Sample records for disease management system



    Bens Pardamean; Anindito; Anjela Djoeang; Nana Tobing


    The study designed an information system model for Disease Management (DisMan) that met the specifications and needs of a consumer electronics manufacturer. The diseases monitored by this study were diabetes, hypertension and tuberculosis. Data were collected through interviews with the companyâs human resources department and occupational health provider. As for the model, literature and online research were conducted to collect health standards and information system standards on existing D...

  2. A comprehensive infectious disease management system. (United States)

    Marcu, Alex; Farley, John D


    An efficient electronic management system is now an essential tool for the successful management and monitoring of those affected by communicable infectious diseases (Human Immunodeficiency Virus - HIV, hepatitis C - HEP C) during the course of the treatment. The current methods which depend heavily on manual collecting, compiling and disseminating treatment information are labor-intensive and time consuming. Clinics specialized in the treatment of infectious diseases use a mix of electronic systems that fail to interact with each other, result in data duplication, and do not support treatment of the patient as a whole. The purpose of the Infectious Disease Management System is to reduce the administrative overhead associated with data collection and analysis while providing correlation abilities and decision support in accordance with defined treatment guidelines. This Infectious Disease Management System was developed to: Ensure cost effectiveness by means of low software licensing costs, Introduce a centralized mechanism of collecting and monitoring all infectious disease management data, Automate electronic retrieval of laboratory findings, Introduce a decision support mechanism as per treatment guidelines, Seamlessly integrate of application modules, Provide comprehensive reporting capabilities, Maintain a high level of user friendliness.

  3. Plant disease management in organic farming systems. (United States)

    van Bruggen, Ariena H C; Gamliel, Abraham; Finckh, Maria R


    Organic farming (OF) has significantly increased in importance in recent decades. Disease management in OF is largely based on the maintenance of biological diversity and soil health by balanced crop rotations, including nitrogen-fixing and cover crops, intercrops, additions of manure and compost and reductions in soil tillage. Most soil-borne diseases are naturally suppressed, while foliar diseases can sometimes be problematic. Only when a severe disease outbreak is expected are pesticides used that are approved for OF. A detailed overview is given of cultural and biological control measures. Attention is also given to regulated pesticides. We conclude that a systems approach to disease management is required, and that interdisciplinary research is needed to solve lingering disease problems, especially for OF in the tropics. Some of the organic regulations are in need of revision in close collaboration with various stakeholders.

  4. Advanced and controlled drug delivery systems in clinical disease management

    NARCIS (Netherlands)

    Brouwers, JRBJ


    Advanced and controlled drug delivery systems are important for clinical disease management. In this review the most important new systems which have reached clinical application are highlighted. Microbiologically controlled drug delivery is important for gastrointestinal diseases like ulcerative co

  5. Disease management in soilless culture systems

    NARCIS (Netherlands)

    Os, van E.A.


    EU legislation, laid down in the Water Framework Directive, demands to minimize emissions of nitrogen, phosphate and crop protection products to achieve an excellent chemical and ecological quality in 2015. The aim is to force growers to a better water and disease management. Supply water of excelle

  6. Disease management in soilless culture systems

    NARCIS (Netherlands)

    Os, van E.A.


    EU legislation, laid down in the Water Framework Directive, demands to minimize emissions of nitrogen, phosphate and crop protection products to achieve an excellent chemical and ecological quality in 2015. The aim is to force growers to a better water and disease management. Supply water of

  7. Disease management in soilless culture systems

    NARCIS (Netherlands)

    Os, van E.A.


    EU legislation, laid down in the Water Framework Directive, demands to minimize emissions of nitrogen, phosphate and crop protection products to achieve an excellent chemical and ecological quality in 2015. The aim is to force growers to a better water and disease management. Supply water of excelle

  8. Chapter 15. Plant pathology and managing wildland plant disease systems (United States)

    David L. Nelson


    Obtaining specific, reliable knowledge on plant diseases is essential in wildland shrub resource management. However, plant disease is one of the most neglected areas of wildland resources experimental research. This section is a discussion of plant pathology and how to use it in managing plant disease systems.

  9. The use and role of predictive systems in disease management. (United States)

    Gent, David H; Mahaffee, Walter F; McRoberts, Neil; Pfender, William F


    Disease predictive systems are intended to be management aids. With a few exceptions, these systems typically do not have direct sustained use by growers. Rather, their impact is mostly pedagogic and indirect, improving recommendations from farm advisers and shaping management concepts. The degree to which a system is consulted depends on the amount of perceived new, actionable information that is consistent with the objectives of the user. Often this involves avoiding risks associated with costly disease outbreaks. Adoption is sensitive to the correspondence between the information a system delivers and the information needed to manage a particular pathosystem at an acceptable financial risk; details of the approach used to predict disease risk are less important. The continuing challenge for researchers is to construct tools relevant to farmers and their advisers that improve upon their current management skill. This goal requires an appreciation of growers' decision calculus in managing disease problems and, more broadly, their overall farm enterprise management.

  10. An architecture model for multiple disease management information systems. (United States)

    Chen, Lichin; Yu, Hui-Chu; Li, Hao-Chun; Wang, Yi-Van; Chen, Huang-Jen; Wang, I-Ching; Wang, Chiou-Shiang; Peng, Hui-Yu; Hsu, Yu-Ling; Chen, Chi-Huang; Chuang, Lee-Ming; Lee, Hung-Chang; Chung, Yufang; Lai, Feipei


    Disease management is a program which attempts to overcome the fragmentation of healthcare system and improve the quality of care. Many studies have proven the effectiveness of disease management. However, the case managers were spending the majority of time in documentation, coordinating the members of the care team. They need a tool to support them with daily practice and optimizing the inefficient workflow. Several discussions have indicated that information technology plays an important role in the era of disease management. Whereas applications have been developed, it is inefficient to develop information system for each disease management program individually. The aim of this research is to support the work of disease management, reform the inefficient workflow, and propose an architecture model that enhance on the reusability and time saving of information system development. The proposed architecture model had been successfully implemented into two disease management information system, and the result was evaluated through reusability analysis, time consumed analysis, pre- and post-implement workflow analysis, and user questionnaire survey. The reusability of the proposed model was high, less than half of the time was consumed, and the workflow had been improved. The overall user aspect is positive. The supportiveness during daily workflow is high. The system empowers the case managers with better information and leads to better decision making.

  11. Possibilities of Strawberry Integrated Disease Management in Different Cultivation System

    Directory of Open Access Journals (Sweden)

    Tihomir Miličević


    Full Text Available In the last few years strawberry production in Croatia is constantly increasing. One of the main problems in production are diseases. During two-year trials in strawberry plantations in northern Croatia, the occurrence of diseases was monitored in order to establish the most effective methods of integrated disease management. Trials were performed in three cultivation system: open field, greenhouse and hydroponics. The most frequent disease in all three production systems was gray mould (Botrytis cinerea. In open field production, the occurrence of common leaf spot (Mycosphaerella fragariae and leaf scorch (Diplocarpon earliana were also frequently observed, while leaf blotch (Gnomonia comari, leaf blight (Phomopsis obscurans and fruit anthracnose (Colletotrichum spp. were only sporadically present. For the control of the most important disease, gray mould, forecast model BOTMAN was implemented. As relatively simple model based on meteorological data, BOTMAN allowed effective, ecologically and economically more acceptable control, based on integrated chemical and biological measures. Meteorological data were obtained from the State Hydrometeorological Department (DHMZ. Results showed no significant difference in intensity of gray mould infection between usual chemical control and BOTMAN-based control. Two-years research on strawberry disease management in Croatia revealed perspective possibilities of integrated strawberry disease management.

  12. Pulmonary disease management system with distributed wearable sensors. (United States)

    Fu, Yongji; Ayyagari, Deepak; Colquitt, Nhedti


    A pulmonary disease management system with on-body and near-body sensors is introduced in this presentation. The system is wearable for continuous ambulatory monitoring. Distributed sensor data is transferred through a wireless body area network (BAN) to a central controller for real time analysis. Physiological and environmental parameters are monitored and analyzed using prevailing clinical guidelines for self-management of environmentally-linked pulmonary ailments. The system provides patients with reminders, warnings, and instructions to reduce emergency room and physician visits, and improve clinical outcomes.

  13. Design of Knowledge Management System for Diabetic Complication Diseases (United States)

    Fiarni, Cut


    This paper examines how to develop a Model for Knowledge Management System (KMS) for diabetes complication diseases. People with diabetes have a higher risk of developing a series of serious health problems. Each patient has different condition that could lead to different disease and health problem. But, with the right information, patient could have early detection so the health risk could be minimized and avoided. Hence, the objective of this research is to propose a conceptual framework that integrates social network model, Knowledge Management activities, and content based reasoning (CBR) for designing such a diabetes health and complication disease KMS. The framework indicates that the critical knowledge management activities are in the process to find similar case and the index table for algorithm to fit the framework for the social media. With this framework, KMS developers can work with healthcare provider to easily identify the suitable IT associated with the CBR process when developing a diabetes KMS.

  14. Multi-disease data management system platform for vector-borne diseases.

    Directory of Open Access Journals (Sweden)

    Lars Eisen

    Full Text Available BACKGROUND: Emerging information technologies present new opportunities to reduce the burden of malaria, dengue and other infectious diseases. For example, use of a data management system software package can help disease control programs to better manage and analyze their data, and thus enhances their ability to carry out continuous surveillance, monitor interventions and evaluate control program performance. METHODS AND FINDINGS: We describe a novel multi-disease data management system platform (hereinafter referred to as the system with current capacity for dengue and malaria that supports data entry, storage and query. It also allows for production of maps and both standardized and customized reports. The system is comprised exclusively of software components that can be distributed without the user incurring licensing costs. It was designed to maximize the ability of the user to adapt the system to local conditions without involvement of software developers. Key points of system adaptability include 1 customizable functionality content by disease, 2 configurable roles and permissions, 3 customizable user interfaces and display labels and 4 configurable information trees including a geographical entity tree and a term tree. The system includes significant portions of functionality that is entirely or in large part re-used across diseases, which provides an economy of scope as new diseases downstream are added to the system at decreased cost. CONCLUSIONS: We have developed a system with great potential for aiding disease control programs in their task to reduce the burden of dengue and malaria, including the implementation of integrated vector management programs. Next steps include evaluations of operational implementations of the current system with capacity for dengue and malaria, and the inclusion in the system platform of other important vector-borne diseases.

  15. Parkinson disease: systemic and orofacial manifestations, medical and dental management. (United States)

    Friedlander, Arthur H; Mahler, Michael; Norman, Keith M; Ettinger, Ronald L


    More than 1.5 million Americans have Parkinson disease (PD), and this figure is expected to rise as the population ages. However, the dental literature offers little information about the illness. The authors conducted a MEDLINE search using the key terms "Parkinson's disease," "medical management" and "dentistry." They selected contemporaneous articles published in peer-reviewed journals and gave preference to articles reporting randomized controlled trials. PD is a progressive neurodegenerative disorder caused by loss of dopaminergic and nondopaminergic neurons in the brain. These deficits result in tremor, slowness of movement, rigidity, postural instability and autonomic and behavioral dysfunction. Treatment consists of administering medications that replace dopamine, stimulate dopamine receptors and modulate other neurotransmitter systems. Oral health may decline because of tremors, muscle rigidity and cognitive deficits. The dentist should consult with the patient's physician to establish the patient's competence to provide informed consent and to determine the presence of comorbid illnesses. Scheduling short morning appointments that begin 90 minutes after administration of PD medication enhances the patient's ability to cooperate with care. Inclination of the dental chair at 45 degrees, placement of a bite prop, use of a rubber dam and high-volume oral evacuation enhance airway protection. To avoid adverse drug interactions with levodopa and entacapone, the dentist should limit administration of local anesthetic agents to three cartridges of 2 percent lidocaine with 1:100,000 epinephrine per half hour, and patients receiving selegiline should not be given agents containing epinephrine or levonordefrin. The dentist should instruct the patient and the caregiver in good oral hygiene techniques.

  16. Information Supply Chain System for Managing Rare Infectious Diseases (United States)

    Gopalakrishna-Remani, Venugopal


    Timely identification and reporting of rare infectious diseases has important economic, social and health implications. In this study, we investigate how different stakeholders in the existing reporting system influence the timeliness in identification and reporting of rare infectious diseases. Building on the vision of the information supply…

  17. Information Supply Chain System for Managing Rare Infectious Diseases (United States)

    Gopalakrishna-Remani, Venugopal


    Timely identification and reporting of rare infectious diseases has important economic, social and health implications. In this study, we investigate how different stakeholders in the existing reporting system influence the timeliness in identification and reporting of rare infectious diseases. Building on the vision of the information supply…

  18. Telemedicine multimedia system to support neurodegenerative diseases participatory management. (United States)

    Menezes Borges, Diogo; Cunha, João Paulo


    Parkinson's disease (PD) is a highly prevalent and disabling condition that requires a constant monitoring of patient's condition. Nevertheless, in Portugal appointments with specialist only occur every 6 months and the patient's capability to recall important past events is not always accurate besides often being a misinterpretation of their symptoms. In this paper we present a user-centred process for the design of a multimedia platform for the self-management of PD.

  19. The role of bacillus-based biological control agents in integrated pest management systems: plant diseases. (United States)

    Jacobsen, B J; Zidack, N K; Larson, B J


    ABSTRACT Bacillus-based biological control agents (BCAs) have great potential in integrated pest management (IPM) systems; however, relatively little work has been published on integration with other IPM management tools. Unfortunately, most research has focused on BCAs as alternatives to synthetic chemical fungicides or bactericides and not as part of an integrated management system. IPM has had many definitions and this review will use the national coalition for IPM definition: "A sustainable approach to managing pests by combining biological, cultural, physical and chemical tools in a way that minimizes economic, health and environmental risks." This review will examine the integrated use of Bacillus-based BCAs with disease management tools, including resistant cultivars, fungicides or bactericides, or other BCAs. This integration is important because the consistency and degree of disease control by Bacillus-based BCAs is rarely equal to the control afforded by the best fungicides or bactericides. In theory, integration of several tools brings stability to disease management programs. Integration of BCAs with other disease management tools often provides broader crop adaptation and both more efficacious and consistent levels of disease control. This review will also discuss the use of Bacillus-based BCAs in fungicide resistance management. Work with Bacillus thuringiensis and insect pest management is the exception to the relative paucity of reports but will not be the focus of this review.

  20. Plant Diseases and Management Approaches in Organic Farming Systems. (United States)

    van Bruggen, A H C; Finckh, M R


    Organic agriculture has expanded worldwide. Numerous papers were published in the past 20 years comparing plant diseases in organic and conventional crops. Root diseases are generally less severe owing to greater soil health, whereas some foliar diseases can be problematic in organic agriculture. The soil microbial community and nitrogen availability play an important role in disease development and yield. Recently, the focus has shifted to optimizing organic crop production by improving plant nutrition, weed control, and plant health. Crop-loss assessment relating productivity to all yield-forming and -reducing factors would benefit organic production and sustainability evaluation.

  1. Integrated approaches to root disease management in organic farming systems

    NARCIS (Netherlands)

    Bruggen, van A.H.C.; Termorshuizen, A.J.


    Conventional agriculture has had major environmental impacts, in particular with respect to soil degradation. Soil structure, fertility, microbial and faunal biodiversity have declined, and root diseases are common unless genetic resistance, soil fumigation and/or seed treatments are used. Primarily

  2. A Mobile Care Coordination System for the Management of Complex Chronic Disease. (United States)

    Haynes, Sarah; Kim, Katherine K


    There is global concern about healthcare cost, quality, and access as the prevalence of complex and chronic diseases, such as heart disease, continues to grow. Care for patients with complex chronic disease involves diverse practitioners and multiple transitions between medical centers, physician practices, clinics, community resources, and patient homes. There are few systems that provide the flexibility to manage these varied and complex interactions. Participatory and user-centered design methodology was applied to the first stage of building a mobile platform for care coordination for complex, chronic heart disease. Key informant interviews with patients, caregivers, clinicians, and care coordinators were conducted. Thematic analysis led to identification of priority user functions including shared care plan, medication management, symptom management, nutrition, physical activity, appointments, personal monitoring devices, and integration of data and workflow. Meaningful stakeholder engagement contributes to a person-centered system that enhances health and efficiency.

  3. An integrated chronic disease management model: a diagonal approach to health system strengthening in South Africa. (United States)

    Mahomed, Ozayr Haroon; Asmall, Shaidah; Freeman, Melvyn


    The integrated chronic disease management model provides a systematic framework for creating a fundamental change in the orientation of the health system. This model adopts a diagonal approach to health system strengthening by establishing a service-linked base to training, supervision, and the opportunity to try out, assess, and implement integrated interventions.

  4. The ubiquitin proteasomal system: a potential target for the management of Alzheimer's disease. (United States)

    Gadhave, Kundlik; Bolshette, Nityanand; Ahire, Ashutosh; Pardeshi, Rohit; Thakur, Krishan; Trandafir, Cristiana; Istrate, Alexandru; Ahmed, Sahabuddin; Lahkar, Mangala; Muresanu, Dafin F; Balea, Maria


    The cellular quality control system degrades abnormal or misfolded proteins and consists of three different mechanisms: the ubiquitin proteasomal system (UPS), autophagy and molecular chaperones. Any disturbance in this system causes proteins to accumulate, resulting in neurodegenerative diseases such as amyotrophic lateral sclerosis, Alzheimer's disease (AD), Parkinson's disease, Huntington's disease and prion or polyglutamine diseases. Alzheimer's disease is currently one of the most common age-related neurodegenerative diseases. However, its exact cause and pathogenesis are unknown. Currently approved medications for AD provide symptomatic relief; however, they fail to influence disease progression. Moreover, the components of the cellular quality control system represent an important focus for the development of targeted and potent therapies for managing AD. This review aims to evaluate whether existing evidence supports the hypothesis that UPS impairment causes the early pathogenesis of neurodegenerative disorders. The first part presents basic information about the UPS and its molecular components. The next part explains how the UPS is involved in neurodegenerative disorders. Finally, we emphasize how the UPS influences the management of AD. This review may help in the design of future UPS-related therapies for AD.

  5. Information systems for administration, clinical documentation and quality assurance in an Austrian disease management programme. (United States)

    Beck, Peter; Truskaller, Thomas; Rakovac, Ivo; Bruner, Fritz; Zanettin, Dominik; Pieber, Thomas R


    5.9% of the Austrian population is affected by diabetes mellitus. Disease Management is a structured treatment approach that is suitable for application to the diabetes mellitus area and often is supported by information technology. This article describes the information systems developed and implemented in the Austrian disease management programme for type 2 diabetes. Several workflows for administration as well as for clinical documentation have been implemented utilizing the Austrian e-Health infrastructure. De-identified clinical data is available for creating feedback reports for providers and programme evaluation.

  6. Management of diverticular disease. (United States)

    Pfützer, Roland H; Kruis, Wolfgang


    Diverticular disease is a common condition in Western countries and the incidence and prevalence of the disease is increasing. The pathogenetic factors involved include structural changes in the gut that increase with age, a diet low in fibre and rich in meat, changes in intestinal motility, the concept of enteric neuropathy and an underlying genetic background. Current treatment strategies are hampered by insufficient options to stratify patients according to individual risk. One of the main reasons is the lack of an all-encompassing classification system of diverticular disease. In response, the German Society for Gastroenterology and Digestive Diseases (DGVS) has proposed a classification system as part of its new guideline for the diagnosis and management of diverticular disease. The classification system includes five main types of disease: asymptomatic diverticulosis, acute uncomplicated and complicated diverticulitis, as well as chronic diverticular disease and diverticular bleeding. Here, we review prevention and treatment strategies stratified by these five main types of disease, from prevention of the first attack of diverticulitis to the management of chronic complications and diverticular bleeding.

  7. Consensus best practice pathway of the UK Systemic Sclerosis Study group: management of cardiac disease in systemic sclerosis. (United States)

    Bissell, Lesley-Anne; Anderson, Marina; Burgess, Malcolm; Chakravarty, Kuntal; Coghlan, Gerry; Dumitru, Raluca B; Graham, Lee; Ong, Voon; Pauling, John D; Plein, Sven; Schlosshan, Dominik; Woolfson, Peter; Buch, Maya H


    Cardiac disease in SSc can manifest in various ways and is associated with a poor prognosis. There is little evidence on how best to detect and manage cardiac disease in SSc. Our objective was to produce an expert consensus best practice pathway for the management of cardiac disease in SSc. The UK Systemic Sclerosis Study Group set up several working groups to develop a number of consensus best practice pathways for the management of SSc-specific complications, including cardiac disease. A multidisciplinary task force was convened. The guidelines were partly informed by a comprehensive literature review. A best practice pathway for cardiac disease (with a focus on primary cardiac disease) in SSc is presented, including approaches for early detection and standard pharmacological and device therapies. Due to the benefits, shared care and a multidisciplinary approach are recommended. A future research agenda has been formulated in response to the relative lack of understanding of the natural history of primary cardiac disease that was highlighted by the initiative. The physician should be alert to the possibility of cardiac disease in SSc; it is best managed within a multidisciplinary team including both rheumatologists and cardiologists. This pathway provides a reference for all physicians managing patients with SSc.

  8. Real Time Alert System: A Disease Management System Leveraging Health Information Exchange (United States)

    Anand, Vibha; Sheley, Meena E.; Xu, Shawn; Downs, Stephen M.


    Background Rates of preventive and disease management services can be improved by providing automated alerts and reminders to primary care providers (PCPs) using of health information technology (HIT) tools. Methods: Using Adaptive Turnaround Documents (ATAD), an existing Health Information Exchange (HIE) infrastructure and office fax machines, we developed a Real Time Alert (RTA) system. RTA is a computerized decision support system (CDSS) that is able to deliver alerts to PCPs statewide for recommended services around the time of the patient visit. RTA is also able to capture structured clinical data from providers using existing fax technology. In this study, we evaluate RTA’s performance for alerting PCPs when their patients with asthma have an emergency room visit anywhere in the state. Results: Our results show that RTA was successfully able to deliver “just in time” patient-relevant alerts to PCPs across the state. Furthermore, of those ATADs faxed back and automatically interpreted by the RTA system, 35% reported finding the provided information helpful. The PCPs who reported finding information helpful also reported making a phone call, sending a letter or seeing the patient for follow up care. Conclusions: We have successfully demonstrated the feasibility of electronically exchanging important patient related information with the PCPs statewide. This is despite a lack of a link with their electronic health records. We have shown that using our ATAD technology, a PCP can be notified quickly of an important event such as a patient’s asthma related emergency room admission so further follow up can happen in near real time. PMID:23569648

  9. Drug nanocarrier, the future of atopic diseases: Advanced drug delivery systems and smart management of disease. (United States)

    Shao, Mei; Hussain, Zahid; Thu, Hnin Ei; Khan, Shahzeb; Katas, Haliza; Ahmed, Tarek A; Tripathy, Minaketan; Leng, Jing; Qin, Hua-Li; Bukhari, Syed Nasir Abbas


    Atopic dermatitis (AD) is a chronically relapsing skin inflammatory disorder characterized by perivascular infiltration of immunoglobulin-E (IgE), T-lymphocytes and mast cells. The key pathophysiological factors causing this disease are immunological disorders and the compromised epidermal barrier integrity. Pruritus, intense itching, psychological stress, deprived physical and mental performance and sleep disturbance are the hallmark features of this dermatological complication. Preventive interventions which include educational programs, avoidance of allergens, exclusive care towards skin, and the rational selection of therapeutic regimen play key roles in the treatment of dermatosis. In last two decades, it is evident from a plethora of studies that scientific focus is being driven from conventional therapies to the advanced nanocarrier-based regimen for an effective management of AD. These nanocarriers which include polymeric nanoparticles (NPs), hydrogel NPs, liposomes, ethosomes, solid lipid nanoparticles (SLNs) and nanoemulsion, provide efficient roles for the target specific delivery of the therapeutic payload. The success of these targeted therapies is due to their pharmaceutical versatility, longer retention time at the target site, avoiding off-target effects and preventing premature degradation of the incorporated drugs. The present review was therefore aimed to summarise convincing evidence for the therapeutic superiority of advanced nanocarrier-mediated strategies over the conventional therapies used in the treatment of AD.

  10. Management of disease-modifying treatments in neurological autoimmune diseases of the central nervous system (United States)

    Salmen, A; Gold, R; Chan, A


    The therapeutic armamentarium for autoimmune diseases of the central nervous system, specifically multiple sclerosis and neuromyelitis optica, is steadily increasing, with a large spectrum of immunomodulatory and immunosuppressive agents targeting different mechanisms of the immune system. However, increasingly efficacious treatment options also entail higher potential for severe adverse drug reactions. Especially in cases failing first-line treatment, thorough evaluation of the risk–benefit profile of treatment alternatives is necessary. This argues for the need of algorithms to identify patients more likely to benefit from a specific treatment. Moreover, paradigms to stratify the risk for severe adverse drug reactions need to be established. In addition to clinical/paraclinical measures, biomarkers may aid in individualized risk–benefit assessment. A recent example is the routine testing for anti-John Cunningham virus antibodies in natalizumab-treated multiple sclerosis patients to assess the risk for the development of progressive multi-focal leucoencephalopathy. Refined algorithms for individualized risk assessment may also facilitate early initiation of induction treatment schemes in patient groups with high disease activity rather than classical escalation concepts. In this review, we will discuss approaches for individiualized risk–benefit assessment both for newly introduced agents as well as medications with established side-effect profiles. In addition to clinical parameters, we will also focus on biomarkers that may assist in patient selection. Other Articles published in this series Paraneoplastic neurological syndromes. Clinical and Experimental Immunology 2014, 175: 336–48. Disease-modifying therapy in multiple sclerosis and chronic inflammatory demyelinating polyradiculoneuropathy: common and divergent current and future strategies. Clinical and Experimental Immunology 2014, 175: 359–72. Monoclonal antibodies in treatment of multiple

  11. ICT use for information management in healthcare system for chronic disease patient (United States)

    Wawrzyniak, Zbigniew M.; Lisiecka-Biełanowicz, Mira


    Modern healthcare systems are designed to fulfill needs of the patient, his system environment and other determinants of the treatment with proper support of technical aids. A whole system of care is compatible to the technical solutions and organizational framework based on legal rules. The purpose of this study is to present how can we use Information and Communication Technology (ICT) systemic tools in a new model of patient-oriented care, improving the effectiveness of healthcare for patients with chronic diseases. The study material is the long-term process of healthcare for patients with chronic illness. Basing on the knowledge of the whole circumstances of patient's ecosystem and his needs allow us to build a new ICT model of long term care. The method used is construction, modeling and constant improvement the efficient ICT layer for the patient-centered healthcare model. We present a new constructive approach to systemic process how to use ICT for information management in healthcare system for chronic disease patient. The use of ICT tools in the model for chronic disease can improve all aspects of data management and communication, and the effectiveness of long-term complex healthcare. In conclusion: ICT based model of healthcare can be constructed basing on the interactions of ecosystem's functional parts through information feedback and the provision of services and models as well as the knowledge of the patient itself. Systematic approach to the model of long term healthcare assisted functionally by ICT tools and data management methods will increase the effectiveness of patient care and organizational efficiency.

  12. Will decision-support systems be widely used for the management of plant diseases? (United States)

    Shtienberg, Dani


    Decision-support systems (DSSs) are interactive computer-based systems that help decision makers solve unstructured problems under complex, uncertain conditions. Experimental use of DSSs has resulted in improved disease suppression and lowered risks of crop damage. In many cases, it has also led to the use of smaller quantities of active substances, as compared with standard spraying practices. Hundreds of DSSs have been developed over the years and are readily available and affordable. However, most farm managers do not use them as part of their integrated pest management (IPM) practices. Since the mid-1980s, the author of this paper, together with numerous colleagues, has developed DSSs and decision rules for the management of diseases in a variety of crops, including extensive crops, such as wheat, sunflower, and pea; semi-intensive crops, such as pear, chickpea, cotton, and tarragon; and intensive crops, such as tomato, potato, cucumber, sweet pepper, carrot, and grapevine. Some of these systems were used widely, but others were not. This experience may allow us to draw general conclusions regarding the use of DSSs and decision rules. Possible explanations for the widely varying acceptance rates are presented, and the effects of anticipated changes in the agribusiness sector on the future use of DSSs are discussed.

  13. Disease Management Update



    The rapid expansion of disease management continues. A multitude of stakeholders and marketplaces are now involved in providing cost-effective quality healthcare for individuals and populations. To help you keep up to date with the very latest developments in disease management, this section of the journal brings you information selected from the disease management and pharmacoeconomic reporting servicePharmacoeconomics & Outcomes News. The following reports are selected from the very latest ...

  14. Disease Management Update



    The rapid expansion of disease management continues. A multitude of stakeholders and marketplaces are now involved in providing cost-effective quality healthcare for individuals and populations. To help you keep up to date with the very latest developments in disease management, this section of the journal brings you information selected from the disease management and pharmacoeconomic reporting service Pharmacoeconomics & Outcomes News. The following reports are selected from the very latest...

  15. Disease Management Update



    The rapid expansion of disease management continues. A multitude of stakeholders and marketplaces are now involved in providing cost-effective quality healthcare for individuals and populations. To help you keep up to date with the very latest developments in disease management, this section of the journal brings you information selected from the disease management and pharmacoeconomic reporting service Pharmacoeconomics & Outcomes News. The following reports are selected from the very latest...

  16. Disease Management Update



    The rapid expansion of disease management continues. A multitude of stakeholders and marketplaces are now involved in providing cost effective quality healthcare for individuals and populations. To help you keep up-to-date with the very latest developments in disease management, this section of the journal brings you information selected from the disease management and pharmacoeconomic reporting service Pharmacoeconomics & Outcomes News . The following reports are selected from the very lates...

  17. Disease Management Update



    The rapid expansion of disease management continues. A multitude of stakeholders and marketplaces are now involved in providing cost-effective quality healthcare for individuals and populations. To help you keep up-to-date with the very latest developments in disease management, this section of the journal brings you information selected from the disease management and pharmacoeconomic reporting service PharmacoEconomics & Outcomes News Weekly. The following reports are selected from the very...

  18. Disease Management Update



    The rapid expansion of disease management continues. A multitude of stakeholders and marketplaces are now involved in providing cost-effective quality healthcare for individuals and populations. To help you keep up-to-date with the very latest developments in disease management, this section of the journal brings you information selected from the disease management and pharmacoeconomic reporting service Pharmacoeconomics & Outcomes News Weekly . The following reports are selected from the ver...

  19. Moderating factors influencing adoption of a mobile chronic disease management system in China. (United States)

    Zhu, Zhangxiang; Liu, Yongmei; Che, Xiaoling; Chen, Xiaohong


    Mobile chronic disease management systems (MCDMS) have become increasingly important in recent years, but in China, challenges remain for their adoption. Existing empirical studies have not completely explored the adoption behavior of potential MCDMS users. This article presents a study in which we investigated factors that influence chronically ill patients in China and their families to adopt or decline to use MCDMS. We applied a research model based on the technology acceptance model (TAM) as well as four contextual constructs (perceived disease threat, perceived risk, initial trust, and technology anxiety) to a survey of 279 potential MCDMS service participants in China. Our key findings include: (1) as consistent with current research, both perceived usefulness and perceived ease of use have positive impact on potential users' MCDMS adoption intention; (2) both perceived disease threat and initial trust have positive impact on MCDMS adoption intention; (3) the impact of perceived risk is negative, and technology anxiety has negative impact on perceived ease of use of MCDMS; (4) young people place more importance on their perceptions of usefulness, ease of operation, and disease threat than middle-aged and older users; (5) family members are more influenced by their perception of ease of use and disease threat than chronically ill patients, while chronically ill patients place more importance on perceived usefulness than family members. This article concludes by discussing the implications of our study for research and practice, as well as limitations and future research directions.

  20. Nanotechnology-based drug delivery systems for Alzheimer's disease management: Technical, industrial, and clinical challenges. (United States)

    Wen, Ming Ming; El-Salamouni, Noha S; El-Refaie, Wessam M; Hazzah, Heba A; Ali, Mai M; Tosi, Giovanni; Farid, Ragwa M; Blanco-Prieto, Maria J; Billa, Nashiru; Hanafy, Amira S


    Alzheimer's disease (AD) is a neurodegenerative disease with high prevalence in the rapidly growing elderly population in the developing world. The currently FDA approved drugs for the management of symptomatology of AD are marketed mainly as conventional oral medications. Due to their gastrointestinal side effects and lack of brain targeting, these drugs and dosage regiments hinder patient compliance and lead to treatment discontinuation. Nanotechnology-based drug delivery systems (NTDDS) administered by different routes can be considered as promising tools to improve patient compliance and achieve better therapeutic outcomes. Despite extensive research, literature screening revealed that clinical activities involving NTDDS application in research for AD are lagging compared to NTDDS for other diseases such as cancers. The industrial perspectives, processability, and cost/benefit ratio of using NTDDS for AD treatment are usually overlooked. Moreover, active and passive immunization against AD are by far the mostly studied alternative AD therapies because conventional oral drug therapy is not yielding satisfactorily results. NTDDS of approved drugs appear promising to transform this research from 'paper to clinic' and raise hope for AD sufferers and their caretakers. This review summarizes the recent studies conducted on NTDDS for AD treatment, with a primary focus on the industrial perspectives and processability. Additionally, it highlights the ongoing clinical trials for AD management.

