifically (a) establishing a content expert and governing bodies, (b) ensuring compliance with policies, and (c) providing educational resources. APP has several key result areas (KRAs). One KRA was compliance with appropriate utilization of intravenous oncology protocols for its HMO population. The protocols for each medication outline the appropriate indication and patient population. These protocols were developed and reviewed by the APP Pharmacy and Technology (PT) committee. The PT-approved indications reflect FDA indications and indications found in national guidelines. The APP KRA target

  11. Fault Management Practice: A Roadmap for Improvement

    Science.gov (United States)

    Fesq, Lorraine M.; Oberhettinger, David

    2010-01-01

    Autonomous fault management (FM) is critical for deep space and planetary missions where the limited communication opportunities may prevent timely intervention by ground control. Evidence of pervasive architecture, design, and verification/validation problems with NASA FM engineering has been revealed both during technical reviews of spaceflight missions and in flight. These problems include FM design changes required late in the life-cycle, insufficient project insight into the extent of FM testing required, unexpected test results that require resolution, spacecraft operational limitations because certain functions were not tested, and in-flight anomalies and mission failures attributable to fault management. A recent NASA initiative has characterized the FM state-of-practice throughout the spacecraft development community and identified common NASA, DoD, and commercial concerns that can be addressed in the near term through the development of a FM Practitioner's Handbook and the formation of a FM Working Group. Initial efforts will focus on standardizing FM terminology, establishing engineering processes and tools, and training.

  12. Current concepts in the management of inguinal hernia and hydrocele in pediatric patients in laparoscopic era.

    Science.gov (United States)

    Esposito, Ciro; Escolino, Maria; Turrà, Francesco; Roberti, Agnese; Cerulo, Mariapina; Farina, Alessandra; Caiazzo, Simona; Cortese, Giuseppe; Servillo, Giuseppe; Settimi, Alessandro

    2016-08-01

    The surgical repair of inguinal hernia and hydrocele is one of the most common operations performed in pediatric surgery practice. This article reviews current concepts in the management of inguinal hernia and hydrocele based on the recent literature and the authors׳ experience. We describe the principles of clinical assessment and anesthetic management of children undergoing repair of inguinal hernia, underlining the differences between an inguinal approach and minimally invasive surgery (MIS). Other points discussed include the current management of particular aspects of these pathologies such as bilateral hernias; contralateral patency of the peritoneal processus vaginalis; hernias in premature infants; direct, femoral, and other rare hernias; and the management of incarcerated or recurrent hernias. In addition, the authors discuss the role of laparoscopy in the surgical treatment of an inguinal hernia and hydrocele, emphasizing that the current use of MIS in pediatric patients has completely changed the management of pediatric inguinal hernias. Copyright © 2016 Elsevier Inc. All rights reserved.

  13. Cancer of the cervix: current management and new approaches.

    Science.gov (United States)

    Shivnani, Anand T; Rimel, B J; Schink, Julian; Small, William

    2006-11-01

    This article summarizes the current management of patients with newly diagnosed cervical cancer. The topics range from the management of early-stage disease to the phase III randomized studies that have established the current standard of care for patients with locally advanced cancer of the cervix. New approaches to combined-modality therapy with the goal of improving outcomes and decreasing complications are also described.

  14. Post-arthroscopy septic arthritis: Current data and practical recommendations.

    Science.gov (United States)

    Bauer, T; Boisrenoult, P; Jenny, J Y

    2015-12-01

    Septic arthritis develops after less than 1% of all arthroscopy procedures. The clinical symptoms may resemble those seen after uncomplicated arthroscopy, raising diagnostic challenges. The diagnosis rests on emergent joint aspiration with microscopic smear examination and prolonged culturing on specific media. Urgent therapeutic measures must be taken, including abundant arthroscopic lavage, synovectomy, and the concomitant administration of two effective antibiotics for at least 6 weeks. Preservation of implants or transplants is increasingly accepted, and repeated joint lavage is a component of the treatment strategy. After knee arthroscopy, infection is the most common complication; most cases occur after cruciate ligament reconstruction, and staphylococci are the predominant causative organisms. Emergent synovectomy with transplant preservation and appropriate antibiotic therapy ensures eradication of the infection in 85% of cases, with no adverse effect on final functional outcomes. After shoulder arthroscopy, infection is 10 times less common than neurological complications and occurs mainly after rotator cuff repair procedures; the diagnosis may be difficult and delayed if Propionibacterium acnes is the causative organism. The update presented here is based on both a literature review and a practice survey. The findings have been used to develop practical recommendations aimed at improving the management of post-arthroscopy infections, which are exceedingly rare but can induce devastating functional impairments.

  15. Research Reproducibility in Geosciences: Current Landscape, Practices and Perspectives

    Science.gov (United States)

    Yan, An

    2016-04-01

    Reproducibility of research can gauge the validity of its findings. Yet currently we lack understanding of how much of a problem research reproducibility is in geosciences. We developed an online survey on faculty and graduate students in geosciences, and received 136 responses from research institutions and universities in Americas, Asia, Europe and other parts of the world. This survey examined (1) the current state of research reproducibility in geosciences by asking researchers' experiences with unsuccessful replication work, and what obstacles that lead to their replication failures; (2) the current reproducibility practices in community by asking what efforts researchers made to try to reproduce other's work and make their own work reproducible, and what the underlying factors that contribute to irreproducibility are; (3) the perspectives on reproducibility by collecting researcher's thoughts and opinions on this issue. The survey result indicated that nearly 80% of respondents who had ever reproduced a published study had failed at least one time in reproducing. Only one third of the respondents received helpful feedbacks when they contacted the authors of a published study for data, code, or other information. The primary factors that lead to unsuccessful replication attempts are insufficient details of instructions in published literature, and inaccessibility of data, code and tools needed in the study. Our findings suggest a remarkable lack of research reproducibility in geoscience. Changing the incentive mechanism in academia, as well as developing policies and tools that facilitate open data and code sharing are the promising ways for geosciences community to alleviate this reproducibility problem.

  16. Current state management of the consumer capital of domestic enterprises

    OpenAIRE

    E.O. Golysheva

    2010-01-01

    In the article the analysis of the current state of management by consumer business capital is carried out. It is based on three components: system of communications with consumers and external subjects, the history of relationship with them and the database about partners; portfolio management of trade marks (brands); the.

  17. Current Issues for Higher Education Information Resources Management.

    Science.gov (United States)

    CAUSE/EFFECT, 1995

    1995-01-01

    Current issues that are important for the future of information resources management in higher education are presented. They include: integrating planning for information resources within institution-wide strategic planning; reengineering fundamental services; change management; distributed computing support; networking; the changing communication…

  18. Current state management of the consumer capital of domestic enterprises

    Directory of Open Access Journals (Sweden)

    E.O. Golysheva

    2010-12-01

    Full Text Available In the article the analysis of the current state of management by consumer business capital is carried out. It is based on three components: system of communications with consumers and external subjects, the history of relationship with them and the database about partners; portfolio management of trade marks (brands; the.

  19. Test result communication in primary care: a survey of current practice.

    Science.gov (United States)

    Litchfield, Ian; Bentham, Louise; Lilford, Richard; McManus, Richard J; Hill, Ann; Greenfield, Sheila

    2015-11-01

    The number of blood tests ordered in primary care continues to increase and the timely and appropriate communication of results remains essential. However, the testing and result communication process includes a number of participants in a variety of settings and is both complicated to manage and vulnerable to human error. In the UK, guidelines for the process are absent and research in this area is surprisingly scarce; so before we can begin to address potential areas of weakness there is a need to more precisely understand the strengths and weaknesses of current systems used by general practices and testing facilities. We conducted a telephone survey of practices across England to determine the methods of managing the testing and result communication process. In order to gain insight into the perspectives from staff at a large hospital laboratory we conducted paired interviews with senior managers, which we used to inform a service blueprint demonstrating the interaction between practices and laboratories and identifying potential sources of delay and failure. Staff at 80% of practices reported that the default method for communicating normal results required patients to telephone the practice and 40% of practices required that patients also call for abnormal results. Over 80% had no fail-safe system for ensuring that results had been returned to the practice from laboratories; practices would otherwise only be aware that results were missing or delayed when patients requested results. Persistent sources of missing results were identified by laboratory staff and included sample handling, misidentification of samples and the inefficient system for collating and resending misdirected results. The success of the current system relies on patients both to retrieve results and in so doing alert staff to missing and delayed results. Practices appear slow to adopt available technological solutions despite their potential for reducing the impact of recurring errors in the

  20. Practice management companies. Creating sound information technology strategies.

    Science.gov (United States)

    Cross, M A

    1997-10-01

    Practice management companies are becoming more prominent players in the health care industry. To improve the performance of the group practices that they acquire, these companies are striving to use updated information technologies.

  1. The Impact of Human Resource Management Practices on ...

    African Journals Online (AJOL)

    AFRREV IJAH: An International Journal of Arts and Humanities ... Abstract. The focus of this paper is on the impact of HRM practices on private sector organisations ... Keywords: Human Resource Management, Performance; Best Practices ...

  2. Energy efficiency potentials and energy management practices in Swedish firms

    OpenAIRE

    Backlund, Sandra; Broberg, Sarah; Ottosson, Mikael; Thollander, Patrik

    2012-01-01

    In order to improve energy efficiency and reach the EU:s 20-20-20 primary energy saving target, focus has mainly been on diffusion of technology. Previous studies have illustrated large untapped energy saving potentials from implementing energy management practices in firms. Energy management practices have large effects on energy utilization and also a short pay-back time. According to these studies, energy management practices also effect investment decisions and the outcome of investments ...

  3. Are Corporate Carbon Management Practices Reducing Corporate Carbon Emissions?

    OpenAIRE

    Doda, B; Gennaoli, C; Gouldson, A; Grover, D.; Sullivan, R.

    2016-01-01

    This paper is the first large scale, quantitative study of the impact of corporate carbon management practices on corporate greenhouse gas (GHG) emissions. Using data for 2009 and 2010 from the Carbon Disclosure Project survey, we find little compelling evidence that commonly adopted management practices are reducing emissions. This finding is unexpected and we propose three possible explanations for it. First, it may be because corporate carbon data and management practice information have n...

  4. Human Resource Management Practices and Innovation

    DEFF Research Database (Denmark)

    Laursen, Keld; Foss, Nicolai Juul

    We survey, organize, and discuss the literature on the role of organizational practices for explaining innovation outcomes. We discuss how individual practices influence innovation, and how the clustering of specific practices matters for innovation outcomes. Relatedly, we discuss various possibl...

  5. An appraisal of construction management practice in Nigeria | Ugwu ...

    African Journals Online (AJOL)

    An appraisal of construction management practice in Nigeria. ... A questionnaire survey was conducted and fifty-seven (57) factors were identified, ... the project team, lack of construction management knowledge and known work progress.

  6. Impact of supply chain management practices on sustainability

    DEFF Research Database (Denmark)

    Govindan, Kannan; Azevedo, Susana G.; Carvalho, Helena

    2014-01-01

    elimination," "supply chain risk management" and "cleaner production." The following lean, resilient and green supply chain management practices do not have a significant impact on supply chain sustainability: "flexible transportation," "flexible sourcing," "ISO 14001 certification," and "reverse logistics...

  7. Animal Waste Management Practices and Perceptions on Public ...

    African Journals Online (AJOL)

    Animal Waste Management Practices and Perceptions on Public and Environmental Health Risks. ... Huria: Journal of the Open University of Tanzania ... and public health risks associated with improper management of animal wastes in 66 ...

  8. Technology management in construction: Lessons for the practice of ...

    African Journals Online (AJOL)

    Abstract. The relevance of managing technology to architectural practices in South .... lead times, lack of continuity in the supply chain, overprocessing, rework ..... Business e-Coach. 2003. Guidelines on technology management for. SMEs.

  9. Assessment of cold chain management practices in immunisation ...

    African Journals Online (AJOL)

    Assessment of cold chain management practices in immunisation centres in Kacheliba division, ... Journal Home > Vol 94, No 2 (2017) > ... Cold chain management should be improved through continuous medical educational programmemes ...

  10. Managing Innovation under Time Pressure: A Practical Perspective

    Directory of Open Access Journals (Sweden)

    Blair Winsor

    2012-08-01

    Full Text Available This article examines the effects of time pressure on innovation. Does time pressure stimulate or eliminate innovation or, in other words, should managers increase or reduce time pressures if they are trying to enhance innovation in their firms? Unfortunately, current research on the subject is ambivalent. To provide some clarity, this innovation management dilemma was examined in a fast-growing, medium-sized communication and IT consultancy (“First”, which claimed to be “highly innovative”. Detailed data on five projects was collected over an 18-month period using practice-based methods. Each project team was followed in real time via observation and interviews. The data was then analyzed by dividing project work into three phases: i negotiating the project particulars with the client; ii conducting project work; and iii project evaluation. This detailed analysis revealed how time pressures eliminated innovation in First’s client-based project work and suggested three implications for the management of innovation. Firstly, managers should try to avoid imposing excessive time pressures on their project teams. Secondly, they should ensure that there is space between projects to enable reflection. Thirdly, managers should ensure that project debriefs occur and that they cover potential innovations.