  1. Data base management system for lymphatic filariasis--a neglected tropical disease.

    Directory of Open Access Journals (Sweden)

    Suryanaryana Murty Upadhyayula

    Full Text Available BACKGROUND: Researchers working in the area of Public Health are being confronted with large volumes of data on various aspects of entomology and epidemiology. To obtain the relevant information out of these data requires particular database management system. In this paper, we have described about the usages of our developed database on lymphatic filariasis. METHODS: This database application is developed using Model View Controller (MVC architecture, with MySQL as database and a web based interface. We have collected and incorporated the data on filariasis in the database from Karimnagar, Chittoor, East and West Godavari districts of Andhra Pradesh, India. CONCLUSION: The importance of this database is to store the collected data, retrieve the information and produce various combinational reports on filarial aspects which in turn will help the public health officials to understand the burden of disease in a particular locality. This information is likely to have an imperative role on decision making for effective control of filarial disease and integrated vector management operations.

  2. Alberta's systems approach to chronic disease management and prevention utilizing the expanded chronic care model. (United States)

    Delon, Sandra; Mackinnon, Blair


    Alberta's integrated approach to chronic disease management programming embraces client-centred care, supports self-management and facilitates care across the continuum. This paper presents strategies implemented through collaboration with primary care to improve care of individuals with chronic conditions, evaluation evidence supporting success and lessons learned from the Alberta perspective.

  3. EULAR evidence‐based recommendations on the management of systemic glucocorticoid therapy in rheumatic diseases (United States)

    Hoes, J N; Jacobs, J W G; Boers, M; Boumpas, D; Buttgereit, F; Caeyers, N; Choy, E H; Cutolo, M; Da Silva, J A P; Esselens, G; Guillevin, L; Hafstrom, I; Kirwan, J R; Rovensky, J; Russell, A; Saag, K G; Svensson, B; Westhovens, R; Zeidler, H; Bijlsma, J W J


    Objective To develop evidence‐based recommendations for the management of systemic glucocorticoid (GC) therapy in rheumatic diseases. Methods The multidisciplinary guideline development group from 11 European countries, Canada and the USA consisted of 15 rheumatologists, 1 internist, 1 rheumatologist–epidemiologist, 1 health professional, 1 patient and 1 research fellow. The Delphi method was used to agree on 10 key propositions related to the safe use of GCs. A systematic literature search of PUBMED, EMBASE, CINAHL, and Cochrane Library was then used to identify the best available research evidence to support each of the 10 propositions. The strength of recommendation was given according to research evidence, clinical expertise and perceived patient preference. Results The 10 propositions were generated through three Delphi rounds and included patient education, risk factors, adverse effects, concomitant therapy (ie, non‐steroidal anti‐inflammatory drugs, gastroprotection and cyclo‐oxygenase‐2 selective inhibitors, calcium and vitamin D, bisphosphonates) and special safety advice (ie, adrenal insufficiency, pregnancy, growth impairment). Conclusion Ten key recommendations for the management of systemic GC‐therapy were formulated using a combination of systematically retrieved research evidence and expert consensus. There are areas of importance that have little evidence (ie, dosing and tapering strategies, timing, risk factors and monitoring for adverse effects, perioperative GC‐replacement) and need further research; therefore also a research agenda was composed. PMID:17660219

  4. Implementation of an integrated information system for the management of swine vesicular disease surveillance activities in Italy. (United States)

    Bellini, Silvia; Ferrarini, Nicola; Santucci, Ugo


    In Europe in the last decade, swine vesicular disease (SVD) outbreaks have been steadily reported in Italy where surveillance and eradication activities are in place. To collect and analyse data gathered during SVD surveillance activities, the Italian reference centre for vesicular diseases (CERVES) has implemented an integrated information system for the management of the national surveillance plan. The system was developed using Web-based technology and open source software. It was designed to gather, integrate and manage data generated by the activities of the Veterinary Services, the laboratory information system, herd and animal registers and the relevant technical and scientific information. A geographic information system provides an interface for the system, which facilitates the planning, implementation and evaluation of disease control actions. Access to the system is feasible through a second level domain.

  5. Management of Crohn's disease. (United States)

    Kammermeier, Jochen; Morris, Mary-Anne; Garrick, Vikki; Furman, Mark; Rodrigues, Astor; Russell, Richard K


    Crohn's disease (CD) is rapidly increasing in children so an up to date knowledge of diagnosis, investigation and management is essential. Exclusive enteral nutrition is the first line treatment for active disease. The vast majority of children will need immunosuppressant treatment and around 20% will need treatment with biologics. Recent guidelines have helped make best use of available therapies.

  6. LINX(™) Reflux Management System: magnetic sphincter augmentation in the treatment of gastroesophageal reflux disease. (United States)

    Bonavina, Luigi; DeMeester, Tom R; Ganz, Robert A


    Gastroesophageal reflux disease (GERD), commonly manifested by heartburn or regurgitation, is a chronic, progressive condition in which failed sphincter function allows the contents of the stomach to reflux into the esophagus, the airways and the mouth. Chronic GERD affects 10% of Western society. The majority of patients receive adequate relief from proton pump inhibitors, but up to 40% have incomplete relief of symptoms that cannot be addressed by increasing the dose of medications. The laparoscopic Nissen fundoplication is the surgical gold standard; however, the level of technical difficulty and its side effects have limited its use to less than 1% of the GERD population. These factors have contributed to the propensity of patients to persist with medical therapy, even when inadequate to control symptoms and complications of the disease. Consequently, a significant gap in the treatment continuum for GERD remains evident in current clinical practice. The LINX(™) Reflux Management System (Torax Medical) is designed to provide a permanent solution to GERD by augmenting the physiologic function of the sphincter barrier with a simple and reproducible laparoscopic procedure that does not alter gastric anatomy and can be easily reversed if necessary.

  7. Phytophthora community structure analyses in Oregon nurseries inform systems approaches to disease management. (United States)

    Parke, Jennifer L; Knaus, Brian J; Fieland, Valerie J; Lewis, Carrie; Grünwald, Niklaus J


    Nursery plants are important vectors for plant pathogens. Understanding what pathogens occur in nurseries in different production stages can be useful to the development of integrated systems approaches. Four horticultural nurseries in Oregon were sampled every 2 months for 4 years to determine the identity and community structure of Phytophthora spp. associated with different sources and stages in the nursery production cycle. Plants, potting media, used containers, water, greenhouse soil, and container yard substrates were systematically sampled from propagation to the field. From 674 Phytophthora isolates recovered, 28 different species or taxa were identified. The most commonly isolated species from plants were Phytophthora plurivora (33%), P. cinnamomi (26%), P. syringae (19%), and P. citrophthora (11%). From soil and gravel substrates, P. plurivora accounted for 25% of the isolates, with P. taxon Pgchlamydo, P. cryptogea, and P. cinnamomi accounting for 18, 17, and 15%, respectively. Five species (P. plurivora, P. syringae, P. taxon Pgchlamydo, P. gonapodyides, and P. cryptogea) were found in all nurseries. The greatest diversity of taxa occurred in irrigation water reservoirs (20 taxa), with the majority of isolates belonging to internal transcribed spacer clade 6, typically including aquatic opportunists. Nurseries differed in composition of Phytophthora communities across years, seasons, and source within the nursery. These findings suggest likely contamination hazards and target critical control points for management of Phytophthora disease using a systems approach.

  8. Impact of agricultural land management systems on soil microbial diversity and plant disease (United States)

    Increased diversity of fungal rDNA ITS-1 amplicons, as measured by the Shannon-Weiner index, was associated with land management practices that minimise soil disturbance (bahiagrass pasture and undisturbed weed fallow) when compared with organic or conventional land management systems. Diversity de...

  9. EULAR evidence-based recommendations on the management of systemic glucocorticoid therapy in rheumatic diseases

    National Research Council Canada - National Science Library

    Hoes, J N; Jacobs, J W G; Boers, M; Boumpas, D; Buttgereit, F; Caeyers, N; Choy, E H; Cutolo, M; Da Silva, J A P; Esselens, G; Guillevin, L; Hafstrom, I; Kirwan, J R; Rovensky, J; Russell, A; Saag, K G; Svensson, B; Westhovens, R; Zeidler, H; Bijlsma, J W J


    ... on proper use of GCs. Hence, a EULAR task force on GCs, including a patient, was formed to develop evidence-based recommendations, to provide a tool for the better use and management of GC-therapy in rheumatic diseases. METHODS Endorsed by EULAR-ESCISIT, a multidisciplinary guideline development committee on GCs was formed, consisting of 20 experts in...

  10. PERFORM: A System for Monitoring, Assessment and Management of Patients with Parkinson’s Disease

    Directory of Open Access Journals (Sweden)

    Alexandros T. Tzallas


    Full Text Available In this paper, we describe the PERFORM system for the continuous remote monitoring and management of Parkinson’s disease (PD patients. The PERFORM system is an intelligent closed-loop system that seamlessly integrates a wide range of wearable sensors constantly monitoring several motor signals of the PD patients. Data acquired are pre-processed by advanced knowledge processing methods, integrated by fusion algorithms to allow health professionals to remotely monitor the overall status of the patients, adjust medication schedules and personalize treatment. The information collected by the sensors (accelerometers and gyroscopes is processed by several classifiers. As a result, it is possible to evaluate and quantify the PD motor symptoms related to end of dose deterioration (tremor, bradykinesia, freezing of gait (FoG as well as those related to over-dose concentration (Levodopa-induced dyskinesia (LID. Based on this information, together with information derived from tests performed with a virtual reality glove and information about the medication and food intake, a patient specific profile can be built. In addition, the patient specific profile with his evaluation during the last week and last month, is compared to understand whether his status is stable, improving or worsening. Based on that, the system analyses whether a medication change is needed—always under medical supervision—and in this case, information about the medication change proposal is sent to the patient. The performance of the system has been evaluated in real life conditions, the accuracy and acceptability of the system by the PD patients and healthcare professionals has been tested, and a comparison with the standard routine clinical evaluation done by the PD patients’ physician has been carried out. The PERFORM system is used by the PD patients and in a simple and safe non-invasive way for long-term record of their motor status, thus offering to the clinician a

  11. Pediatric asthma disease management. (United States)

    Myers, T R; Chatburn, R L


    The prevalence of asthma in children in the United States is estimated at more than 5% of the population, and it has risen more than 40% in the previous decade. Several guidelines for the management of acute and chronic asthma exist, and they all emphasize several basic components including state-of-the-art pharmacologic treatment, trigger avoidance, and patient self-management skills. This Article highlights the necessary components for pediatric asthma disease management to insure a smooth continuum of care across all disciplines and settings.

  12. Chronic disease management in rural and underserved populations: innovation and system improvement help lead to success. (United States)

    Bolin, Jane; Gamm, Larry; Kash, Bita; Peck, Mitchell


    Successful implementation of disease management (DM) is based on the ability of an organization to overcome a variety of barriers to deliver timely, appropriate care of chronic illnesses. Such programs initiate DM services to patient populations while initiating self-management education among medication-resistant patients who are chronically ill. Despite formidable challenges, rural health care providers have been successful in initiating DM programs and have discovered several ways in which these programs benefit their organizations. This research reports on six DM programs that serve large rural and underserved populations and have demonstrated that DM can be successfully implemented in such areas.

  13. Chronic disease management: time for consultant physicians to take more leadership in system redesign. (United States)

    Brand, C; Scott, I; Greenberg, P; Sargious, P


    There is a need for system redesign to meet the needs of individuals with chronic disease. New models of chronic disease care include team-based paradigms that focus on continuous and patient-centred care. In such models the roles of providers and patients must change. In this article we focus on new roles for consultant physicians, as well as barriers and incentives to these roles.

  14. Effects of different potato cropping system approaches and water management on soilborne diseases and soil microbial communities. (United States)

    Larkin, Robert P; Honeycutt, C Wayne; Griffin, Timothy S; Olanya, O Modesto; Halloran, John M; He, Zhongqi


    Four different potato cropping systems, designed to address specific management goals of soil conservation, soil improvement, disease suppression, and a status quo standard rotation control, were evaluated for their effects on soilborne diseases of potato and soil microbial community characteristics. The status quo system (SQ) consisted of barley underseeded with red clover followed by potato (2-year). The soil-conserving system (SC) featured an additional year of forage grass and reduced tillage (3-year, barley/timothy-timothy-potato). The soil-improving system (SI) added yearly compost amendments to the SC rotation, and the disease-suppressive system (DS) featured diverse crops with known disease-suppressive capability (3-year, mustard/rapeseed-sudangrass/rye-potato). Each system was also compared with a continuous potato control (PP) and evaluated under both irrigated and nonirrigated conditions. Data collected over three potato seasons following full rotation cycles demonstrated that all rotations reduced stem canker (10 to 50%) relative to PP. The SQ, SC, and DS systems reduced black scurf (18 to 58%) relative to PP; SI reduced scurf under nonirrigated but not irrigated conditions; and scurf was lower in DS than all other systems. The SQ, SC, and DS systems also reduced common scab (15 to 45%), and scab was lower in DS than all other systems. Irrigation increased black scurf and common scab but also resulted in higher yields for most rotations. SI produced the highest yields under nonirrigated conditions, and DS produced high yields and low disease under both irrigation regimes. Each cropping system resulted in distinctive changes in soil microbial community characteristics as represented by microbial populations, substrate utilization, and fatty acid methyl-ester (FAME) profiles. SI tended to increase soil moisture, microbial populations, and activity, as well result in higher proportions of monounsaturated FAMEs and the FAME biomarker for mycorrhizae (16:1

  15. Principles of disease management in neonatology. (United States)

    Bowen, F W; Gwiazdowski, S


    This article emphasizes the emerging facets of disease-management practice that impact directly on establishing a measured care system that can produce the information needed to establish a continuous quality improvement program. The areas discussed are risk assessment, clinical management guidelines and carepaths, and the measurement of system output known as clinical outcomes. The remainder of the article details the aspects of risk assessment, guideline function, and outcome assessment, critical in a disease-managed measured care system.

  16. A Classification System to Guide Physical Therapy Management in Huntington Disease: A Case Series. (United States)

    Fritz, Nora E; Busse, Monica; Jones, Karen; Khalil, Hanan; Quinn, Lori


    Individuals with Huntington disease (HD), a rare neurological disease, experience impairments in mobility and cognition throughout their disease course. The Medical Research Council framework provides a schema that can be applied to the development and evaluation of complex interventions, such as those provided by physical therapists. Treatment-based classifications, based on expert consensus and available literature, are helpful in guiding physical therapy management across the stages of HD. Such classifications also contribute to the development and further evaluation of well-defined complex interventions in this highly variable and complex neurodegenerative disease. The purpose of this case series was to illustrate the use of these classifications in the management of 2 individuals with late-stage HD. Two females, 40 and 55 years of age, with late-stage HD participated in this case series. Both experienced progressive declines in ambulatory function and balance as well as falls or fear of falling. Both individuals received daily care in the home for activities of daily living. Physical therapy Treatment-Based Classifications for HD guided the interventions and outcomes. Eight weeks of in-home balance training, strength training, task-specific practice of functional activities including transfers and walking tasks, and family/carer education were provided. Both individuals demonstrated improvements that met or exceeded the established minimal detectible change values for gait speed and Timed Up and Go performance. Both also demonstrated improvements on Berg Balance Scale and Physical Performance Test performance, with 1 of the 2 individuals exceeding the established minimal detectible changes for both tests. Reductions in fall risk were evident in both cases. These cases provide proof-of-principle to support use of treatment-based classifications for physical therapy management in individuals with HD. Traditional classification of early-, mid-, and late

  17. DAS: Personal Diabetes Management System

    Directory of Open Access Journals (Sweden)

    Aisha Batool


    Full Text Available In this study we have presented the design and implementation of a Diabetes Assistant System (DAS which is able to store and manage the diabetic patient’s medical data. DAS (Diabetes Assistance System is developed after studying several well-known existing diabetes management systems and includes many features that were not available in past. In addition to this many features of existing systems are redesigned for more productivity and effective disease management. DAS not only facilitates diabetic patients to manage their lifestyles but it also provides functionalities for medical practitioners and support staff for disease management features. DAS supports core features of user management, disease management, visit management and extended features for socialization. DAS is developed by focusing users’ needs of mobility and ease of access hence available as web-based and mobile-based diabetes management system. DAS enables doctors to support patients remotely and view their disease history. Moreover, a doctor can manage his/her personal profile and daily schedule of online availability. Patients can manage their profiles, daily activities, test results, medications, foods intakes and appointments. In addition to this, patients can view their disease history, doctor’s schedule and health tips. The support staff manages disease related information like medicines, manufacturers, tests, foods and exercises data. In addition they can view/manage doctor’s schedule and appointments.

  18. Ecology of Fungus Gnats (Bradysia spp. in Greenhouse Production Systems Associated with Disease-Interactions and Alternative Management Strategies

    Directory of Open Access Journals (Sweden)

    Raymond A. Cloyd


    Full Text Available Fungus gnats (Bradysia spp. are major insect pests of greenhouse-grown horticultural crops mainly due to the direct feeding damage caused by the larvae, and the ability of larvae to transmit certain soil-borne plant pathogens. Currently, insecticides and biological control agents are being used successively to deal with fungus gnat populations in greenhouse production systems. However, these strategies may only be effective as long as greenhouse producers also implement alternative management strategies such as cultural, physical, and sanitation. This includes elimination of algae, and plant and growing medium debris; placing physical barriers onto the growing medium surface; and using materials that repel fungus gnat adults. This article describes the disease-interactions associated with fungus gnats and foliar and soil-borne diseases, and the alternative management strategies that should be considered by greenhouse producers in order to alleviate problems with fungus gnats in greenhouse production systems.

  19. Facilitating superior chronic disease management through a knowledge-based systems development model. (United States)

    Wickramasinghe, Nilmini S; Goldberg, Steve


    To date, the adoption and diffusion of technology-enabled solutions to deliver better healthcare has been slow. There are many reasons for this. One of the most significant is that the existing methodologies that are normally used in general for Information and Communications Technology (ICT) implementations tend to be less successful in a healthcare context. This paper describes a knowledge-based adaptive mapping to realisation methodology to traverse successfully from idea to realisation rapidly and without compromising rigour so that success ensues. It is discussed in connection with trying to implement superior ICT-enabled approaches to facilitate superior Chronic Disease Management (CDM).

  20. Tractor-mounted, GPS-based spot fumigation system manages Prunus replant disease (United States)

    Our research goal was to use recent advances in global positioning system (GPS) and computer technology to apply just the right amount of fumigant where it is most needed (i.e., in a small target treatment zone in and around each tree replanting site) to control Prunus replant disease (PRD). We deve...

  1. The Green, Amber, Red Delineation of Risk and Need (GARDIAN) management system: a pragmatic approach to optimizing heart health from primary prevention to chronic disease management. (United States)

    Carrington, Melinda J; Kok, Simone; Jansen, Kiki; Stewart, Simon


    A sustained epidemic of cardiovascular disease and related risk factors is a global phenomenon contributing significantly to premature deaths and costly morbidity. Preventative strategies across the full continuum of life, from a population to individual perspective, are not optimally applied. This paper describes a simple and adaptable 'traffic-light' system we have developed to systematically perform individual risk and need delineation in order to 'titrate' the intensity and frequency of healthcare intervention in a cost-effective manner. The GARDIAN (Green Amber Red Delineation of Risk and Need) system is an individual assessment of risk and need that modulates the frequency and intensity of future healthcare intervention. Individual assessment of risk and need for ongoing intervention and support is determined with reference to three domains: (1) clinical stability, (2) gold-standard management, and (3) a broader, holistic assessment of individual circumstance. This can be applied from a primary prevention, secondary prevention, or chronic disease management perspective. Our experience with applying and validating GARDIAN to titrate healthcare resources according to need has been extensive to date, with >5000 individuals profiled in a host of clinical settings. A series of clinical randomized trials will determine the impact of the GARDIAN system on important indices of healthcare utilization and health status. The GARDIAN model to delineating risk and need for varied intensity of management shows strong potential to cost effectively improve health outcomes for both individuals at risk of heart disease and those with established heart disease.

  2. Microbiome Networks: A Systems Framework for Identifying Candidate Microbial Assemblages for Disease Management. (United States)

    Poudel, R; Jumpponen, A; Schlatter, D C; Paulitz, T C; Gardener, B B McSpadden; Kinkel, L L; Garrett, K A


    Network models of soil and plant microbiomes provide new opportunities for enhancing disease management, but also challenges for interpretation. We present a framework for interpreting microbiome networks, illustrating how observed network structures can be used to generate testable hypotheses about candidate microbes affecting plant health. The framework includes four types of network analyses. "General network analysis" identifies candidate taxa for maintaining an existing microbial community. "Host-focused analysis" includes a node representing a plant response such as yield, identifying taxa with direct or indirect associations with that node. "Pathogen-focused analysis" identifies taxa with direct or indirect associations with taxa known a priori as pathogens. "Disease-focused analysis" identifies taxa associated with disease. Positive direct or indirect associations with desirable outcomes, or negative associations with undesirable outcomes, indicate candidate taxa. Network analysis provides characterization not only of taxa with direct associations with important outcomes such as disease suppression, biofertilization, or expression of plant host resistance, but also taxa with indirect associations via their association with other key taxa. We illustrate the interpretation of network structure with analyses of microbiomes in the oak phyllosphere, and in wheat rhizosphere and bulk soil associated with the presence or absence of infection by Rhizoctonia solani.

  3. [Establishment and application effect appraisement of community chronic obstructive pulmonary disease integrated management system]. (United States)

    Zhao, D X; Chen, S Y; Zhou, Y M; Li, X C; Zou, W F; Chen, X M; Ran, P X


    Objective: To establish the COPD community integrated management system suitable for our national situation and assess its effects in the prevention and treatment for COPD. Methods: The COPD community integrated management system based on the electronic management system was established, including the functional modules of preliminary screening for COPD, electronic health record, grading management and dual referral system, ect. Two townships were randomly selected from the rural areas in north Guangdong as Observational Community and Control Community, respectively. Resident families were randomly selected from the two communities. One resident aged 40 or higher who was selected randomly from each family was enrolled in the trial and followed up for 2 years.Of a total of 460 participants from the Observational Community, 340 participants accomplished the two-years the follow-up, among whom there were 45 COPD patients, 117 high risk population, 178 common population. Of a total of 380 participants from the Control Community, 212 participants accomplished the follow-up, among whom there were 39 COPD patients, 68 high risk population, 105 common population.According to the COPD community integrated management system, the health cares including preliminary screening for COPD, grading management and dual referral, ect. were implemented in the Observational Community. Essential diagnosis and treatment services were performed in the Control Community. The effects of the system were appraised by comparisons of the pulmonary function change, acute exacerbation, quality of life and change of risk factors, ect. between the two communities. Results: After the intervention, the follow-up rate, smoking-quitting rate, the proportions of decline in current smoking, passive smoking and switching to clean energy for cooking in the Observational Community were significantly greater than those in the Control Community(73.9% vs. 55.8%, 70.8% vs. 9.1%, 24.2% vs. 7.1%, 32.6% vs. 3

  4. Disease management and medication compliance. (United States)

    Cohen, Joshua; Christensen, Kathyrn; Feldman, Lanna


    Lack of medication compliance is harmful to health care systems from both a clinical and economic perspective. This study examines the methods that disease management organizations employ to identify nonadherent patients and to measure effectiveness of compliance programs for patients with diabetes, hyperlipidemia, and cystic fibrosis. In addition, this study investigates the degree to which disease managers assume risk in their contracts, and whether compliance strategies are being coordinated with payers' use of value-based insurance design, in which patient cost sharing is a function of the relative value of pharmaceuticals. This study's findings suggest that disease management may be falling short in terms of: (a) comprehensive commitment to expert-recommended at-home devices used to self-diagnose and measure health indicators; (b) early adoption of expert-recommended new technologies to measure and improve compliance; (c) intensity of use of standard tests in outpatient clinics; (d) coordination of compliance strategies with payers' use of value-based insurance design; and (e) the proportion of risk assumed in disease management contracts.

  5. Surveillance and Outbreak Response Management System (SORMAS) to support the control of the Ebola virus disease outbreak in West Africa. (United States)

    Fähnrich, C; Denecke, K; Adeoye, O O; Benzler, J; Claus, H; Kirchner, G; Mall, S; Richter, R; Schapranow, M P; Schwarz, N; Tom-Aba, D; Uflacker, M; Poggensee, G; Krause, G


    In the context of controlling the current outbreak of Ebola virus disease (EVD), the World Health Organization claimed that 'critical determinant of epidemic size appears to be the speed of implementation of rigorous control measures', i.e. immediate follow-up of contact persons during 21 days after exposure, isolation and treatment of cases, decontamination, and safe burials. We developed the Surveillance and Outbreak Response Management System (SORMAS) to improve efficiency and timeliness of these measures. We used the Design Thinking methodology to systematically analyse experiences from field workers and the Ebola Emergency Operations Centre (EOC) after successful control of the EVD outbreak in Nigeria. We developed a process model with seven personas representing the procedures of EVD outbreak control. The SORMAS system architecture combines latest In-Memory Database (IMDB) technology via SAP HANA (in-memory, relational database management system), enabling interactive data analyses, and established SAP cloud tools, such as SAP Afaria (a mobile device management software). The user interface consists of specific front-ends for smartphones and tablet devices, which are independent from physical configurations. SORMAS allows real-time, bidirectional information exchange between field workers and the EOC, ensures supervision of contact follow-up, automated status reports, and GPS tracking. SORMAS may become a platform for outbreak management and improved routine surveillance of any infectious disease. Furthermore, the SORMAS process model may serve as framework for EVD outbreak modeling.

  6. Huanglongbing: Pathogen detection system for integrated disease management – A review

    Directory of Open Access Journals (Sweden)

    Yasir Iftikhar


    Full Text Available Huanglongbing (HLB is a major threat to citrus sustainable yield and production. Therefore, various strategies are discussed in this review to provide solutions for the control of the disease. These include phyto-sanitory techniques to reduce pathogen inoculum in the field which are based on several approaches such as the presence of a reliable pathogen detection system, control over vector populations, cultural practices, chemotherapy and finally the production of disease-free propagating material. In addition to phytosanitory techniques, efforts to introduce resistant genes into cultivatable germplasm are also needed and are thus also discussed in this review.

  7. Toward a joint health and disease management program. Toronto hospitals partner to provide system leadership. (United States)

    Macleod, Anne Marie; Gollish, Jeffrey; Kennedy, Deborah; McGlasson, Rhona; Waddell, James


    The Joint Health and Disease Management Program in the Toronto Central Local Health Integration Network (TC LHIN) is envisioned as a comprehensive model of care for patients with hip and knee arthritis. It includes access to assessment services, education, self-management programs and other treatment programs, including specialist care as needed. As the first phase of this program, the hospitals in TC LHIN implemented a Hip and Knee Replacement Program to focus on improving access and quality of care, coordinating services and measuring wait times for patients waiting for hip or knee replacement surgery. The program involves healthcare providers, consumers and constituent hospitals within TC LHIN. The approach used for this program involved a definition of governance structure, broad stakeholder engagement to design program elements and plans for implementation and communication to ensure sustainability. The program and approach were designed to provide a model that is transferrable in its elements or its entirety to other patient populations and programs. Success has been achieved in creating a single wait list, developing technology to support referral management and wait time reporting, contributing to significant reductions in waits for timely assessment and treatment, building human resource capacity and improving patient and referring physician satisfaction with coordination of care.

  8. Management of Systemic Sclerosis-Related Skin Disease: A Review of Existing and Experimental Therapeutic Approaches. (United States)

    Volkmann, Elizabeth R; Furst, Daniel E


    The skin is the most common organ system involved in patients with systemic sclerosis (SSc). Nearly all patients experience cutaneous symptoms, including sclerosis, Raynaud's phenomenon, digital ulcers, telangiectasias, and calcinosis. In addition to posing functional challenges, cutaneous symptoms are often a major cause of pain, psychological distress, and body image dissatisfaction. The present article reviews the main features of SSc-related cutaneous manifestations and highlights an evidence-based treatment approach for treating each manifestation. This article also describes novel treatment approaches and opportunities for further research in managing this important clinical dimension of SSc.

  9. Computerized clinical decision support systems for chronic disease management: a decision-maker-researcher partnership systematic review. (United States)

    Roshanov, Pavel S; Misra, Shikha; Gerstein, Hertzel C; Garg, Amit X; Sebaldt, Rolf J; Mackay, Jean A; Weise-Kelly, Lorraine; Navarro, Tamara; Wilczynski, Nancy L; Haynes, R Brian


    The use of computerized clinical decision support systems (CCDSSs) may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease) and associated patient outcomes (such as effects on biomarkers and clinical exacerbations). We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes. Of 55 included trials, 87% (n = 48) measured system impact on the process of care and 52% (n = 25) of those demonstrated statistically significant improvements. Sixty-five percent (36/55) of trials measured impact on, typically, non-major (surrogate) patient outcomes, and 31% (n = 11) of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported. A small majority (just over half) of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies measuring patient outcomes.

  10. Computerized clinical decision support systems for chronic disease management: A decision-maker-researcher partnership systematic review

    Directory of Open Access Journals (Sweden)

    Navarro Tamara


    Full Text Available Abstract Background The use of computerized clinical decision support systems (CCDSSs may improve chronic disease management, which requires recurrent visits to multiple health professionals, ongoing disease and treatment monitoring, and patient behavior modification. The objective of this review was to determine if CCDSSs improve the processes of chronic care (such as diagnosis, treatment, and monitoring of disease and associated patient outcomes (such as effects on biomarkers and clinical exacerbations. Methods We conducted a decision-maker-researcher partnership systematic review. We searched MEDLINE, EMBASE, Ovid's EBM Reviews database, Inspec, and reference lists for potentially eligible articles published up to January 2010. We included randomized controlled trials that compared the use of CCDSSs to usual practice or non-CCDSS controls. Trials were eligible if at least one component of the CCDSS was designed to support chronic disease management. We considered studies 'positive' if they showed a statistically significant improvement in at least 50% of relevant outcomes. Results Of 55 included trials, 87% (n = 48 measured system impact on the process of care and 52% (n = 25 of those demonstrated statistically significant improvements. Sixty-five percent (36/55 of trials measured impact on, typically, non-major (surrogate patient outcomes, and 31% (n = 11 of those demonstrated benefits. Factors of interest to decision makers, such as cost, user satisfaction, system interface and feature sets, unique design and deployment characteristics, and effects on user workflow were rarely investigated or reported. Conclusions A small majority (just over half of CCDSSs improved care processes in chronic disease management and some improved patient health. Policy makers, healthcare administrators, and practitioners should be aware that the evidence of CCDSS effectiveness is limited, especially with respect to the small number and size of studies

  11. Dental management considerations for the patient with an acquired coagulopathy. Part 1: Coagulopathies from systemic disease


    Lockhart, P.B.; Gibson, J; Pond, S.H.; Leitch, J


    Current teaching suggests that many patients are at risk for prolonged bleeding during and following invasive dental procedures, due to an acquired coagulopathy from systemic disease and/or from medications. However, treatment standards for these patients often are the result of long-standing dogma with little or no scientific basis. The medical history is critical for the identification of patients potentially at risk for prolonged bleeding from dental treatment. Some time-honoured laborator...

  12. A novel personal health system with integrated decision support and guidance for the management of chronic liver disease. (United States)

    Kiefer, Stephan; Schäfer, Michael; Bransch, Marco; Brimmers, Peter; Bartolomé, Diego; Baños, Janie; Orr, James; Jones, Dave; Jara, Maximilian; Stockmann, Martin


    A personal health system platform for the management of patients with chronic liver disease that incorporates a novel approach to integrate decision support and guidance through care pathways for patients and their doctors is presented in this paper. The personal health system incorporates an integrated decision support engine that guides patients and doctors through the management of the disease by issuing tasks and providing recommendations to both the care team and the patient and by controlling the execution of a Care Flow Plan based on the results of tasks and the monitored health status of the patient. This Care Flow Plan represents a formal, business process based model of disease management designed off-line by domain experts on the basis of clinical guidelines, knowledge of care pathways and an organisational model for integrated, patient-centred care. In this way, remote monitoring and treatment are dynamically adapted to the patient's actual condition and clinical symptoms and allow flexible delivery of care with close integration of specialists, therapists and care-givers.

  13. Quality management system

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Mu Sung


    This book deals with ISO9001 quality management system which includes summary of this system such as classification of quality, principle of quality management, and definition, requirement and procedure of quality management system, introduction of ISO9001 system like model of ISO9001 quality management system, ISO certificate system, structure of ISO9001 standard, requirement of ISO9001 quality management system, process approach and documentation of system, propel cases of ISO9001 quality management system.

  14. Chronic disease management: implementation and coordination of healthcare systems for depressed elderly persons. (United States)

    Severinsson, Elisabeth; Holm, Anne Lise


    The aim of this study was to evaluate the implementation of the research-based Chronic Care Model (CCM), discuss methods and summarise research recommendations for improving the care of depressed elderly persons. Interviews were conducted and state-of-the-art reviews employed. Three important areas emerged: (1) barriers to and facilitating factors in the implementation of the CCM; (2) the challenges involved in re-designing the delivery system and interdisciplinary team collaboration; and (3) empirical evidence pertaining to self-management support and how older persons manage to live with depressive ill-health. In conclusion, implementation research requires evidence-based knowledge, staff involvement and familiarity with the context in which development occurs.

  15. Systemic abnormalities in liver disease

    Institute of Scientific and Technical Information of China (English)

    Masami Minemura; Kazuto Tajiri; Yukihiro Shimizu


    Systemic abnormalities often occur in patients with liver disease. In particular, cardiopulmonary or renal diseases accompanied by advanced liver disease can be serious and may determine the quality of life and prognosis of patients. Therefore, both hepatologists and non-hepatologists should pay attention to such abnormalities in the management of patients with liver diseases.

  16. Population management, systems-based practice, and planned chronic illness care: integrating disease management competencies into primary care to improve composite diabetes quality measures. (United States)

    Kimura, Joe; DaSilva, Karen; Marshall, Richard


    The increasing prevalence of chronic illnesses in the United States requires a fundamental redesign of the primary care delivery system's structure and processes in order to meet the changing needs and expectations of patients. Population management, systems-based practice, and planned chronic illness care are 3 potential processes that can be integrated into primary care and are compatible with the Chronic Care Model. In 2003, Harvard Vanguard Medical Associates, a multispecialty ambulatory physician group practice based in Boston, Massachusetts, began implementing all 3 processes across its primary care practices. From 2004 to 2006, the overall diabetes composite quality measures improved from 51% to 58% for screening (HgA1c x 2, low-density lipoprotein, blood pressure in 12 months) and from 13% to 17% for intermediate outcomes (HgA1c system integrated these disease management functions into the front lines of primary care and the positive impact of those changes on overall diabetes quality of care.

  17. Web 2.0 systems supporting childhood chronic disease management: a pattern language representation of a general architecture. (United States)

    Timpka, Toomas; Eriksson, Henrik; Ludvigsson, Johnny; Ekberg, Joakim; Nordfeldt, Sam; Hanberger, Lena


    Chronic disease management is a global health concern. By the time they reach adolescence, 10-15% of all children live with a chronic disease. The role of educational interventions in facilitating adaptation to chronic disease is receiving growing recognition, and current care policies advocate greater involvement of patients in self-care. Web 2.0 is an umbrella term for new collaborative Internet services characterized by user participation in developing and managing content. Key elements include Really Simple Syndication (RSS) to rapidly disseminate awareness of new information; weblogs (blogs) to describe new trends, wikis to share knowledge, and podcasts to make information available on personal media players. This study addresses the potential to develop Web 2.0 services for young persons with a chronic disease. It is acknowledged that the management of childhood chronic disease is based on interplay between initiatives and resources on the part of patients, relatives, and health care professionals, and where the balance shifts over time to the patients and their families. Participatory action research was used to stepwise define a design specification in the form of a pattern language. Support for children diagnosed with diabetes Type 1 was used as the example area. Each individual design pattern was determined graphically using card sorting methods, and textually in the form Title, Context, Problem, Solution, Examples and References. Application references were included at the lowest level in the graphical overview in the pattern language but not specified in detail in the textual descriptions. The design patterns are divided into functional and non-functional design elements, and formulated at the levels of organizational, system, and application design. The design elements specify access to materials for development of the competences needed for chronic disease management in specific community settings, endorsement of self-learning through online peer

  18. Web 2.0 systems supporting childhood chronic disease management: A pattern language representation of a general architecture

    Directory of Open Access Journals (Sweden)

    Ekberg Joakim


    Full Text Available Abstract Background Chronic disease management is a global health concern. By the time they reach adolescence, 10–15% of all children live with a chronic disease. The role of educational interventions in facilitating adaptation to chronic disease is receiving growing recognition, and current care policies advocate greater involvement of patients in self-care. Web 2.0 is an umbrella term for new collaborative Internet services characterized by user participation in developing and managing content. Key elements include Really Simple Syndication (RSS to rapidly disseminate awareness of new information; weblogs (blogs to describe new trends, wikis to share knowledge, and podcasts to make information available on personal media players. This study addresses the potential to develop Web 2.0 services for young persons with a chronic disease. It is acknowledged that the management of childhood chronic disease is based on interplay between initiatives and resources on the part of patients, relatives, and health care professionals, and where the balance shifts over time to the patients and their families. Methods Participatory action research was used to stepwise define a design specification in the form of a pattern language. Support for children diagnosed with diabetes Type 1 was used as the example area. Each individual design pattern was determined graphically using card sorting methods, and textually in the form Title, Context, Problem, Solution, Examples and References. Application references were included at the lowest level in the graphical overview in the pattern language but not specified in detail in the textual descriptions. Results The design patterns are divided into functional and non-functional design elements, and formulated at the levels of organizational, system, and application design. The design elements specify access to materials for development of the competences needed for chronic disease management in specific community

  19. The Role of Personal Health Record Systems in Chronic Disease Management. (United States)

    Prashad, Reshma


    Chronic illnesses account for the largest portion of healthcare spending in Canada; they are the leading cause of premature death. As a result, healthcare organizations are focused on improving both health and financial outcomes. Addressing chronic illnesses involves more frequent and impactful interactions with both current patients and those at risk of developing a chronic condition. This transformation requires that healthcare organizations shift from a system based solely on in-person interactions to one that leverages digital solutions that support interactions regardless of the patients' location. Personal health record systems (PHRS) can facilitate patients' access to their health data at any time of the day, anywhere in the world. PHRS also offers a myriad of features to help providers' engage, educate and empower patients to make proactive and preventive care a reality. Discussed in this paper are the ways in which PHRS can support the optimal management of chronic conditions and the current barriers to widespread adoption.

  20. Promotion of Standard Treatment Guidelines and Building Referral System for Management of Common Noncommunicable Diseases in India

    Directory of Open Access Journals (Sweden)

    S K Jindal


    Full Text Available Treatment services constitute one of the five priority actions to face the global crisis due to noncommunicable diseases (NCDs. It is important to formulate standard treatment guidelines (STGs for an effective management, particularly at the primary and secondary levels of health care. Dissemination and implementation of STGs for NCDs on a country-wide scale involves difficult and complex issues. The management of NCDs and the associated costs are highly variable and huge. Besides the educational strategies for promotion of STGs, the scientific and administrative sanctions and sanctity are important for purposes of reimbursements, insurance, availability of facilities, and legal protection. An effective and functional referral- system needs to be built to ensure availability of appropriate care at all levels of health- services. The patient-friendly "to and fro" referral system will help to distribute the burden, lower the costs, and maintain the sustainability of services.

  1. Infectious disease surveillance in the 21st century: an integrated web-based surveillance and case management system. (United States)

    Troppy, Scott; Haney, Gillian; Cocoros, Noelle; Cranston, Kevin; DeMaria, Alfred


    The Massachusetts Virtual Epidemiologic Network (MAVEN) was deployed in 2006 by the Massachusetts Department of Public Health, Bureau of Infectious Disease to serve as an integrated, Web-based disease surveillance and case management system. MAVEN replaced program-specific, siloed databases, which were inaccessible to local public health and unable to integrate electronic reporting. Disease events are automatically created without human intervention when a case or laboratory report is received and triaged in real time to state and local public health personnel. Events move through workflows for initial notification, case investigation, and case management. Initial development was completed within 12 months and recent state regulations mandate the use of MAVEN by all 351 jurisdictions. More than 300 local boards of health are using MAVEN, there are approximately one million events, and 70 laboratories report electronically. MAVEN has demonstrated responsiveness and flexibility to emerging diseases while also streamlining routine surveillance processes and improving timeliness of notifications and data completeness, although the long-term resource requirements are significant.

  2. Periodontal Disease and Systemic Health (United States)

    ... Gum Disease and Other Diseases Gum Disease and Diabetes Gum Disease and Heart Disease Gum Disease and Other Systemic ... Gum Disease and Other Diseases Gum Disease and Diabetes Gum Disease and Heart Disease Gum Disease and Other Systemic ...

  3. Bridge Management Systems

    DEFF Research Database (Denmark)

    Thoft-Christensen, Palle

    In this paper bridge management systems are discussed with special emphasis on management systems for reinforced concrete bridges. Management systems for prestressed concrete bridges, steel bridges, or composite bridges can be developed in a similar way....

  4. The concept of psoriasis as a systemic inflammation: implications for disease management. (United States)

    Reich, K


    Psoriasis is a systemic, immune-mediated disorder, characterized by inflammatory skin and joint manifestations. A range of co-morbidities is associated with psoriasis, including metabolic diseases, such as diabetes, and psychological disorders. Although the systemic nature of psoriasis often remains unrecognized, the inflammatory processes involved may be associated with the development of co-morbidities, which, themselves, have a significant impact on the patient's health and quality of life. The relative risks of myocardial infarction (MI) and stroke are increased in patients with psoriasis compared with the general population. These are especially seen in younger patients with more severe disease, and are believed to contribute to the 3- to 4-year reduction in life expectancy among patients with severe psoriasis. The recent results of large studies indicate that the increased cardiovascular (CV) risk is at least partially attributable to psoriasis and independent of the presence of metabolic co-morbidities. The possible interplay between psoriasis and CV disease is complex. Metabolic diseases such as obesity and diabetes have overlapping genetic predispositions with psoriasis. Both conditions are likely to also interact at a functional level because obesity and the up-regulation of pro-inflammatory mediators in psoriasis appear to influence adipocyte homoeostasis, inducing non-professional immune functions. This may perpetuate psoriatic inflammation, displaying similarities to the immunopathogenesis of atherosclerosis. Finally, the disturbed adipokine profile and inflammation associated with psoriasis enhances insulin resistance, causing subsequent endothelial dysfunction, atherosclerosis and eventual coronary events. The differential contribution of psoriasis and uncontrolled classical CV risk factors to the increased CV risk seen in psoriasis patients is not clear. Successful treatment with methotrexate appears to lower the rates of MI in patients with

  5. A systematic review of prevalence, disease characteristics and management of systemic lupus erythematosus in Australia: identifying areas of unmet need. (United States)

    Nikpour, M; Bridge, J A; Richter, S


    Few epidemiological studies of systemic lupus erythematosus (SLE) have been conducted in Australia, and current management practice and levels of unmet need in this country are not well characterised. To perform a systematic literature review to identify Australia-specific information on SLE, particularly areas of unmet need. MEDLINE, EMBASE and the Cochrane Library were searched (1 January 1990 to 29 November 2013). All articles on prevalence, disease characteristics, management and outcomes of SLE in Australia were included. There is limited published information on SLE in Australia. Of 24 articles included, 18 described results from observational studies, three were narrative reviews, one was a clinical update, and two were medical education articles. In remote regions, SLE was reported to be more prevalent in Aboriginal Australians than non-Aboriginal Australians; information in urban populations is lacking. Asian Australians may be more affected by SLE than non-Asian Australians. Pregnancy outcomes may also be adversely affected. Many Australians with SLE may experience high levels of unmet need, including delayed diagnosis, ongoing symptoms, flares, depression/anxiety, sleeping difficulty and decreased quality of life. Published guidance on the SLE management in Australia is limited and dated. Published information on SLE in Australia is limited, but suggests that ethnicity may affect the prevalence and disease characteristics and that many Australians with SLE have unmet needs. Improvements in diagnosis, treatment and management are needed to alleviate these needs. Up-to-date guidance on the management of SLE would benefit healthcare professionals and patients. © 2014 The Authors; Internal Medicine Journal © 2014 Royal Australasian College of Physicians.

  6. Temporal dynamics of brown rot in different apple management systems and importance of dropped fruit for disease development. (United States)

    Holb, I J; Scherm, H


    ABSTRACT Epidemic development of brown rot, caused by Monilinia fructigena, was monitored in integrated and organic apple orchards at two locations in eastern Hungary between 2002 and 2005 on three cultivars with early, midseason, and late ripening periods. Disease incidence and severity measures were affected significantly (P system (organic versus integrated) and cultivar, but there was no significant management system-cultivar interaction. Epidemics started 2 to 4 weeks earlier in organic orchards and on the early cv. Prima compared with integrated orchards and the late cv. Mutsu. Disease intensity increased markedly in the final 3 to 5 weeks before harvest and was considerably lower in integrated than in organic orchards. Final brown rot incidence on fruit in the tree was correlated with incidence on dropped fruit on the orchard floor (r > 0.75, P < 0.05), whereby the lag period from the appearance of the first symptomatic fruit on the ground to the occurrence of the first symptomatic fruit in the tree ranged from 2 weeks to 2 months, depending on the cultivar. The inflection point of the disease progress curve was attained first by fruit on the ground, followed successively by fruit in the lower, middle, and upper thirds of the tree canopy. This may indicate that dropped fruit that became infected early provided a source of inoculum for subsequent epidemics by serving as a bridge between sporulation from overwintered fruit mummies in the spring and the first fruit with sporulating lesions in the tree in midsummer. Removal of dropped fruit from the orchard floor resulted in a significantly lower disease incidence on fruit in the tree on all cultivars; thus, drop-removal may be useful as a brown rot management practice in apple orchards.

  7. Informing physicians using a situated decision support system: Disease management for the smart city

    Directory of Open Access Journals (Sweden)

    Raafat George Saade


    Full Text Available We are in the midst of a healthcare paradigm shift driven by the wide adoption of ubiquitous computing and various modes of information communications technologies. As a result, cities worldwide are undergoing a major process of urbanization with ever increasing wealth of sensing capabilities – hence the Internet of Things (IoT. These trends impose great pressure on how healthcare is done. This paper describes the design and implementation of a situated clinical decision support (SCDSS system, most appropriate for smart cities. The SCDSS was prototyped and enhanced in a clinic. The SCDSS was then used in a clinic as well as in a university hospital centre. In this article, the system’s architecture, subcomponents and integrated workflow are described. The systems’ design was the result of a knowledge acquisition process involving interviews with five specialists and testing with 50 patients. The reports (specialist consultation report generated by the SCDSS were shown to general practitioners who were not able to distinguish them from human specialist reports. We propose a context-aware CDSS and assess its effectiveness in managing a wide medical range of patients. Five different patient cases were identified for analysis. The SCDSS was used to produce draft electronic specialist consultations, which were then compared to the original specialists’ consultations. It was found that the SCDSS-generated consults were of better quality for a number of reasons discussed herein. SCDSSs have great promise for their use in the clinical environment of smart cities. Valuable insights into the integration and use of situated clinical decision support systems are highlighted and suggestions for future research are given.

  8. Managing Your Parkinson's Disease (United States)

    ... Patient Advocates Sign Up for Funding News npj Parkinson's Disease Scientific Advisory Board Understanding Parkinson's Coping with a Diagnosis What is Parkinson’s Disease? National HelpLine Educational Publications Online Seminars Parkinson's News ...

  9. Pathological and Clinical Features and Management of Central Nervous System Hemangioblastomas in von Hippel-Lindau Disease

    Directory of Open Access Journals (Sweden)

    Hiroshi Kanno


    Full Text Available Central nervous system (CNS hemangioblastoma is the most common manifestation of von Hippel-Lindau (VHL disease. It is found in 70-80% of VHL patients. Hemangioblastoma is a rare form of benign vascular tumor of the CNS, accounting for 2.0% of CNS tumors. It can occur sporadically or as a familial syndrome. CNS hemangioblastomas are typically located in the posterior fossa and the spinal cord. VHL patients usually develop a CNS hemangioblastoma at an early age. Therefore, they require a special routine for diagnosis, treatment and follow-up. The surgical management of symptomatic tumors depends on many factors such as symptom, location, multiplicity, and progression of the tumor. The management of asymptomatic tumors in VHL patients is controversial since CNS hemangioblastomas grow with intermittent quiescent and rapid-growth phases. Preoperative embolization of large solid hemangioblastomas prevents perioperative hemorrhage but is not necessary in every case. Radiotherapy should be reserved for inoperable tumors. Because of complexities of VHL, a better understanding of the pathological and clinical features of hemangioblastoma in VHL is essential for its proper management.

  10. Exploring Health System Responsiveness in Ambulatory Care and Disease Management and its Relation to Other Dimensions of Health System Performance (RAC) - Study Design and Methodology. (United States)

    Röttger, Julia; Blümel, Miriam; Engel, Susanne; Grenz-Farenholtz, Brigitte; Fuchs, Sabine; Linder, Roland; Verheyen, Frank; Busse, Reinhard


    The responsiveness of a health system is considered to be an intrinsic goal of health systems and an essential aspect in performance assessment. Numerous studies have analysed health system responsiveness and related concepts, especially across different countries and health systems. However, fewer studies have applied the concept for the evaluation of specific healthcare delivery structures and thoroughly analysed its determinants within one country. The aims of this study are to assess the level of perceived health system responsiveness to patients with chronic diseases in ambulatory care in Germany and to analyse the determinants of health system responsiveness as well as its distribution across different population groups. The target population consists of chronically ill people in Germany, with a focus on patients suffering from type 2 diabetes and/or from coronary heart disease (CHD). Data comes from two different sources: (i) cross-sectional survey data from a postal survey and (ii) claims data from a German sickness fund. Data from both sources will be linked at an individual-level. The postal survey has the purpose of measuring perceived health system responsiveness, health related quality of life, experiences with disease management programmes (DMPs) and (subjective) socioeconomic background. The claims data consists of information on (co)morbidities, service utilization, enrolment within a DMP and sociodemographic characteristics, including the type of residential area. RAC is one of the first projects linking survey data on health system responsiveness at individual level with claims data. With this unique database, it will be possible to comprehensively analyse determinants of health system responsiveness and its relation to other aspects of health system performance assessment. The results of the project will allow German health system decision-makers to assess the performance of nonclinical aspects of healthcare delivery and their determinants in two

  11. Confronting inconsistencies in the amphibian-chytridiomycosis system: implications for disease management. (United States)

    Venesky, Matthew D; Raffel, Thomas R; McMahon, Taegan A; Rohr, Jason R


    Chytridiomycosis, caused by the pathogenic fungus Batrachochytrium dendrobatidis (Bd), is one of the largest threats to wildlife and is putatively linked to the extirpation of numerous amphibians. Despite over a decade of research on Bd, conflicting results from a number of studies make it difficult to forecast where future epizootics will occur and how to manage this pathogen effectively. Here, we emphasize how resolving these conflicts will advance Bd management and amphibian conservation efforts. We synthesize current knowledge on whether Bd is novel or endemic, whether amphibians exhibit acquired resistance to Bd, the importance of host resistance versus tolerance to Bd, and how biotic (e.g. species richness) and abiotic factors (e.g. climate change) affect Bd abundance. Advances in our knowledge of amphibian-chytrid interactions might inform the management of fungal pathogens in general, which are becoming more common and problematic globally. © 2013 The Authors. Biological Reviews © 2013 Cambridge Philosophical Society.

  12. Disease management strategies for wildlife. (United States)

    Wobeser, G


    Three basic forms of management strategies exist for wildlife disease, as follows: prevention of introduction of disease, control of existing disease or eradication. Management may be directed at the disease agent, host population, habitat or be focused on human activities. Disease agents may be dealt with in the environment through disinfection or in the host through treatment. Disinfection and pesticides used to destroy agents or vectors are limited to local situations, may have serious environmental effects and may result in acquired resistance. Difficulty in delivering treatment limits chemotherapy to local situations. Host populations may be managed by immunisation, by altering their distribution or density, or by extirpation. Immunisation is best suited for microparasitic exogenous infections with a low reproductive rate and in populations which have a low turnover. Mass immunisation with oral baits has been effective, but this strategy is limited to a few serious diseases. It is difficult to move wild animals and techniques to discourage animals from entering an area become ineffective rapidly. The setting up of fences is feasible only in local situations. Selective culling is limited to situations in which affected individuals are readily identifiable. General population reduction has had little success in disease control but reducing populations surrounding a focus or creating a barrier to disease movement have been successful. Population reduction is a temporary measure. Eradication of a wildlife population has not been attempted for disease management. Habitat modification may be used to reduce exposure to disease agents, or to alter host distribution or density. Management of diseases of wild animals usually requires a change in human activities. The most important method is by restricting translocation of wild animals to prevent movement of disease.

  13. Liver in systemic disease

    Institute of Scientific and Technical Information of China (English)


    Potential causes of abnormal liver function tests include viral hepatitis, alcohol intake, nonalcoholic fatty liver disease, autoimmune liver diseases, hereditary diseases, hepatobiliary malignancies or infection, gallstones and drug-induced liver injury. Moreover, the liver may be involved in systemic diseases that mainly affect other organs. Therefore, in patients without etiology of liver injury by screening serology and diagnostic imaging, but who have systemic diseases, the abnormal liver function test results might be caused by the systemic disease. In most of these patients, the systemic disease should be treated primarily. However, some patients with systemic disease and severe liver injury or fulminant hepatic failure require intensive treatments of the liver.

  14. New Directions in Chronic Disease Management

    Directory of Open Access Journals (Sweden)

    Hun-Sung Kim


    Full Text Available A worldwide epidemic of chronic disease, and complications thereof, is underway, with no sign of abatement. Healthcare costs have increased tremendously, principally because of the need to treat chronic complications of non-communicable diseases including cardiovascular disease, blindness, end-stage renal disease, and amputation of extremities. Current healthcare systems fail to provide an appropriate quality of care to prevent the development of chronic complications without additional healthcare costs. A new paradigm for prevention and treatment of chronic disease and the complications thereof is urgently required. Several clinical studies have clearly shown that frequent communication between physicians and patients, based on electronic data transmission from medical devices, greatly assists in the management of chronic disease. However, for various reasons, these advantages have not translated effectively into real clinical practice. In the present review, we describe current relevant studies, and trends in the use of information technology for chronic disease management. We also discuss limitations and future directions.

  15. Human Resource Management System


    Navaz, A. S. Syed; Fiaz, A. S. Syed; Prabhadevi, C.; V.Sangeetha; Gopalakrishnan,S.


    The paper titled HUMAN RESOURCE MANAGEMENT SYSTEM is basically concerned with managing the Administrator of HUMAN RESOURCE Department in a company. A Human Resource Management System, refers to the systems and processes at the intersection between human resource management and information technology. It merges HRM as a discipline and in particular its basic HR activities and processes with the information technology field, whereas the programming of data processing systems evolved into standa...

  16. Systems for the management of respiratory disease in primary care--an international series: South Africa. (United States)

    Bateman, Eric; Feldman, Charles; Mash, Robert; Fairall, Lara; English, Rene; Jithoo, Anamika


    Progress to democracy in South Africa in 1994 was followed by the adoption of a primary health care approach with free access for all. State health facilities serve 80% of the population, and a private sector comprising general practitioners, specialists and private hospitals, serves the remainder. NATIONAL POLICIES AND MODELS: There are national prescribing guidelines for common diseases, and these specify the medicines on the Essential Drugs List that are available at primary care facilities for respiratory diseases including asthma, COPD, pneumonia and tuberculosis. Asthma prevalence is average among children (13%) but morbidity is high. COPD rates are high owing to concurrent risk factors of smoking (in both men and women), occupational exposures, biomass fuel use and previous lung infections including tuberculosis. Tuberculosis and HIV are rampant, and together with pneumococcal co-infection account for considerable mortality. Primary care facilities are within reach of most communities, but major barriers to care include loss of income, waiting times in clinics, cost of transportation, and inconvenient hours. The country is divided into districts each served by a hospital, several community health centres and many fixed or mobile clinics. The latter provide predominantly nurse-led care by nurse practitioners with additional qualifications. Some clinics and most community health centres are served by doctors. Referrals are made to secondary and tertiary hospitals served by specialists. Innovations to address staff shortages include the creation of the specialty of family medicine for physicians and development of the clinical associate who is trained to perform a limited clinical role, as well as in-service on-site training of nurses through programmes of integrated care for infectious and chronic diseases. There is an urgent need to address low staff morale and medical migration resulting from a decade of poor leadership and AIDS denialism. The structures and

  17. Credit Management System (United States)

    US Agency for International Development — Credit Management System. Outsourced Internet-based application. CMS stores and processes data related to USAID credit programs. The system provides information...

  18. Acne and systemic disease. (United States)

    Lolis, Margarita S; Bowe, Whitney P; Shalita, Alan R


    Acne is the most common disease of the skin. It affects 85% of teenagers, 42.5% of men, and 50.9% of women between the ages of 20 and 30 years.96,97 The role of hormones, particularly as a trigger of sebum production and sebaceous growth and differentiation, is well known. Excess production of hormones, specifically androgens, GH, IGF-1, insulin, CRH, and glucocorticoids, is associated with increased rates of acne development. Acne may be a feature in many endocrine disorders, including polycystic ovary disease, Cushing syndrome, CAH, androgen-secreting tumors, and acromegaly. Other nonendocrine diseases associated with acne include Apert syndrome, SAPHO syndrome, Behçet syndrome and PAPA syndrome. Acne medicamentosa is the development of acne vulgaris or an acneiform eruption with the use of certain medications. These medications include testosterone, progesterone,steroids, lithium, phenytoin, isoniazid, vitamins B2, B6, and B12, halogens, and epidermal growth factor inhibitors. Management of acne medicamentosa includes standard acne therapy. Discontinuation of the offending drug may be necessary in recalcitrant cases. Basic therapeutic interventions for acne include topical therapy, systemic antibiotics,hormonal agents, isotretinoin, and physical treatments. Generally, the severity of acne lesions determines the type of acne regimen necessary. The emergence of drug-resistant P acnes and adverse side effects are current limitations to effective acne management.

  19. Management of Perthes′ disease

    Directory of Open Access Journals (Sweden)

    Benjamin Joseph


    Full Text Available The main complication of Perthes′ disease is femoral head deformation. Evidence from the literature highlights two important factors related to the cause and timing of this complication. (1 Extrusion of the femoral head appears to be a major factor that leads to femoral head deformation. (2 Deformation of the femoral head occurs in the latter part of the stage of fragmentation. The likelihood of preventing femoral head deformation is over 16 times higher if extrusion is reversed or prevented by the early stage of fragmentation than if done later. Several treatment options have been described in children who present later in the course of the disease but the outcomes of all these measures do not compare with those of early intervention.

  20. Health system responsiveness and chronic disease care - What is the role of disease management programs? An analysis based on cross-sectional survey and administrative claims data. (United States)

    Röttger, Julia; Blümel, Miriam; Linder, Roland; Busse, Reinhard


    Health system responsiveness is an important aspect of health systems performance. The concept of responsiveness relates to the interpersonal and contextual aspects of health care. While disease management programs (DMPs) aim to improve the quality of health care (e.g. by improving the coordination of care), it has not been analyzed yet whether these programs improve the perceived health system responsiveness. Our study aims to close this gap by analyzing the differences in the perceived health system responsiveness between DMP-participants and non-participants. We used linked survey- and administrative claims data from 7037 patients with coronary heart disease in Germany. Of those, 5082 were enrolled and 1955 were not enrolled in the DMP. Responsiveness was assessed with an adapted version of the WHO responsiveness questionnaire in a postal survey in 2013. The survey covered 9 dimensions of responsiveness and included 17 items for each, GP and specialist care. Each item had five answer categories (very good - very bad). We handled missing values in the covariates by multiple imputation and applied propensity score matching (PSM) to control for differences between the two groups (DMP/non-DMP). We used Wilcoxon-signed-rank and McNemar test to analyze differences regarding the reported responsiveness. The PSM led to a matched and well balanced sample of 1921 pairs. Overall, DMP-participants rated the responsiveness of care more positive. The main difference was found for the coordination of care at the GP, with 62.0% of 1703 non-participants reporting a "good" or "very good" experience, compared to 69.1% of 1703 participants (p < 0.001). The results of our study indicate an overall high responsiveness for CHD-care, as well for DMP-participants as for non-participants. Yet, the results also clearly indicate that there is still a need to improve the coordination of care. Copyright © 2017 Elsevier Ltd. All rights reserved.

  1. Celiac Disease Diagnosis and Management (United States)

    Leffler, Daniel


    Celiac disease is one of the most prevalent autoimmune gastrointestinal disorders but as the case of Ms. J illustrates, diagnosis is often delayed or missed. Based on serology studies, the prevalence of celiac disease in many populations is estimated to be approximately 1% and has been increasing steadily over the last 50 years. Evaluation for celiac disease is generally straightforward, and uses commonly available serologic tests, however the signs and symptoms of celiac disease are nonspecific and highly heterogeneous making diagnosis difficult. While celiac disease is often considered a mild disorder treatable with simple dietary changes, in reality celiac disease imparts considerable risks including reduced bone mineral density, impaired quality of life, and increased overall mortality. In addition, the gluten free diet is highly burdensome and can profoundly affect patients and their families. For these reasons, care of individuals with celiac disease requires prompt diagnosis and ongoing multidisciplinary management. PMID:21990301

  2. Potential of microemulsified entacapone drug delivery systems in the management of acute Parkinson's disease

    Institute of Scientific and Technical Information of China (English)

    Harini Chowdary Vadlamudi; Prasanna Raju Yalavarthi; Jyotsna Thanniru; Vandana KR; Sundaresan CR


    Objective: To design solid self-microemulsifying drug delivery system (S-SMEDDS) of entacapone and evaluate for its anti-Parkinson's potentials. Methods: Solubility studies were performed in various vehicles i.e., oils, surfactants and co-surfactants and pseudo-ternary phase diagrams were plotted to understand the microemulsion formation region. Liquid self-microemulsifying drug delivery systems (SMEDDS) were developed using gingelly and rice bran oil as lipid vehicles, Tween 80 and Span 20 as surfactants and glycerin, propylene glycol as co-surfactants. They were characterized by Fourier transform infrared spectroscopy, pH, viscosity, zeta potential, polydispersibility index and droplet size analysis and evaluated for drug content, in-vitro release, in-vitro diffusion and ex-vivo permeation. Optimized liquid SMEDDS were converted into S-SMEDDS by adsorption and melt granulation procedures. Character-ization by differential scanning calorimetry, SEM, micrometrics, reconstitution property, moisture content and evaluation by drug content, drug release kinetics and shelf-life were performed for S-SMEDDS. Parkinsonism was induced and pharmacodynamic potentials of S-SMEDDS were evaluated. Results: S-SMEDDS formulation AG8 had shown the highest drug release of 90.92%within 60 min. Pharmacodynamic studies also proved the efficiency of entacapone S-SMEDDS against Parkinsonism. Conclusions: Entacapone S-SMEDDS is an effective drug delivery system that offers more predictable and extensive drug release with enhanced shelf-life in the treatment of acute Parkinsonism.

  3. Evolving lipid-based delivery systems in the management of neoplastic disease

    Directory of Open Access Journals (Sweden)

    Iuliana Shapira


    Full Text Available Drug delivery systems for the therapeutic use of cytotoxic chemotherapy are an essential aspect of successful treatment and remain under active evaluation. Such systems offer advantages such as they can change the pharmacologic and pharmacodynamic properties of an active drug in preclinical screens to meet the needs of therapy in humans. For example, unstable or insoluble agents can be formulated in a manner to allow effective exposure in the tumor. Liposomal delivery systems are the most mature with regulatory approval for several liposomal preparations. The liposome is attractive as the charge, size, composition, and the payload (drug can be manipulated to enhance efficacy. Targeting agents such as antibodies, antibody fragments, or ligands can be incorporated into the liposomal structure to enhance specificity. The liposome can be manipulated to be thermal or pH sensitive. In addition, variations of the liposome can incorporate more than one agent and also allow for sequential exposure of the active agents to the tumor. Additional lipid formulations include micelles and nanocochleates, which are earlier in development, but many offer an alternative to liposomal technology. The size, shape, adducts, and composition of the micelles may offer more flexibility in the delivery platform. Further clinical trials are eagerly awaited.