  11. The emergence of thanatology and current practice in death education.

    Science.gov (United States)

    Fonseca, Luciana Mascarenhas; Testoni, Ines

    Thanatology is a recent field that contemplates death studies and employs an interdisciplinary approach to practice. This science emerged in a historical context marked by intense social, economic, and political changes that contributed to the concept of death being excluded from social life. This literature review aims to outline the history and evolution ofthanatology in Western society, delineating the contextual circumstances that led to its origin and drawing special attention to current works on death education. In our post-modern society, the call for studies in the field of thanatology appears to be increasing. However, although there have been significant contributions and promising research is underway, there are still many questions to be answered.

  12. Strength and conditioning in tennis: current research and practice.

    Science.gov (United States)

    Reid, Machar; Schneiker, Knut

    2008-06-01

    Virtually all professional tennis players are in continuous pursuit of enhanced performance. With the modern game becoming increasingly dynamic and tournament schedules no less demanding, the importance of physical fitness is well accepted. Indeed, most professional tennis players resource strength and conditioning specialists on a full- or part-time basis. As tennis play is characterised by intricate bio-energetics, planning specific strength and conditioning interventions represents a significant challenge for the specialist. Further, where game physiology and mechanics have been described extensively, critiques of the efficacy of different training initiatives are far less common. This review therefore considers the current scientific, tennis-specific fitness training evidence base in light of contemporary conditioning, and more particularly resistance training, practices.

  13. Typography and layout of technical reports - Survey of current practices

    Science.gov (United States)

    Pinelli, T. E.; Cordle, V. M.; Mccullough, R.

    1985-01-01

    As part of a review of the NASA Langley Research Center scientific and technical information program, 50 technical reports from industry, research institutions, and government agencies were systematically examined and analyzed to determine current usage and practice in regard to (1) typography, including composition method, type style, type size, and margin treatment; (2) graphic design, including layout and imposition of material on the page; and (3) physical media, including paper, ink, and binding methods. The results indicate that approximately 50 percent of the reports were typeset, 70 percent used Roman (serif) type, 80 percent used 10- or 11-point type for text, 60 percent used a ragged right-hand margin, slightly more than half used paragraph indentation, 75 percent used a single-column layout, 65 percent had one or more figures or tables placed perpendicular to (not aligned with) the text, and perfect binding was the most frequently used binding method.

  14. Preparation of intravenous cholesterol tracer using current good manufacturing practices.

    Science.gov (United States)

    Lin, Xiaobo; Ma, Lina; Racette, Susan B; Swaney, William P; Ostlund, Richard E

    2015-12-01

    Studies of human reverse cholesterol transport require intravenous infusion of cholesterol tracers. Because insoluble lipids may pose risk and because it is desirable to have consistent doses of defined composition available over many months, we investigated the manufacture of cholesterol tracer under current good manufacturing practice (CGMP) conditions appropriate for phase 1 investigation. Cholesterol tracer was prepared by sterile admixture of unlabeled cholesterol or cholesterol-d7 in ethanol with 20% Intralipid(®). The resulting material was filtered through a 1.2 micron particulate filter, stored at 4°C, and tested at time 0, 1.5, 3, 6, and 9 months for sterility, pyrogenicity, autoxidation, and particle size and aggregation. The limiting factor for stability was a rise in thiobarbituric acid-reacting substances of 9.6-fold over 9 months (P postproduction. CGMP manufacturing methods can be achieved in the academic setting and need to be considered for critical components of future metabolic studies.

  15. Mapping Best and Emerging Practices of Project Management

    DEFF Research Database (Denmark)

    Thuesen, Christian; Aaris Boas, Charlotte; Thorslund, Michael V.

    2013-01-01

    This paper presents results of a study of the connection between Best and Emerging practices of project management. Drawing upon network mapping as an analytical strategy, cases of Best and Emerging practices is analysed and juxtaposed. The case of Best practice is represented by the newly...... published ISO 21500 standard and the case for the Emerging practices by a deconstruction of the practices of a group of experienced project managers. The network analysis reveals a substantial difference between the Best and Emerging practices. Only two central concepts where shared namely Communication...... and Planning. Of these two concepts Communication where found to be the most central to both the Emerging and Best practices. The analysis further reveals a soft side of project management that is central in the Emerging practice but absent from the Best practices. Although this soft side might be interpreted...

  16. [Methodology for the development and update of practice guidelines: current state].

    Science.gov (United States)

    Barrera-Cruz, Antonio; Viniegra-Osorio, Arturo; Valenzuela-Flores, Adriana Abigail; Torres-Arreola, Laura Pilar; Dávila-Torres, Javier

    2016-01-01

    The current scenario of health services in Mexico reveals as a priority the implementation of strategies that allow us to better respond to the needs and expectations of individuals and society as a whole, through the provision of efficient and effective alternatives for the prevention, diagnosis and treatment of diseases. In this context, clinical practice guidelines constitute an element of management in the health care system, whose objective is to establish a national bechmark for encouraging clinical and management decision making, based on recommendations from the best available evidence, in order to contribute to the quality and effectiveness of health care. The purpose of this document is to show the methodology used for the development and updating of clinical practice guidelines that the Instituto Mexicano del Seguro Social has developed in line with the sectorial model in order to serve the user of these guidelines.

  17. Effects of management practices on grassland birds: Sedge Wren

    Science.gov (United States)

    Dechant, Jill A.; Sondreal, Marriah L.; Johnson, Douglas H.; Igl, Lawrence D.; Goldade, Christopher M.; Parkin, Barry D.; Euliss, Betty R.

    1998-01-01

    Information on the habitat requirements and effects of habitat management on grassland birds were summarized from information in more than 5,500 published and unpublished papers. A range map is provided to indicate the relative densities of the species in North America, based on Breeding Bird Survey (BBS) data. Although birds frequently are observed outside the breeding range indicated, the maps are intended to show areas where managers might concentrate their attention. It may be ineffectual to manage habitat at a site for a species that rarely occurs in an area. The species account begins with a brief capsule statement, which provides the fundamental components or keys to management for the species. A section on breeding range outlines the current breeding distribution of the species in North America, including areas that could not be mapped using BBS data. The suitable habitat section describes the breeding habitat and occasionally microhabitat characteristics of the species, especially those habitats that occur in the Great Plains. Details on habitat and microhabitat requirements often provide clues to how a species will respond to a particular management practice. A table near the end of the account complements the section on suitable habitat, and lists the specific habitat characteristics for the species by individual studies. A special section on prey habitat is included for those predatory species that have more specific prey requirements. The area requirements section provides details on territory and home range sizes, minimum area requirements, and the effects of patch size, edges, and other landscape and habitat features on abundance and productivity. It may be futile to manage a small block of suitable habitat for a species that has minimum area requirements that are larger than the area being managed. The Brown-headed Cowbird (Molothrus ater) is an obligate brood parasite of many grassland birds. The section on cowbird brood parasitism summarizes rates

  18. Effects of management practices on grassland birds: Upland Sandpiper

    Science.gov (United States)

    Dechant, Jill A.; Dinkins, Meghan F.; Johnson, Douglas H.; Igl, Lawrence D.; Goldade, Christopher M.; Parkin, Barry D.; Euliss, Betty R.

    1999-01-01

    Information on the habitat requirements and effects of habitat management on grassland birds were summarized from information in more than 5,500 published and unpublished papers. A range map is provided to indicate the relative densities of the species in North America, based on Breeding Bird Survey (BBS) data. Although birds frequently are observed outside the breeding range indicated, the maps are intended to show areas where managers might concentrate their attention. It may be ineffectual to manage habitat at a site for a species that rarely occurs in an area. The species account begins with a brief capsule statement, which provides the fundamental components or keys to management for the species. A section on breeding range outlines the current breeding distribution of the species in North America, including areas that could not be mapped using BBS data. The suitable habitat section describes the breeding habitat and occasionally microhabitat characteristics of the species, especially those habitats that occur in the Great Plains. Details on habitat and microhabitat requirements often provide clues to how a species will respond to a particular management practice. A table near the end of the account complements the section on suitable habitat, and lists the specific habitat characteristics for the species by individual studies. A special section on prey habitat is included for those predatory species that have more specific prey requirements. The area requirements section provides details on territory and home range sizes, minimum area requirements, and the effects of patch size, edges, and other landscape and habitat features on abundance and productivity. It may be futile to manage a small block of suitable habitat for a species that has minimum area requirements that are larger than the area being managed. The Brown-headed Cowbird (Molothrus ater) is an obligate brood parasite of many grassland birds. The section on cowbird brood parasitism summarizes rates

  19. Effects of management practices on grassland birds: Lark Sparrow

    Science.gov (United States)

    Dechant, Jill A.; Sondreal, Marriah L.; Johnson, Douglas H.; Igl, Lawrence D.; Goldade, Christopher M.; Parkin, Barry D.; Euliss, Betty R.

    1999-01-01

    Information on the habitat requirements and effects of habitat management on grassland birds were summarized from information in more than 5,500 published and unpublished papers. A range map is provided to indicate the relative densities of the species in North America, based on Breeding Bird Survey (BBS) data. Although birds frequently are observed outside the breeding range indicated, the maps are intended to show areas where managers might concentrate their attention. It may be ineffectual to manage habitat at a site for a species that rarely occurs in an area. The species account begins with a brief capsule statement, which provides the fundamental components or keys to management for the species. A section on breeding range outlines the current breeding distribution of the species in North America, including areas that could not be mapped using BBS data. The suitable habitat section describes the breeding habitat and occasionally microhabitat characteristics of the species, especially those habitats that occur in the Great Plains. Details on habitat and microhabitat requirements often provide clues to how a species will respond to a particular management practice. A table near the end of the account complements the section on suitable habitat, and lists the specific habitat characteristics for the species by individual studies. A special section on prey habitat is included for those predatory species that have more specific prey requirements. The area requirements section provides details on territory and home range sizes, minimum area requirements, and the effects of patch size, edges, and other landscape and habitat features on abundance and productivity. It may be futile to manage a small block of suitable habitat for a species that has minimum area requirements that are larger than the area being managed. The Brown-headed Cowbird (Molothrus ater) is an obligate brood parasite of many grassland birds. The section on cowbird brood parasitism summarizes rates

  20. Effects of management practices on grassland birds: Horned Lark

    Science.gov (United States)

    Dinkins, Meghan F.; Zimmerman, Amy L.; Dechant, Jill A.; Parkin, Barry D.; Johnson, Douglas H.; Igl, Lawrence D.; Goldade, Christopher M.; Euliss, Betty R.

    2000-01-01

    Information on the habitat requirements and effects of habitat management on grassland birds were summarized from information in more than 5,500 published and unpublished papers. A range map is provided to indicate the relative densities of the species in North America, based on Breeding Bird Survey (BBS) data. Although birds frequently are observed outside the breeding range indicated, the maps are intended to show areas where managers might concentrate their attention. It may be ineffectual to manage habitat at a site for a species that rarely occurs in an area. The species account begins with a brief capsule statement, which provides the fundamental components or keys to management for the species. A section on breeding range outlines the current breeding distribution of the species in North America, including areas that could not be mapped using BBS data. The suitable habitat section describes the breeding habitat and occasionally microhabitat characteristics of the species, especially those habitats that occur in the Great Plains. Details on habitat and microhabitat requirements often provide clues to how a species will respond to a particular management practice. A table near the end of the account complements the section on suitable habitat, and lists the specific habitat characteristics for the species by individual studies. A special section on prey habitat is included for those predatory species that have more specific prey requirements. The area requirements section provides details on territory and home range sizes, minimum area requirements, and the effects of patch size, edges, and other landscape and habitat features on abundance and productivity. It may be futile to manage a small block of suitable habitat for a species that has minimum area requirements that are larger than the area being managed. The Brown-headed Cowbird (Molothrus ater) is an obligate brood parasite of many grassland birds. The section on cowbird brood parasitism summarizes rates

  1. Effects of management practices on grassland birds: Willet

    Science.gov (United States)

    Dechant, Jill A.; Sondreal, Marriah L.; Johnson, Douglas H.; Igl, Lawrence D.; Goldade, Christopher M.; Parkin, Barry D.; Euliss, Betty R.