  4. Humanoid Intelligent Management System

    Institute of Scientific and Technical Information of China (English)

    DU Jun-ping; TU Xu-yan


    This paper proposes a concept and design strategy for the humanoid intelligent management system (HIMS) based on artificial life. Various topics are discussed including the design method and implementation techniques for the dual management scheme (DMS), humanoid intelligent management model (HIMM), central-decentralized management pattern, and multi-grade coordination function.


    DEFF Research Database (Denmark)

    Glintborg, Dorte; Andersen, Marianne


    than 50% patients with PCOS, these factors along with hyperandrogenism could have adverse effects on long term health. Hyperinflammation and impaired epithelial function were reported to a larger extent in women with PCOS and could particularly be associated with hyperandrogenism, obesity and insulin...... controls within all diagnose categories including antibiotics. The causal relationship between PCOS and autoimmune disease represents an interesting new area of research. PCOS is a lifelong condition and long term morbidity could be worsened by obesity, sedentary way of life, western style diet and smoking......, whereas lifestyle intervention including weight loss may partly or fully resolve the symptoms of PCOS and could improve the long term prognosis. In this review the possible implications of increased morbidity for the clinical and biochemical evaluation of patients with PCOS at diagnosis and follow up...

  6. Exploration of the financing and management model of a children's critical disease security system in China based on the implementation of Shanghai Children Hospital Care Aid

    Institute of Scientific and Technical Information of China (English)

    ZHANG Zhi-ruo; WEN Zhao-jun; CHEN Sai-juan; CHEN Zhu


    This study is designed to serve as a reference for the establishment of health security systems for children's critical diseases. Through analysis of the operation of Shanghai Children Hospital Care Aid (SCHCA), this study explored the financing model and management of a children's critical disease healthcare system and analyzed the possibility of expanding this system to other areas. It is found that a premium as Iow as RMB 7 per capita per year under SCHCA can provide high-level security for children's critical diseases. With the good experience in Shanghai and based on the current basic medical insurance system for urban residents and the new rural cooperative medical scheme (NRCMS), it is necessary and feasible to build a health security system for children's critical diseases at the national level.

  7. Evaluation of a chronic disease management system for the treatment and management of diabetes in primary health care practices in Ontario: an observational study. (United States)

    O'Reilly, D J; Bowen, J M; Sebaldt, R J; Petrie, A; Hopkins, R B; Assasi, N; MacDougald, C; Nunes, E; Goeree, R


    Computerized chronic disease management systems (CDMSs), when aligned with clinical practice guidelines, have the potential to effectively impact diabetes care. The objective was to measure the difference between optimal diabetes care and actual diabetes care before and after the introduction of a computerized CDMS. This 1-year, prospective, observational, pre/post study evaluated the use of a CDMS with a diabetes patient registry and tracker in family practices using patient enrolment models. Aggregate practice-level data from all rostered diabetes patients were analyzed. The primary outcome measure was the change in proportion of patients with up-to-date "ABC" monitoring frequency (i.e., hemoglobin A1c, blood pressure, and cholesterol). Changes in the frequency of other practice care and treatment elements (e.g., retinopathy screening) were also determined. Usability and satisfaction with the CDMS were measured. Nine sites, 38 health care providers, and 2,320 diabetes patients were included. The proportion of patients with up-to-date ABC (12%), hemoglobin A1c (45%), and cholesterol (38%) monitoring did not change over the duration of the study. The proportion of patients with up-to-date blood pressure monitoring improved, from 16% to 20%. Data on foot examinations, retinopathy screening, use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, and documentation of self-management goals were not available or not up to date at baseline for 98% of patients. By the end of the study, attitudes of health care providers were more negative on the Training, Usefulness, Daily Practice, and Support from the Service Provider domains of the CDMS, but more positive on the Learning, Using, Practice Planning, CDMS, and Satisfaction domains. Few practitioners used the CDMS, so it was difficult to draw conclusions about its efficacy. Simply giving health care providers a potentially useful technology will not ensure its use. This real-world evaluation of a

  8. Evaluation of a Chronic Disease Management System for the Treatment and Management of Diabetes in Primary Health Care Practices in Ontario (United States)

    DJ, O’Reilly; JM, Bowen; RJ, Sebaldt; A, Petrie; RB, Hopkins; N, Assasi; C, MacDougald; E, Nunes; R, Goeree


    Background Computerized chronic disease management systems (CDMSs), when aligned with clinical practice guidelines, have the potential to effectively impact diabetes care. Objective The objective was to measure the difference between optimal diabetes care and actual diabetes care before and after the introduction of a computerized CDMS. Methods This 1-year, prospective, observational, pre/post study evaluated the use of a CDMS with a diabetes patient registry and tracker in family practices using patient enrolment models. Aggregate practice-level data from all rostered diabetes patients were analyzed. The primary outcome measure was the change in proportion of patients with up-to-date “ABC” monitoring frequency (i.e., hemoglobin A1c, blood pressure, and cholesterol). Changes in the frequency of other practice care and treatment elements (e.g., retinopathy screening) were also determined. Usability and satisfaction with the CDMS were measured. Results Nine sites, 38 health care providers, and 2,320 diabetes patients were included. The proportion of patients with up-to-date ABC (12%), hemoglobin A1c (45%), and cholesterol (38%) monitoring did not change over the duration of the study. The proportion of patients with up-to-date blood pressure monitoring improved, from 16% to 20%. Data on foot examinations, retinopathy screening, use of angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers, and documentation of self-management goals were not available or not up to date at baseline for 98% of patients. By the end of the study, attitudes of health care providers were more negative on the Training, Usefulness, Daily Practice, and Support from the Service Provider domains of the CDMS, but more positive on the Learning, Using, Practice Planning, CDMS, and Satisfaction domains. Limitations Few practitioners used the CDMS, so it was difficult to draw conclusions about its efficacy. Simply giving health care providers a potentially useful technology

  9. Prevention and management of chronic disease: a litmus test for health-systems strengthening in low-income and middle-income countries. (United States)

    Samb, Badara; Desai, Nina; Nishtar, Sania; Mendis, Shanti; Bekedam, Henk; Wright, Anna; Hsu, Justine; Martiniuk, Alexandra; Celletti, Francesca; Patel, Kiran; Adshead, Fiona; McKee, Martin; Evans, Tim; Alwan, Ala; Etienne, Carissa


    National health systems need strengthening if they are to meet the growing challenge of chronic diseases in low-income and middle-income countries. By application of an accepted health-systems framework to the evidence, we report that the factors that limit countries' capacity to implement proven strategies for chronic diseases relate to the way in which health systems are designed and function. Substantial constraints are apparent across each of the six key health-systems components of health financing, governance, health workforce, health information, medical products and technologies, and health-service delivery. These constraints have become more evident as development partners have accelerated efforts to respond to HIV, tuberculosis, malaria, and vaccine-preventable diseases. A new global agenda for health-systems strengthening is arising from the urgent need to scale up and sustain these priority interventions. Most chronic diseases are neglected in this dialogue about health systems, despite the fact that non-communicable diseases (most of which are chronic) will account for 69% of all global deaths by 2030 with 80% of these deaths in low-income and middle-income countries. At the same time, advocates for action against chronic diseases are not paying enough attention to health systems as part of an effective response. Efforts to scale up interventions for management of common chronic diseases in these countries tend to focus on one disease and its causes, and are often fragmented and vertical. Evidence is emerging that chronic disease interventions could contribute to strengthening the capacity of health systems to deliver a comprehensive range of services-provided that such investments are planned to include these broad objectives. Because effective chronic disease programmes are highly dependent on well-functioning national health systems, chronic diseases should be a litmus test for health-systems strengthening.

  10. Integrated management systems

    CERN Document Server

    Bugdol, Marek


    Examining the challenges of integrated management, this book explores the importance and potential benefits of using an integrated approach as a cross-functional concept of management. It covers not only standardized management systems (e.g. International Organization for Standardization), but also models of self-assessment, as well as different types of integration. Furthermore, it demonstrates how processes and systems can be integrated, and how management efficiency can be increased. The major part of this book focuses on management concepts which use integration as a key tool of management processes (e.g. the systematic approach, supply chain management, virtual and network organizations, processes management and total quality management). Case studies, illustrations, and tables are also provided to exemplify and illuminate the content, as well as examples of successful and failed integrations. Providing a particularly useful resource to managers and specialists involved in the improvement of organization...

  11. Team management of Parkinson's disease. (United States)

    Davis, J C


    This report describes a multidisciplinary approach to the treatment of Parkinson's disease. By using published sources, the disease process, clinical findings, and medical management of Parkinson's disease are reviewed. The continual change in the clinical picture as well as the therapeutic needs require that clinicians have a full understanding of the disease and drugs used. This is followed by a description of a group program, including the evaluation process, treatment goals, and individual and group activities employed. Rehabilitation services are needed as medical management alone is not sufficient to maintain patient's daily living skills. The occupational therapist is skilled in assessment and training of activities for daily living. As a result, occupational therapy can be an integral part of the treatment program.

  12. Logistics Management Information System

    Institute of Scientific and Technical Information of China (English)


    The logistics information is the logistics manageme nt 's inevitable request. The paper introduces several kinds of logistics informat ion system and their functions in the logistics management, such as the warehous e management system (WMS) in the delivery center, the control system for transpo rtation and delivery, the supply chain management (SCM), the optimization of th e logistics system, etc. In the author's opinion, the development of logistics could been divided into four phases. And the logistic...

  13. Content management systems (CMS)


    Oriahi, Harrison


    This thesis describes the three most common and widely used content management systems (CMS) used to power several millions of business websites on the internet. Since there are many other content managements systems online, this report provides some helpful guides on each of the three most used systems and the web design projects that each of them maybe most suitable. There are plenty of options when it comes to selecting a content management system for a development project and this the...

  14. Audit Information Management System (United States)

    US Agency for International Development — USAID/OIG has initiated its new Audit Information Management System (AIMS) to track OIG's audit recommendations and USAID's management decisions. OIG's in-house...

  15. Digital Identity Management Systems


    Kuhar, Marko


    The goal of this thesis is a review of existing systems and technologies for managing digital identities. After the selection of the two most promising systems there will be a detailed comparison for a typical environment. In the first part of my thesis, the theory for understanding issues of identity management is introduced. Furthermore, the difference between identity and digital identity is explained and identity management itself is interpreted. An example of identity management solut...

  16. Information systems project management

    CERN Document Server

    Olson, David


    Information Systems Project Management addresses project management in the context of information systems. It deals with general project management principles, with focus on the special characteristics of information systems. It is based on an earlier text, but shortened to focus on essential project management elements.This updated version presents various statistics indicating endemic problems in completing information system projects on time, within budget, at designed functionality. While successful completion of an information systems project is a challenge, there are some things that ca

  17. Medication therapy disease management: Geisinger's approach to population health management. (United States)

    Jones, Laney K; Greskovic, Gerard; Grassi, Dante M; Graham, Jove; Sun, Haiyan; Gionfriddo, Michael R; Murray, Michael F; Manickam, Kandamurugu; Nathanson, Douglas C; Wright, Eric A; Evans, Michael A


    Pharmacists' involvement in a population health initiative focused on chronic disease management is described. Geisinger Health System has cultivated a culture of innovation in population health management, as highlighted by its ambulatory care pharmacy program, the Medication Therapy Disease Management (MTDM) program. Initiated in 1996, the MTDM program leverages pharmacists' pharmacotherapy expertise to optimize care and improve outcomes. MTDM program pharmacists are trained and credentialed to manage over 16 conditions, including atrial fibrillation (AF) and multiple sclerosis (MS). Over a 15-year period, Geisinger Health Plan (GHP)-insured patients with AF whose warfarin therapy was managed by the MTDM program had, on average, 18% fewer emergency department (ED) visits and 18% fewer hospitalizations per year than GHP enrollees with AF who did not receive MTDM services, with 23% lower annual total care costs. Over a 2-year period, GHP-insured patients with MS whose pharmacotherapy was managed by pharmacists averaged 28% fewer annual ED visits than non-pharmacist-managed patients; however, the mean annual total care cost was 21% higher among MTDM clinic patients. The Geisinger MTDM program has evolved over 20 years from a single pharmacist-run anticoagulation clinic into a large program focused on managing the health of an ever-growing population. Initial challenges in integrating pharmacists into the Geisinger patient care framework as clinical experts were overcome by demonstrating the MTDM program's positive impact on patient outcomes. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  18. Better Management of Alcohol Liver Disease Using a ‘Microstructured Synbox’ System Comprising L. plantarum and EGCG (United States)

    Rishi, Praveen; Arora, Sumeha; Kaur, Ujjwal Jit; Chopra, Kanwaljit; Kaur, Indu Pal


    Synergistic combination of probiotics with carbohydrate based prebiotics is widely employed for the treatment of various gut related disorders. However, such carbohydrate based prebiotics encourage the growth of pathogens and probiotics, equally. Aim of the study was (i) to explore the possibility of using epigallocatechin gallate (EGCG) a phenolic compound, as a prebiotic for L.plantarum; (ii) to develop and evaluate a microstructured synbox (microencapsulating both probiotic and EGCG together) in rat model of alcohol liver disease (ALD); and, (iii) to confirm whether the combination can address issues of EGCG bioavailability and probiotic survivability in adverse gut conditions. Growth enhancing effect of EGCG on L. plantarum (12.8±0.5 log 10 units) was significantly (p≤0.05) better than inulin (11.4±0.38 log 10 units), a natural storage carbohydrate. The formulated synbox significantly modulated the levels of alcohol, endotoxin, hepatic enzymes and restored the hepatoarchitecture in comparison to simultaneous administration of free agents. Additionally, using a battery of techniques, levels of various cellular and molecular markers viz. NF-kB/p50, TNF-α, IL12/p40, and signalling molecules TLR4, CD14, MD2, MyD88 and COX-2 were observed to be suppressed. Developed microbead synbox, as a single delivery system for both the agents showed synergism and hence, holds promise as a therapeutic option for ALD management. PMID:28060832

  19. Management of active Crohn disease. (United States)

    Cheifetz, Adam S


    Treatment of Crohn disease is rapidly evolving, with the induction of novel biologic therapies and newer, often more intensive treatment approaches. Knowing how to treat individual patients in this quickly changing milieu can be a challenge. To review the diagnosis and management of moderate to severe Crohn disease, with a focus on newer treatments and goals of care. MEDLINE was searched from 2000 to 2011. Additional citations were procured from references of select research and review articles. Evidence was graded using the American Heart Association level-of-evidence guidelines. Although mesalamines are still often used to treat Crohn disease, the evidence for their efficacy is lacking. Corticosteroids can be effectively used to induce remission in moderate to severe Crohn disease, but they do not maintain remission. The mainstays of treatment are immunomodulators and biologics, particularly anti-tumor necrosis factor. Immunomodulators and biologics are now the preferred treatment options for Crohn disease.

  20. Scalable Content Management System

    Directory of Open Access Journals (Sweden)

    Sandeep Krishna S, Jayant Dani


    Full Text Available Immense growth in the volume of contents every day demands more scalable system to handle and overcome difficulties in capture, storage, transform, search, sharing and visualization of data, where the data can be a structured or unstructured data of any type. A system to manage the growing contents and overcome the issues and complexity faced using appropriate technologies would advantage over measurable qualities like flexibility, interoperability, customizability, security, auditability, quality, community support, options and cost of licensing. So architecting aContent Management System in terms of enterprise needs and a scalable solution to manage the huge data growth necessitates a Scalable Content Management System.

  1. Facility Environmental Management System (United States)

    Federal Laboratory Consortium — This is the Web site of the Federal Highway Administration's (FHWA's) Turner-Fairbank Highway Research Center (TFHRC) facility Environmental Management System (EMS)....

  2. Learning Content Management Systems

    Directory of Open Access Journals (Sweden)



    Full Text Available The paper explains the evolution of e-Learning and related concepts and tools and its connection with other concepts such as Knowledge Management, Human Resources Management, Enterprise Resource Planning, and Information Technology. The paper also distinguished Learning Content Management Systems from Learning Management Systems and Content Management Systems used for general web-based content. The newest Learning Content Management System, very expensive and yet very little implemented is one of the best tools that helps us to cope with the realities of the 21st Century in what learning concerns. The debates over how beneficial one or another system is for an organization, can be driven by costs involved, efficiency envisaged, and availability of the product on the market.

  3. Management of hair loss diseases

    Directory of Open Access Journals (Sweden)

    Manabu Ohyama


    Full Text Available The treatment of hair loss diseases is sometimes difficult because of insufficient efficacy and limited options. However, recent advances in understanding of the pathophysiology and development of new remedies have improved the treatment of refractory hair loss conditions. In this article, an update on the management of hair loss diseases is provided, especially focusing on recently reported therapeutic approaches for alopecia areata (AA. An accurate diagnosis is indispensable to optimize treatment. Dry dermoscopy represents new diagnostic techniques, which could enable the differentiation of barely indistinguishable alopecias, e.g. AA and trichotillomania. An organized scalp biopsy adopting both vertical and transverse sectioning approaches also provides a deep insight into the pathophysiology of ongoing alopecias. Among various treatments for AA, intraregional corticosteroid and contact immunotherapy have been recognized as first-line therapies. However, some AA cases are refractory to both treatments. Recent studies have demonstrated the efficacy of pulse corticosteroid therapy or the combination of oral psoralen ultraviolet A therapy and systemic corticosteroids for severe AA. Previous clinical observations have suggested the potential role of antihistamines as supportive medications for AA. Experimental evaluation using AA model mice further supports their effectiveness in AA treatment. Finasteride opens up new possibilities for the treatment of androgenetic alopecia. For androgenetic alopecia patients refractory to finasteride, the combination of finasteride with topical minoxidil or the administration of dutasteride, another 5 alpha-reductase inhibitor, may provide better outcomes. Scarring alopecia is the most difficult form of hair loss disorder to treat. The bulge stem cell area is destroyed by unnecessary immune reactions with resultant permanent loss of hair follicle structures in scarring alopecia. Currently, treatment options for

  4. A model to evaluate quality and effectiveness of disease management. (United States)

    Lemmens, K M M; Nieboer, A P; van Schayck, C P; Asin, J D; Huijsman, R


    Disease management has emerged as a new strategy to enhance quality of care for patients suffering from chronic conditions, and to control healthcare costs. So far, however, the effects of this strategy remain unclear. Although current models define the concept of disease management, they do not provide a systematic development or an explanatory theory of how disease management affects the outcomes of care. The objective of this paper is to present a framework for valid evaluation of disease-management initiatives. The evaluation model is built on two pillars of disease management: patient-related and professional-directed interventions. The effectiveness of these interventions is thought to be affected by the organisational design of the healthcare system. Disease management requires a multifaceted approach; hence disease-management programme evaluations should focus on the effects of multiple interventions, namely patient-related, professional-directed and organisational interventions. The framework has been built upon the conceptualisation of these disease-management interventions. Analysis of the underlying mechanisms of these interventions revealed that learning and behavioural theories support the core assumptions of disease management. The evaluation model can be used to identify the components of disease-management programmes and the mechanisms behind them, making valid comparison feasible. In addition, this model links the programme interventions to indicators that can be used to evaluate the disease-management programme. Consistent use of this framework will enable comparisons among disease-management programmes and outcomes in evaluation research.

  5. An easy to use and affordable home-based personal eHealth system for chronic disease management based on free open source software. (United States)

    Burkow, Tatjana M; Vognild, Lars K; Krogstad, Trine; Borch, Njål; Ostengen, Geir; Bratvold, Astrid; Risberg, Marijke Jongsma


    This paper describes an easy to use home-based eHealth system for chronic disease management. We present the design and implementation of a prototype for home based education, exercises, treatment and following-up, with the TV and a remote control as user interface. We also briefly describe field trials of the system for patients with COPD and diabetes, and their experience with the technology.

  6. NASA's Risk Management System (United States)

    Perera, Jeevan S.


    Phased-approach for implementation of risk management is necessary. Risk management system will be simple, accessible and promote communication of information to all relevant stakeholders for optimal resource allocation and risk mitigation. Risk management should be used by all team members to manage risks - not just risk office personnel. Each group/department is assigned Risk Integrators who are facilitators for effective risk management. Risks will be managed at the lowest-level feasible, elevate only those risks that require coordination or management from above. Risk informed decision making should be introduced to all levels of management. ? Provide necessary checks and balances to insure that risks are caught/identified and dealt with in a timely manner. Many supporting tools, processes & training must be deployed for effective risk management implementation. Process improvement must be included in the risk processes.

  7. Movement disorders in systemic diseases. (United States)

    Poewe, Werner; Djamshidian-Tehrani, Atbin


    Movement disorders, classically involving dysfunction of the basal ganglia commonly occur in neurodegenerative and structural brain disorders. At times, however, movement disorders can be the initial manifestation of a systemic disease. In this article we discuss the most common movement disorders which may present in infectious, autoimmune, paraneoplastic, metabolic and endocrine diseases. Management often has to be multidisciplinary involving primary care physicians, neurologists, allied health professionals including nurses, occupational therapists and less frequently neurosurgeons. Recognizing and treating the underlying systemic disease is important in order to improve the neurological symptoms.

  8. Quality Management and Integrated Management System



    Graduation theses is directed on the Management System and the characteristics of the company and its development since 2003. Theses is introduced on the Integrated Management System, which consists of the Quality Management System, the Environmental Management System and the Occupational Health and Safety Assessment Series. The theses is especially directed on the Occupational Health and Safety Assessment Series. Management System is analyzed and steps are recommended to improve these proces...

  9. Dynamic performance management system

    Institute of Scientific and Technical Information of China (English)


    An integrated, efficient and effective performance management system, "dynamic performance management system", is presented, which covers the entire performance management process including measures design, analysis, and dynamic update. The analysis of performance measures using causal loop diagrams, qualitative inference and analytic network process is mainly discussed. A real world case study is carried out throughout the paper to explain how the framework works. A software tool for DPMS, Performance Analyzer, is also introduced.

  10. [Perioperative management of Parkinson's disease]. (United States)

    Mariscal, A; Medrano, I Hernández; Cánovas, A Alonso; Lobo, E; Loinaz, C; Vela, L; Espiga, P García-Ruiz; Castrillo, J C Martínez


    One of the particular characteristics of Parkinson's disease (PD) is the wide clinical variation as regards the treatment that can be found in the same patient. This occurs with specific treatment for PD, as well as with other drug groups that can make motor function worse. For this reason, the perioperative management of PD requires experience and above all appropriate planning. In this article, the peculiarities of PD and its treatment are reviewed, and a strategy is set out for the perioperative management of these patients. Copyright © 2010 Sociedad Española de Neurología. Published by Elsevier Espana. All rights reserved.

  11. Medical Information Management System (United States)

    Alterescu, S.; Hipkins, K. R.; Friedman, C. A.


    On-line interactive information processing system easily and rapidly handles all aspects of data management related to patient care. General purpose system is flexible enough to be applied to other data management situations found in areas such as occupational safety data, judicial information, or personnel records.

  12. Anesthesia information management systems. (United States)

    Williams, Joe R


    Documentation is the last component of anesthesia patient management to be affected by technology. Anesthesia information management systems (AIMS) have been introduced in a limited number of practice sites. The automated systems provide unbiased reporting of most patient information. This results in improved patient care and possible medical legal advantages. AIMS also allow anesthesia departments to monitor their business related activity.

  13. Management Systems in Education. (United States)

    Wagner, Ivan D.

    Management systems have been adapted for educational administration in response to the need for quality of educational opportunity, collective bargaining, school district consolidation, decreasing enrollments, accountability laws, limited financial resources, and participatory decision-making. Management systems adapted, not adopted, from business…

  14. Lithium battery management system (United States)

    Dougherty, Thomas J [Waukesha, WI


    Provided is a system for managing a lithium battery system having a plurality of cells. The battery system comprises a variable-resistance element electrically connected to a cell and located proximate a portion of the cell; and a device for determining, utilizing the variable-resistance element, whether the temperature of the cell has exceeded a predetermined threshold. A method of managing the temperature of a lithium battery system is also included.

  15. Cyberphysical systems for epilepsy and related brain disorders multi-parametric monitoring and analysis for diagnosis and optimal disease management

    CERN Document Server

    Antonopoulos, Christos


    This book introduces a new cyberphysical system that combines clinical and basic neuroscience research with advanced data analysis and medical management tools for developing novel applications for the management of epilepsy. The authors describe the algorithms and architectures needed to provide ambulatory, diagnostic and long-term monitoring services, through multi parametric data collection. Readers will see how to achieve in-hospital quality standards, addressing conventional “routine” clinic-based service purposes, at reduced cost, enhanced capability, and increased geographical availability. The cyberphysical system described in this book is flexible, can be optimized for each patient, and is demonstrated in several case studies.

  16. Role of the New South Wales Department of Primary Industries' Laboratory Information Management System (LIMS) in the 2007 equine influenza emergency animal disease response. (United States)

    Croft, M G; Fraser, G C; Gaul, W N


    A Laboratory Information Management System (LIMS) was used to manage the laboratory data and support planning and field activities as part of the response to the equine influenza outbreak in Australia in 2007. The database structure of the LIMS and the system configurations that were made to best handle the laboratory implications of the disease response are discussed. The operational aspects of the LIMS and the related procedures used at the laboratory to process the increased sample throughput are reviewed, as is the interaction of the LIMS with other corporate systems used in the management of the response. Outcomes from this tailored configuration and operation of the LIMS resulted in effective provision and control of the laboratory and laboratory information aspects of the response. The extent and immediate availability of the information provided from the LIMS was critical to some of the activities of key operatives involved in controlling the response.

  17. Operations management system (United States)

    Brandli, A. E.; Eckelkamp, R. E.; Kelly, C. M.; Mccandless, W.; Rue, D. L.


    The objective of an operations management system is to provide an orderly and efficient method to operate and maintain aerospace vehicles. Concepts are described for an operations management system and the key technologies are highlighted which will be required if this capability is brought to fruition. Without this automation and decision aiding capability, the growing complexity of avionics will result in an unmanageable workload for the operator, ultimately threatening mission success or survivability of the aircraft or space system. The key technologies include expert system application to operational tasks such as replanning, equipment diagnostics and checkout, global system management, and advanced man machine interfaces. The economical development of operations management systems, which are largely software, will require advancements in other technological areas such as software engineering and computer hardware.

  18. Relationships of crop and soil management systems to meteorological variables and potato diseases on a Russet burbank cultivar (United States)

    Crop, soil and water management systems may alter microclimatic conditions and affect plant growth and pest dynamics. However, the extent to which meteorological variables of potato canopy may be impacted in a humid temperate region has not been adequately ascertained. Field plots of a Russet Burban...

  19. Management Information Systems Research. (United States)

    Research on management information systems is illusive in many respects. Part of the basic research problem in MIS stems from the absence of standard...definitions and the lack of a unified body of theory. Organizations continue to develop large and often very efficient information systems , but...decision making. But the transition from these results to the realization of ’satisfactory’ management information systems remains difficult indeed. The

  20. Systems engineering management plans.

    Energy Technology Data Exchange (ETDEWEB)

    Rodriguez, Tamara S.


    The Systems Engineering Management Plan (SEMP) is a comprehensive and effective tool used to assist in the management of systems engineering efforts. It is intended to guide the work of all those involved in the project. The SEMP is comprised of three main sections: technical project planning and control, systems engineering process, and engineering specialty integration. The contents of each section must be tailored to the specific effort. A model outline and example SEMP are provided. The target audience is those who are familiar with the systems engineering approach and who have an interest in employing the SEMP as a tool for systems management. The goal of this document is to provide the reader with an appreciation for the use and importance of the SEMP, as well as provide a framework that can be used to create the management plan.

  1. Targeting the non-neuronal cholinergic system in macrophages for the management of infectious diseases and cancer: challenge and promise (United States)

    Reichrath, Sandra; Reichrath, Jörg; Moussa, Amira-Talaat; Meier, Carola; Tschernig, Thomas


    Macrophages represent key players of the immune system exerting highly effective defense mechanisms against microbial infections and cancer that include phagocytosis and programmed cell removal. Recent findings highlight the relevance of the non-neuronal cholinergic system for the regulation of macrophage function that opens promising new concepts for the treatment of infectious diseases and cancer. This mini review summarizes our present knowledge on this topic and gives an outlook on future developments.

  2. TATTOO Data management system


    Kryvytskyy, Denys


    English: The present document is a Tattoo data management system memory. It is a final master project developed in a real world company Logoscript S.L. The objective of the project was to centralize and automate Logoscript S.L. data management.

  3. Immunosuppression and Chagas disease: a management challenge.

    Directory of Open Access Journals (Sweden)

    María-Jesús Pinazo

    Full Text Available Immunosuppression, which has become an increasingly relevant clinical condition in the last 50 years, modifies the natural history of Trypanosoma cruzi infection in most patients with Chagas disease. The main goal in this setting is to prevent the consequences of reactivation of T. cruzi infection by close monitoring. We analyze the relationship between Chagas disease and three immunosuppressant conditions, including a description of clinical cases seen at our center, a brief review of the literature, and recommendations for the management of these patients based on our experience and on the data in the literature. T. cruzi infection is considered an opportunistic parasitic infection indicative of AIDS, and clinical manifestations of reactivation are more severe than in acute Chagas disease. Parasitemia is the most important defining feature of reactivation. Treatment with benznidazole and/or nifurtimox is strongly recommended in such cases. It seems reasonable to administer trypanocidal treatment only to asymptomatic immunosuppressed patients with detectable parasitemia, and/or patients with clinically defined reactivation. Specific treatment for Chagas disease does not appear to be related to a higher incidence of neoplasms, and a direct role of T. cruzi in the etiology of neoplastic disease has not been confirmed. Systemic immunosuppressive diseases or immunosuppressants can modify the natural course of T. cruzi infection. Immunosuppressive doses of corticosteroids have not been associated with higher rates of reactivation of Chagas disease. Despite a lack of evidence-based data, treatment with benznidazole or nifurtimox should be initiated before immunosuppression where possible to reduce the risk of reactivation. Timely antiparasitic treatment with benznidazole and nifurtimox (or with posaconazole in cases of therapeutic failure has proven to be highly effective in preventing Chagas disease reactivation, even if such treatment has not been

  4. Portfolio Management System (United States)

    US Agency for International Development — PfMS is an implementation of WorkLenz. WorkLenz is USAID's portfolio management system tool. It is a commercially available, off-the-shelf (COTS) package that...

  5. Earned Value Management System (United States)

    US Agency for International Development — EVMS is a system for measuring project performance and progress in an objective manner by supporting earned value management. EVMS has the ability to combine...

  6. Intranet Document Management Systems. (United States)

    Wen, H. Joseph; Yen, David C.; Lin, Binshan


    Explains how intranets facilitate documentation availability within a company at substantial cost savings. Topics include intranet document management systems (IDMS); publication costs for printed materials; hardware and software specifications; performance; and security. (Author/LRW)

  7. A distribution management system

    Energy Technology Data Exchange (ETDEWEB)

    Verho, P.; Jaerventausta, P.; Kaerenlampi, M.; Paulasaari, H. [Tampere Univ. of Technology (Finland); Partanen, J. [Lappeenranta Univ. of Technology (Finland)


    The development of new distribution automation applications is considerably wide nowadays. One of the most interesting areas is the development of a distribution management system (DMS) as an expansion of the traditional SCADA system. At the power transmission level such a system is called an energy management system (EMS). The idea of these expansions is to provide supporting tools for control center operators in system analysis and operation planning. The needed data for new applications is mainly available in some existing systems. Thus the computer systems of utilities must be integrated. The main data source for the new applications in the control center are the AM/FM/GIS (i.e. the network database system), the SCADA, and the customer information system (CIS). The new functions can be embedded in some existing computer system. This means a strong dependency on the vendor of the existing system. An alternative strategy is to develop an independent system which is integrated with other computer systems using well-defined interfaces. The latter approach makes it possible to use the new applications in various computer environments, having only a weak dependency on the vendors of the other systems. In the research project this alternative is preferred and used in developing an independent distribution management system

  8. Management systems and software. (United States)

    Levin, R P


    To ensure that your software optimizes your practice management systems, design systems that allow you and your team to achieve your goals and provide high levels of quality dentistry and customer service to your patients. Then use your current software system or purchase a new practice management software program that will allow your practice to operate within the guidelines of the systems which you have established. You can be certain that taking these steps will allow you to practice dentistry with maximum profitability and minimum stress for the remainder of your career.

  9. Critical appraisal of rotigotine transdermal system in management of Parkinson’s disease and restless legs syndrome – patient considerations

    Directory of Open Access Journals (Sweden)

    Kesayan T


    Full Text Available Tigran Kesayan,1 Jessica D Shaw,1 Tracy M Jones,1 Joseph S Staffetti,1 Theresa A Zesiewicz1,21Department of Neurology, Morsani College of Medicine, University of South Florida, 2Department of Neurology, James A Haley VA Hospital, Tampa, FL, USAAbstract: Rotigotine (RTG is a dopamine agonist that is used as mono and adjunct therapy to treat Parkinson’s disease, and as therapy for moderate-to-severe restless legs syndrome. RTG is the only dopamine agonist currently available as a 24-hour/day transdermal system, providing once-a-day dosing. As a transdermal patch, RTG bypasses the gastrointestinal tract, making it a treatment option for patients with dysphagia. The use of RTG also avoids the need to schedule administration of medication around meals. This review provides a critical appraisal of RTG as treatment of Parkinson’s disease and RLS.Keywords: rotigotine, dopamine agonist, Parkinson’s disease, restless legs syndrome

  10. Contemporary disease management in Quebec. (United States)

    Gogovor, Amédé; Savoie, Michelle; Moride, Yola; Krelenbaum, Marilyn; Montague, Terrence


    Health or disease management (DM) has emerged as a promising solution to improve the quality of healthcare and patient outcomes in a cost-efficient way. This solution is particularly relevant in the care of our increasing, and aging, patient populations with multiple chronic diseases. This article reviews the recent history and current status of DM in the province of Quebec and summarizes its evolving perspectives and future prospects. Most DM projects in Quebec have developed from a public-private partnership, and they have addressed several disease states. The results of completed programs confirmed the presence of care gaps--the differences between best and usual care in several disease states. They also identified process changes leading to improved practices and enhanced professional satisfaction among stakeholders. Priorities identified for further research include increased knowledge of the underlying causes of care gaps and greater concentration on the measurement of clinical, humanistic and fiscal outcomes and their causal links to DM structures and processes. Although still embryonic in Quebec and Canada, the available evidence suggests that DM partnerships are practical and functional vehicles to expedite knowledge creation and transfer in the care of whole populations of patients. Future projects offer the promise of updated knowledge and continuously improved care and outcomes.

  11. Audit Management System

    CERN Document Server

    Alconada, Federico


    In the need of renewing their system, the Internal Audit department has given a proposal for building a new one. Taking into consideration the problems of their system they elaborated a requirement's list with the functionalities and features they were expecting from the new management system. This new system would be primarily for the use of the Internal Audit staff but it would also support the follow-up of internal audit recommendations by potentially all CERN staff members.

  12. Reliability block diagrams to model disease management. (United States)

    Sonnenberg, A; Inadomi, J M; Bauerfeind, P


    Studies of diagnostic or therapeutic procedures in the management of any given disease tend to focus on one particular aspect of the disease and ignore the interaction between the multitude of factors that determine its final outcome. The present article introduces a mathematical model that accounts for the joint contribution of various medical and non-medical components to the overall disease outcome. A reliability block diagram is used to model patient compliance, endoscopic screening, and surgical therapy for dysplasia in Barrett's esophagus. The overall probability of a patient with a Barrett's esophagus to comply with a screening program, be correctly diagnosed with dysplasia, and undergo successful therapy is 37%. The reduction in the overall success rate, despite the fact that the majority of components are assumed to function with reliability rates of 80% or more, is a reflection of the multitude of serial subsystems involved in disease management. Each serial component influences the overall success rate in a linear fashion. Building multiple parallel pathways into the screening program raises its overall success rate to 91%. Parallel arrangements render systems less sensitive to diagnostic or therapeutic failures. A reliability block diagram provides the means to model the contributions of many heterogeneous factors to disease outcome. Since no medical system functions perfectly, redundancy provided by parallel subsystems assures a greater overall reliability.

  13. Management of Pruritus in Chronic Liver Disease

    Directory of Open Access Journals (Sweden)

    Angeline Bhalerao


    Full Text Available Background. There continues to be uncertainty on the ideal treatment of pruritus in chronic liver disease. The aim of this study was to gather the latest information on the evidence-based management of pruritus in chronic liver disease. Methodology. A literature search for pruritus in chronic liver disease was conducted using Pubmed and Embase database systems using the MeSH terms “pruritus,” “chronic liver disease,” “cholestatic liver disease,” and “treatment.” Results. The current understanding of the pathophysiology of pruritus is described in addition to detailing research into contemporary treatment options of the condition. These medical treatments range from bile salts, rifampicin, and opioid receptor antagonists to antihistamines. Conclusion. The burden of pruritus in liver disease patients persists and, although it is a common symptom, it can be difficult to manage. In recent years there has been greater study into the etiology and treatment of the condition. Nonetheless, pruritus remains poorly understood and many patients continue to suffer, reiterating the need for further research to improve our understanding of the etiology and treatment for the condition.

  14. Shifting chronic disease management from hospitals to primary care in Estonian health system: analysis of national panel data. (United States)

    Atun, Rifat; Gurol-Urganci, Ipek; Hone, Thomas; Pell, Lisa; Stokes, Jonathan; Habicht, Triin; Lukka, Kaija; Raaper, Elin; Habicht, Jarno


    Following independence from the Soviet Union in 1991, Estonia introduced a national insurance system, consolidated the number of health care providers, and introduced family medicine centred primary health care (PHC) to strengthen the health system. Using routinely collected health billing records for 2005-2012, we examine health system utilisation for seven ambulatory care sensitive conditions (ACSCs) (asthma, chronic obstructive pulmonary disease [COPD], depression, Type 2 diabetes, heart failure, hypertension, and ischemic heart disease [IHD]), and by patient characteristics (gender, age, and number of co-morbidities). The data set contained 552 822 individuals. We use patient level data to test the significance of trends, and employ multivariate regression analysis to evaluate the probability of inpatient admission while controlling for patient characteristics, health system supply-side variables, and PHC use. Over the study period, utilisation of PHC increased, whilst inpatient admissions fell. Service mix in PHC changed with increases in phone, email, nurse, and follow-up (vs initial) consultations. Healthcare utilisation for diabetes, depression, IHD and hypertension shifted to PHC, whilst for COPD, heart failure and asthma utilisation in outpatient and inpatient settings increased. Multivariate regression indicates higher probability of inpatient admission for males, older patient and especially those with multimorbidity, but protective effect for PHC, with significantly lower hospital admission for those utilising PHC services. Our findings suggest health system reforms in Estonia have influenced the shift of ACSCs from secondary to primary care, with PHC having a protective effect in reducing hospital admissions.

  15. Sewer System Management Plan.

    Energy Technology Data Exchange (ETDEWEB)

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


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

  16. Purge water management system (United States)

    Cardoso-Neto, Joao E.; Williams, Daniel W.


    A purge water management system for effectively eliminating the production of purge water when obtaining a groundwater sample from a monitoring well. In its preferred embodiment, the purge water management system comprises an expandable container, a transportation system, and a return system. The purge water management system is connected to a wellhead sampling configuration, typically permanently installed at the well site. A pump, positioned with the monitoring well, pumps groundwater through the transportation system into the expandable container, which expands in direct proportion with volume of groundwater introduced, usually three or four well volumes, yet prevents the groundwater from coming into contact with the oxygen in the air. After this quantity of groundwater has been removed from the well, a sample is taken from a sampling port, after which the groundwater in the expandable container can be returned to the monitoring well through the return system. The purge water management system prevents the purge water from coming in contact with the outside environment, especially oxygen, which might cause the constituents of the groundwater to oxidize. Therefore, by introducing the purge water back into the monitoring well, the necessity of dealing with the purge water as a hazardous waste under the Resource Conservation and Recovery Act is eliminated.

  17. Pricing specialty carve-outs and disease management programs under managed care. (United States)

    LaPensee, K T


    The drive toward improved efficiency and effectiveness in health care has spawned disease management programs to address the needs of patients with certain conditions. These programs parallel traditional case management programs in monitoring patients, but disease management differs from case management in early assessment of patient risk, with proactive clinical interventions and educational efforts. The most comprehensive programs include a coordinated delivery system that can be "carved out" from other health care benefits. Pricing disease management can benefit from the analysis of detailed, disease-specific and community-specific data from public or private sources.

  18. A distribution management system

    Energy Technology Data Exchange (ETDEWEB)

    Jaerventausta, P.; Verho, P.; Kaerenlampi, M.; Pitkaenen, M. [Tampere Univ. of Technology (Finland); Partanen, J. [Lappeenranta Univ. of Technology (Finland)


    The development of new distribution automation applications is considerably wide nowadays. One of the most interesting areas is the development of a distribution management system (DMS) as an expansion to the traditional SCADA system. At the power transmission level such a system is called an energy management system (EMS). The idea of these expansions is to provide supporting tools for control center operators in system analysis and operation planning. Nowadays the SCADA is the main computer system (and often the only) in the control center. However, the information displayed by the SCADA is often inadequate, and several tasks cannot be solved by a conventional SCADA system. A need for new computer applications in control center arises from the insufficiency of the SCADA and some other trends. The latter means that the overall importance of the distribution networks is increasing. The slowing down of load-growth has often made network reinforcements unprofitable. Thus the existing network must be operated more efficiently. At the same time larger distribution areas are for economical reasons being monitored at one control center and the size of the operation staff is decreasing. The quality of supply requirements are also becoming stricter. The needed data for new applications is mainly available in some existing systems. Thus the computer systems of utilities must be integrated. The main data source for the new applications in the control center are the AM/FM/GIS (i.e. the network database system), the SCADA, and the customer information system (CIS). The new functions can be embedded in some existing computer system. This means a strong dependency on the vendor of the existing system. An alternative strategy is to develop an independent system which is integrated with other computer systems using well-defined interfaces. The latter approach makes it possible to use the new applications in various computer environments, having only a weak dependency on the

  19. Web 2.0 systems supporting childhood chronic disease management: design guidelines based on information behaviour and social learning theories. (United States)

    Ekberg, Joakim; Ericson, Leni; Timpka, Toomas; Eriksson, Henrik; Nordfeldt, Sam; Hanberger, Lena; Ludvigsson, Johnny


    Self-directed learning denotes that the individual is in command of what should be learned and why it is important. In this study, guidelines for the design of Web 2.0 systems for supporting diabetic adolescents' every day learning needs are examined in light of theories about information behaviour and social learning. A Web 2.0 system was developed to support a community of practice and social learning structures were created to support building of relations between members on several levels in the community. The features of the system included access to participation in the culture of diabetes management practice, entry to information about the community and about what needs to be learned to be a full practitioner or respected member in the community, and free sharing of information, narratives and experience-based knowledge. After integration with the key elements derived from theories of information behaviour, a preliminary design guideline document was formulated.

  20. Psoriasis, a Systemic Disease?

    Directory of Open Access Journals (Sweden)

    Nilgün Atakan


    Full Text Available Psoriasis is a chronic inflammatory disease which is characterized by plaques with shiny white desquamation on the skin. It affects 1 to 3% of different ethnic populations. The disease significantly lowers the quality of life for the patients as the lesions appear on visible regions such as the scalp, face and extremities causing pruritus and extensive use of topical agents with a poor rate of recovery and the disease has a recurrent course with frequent attacks. Psoriasis was previously assumed to be a cutaneous disease resulting from epidermal cell hyperproliferation for a long time. However, studies conducted on the etiopathogenesis of the disease revealed that psoriasis is a chronic autoinflammatory disease which is caused by immune system dysregulation. Recently, the frequent association of psoriasis with other autoinflammatory diseases, comorbidities and complications which indeed shorten life expectancy concluded that psoriasis is a systemic disease and created a major difference in its treatment and follow-up modalities. In this review, the comorbidities, which are shown to be related to systemic inflammation and which also share a common pathogenesis with psoriasis, will be discussed. (Turk J Dermatol 2012; 6: 119-22

  1. A population approach to disease management: hepatitis C direct-acting antiviral use in a large health care system. (United States)

    Belperio, Pamela S; Backus, Lisa I; Ross, David; Neuhauser, Melinda M; Mole, Larry A


    The introduction of the first direct-acting antiviral agents (DAAs) for the treatment of hepatitis C virus (HCV), telaprevir and boceprevir, marked a unique event in which 2 disease-changing therapies received FDA approval at the same time. Comparative safety and effectiveness data in real-world populations upon which to make formulary decisions did not exist. To describe the implementation, measurement, and outcomes of an enduring population-based approach of surveillance of medication management for HCV. The foundation of the population approach to HCV medication management used by the Department of Veterans Affairs (VA) relied upon a basic framework of (a) providing data for effective regional and local management, (b) education and training, (c) real-time oversight and feedback from a higher organization level, and (d) prompt outcome sharing. These population-based processes spanned across the continuum of the direct-acting antiviral oversight process. We used the VA's HCV Clinical Case Registry-which includes pharmacy, laboratory, and diagnosis information for all HCV-infected veterans from all VA facilities-to assess DAA treatment eligibility, DAA uptake and timing, appropriate use of DAAs including HCV RNA monitoring and medication possession ratios (MPR), nonconcordance with guidance for adjunct erythropoiesis-stimulating agent (ESA) and granulocyte colony-stimulating factor (GCSF) use, hematologic adverse effects, discontinuation rates, and early and sustained virologic responses. Training impact was assessed via survey and change in pharmacist scope of practice. One year after FDA approval, DAAs had been prescribed at 120 of 130 VA facilities. Over 680 VA providers participated in live educational training programs including 380 pharmacists, and pharmacists with a scope of practice for HCV increased from 59 to 110 pharmacists (86%). HCV RNA futility testing improved such that only 1%-3% of veterans did not have appropriate testing compared with 15%-17% 6

  2. Management Information System (United States)


    New Automated Management Information Center (AMIC) employs innovative microcomputer techniques to create color charts, viewgraphs, or other data displays in a fraction of the time formerly required. Developed under Kennedy Space Center's contract by Boeing Services International Inc., Seattle, WA, AMIC can produce an entirely new informational chart in 30 minutes, or an updated chart in only five minutes. AMIC also has considerable potential as a management system for business firms.

  3. Taming wildlife disease: bridging the gap between science and management (United States)

    Joseph, Maxwell B.; Mihaljevic, Joseph R.; Arellano, Ana Lisette; Kueneman, Jordan G.; Cross, Paul C.; Johnson, Pieter T.J.


    1.Parasites and pathogens of wildlife can threaten biodiversity, infect humans and domestic animals, and cause significant economic losses, providing incentives to manage wildlife diseases. Recent insights from disease ecology have helped transform our understanding of infectious disease dynamics and yielded new strategies to better manage wildlife diseases. Simultaneously, wildlife disease management (WDM) presents opportunities for large-scale empirical tests of disease ecology theory in diverse natural systems. 2.To assess whether the potential complementarity between WDM and disease ecology theory has been realized, we evaluate the extent to which specific concepts in disease ecology theory have been explicitly applied in peer-reviewed WDM literature. 3.While only half of WDM articles published in the past decade incorporated disease ecology theory, theory has been incorporated with increasing frequency over the past 40 years. Contrary to expectations, articles authored by academics were no more likely to apply disease ecology theory, but articles that explain unsuccessful management often do so in terms of theory. 4.Some theoretical concepts such as density-dependent transmission have been commonly applied, whereas emerging concepts such as pathogen evolutionary responses to management, biodiversity–disease relationships and within-host parasite interactions have not yet been fully integrated as management considerations. 5.Synthesis and applications. Theory-based disease management can meet the needs of both academics and managers by testing disease ecology theory and improving disease interventions. Theoretical concepts that have received limited attention to date in wildlife disease management could provide a basis for improving management and advancing disease ecology in the future.

  4. Anesthesia information management systems


    Feri Štivan; Janez Benedik; Tomaž Lužar


    Introduction: The use of anesthesia information management systems (AIMS) is on the increase. This is particularly true for academic anesthesia departments. The main reasons for slow adoption of these systems in the past are financial barriers associated with implementation of these systems and their not so traditionally obvious potential to improve patient care. In addition, a major obstacle to acceptance of this technology is the concern of users over the impact of the electronic anesthesia...

  5. Hypertension in Sub-Saharan Africa: A Contextual View of Patterns of Disease, Best Management, and Systems Issues. (United States)

    Nulu, Shanti; Aronow, Wilbert S; Frishman, William H


    Sub-Saharan Africa (SSA) bears the highest burden of both communicable and noncommunicable disease and has the weakest health systems. Much attention is directed toward a rising burden of chronic disease in the setting of epidemiologic transition and urbanization. Indeed, the highest prevalence of hypertension globally is in the World Health Organization's African region at 46% of adults aged 25 and above. And while hypertension in SSA is common, its prevalence varies significantly between urban and rural settings. Although there is evidence for epidemiologic transition in urban areas, there is also evidence of static levels of hypertension within rural areas, which comprise more than 70% of the population of SSA. Furthermore, overall cardiovascular (CV) risk in rural areas remains low. The mean age of hypertensives in SSA is approximately 30s to 40s, burdening those at peak productivity. Complications of hypertension are frequent, given the poor levels of awareness and treatment (hypertension on the continent. Such complications include primarily stroke and hypertensive heart disease, as ischemic heart disease is uncommon. Mortality associated with these complications is high, with in-hospital mortality from 2 different sites reported as around 20%. The overall burden of hypertension is likely to be more related to poor access and availability of health systems and is representative of a looming crisis in health care delivery. The best approaches to population-wide treatment are those that utilize CV risk prediction for those with stage 1 hypertension, whereas treatment is generally indicated for all those with stage 2 or greater hypertension, especially in light of the high burden of stroke in SSA. Current guidelines recommend first-line drug therapy with a diuretic or calcium channel blocker. Despite these recommendations, the major obstacles to hypertension treatment are systemic and include the availability and cost of medications, the adequacy of health

  6. Management Activities on the Reduction of Ecological-related Diseases of the Nervous System of Population in Ust-Kamenogorsk

    Directory of Open Access Journals (Sweden)

    Sharbanu Battakova


    Full Text Available The article features the research results of psychological status and the nervous system. The study was conducted on the basis of multivariate analysis of morbidity rates of the nervous system with the aim of developing of administrative actions towards the population of Ust-Kamenogorsk. The correlation analysis has shown that the of coefficients of correlation coincide with the analysis data of morbidity rates of the nervous system showing that that morbidity rates are mostly influenced by high concentration of harmful pollutants. Besides, the correlation analysis has allowed identifying the levels of pollution in the atmosphere of the city above which the interrelation between fluctuations of morbidity rates is shown and below which correlation has been not observed. From the provided data we can see that the main sources of harmful substances entering our bodies are polluted atmospheric air and soils. The study revealed that with the growth of anthropogenesis loading by toxic metals, the morbidity rates of encephalopathies of unspecified genesis and the cerebrovascular diseases increase. Changes in psycho-emotional sphere have been revealed. The novelty of research is the development of administrative procedures aimed at reduction of the disease prevalence for people living in Ust-Kamenogorsk.

  7. Diagnosis and management of kawasaki disease. (United States)

    Saguil, Aaron; Fargo, Matthew; Grogan, Scott


    Kawasaki disease is an acute, systemic vasculitis that predominantly affects patients younger than five years. It represents the most prominent cause of acquired coronary artery disease in childhood. In the United States, 19 per 100,000 children younger than five years are hospitalized with Kawasaki disease annually. According to U.S. and Japanese guidelines, Kawasaki disease is a clinical diagnosis. Classic (typical) Kawasaki disease is diagnosed based on the presence of a fever lasting five or more days, accompanied by four out of five findings: bilateral conjunctival injection, oral changes such as cracked and erythematous lips and strawberry tongue, cervical lymphadenopathy, extremity changes such as erythema or palm and sole desquamation, and polymorphous rash. Incomplete (atypical) Kawasaki disease occurs in persons with fever lasting five or more days and with two or three of these findings. Transthoracic echocardiography is the diagnostic imaging modality of choice to screen for coronary aneurysms, although other techniques are being evaluated for diagnosis and management. Treatment for acute disease is intravenous immunoglobulin and aspirin. If there is no response to treatment, patients are given a second dose of intravenous immunoglobulin with or without corticosteroids or other adjunctive treatments. The presence and severity of coronary aneurysms and obstruction at diagnosis determine treatment options and the need, periodicity, and intensity of long-term cardiovascular monitoring for potential atherosclerosis.

  8. Disease management contracting: key elements. (United States)

    Knutson, D J


    Although the data at the outset of a contractual agreement can often be incomplete or inaccurate, and the analytical tools necessary to interpret these data are still being developed, partners about to enter a disease management (DM) arrangement can nonetheless take steps to ensure that the relationship will be sound and successful. Pharmaceutical firms (and other service providers) wishing to enter into DM relationships with managed-care organizations must consider several important factors of the contracting process to protect their financial interests and benefit from the partnership, particularly in the first 1 to 2 years of the arrangement. This paper provides recommendations for both general strategies and financial elements of DM contracting, and defines several contractual elements that can help to secure a harmonious and profitable partnership. These suggestions address concerns for various types of partnerships, including risk-sharing and fee-for-service plans. Early and careful consideration of the legal aspects of the DM business can protect companies from incurring significant, unanticipated losses.

  9. Management control system description

    Energy Technology Data Exchange (ETDEWEB)

    Bence, P. J.


    This Management Control System (MCS) description describes the processes used to manage the cost and schedule of work performed by Westinghouse Hanford Company (Westinghouse Hanford) for the US Department of Energy, Richland Operations Office (DOE-RL), Richland, Washington. Westinghouse Hanford will maintain and use formal cost and schedule management control systems, as presented in this document, in performing work for the DOE-RL. This MCS description is a controlled document and will be modified or updated as required. This document must be approved by the DOE-RL; thereafter, any significant change will require DOE-RL concurrence. Westinghouse Hanford is the DOE-RL operations and engineering contractor at the Hanford Site. Activities associated with this contract (DE-AC06-87RL10930) include operating existing plant facilities, managing defined projects and programs, and planning future enhancements. This document is designed to comply with Section I-13 of the contract by providing a description of Westinghouse Hanford's cost and schedule control systems used in managing the above activities. 5 refs., 22 figs., 1 tab.

  10. The use of an anesthesia information system to identify and trend gender disparities in outpatient medical management of patients with coronary artery disease. (United States)

    Vigoda, Michael M; Rodríguez, Luis I; Wu, Eric; Perry, Kevin; Duncan, Robert; Birnbach, David J; Lubarsky, David A


    Previous anesthesia information management systems-based studies have focused on intraoperative data analysis. Reviewing preoperative data could provide insight into the outpatient treatment of patients presenting for surgical procedures. As gender-based disparities have been demonstrated in the treatment of patients with cardiac disease, we hypothesized that there would be gender disparities in the outpatient pharmacologic management of patients with coronary artery disease (CAD) scheduled for elective noncardiac surgery. We analyzed electronic medical records of ambulatory patients with CAD (prior myocardial infarction [MI], coronary artery bypass surgery, and angioplasty with or without stenting, angina) presenting for elective noncardiac surgery between 1/2004 and 6/2006 (30 mo) at an inner city hospital. Of 21,039 ambulatory patients seen in the preanesthesia clinic, 6.4% (1346) had CAD. Patients with CAD: Men were more likely to be taking beta-blockers (P anesthesia management information systems data provides an epidemiological perspective of community care of patients presenting for surgery. We found that gender disparities in outpatient medical treatment of patients with CAD, which previously favored men, have diminished primarily as a result of increased use of these medications in women. Nonetheless, despite evidence supporting the use of risk-reduction strategies, our patients are undertreated with standard medical therapies.

  11. International trade standards for commodities and products derived from animals: the need for a system that integrates food safety and animal disease risk management. (United States)

    Thomson, G R; Penrith, M-L; Atkinson, M W; Thalwitzer, S; Mancuso, A; Atkinson, S J; Osofsky, S A


    A case is made for greater emphasis to be placed on value chain management as an alternative to geographically based disease risk mitigation for trade in commodities and products derived from animals. The geographic approach is dependent upon achievement of freedom in countries or zones from infectious agents that cause so-called transboundary animal diseases, while value chain-based risk management depends upon mitigation of animal disease hazards potentially associated with specific commodities or products irrespective of the locality of production. This commodity-specific approach is founded on the same principles upon which international food safety standards are based, viz. hazard analysis critical control points (HACCP). Broader acceptance of a value chain approach enables animal disease risk management to be combined with food safety management by the integration of commodity-based trade and HACCP methodologies and thereby facilitates 'farm to fork' quality assurance. The latter is increasingly recognized as indispensable to food safety assurance and is therefore a pre-condition to safe trade. The biological principles upon which HACCP and commodity-based trade are based are essentially identical, potentially simplifying sanitary control in contrast to current separate international sanitary standards for food safety and animal disease risks that are difficult to reconcile. A value chain approach would not only enable more effective integration of food safety and animal disease risk management of foodstuffs derived from animals but would also ameliorate adverse environmental and associated socio-economic consequences of current sanitary standards based on the geographic distribution of animal infections. This is especially the case where vast veterinary cordon fencing systems are relied upon to separate livestock and wildlife as is the case in much of southern Africa. A value chain approach would thus be particularly beneficial to under-developed regions of

  12. Anesthesia information management systems

    Directory of Open Access Journals (Sweden)

    Feri Štivan


    Full Text Available Introduction: The use of anesthesia information management systems (AIMS is on the increase. This is particularly true for academic anesthesia departments. The main reasons for slow adoption of these systems in the past are financial barriers associated with implementation of these systems and their not so traditionally obvious potential to improve patient care. In addition, a major obstacle to acceptance of this technology is the concern of users over the impact of the electronic anesthesia record on malpractice exposure.Conclusions: The experience reported by departments using AIMS indicates that these systems are useful for managing malpractice risk. AIMS can enhance the efficiency and effectiveness of preoperative, intraoperative, and post-operative anesthesia care. However, AIMS are able to increase the quality of care and improve operating room efficiency only with careful planning, installation, and customization. Strengths, weaknesses, opportunities and threats (SWOT analysis performed for AIMS could help departments in making better decisions when implementing AIMS.

  13. Inspection management system

    Energy Technology Data Exchange (ETDEWEB)

    Coto, L.F.M.; Alvarez, M.A.L.


    The main features of the application developed by UNION FENOSA and NorControl for inspection management are exposed. This application has been built on the basis of a Geographic Information System, whose advantages on other database systems are explained. This system, has been developed with the main objective of getting a better and easier utilization of the data collected from the inspections, in order to reduce service failures and obtain a bigger return of the effort invested in them. They are also exposed the work line and the steps followed for the implementation of the system in the Meirama steam plant, and the results obtained up to date.

  14. Advanced Distribution Management System (United States)

    Avazov, Artur R.; Sobinova, Liubov A.


    This article describes the advisability of using advanced distribution management systems in the electricity distribution networks area and considers premises of implementing ADMS within the Smart Grid era. Also, it gives the big picture of ADMS and discusses the ADMS advantages and functionalities.

  15. Integrated management systems

    DEFF Research Database (Denmark)

    Jørgensen, Tine Herreborg; Remmen, Arne; Mellado, M. Dolores


    Different approaches to integration of management systems (ISO 9001, ISO 14001, OHSAS 18001 and SA 8000) with various levels of ambition have emerged. The tendency of increased compatibility between these standards has paved the road for discussions of, how to understand the different aspects of ...

  16. Content Management Systems (United States)

    Wisniewski, Jeff; Stenstrom, Cheryl


    In this article, the authors provide a guide in acquiring content management system. They conducted a vendor survey that covers four areas: (1) general information about the product (including standards supported); (2) administration of the product; (3) functionality; and (4) contact information for readers who want to know more. A list of product…

  17. Managing Complex Dynamical Systems (United States)

    Cox, John C.; Webster, Robert L.; Curry, Jeanie A.; Hammond, Kevin L.


    Management commonly engages in a variety of research designed to provide insight into the motivation and relationships of individuals, departments, organizations, etc. This paper demonstrates how the application of concepts associated with the analysis of complex systems applied to such data sets can yield enhanced insights for managerial action.

  18. DIRAC Workload Management System

    CERN Document Server

    Garonne, V; Stokes-Rees, I


    The Workload Management System is the core component of the DIRAC distributed MC production and analysis grid environment of the CERN LHCb experiment. This paper discusses the architecture, implementation and performance of this system. The WMS is a community scheduler, realizing a pull paradigm, particulary for the high troughput computing context. It has recently been used for an intensive physics simulation production involving more than 60 sites, 65 TB of data, and over 1000-GHz processor-years.

  19. Scalable Content Management System


    Sandeep Krishna S, Jayant Dani


    Immense growth in the volume of contents every day demands more scalable system to handle and overcome difficulties in capture, storage, transform, search, sharing and visualization of data, where the data can be a structured or unstructured data of any type. A system to manage the growing contents and overcome the issues and complexity faced using appropriate technologies would advantage over measurable qualities like flexibility, interoperability, customizabi...

  20. Distribution management system

    Energy Technology Data Exchange (ETDEWEB)

    Verho, P.; Kaerenlampi, M.; Pitkaenen, M.; Jaerventausta, P.; Partanen, J.


    This report comprises a general description of the results obtained in the research projects `Information system applications of a distribution control center`, `Event analysis in primary substation`, and `Distribution management system` of the EDISON research program during the years of 1993 - 1997. The different domains of the project are presented in more detail in other reports. An operational state analysis of a distribution network has been made from the control center point of view and the functions which can not be solved by a conventional SCADA system are determined. The basis for new computer applications is shown to be integration of the computer systems. The main result of the work is a distribution management system (DMS), which is an autonomous system integrated to the existing information systems, SCADA and AM/FM/GIS. The system uses a large number of modelling and computation methods and provides an extensive group of advanced functions to support the distribution network monitoring, fault management, operations planning and optimization. The development platform of the system consists of a Visual C++ programming environment, Windows NT operating system and PC. During the development the DMS has been tested in a pilot utility and it is nowadays in practical use in several Finnish utilities. The use of a DMS improves the quality and economy of power supply in many ways; the outage times can, in particular, be reduced using the system. Based on the achieved experiences some parts of the DMS reached the commercialization phase, too. Initially the commercial products were developed by a software company, Versoft Oy. At present the research results are the basis of a worldwide software product supplied by ABB Transmit Co. (orig.) EDISON Research Programme. 28 refs.

  1. Air System Information Management (United States)

    Filman, Robert E.


    I flew to Washington last week, a trip rich in distributed information management. Buying tickets, at the gate, in flight, landing and at the baggage claim, myriad messages about my reservation, the weather, our flight plans, gates, bags and so forth flew among a variety of travel agency, airline and Federal Aviation Administration (FAA) computers and personnel. By and large, each kind of information ran on a particular application, often specialized to own data formats and communications network. I went to Washington to attend an FAA meeting on System-Wide Information Management (SWIM) for the National Airspace System (NAS) ( NAS (and its information infrastructure, SWIM) is an attempt to bring greater regularity, efficiency and uniformity to the collection of stovepipe applications now used to manage air traffic. Current systems hold information about flight plans, flight trajectories, weather, air turbulence, current and forecast weather, radar summaries, hazardous condition warnings, airport and airspace capacity constraints, temporary flight restrictions, and so forth. Information moving among these stovepipe systems is usually mediated by people (for example, air traffic controllers) or single-purpose applications. People, whose intelligence is critical for difficult tasks and unusual circumstances, are not as efficient as computers for tasks that can be automated. Better information sharing can lead to higher system capacity, more efficient utilization and safer operations. Better information sharing through greater automation is possible though not necessarily easy.