    1999-01-01

    Information on the habitat requirements and effects of habitat management on grassland birds were summarized from information in more than 5,500 published and unpublished papers. A range map is provided to indicate the relative densities of the species in North America, based on Breeding Bird Survey (BBS) data. Although birds frequently are observed outside the breeding range indicated, the maps are intended to show areas where managers might concentrate their attention. It may be ineffectual to manage habitat at a site for a species that rarely occurs in an area. The species account begins with a brief capsule statement, which provides the fundamental components or keys to management for the species. A section on breeding range outlines the current breeding distribution of the species in North America, including areas that could not be mapped using BBS data. The suitable habitat section describes the breeding habitat and occasionally microhabitat characteristics of the species, especially those habitats that occur in the Great Plains. Details on habitat and microhabitat requirements often provide clues to how a species will respond to a particular management practice. A table near the end of the account complements the section on suitable habitat, and lists the specific habitat characteristics for the species by individual studies. A special section on prey habitat is included for those predatory species that have more specific prey requirements. The area requirements section provides details on territory and home range sizes, minimum area requirements, and the effects of patch size, edges, and other landscape and habitat features on abundance and productivity. It may be futile to manage a small block of suitable habitat for a species that has minimum area requirements that are larger than the area being managed. The Brown-headed Cowbird (Molothrus ater) is an obligate brood parasite of many grassland birds. The section on cowbird brood parasitism summarizes rates

  2. Effects of management practices on grassland birds: Field Sparrow

    Science.gov (United States)

    Dechant, Jill A.; Sondreal, Marriah L.; Johnson, Douglas H.; Igl, Lawrence D.; Goldade, Christopher M.; Parkin, Barry D.; Euliss, Betty R.

    1999-01-01

    Information on the habitat requirements and effects of habitat management on grassland birds were summarized from information in more than 5,500 published and unpublished papers. A range map is provided to indicate the relative densities of the species in North America, based on Breeding Bird Survey (BBS) data. Although birds frequently are observed outside the breeding range indicated, the maps are intended to show areas where managers might concentrate their attention. It may be ineffectual to manage habitat at a site for a species that rarely occurs in an area. The species account begins with a brief capsule statement, which provides the fundamental components or keys to management for the species. A section on breeding range outlines the current breeding distribution of the species in North America, including areas that could not be mapped using BBS data. The suitable habitat section describes the breeding habitat and occasionally microhabitat characteristics of the species, especially those habitats that occur in the Great Plains. Details on habitat and microhabitat requirements often provide clues to how a species will respond to a particular management practice. A table near the end of the account complements the section on suitable habitat, and lists the specific habitat characteristics for the species by individual studies. A special section on prey habitat is included for those predatory species that have more specific prey requirements. The area requirements section provides details on territory and home range sizes, minimum area requirements, and the effects of patch size, edges, and other landscape and habitat features on abundance and productivity. It may be futile to manage a small block of suitable habitat for a species that has minimum area requirements that are larger than the area being managed. The Brown-headed Cowbird (Molothrus ater) is an obligate brood parasite of many grassland birds. The section on cowbird brood parasitism summarizes rates

  3. Effects of management practices on grassland birds: Henslow's sparrow

    Science.gov (United States)

    Herkert, James R.

    1998-01-01

    Information on the habitat requirements and effects of habitat management on grassland birds were summarized from information in more than 4,000 published and unpublished papers. A range map is provided to indicate the relative densities of the species in North America, based on Breeding Bird Survey (BBS) data. Although birds frequently are observed outside the breeding range indicated, the maps are intended to show areas where managers might concentrate their attention. It may be ineffectual to manage habitat at a site for a species that rarely occurs in an area. The species account begins with a brief capsule statement, which provides the fundamental components or keys to management for the species. A section on breeding range outlines the current breeding distribution of the species in North America, including areas that could not be mapped using BBS data. The suitable habitat section describes the breeding habitat and occasionally microhabitat characteristics of the species, especially those habitats that occur in the Great Plains. Details on habitat and microhabitat requirements often provide clues to how a species will respond to a particular management practice. A table near the end of the account complements the section on suitable habitat, and lists the specific habitat characteristics for the species by individual studies. A special section on prey habitat is included for those predatory species that have more specific prey requirements. The area requirements section provides details on territory and home range sizes, minimum area requirements, and the effects of patch size, edges, and other landscape and habitat features on abundance and productivity. It may be futile to manage a small block of suitable habitat for a species that has minimum area requirements that are larger than the area being managed. The Brown-headed Cowbird (Molothrus ater) is an obligate brood parasite of many grassland birds. The section on cowbird brood parasitism summarizes rates

  4. Effects of management practices of grassland birds: Savannah Sparrow

    Science.gov (United States)

    Swanson, David A.

    1998-01-01

    Information on the habitat requirements and effects of habitat management on grassland birds were summarized from information in more than 4,000 published and unpublished papers. A range map is provided to indicate the relative densities of the species in North America, based on Breeding Bird Survey (BBS) data. Although birds frequently are observed outside the breeding range indicated, the maps are intended to show areas where managers might concentrate their attention. It may be ineffectual to manage habitat at a site for a species that rarely occurs in an area. The species account begins with a brief capsule statement, which provides the fundamental components or keys to management for the species. A section on breeding range outlines the current breeding distribution of the species in North America, including areas that could not be mapped using BBS data. The suitable habitat section describes the breeding habitat and occasionally microhabitat characteristics of the species, especially those habitats that occur in the Great Plains. Details on habitat and microhabitat requirements often provide clues to how a species will respond to a particular management practice. A table near the end of the account complements the section on suitable habitat, and lists the specific habitat characteristics for the species by individual studies. A special section on prey habitat is included for those predatory species that have more specific prey requirements. The area requirements section provides details on territory and home range sizes, minimum area requirements, and the effects of patch size, edges, and other landscape and habitat features on abundance and productivity. It may be futile to manage a small block of suitable habitat for a species that has minimum area requirements that are larger than the area being managed. The Brown-headed Cowbird (Molothrus ater) is an obligate brood parasite of many grassland birds. The section on cowbird brood parasitism summarizes rates

  5. Effects of management practices on grassland birds: Grasshopper Sparrow

    Science.gov (United States)

    Dechant, Jill A.; Sondreal, Marriah L.; Johnson, Douglas H.; Igl, Lawrence D.; Goldade, Christopher M.; Nenneman, Melvin P.; Euliss, Betty R.

    1998-01-01

    Information on the habitat requirements and effects of habitat management on grassland birds were summarized from information in more than 5,500 published and unpublished papers. A range map is provided to indicate the relative densities of the species in North America, based on Breeding Bird Survey (BBS) data. Although birds frequently are observed outside the breeding range indicated, the maps are intended to show areas where managers might concentrate their attention. It may be ineffectual to manage habitat at a site for a species that rarely occurs in an area. The species account begins with a brief capsule statement, which provides the fundamental components or keys to management for the species. A section on breeding range outlines the current breeding distribution of the species in North America, including areas that could not be mapped using BBS data. The suitable habitat section describes the breeding habitat and occasionally microhabitat characteristics of the species, especially those habitats that occur in the Great Plains. Details on habitat and microhabitat requirements often provide clues to how a species will respond to a particular management practice. A table near the end of the account complements the section on suitable habitat, and lists the specific habitat characteristics for the species by individual studies. A special section on prey habitat is included for those predatory species that have more specific prey requirements. The area requirements section provides details on territory and home range sizes, minimum area requirements, and the effects of patch size, edges, and other landscape and habitat features on abundance and productivity. It may be futile to manage a small block of suitable habitat for a species that has minimum area requirements that are larger than the area being managed. The Brown-headed Cowbird (Molothrus ater) is an obligate brood parasite of many grassland birds. The section on cowbird brood parasitism summarizes rates

  6. Effects of management practices on grassland birds: Le Conte's Sparrow

    Science.gov (United States)

    Dechant, J.A.; Sondreal, M.L.; Johnson, D.H.; Igl, L.D.; Goldade, C.M.; Zimmerman, A.L.; Euliss, B.R.

    1998-01-01

    Information on the habitat requirements and effects of habitat management on grassland birds were summarized from information in more than 4,000 published and unpublished papers. A range map is provided to indicate the relative densities of the species in North America, based on Breeding Bird Survey (BBS) data. Although birds frequently are observed outside the breeding range indicated, the maps are intended to show areas where managers might concentrate their attention. It may be ineffectual to manage habitat at a site for a species that rarely occurs in an area. The species account begins with a brief capsule statement, which provides the fundamental components or keys to management for the species. A section on breeding range outlines the current breeding distribution of the species in North America, including areas that could not be mapped using BBS data. The suitable habitat section describes the breeding habitat and occasionally microhabitat characteristics of the species, especially those habitats that occur in the Great Plains. Details on habitat and microhabitat requirements often provide clues to how a species will respond to a particular management practice. A table near the end of the account complements the section on suitable habitat, and lists the specific habitat characteristics for the species by individual studies. A special section on prey habitat is included for those predatory species that have more specific prey requirements. The area requirements section provides details on territory and home range sizes, minimum area requirements, and the effects of patch size, edges, and other landscape and habitat features on abundance and productivity. It may be futile to manage a small block of suitable habitat for a species that has minimum area requirements that are larger than the area being managed. The Brown-headed Cowbird (Molothrus ater) is an obligate brood parasite of many grassland birds. The section on cowbird brood parasitism summarizes rates

  7. Effects of management practices on grassland birds: Baird's Sparrow

    Science.gov (United States)

    Dechant, Jill A.; Sondreal, Marriah L.; Johnson, Douglas H.; Igl, Lawrence D.; Goldade, Christopher M.; Nenneman, Melvin P.; Euliss, Betty R.

    1998-01-01

    Information on the habitat requirements and effects of habitat management on grassland birds were summarized from information in more than 5,500 published and unpublished papers. A range map is provided to indicate the relative densities of the species in North America, based on Breeding Bird Survey (BBS) data. Although birds frequently are observed outside the breeding range indicated, the maps are intended to show areas where managers might concentrate their attention. It may be ineffectual to manage habitat at a site for a species that rarely occurs in an area. The species account begins with a brief capsule statement, which provides the fundamental components or keys to management for the species. A section on breeding range outlines the current breeding distribution of the species in North America, including areas that could not be mapped using BBS data. The suitable habitat section describes the breeding habitat and occasionally microhabitat characteristics of the species, especially those habitats that occur in the Great Plains. Details on habitat and microhabitat requirements often provide clues to how a species will respond to a particular management practice. A table near the end of the account complements the section on suitable habitat, and lists the specific habitat characteristics for the species by individual studies. A special section on prey habitat is included for those predatory species that have more specific prey requirements. The area requirements section provides details on territory and home range sizes, minimum area requirements, and the effects of patch size, edges, and other landscape and habitat features on abundance and productivity. It may be futile to manage a small block of suitable habitat for a species that has minimum area requirements that are larger than the area being managed. The Brown-headed Cowbird (Molothrus ater) is an obligate brood parasite of many grassland birds. The section on cowbird brood parasitism summarizes rates

  8. Effects of management practices on grassland birds: Brewer's sparrow

    Science.gov (United States)

    Walker, Brett L.

    2004-01-01

    Information on the habitat requirements and effects of habitat management on grassland birds were summarized from information in more than 5,500 published and unpublished papers. A range map is provided to indicate the relative densities of the species in North America, based on Breeding Bird Survey (BBS) data. Although birds frequently are observed outside the breeding range indicated, the maps are intended to show areas where managers might concentrate their attention. It may be ineffectual to manage habitat at a site for a species that rarely occurs in an area. The species account begins with a brief capsule statement, which provides the fundamental components or keys to management for the species. A section on breeding range outlines the current breeding distribution of the species in North America, including areas that could not be mapped using BBS data. The suitable habitat section describes the breeding habitat and occasionally microhabitat characteristics of the species, especially those habitats that occur in the Great Plains. Details on habitat and microhabitat requirements often provide clues to how a species will respond to a particular management practice. A table near the end of the account complements the section on suitable habitat, and lists the specific habitat characteristics for the species by individual studies. A special section on prey habitat is included for those predatory species that have more specific prey requirements. The area requirements section provides details on territory and home range sizes, minimum area requirements, and the effects of patch size, edges, and other landscape and habitat features on abundance and productivity. It may be futile to manage a small block of suitable habitat for a species that has minimum area requirements that are larger than the area being managed. The Brown-headed Cowbird (Molothrus ater) is an obligate brood parasite of many grassland birds. The section on cowbird brood parasitism summarizes rates

  9. Effects of management practices on grassland birds: Vesper Sparrow

    Science.gov (United States)

    Dechant, Jill A.; Dinkins, Meghan F.; Johnson, Douglas H.; Igl, Lawrence D.; Goldade, Christopher M.; Euliss, Betty R.

    2000-01-01

    Information on the habitat requirements and effects of habitat management on grassland birds were summarized from information in more than 5,500 published and unpublished papers. A range map is provided to indicate the relative densities of the species in North America, based on Breeding Bird Survey (BBS) data. Although birds frequently are observed outside the breeding range indicated, the maps are intended to show areas where managers might concentrate their attention. It may be ineffectual to manage habitat at a site for a species that rarely occurs in an area. The species account begins with a brief capsule statement, which provides the fundamental components or keys to management for the species. A section on breeding range outlines the current breeding distribution of the species in North America, including areas that could not be mapped using BBS data. The suitable habitat section describes the breeding habitat and occasionally microhabitat characteristics of the species, especially those habitats that occur in the Great Plains. Details on habitat and microhabitat requirements often provide clues to how a species will respond to a particular management practice. A table near the end of the account complements the section on suitable habitat, and lists the specific habitat characteristics for the species by individual studies. A special section on prey habitat is included for those predatory species that have more specific prey requirements. The area requirements section provides details on territory and home range sizes, minimum area requirements, and the effects of patch size, edges, and other landscape and habitat features on abundance and productivity. It may be futile to manage a small block of suitable habitat for a species that has minimum area requirements that are larger than the area being managed. The Brown-headed Cowbird (Molothrus ater) is an obligate brood parasite of many grassland birds. The section on cowbird brood parasitism summarizes rates

  10. A Practical Guide for Personnel Management: The Essential Elements.

    Science.gov (United States)

    Todaro, Julie B.

    The essential elements of personnel management are outlined. Personnel management may be called by various names and may be practiced by various levels of management, but in any case it is one of the most important elements of a management position. While sample forms generally relate to Texas community colleges and libraries, the guide is written…

  11. Practical management of adverse events related to apomorphine therapy

    DEFF Research Database (Denmark)

    Bhidayasiri, Roongroj; Garcia Ruiz, Pedro J; Henriksen, Tove

    2016-01-01

    The potential for adverse events is often cited as a barrier to the use of subcutaneous apomorphine therapy (intermittent injections and continuous infusion) in the management of Parkinson's disease. However, with proactive management most adverse effects are manageable if reported and tackled...... titration, initiation and long-term treatment, and discuss practical management strategies....

  12. Snow management practices in French ski resorts

    Science.gov (United States)

    Spandre, Pierre; Francois, Hugues; George-Marcelpoil, Emmanuelle; Morin, Samuel

    2016-04-01

    Winter tourism plays a fundamental role in the economy of French mountain regions but also in other countries such as Austria, USA or Canada. Ski operators originally developed grooming methods to provide comfortable and safe skiing conditions. The interannual variability of snow conditions and the competition with international destinations and alternative tourism activities encouraged ski resorts to mitigate their dependency to weather conditions through snowmaking facilities. However some regions may not be able to produce machine made snow due to inadequate conditions and low altitude resorts are still negatively impacted by low snow seasons. In the meantime, even though the operations of high altitude resorts do not show any dependency to the snow conditions they invest in snowmaking facilities. Such developments of snowmaking facilities may be related to a confused and contradictory perception of climate change resulting in individualistic evolutions of snowmaking facilities, also depending on ski resorts main features such as their altitude and size. Concurrently with the expansion of snowmaking facilities, a large range of indicators have been used to discuss the vulnerability of ski resorts such as the so-called "100 days rule" which was widely used with specific thresholds (i.e. minimum snow depth, dates) and constraints (i.e. snowmaking capacity). The present study aims to provide a detailed description of snow management practices and major priorities in French ski resorts with respect to their characteristics. We set up a survey in autumn 2014, collecting data from 56 French ski operators. We identify the priorities of ski operators and describe their snowmaking and grooming practices and facilities. The operators also provided their perception of the ski resort vulnerability to snow and economic challenges which we could compare with the actual snow conditions and ski lift tickets sales during the period from 2001 to 2012.

  13. Indoor Environmental Control Practices and Asthma Management.

    Science.gov (United States)

    Matsui, Elizabeth C; Abramson, Stuart L; Sandel, Megan T

    2016-11-01

    Indoor environmental exposures, particularly allergens and pollutants, are major contributors to asthma morbidity in children; environmental control practices aimed at reducing these exposures are an integral component of asthma management. Some individually tailored environmental control practices that have been shown to reduce asthma symptoms and exacerbations are similar in efficacy and cost to controller medications. As a part of developing tailored strategies regarding environmental control measures, an environmental history can be obtained to evaluate the key indoor environmental exposures that are known to trigger asthma symptoms and exacerbations, including both indoor pollutants and allergens. An environmental history includes questions regarding the presence of pets or pests or evidence of pests in the home, as well as knowledge regarding whether the climatic characteristics in the community favor dust mites. In addition, the history focuses on sources of indoor air pollution, including the presence of smokers who live in the home or care for children and the use of gas stoves and appliances in the home. Serum allergen-specific immunoglobulin E antibody tests can be performed or the patient can be referred for allergy skin testing to identify indoor allergens that are most likely to be clinically relevant. Environmental control strategies are tailored to each potentially relevant indoor exposure and are based on knowledge of the sources and underlying characteristics of the exposure. Strategies include source removal, source control, and mitigation strategies, such as high-efficiency particulate air purifiers and allergen-proof mattress and pillow encasements, as well as education, which can be delivered by primary care pediatricians, allergists, pediatric pulmonologists, other health care workers, or community health workers trained in asthma environmental control and asthma education.

  14. Retention practices in education human resources management

    African Journals Online (AJOL)

    Erna Kinsey

    Department of Education Management and Policy Studies, University of Pretoria, ... teachers is premised on the principles of quality management which aim at continual ... (tenure) applied in the management of human resources in education.

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

    Science.gov (United States)

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

    2016-10-01

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

  16. Impact on quality culture of total quality management practices factors

    Directory of Open Access Journals (Sweden)

    Faihan Mosaad Saud Alotaibi

    2014-09-01

    Full Text Available This study investigated total quality management practices and quality culture of Saudi Arabian contractors. Improving the quality can be achieved through implementation of total quality management although studies and researches work regarding this improvement is still lacking. A quantitative approach using the survey method was employed. With assistance from the Saudi Arabia Ministry of Municipal and Rural Affairs, survey questionnaires were distributed to selected contractors in Saudi Arabia. The collected data were analysed using correlation, and multiple regression analyses. The key findings were the confirmation of significant relationships between all total quality management practices and quality culture and a positive relationship between quality management practices and quality culture. Furthermore, total quality management practices were found to be able to explain 68.1% of the variance in quality culture, while quality culture explained 12.5% of the variance in competitiveness. Quality culture was found to only partially mediate the relationship between total quality management practices and competitiveness.

  17. SECOND LANGUAGE VOCABULARY ASSESSMENT: CURRENT PRACTICES AND NEW DIRECTIONS

    Directory of Open Access Journals (Sweden)

    John Read

    2007-12-01

    Full Text Available This paper surveys some current developments in second language vocabulary assessment, with particular attention to the ways in which computer corpora can provide better quality information about the frequency of words and how they are used in specific contexts. The relative merits of different word lists are discussed, including the Academic Word List and frequency lists derived from the British National Corpus. Word frequency data is needed for measures of vocabulary size, such as the Yes/No format, which is being developed and used for a variety of purposes. The paper also reviews work on testing depth of knowledge of vocabulary, where rather less progress has been made, both in defining depth as a construct and in developing tests for practical use. Another important perspective is the use of vocabulary within particular contexts of use or registers, and recent corpus research is extending our understanding of the lexical features of academic registers. This provides a basis for assessing learners’ ability to deploy their vocabulary knowledge effectively for functional communication in specific academic contexts. It is concluded that, while current tests of vocabulary knowledge are valuable for certain purposes, they need to be complemented by more contextualised measures of vocabulary use.

  18. Assessment of human resources management practices in Lebanese hospitals

    Directory of Open Access Journals (Sweden)

    Jamal Diana

    2009-11-01

    Full Text Available Abstract Background Sound human resources (HR management practices are essential for retaining effective professionals in hospitals. Given the recruitment and retention reality of health workers in the twenty-first century, the role of HR managers in hospitals and those who combine the role of HR managers with other responsibilities should not be underestimated. The objective of this study is to assess the perception of HR managers about the challenges they face and the current strategies being adopted. The study also aims at assessing enabling factors including role, education, experience and HR training. Methods A cross-sectional survey design of HR managers (and those who combine their role as HR manager with other duties in Lebanese hospitals was utilized. The survey included a combination of open- and close-ended questions. Questions included educational background, work experience, and demographics, in addition to questions about perceived challenges and key strategies being used. Quantitative data analysis included uni-variate analysis, whereas thematic analysis was used for open-ended questions. Results A total of 96 respondents from 61 hospitals responded. Respondents had varying levels of expertise in the realm of HR management. Thematic analysis revealed that challenges varied across respondents and participating hospitals. The most frequently reported challenge was poor employee retention (56.7%, lack of qualified personnel (35.1%, and lack of a system for performance evaluation (28.9%. Some of the strategies used to mitigate the above challenges included offering continuing education and training for employees (19.6%, improving salaries (14.4%, and developing retention strategies (10.3%. Mismatch between reported challenges and strategies were observed. Conclusion To enable hospitals to deliver good quality, safe healthcare, improving HR management is critical. There is a need for a cadre of competent HR managers who can fully

  19. Assessment of human resources management practices in Lebanese hospitals.

    Science.gov (United States)

    El-Jardali, Fadi; Tchaghchagian, Victoria; Jamal, Diana

    2010-01-01

    Sound human resources (HR) management practices are essential for retaining effective professionals in hospitals. Given the recruitment and retention reality of health workers in the twenty-first century, the role of HR managers in hospitals and those who combine the role of HR managers with other responsibilities should not be underestimated. The objective of this study is to assess the perception of HR managers about the challenges they face and the current strategies being adopted. The study also aims at assessing enabling factors including role, education, experience and HR training. A cross-sectional survey design of HR managers (and those who combine their role as HR manager with other duties) in Lebanese hospitals was utilized. The survey included a combination of open- and close-ended questions. Questions included educational background, work experience, and demographics, in addition to questions about perceived challenges and key strategies being used. Quantitative data analysis included uni-variate analysis, whereas thematic analysis was used for open-ended questions. A total of 96 respondents from 61 hospitals responded. Respondents had varying levels of expertise in the realm of HR management. Thematic analysis revealed that challenges varied across respondents and participating hospitals. The most frequently reported challenge was poor employee retention (56.7%), lack of qualified personnel (35.1%), and lack of a system for performance evaluation (28.9%). Some of the strategies used to mitigate the above challenges included offering continuing education and training for employees (19.6%), improving salaries (14.4%), and developing retention strategies (10.3%). Mismatch between reported challenges and strategies were observed. To enable hospitals to deliver good quality, safe healthcare, improving HR management is critical. There is a need for a cadre of competent HR managers who can fully assume these responsibilities and who can continuously improve

  20. Sarcopenia in daily practice: assessment and management.

    Science.gov (United States)

    Beaudart, Charlotte; McCloskey, Eugène; Bruyère, Olivier; Cesari, Matteo; Rolland, Yves; Rizzoli, René; Araujo de Carvalho, Islène; Amuthavalli Thiyagarajan, Jotheeswaran; Bautmans, Ivan; Bertière, Marie-Claude; Brandi, Maria Luisa; Al-Daghri, Nasser M; Burlet, Nansa; Cavalier, Etienne; Cerreta, Francesca; Cherubini, Antonio; Fielding, Roger; Gielen, Evelien; Landi, Francesco; Petermans, Jean; Reginster, Jean-Yves; Visser, Marjolein; Kanis, John; Cooper, Cyrus

    2016-10-05

    Sarcopenia is increasingly recognized as a correlate of ageing and is associated with increased likelihood of adverse outcomes including falls, fractures, frailty and mortality. Several tools have been recommended to assess muscle mass, muscle strength and physical performance in clinical trials. Whilst these tools have proven to be accurate and reliable in investigational settings, many are not easily applied to daily practice. This paper is based on literature reviews performed by members of the European Society for Clinical and Economic Aspects of Osteoporosis and Osteoarthritis (ESCEO) working group on frailty and sarcopenia. Face-to-face meetings were afterwards organized for the whole group to make amendments and discuss further recommendations. This paper proposes some user-friendly and inexpensive methods that can be used to assess sarcopenia in real-life settings. Healthcare providers, particularly in primary care, should consider an assessment of sarcopenia in individuals at increased risk; suggested tools for assessing risk include the Red Flag Method, the SARC-F questionnaire, the SMI method or different prediction equations. Management of sarcopenia should primarily be patient centered and involve the combination of both resistance and endurance based activity programmes with or without dietary interventions. Development of a number of pharmacological interventions is also in progress. Assessment of sarcopenia in individuals with risk factors, symptoms and/or conditions exposing them to the risk of disability will become particularly important in the near future.

  1. Evaluation of Bio-Medical Waste Management Practices in a Government Medical College and Hospital

    Directory of Open Access Journals (Sweden)

    Srivastav Shalini, Mahajan Harsh, Mathur B P

    2012-01-01

    Full Text Available Background: Biomedical waste (BMW collection and proper disposal has become a significant concern for both the medical and the general community as improper management poses risks to the health care workers, waste handlers, patients, community in general and largely the environment. Objectives: (i Assessment of current Bio-medical waste management practices including collection, segregation, transportation, storage, treatment and disposal technologies in tertiary health care center. (ii Assessment of health and safety practices for the health care personnel involved in Bio-Medical Waste Management. Materials and Methods: Waste management practices in the Government Hospital was studied during March 2009 – May 2009.The information / data regarding Bio-Medical Waste Management practices and safety was collected by way of semi- structured interview. Results: M.L.B Medical College generates 0.52Kgs waste per bed per day and maximum waste is generated in wards. The institute has got separate color coded bins in wards for collection of waste but segregation practices needs to be more refined. The safety measures taken by health care workers was not satisfactory, it was basically due to un-awareness of health hazards which may occur because of improper waste management practices. Conclusion: Thus it is concluded that there should be strict implementation of a waste management policy set up in the institute; training and motivation must be given paramount importance to meet the current needs and standards of bio-medical waste management.