  2. Effects of plant conduction systems and organic fertilizer management on disease incidence and severity in ‘Osiana’ and ‘Carola’ roses

    Directory of Open Access Journals (Sweden)

    Márcia de Nazaré Oliveira Ribeiro


    Full Text Available Conventional pruning is a very common practice for pruning rose cultivars in Brazil. However, few Brazilian producers known any other efficient plant training method for roses, namely “lateral stem bending” or “arching technique”, which involves bending the branches of the rosebush in order to increase the photosynthetic rate of the plant. As well as plant training, the use of fertilizers must also be done carefully in order to obtain high quality roses. Biofertilizers are recommended because of their multiple effects: fertilizer, protein synthesis stimulant, insect repellent, and disease controller. The aim of this study was to assess the plant training system and management of organic fertilizer on the incidence and severity of disease in the ‘Osiana’ and ‘Carola’ roses. The ‘Osiana’ rosebushes received three concentrations (0%, 5%, and 15% of foliar biofertilizer applied monthly to the leaves together with two plant conduction methods (conventional pruning and lateral stem bending. ‘Carola’ roses were treated with three types of fertilizer (chemical fertilizer on the soil + bokashi on the soil, chemical fertilizer on the soil + foliar FishfertilÒand chemical fertilization on the soil without applying organic fertilizers every two weeks, together with 2 plant conduction systems (conventional pruning and lateral stem bending. The additional treatments in ‘Carola’ roses were composed of two organic fertilizers (Bokashi and foliar Fishfertil® and chemical fertilization with lateral pruning. The incidence and severity of disease in these plants during the experiment were assessed over 5 months. For the ‘Osiana’ rose, the incidence and severity of disease were not influenced by fertilizer management or plant training methods. For the ‘Carola’ roses, the different types of fertilizer caused different responses according to the plant training system used, with the biofertilizer Fishfertil® reducing the incidence

  3. Disease assessment in systemic vasculitis. (United States)

    Luqmani, Raashid Ahmed


    The anti-neutrophil cytoplasm antibody-associated vasculitides are complex multi-system disorders with many overlapping clinical features. Their outcome has been transformed by effective immunosuppression, preventing death in over 70% of cases. The quality of survival is affected by the disease course, which is characterized by a significant likelihood of relapse in 38%, chronic effects from the disease and its treatment, as well as emerging or worsening comorbidity, all of which contribute to the patient's clinical condition and outcome. Whilst imaging and laboratory testing including histology are important aspects of diagnosis, they are of limited value in assessing response to therapy or subsequent disease course. We have developed standardized validated clinical methods to quantify disease activity and damage; we are developing effective measures of patient experience to complement these procedures. This approach provides a rational basis for clinical management as well as being essential in the conduct of clinical trials and studies in vasculitis, by providing reproducible definitions of relapse, remission and response to therapy for patients with systemic vasculitis. Clinical assessment remains the current gold standard for evaluating disease progress, but requires regular training to ensure standardization. The development of biomarkers in future may produce a more accurate description of disease and identify potential targets for therapy as well as predictors of response to drugs.

  4. A Japanese model of disease management. (United States)

    Nakashima, Naoki; Kobayashi, Kunihisa; Inoguchi, Toyoshi; Nishida, Daisuke; Tanaka, Naomi; Nakazono, Hiromi; Hoshino, Akihiko; Soejima, Hidehisa; Takayanagi, Ryoichi; Nawata, Hajime


    We started a disease management model, Carna, that includes two programs: one for primary prevention of lifestyle diseases and one for secondary/tertiary prevention of diabetes mellitus. These programs support the family doctor system and education for participants to allow the concept of disease management to take root in Japan. We developed a critical pathway system that can optimize health care of individual participants by matching individual status. This is the core technology of the project. Under the primary prevention program, we can perform the health check-up/ instruction tasks in the 'Tokutei Kenshin', which will start for all Japanese citizens aged 40-74 years in April 2008. In the diabetic program, Carna matches doctors and new patients, prevents patient dropout, supports detection of early-stage complications by distributing questionnaires periodically, and facilitates medical specialists' cooperation with family doctors. Carna promotes periodic medical examinations and quickly provides the result of blood tests to patients. We are conducting a study to assess the medical outcomes and business model. The study will continue until the end of 2007.

  5. Petascale system management experiences.

    Energy Technology Data Exchange (ETDEWEB)

    Desai, N.; Bradshaw, R.; Lueninghoener, C.; Cherry, A.; Coghlan, S.; Scullin, W. (LCF); ( MCS)


    National Laboratory, and a 504 TF Opteron-based system has been deployed at Texas Advanced Computing Center (TACC). Intrepid is comprised of 40,960 nodes with a total of 163,840 cores. While systems like these are uncommon now, we expect them to become more widespread in the coming years. The scale of these large systems impose several requirements upon system architecture. The need for scalability is obvious, however, power efficiency and density constraints have become increasingly important in recent years. At the same time, because the size of administrative staff cannot grow linearly with the system size, more efficient system management techniques are needed. In this paper we will describe our experiences administering Intrepid. Over the last year, we have experienced a number of interesting challenges in this endeavor. Our initial expectation was for scalability to be the dominant system issue. This expectation was not accurate. Several issues expected to have minor impact have played a much greater role in system operations. Debugging, due to the large numbers of components used in scalable system operations, has become a much more difficult endeavor. The system has a sophisticated monitoring system, however, the analysis of this data has been problematic. These issues are not specific to HPC workloads in any way, so we expect them to be of general interest. This paper consists of three major parts. First, we will provide a detailed overview of several important aspects of Intrepid's hardware and software. In this, we will highlight aspects that have featured prominently in our system management experiences. Next, we will describe our administration experiences in detail. Finally, we will draw some conclusions based on these experiences. In particular, we will discuss the implications for the non-HPC world, system managers, and system software developers.

  6. A taxonomy for disease management: a scientific statement from the American Heart Association Disease Management Taxonomy Writing Group. (United States)

    Krumholz, Harlan M; Currie, Peter M; Riegel, Barbara; Phillips, Christopher O; Peterson, Eric D; Smith, Renee; Yancy, Clyde W; Faxon, David P


    Disease management has shown great promise as a means of reorganizing chronic care and optimizing patient outcomes. Nevertheless, disease management programs are widely heterogeneous and lack a shared definition of disease management, which limits our ability to compare and evaluate different programs. To address this problem, the American Heart Association's Disease Management Taxonomy Writing Group developed a system of classification that can be used both to categorize and compare disease management programs and to inform efforts to identify specific factors associated with effectiveness. The AHA Writing Group began with a conceptual model of disease management and its components and subsequently validated this model over a wide range of disease management programs. A systematic MEDLINE search was performed on the terms heart failure, diabetes, and depression, together with disease management, case management, and care management. The search encompassed articles published in English between 1987 and 2005. We then selected studies that incorporated (1) interventions designed to improve outcomes and/or reduce medical resource utilization in patients with heart failure, diabetes, or depression and (2) clearly defined protocols with at least 2 prespecified components traditionally associated with disease management. We analyzed the study protocols and used qualitative research methods to develop a disease management taxonomy with our conceptual model as the organizing framework. The final taxonomy includes the following 8 domains: (1) Patient population is characterized by risk status, demographic profile, and level of comorbidity. (2) Intervention recipient describes the primary targets of disease management intervention and includes patients and caregivers, physicians and allied healthcare providers, and healthcare delivery systems. (3) Intervention content delineates individual components, such as patient education, medication management, peer support, or some

  7. IT Solution For Disease Management At PT Panasonic Manufacturing Indonesia

    Directory of Open Access Journals (Sweden)

    Bens Pardamean


    Full Text Available One of company’s occupational health programs is disease management which is a part of preventive health care. In its realization, it was discovered that there some challenges in data collection, monitoring of catering and sport activity, employee health reports, and medical costs. The purpose of this study is to design an IT solution for the disease management program at PT. Panasonic Manufacturing Indonesia (PMI. The diseases in focus are diabetes, hypertension, and tuberculosis. Methodology starts with survey on PT. PMI requirements, research parameters, problem analysis, literature study, and system design. Solution is focused on designing a registry system that includes Alert Management System, Food Tracking, EHR, Sport Tracking, Guidelines, and Report System. The results of this study is a web-based information system that can assist health care workers in seeking data, monitoring food intake and sport activity, and reporting systems for upper-level management

  8. Adaptive Learning Management System

    Directory of Open Access Journals (Sweden)

    Violeta Moisa


    Full Text Available This article is an introduction to a new model for an adaptive Learning Management System. It presents the current e-learning standards and describes the elements that can be used to create the system: the sequencing control modes, sequencing rules, navigation controls, learning records and learning record stores. The model is based on artificial intelligent algorithms that analyze the data captured for each user and creates an adaptive navigation path through the learning content of the system, allowing each user to experience the content in different ways

  9. Power management system (United States)

    Algrain, Marcelo C.; Johnson, Kris W.; Akasam, Sivaprasad; Hoff, Brian D.


    A method of managing power resources for an electrical system of a vehicle may include identifying enabled power sources from among a plurality of power sources in electrical communication with the electrical system and calculating a threshold power value for the enabled power sources. A total power load placed on the electrical system by one or more power consumers may be measured. If the total power load exceeds the threshold power value, then a determination may be made as to whether one or more additional power sources is available from among the plurality of power sources. At least one of the one or more additional power sources may be enabled, if available.

  10. Gene Disease Diagnostic System

    Institute of Scientific and Technical Information of China (English)

    黄国亮; 张腾飞; 程京; 周玉祥; 刘诚迅; 金国藩; 邬敏贤; 严瑛白; 杨蓉


    Binary optics, where the optical element can be fabricated on a thin glass plate with micro-ion-etching film layer, has been widely applied in recent years. A novel optical scanning system for gene disease diagnostics described in this paper has four kinds of optical devices, including beam splitters, an array lens, an array filter and detection arrays. A software was developed to design the binary optics system using an iterative method. Two beam splitters were designed and fabricated, which can divide a beam into a 9×9 array or into a 13×13 array. The beam splitters have good diffraction efficiencies (>70%) and an even energy distribution. The gene disease diagnostic system is a portable biochip and binary optics technology. The binary optical devices in the non-confocal scanning system can raise the fluorescence detection sensitivity of the micro-array hybrid biochip.

  11. Verification Account Management System (VAMS) (United States)

    Social Security Administration — The Verification Account Management System (VAMS) is the centralized location for maintaining SSA's verification and data exchange accounts. VAMS account management...

  12. Systemic manifestations of oral diseases


    N Chaitanya Babu; Andrea Joan Gomes


    The oral cavity is the site of much infectious and inflammatory disease which has been associated with systemic diseases such as diabetes, cardiovascular disease and pre-term low births. This article emphasizes on the oral-systemic disease connection which is now a rapidly advancing area of research. The possible systemic diseases which arise from oral microorganisms are hereby focused.

  13. Hands in Systemic Disease (United States)

    ... Z Videos Infographics Symptom Picker Anatomy Bones Joints Muscles Nerves Vessels Tendons About Hand Surgery What is a Hand Surgeon? What is ... nerves, skin and skin-related tissues, bones, and ... a systemic diseases. The hands may show changes noticed by the patient or ...

  14. Association between periodontal diseases and systemic diseases. (United States)

    Weidlich, Patrícia; Cimões, Renata; Pannuti, Claudio Mendes; Oppermann, Rui Vicente


    Current evidence suggests that periodontal disease may be associated with systemic diseases. This paper reviewed the published data about the relationship between periodontal disease and cardiovascular diseases, adverse pregnancy outcomes, diabetes and respiratory diseases, focusing on studies conducted in the Brazilian population. Only a few studies were found in the literature focusing on Brazilians (3 concerning cardiovascular disease, 7 about pregnancy outcomes, 9 about diabetes and one regarding pneumonia). Although the majority of them observed an association between periodontitis and systemic conditions, a causal relationship still needs to be demonstrated. Further studies, particularly interventional well-designed investigations, with larger sample sizes, need to be conducted in Brazilian populations.

  15. Association between periodontal diseases and systemic diseases

    Directory of Open Access Journals (Sweden)

    Patrícia Weidlich


    Full Text Available Current evidence suggests that periodontal disease may be associated with systemic diseases. This paper reviewed the published data about the relationship between periodontal disease and cardiovascular diseases, adverse pregnancy outcomes, diabetes and respiratory diseases, focusing on studies conducted in the Brazilian population. Only a few studies were found in the literature focusing on Brazilians (3 concerning cardiovascular disease, 7 about pregnancy outcomes, 9 about diabetes and one regarding pneumonia. Although the majority of them observed an association between periodontitis and systemic conditions, a causal relationship still needs to be demonstrated. Further studies, particularly interventional well-designed investigations, with larger sample sizes, need to be conducted in Brazilian populations.

  16. Mastering the management system. (United States)

    Kaplan, Robert S; Norton, David P


    Companies have always found it hard to balance pressing operational concerns with long-term strategic priorities. The tension is critical: World-class processes won't lead to success without the right strategic direction, and the best strategy in the world will get nowhere without strong operations to execute it. In this article, Kaplan, of Harvard Business School, and Norton, founder and director of the Palladium Group, explain how to effectively manage both strategy and operations by linking them tightly in a closed-loop management system. The system comprises five stages, beginning with strategy development, which springs from a company's mission, vision, and value statements, and from an analysis of its strengths, weaknesses, and competitive environment. In the next stage, managers translate the strategy into objectives and initiatives with strategy maps, which organize objectives by themes, and balanced scorecards, which link objectives to performance metrics. Stage three involves creating an operational plan to accomplish the objectives and initiatives; it includes targeting process improvements and preparing sales, resource, and capacity plans and dynamic budgets. Managers then put plans into action, monitoring their effectiveness in stage four. They review operational, environmental, and competitive data; assess progress; and identify barriers to execution. In the final stage, they test the strategy, analyzing cost, profitability, and correlations between strategy and performance. If their underlying assumptions appear faulty, they update the strategy, beginning another loop. The authors present not only a comprehensive blueprint for successful strategy execution but also a managerial tool kit, illustrated with examples from HSBC Rail, Cigna Property and Casualty, and Store 24. The kit incorporates leading management experts' frameworks, outlining where they fit into the management cycle.

  17. Soil health paradigms and implications for disease management. (United States)

    Larkin, Robert P


    Soil health has been defined as the capacity of soil to function as a vital living system to sustain biological productivity, maintain environmental quality, and promote plant, animal, and human health. Building and maintaining soil health are essential to agricultural sustainability and ecosystem function. Management practices that promote soil health, including the use of crop rotations, cover crops and green manures, organic amendments, and conservation tillage, also have generally positive effects on the management of soilborne diseases through a number of potential mechanisms, including increasing soil microbial biomass, activity, and diversity, resulting in greater biological suppression of pathogens and diseases. However, there also may be particular disease issues associated with some soil health management practices. In this review, research and progress made over the past twenty years regarding soil health, sustainability, and soil health management practices, with an emphasis on their implications for and effects on plant disease and disease management strategies, are summarized.

  18. Economic value evaluation in disease management programs. (United States)

    Magnezi, Racheli; Reicher, Sima; Shani, Mordechai


    Chronic disease management has been a rapidly growing entity in the 21st century as a strategy for managing chronic illnesses in large populations. However, experience has shown that disease management programs have not been able to demonstrate their financial value. The objectives of disease management programs are to create quality benchmarks, such as principles and guidelines, and to establish a uniform set of metrics and a standardized methodology for evaluating them. In order to illuminate the essence of disease management and its components, as well as the complexity and the problematic nature of performing economic calculations of their profitability and value, we collected data from several reports that dealt with the economic intervention of disease management programs. The disease management economic evaluation is composed of a series of steps, including the following major categories: data/information technology, information generation, assessment/recommendations, actionable customer plans, and program assessment/reassessment. We demonstrate the elements necessary for economic analysis. Disease management is one of the most innovative tools in the managed care environment and is still in the process of being defined. Therefore, objectives should include the creation of quality measures, such as principles and guidelines, and the establishment of a uniform set of metrics and a standardized methodology for evaluating them.

  19. HLT configuration management system

    CERN Document Server

    Daponte, Vincenzo


    The CMS High Level Trigger (HLT) is implemented running a streamlined version of the CMS offline reconstruction software running on thousands of CPUs. The CMS software is written mostly in C++, using Python as its configuration language through an embedded CPython interpreter. The configuration of each process is made up of hundreds of modules, organized in sequences and paths. As an example, the HLT configurations used for 2011 data taking comprised over 2200 different modules, organized in more than 400 independent trigger paths. The complexity of the HLT configurations and the large number of configuration produced require the design of a suitable data management system. The present work describes the designed solution to manage the considerable number of configurations developed and to assist the editing of new configurations. The system is required to be remotely accessible and OS-independent as well as easly maintainable easy to use. To meet these requirements a three-layers architecture has been choose...

  20. Development, deployment and usability of a point-of-care decision support system for chronic disease management using the recently-approved HL7 decision support service standard. (United States)

    Lobach, David F; Kawamoto, Kensaku; Anstrom, Kevin J; Russell, Michael L; Woods, Peter; Smith, Dwight


    Clinical decision support is recognized as one potential remedy for the growing crisis in healthcare quality in the United States and other industrialized nations. While decision support systems have been shown to improve care quality and reduce errors, these systems are not widely available. This lack of availability arises in part because most decision support systems are not portable or scalable. The Health Level 7 international standard development organization recently adopted a draft standard known as the Decision Support Service standard to facilitate the implementation of clinical decision support systems using software services. In this paper, we report the first implementation of a clinical decision support system using this new standard. This system provides point-of-care chronic disease management for diabetes and other conditions and is deployed throughout a large regional health system. We also report process measures and usability data concerning the system. Use of the Decision Support Service standard provides a portable and scalable approach to clinical decision support that could facilitate the more extensive use of decision support systems.

  1. Management systems research study (United States)

    Bruno, A. V.


    The development of a Monte Carlo simulation of procurement activities at the NASA Ames Research Center is described. Data cover: simulation of the procurement cycle, construction of a performance evaluation model, examination of employee development, procedures and review of evaluation criteria for divisional and individual performance evaluation. Determination of the influences and apparent impact of contract type and structure and development of a management control system for planning and controlling manpower requirements.


    Directory of Open Access Journals (Sweden)

    Sion Hannuna


    Full Text Available Around 52% of the population of India rely on farming for their livelihood which accounts for 17% of India’s GDP. Whilst most farmers are familiar with conventional farming practices, they are often ill positioned to promptly deal with diseases and plant infestations affecting their crops. Current advisory systems tend to be generic and are not tailored to specific plots or farms. This work comprises an agriculture advisory call center similar to a modern call center to provide an agriculture disease mitigation system. The information regarding an individual farm is collected using mobile phones. The image of diseased/infected crop is also captured using mobile phones and is made available to the expert to provide the advisory. To scale the advisory, an attempt is also made to automate the disease recognition process using image processing. Unfortunately, the photos taken will be sensitive to a number of factors including camera type and lighting incident on the scene. Ideally, the images would be processed in such a way as to provide the expert with a visual representation of the affected crops that reflects the true nature of the scene. We describe a framework for standardising the colour of plant images taken using both mobile phones and compact cameras within the context of the advisory system.

  3. Pathogenesis and management of Wilson disease. (United States)

    Harada, Masaru


    Hepatolenticular degeneration, commonly known as Wilson disease, is an autosomal recessive inherited disease of abnormal copper metabolism, characterized by the accumulation of copper in the body due to decreased biliary excretion of copper from hepatocytes. Wilson disease protein, ATP7B, functions in copper excretion into bile and in copper secretion to the bloodstream coupled with ceruloplasmin synthesis. Various kinds of mutations of ATP7B cause Wilson disease. Wilson disease is a rare genetic disease that can be treated pharmacologically. Recognition and prompt diagnosis are very important, because Wilson disease is fatal if left untreated. In this review, I summarize the pathogenesis and management of Wilson disease.

  4. Pregnancy in patients with rheumatic diseases: obstetric management and monitoring. (United States)

    Branch, D W


    The obstetric management of the pregnant rheumatic patient is largely dictated by the specific disease and the degree to which it is associated with recognizable and treatable adverse obstetric outcomes, maternal or fetal. This review will cover the obstetric management of women with systemic lupus erythematosus (SLE), antiphospholipid syndrome (APS), rheumatoid arthritis (RA) and systemic sclerosis (SSc). Most experts agree that a co-ordinated management effort on the part of obstetricians and rheumatologists will likely yield the optimal achievable results.

  5. Wireless technology in disease management and medicine. (United States)

    Clifford, Gari D; Clifton, David


    Healthcare information, and to some extent patient management, is progressing toward a wireless digital future. This change is driven partly by a desire to improve the current state of medicine using new technologies, partly by supply-and-demand economics, and partly by the utility of wireless devices. Wired technology can be cumbersome for patient monitoring and can restrict the behavior of the monitored patients, introducing bias or artifacts. However, wireless technologies, while mitigating some of these issues, have introduced new problems such as data dropout and "information overload" for the clinical team. This review provides an overview of current wireless technology used for patient monitoring and disease management. We identify some of the major related issues and describe some existing and possible solutions. In particular, we discuss the rapidly evolving fields of telemedicine and mHealth in the context of increasingly resource-constrained healthcare systems.

  6. Disease management programs for the underserved. (United States)

    Horswell, Ronald; Butler, Michael K; Kaiser, Michael; Moody-Thomas, Sarah; McNabb, Shannon; Besse, Jay; Abrams, Amir


    Disease management has become an important tool for improving population patient outcomes. The Louisiana State University Health Care Services Division (HCSD) has used this tool to provide care to a largely uninsured population for approximately 10 years. Eight programs currently exist within the HCSD focusing on diabetes, asthma, congestive heart failure, HIV, cancer screening, smoking cessation, chronic kidney disease, and diet, exercise, and weight control. These programs operate at hospital and clinic sites located in 8 population centers throughout southern Louisiana. The programs are structured to be managed at the system level with a clinical expert for each area guiding the scope of the program and defining new goals. Care largely adheres to evidence-based guidelines set forth by professional organizations. To monitor quality of care, indicators are defined within each area and benchmarked to achieve the most effective measures in our population. For example, hemoglobin A1c levels have shown improvements with nearly 54% of the population management efforts, HCSD utilizes an electronic data repository that allows physicians to track patient labs and other tests as well as reminders. To ensure appropriate treatment, patients are able to enroll in the Medication Assistance program. This largely improves adherence to medications for those patients unable to afford them otherwise.

  7. Managing the Chronic : Investigating chronic disease management in the Netherlands

    NARCIS (Netherlands)

    B.J. Hipple (Bethany)


    markdownabstractThis thesis is based on research conducted on twenty-two disease management programs in the Netherlands. These programs were predominantly based in primary care facilities and focused on chronic diseases including diabetes, COPD, risk of cardiovascular disease, mental health issues,

  8. Translation of Contextual Control Model to chronic disease management: A paradigm to guide design of cognitive support systems. (United States)

    Leecaster, Molly K; Weir, Charlene R; Drews, Frank A; Hellewell, James L; Bolton, Daniel; Jones, Makoto M; Nebeker, Jonathan R


    Electronic health records (EHRs) continue to be criticized for providing poor cognitive support. Defining cognitive support has lacked theoretical foundation. We developed a measurement model of cognitive support based on the Contextual Control Model (COCOM), which describes control characteristics of an "orderly" joint system and proposes 4 levels of control: scrambled, opportunistic, tactical, and strategic. 35 clinicians (5 centers) were interviewed pre and post outpatient clinical visits and audiotaped during the visit. Behaviors pertaining to hypertension management were systematically mapped to the COCOM control characteristics of: (1) time horizon, (2) uncertainty assessment, (3) consideration of multiple goals, (4) causal model described, and (5) explicitness of plan. Each encounter was classified for overall mode of control. Visits with deviation versus no deviation from hypertension goals were compared. Reviewer agreement was high. Control characteristics differed significantly between deviation groups (Wilcox rank sum p<.01). K-means cluster analysis of control characteristics, stratified by deviation were distinct, with higher goal deviations associated with more control characteristics. The COCOM control characteristics appear to be areas of potential yield for improved user-experience design. Published by Elsevier Inc.

  9. Achieving sustainable plant disease management through evolutionary principles. (United States)

    Zhan, Jiasui; Thrall, Peter H; Burdon, Jeremy J


    Plants and their pathogens are engaged in continuous evolutionary battles and sustainable disease management requires novel systems to create environments conducive for short-term and long-term disease control. In this opinion article, we argue that knowledge of the fundamental factors that drive host-pathogen coevolution in wild systems can provide new insights into disease development in agriculture. Such evolutionary principles can be used to guide the formulation of sustainable disease management strategies which can minimize disease epidemics while simultaneously reducing pressure on pathogens to evolve increased infectivity and aggressiveness. To ensure agricultural sustainability, disease management programs that reflect the dynamism of pathogen population structure are essential and evolutionary biologists should play an increasing role in their design. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. The management of rheumatic diseases in pregnancy. (United States)

    Mitchell, K; Kaul, M; Clowse, Megan E B


    Pregnancy can create a challenge for physicians caring for women with rheumatic diseases. For many women with rheumatoid arthritis (RA), pregnancy can provide a reprieve from long-term joint pain and inflammation, but others will not experience remission and will continue to need medication. Systemic lupus erythematosus (SLE) may remain quiet in some women, but in others may become more aggressive during pregnancy, putting both mother and foetus at risk. Women with limited scleroderma can do remarkably well, but scleroderma renal crises can be difficult to manage. A third of pregnancies in women with antiphospholipid syndrome (APS) may be refractory to our best therapy. In general, active inflammation from rheumatic diseases poses a stronger threat to the well-being of both mother and foetus than many immunosuppressant medications. Therefore, continued immunosuppression with the least risky medications will allow for the most optimal pregnancy outcomes.

  11. Incident Management Systems are essential for Effective Coordination of Large Disease Outbreaks: Perspectives from the Coordination of the Ebola Outbreak Response in Sierra Leone

    Directory of Open Access Journals (Sweden)

    Olushayo Oluseun Olu


    Full Text Available Background: Response to the 2014–2015 Ebola Virus Disease (EVD outbreak in Sierra Leone overwhelmed the national capacity to contain it and necessitated a massive international response and strong coordination platform. Consequently, the Sierra Leone Government, with support of the international humanitarian community, established and implemented various models for national coordination of the outbreak. In this article we review the strengths and limitations of the EVD outbreak response coordination systems in Sierra Leone and propose recommendations for improving coordination of similar outbreaks in the future. Conclusions: There were two main frameworks used for the coordination of the outbreak; the Emergency Operation Center (EOC and the National Ebola Response Center (NERC. We observed an improvement in outbreak coordination as the management mechanism evolved from the EOC to the NERC. Both coordination systems had their advantages and disadvantages; however the NERC coordination mechanism appeared to be more robust. We identified challenges, such as competition and duplication of efforts between the numerous coordination groups, slow resource mobilization, inadequate capacity of NERC/EOC staff for health coordination and an overtly centralized coordination and decision making system as the main coordination challenges during the outbreak. Recommendations: We recommend the establishment of emergency operation centers with simple incident management system-based coordination prior to outbreaks, strong government leadership, decentralization of coordination systems and functions to the epicenter of outbreaks, with clear demarcation of roles and responsibilities between different levels, regular training of key coordination leaders and better community participation as methods to improve coordination of future disease outbreaks.

  12. Effect of a web-based chronic disease management system on asthma control and health-related quality of life: study protocol for a randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Ahmed Sara


    Full Text Available Abstract Background Asthma is a prevalent and costly disease resulting in reduced quality of life for a large proportion of individuals. Effective patient self-management is critical for improving health outcomes. However, key aspects of self-management such as self-monitoring of behaviours and symptoms, coupled with regular feedback from the health care team, are rarely addressed or integrated into ongoing care. Health information technology (HIT provides unique opportunities to facilitate this by providing a means for two way communication and exchange of information between the patient and care team, and access to their health information, presented in personalized ways that can alert them when there is a need for action. The objective of this study is to evaluate the acceptability and efficacy of using a web-based self-management system, My Asthma Portal (MAP, linked to a case-management system on asthma control, and asthma health-related quality of life. Methods The trial is a parallel multi-centered 2-arm pilot randomized controlled trial. Participants are randomly assigned to one of two conditions: a MAP and usual care; or b usual care alone. Individuals will be included if they are between 18 and 70, have a confirmed asthma diagnosis, and their asthma is classified as not well controlled by their physician. Asthma control will be evaluated by calculating the amount of fast acting beta agonists recorded as dispensed in the provincial drug database, and asthma quality of life using the Mini Asthma Related Quality of Life Questionnaire. Power calculations indicated a needed total sample size of 80 subjects. Data are collected at baseline, 3, 6, and 9 months post randomization. Recruitment started in March 2010 and the inclusion of patients in the trial in June 2010. Discussion Self-management support from the care team is critical for improving chronic disease outcomes. Given the high volume of patients and time constraints during clinical

  13. Management Information Systems at CERN

    CERN Document Server

    Ferguson, J


    The specific areas addressed in the study are 1.Management decision support (data presentation, data base management systems â" DBMS, modeling) 2.Text processing, 3.Electronic communication for management purposes, 4.Office automation, 5.Administrative use of Management Information Systems (MIS) and in particular Administrative Data Processing (ADP).

  14. DIRAC Workload Management System

    CERN Document Server

    Paterson, S


    DIRAC (Distributed Infrastructure with Remote Agent Control) is the Workload and Data Management system (WMS) for the LHCb experiment. The DIRAC WMS offers a transparent way for LHCb users to submit jobs to the EGEE Grid as well as local clusters and individual PCs. This paper will describe workload management optimizations, which ensure high job efficiency and minimized job start times. The computing requirements of the LHCb experiment can only be fulfilled through the use of many distributed compute resources. DIRAC provides a robust platform to run data productions on all the resources available to LHCb including the EGEE Grid. More recently, user support was added to DIRAC that greatly simplifies the procedure of submitting, monitoring and retrieving output of Grid jobs for the LHCb user community. DIRAC submits Pilot Agents to the EGEE Grid via the gLite WMS as normal jobs. Pilot Agents then request jobs from the DIRAC Workload Management System after the local environment has been checked. Therefore DIR...

  15. Bank Customers Management System

    Directory of Open Access Journals (Sweden)

    Ebubeogu Amarachukwu Felix


    Full Text Available ABSTRACT The purpose of this project is in partial fulfilment of the requirements of Bachelor of Science Hon in Information Technology. The Design and development of this Bank customers Management system provides a more secured approach in managing bank customers information which strengthens the relationships between banks and their customers by providing the right solutions that uses a multi-level security to improve customer satisfaction. The technology used in developing this project is ASP.NET and the programming language used to develop this project is C and the IDE used is Microsoft Visual Studio 2013 professional in designing the front end while the back end uses Microsoft SQL Server 2012.

  16. Environmental Management System Plan

    Energy Technology Data Exchange (ETDEWEB)

    Fox, Robert; Thorson, Patrick; Horst, Blair; Speros, John; Rothermich, Nancy; Hatayama, Howard


    Executive Order 13423, Strengthening Federal Environmental, Energy, and Transportation Management establishes the policy that Federal agencies conduct their environmental, transportation, and energy-related activities in a manner that is environmentally, economically and fiscally sound, integrated, continually improving, efficient, and sustainable. The Department of Energy (DOE) has approved DOE Order 450.1A, Environmental Protection Program and DOE Order 430.2B, Departmental Energy, Renewable Energy and Transportation Management as the means of achieving the provisions of this Executive Order. DOE Order 450.1A mandates the development of Environmental Management Systems (EMS) to implement sustainable environmental stewardship practices that: (1) Protect the air, water, land, and other natural and cultural resources potentially impacted by facility operations; (2) Meet or exceed applicable environmental, public health, and resource protection laws and regulations; and (3) Implement cost-effective business practices. In addition, the DOE Order 450.1A mandates that the EMS must be integrated with a facility's Integrated Safety Management System (ISMS) established pursuant to DOE P 450.4, 'Safety Management System Policy'. DOE Order 430.2B mandates an energy management program that considers energy use and renewable energy, water, new and renovated buildings, and vehicle fleet activities. The Order incorporates the provisions of the Energy Policy Act of 2005 and Energy Independence and Security Act of 2007. The Order also includes the DOE's Transformational Energy Action Management initiative, which assures compliance is achieved through an Executable Plan that is prepared and updated annually by Lawrence Berkeley National Laboratory (LBNL, Berkeley Lab, or the Laboratory) and then approved by the DOE Berkeley Site Office. At the time of this revision to the EMS plan, the 'FY2009 LBNL Sustainability Executable Plan' represented the most

  17. Pollution management system

    DEFF Research Database (Denmark)


    A pollution management system comprises an array of one or more inlets and at least one outlet. The one or more inlets are arranged to collect polluted air and supply said polluted air to a polluted air treatment element. The one or more inlets each comprise a respective inlet sensor for measuring...... a level of pollution at the inlet, and the at least one outlet comprises an outlet sensor for measuring a level of pollution at the outlet. The inlet sensors and the outlet sensor are arranged to provide feedback to the polluted air treatment element....

  18. Disease management as a performance improvement strategy. (United States)

    McClatchey, S


    Disease management is a strategy of organizing care and services for a patient population across the continuum. It is characterized by a population database, interdisciplinary and interagency collaboration, and evidence-based clinical information. The effectiveness of a disease management program has been measured by a combination of clinical, financial, and quality of life outcomes. In early 1997, driven by a strategic planning process that established three Centers of Excellence (COE), we implemented disease management as the foundation for a new approach to performance improvement utilizing five key strategies. The five implementation strategies are outlined, in addition to a review of the key elements in outcome achievement.

  19. Ground Enterprise Management System Project (United States)

    National Aeronautics and Space Administration — Emergent Space Technologies Inc. proposes to develop the Ground Enterprise Management System (GEMS) for spacecraft ground systems. GEMS will provide situational...