  2. Environmental management practices and engineering science: a review and typology for future research.

    Science.gov (United States)

    Evangelinos, Konstantinos I; Allan, Stuart; Jones, Keith; Nikolaou, Ioannis E

    2014-04-01

    Current literature describes a number of environmental management practices and cleaner production methods that facilitate different industrial sectors to address their various environmental impacts. The high number of present practices makes their use especially difficult and complicated. This paper aims to shed light on this field by providing a typology of those environmental management practices (such as environmental management systems, environmental indicators assessment methodologies, and cleaner productions methods) and their limitations. It also describes the strengths and weaknesses of using such tools and thoughts for future research. © 2013 SETAC.

  3. [The practice and proposals for standardized management of neonatal insulation technology].

    Science.gov (United States)

    Wang, Xi; Xiong, Ying; Hu, Yanling; Zhang, Xuelong

    2012-05-01

    In clinical practice, incubators can contribute to better diagnosis and treatment of diseases. Currently, insulation medical equipment used for the newborn are mainly warm-boxes. With the use popularity of warm-boxes in the country, medical accidents caused by improper use are on the increase. According to neonatal insulation technology and standardized management of practice, this article puts forward technical requirements of infant incubators with constant temperature and humidity, operation regulations and management specifications to better regulate the use of such devices. Meanwhile, it also suggests national related departments to formulate "incubator technology management norms" and "warm-box technology and practice", intending to standardize industry behaviors and ensure medical safety.

  4. Talent management : Current theories and future research directions

    NARCIS (Netherlands)

    Al Ariss, A.; Cascio, W.F.; Paauwe, J.

    2014-01-01

    Research on Talent Management (TM) has been lagging behind businesses in offering vision and leadership in this field. After sketching a comprehensive outline of knowledge about TM, theoretical as well as practical, we introduce the papers in this special issue and their important contributions.

  5. Nutritional management of newborn infants: Practical guidelines

    Institute of Scientific and Technical Information of China (English)

    Xiao-Ming Ben

    2008-01-01

    The requirements of growth and organ development create a challenge in nutritional management of newborn infants, especially premature newborn and intestinal-failure infants. Since their feeding may increase the risk of necrotizing enterocolitis, some high-risk infants receive a small volume of feeding or parenteral nutrition (PN) without enteral feeding. This review summarizes the current research progress in the nutritional management of newborn infants. Searches of MEDLINE (1998-2007), Cochrane Central Register of Controlled Trials (The Cochrane Library, Issue 3, 2007), abstracts and conference proceedings, references from relevant publications in the English language were performed, showing that breast milk is the preferred source of nutrients for enteral feeding of newborn infants. The number of nutrients found in human milk was recommended as a guideline in establishing the minimum and maximum levels in infant formulas. The fear of necrotizing enterocolitis and feeding intolerance are the major factors limiting the use of the enteral route as the primary means of nourishing premature infants. PN may help to meet many of the nutritional needs of these infants, but has significant detrimental side effects. Trophic feedings (small volume of feeding given at the same rate for at least 5 d) during PN are a strategy to enhance the feeding tolerance and decrease the side effects of PN and the time to achieve full feeding. Human milk is aey component of any strategy for enteral nutrition of all infants. However, the amounts of calcium, phosphorus, zinc and other nutrients are inadequate to meet the needs of the very low birth weight (VLBW) infants during growth. Therefore, safe and effective means to fortify human milk are essential to the care of VLBW infants.

  6. New management practice in the hotel business – The case of the hotel Excelsior

    Directory of Open Access Journals (Sweden)

    Ivona Vrdoljak

    2004-01-01

    Full Text Available The paper analyses the new management practice in the hotel industry. Over recent years, the environment for hotel management in Croatia has changed radically. Difficult business conditions require the transformation of management in the hotel industry. From the old-style business model, in which hotel managers were focused inwards on the hotel and its operation, a new paradigm encompassing a more externally oriented focus is now required. The current transformation of socially-owned hotels into capital-based and market-oriented business enterprises will accelerate the general process of privatisation and promote incentive management strategies. The article gives the research results of the new management practice in the case of the hotel "Excelsior" in Dubrovnik. It is one of the most successful hotels on the Croatian coast, which practises modern management. The research referred to management level, sex, age and educational structure of managers, their continuing education, knowledge, skills and characteristics of management, main functions of management, delegation of authorities and responsibilities, management system, decision-making, styles of leading and governing of managers by their time. The received results have been compared with the earlier management approach of the above-mentioned hotel. The objective of the paper is to point out the importance of the new management practice and its contribution to the successful hotel business.

  7. Current practices and improved recommendations for treating hereditary fructose intolerance.

    Science.gov (United States)

    Bell, L; Sherwood, W G

    1987-06-01

    A study of treatment practices of pediatric centers managing hereditary fructose intolerance and a review of recent literature on this subject were undertaken in an attempt to establish the degree of dietary liberalization allowable with age and the acceptability of foods containing trace amounts of fructose. The information was needed to plan optimal therapy and thus avoid the consequences of the disorder, namely intestinal dysfunction, metabolic imbalance, and hepatic and renal damage. Fifty responses to 113 letters to centers in Canada and the United States, as well as data from The Hospital for Sick Children, Toronto, Ontario, identified only 29 affected children and provided information on their care, including food lists and literature references. Major principles of treatment were similar, but the approach to allowing and quantifying dietary fructose differed. In response to the apparent need for standardization of treatment, the authors formulated improved recommendations for the control of dietary fructose (less than 1.5 gm/day). Only a few foods of vegetable origin are allowed, including a limited selection of vegetables and cereal products from grain endosperm. Repeated dietary counseling is advocated with regard to allowed foods, sweeteners, and medications to ensure long-term dietary compliance.

  8. Fish quarantine: current practices in public zoos and aquaria.

    Science.gov (United States)

    Hadfield, Catherine A; Clayton, Leigh A

    2011-12-01

    The primary goal of quarantine is to reduce the risk of introducing infectious diseases into established collections. Fish quarantine is inherently complex because of the variety of species, environmental requirements, and facilities. To examine current practices, questionnaires were submitted to 60 public zoos and aquaria, predominantly in North America. Questions reviewed system type (closed, flow-through), quarantine length, diagnostics, treatments, and cleaning and disinfection. Forty-two of the 60 institutions responded. Most institutions had separate quarantine protocols for freshwater teleosts, marine teleosts, and elasmobranchs. Ninety-five percent of institutions had a minimum quarantine period of 30 days or more. Sixty-four percent of institutions used isolated areas for some or all of their fish quarantine. Twenty-five percent had designated fish quarantine staff. All institutions used regular visual examinations to assess animal health. Fifty-four percent of the institutions carried out routine hands-on diagnostics on some fish; this was more common for elasmobranchs than teleosts. All institutions carried out necropsies on mortalities. Fifteen percent of institutions performed histopathology on almost all fresh mortalities; 54% percent performed histopathology on less than 10% of mortalities. Prophylactic treatments were common in closed systems, in particular, formalin immersion for teleosts, freshwater dips and copper sulfate immersion for marine teleosts, and praziquantel immersion for marine teleosts and elasmobranchs. Institutions using dips generally did so at the start or end of quarantine. Fenbendazole- and praziquantel-medicated foods were used commonly in teleosts, but dosages varied greatly. Cleaning and disinfection of systems and equipment increased in response to known pathogens. These results can be used to compare and discuss fish quarantine practices at display facilities in order to improve quarantine success.

  9. Student Teachers' Management Practices in Elementary Classrooms: A Qualitative Study

    Science.gov (United States)

    Hildenbrand, Susan M.; Arndt, Katrina

    2016-01-01

    This qualitative study of four student teachers completing certification in elementary and special education investigated the classroom management practices of the student teachers. This is an important area of study because management practices are essential for an effective classroom, and student teachers often lack confidence and skill in the…

  10. Supply chain management: New organisational practices for changing procurement realities

    DEFF Research Database (Denmark)

    Rask, Morten; Andersen, Poul Houman

    2003-01-01

    we use an analytical technique known as the degree-of-freedom analysis. It is suggested that new organisational practices such as key supply management, team based management and changing skill requirements of purchasing personnel may be an outcome of implementing SCM practices towards suppliers...

  11. Effective population management practices in diabetes care - an observational study

    DEFF Research Database (Denmark)

    Frølich, Anne; Bellows, Jim; Nielsen, Bo Friis

    2010-01-01

    Of fifteen diabetes care management practices, our data indicate that high performance is most associated with provider alerts and more weakly associated with action plans and with guideline distribution and training. Lack of convergence in the literature on effective care management practices...

  12. STORMWATER BEST MANAGEMENT PRACTICES DESIGN GUIDE VOLUME 2 - VEGETATIVE BIOFILTERS

    Science.gov (United States)

    This document is Volume 2 of a three volume document that provides guidance on the selection and design of stormwater management Best Management Practices (BMPs). This second volume provides specific design guidance for a group of onsite BMP control practices that are referred t...

  13. Supply chain management: New organisational practices for changing procurement realities

    DEFF Research Database (Denmark)

    Rask, Morten; Andersen, Poul Houman

    2003-01-01

    we use an analytical technique known as the degree-of-freedom analysis. It is suggested that new organisational practices such as key supply management, team based management and changing skill requirements of purchasing personnel may be an outcome of implementing SCM practices towards suppliers...

  14. Student Teachers' Management Practices in Elementary Classrooms: A Qualitative Study

    Science.gov (United States)

    Hildenbrand, Susan M.; Arndt, Katrina

    2016-01-01

    This qualitative study of four student teachers completing certification in elementary and special education investigated the classroom management practices of the student teachers. This is an important area of study because management practices are essential for an effective classroom, and student teachers often lack confidence and skill in the…

  15. STORMWATER BEST MANAGEMENT PRACTICES DESIGN GUIDE VOLUME 2 - VEGETATIVE BIOFILTERS

    Science.gov (United States)

    This document is Volume 2 of a three volume document that provides guidance on the selection and design of stormwater management Best Management Practices (BMPs). This second volume provides specific design guidance for a group of onsite BMP control practices that are referred t...

  16. Adapting Project Management Practices to Research-Based Projects

    Science.gov (United States)

    Bahr, P.; Baker, T.; Corbin, B.; Keith, L.; Loerch, L.; Mullenax, C.; Myers, R.; Rhodes, B.; Skytland, N.

    2007-01-01

    From dealing with the inherent uncertainties in outcomes of scientific research to the lack of applicability of current NASA Procedural Requirements guidance documentation, research-based projects present challenges that require unique application of classical project management techniques. If additionally challenged by the creation of a new program transitioning from basic to applied research in a technical environment often unfamiliar with the cost and schedule constraints addressed by project management practices, such projects can find themselves struggling throughout their life cycles. Finally, supplying deliverables to a prime vehicle customer, also in the formative stage, adds further complexity to the development and management of research-based projects. The Biomedical Research and Countermeasures Projects Branch at NASA Johnson Space Center encompasses several diverse applied research-based or research-enabling projects within the newly-formed Human Research Program. This presentation will provide a brief overview of the organizational structure and environment in which these projects operate and how the projects coordinate to address and manage technical requirements. We will identify several of the challenges (cost, technical, schedule, and personnel) encountered by projects across the Branch, present case reports of actions taken and techniques implemented to deal with these challenges, and then close the session with an open forum discussion of remaining challenges and potential mitigations.

  17. Is dosimetry still a necessity in current dental practice?

    Science.gov (United States)

    Reddy, S S; Rakesh, N; Chauhan, Pallavi; Clint, Joseph Ben; Sharma, Shivani

    2015-12-01

    Today, dentists have a wide range of imaging modalities to choose from, the film based techniques, digital techniques, and the recent introduction of 3D volumetric or cone beam computed tomography (CBCT). The inherent design features of the new generation dental x-ray equipment has significantly improved over the years with no evidence of substandard x-ray units in operation. In dental facilities radiological workload is comparatively low, newer radiation equipments and accessories follow safety guidelines and employ better radiation protection measures for the patient and the operator. Dentists' knowledge and expertise in radiation protection measures is good, enabling them to carry out riskfree radiation procedures in their practice. Therefore, the present study is aimed at assessing the need for dosimeters in current dental scenario. 'Is there currently a significant risk from dental radiography to merit the use of personal dosimetery in dental practice. 'Dental health professionals (Oral radiologists) and radiographic assistants of fourteen dental colleges in Karnataka state participated in this questionnaire study. The questionnaire consisted of the following questions--the make, type, year of manufacture of radiographic machines used in their setup, number of radiographs made per day in the institution, type of receptors used, number of personnel at risk for radiation exposure, radiation protection measures used, regular monitoring by personal dosimeters, equivalent dosage readings for the past 12 months and whether the reading of thermoluminescent dosimeters (TLD) for any personnel had exceeded the recommended exposure value in the last 3 years. Dosimetry records of the radiology staff in the last three years shows doses no more than 1.50 mSv per year. The various institutions' dose (person mSv) was in the range of 3.70 mSv-3.90 mSv. Personal monitoring for Dentists can be omitted in the dental colleges since the estimated dose of oral radiologists

  18. 75 FR 78715 - Small Entity Compliance Guide: Current Good Manufacturing Practice in Manufacturing, Packaging...

    Science.gov (United States)

    2010-12-16

    ... HUMAN SERVICES Food and Drug Administration Small Entity Compliance Guide: Current Good Manufacturing Practice in Manufacturing, Packaging, Labeling, or Holding Operations for Dietary Supplements; Availability...) is announcing the availability of a guidance entitled ``Current Good Manufacturing Practice in...

  19. Assessment of Quality Management Practices Within the Healthcare Industry

    Directory of Open Access Journals (Sweden)

    William J. Miller

    2009-01-01

    Full Text Available Problem Statement: Considerable effort has been devoted over the years by many organizations to adopt quality management practices, but few studies have assessed critical factors that affect quality practices in healthcare organizations. The problem addressed in this study was to assess the critical factors influencing the quality management practices in a single important industry (i.e., healthcare. Approach: A survey instrument was adapted from business quality literature and was sent to all hospitals in a large US Southeastern state. Valid responses were received from 147 of 189 hospitals yielding a 75.6% response rate. Factor analysis using principal component analysis with an orthogonal rotation was performed to assess 58 survey items designed to measure ten dimensions of hospital quality management practices. Results: Eight factors were shown to have a statistically significant effect on quality management practices and were classified into two groups: (1 four strategic factors (role of management leadership, role of the physician, customer focus, training resources investment and (2 four operational factors (role of quality department, quality data/reporting, process management/training and employee relations. The results of this study showed that a valid and reliable instrument was developed and used to assess quality management practices in hospitals throughout a large US state. Conclusion: The implications of this study provided an understanding that management of quality required both a focus on longer-term strategic leadership, as well as day-to-day operational management. It was recommended that healthcare researchers and practitioners focus on the critical factors identified and employ this survey instrument to manage and better understand the nature of hospital quality management practices across wider geographical regions and over longer time periods. Furthermore, this study extended the scope of existing quality management

  20. Potential for Applying Intergenerational Practice to Protected Area Management in Mountainous Regions

    Directory of Open Access Journals (Sweden)

    Tamara Mitrofanenko

    2015-02-01

    Full Text Available One way of preserving the natural and cultural diversity of mountain areas and supporting their sustainable development is the establishment of protected areas. The scientific literature acknowledges the importance of participation by local stakeholders and of considering social cohesion in protected area management. Intergenerational practice has been shown to enhance participation and improve social cohesion; however, its potential role in natural resource management has not been considered by the research community. This paper explores the potential for integrating intergenerational practice into protected area management in mountainous regions, guided by 3 research questions: What challenges of protected area management could benefit from intergenerational practice? How can intergenerational practice help to address these challenges? And how could intergenerational practice be more strongly integrated into current protected area management? The paper focuses on selected management challenges, mostly related to the development function of protected areas, and suggests intergenerational practice solution pathways for each challenge, derived from qualitative content analysis of the literature, interviews with protected area and regional development experts, and participation in the project Big Foot: Crossing Generations, Crossing Mountains, which tested intergenerational learning approaches in 3 rural municipalities—one each in Bulgaria, Greece, and Italy. Recommendations are proposed for integrating intergenerational practice into protected area management policy and practice at the global, regional, and local levels.

  1. Current Practices in Global/International Advanced Pharmacy Practice Experiences: Home/Host Country or Site/Institution Considerations

    National Research Council Canada - National Science Library

    Naser Z Alsharif; Adnan Dakkuri; Jeanine P Abrons; Dennis Williams; David N Ombengi; HaiAn Zheng; Sara Al-Dahir; Toyin Tofade; Suzanna Gim; Mary Beth O'Connell; Anna Ratka; Emily Dornblaser

    2016-01-01

      International outreach by schools and colleges of pharmacy is increasing. In this paper, we provide current practice guidelines to establish and maintain successful global/international advanced pharmacy practice experiences (G/I APPEs...

  2. Gender relations and health research: a review of current practices

    Directory of Open Access Journals (Sweden)

    Bottorff Joan L

    2011-12-01

    Full Text Available Abstract Introduction The importance of gender in understanding health practices and illness experiences is increasingly recognized, and key to this work is a better understanding of the application of gender relations. The influence of masculinities and femininities, and the interplay within and between them manifests within relations and interactions among couples, family members and peers to influence health behaviours and outcomes. Methods To explore how conceptualizations of gender relations have been integrated in health research a scoping review of the existing literature was conducted. The key terms gender relations, gender interactions, relations gender, partner communication, femininities and masculinities were used to search online databases. Results Through analysis of this literature we identified two main ways gender relations were integrated in health research: a as emergent findings; and b as a basis for research design. In the latter, gender relations are included in conceptual frameworks, guide data collection and are used to direct data analysis. Conclusions Current uses of gender relations are typically positioned within intimate heterosexual couples whereby single narratives (i.e., either men or women are used to explore the influence and/or impact of intimate partner gender relations on health and illness issues. Recommendations for advancing gender relations and health research are discussed. This research has the potential to reduce gender inequities in health.

  3. Current safety practices in nano-research laboratories in China.

    Science.gov (United States)

    Zhang, Can; Zhang, Jing; Wang, Guoyu

    2014-06-01

    China has become a key player in the global nanotechnology field, however, no surveys have specifically examined safety practices in the Chinese nano-laboratories in depth. This study reports results of a survey of 300 professionals who work in research laboratories that handle nanomaterials in China. We recruited participants at three major nano-research laboratories (which carry out research in diverse fields such as chemistry, material science, and biology) and the nano-chemistry session of the national meeting of the Chinese Chemical Society. Results show that almost all nano-research laboratories surveyed had general safety regulations, whereas less than one third of respondents reported having nanospecific safety rules. General safety measures were in place in most surveyed nano-research laboratories, while nanospecific protective measures existed or were implemented less frequently. Several factors reported from the scientific literature including nanotoxicology knowledge gaps, technical limitations on estimating nano-exposure, and the lack of nano-occupational safety legislation may contribute to the current state of affairs. With these factors in mind and embracing the precautionary principle, we suggest strengthening or providing nanosafety training (including raising risk awareness) and establishing nanosafety guidelines in China, to better protect personnel in the nano-workplace.

  4. Current Continuing Professional Education Practice among Malaysian Nurses

    Directory of Open Access Journals (Sweden)

    Mei Chan Chong

    2014-01-01

    Full Text Available Nurses need to participate in CPE to update their knowledge and increase their competencies. This research was carried out to explore their current practice and the future general needs for CPE. This cross-sectional descriptive study involved registered nurses from government hospitals and health clinics from Peninsular Malaysia. Multistage cluster sampling was used to recruit 1000 nurses from four states of Malaysia. Self-explanatory questionnaires were used to collect the data, which were analyzed using SPSS version 16. Seven hundred and ninety-two nurses participated in this survey. Only 80% (562 of the nurses had engaged in CPE activities during the past 12 months. All attendance for the various activities was below 50%. Workshops were the most popular CPE activity (345, 43.6% and tertiary education was the most unpopular activity (10, 1.3%. The respondents did perceive the importance of future CPE activities for career development. Mandatory continuing professional education (MCPE is a key measure to ensure that nurses upgrade their knowledge and skills; however, it is recommended that policy makers and nurse leaders in the continuing professional development unit of health service facilities plan CPE activities to meet registered nurses’ (RNs needs and not simply organizational requirements.

  5. Computational structures technology at Grumman: Current practice/future needs

    Science.gov (United States)

    Pifko, Allan B.; Eidinoff, Harvey

    1992-05-01

    The current practice for the design analysis of new airframe structural systems is to construct a master finite element model of the vehicle in order to develop internal load distributions. The inputs to this model include the geometry which is taken directly from CADAM and CATIA structural layout and aerodynamic loads and mass distribution computer models. This master model is sufficiently detailed to define major load paths and for the computation of dynamic mode shapes and structural frequencies, but not detailed enough to define local stress gradients and notch stresses. This master model is then used to perform structural optimization studies that will provide minimum weights for major structural members. The post-processed output from the master model, load, stress, and strain analysis is then used by structural analysts to perform detailed stress analysis of local regions in order to design local structure with all its required details. This local analysis consists of hand stress analysis and life prediction analysis with the assistance of manuals, design charts, computer stress and structural life analysis and sometimes finite element or boundary element analysis. The resulting design is verified by fatigue tests.

  6. Current Continuing Professional Education Practice among Malaysian Nurses.

    Science.gov (United States)

    Chong, Mei Chan; Francis, Karen; Cooper, Simon; Abdullah, Khatijah Lim

    2014-01-01

    Nurses need to participate in CPE to update their knowledge and increase their competencies. This research was carried out to explore their current practice and the future general needs for CPE. This cross-sectional descriptive study involved registered nurses from government hospitals and health clinics from Peninsular Malaysia. Multistage cluster sampling was used to recruit 1000 nurses from four states of Malaysia. Self-explanatory questionnaires were used to collect the data, which were analyzed using SPSS version 16. Seven hundred and ninety-two nurses participated in this survey. Only 80% (562) of the nurses had engaged in CPE activities during the past 12 months. All attendance for the various activities was below 50%. Workshops were the most popular CPE activity (345, 43.6%) and tertiary education was the most unpopular activity (10, 1.3%). The respondents did perceive the importance of future CPE activities for career development. Mandatory continuing professional education (MCPE) is a key measure to ensure that nurses upgrade their knowledge and skills; however, it is recommended that policy makers and nurse leaders in the continuing professional development unit of health service facilities plan CPE activities to meet registered nurses' (RNs) needs and not simply organizational requirements.

  7. Cytokine release assays: current practices and future directions.

    Science.gov (United States)

    Finco, D; Grimaldi, C; Fort, M; Walker, M; Kiessling, A; Wolf, B; Salcedo, T; Faggioni, R; Schneider, A; Ibraghimov, A; Scesney, S; Serna, D; Prell, R; Stebbings, R; Narayanan, P K

    2014-04-01

    As a result of the CD28 superagonist biotherapeutic monoclonal antibody (TGN 1412) "cytokine storm" incident, cytokine release assays (CRA) have become hazard identification and prospective risk assessment tools for screening novel biotherapeutics directed against targets having a potential risk for eliciting adverse pro-inflammatory clinical infusion reactions. Different laboratories may have different strategies, assay formats, and approaches to the reporting, interpretation, and use of data for either decision making or risk assessment. Additionally, many independent contract research organizations (CROs), academic and government laboratories are involved in some aspect of CRA work. As a result, while some pharmaceutical companies are providing CRA data as part of the regulatory submissions when necessary, technical and regulatory practices are still evolving to provide data predictive of cytokine release in humans and that are relevant to safety. This manuscript provides an overview of different approaches employed by the pharmaceutical industry and CROs, for the use and application of CRA based upon a survey and post survey follow up conducted by ILSI-Health and Environmental Sciences Institute (HESI) Immunotoxicology Committee CRA Working Group. Also discussed is ongoing research in the academic sector, the regulatory environment, current limitations of the assays, and future directions and recommendations for cytokine release assays.

  8. NanoSIMS for Biological Applications: Current Practices and Analyses

    Energy Technology Data Exchange (ETDEWEB)

    Dunn, Jamie R.; Renslow, Ryan S.; Cliff, John B.; Anderton, Christopher R.

    2017-09-27

    Secondary ion mass spectrometry (SIMS) has become an increasingly utilized tool in biologically-relevant studies. Of these, high lateral resolution methodologies using the NanoSIMS 50/50L have been especially powerful within many biological fields over the past decade. Here, we provide a review of this technology, sample preparation and analysis considerations, examples of recent biological studies, data analysis, and current outlooks. Specifically, we offer an overview of SIMS and development of the NanoSIMS. We describe the major experimental factors that should be considered prior to NanoSIMS analysis and then provide information on best practices for data analysis and image generation, which includes an in-depth discussion of appropriate colormaps. Additionally, we provide an open-source method for data representation that allows simultaneous visualization of secondary electron and ion information within a single image. Finally, we present a perspective on the future of this technology and where we think it will have the greatest impact in near future.

  9. Current practice of therapeutic drug monitoring of biopharmaceuticals in spondyloarthritis.

    Science.gov (United States)

    Medina, Frédéric; Placensia, Chamaida; Goupille, Philippe; Paintaud, Gilles; Balsa, Alejandro; Mulleman, Denis

    2017-04-04

    Treatment of spondyloarthritis (SpA) has greatly improved in the biopharmaceutical era. These compounds, primarily tumor necrosis factor (TNF) inhibitors, are effective, but some patients may show poor response, sometimes due to the presence of anti-drug antibodies (ADAs). In some instances, clinicians may increase or taper the dose, depending on the clinical response. Besides the current clinical practice, a tailored strategy based on drug monitoring is emerging as a way to improve the use of these drugs. However, the relevance of this therapeutic drug monitoring (TDM) of biopharmaceuticals for SpA is still unknown. In this literature review, we examined the most relevant articles dealing with the concentration-response relation, ADA detection, and pharmacokinetics in SpA treated with biopharmaceuticals. ADAs were associated with low or undetectable concentration of monoclonal antibodies. The relation between drug concentration and clinical response in SpA is debated, some studies showing an association and others not. Therefore, TDM of biopharmaceuticals for SpA requires a better understanding of the association among the pharmacokinetics, pharmacodynamics, and immunogenicity of these drugs.