  20. Management of polycystic liver disease. (United States)

    Everson, Gregory T; Taylor, Matthew R G


    The adult forms of polycystic liver disease are characterized by autosomal dominant inheritance and numerous hepatic cysts, with or without renal involvement. Mutations in two distinct genes predispose to renal and liver cysts (PKD1 and PKD2), and mutations in two different genes yield isolated liver cysts (PRKCSH and SEC63). Mutations at certain loci of PKD1 may predispose to more severe renal cystic disease or cerebral aneurysms. Risk factors for severe hepatic cystic disease include aging, female sex, pregnancy, use of exogenous female steroid hormones, degree of renal cystic disease, or severity of renal dysfunction (in patients with mutations in PKD1 or PKD2). Although liver failure or complications of advanced liver disease is rare, some patients develop massive hepatic cystic disease and become clinically symptomatic. There is no effective medical therapy. Treatment options include cyst aspiration and sclerosis, open or laparoscopic cyst fenestration, hepatic resection, and liver transplantation.

  1. Celiac disease: diagnosis and management. (United States)

    Pelkowski, Timothy D; Viera, Anthony J


    Celiac disease is an autoimmune disorder of the gastrointestinal tract. It is triggered by exposure to dietary gluten in genetically susceptible individuals. Gluten is a storage protein in wheat, rye, and barley, which are staples in many American diets. Celiac disease is characterized by chronic inflammation of the small intestinal mucosa, which leads to atrophy of the small intestinal villi and subsequent malabsorption. The condition may develop at any age. Intestinal manifestations include diarrhea and weight loss. Common extraintestinal manifestations include iron deficiency anemia, decreased bone mineral density, and neuropathy. Most cases of celiac disease are diagnosed in persons with extraintestinal manifestations. The presence of dermatitis herpetiformis is pathognomonic for celiac disease. Diagnosis is supported by a positive tissue transglutaminase serologic test but, in general, should be confirmed by a small bowel biopsy showing the characteristic histology associated with celiac disease. The presence of human leukocyte antigen alleles DQ2, DQ8, or both is essential for the development of celiac disease, and can be a useful genetic test in select instances. Treatment of celiac disease is a gluten-free diet. Dietary education should focus on identifying hidden sources of gluten, planning balanced meals, reading labels, food shopping, dining out, and dining during travel. About 5% of patients with celiac disease are refractory to a gluten-free diet. These patients should be referred to a gastroenterologist for reconsideration of the diagnosis or for aggressive treatment of refractory celiac disease, which may involve corticosteroids and immunomodulators.

  2. Climate change and plant disease management. (United States)

    Coakley, S M; Scherm, H; Chakraborty, S


    ▪ Abstract  Research on impacts of climate change on plant diseases has been limited, with most work concentrating on the effects of a single atmospheric constituent or meteorological variable on the host, pathogen, or the interaction of the two under controlled conditions. Results indicate that climate change could alter stages and rates of development of the pathogen, modify host resistance, and result in changes in the physiology of host-pathogen interactions. The most likely consequences are shifts in the geographical distribution of host and pathogen and altered crop losses, caused in part by changes in the efficacy of control strategies. Recent developments in experimental and modeling techniques offer considerable promise for developing an improved capability for climate change impact assessment and mitigation. Compared with major technological, environmental, and socioeconomic changes affecting agricultural production during the next century, climate change may be less important; it will, however, add another layer of complexity and uncertainty onto a system that is already exceedingly difficult to manage on a sustainable basis. Intensified research on climate change-related issues could result in improved understanding and management of plant diseases in the face of current and future climate extremes.

  3. Psoriasis and comorbid diseases: Implications for management. (United States)

    Takeshita, Junko; Grewal, Sungat; Langan, Sinéad M; Mehta, Nehal N; Ogdie, Alexis; Van Voorhees, Abby S; Gelfand, Joel M


    As summarized in the first article in this continuing medical education series, the currently available epidemiologic data suggest that psoriasis may be a risk factor for cardiometabolic disease. Emerging data also suggest associations between psoriasis and other comorbidities beyond psoriatic arthritis, including chronic kidney disease, inflammatory bowel disease, hepatic disease, certain malignancies, infections, and mood disorders. Recognizing the comorbid disease burden of psoriasis is essential for ensuring comprehensive care of patients with psoriasis. The clinical implications of the comorbid diseases that are associated with psoriasis and recommendations for clinical management are reviewed in this article. Copyright © 2016 American Academy of Dermatology, Inc. All rights reserved.

  4. Reliability Management for Information System

    Institute of Scientific and Technical Information of China (English)

    李睿; 俞涛; 刘明伦


    An integrated intelligent management is presented to help organizations manage many heterogeneous resources in their information system. A general architecture of management for information system reliability is proposed, and the architecture from two aspects, process model and hierarchical model, described. Data mining techniques are used in data analysis. A data analysis system applicable to real-time data analysis is developed by improved data mining on the critical processes. The framework of the integrated management for information system reliability based on real-time data mining is illustrated, and the development of integrated and intelligent management of information system discussed.


    Directory of Open Access Journals (Sweden)



    Full Text Available Sickle cell disease (SCD is a genetically transmitted multisystem disease1 which includes a group of disorders that differs in severity sign and symptoms, The disease is not uniformly seen everywhere but it has some topographical distribution. In India, it is frequently seen in Central India, in and around the vicinity of Chhattisgarh in some religions in caste like kurmis, satnami, mahar, other backward caste and some tribes, it has great pathological significance considering the high morbidity and mortality resulting from the disease process. We have studied the cases of SCD from 2001 to 2015 series of such patients, since there is no cure of this disease, in regards to prevention of this genetic autosomal recessive disorder by marriage counseling, the incidence can be significantly reduced by avoiding consanguineous marriages in the susceptible community.

  6. Crohn Disease: Epidemiology, Diagnosis, and Management. (United States)

    Feuerstein, Joseph D; Cheifetz, Adam S


    Crohn disease is a chronic idiopathic inflammatory bowel disease condition characterized by skip lesions and transmural inflammation that can affect the entire gastrointestinal tract from the mouth to the anus. For this review article, we performed a review of articles in PubMed through February 1, 2017, by using the following Medical Subject Heading terms: crohns disease, crohn's disease, crohn disease, inflammatory bowel disease, and inflammatory bowel diseases. Presenting symptoms are often variable and may include diarrhea, abdominal pain, weight loss, nausea, vomiting, and in certain cases fevers or chills. There are 3 main disease phenotypes: inflammatory, structuring, and penetrating. In addition to the underlying disease phenotype, up to a third of patients will develop perianal involvement of their disease. In addition, in some cases, extraintestinal manifestations may develop. The diagnosis is typically made with endoscopic and/or radiologic findings. Disease management is usually with pharmacologic therapy, which is determined on the basis of disease severity and underlying disease phenotype. Although the goal of management is to control the inflammation and induce a clinical remission with pharmacologic therapy, most patients will eventually require surgery for their disease. Unfortunately, surgery is not curative and patients still require ongoing therapy even after surgery for disease recurrence. Importantly, given the risks of complications from both Crohn disease and the medications used to treat the disease process, primary care physicians play an important role in optimizing the preventative care management to reduce the risk of complications. Copyright © 2017 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  7. Microbially produced phytotoxins and plant disease management ...

    African Journals Online (AJOL)

    Microbially produced phytotoxins and plant disease management. ... African Journal of Biotechnology ... Pathogenic fungi and bacteria often damage their host (plants) tissues by producing toxic metabolites, which induced various symptoms ...

  8. Mucormycosis in systemic autoimmune diseases. (United States)

    Royer, Mathieu; Puéchal, Xavier


    Mucormycosis is an emerging infection in systemic autoimmune diseases. All published cases of systemic autoimmune diseases complicated by mucormycosis were reviewed. The clinical features, diagnostic procedures and the main principles of treatment were analyzed. Twenty-four cases of mucormycosis have been reported in systemic auto-immune diseases, of which 83% in systemic lupus erythematosus, all occurring during immunosuppressants. In most cases, the infection was disseminated or rhinocerebral and it had mimicked a flare of the underlying connective tissue disease. A fatal outcome was reported in 58.3% of these patients. In conclusion, mucormycosis often mimics a flare of the underlying systemic disease and is associated with a high mortality rate. Systemic lupus erythematosus is by far the most common associated systemic autoimmune disease. A high degree of awareness is warranted to rapidly rule out infection, of which mucormycosis, in immunocompromised patients with systemic autoimmune disease before a disease flare is conclusively diagnosed.

  9. Managing diseases in seed garlic: What are the options? (United States)

    Organisms (fungi, bacteria, viruses and nematodes) causing diseases of seed garlic are discussed in terms of their pathogenic abilities, aggressiveness, management constraints and management options. Management options for vectors (for viral diseases) are placed in context. Concise and general manag...

  10. Current management of Parkinson's disease

    African Journals Online (AJOL)

    Although Parkinson's disease (PD) is still incurable, a large number of different treatments have become ... (impaired balance); and pathologically by neuronal ..... neurons and at the same time, a reduction in the .... produce energy inside cells.

  11. [Management of systemic lupus erythematosus]. (United States)

    Aringer, M; Schneider, M


    In the last few decades a number of small, often largely unrecognized steps have fundamentally changed the management of systemic lupus erythematosus (SLE). The current goal is to stop all disease activity without long-term use of more than 5 mg prednisolone per day. Remission, i.e. absence of activity in the SLE activity score of choice, is the defined target in the treat to target approach. The essential basic measures include life-long hydroxychloroquine as well as protection from sunlight (UV) and vitamin D substitution. Patients suffering from SLE need more vaccinations than the healthy population and control of risk factors for atherosclerosis is critical for long-term survival. Methotrexate is on par with azathioprine. If disease activity cannot be controlled in this way, belimumab is an approved therapeutic option. Cyclophosphamide is still used but only in life-threatening situations, such as lupus nephritis or central nervous system (CNS) vasculitis and in drastically reduced doses. Alternatively, off-label mycophenolate mofetil (MMF) can be used particularly for lupus nephritis and off-label rituximab in refractory disease courses. Numerous novel approaches are being tested in controlled trials and it is hoped that new drugs will be available for SLE patients within a few years.

  12. Perioperative management of cardiac disease. (United States)

    Aresti, N A; Malik, A A; Ihsan, K M; Aftab, S M E; Khan, W S


    Pre-existing cardiac disease contributes significantly to morbidity and mortality amongst patients undergoing non cardiac surgery. Patients with pre-existing cardiac disease or with risk factors for it, have as much as a 3.9% risk of suffering a major perioperative cardiac event (Lee et al 1999, Devereaux 2005). Furthermore, the incidence of perioperative myocardial infarction (MI) is increased 10 to 50 fold in patients with previous coronary events (Jassal 2008).

  13. Disease and health management in Asian aquaculture. (United States)

    Bondad-Reantaso, Melba G; Subasinghe, Rohana P; Arthur, J Richard; Ogawa, Kazuo; Chinabut, Supranee; Adlard, Robert; Tan, Zilong; Shariff, Mohamed


    Asia contributes more than 90% to the world's aquaculture production. Like other farming systems, aquaculture is plagued with disease problems resulting from its intensification and commercialization. This paper describes the various factors, providing specific examples, which have contributed to the current disease problems faced by what is now the fastest growing food-producing sector globally. These include increased globalization of trade and markets; the intensification of fish-farming practices through the movement of broodstock, postlarvae, fry and fingerlings; the introduction of new species for aquaculture development; the expansion of the ornamental fish trade; the enhancement of marine and coastal areas through the stocking of aquatic animals raised in hatcheries; the unanticipated interactions between cultured and wild populations of aquatic animals; poor or lack of effective biosecurity measures; slow awareness on emerging diseases; the misunderstanding and misuse of specific pathogen free (SPF) stocks; climate change; other human-mediated movements of aquaculture commodities. Data on the socio-economic impacts of aquatic animal diseases are also presented, including estimates of losses in production, direct and indirect income and employment, market access or share of investment, and consumer confidence; food availability; industry failures. Examples of costs of investment in aquatic animal health-related activities, including national strategies, research, surveillance, control and other health management programmes are also provided. Finally, the strategies currently being implemented in the Asian region to deal with transboundary diseases affecting the aquaculture sector are highlighted. These include compliance with international codes, and development and implementation of regional guidelines and national aquatic animal health strategies; new diagnostic and therapeutic techniques and new information technology; new biosecurity measures including

  14. Diagnosis and management of thyroid eye disease. (United States)

    Denniston, Alastair; Dodson, Paul; Reuser, Tristan


    Recent advances are helping elucidate the pathogenesis and improve the management of thyroid eye disease. While biochemical investigations and imaging may be supportive, ophthalmological and medical clinical assessments remain the key to the diagnosis and management of this sight-threatening disorder.

  15. Cryptographic Key Management System

    Energy Technology Data Exchange (ETDEWEB)

    No, author


    This report summarizes the outcome of U.S. Department of Energy (DOE) contract DE-OE0000543, requesting the design of a Cryptographic Key Management System (CKMS) for the secure management of cryptographic keys for the energy sector infrastructure. Prime contractor Sypris Electronics, in collaboration with Oak Ridge National Laboratories (ORNL), Electric Power Research Institute (EPRI), Valicore Technologies, and Purdue University's Center for Education and Research in Information Assurance and Security (CERIAS) and Smart Meter Integration Laboratory (SMIL), has designed, developed and evaluated the CKMS solution. We provide an overview of the project in Section 3, review the core contributions of all contractors in Section 4, and discuss bene ts to the DOE in Section 5. In Section 6 we describe the technical construction of the CKMS solution, and review its key contributions in Section 6.9. Section 7 describes the evaluation and demonstration of the CKMS solution in different environments. We summarize the key project objectives in Section 8, list publications resulting from the project in Section 9, and conclude with a discussion on commercialization in Section 10 and future work in Section 11.

  16. Supplier Management System (United States)

    Ramirez, Eric; Gutheinz, Sandy; Brison, James; Ho, Anita; Allen, James; Ceritelli, Olga; Tobar, Claudia; Nguyen, Thuykien; Crenshaw, Harrel; Santos, Roxann


    Supplier Management System (SMS) allows for a consistent, agency-wide performance rating system for suppliers used by NASA. This version (2.0) combines separate databases into one central database that allows for the sharing of supplier data. Information extracted from the NBS/Oracle database can be used to generate ratings. Also, supplier ratings can now be generated in the areas of cost, product quality, delivery, and audit data. Supplier data can be charted based on real-time user input. Based on these individual ratings, an overall rating can be generated. Data that normally would be stored in multiple databases, each requiring its own log-in, is now readily available and easily accessible with only one log-in required. Additionally, the database can accommodate the storage and display of quality-related data that can be analyzed and used in the supplier procurement decision-making process. Moreover, the software allows for a Closed-Loop System (supplier feedback), as well as the capability to communicate with other federal agencies.

  17. Managing Distributed Knowledge Systems

    DEFF Research Database (Denmark)

    Sørensen, Brian Vejrum; Gelbuda, Modestas


    of integrating new people, building new units and adding activities to the existing organization. It is argued that knowledge is not a stable capacity that belongs to any actor alone, but that it is rather an ongoing social accomplishment, which is created and recreated as actors engage in mutual activities....... This paper contributes to the research on organizations as distributed knowledge systems by addressing two weaknesses of the social practice literature. Firstly, it downplays the importance of formal structure and organizational design and intervention efforts by key organizational members. Secondly, it does......The article argues that the growth of de novo knowledge-based organization depends on managing and coordinating increasingly growing and, therefore, distributed knowledge. Moreover, the growth in knowledge is often accompanied by an increasing organizational complexity, which is a result...


    Directory of Open Access Journals (Sweden)

    Aniko Miler-Virc


    Full Text Available ISO 14001 prescribes the requirements for a system, not environmental performance itself. Similarly, certification is of the management system itself, not environmental performance. An audit is not conducted to ascertain whether your flue gas emissions are less than X part per million nitrous oxide or that your wastewater effluent contains less that Y milligrams of bacteria per litre. Consequently, the procces of auditing the system for compliance to the standard entails checking to see that all of the necessary components of a functioning system are present and working properly.           A company can have a complete and fully functional EMS as prescribed by ISO 14001 without being certified. As certification can add to the time and expense of EMS development, it is important for you to establish, in advance, whether certification is of net benefit to you. Although most companies that develop an EMS do in fact certify, there are cases where certification does not add immediate value. Certification is not always beneficial to small and medium sized companies. Certification is not always necessary for companies with one or two large clients with environmental demands who are satisfied that you have a functional EMS (second-party declaration. Whatever decision you make, it is important to remember that just as a driver′s licence does not automatically make you a good driver, ISO 14001 certification does not automatically make your company environmentally benign or ensure that you will continually improve environmental performance. The system is only as good as the people who operate it.

  19. Management of inflammatory bowel disease in pregnancy

    NARCIS (Netherlands)

    S. Vermeire (Silvio); F. Carbonnel (Franck); P.G. Coulie (Pierre); V. Geenen (Vincent); J.M.W. Hazes (Mieke); P.L. Masson (Pierre); F. de Keyser (Filip); E. Louis (Edouard)


    textabstractBackground and Aims: Inflammatory bowel disease (IBD) is a chronic disease affecting mainly young people in their reproductive years. IBD therefore has a major impact on patients' family planning decisions. Management of IBD in pregnancy requires a challenging balance between optimal dis

  20. Management of Paget's Disease of the Calcaneum. (United States)

    Humphrey, Joel; Pervez, Anum; Walker, Roland; Abbasian, Ali; Singh, Sam

    The calcaneum is not the most common site for Paget's disease of bone, with only a few reports of monostotic involvement. We present 2 cases of Paget's disease of bone affecting the calcaneus, present an overview of the published data, and describe our management of these interesting cases.

  1. Diagnosis and management of bullous disease. (United States)

    Hurley, Maria Yadira; Mattox, Adam R


    As the population ages, the prevalence of bullous skin diseases will escalate. Efficient management depends on timely recognition by the physician and reduces the morbidity associated with the disease course. This article outlines the common bullous dermatoses affecting older adults and provides tips for a streamlined approach to workup and treatment.

  2. Mobile phone technology in chronic disease management


    Blake, Holly


    Mobile phones are being used to improve nurse-patient communication and monitor health outcomes in chronic disease. Innovative applications of mobile technology are expected to increase over time in community management of cancer, heart disease, asthma and diabetes. This article focuses on mobile phone technology and its contribution to health care.

  3. Trevor's Disease: Management Difficulties and Proposed Classification. (United States)

    Clarke, Daine O


    Dysplasia epiphysealis hemimelica, also known as Trevor's disease, is a rare developmental disorder with osteocartilagenous overgrowth of the epiphysis or epiphyseal equivalent. The condition bears similarities to osteochondroma in terms of its radiographic appearance, but differs in its pathobiology and geographic occurrence. Unlike the metaphyseal occurrence of osteochondromata, it arises from the epiphysis. The clinical presentation is wide and varied, but mechanical symptoms and deformities predominate. Early reports of the condition suggested involvement of the lower limbs only. However, since then, numerous reports have indicated a more generalized distribution. Difficulties in management and recurrence rates seem to hinge on whether its origin is intra-articular or extra-articular. A new classification system to include these parameters is discussed. [Orthopedics.2016; 39(5):e967-e969.].

  4. Manpower management information system /MIS/ (United States)

    Gravette, M. C.; King, W. L.


    System of programs capable of building and maintaining data bank provides all levels of management with regular manpower evaluation reports and data source for special management exercises on manpower.

  5. Project management and Enterprise systems

    DEFF Research Database (Denmark)

    Koch, Christian; Buhl, Henrik


    Implementing and Operating integrated Enterprise Systems are a multidimensional effort. It seriously challenges the IT supplier as well as the professional service provider client. The paper discuss these issues in a project management perspective. A framework for supporting project management...

  6. System Security Management in SNMP

    Directory of Open Access Journals (Sweden)

    P. Deivendran


    Full Text Available We present a framework for managing system security, based on a SNMP Management Information Base (MIB, namely the System Security MIB (SSEC MIB, We have defined managed objects and completed the ASN.1 description of the MIB that embeds them. The related security management functions are mainly focused on monitoring external script execution for system security scanning and access control. The main goal of this work is to introduce the semantics and a standard interface that will allow the realization of specific system security management functions independently of the underlying architecture. Our definitions pertain to multi-user; multi-tasking operating systems that support TCP/IP communications and a prototype of the SSEC MIB are under development for UNIX system. The proposed management framework follows the manager agent paradigm: an agent is installed on every system connected to the network, communicating with one or more central managers through a management protocol. We have tried not to heavily rely on polling for the manager-agent interaction by using as much as possible asynchronous notification mechanisms and allowing some limited delegated functionality for the agent (scheduling and handling of local scripts. The manager scans the agents for security information, sets specific parameters for monitoring and script execution and receives asynchronous notifications on specific events, whereas the agent maintains a MIB that provides the system-independent interface semantics, executes scripts for security scanning, performs monitoring & logging and generates the asynchronous notification PDUs.


    Directory of Open Access Journals (Sweden)

    A. Dligach


    Full Text Available This article reviews the System Reflexive paradigm of strategic marketing management, being based on the alignment of strategic economic interests of stakeholders, specifically, enterprise owners and hired managers, and consumers. The essence of marketing concept of management comes under review, along with the strategic management approaches to business, buildup and alignment of economic interests of business stakeholders. A roadmap for resolving the problems of modern marketing is proposed through the adoption of System Reflexive marketing theory.


    Directory of Open Access Journals (Sweden)

    Andrii A. DLIGACH


    Full Text Available This article reviews the System Reflexive paradigm of strategic marketing management, being based on the alignment of strategic economic interests of stakeholders, specifically, enterprise owners and hired managers, and consumers. The essence of marketing concept of management comes under review, along with the strategic management approaches to business, buildup and alignment of economic interests of business stakeholders. A roadmap for resolving the problems of modern marketing is proposed through the adoption of System Reflexive marketing theory.

  9. Changeability of production management systems

    NARCIS (Netherlands)

    Hoogenraad, M. S.; Wortmann, J. C.; Olhager, J; Persson, F


    Modem production management systems consist of transaction processing systems and decision enhancement systems. A clear example of two such components are an ERP systems and APS systems. These systems are often standard software systems, and therefore suitable for many different situations. This pap

  10. Changeability of production management systems

    NARCIS (Netherlands)

    Hoogenraad, M. S.; Wortmann, J. C.; Olhager, J; Persson, F


    Modem production management systems consist of transaction processing systems and decision enhancement systems. A clear example of two such components are an ERP systems and APS systems. These systems are often standard software systems, and therefore suitable for many different situations. This

  11. Systemic Cat Scratch Disease

    Directory of Open Access Journals (Sweden)

    Hui-Min Liao


    Full Text Available Systemic cat scratch disease (CSD is often associated with prolonged fever and microabscesses in the liver and/or spleen. We report a case of systemic CSD with hepatic, splenic and renal involvement in an aboriginal child in Taiwan. A previously healthy 9-year-old girl had an intermittent fever for about 17 days, and complained of abdominal pain, headache and weight loss. Abdominal computed tomography showed multiple tiny hypodense nodular lesions in the spleen and both kidneys. Laparotomy revealed multiple soft, whitishtan lesions on the surface of the liver and spleen. Histopathologic examination of a biopsy specimen of the spleen showed necrotizing granulomatous inflammation with central necrosis surrounded by epithelioid cells and occasional Langhans' giant cells, strongly suggestive of Bartonella henselae infection. History revealed close contact with a cat. B. henselae DNA was detected by polymerase chain reaction in the tissue specimen, and the single antibody titer against B. henselae was greater than 1:2048. These results confirmed the diagnosis of visceral CSD caused by B. henselae. The patient's symptoms resolved after treatment with rifampin and tetracycline. This case illustrates the need for inclusion of systemic CSD in patients with fever of unknown origin and abdominal pain.

  12. Neuromuscular disease classification system (United States)

    Sáez, Aurora; Acha, Begoña; Montero-Sánchez, Adoración; Rivas, Eloy; Escudero, Luis M.; Serrano, Carmen


    Diagnosis of neuromuscular diseases is based on subjective visual assessment of biopsies from patients by the pathologist specialist. A system for objective analysis and classification of muscular dystrophies and neurogenic atrophies through muscle biopsy images of fluorescence microscopy is presented. The procedure starts with an accurate segmentation of the muscle fibers using mathematical morphology and a watershed transform. A feature extraction step is carried out in two parts: 24 features that pathologists take into account to diagnose the diseases and 58 structural features that the human eye cannot see, based on the assumption that the biopsy is considered as a graph, where the nodes are represented by each fiber, and two nodes are connected if two fibers are adjacent. A feature selection using sequential forward selection and sequential backward selection methods, a classification using a Fuzzy ARTMAP neural network, and a study of grading the severity are performed on these two sets of features. A database consisting of 91 images was used: 71 images for the training step and 20 as the test. A classification error of 0% was obtained. It is concluded that the addition of features undetectable by the human visual inspection improves the categorization of atrophic patterns.

  13. Management Strategies for CLN2 Disease. (United States)

    Williams, Ruth E; Adams, Heather R; Blohm, Martin; Cohen-Pfeffer, Jessica L; de Los Reyes, Emily; Denecke, Jonas; Drago, Kristen; Fairhurst, Charlie; Frazier, Margie; Guelbert, Norberto; Kiss, Szilárd; Kofler, Annamaria; Lawson, John A; Lehwald, Lenora; Leung, Mary-Anne; Mikhaylova, Svetlana; Mink, Jonathan W; Nickel, Miriam; Shediac, Renée; Sims, Katherine; Specchio, Nicola; Topcu, Meral; von Löbbecke, Ina; West, Andrea; Zernikow, Boris; Schulz, Angela


    CLN2 disease (neuronal ceroid lipofuscinosis type 2) is a rare, autosomal recessive, pediatric-onset, rapidly progressive neurodegenerative lysosomal storage disorder caused by tripeptidyl peptidase 1 (TPP1) enzyme deficiency, and is characterized by language delay, seizures, rapid cognitive and motor decline, blindness, and early death. No management guidelines exist and there is a paucity of published disease-specific evidence to inform clinical practice, which currently draws upon experience from the field of childhood neurodisability. Twenty-four disease experts were surveyed on CLN2 disease management and a subset met to discuss current practice. Management goals and strategies are consistent among experts globally and are guided by the principles of pediatric palliative care. Goals and interventions evolve as the disease progresses, with a shift in focus from maintenance of function early in the disease to maintenance of quality of life. A multidisciplinary approach is critical for optimal patient care. This work represents an initial step toward the development of consensus-based management guidelines for CLN2 disease. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Metadata Management System for Healthcare Information Systems


    Patil, Ketan Shripat


    The Utah Department of Health (UDOH) uses multiple and diverse healthcare information systems for managing, maintaining, and sharing the health information. To keep track of the important details about these information systems such as the operational details, data semantics, data exchange standards, and personnel responsible for maintaining and managing it is a monumental task, with several limitations. This report describes the design and implementation of the Metadata Management System (MD...

  15. Hybrid Workflow Policy Management for Heart Disease Identification

    Directory of Open Access Journals (Sweden)

    Dong-Hyun Kim


    Full Text Available As science technology grows, medical application is becoming more complex to solve the physiological problems within expected time. Workflow management systems (WMS in Grid computing are promisingsolution to solve the sophisticated problem such as genomic analysis, drug discovery, disease identification, etc. Although existing WMS can provide basic management functionality in Grid environment, consideration of user requirements such as performance, reliability and interaction with user is missing. In this paper, we proposehybrid workflow management system for heart disease identification and discuss how to guarantee different user requirements according to user SLA. The proposed system is applied to Physio-Grid e-health platform to identify human heart disease with ECG analysis and Virtual Heart Simulation (VHS workflow applications.

  16. Hybrid Workflow Policy Management for Heart Disease Identification

    CERN Document Server

    Kim, Dong-Hyun; Youn, Chan-Hyun


    As science technology grows, medical application is becoming more complex to solve the physiological problems within expected time. Workflow management systems (WMS) in Grid computing are promising solution to solve the sophisticated problem such as genomic analysis, drug discovery, disease identification, etc. Although existing WMS can provide basic management functionality in Grid environment, consideration of user requirements such as performance, reliability and interaction with user is missing. In this paper, we propose hybrid workflow management system for heart disease identification and discuss how to guarantee different user requirements according to user SLA. The proposed system is applied to Physio-Grid e-health platform to identify human heart disease with ECG analysis and Virtual Heart Simulation (VHS) workflow applications.

  17. Management of thyroid eye disease

    Energy Technology Data Exchange (ETDEWEB)

    Bartalena, Luigi; Tanda, Maria Laura [Department of Endocrinology, University of Insubria, Ospedale di Circolo, Viale Borri, 57, 21100 Varese (Italy); Marcocci, Claudio; Pinchera, Aldo [Department of Endocrinology and Metabolism, University of Pisa, Pisa (Italy)


    Thyroid eye disease (TED) is the most frequent extrathyroidal manifestation of Graves' disease. In most instances it is mild and non-progressive, but in 3%-5% of cases it is severe. Non-severe TED requires only supportive measures, such as eye ointments, sunglasses and prisms. By contrast, severe TED requires aggressive treatment, either medical (high-dose glucocorticoids, orbital radiotherapy) or surgical (orbital decompression). The choice of treatment relies on the assessment of both TED severity and activity. Removal of controllable risk factors, especially cigarette smoking, is important to improve the course and the therapeutic outcome. A coordinated approach to the treatment of hyperthyroidism and TED is also required. Novel promising treatments, to be verified in large series of patients, include somatostatin analogues and cytokine antagonists. (orig.)

  18. [Systemic sclerosis: a multisystem disease

    NARCIS (Netherlands)

    Berrevoets, M.A.; Markhorst, J.; Meek, I.; Ede, A.E. van; Vonk, M.C.


    Systemic sclerosis is a rare, systemic autoimmune disease, characterized by inflammation, vasculopathy and fibrosis of the skin and internal organs. The disease is associated with a significantly increased morbidity and mortality, and can be rapidly progressive. Interstitial lung disease, renal hype

  19. Management of adynamic bone disease in chronic kidney disease: A brief review

    Directory of Open Access Journals (Sweden)

    Swathi K. Sista


    Full Text Available The Kidney Disease: Improving Global Outcomes (KDIGO work group released recommendations in 2006 to define the bone-related pathology associated with chronic kidney disease as renal osteodystrophy. In 2009, KDIGO released revised clinical practice guidelines which redefined systemic disorders of bone and mineral metabolism due to chronic kidney disease as chronic kidney disease-mineral and bone disorders. Conditions under this overarching term include osteitis fibrosa cystica, osteomalacia, and adynamic bone disease. We aim to provide a brief review of the histopathology, pathophysiology, epidemiology, and diagnostic features of adynamic bone disease, focusing on current trends in the management of this complex bone disorder.

  20. Managing Temporal Knowledge in Port Management Systems

    Directory of Open Access Journals (Sweden)

    Anita Gudelj


    Full Text Available Large ports need to deal with a number of disparate activities:the movement of ships, containers and other cargo, theloading and unloading of ships and containers, customs activities.As well as human resources, anchorages, channels, lighters,tugs, berths, warehouse and other storage spaces have to beallocated and released. The efficient management of a port involvesmanaging these activities and resources, managing theflows of money involved between the agents providing and usingthese resources, and providing management information.Many information systems will be involved.Many applications have to deal with a large amount of datawhich not only represent the perceived state of the real world atpresent, but also past and/or future states. These applicationsare not served adequately by today's computer managementand database systems. In particular, deletions and updates insuch systems have destructive semantics. This means that previousdatabase contents (representing previous perceived statesof the real world cannot be accessed anymore.A review of how define temporal data models, based ongeneralizing a non-temporal data model in to a temporal one toimprove port management is presented. This paper describes apractical experiment which supports managing temporal dataalong with the corresponding prototype implementations.

  1. Disease management in healthcare organizations: results of in-depth interviews with disease management decision makers. (United States)

    Whellan, David J; Cohen, Elizabeth J; Matchar, David B; Califf, Robert M


    Despite the widening use of disease management (DM) programs throughout the country, little is understood about the "state of DM" in healthcare systems and managed care organizations. To better characterize the range of users of DM in healthcare and to identify critical issues, both present and future, for DM. Qualitative survey. Forty-seven healthcare systems (n = 22) and managed care organizations (n = 25) were randomly selected. Decision makers were identified and interviewed between January 1, 2000, and March 31, 2000. We limited quantitative analysis to tabulations of suitable responses, without statistical testing. Responses were organized around 3 themes: models for DM, implementation strategies, and measurements of success. Of 47 decision makers surveyed, 42 (89%) reported that their organizations currently have (75%) or are working to develop (14%) DM programs. Although the goals of DM programs were similar, organizations took a variety of approaches to achieving these ends. There were typically 3 steps in implementing a DM program: analysis of patient data, external analysis, and organizational analysis. Decision makers believed that DM programs had only achieved partial success in reaching the 2 main goals of improved quality of care and cost savings. Given the variety of DM programs, there is a need to develop a classification scheme to allow for better comparison between programs. Further quantitative studies of decision makers' opinions would be helpful in developing programs and in designing necessary studies of patient management strategies.