  10. Life cycle assessment part 2: current impact assessment practice.

    Science.gov (United States)

    Pennington, D W; Potting, J; Finnveden, G; Lindeijer, E; Jolliet, O; Rydberg, T; Rebitzer, G

    2004-07-01

    Providing our society with goods and services contributes to a wide range of environmental impacts. Waste generation, emissions and the consumption of resources occur at many stages in a product's life cycle-from raw material extraction, energy acquisition, production and manufacturing, use, reuse, recycling, through to ultimate disposal. These all contribute to impacts such as climate change, stratospheric ozone depletion, photooxidant formation (smog), eutrophication, acidification, toxicological stress on human health and ecosystems, the depletion of resources and noise-among others. The need exists to address these product-related contributions more holistically and in an integrated manner, providing complimentary insights to those of regulatory/process-oriented methodologies. A previous article (Part 1, Rebitzer et al., 2004) outlined how to define and model a product's life cycle in current practice, as well as the methods and tools that are available for compiling the associated waste, emissions and resource consumption data into a life cycle inventory. This article highlights how practitioners and researchers from many domains have come together to provide indicators for the different impacts attributable to products in the life cycle impact assessment (LCIA) phase of life cycle assessment (LCA).

  11. Management of rhinosinusitis in Dutch general practice

    NARCIS (Netherlands)

    Hoffmans, R.; Schermer, T.R.J.; Weel, C. van; Fokkens, W.

    2011-01-01

    AIMS: To determine whether general practitioners (GPs) distinguish between the management of acute rhinosinusitis (ARS) and chronic rhinosinusitis (CRS), especially with regard to prescription of antibiotics and nasal steroids. METHODS: A questionnaire on the management of rhinosinusitis was sent to

  12. Performance appraisal: helpful hints for the busy medical practice manager.

    Science.gov (United States)

    Bolon, Douglas S

    2006-01-01

    This article describes the performance appraisal process in terms of its three fundamental steps. defining job performance, measuring actual job performance, and providing job performance feedback. Given that most practice managers wear many hats and do not have extensive experience or staff support in human resources, the purpose of this article is to provide these busy individuals with useful, practical suggestions that should enhance the effectiveness of the performance appraisal process for nonphysician employees within the medical practice setting. Performance appraisal should be a priority for all practice managers, as the performance of individual employees represents the key to long-term success for any medical practice.

  13. Risk management in clinical practice. Part 10. Periodontology.

    Science.gov (United States)

    Baker, P; Needleman, I

    2010-12-11

    A sizeable proportion of patients in clinical practice will have some form of periodontal disease and most of these patients can be well managed in primary care. Unfortunately, dento-legal claims regarding inappropriate periodontal care are increasing rapidly and are now one of the most common reasons for litigation in dentistry. In this paper we will look at aspects of contemporary management of periodontal disease in clinical practice and offer guidance for examination, management and referral.

  14. MANAGEMENT AND MARKETING PRACTICES OF SOCIAL MEDIA FIRMS

    OpenAIRE

    Abdulaziz AlShubaily

    2016-01-01

    This paper examines the key variances in application and strategy between different social media management strategies and its effective marketing. Social media firms have shown a great ability to control the stages in their product life cycles. These practices lead to managers in these firms overachieving on their respective KPIs and garnering industry attention. An analysis of social media management firms practice shows those high participatory-decisions and intellectual and manual skills ...

  15. ECONOMIC ANALYSIS OF ALFALFA INTEGRATED MANAGEMENT PRACTICES

    OpenAIRE

    Ward, Clement E.; Dowdy, Alan K.; Berberet, Richard C.; Stritzke, Jimmie F.

    1990-01-01

    Integrated pest management (IMP) initially focused on insect pest control. More recently, IPM encompasses a broader concept of management, one which crosses several disciplinary boundaries. This article reports results of research dealing with four integrated management decisions for alfalfa (cultivar selection, inset control, weed control, and end-of-season harvest options.

  16. Practical guide to energy management for processors

    CERN Document Server

    Consortium, Energywise

    2012-01-01

    Do you know how best to manage and reduce your energy consumption? This book gives comprehensive guidance on effective energy management for organisations in the polymer processing industry. This book is one of three which support the ENERGYWISE Plastics Project eLearning platform for European plastics processors to increase their knowledge and understanding of energy management. Topics covered include: Understanding Energy,

  17. 21 CFR 212.2 - What is current good manufacturing practice for PET drugs?

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false What is current good manufacturing practice for... HUMAN SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE FOR POSITRON EMISSION TOMOGRAPHY DRUGS (Eff. 12-12-2011) General Provisions § 212.2 What is current good manufacturing practice...

  18. 21 CFR 210.1 - Status of current good manufacturing practice regulations.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 4 2010-04-01 2010-04-01 false Status of current good manufacturing practice... SERVICES (CONTINUED) DRUGS: GENERAL CURRENT GOOD MANUFACTURING PRACTICE IN MANUFACTURING, PROCESSING, PACKING, OR HOLDING OF DRUGS; GENERAL § 210.1 Status of current good manufacturing practice...

  19. Critical analysis of biomarkers in the current periodontal practice.

    Science.gov (United States)

    Khiste, Sujeet V; Ranganath, V; Nichani, Ashish S; Rajani, V

    2011-04-01

    Periodontal disease is a chronic microbial infection that triggers inflammation-mediated loss of the periodontal ligament and alveolar bone that supports the teeth. Because of the increasing prevalence and associated comorbidities, there is a need for the development of new diagnostic tests that can detect the presence of active disease, predict future disease progression, and evaluate the response to periodontal therapy, thereby improving the clinical management of periodontal patients. The diagnosis of active phases of periodontal disease and the identification of patients at risk for active disease represent challenges for clinical investigators and practitioners. Advances in diagnostic research are moving toward methods whereby the periodontal risk can be identified and quantified by objective measures using biomarkers. Patients with periodontitis may have elevated circulating levels of specific inflammatory markers that can be correlated to the severity of the disease. Advances in the use of oral fluids as possible biological samples for objective measures of the current disease state, treatment monitoring, and prognostic indicators have boosted saliva- and other oral-based fluids to the forefront of technology. Gingival crevicular fluid (GCF) is an inflammatory exudate that can be collected at the gingival margin or within the gingival crevice. This article highlights recent advances in the use of biomarker-based disease diagnostics that focus on the identification of active periodontal disease from plaque biofilms, GCF, and saliva.

  20. Peripheral interventions and antiplatelet therapy: Role in current practice.

    Science.gov (United States)

    Singh, Pahul; Harper, Yenal; Oliphant, Carrie S; Morsy, Mohamed; Skelton, Michelle; Askari, Raza; Khouzam, Rami N

    2017-07-26

    Peripheral arterial disease (PAD) is a common disorder associated with a high risk of cardiovascular mortality and continues to be under-recognized. The major risk factors for PAD are similar to those for coronary and cerebrovascular disease. Management includes exercise program, pharmacologic therapy and revascularization including endovascular and surgical approach. The optimal revascularization strategy, endovascular or surgical intervention, is often debated due to the paucity of head to head randomized controlled studies. Despite significant advances in endovascular interventions resulting in increased utilization over surgical bypass, significant challenges still remain. Platelet activation and aggregation after percutaneous transluminal angioplasty of atherosclerotic arteries are important risk factors for re-occlusion/restenosis and life-threatening thrombosis following endovascular procedures. Antiplatelet agents are commonly prescribed to reduce the risk of myocardial infarction, stroke and death from cardiovascular causes in patients with PAD. Despite an abundance of data demonstrating efficacy of antiplatelet therapy in coronary artery disease and cerebrovascular disease, there is a paucity of clinical information, clinical guidelines and randomized controlled studies in the PAD population. Hence, data on antiplatelet therapy in coronary interventions is frequently extrapolated to peripheral interventions. The aim of this review article is to elucidate the current data on revascularization and the role and duration of antiplatelet and anticoagulant therapy in re-vascularized lower limb PAD patients.

  1. Current practice in the management of acute/unstable slipped capital femoral epiphyses in the United Kingdom and the Netherlands: results of a survey of the membership of the British Society of Children's Orthopaedic Surgery and the Werkgroep Kinder Orthopaedie.

    Science.gov (United States)

    Witbreuk, Melinda; Besselaar, Philip; Eastwood, Deborah

    2007-03-01

    A questionnaire was sent to all members of the British Society for Children's Orthopaedic Surgery and the Werkgroep Kinder Orthopaedie to identify points of agreement/disagreement on the management of the acute unstable slip of the upper femoral epiphysis and to compare these European results with those from a similar North American survey. Sixty-five per cent responded. Overall, both countries evaluated cases similarly and believed in their urgent management. Sixty-six per cent did not reposition the slip. Significant differences were observed in attitude towards single screw usage, prophylactic pinning and metalwork removal both between the two countries and in comparison with North America.

  2. Coliform Bacteria Monitoring in Fish Systems: Current Practices in Public Aquaria.

    Science.gov (United States)

    Culpepper, Erin E; Clayton, Leigh A; Hadfield, Catherine A; Arnold, Jill E; Bourbon, Holly M

    2016-06-01

    Public aquaria evaluate coliform indicator bacteria levels in fish systems, but the purpose of testing, testing methods, and management responses are not standardized, unlike with the coliform bacteria testing for marine mammal enclosures required by the U.S. Department of Agriculture. An online survey was sent to selected aquaria to document current testing and management practices in fish systems without marine mammals. The information collected included indicator bacteria species, the size and type of systems monitored, the primary purpose of testing, sampling frequency, test methods, the criteria for interpreting results, corrective actions, and management changes to limit human exposure. Of the 25 institutions to which surveys were sent, 19 (76%) responded. Fourteen reported testing for fecal indicator bacteria in fish systems. The most commonly tested indicator species were total (86%) and fecal (79%) coliform bacteria, which were detected by means of the membrane filtration method (64%). Multiple types and sizes of systems were tested, and the guidelines for testing and corrective actions were highly variable. Only three institutions performed additional tests to confirm the identification of indicator organisms. The results from this study can be used to compare bacterial monitoring practices and protocols in fish systems, as an aid to discussions relating to the accuracy and reliability of test results, and to help implement appropriate management responses. Received August 23, 2015; accepted December 29, 2015.

  3. Anesthesia information management systems marketplace and current vendors.

    Science.gov (United States)

    Stonemetz, Jerry

    2011-09-01

    This article addresses the brief history of anesthesia information management systems (AIMS) and discusses the vendors that currently market AIMS. The current market penetration based on the information provided by these vendors is presented and the rationale for the purchase of AIMS is discussed. The considerations to be evaluated when making a vendor selection are also discussed. Copyright © 2011 Elsevier Inc. All rights reserved.

  4. Managing Self-Access Language Learning: Principles and Practice

    Science.gov (United States)

    Gardner, David; Miller, Lindsay

    2011-01-01

    This paper is based on a research project looking at the management of self-access language learning (SALL) from the perspective of the managers of self-access centres. It looks at the factors which influence the practice of seven managers of self-access language learning in tertiary institutions in Hong Kong. The discussion centres around five…

  5. The Development of Novice Teachers' Culturally Responsive Classroom Management Practice

    Science.gov (United States)

    Patish, Yelena

    2016-01-01

    While extensive research has been conducted on classroom management little research exists on culturally responsive classroom management. The primary purpose of this qualitative study was to examine how four novice teachers developed their culturally responsive management practice (CRCM) to better meet the needs of their students. My analysis was…

  6. The Development of Novice Teachers' Culturally Responsive Classroom Management Practice

    Science.gov (United States)

    Patish, Yelena

    2016-01-01

    While extensive research has been conducted on classroom management little research exists on culturally responsive classroom management. The primary purpose of this qualitative study was to examine how four novice teachers developed their culturally responsive management practice (CRCM) to better meet the needs of their students. My analysis was…

  7. Managing Self-Access Language Learning: Principles and Practice

    Science.gov (United States)

    Gardner, David; Miller, Lindsay

    2011-01-01

    This paper is based on a research project looking at the management of self-access language learning (SALL) from the perspective of the managers of self-access centres. It looks at the factors which influence the practice of seven managers of self-access language learning in tertiary institutions in Hong Kong. The discussion centres around five…

  8. Pain Management Practices by Nurses: An Application of the Knowledge, Attitude and Practices (KAP) Model.

    Science.gov (United States)

    Alzghoul, Bashar I; Abdullah, Nor Azimah Chew

    2015-10-26

    Pain is one of the most common reasons that drive people to go to hospitals. It has been found that several factors affect the practices of pain management. In this regard, this study aimed at investigating the underlying determinants in terms of pain management practices. Based on reviewing the previous studies and the suggestions of the KAP model, it was hypothesized that the main elements of the KAP model (attitudes and knowledge) significantly predict the variation in the practices of nurses regarding pain management. A questionnaire comprising the KAP model' s constructs, i.e. knowledge and attitude towards pain management, as well as pain management practices, was used to collect data from 266 registered nurses (n=266) who are deemed competent in the management of patients' pain in the Jordanian public hospitals. The two constructs, attitude and knowledge, which are the main determinants of the KAP model were found to independently predict nurses' practices of managing patients' pain. Knowledge of pain management was found to be the strongest predictor. Additionally, it was found that about 69% of the variance in pain management could be explained by the constructs of the KAP model. Therefore, it is recommended that the Jordanian hospitals and universities focus on nurses' knowledge and attitude towards pain management in order to enhance their practices in the field of pain management.

  9. Evaluation of Existing Bridge Maintenance Management Practices for Application to the Army.

    Science.gov (United States)

    1987-09-01

    This element of a bridge management system provides the raw information used to determine the M&R requirements and to prioritize and program projects...Current Practice Most states use the Federal Sufficiency Rating (FSR) or a variant of it as the analysis element of their network level bridge management system . The...the function of a network level bridge management system , which is to give administrators and engineers greater flexibility in making tradeoffs

  10. Theory, Practice and Characteristics of Management in Serbia

    Directory of Open Access Journals (Sweden)

    Svetlana Vukotic

    2013-03-01

    Full Text Available The paper analyses management and manager's characteristics which determine the success of organisations. For Serbian managers the only constant is change. The paper deals with this aspect in 3 segments: general characteristics in international and domestic context, the influence for national culture on the characteristics of managers and the characteristics of managers in times of change. The focus of our paper is on theory and practice of management in Serbia, a country that went through significant political, economic and social changes in the postsocialistic period, but which is already transforming in every aspect including educating managers for contemporary and future work challenges.

  11. Standard Practice for Quality Management Systems for Nondestructive Testing Agencies

    CERN Document Server

    American Society for Testing and Materials. Philadelphia

    2009-01-01

    1.1 This practice covers general requirements for the establishment and maintenance of a quality management system for agencies engaged in nondestructive testing (NDT). 1.2 This practice utilizes criteria contained in Practice E 543. 1.3 This practice utilizes criteria contained in American National Standard ANSI/ISO/ASQ Q9001–2000, Quality management systems—Requirements. 1.4 This practice recognizes the importance of establishing minimum safety criteria. 1.5 The use of SI or inch-pound units, or combinations thereof, will be the responsibility of the technical committee whose standards are referred to in this standard. 1.6 This practice does not purport to address all of the safety concerns, if any, associated with its use. It is the responsibility of the user of this practice to establish appropriate safety and health practices and determine the applicability of regulatory limitations prior to use.

  12. Smartphone use in dermatology for clinical photography and consultation: Current practice and the law.

    Science.gov (United States)

    Abbott, Lisa M; Magnusson, Roger S; Gibbs, Emma; Smith, Saxon D

    2017-02-28

    Smartphones are rapidly changing the way doctors capture and communicate clinical information, particularly in highly visual specialties such as dermatology. An understanding of how and why smartphones are currently used in clinical practice is critical in order to evaluate professional and legal risks, and to formulate policies that enable safe use of mobile technologies for the maximal benefit of practitioners and patients. Australian dermatologists and dermatology trainees were surveyed on their current practices relating to clinical smartphone use. Of the 105 respondents, 101 provided useable results. The data show clinical smartphone use is common and frequent, with more than 50% of respondents sending and receiving images on their smartphones at least weekly. Clinical photographs were usually sent via multimedia message or email and were commonly stored on smartphones (46%). Security measures adopted to protect data were limited. There was inadequate documentation of consent for transmission of photographs and advice provided. Only 22% of respondents were aware of clear policies in their workplace regarding smartphone use, and a majority desired further education on digital image management. Given the frequency of use and the degree of importance placed on the ability to send and receive clinical images, clinical smartphone use will persist and will likely increase over time. Current practices are insufficient to comply with professional and legal obligations, and increase practitioners' vulnerability to civil and disciplinary proceedings. Further education, realistic policies and adequate software resources are critical to ensure protection of patients, practitioners and the reputation of the dermatological profession. © 2017 The Australasian College of Dermatologists.

  13. Current Status of Nuclear Medicine Practice in the Middle East.

    Science.gov (United States)

    Paez, Diana; Becic, Tarik; Bhonsle, Uday; Jalilian, Amir R; Nuñez-Miller, Rodolfo; Osso, Joao Alberto

    2016-07-01

    availability of (68)Ge-(68)Ga generators is increasing and studies involving prostate-specific membrane antigen or DOTA-chelated peptides or both are performed in at least seven countries. Although therapeutic radionuclide agents are mostly imported from outside the region, this does not limit the availability of therapies with (90)Y, (153)Sm, (177)Lu, (131)I, (188)Re, and (89)Sr. Nevertheless, therapies based on alpha particle emitters are still largely not available in the region and are currently only available in Israel and Turkey. Regarding human resources, according to the data provided there are 1157 NM physicians, 1953 technologists, 586 medical physicists, and 173 radiopharmacists or radiochemists in the region. Approximately half of all available human resources are accounted for by Turkey. The region has great potential for expanding the applications of NM; this becomes especially important in view of the high prevalence of non-communicable diseases. Further increasing awareness of the clinical applications of NM in healthcare and strengthening technical and human capacities including the establishment of training programs for all professionals and disciplines in the field are recognized as key components in advancing the practice of NM in the Middle East.

  14. Analysis of Management Practices in Lagos State Tertiary Institutions through Total Quality Management Structural Framework

    Science.gov (United States)

    AbdulAzeez, Abbas Tunde

    2016-01-01

    This research investigated total quality management practices and quality teacher education in public tertiary institutions in Lagos State. The study was therefore designed to analyse management practices in Lagos state tertiary institutions through total quality management structural framework. The selected public tertiary institutions in Lagos…

  15. The Development of Perioperative Practices for Liver Transplantation: Advances and Current Trends

    Directory of Open Access Journals (Sweden)

    Merceds Susan Mandell

    2008-09-01

    Full Text Available Transplantation is a young medical specialty that has grown rapidly over the past 50 years. Anesthesiologists, surgeons and hepatologists are all essential partners in the process of determining patient outcome. Each specialty has made landmark improvements in patient outcome. However, there is still variability in practice patterns in each of the 3 major specialties. This review will use a historic perspective to explore the unique forces that shaped specific transplant practices and those that gave rise to differences in perioperative practices. Anesthesiologists and surgeons have made significant improvements in the management of blood loss, and coagulation monitoring and intervention. This has improved operative survival and early patient outcome. Perioperative survival has improved despite a worldwide shortage of donor organs and a trend to transplant sicker patients. A smaller pool of donor organs is required to meet the needs of an expanding waiting list. The innovations to reduce deaths on the transplant wait list are reviewed along with their impact on overall patient outcome. The evolving organ shortage is the pinnacle point in shaping future transplant practices. Currently, institutional-specific practices may be reinforced by the informal “tutorship” that is used to train physicians and by the resources available at each site of practice. However, there is evidence that specific intraoperative practices such as the use of a low central venous pressure, selection of vasopressors and certain surgical techniques can modify patient outcome. Further investigation is needed to determine whether the good or the bad associated with each practice prevails and in what unique circumstance.

  16. Key Practice for Green Building Management In Malaysia

    Directory of Open Access Journals (Sweden)

    Aghili Nasim

    2016-01-01

    Full Text Available This paper identifies the management practices for green building management in Malaysia. A set of practices was ascertained from the reviewed of various established Green Building Standard in the world. Green building practices are significant role in attaining sustainability particularly in the construction industry. Green building is constructed for minimizing impacts to environment as well as decreasing building effects on occupants. To achieve the goals of green buildings, set of management practices is required. A comprehensive review on the world green building standards that include the criteria of “management” has been carried out. The results of the content analysis have identified a total of five clusters of practices that found important for effective management of green building in Malaysia. These including Sustainable Procurement, Sustainable Operation, Resource Management, Repair and Maintenance Management, and Environmental Health. Each cluster of management practice composed of few activities. The identification of the set of practices contributes to the effective and efficient operation of green building in advancing the sustainability agenda, hence decreasing building’s operating costs and realising increase in return of investment.

  17. A preliminary report of an educational intervention in practice management

    Directory of Open Access Journals (Sweden)

    Schuster Richard J

    2004-09-01

    Full Text Available Abstract Background Practice management education continues to evolve, and little information exists regarding its curriculum design and effectiveness for resident education. We report the results of an exploratory study of a practice management curriculum for primary care residents. Methods After performing a needs assessment with a group of primary care residents at Wright State University, we designed a monthly seminar series covering twelve practice management topics. The curriculum consisted of interactive lectures and practice-based application, whenever possible. We descriptively evaluated two cognitive components (practice management knowledge and skills and the residents' evaluation of the curriculum. Results The mean correct on the knowledge test for this group of residents was 74% (n = 12 and 91% (n = 12 before and after the curriculum, respectively. The mean scores for the practice management skill assessments were 2.62 before (n = 12, and 3.65 after (n = 12 the curriculum (modified Likert, 1 = strongly disagree, 5 = strongly agree. The residents rated the curriculum consistently high. Conclusions This exploratory study suggests that this curriculum may be useful in developing knowledge and skills in practice management for primary care residents. This study suggests further research into evaluation of this curriculum may be informative for practice-based education.

  18. Cardiovascular pharmacogenomics; state of current knowledge and implementation in practice.

    Science.gov (United States)

    Shahabi, Payman; Dubé, Marie-Pierre

    2015-04-01

    Pharmacogenomics (PGx) is the science that examines how an individual's genetic make-up affects the safety and efficacy of therapeutic drugs. PGx of response to cardiovascular (CV) medications is of the most successfully translated branches of PGx into the clinical workout. However, the clinical implementation of PGx of CV drugs is yet far beyond the growth of our understanding of the role of genetics in drug therapy. A considerable amount of efforts have been devoted by the regulatory agents like the food and drug administration (FDA) as well as the expert-based networks such as the Clinical Pharmacogenetics Implementation Consortium (CPIC) to overcome the existing barriers. This has been done, at least in part, for some of the most widely prescribed CV drugs, including clopidogrel, warfarin and simvastatin for which the PGx knowledge have been satisfactorily robust to provoke the CPIC to issue the guidelines for these drugs and the FDA to update the drugs' labeling, both strongly recommended the use of genotype-guided dosing for these medications, provided that the genetic data are available. For other drugs, however, studies have produced contradictory results and further large and well-designed clinical trials are required to expand and confirm the clinical utility of their PGx data. This review paper presents the current state of knowledge in the field of PGx of CV medications and describes the facilities assisting to the translation of PGx data into the clinical practice. Afterward, the existing body of PGx literature of the most-commonly used CV medications is comprehensively discussed.

  19. Current problems regarding abortion, prenatal genetic testing and managing pregnancy

    Directory of Open Access Journals (Sweden)

    Klajn-Tatić Vesna

    2011-01-01

    Full Text Available Current ethical and legal issues with regard to abortion, prenatal genetic testing and managing pregnancy are discussed in this paper. These problems are considered from the legal theory point of view as well as from the standpoint of the Serbian Law, the European Convention for the Protection of Human Rights and Fundamental Freedoms, European Court of Human Rights, legal regulations of several EU countries, the USA, Japan, and their judicial practice. First, the pregnancy termination standards that exist in Serbia are introduced. Then the following issues are explained separately: the pro life and pro choice approaches to abortion; abortion according to the legal approach as a way of survival; the moral and legal status of the fetus; prenatal genetic testing, and finally matters regarding managing pregnancy today. Moral and legal principals of autonomy, namely freedom of choice of the individual, privacy and self-determination give women the right to terminate unwanted pregnancies. In addition, the basic question is whether the right of the woman to abortion clashes with the rights of others. Firstly, with the right of the "fetus to life". Secondly, with the right of the state to intervene in the interest of protecting "the life of the fetus". Third, with the rights of the woman’s partner. The fetus has the moral right to life, but less in relation to the same right of the woman as well as in relation to her right to control her life and her physical and moral integrity. On the other hand, the value of the life of the fetus increases morally and legally with the maturity of gestation; from the third trimester, the interest of the state prevails in the protection of the "life of the fetus" except when the life or health of the pregnant woman are at risk. As regards the rights of the woman’s partner, namely the husband’s opinion, there is no legal significance. The law does not request his participation in the decision on abortion because

  20. Current concepts in wound management and wound healing products.

    Science.gov (United States)

    Davidson, Jacqueline R

    2015-05-01

    Current concepts in wound management are summarized. The emphasis is on selection of the contact layer of the bandage to promote a moist wound environment. Selection of an appropriate contact layer is based on the stage of wound healing and the amount of wound exudate. The contact layer can be used to promote autolytic debridement and enhance wound healing.