  2. Managing the inventory control system. (United States)

    Daniels, C E


    The four functions of management--planning, organizing, directing, and controlling--are described in relation to the hospital pharmacy inventory control system. Planning includes the development of inventory system objectives and identification of the resources needed to complete them. Organizing requires the manager to decide on the best method of grouping system activities and resources to complete the objectives in order of priority. Directing is a continual activity that involves obtaining optimal performance from the inventory system resources available. Controlling consists of regulation and verification of inventory system activities. The effective inventory system manager integrates planning, organizing, directing, and controlling in a continuous cycle.

  3. Managing organizational culture within a management system

    Energy Technology Data Exchange (ETDEWEB)

    Comeau, L.; Watts, G. [New Brunswick Power Nuclear, Point Lepreau Generating Station, New Brunswick (Canada)


    The Point Lepreau Generating Station (PLGS) is currently undergoing a major refurbishment of its nuclear reactor. At the same time, a small team is designing the organization that will operate the plant after refurbishment. This paper offers a high level overview of the Post-Refurbishment Organization (PRO) project and will focus primarily on the approach used to address organizational culture and human system dynamics. We will describe how various tools, used to assess organization culture, team performance, and individual self-understanding, are used collectively to place the right person in the right position. We will explain how the career system, Pathfinder, is used to integrate these tools to support a comprehensive model for organization design and development. Finally, we demonstrate how the management of organizational cultural and human system dynamics are integrated into the PLGS Integrated Management System. (author)

  4. Disease management strategy: initiative links pharmaceutical and mental health data. (United States)

    Docherty, J P


    The emphasis in healthcare is shifting to practical applications of medical knowledge for the provision of more cost-effective care. This requires greater linkages among clinical information systems across multiple organizations. This article describes new initiatives in disease management to link the traditionally separate data systems fo pharmaceutical, behavioral and general medical care. The potential for improved patient care is highlighted. The author is an expert consultant for a large pharmaceutical manufacturer's disease state management initiative, and has an extensive leadership background in many segments of the behavioral healthcare industry.

  5. Bespoke microbiome therapy to manage plant diseases

    Directory of Open Access Journals (Sweden)

    Murali eGopal


    Full Text Available Advanced biological technologies are revealing that the microbiome, located in gut and rhizosphere, is responsible for maintaining the health of human beings and plants, respectively. Within the complete microbiome a ‘core-microbiome’ exists that plays the pivotal role. Recent studies in medicine have shown that an artificial mixture of bacteria representing the core gut microbiome of healthy person when transferred into gut of diseased person results in re-establishment of normal microflora in the latter leading to alleviation from diseased condition. In agriculture, plant disease management has been achieved through transfer of microbiome by mixing disease suppressive soils with disease conducive soils. However, the exact practice of transferring artificially cultivated core-microbiome as in medicine has not thus far been attempted in plant disease management. Nonetheless, as the gut and rhizosphere microbiome are known to share many common traits, there exists a good scope for accomplishing similar studies in agriculture. Based upon the information in microbiome studies of gut and rhizosphere, we propose that tailor-made core-microbiome transfer therapy can become a viable strategy for management of plant diseases in future.

  6. Perioperative management of patients with Parkinson's disease. (United States)

    Katus, Linn; Shtilbans, Alexander


    Parkinson's disease is the second most common neurodegenerative disease worldwide, leading to a wide range of disability and medical complications. Managing patients with Parkinson's disease in the perioperative hospital setting can be particularly challenging. Suboptimal management can lead to medical complications, prolonged hospital stays, and delayed recovery. This review aims to address the most important issues related to caring for patients with Parkinson's disease perioperatively who are undergoing emergent or planned general surgery. It also intends to help hospitalists, internists, and other health care providers mitigate potential in-hospital morbidity and prevent prolonged recovery. Challenges in managing patients with Parkinson's disease in the perioperative hospital setting include disruption of medication schedules, "nothing by mouth" status, reduced mobility, and medication interactions and their side effects. Patients with Parkinson's disease are more prone to immobility and developing dysphagia, respiratory dysfunction, urinary retention, and psychiatric symptoms. These issues lead to higher rates of pneumonia, urinary tract infections, deconditioning, and falls compared with patients without Parkinson's disease, as well as prolonged hospital stays and a greater need for post-hospitalization rehabilitation. Steps can be taken to decrease these complications, including minimizing nothing by mouth status duration, using alternative routes of drugs administration when unable to give medications orally, avoiding drug interactions and medications that can worsen parkinsonism, assessing swallowing ability frequently, encouraging incentive spirometry, performing bladder scans, avoiding Foley catheters, and providing aggressive physical therapy. Knowing and anticipating these potential complications allow hospital physicians to mitigate nosocomial morbidity and shorten recovery times and hospital stays.

  7. Lighting system with thermal management system (United States)

    Arik, Mehmet; Weaver, Stanton; Stecher, Thomas; Seeley, Charles; Kuenzler, Glenn; Wolfe, Jr., Charles; Utturkar, Yogen; Sharma, Rajdeep; Prabhakaran, Satish; Icoz, Tunc


    Lighting systems having unique configurations are provided. For instance, the lighting system may include a light source, a thermal management system and driver electronics, each contained within a housing structure. The light source is configured to provide illumination visible through an opening in the housing structure. The thermal management system is configured to provide an air flow, such as a unidirectional air flow, through the housing structure in order to cool the light source. The driver electronics are configured to provide power to each of the light source and the thermal management system.

  8. Lighting system with thermal management system

    Energy Technology Data Exchange (ETDEWEB)

    Arik, Mehmet; Weaver, Stanton Earl; Stecher, Thomas Elliot; Seeley, Charles Erklin; Kuenzler, Glenn Howard; Wolfe, Jr, Charles Franklin; Utturkar, Yogen Vishwas; Sharma, Rajdeep; Prabhakaran, Satish; Icoz, Tunc


    Lighting systems having unique configurations are provided. For instance, the lighting system may include a light source, a thermal management system and driver electronics, each contained within a housing structure. The light source is configured to provide illumination visible through an opening in the housing structure. The thermal management system is configured to provide an air flow, such as a unidirectional air flow, through the housing structure in order to cool the light source. The driver electronics are configured to provide power to each of the light source and the thermal management system.

  9. Chronic disease management and the development of virtual communities. (United States)

    Smith, Alan D


    The current volume and expected increases in the number of patients with chronic diseases are concerned significant and substantial. Patients with chronic diseases have a great need to personally manage their health-related behaviour, such as food consumption, and its impact on their health indicators, like blood pressure, body weight, blood sugar, cholesterol, to name a few. Current healthcare systems are unable to meet the needs of patients with chronic diseases for management, due to the need for acute care. An analysis of the needs was performed and recommendations for virtual communities were made to help patients with chronic diseases monitor and manage their health. Virtual communities have the potential to meet the need to assist with monitoring activities, education, community membership, and the sale of products and services. However, they also face risks inherent to accepting and storing any form of personal health information, and of remaining in compliance with the Health Insurance Portability and Accessibility Act of 2001.

  10. Clinical utility of sympathetic blockade in cardiovascular disease management. (United States)

    Park, Chan Soon; Lee, Hae-Young


    A dysregulated sympathetic nervous system is a major factor in the development and progression of cardiovascular disease; thus, understanding the mechanism and function of the sympathetic nervous system and appropriately regulating sympathetic activity to treat various cardiovascular diseases are crucial. Areas covered: This review focused on previous studies in managing hypertension, atrial fibrillation, coronary artery disease, heart failure, and perioperative management with sympathetic blockade. We reviewed both pharmacological and non-pharmacological management. Expert commentary: Chronic sympathetic nervous system activation is related to several cardiovascular diseases mediated by various pathways. Advancement in measuring sympathetic activity makes visualizing noninvasively and evaluating the activation level even in single fibers possible. Evidence suggests that sympathetic blockade still has a role in managing hypertension and controlling the heart rate in atrial fibrillation. For ischemic heart disease, beta-adrenergic receptor antagonists have been considered a milestone drug to control symptoms and prevent long-term adverse effects, although its clinical implication has become less potent in the era of successful revascularization. Owing to pathologic involvement of sympathetic nervous system activation in heart failure progression, sympathetic blockade has proved its value in improving the clinical course of patients with heart failure.

  11. Prevalence and management of Gaucher disease

    Directory of Open Access Journals (Sweden)

    Burrow TA


    Full Text Available T Andrew Burrow, Sonya Barnes, Gregory A GrabowskiThe Division of Human Genetics, Cincinnati Children's Hospital Medical Center, and the Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, USAAbstract: Gaucher disease is a phenotypically heterogeneous autosomal recessively inherited lysosomal storage disease, resulting from deficient activity of the enzyme glucocerebrosidase (GCase, acid ß-glucosidase due to mutations in GBA1. Gaucher disease is the prototype for which disease-specific pharmacological therapy was successfully employed. The objective of this review is to provide a comprehensive review and critical examination of the prevalence, pathophysiology, natural history, and management of Gaucher disease.Keywords: lysosomal storage disease, pathophysiology, treatment, inborn errors of metabolism

  12. Virtual Organisation Document Management System


    Sturis, Ričardas


    The main goal of Masters final work is to analize basics of virtual organization and its needs for document management system. Virtual organisation is a one of organisations methods to colaborate. Virtual organisation require the system, who will guarantee document managent and control.

  13. Car insurance information management system


    Sun, Yu


    A customer information system is a typical information management system. It involves three aspects, the backstage database establishment, the application development and the system maintenance. A car insurance information management system is based on browser/server structure. Microsoft SQL Server establishes the backstage database. Active Server Pages, from Microsoft as well is used as the interface layer. The objective of this thesis was to apply ASP to the dynamic storage of a web page...

  14. Surgical management of hepatic hydatid disease



    Hydatidosis is strictly a zoonosis. Humans are an accidental host. The disease is endemic in rural agricultural areas. However if acquired by humans, it can cause extensive spread affecting a wide range of organs with predilection for the liver. Managing such cases requires a sound fundamental knowledge of the parasite and its pathogenicity. It is essential that surgeons who deal with such cases have a good working knowledge of the disease. The approaches to hepatic hydatids with respect to t...

  15. Management of gastroesophageal reflux disease. (United States)

    Tutuian, Radu; Castell, Donald O


    Gastroesophageal reflux disease (GERD) is a chronic condition requiring long-term treatment. Simple lifestyle modifications are the first methods employed by patients and, because of their low cost and simplicity, should be continued even when more potent therapies are initiated. Potent acid-suppressive therapy is currently the most important and successful medical therapy. Whereas healing of the esophageal mucosa is achieved with a single dose of any proton pump inhibitor (PPI) in more than 80% of cases, symptoms are more difficult to control. Patients with persistent symptoms on therapy should be tested (preferably with combined multichannel intraluminal impedance and pH) for association of symptoms with acid, nonacid, or no GER. Long-term follow-up studies indicate that PPIs are efficacious, tolerable, and safe medication. So far, promotility agents have shown limited efficacy, and their side-effect profile outweighs their benefits. Antireflux surgery in carefully selected patients (ie, young, typical GERD symptoms, abnormal pH study, and good response to PPI) is as effective as PPI therapy and should be offered to these patients as an alternative to medication. Still, patients should be informed about the risks of antireflux surgery (ie, risk of postoperative dysphagia; decreased ability to belch, possibly leading to bloating; increased flatulence). Endoscopic antireflux procedures are recommended only in selected patients and given the relative short experience with these techniques, patients treated with endoscopic procedures should be enrolled in a rigorous follow-up program.

  16. IT Asset Management System - (United States)

    Department of Transportation — ITAMS provides a web frontend for the managing of all HW Assets lifecycle data purchased by ATO since 2006. In addition it contains much of our Enterprise SW license...

  17. The cornea in systemic disease

    Directory of Open Access Journals (Sweden)

    W.D.H. Gillan


    Full Text Available Systemic  disease  often  results  in  corneal signs that are easily observable by means of bio-microscopy. Optometry is in a unique position to detect the corneal manifestations of systemic disease. This review presents corneal signs of various systemic diseases. The list is not com-plete but the review rather attempts to empha-size the importance of detection, and referral, of systemic diseases.

  18. Medical-Information-Management System (United States)

    Alterescu, Sidney; Friedman, Carl A.; Frankowski, James W.


    Medical Information Management System (MIMS) computer program interactive, general-purpose software system for storage and retrieval of information. Offers immediate assistance where manipulation of large data bases required. User quickly and efficiently extracts, displays, and analyzes data. Used in management of medical data and handling all aspects of data related to care of patients. Other applications include management of data on occupational safety in public and private sectors, handling judicial information, systemizing purchasing and procurement systems, and analyses of cost structures of organizations. Written in Microsoft FORTRAN 77.

  19. Management of Kawasaki disease in adults. (United States)

    Denby, Kara J; Clark, Daniel E; Markham, Larry W


    Kawasaki disease is the most common childhood vasculitis in the USA and the most common cause of acquired cardiac disease in children in developed countries. Since the vast majority of Kawasaki disease initially presents at Kawasaki disease, making it increasingly relevant for adult cardiologists as this population transitions into adulthood. As the 2017 American Heart Association (AHA) and 2014 Japanese Circulation Society (JCS) guidelines emphasise, Kawasaki disease requires rigorous follow-up with cardiac stress testing and non-invasive imaging to detect progressive stenosis, thrombosis and luminal occlusion that may lead to myocardial ischaemia and infarction. Due to differences in disease mechanisms, coronary disease due to Kawasaki disease should be managed with different pharmacological and non-pharmacological treatment algorithms than atherosclerotic coronary disease. This review addresses gaps in the current knowledge of the disease and its optimal treatment, differences in the AHA and JCS guidelines, targets for future research and obstacles to transition of care from adolescence into adulthood. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  20. Managing Amphibian Disease with Skin Microbiota. (United States)

    Woodhams, Douglas C; Bletz, Molly; Kueneman, Jordan; McKenzie, Valerie


    The contribution of emerging amphibian diseases to the sixth mass extinction is driving innovative wildlife management strategies, including the use of probiotics. Bioaugmentation of the skin mucosome, a dynamic environment including host and microbial components, may not provide a generalized solution. Multi-omics technologies and ecological context underlie effective implementation.

  1. Disease Management in the Dutch Context

    NARCIS (Netherlands)

    Schrijvers, Guus; Spreeuwenberg, Cor; Laag, Han van der; Rutten, Guy; Nabarro, Guido; Schene, Aart; Linden, Barbara van der; Acampo, Marianne


    This book explores the extent to which ten characteristics of the concept of disease management are advisable in the long-term for certain types of patient care in the Netherlands. The care in mind for this concept covers certain patient populations as well as a number of health problems. For this p

  2. Huntington's disease: review and anesthetic case management. (United States)

    Cangemi, C F; Miller, R J


    Huntington's disease is a dominantly inherited progressive autosomal disease that affects the basal ganglia. Symptoms appear later in life and manifest as progressive mental deterioration and involuntary choreiform movements. Patients with Huntington's disease develop a progressive but variable dementia. Dysphagia, the most significant related motor symptom, hinders nutrition intake and places the patient at risk for aspiration. The combination of involuntary choreoathetoid movements, depression, and apathy leads to cachexia. Factors of considerable concern to the anesthesiologist who treats patients with Huntington's disease may include how to treat frail elderly people incapable of cooperation, how to treat patients suffering from malnourishment, and how to treat patients with an increased risk for aspiration or exaggerated responses to sodium thiopental and succinylcholine. The successful anesthetic management of a 65-yr-old woman with Huntington's disease who presented for full-mouth extractions is described.

  3. Updates in management of coronary artery disease

    Energy Technology Data Exchange (ETDEWEB)

    Yang, Dong Heon; Chae, Shung Chull [Kyungpook National University Medical School, Daegu (Korea, Republic of)


    Coronary artery disease (CAD) has been increasing during the last decade and is the one of major causes of death. The management of patients with coronary artery disease has evolved considerably. There are two main strategies in the management of CAD, complementary, not competitive, each other; the pharmacologic therapy to prevent and treat CAD and the percutaneous coronary intervention (PCI) to restore coronary flow. Antiplatelet drugs and cholesterol lowering drugs have central roles in pharmacotherapy. Drug eluting stent (DES) bring about revolutional changes in PCL in the management of patients with ST segment elevation acute myocardial infarction (AMI), there has been a debate on the better strategy for the restoration of coronary flow. Thrombolytic therapy is widely available and easy to administer, whereas primary PCI is less available and more complex, but more complete. Recently published evidences in the pharmacologic therapy including antiplatelet and statin, and PCI including DES and reperfusion therapy in patients with ST segment elevation AMI were reviewed.

  4. Principles for assessing disease management outcomes. (United States)

    Fitzner, Karen; Sidorov, Jaan; Fetterolf, Don; Wennberg, David; Eisenberg, Edward; Cousins, Michael; Hoffman, Joel; Haughton, John; Charlton, Warwick; Krause, David; Woolf, Allen; Mcdonough, Kenneth; Todd, Warren; Fox, Kathe; Plocher, David; Juster, Iver; Stiefel, Matt; Villagra, Victor; Duncan, Ian


    Disease management (DM) is rapidly becoming an important force in the late 20th and early 21st century as a strategy for managing the chronic illness of large populations. Given the increasing visibility of DM programs, the clinical, economic and financial impact of this support are vital to DM program accountability and its acceptance as a solution to the twin challenges of achieving affordable, quality health care. Measuring and reporting outcomes in DM is difficult. DM programs must adapt to local market conditions and customer desires, which in turn limits generalizability, and still account for the overlapping/interlocking/multifaceted nature of the interventions included in any DM program. The Disease Management Association of America convened a Steering Committee to suggest a preferred approach, not a mandated or standardized approach for DM program evaluation. This paper presents the Steering Committee's "Consensus Statement" and "Guiding Principles" for robust evaluation.

  5. Pheochromocytoma – update on disease management (United States)

    Lenders, Jacques W.M.; Hofbauer, Lorenz C.; Naumann, Bernd; Bornstein, Stefan R.; Eisenhofer, Graeme


    Pheochromocytomas are rare endocrine tumors that can present insidiously and remain undiagnosed until death or onset of clear manifestations of catecholamine excess. They are often referred to as one of the ‘great mimics’ in medicine. These tumors can no longer be regarded as a uniform disease entity, but rather as a highly heterogeneous group of chromaffin cell neoplasms with different ages of onset, secretory profiles, locations, and potential for malignancy according to underlying genetic mutations. These aspects all have to be considered when the tumor is encountered, thereby enabling optimal management for the patient. Referral to a center of specialized expertise for the disease should be considered wherever possible. This is not only important for surgical management of patients, but also for post-surgical follow up and screening of disease in patients with a hereditary predisposition to the tumor. While preoperative management has changed little over the last 20 years, surgical procedures have evolved so that laparoscopic resection is the standard of care and partial adrenalectomy should be considered in all patients with a hereditary condition. Follow-up testing is essential and should be recommended and ensured on a yearly basis. Managing such patients must now also take into account possible underlying mutations and the appropriate selection of genes for testing according to disease presentation. Patients and family members with identified mutations then require an individualized approach to management. This includes consideration of distinct patterns of biochemical test results during screening and the appropriate choice of imaging studies for tumor localization according to the mutation and associated differences in predisposition to adrenal, extra-adrenal and metastatic disease. PMID:23148191

  6. The CMS workload management system (United States)

    Cinquilli, M.; Evans, D.; Foulkes, S.; Hufnagel, D.; Mascheroni, M.; Norman, M.; Maxa, Z.; Melo, A.; Metson, S.; Riahi, H.; Ryu, S.; Spiga, D.; Vaandering, E.; Wakefield, S.; Wilkinson, R.


    CMS has started the process of rolling out a new workload management system. This system is currently used for reprocessing and Monte Carlo production with tests under way using it for user analysis. It was decided to combine, as much as possible, the production/processing, analysis and T0 codebases so as to reduce duplicated functionality and make best use of limited developer and testing resources. This system now includes central request submission and management (Request Manager); a task queue for parcelling up and distributing work (WorkQueue) and agents which process requests by interfacing with disparate batch and storage resources (WMAgent).

  7. BIMS: Biomedical Information Management System


    Mora, Oscar; Bisbal, Jesús


    In this paper, we present BIMS (Biomedical Information Management System). BIMS is a software architecture designed to provide a flexible computational framework to manage the information needs of a wide range of biomedical research projects. The main goal is to facilitate the clinicians' job in data entry, and researcher's tasks in data management, in high data quality biomedical research projects. The BIMS architecture has been designed following the two-level modeling paradigm, a promising...

  8. Content Management System (CMS)


    Καλτουρουμίδης, Κυριάκος Ο.


    Ένα σύστημα διαχείρισης περιεχομένων (content management system - CMS) είναι η συλλογή των διαδικασιών με τις οποίες μπορεί να γίνει διαχείριση της ροής εργασιών σε ένα συνεργατικό περιβάλλον. Αυτές οι διαδικασίες θα πρέπει να επιτρέπουν σε πολλά άτομα να συμμετέχουν και να μοιράζονται αποθηκευμένα δεδομένα, να ελέγχεται η πρόσβαση στα δεδομένα με βάση τους ρόλους των χρηστών, να βοηθείται η εύκολη αποθήκευση και ανάκτηση των δεδομένων, να διευκολύνεται η σύνταξη εκθέσεων και η επικοινωνία με...

  9. Managed care and the infectious diseases specialist. (United States)

    Tice, A D; Slama, T G; Berman, S; Braun, P; Burke, J P; Cherney, A; Gross, P A; Harris, P; Reid-Hatton, M; Hoffman, R; Joseph, P; Lawton, S; Massanari, R M; Miller, Z I; Osheroff, W J; Poretz, D; Shalowitz, M; Simmons, B; Turner, J P; Wade, B; Nolet, B R


    There is growing demand to contain health care costs and to reassess the value of medical services. The traditional hospital, academic, and research roles of the infectious disease (ID) specialist are threatened, yet there is an increasing need for expertise because of growing antimicrobial resistance and emerging pathogens. Opportunities exist to develop and expand services for the care of patients infected with human immunodeficiency virus and in infection control, epidemiology, outcomes research, outpatient intravenous therapy, and resource management. It is important for ID physicians to appreciate the principles involved in managed care and the areas in which ID services can be valuable. To be effective, physicians need to know about tools such as practice guidelines, physician profiling, outcomes monitoring, computerized information management, risk sharing, networking, and marketing, as well as related legal issues. With a positive attitude toward learning, application, and leadership, ID physicians can redefine their role and expand their services through managed care.

  10. A framework for modeling emerging diseases to inform management (United States)

    Russell, Robin E.; Katz, Rachel A.; Richgels, Katherine L.D.; Walsh, Daniel P.; Grant, Evan


    The rapid emergence and reemergence of zoonotic diseases requires the ability to rapidly evaluate and implement optimal management decisions. Actions to control or mitigate the effects of emerging pathogens are commonly delayed because of uncertainty in the estimates and the predicted outcomes of the control tactics. The development of models that describe the best-known information regarding the disease system at the early stages of disease emergence is an essential step for optimal decision-making. Models can predict the potential effects of the pathogen, provide guidance for assessing the likelihood of success of different proposed management actions, quantify the uncertainty surrounding the choice of the optimal decision, and highlight critical areas for immediate research. We demonstrate how to develop models that can be used as a part of a decision-making framework to determine the likelihood of success of different management actions given current knowledge.

  11. Recommendations for the management of autoinflammatory diseases

    NARCIS (Netherlands)

    ter Haar, Nienke M.; Oswald, Marlen; Jeyaratnam, Jerold; Anton, Jordi; Barron, Karyl S.; Brogan, Paul A.; Cantarini, Luca; Galeotti, Caroline; Grateau, Gilles; Hentgen, Veronique; Hofer, Michael; Kallinich, Tilmann; Kone-Paut, Isabelle; Lachmann, Helen J.; Ozdogan, Huri; Ozen, Seza; Russo, Ricardo; Simon, Anna; Uziel, Yosef; Wouters, Carine; Feldman, Brian M.; Vastert, SJ; Wulffraat, Nico W.; Benseler, Susanne M.; Frenkel, Joost; Gattorno, Marco; Kuemmerle-Deschner, Jasmin B.


    Autoinflammatory diseases are characterised by fever and systemic inflammation, with potentially serious complications. Owing to the rarity of these diseases, evidence-based guidelines are lacking. In 2012, the European project Single Hub and Access point for paediatric Rheumatology in Europe (SHARE

  12. Quality Management for School System



    This paper presents the two most important factors that influence the development of quality management in education: the globalization and the sustainable development. The four well known quality management principles (Deming) can be adapted and implemented in the education system case, too.

  13. Periodontal disease and systemic complications

    Directory of Open Access Journals (Sweden)

    Rui Vicente Oppermann


    Full Text Available Periodontal diseases comprise a number of infectious and inflammatory conditions brought about by the interaction between supragingival and subgingival biofilms and the host inflammatory response. Periodontal diseases should be considered systemic conditions. This means that they are both modulated by the body's systems and play a role as a risk factor for systemic derangements. The current evidence supports some of these interactions, such as smoking as a risk factor for periodontal disease and diabetes mellitus, as both influenced by and influencing inflammatory changes in the periodontal tissue. Other potential associations are still being researched, such as obesity, hormonal changes, cardiovascular disease, and adverse outcomes in pregnancy. These, and others, still require further investigation before the repercussions of periodontal disease can be fully elucidated. Nevertheless, at the present time, the treatment of periodontal diseases-and, most importantly, their prevention-enables adequate intervention as a means of ensuring periodontal health.

  14. Periodontal disease and systemic complications. (United States)

    Oppermann, Rui Vicente; Weidlich, Patricia; Musskopf, Marta Liliana


    Periodontal diseases comprise a number of infectious and inflammatory conditions brought about by the interaction between supragingival and subgingival biofilms and the host inflammatory response. Periodontal diseases should be considered systemic conditions. This means that they are both modulated by the body's systems and play a role as a risk factor for systemic derangements. The current evidence supports some of these interactions, such as smoking as a risk factor for periodontal disease and diabetes mellitus, as both influenced by and influencing inflammatory changes in the periodontal tissue. Other potential associations are still being researched, such as obesity, hormonal changes, cardiovascular disease, and adverse outcomes in pregnancy. These, and others, still require further investigation before the repercussions of periodontal disease can be fully elucidated. Nevertheless, at the present time, the treatment of periodontal diseases-and, most importantly, their prevention-enables adequate intervention as a means of ensuring periodontal health.

  15. Building the chronic kidney disease management team. (United States)

    Spry, Leslie


    The need to be efficient and the demands for performance-based service are changing how nephrologists deliver care. Chronic kidney disease (CKD) occurs in patients with complex medical and social problems. CKD management requires that multidisciplinary professionals provide patient education, disease management, and psychosocial support. To remain cost-efficient, many physicians are training and supervising midlevel practitioners in the delivery of specialized health care. Specialized care that meets present CKD patient needs is best delivered in a CKD clinic. Three models of CKD clinic are identified: (1) anemia management CKD clinic, (2) the basic CKD clinic, and (3) the comprehensive CKD clinic. Each clinic model is based on critical elements of staffing, billable services, and patient-focused health care. Billable services are anemia-management services, physician services that may be provided by midlevel practitioners, and medical nutrition therapy. In some cases, social worker services may be billable. Building a patient-focused clinic that offers CKD management requires planning, familiarity with federal regulations and statutes, and skillful practitioners. Making services cost-efficient and outcome oriented requires careful physician leadership, talented midlevel practitioners, and billing professionals who understand the goals of the CKD clinic. As Medicare payment reforms evolve, a well-organized CKD program can be well poised to meet the requirements of payers and congressional mandates for performance-based purchasing.

  16. Design management of EDI systems.

    NARCIS (Netherlands)

    Heck, van E.


    This study deals with the management of the design process of Electronic Data Interchange (EDI) systems. Its objectives are (1) to investigate the design process of EDI systems from a practical and theoretical perspective; (2) to develop a model to describe factors relevant to EDI system-design succ

  17. System Wide Information Management (SWIM) (United States)

    Hritz, Mike; McGowan, Shirley; Ramos, Cal


    This viewgraph presentation lists questions regarding the implementation of System Wide Information Management (SWIM). Some of the questions concern policy issues and strategies, technology issues and strategies, or transition issues and strategies.

  18. Special Use Airspace Management System (United States)

    Department of Transportation — The Special-Use Airspace Management System (SAMS) supports the FAA military operations (MILOPS) mission. It automates the coordination of FAA and U.S. Department of...

  19. Update on thyroid eye disease and management

    Directory of Open Access Journals (Sweden)

    Erick D Bothun


    Full Text Available Erick D Bothun,1,2 Ryan A Scheurer,1 Andrew R Harrison,1,3 Michael S Lee1,4,51Departments of Ophthalmology, 2Pediatrics, 3Otolaryngology, 4Neurosurgery, and 5Neurology, University of Minnesota, Minneapolis, Minnesota, USAAbstract: Thyroid eye disease is a heterogeneous autoimmune orbital reaction typically manifesting in middle age. The inflammation may parallel or remain isolated from a related inflammatory cascade in the thyroid called Graves’ disease. The orbital manifestations can lead to severe proptosis, dry eyes, strabismus, and optic neuropathy. In this article, we will discuss this unique condition including the ophthalmic findings and management. Keywords: Graves’ disease, thyroid eye disease, proptosis, orbital decompression, enlarged extraocular muscles

  20. The nursing contribution to chronic disease management: a whole systems approach: Report for the National Institute for Health Research Service Delivery and Organisation programme


    Kendall , Sally; Wilson, Patricia M.; Procter, Susan; Brooks, Fiona; Bunn, Frances; Gage, Heather; McNeilly, Elaine


    Background Transforming the delivery of care for people with Long Term Conditions (LTCs) requires understanding about how health care policies in England and historical patterns of service delivery have led to different models of chronic disease management (CDM). It is also essential in this transformation to analyse and critique the models that have emerged to provide a more detailed evidence base for future decision making and better patient care. Nurses have made, and continue to make, ...

  1. Identifying intelligent Building Management Systems (BMS) in ...

    African Journals Online (AJOL)

    Identifying intelligent Building Management Systems (BMS) in sustainable housing. ... Journal of Fundamental and Applied Sciences ... Keywords: Building Automation, Intelligent Management, Sustainable Architecture, Building Management ...

  2. Gestational trophoblastic disease with hyperthyroidism: Anesthetic management

    Directory of Open Access Journals (Sweden)

    Puneet Khanna


    Full Text Available The coexistence of hyperthyroidism with gestational trophoblastic disease is a known albeit rare clinical condition. We herein report the successful anesthetic management of such a case in our institute. There are only few case reports in literature of this association. Often, the diagnosis of hyperthyroid state is retrospective one, as it can be missed in the emergency scenario of patient requiring molar evacuation. This case report highlights the perioperative management and optimization of hyperthyroid state prior to surgical evacuation of the invasive hydatidiform mole.

  3. RIMS: Resource Information Management System (United States)

    Symes, J.


    An overview is given of the capabilities and functions of the resource management system (RIMS). It is a simple interactive DMS tool which allows users to build, modify, and maintain data management applications. The RIMS minimizes programmer support required to develop/maintain small data base applications. The RIMS also assists in bringing the United Information Services (UIS) budget system work inhouse. Information is also given on the relationship between the RIMS and the user community.

  4. [Corneal manifestations in systemic diseases]. (United States)

    Zarranz Ventura, J; De Nova, E; Moreno-Montañés, J


    Systemic diseases affecting the cornea have a wide range of manifestations. The detailed study of all pathologies that cause corneal alteration is unapproachable, so we have centered our interest in the most prevalent or characteristic of them. In this paper we have divided these pathologies in sections to facilitate their study. Pulmonar and conective tissue (like colagen, rheumatologic and idiopathic inflamatory diseases), dermatologic, cardiovascular, hematologic, digestive and hepatopancreatic diseases with corneal alteration are described. Endocrine and metabolic diseases, malnutrition and carential states are also studied, as well as some otorhinolaryngologic and genetic diseases that affect the cornea. Finally, a brief report of ocular toxicity induced by drugs is referred.

  5. Opportunities for administrators to promote disease management. (United States)

    Kash, Bita A; Gamm, Larry D; Bolin, Jane Nelson; Peck, B Mitchell


    Studies of disease management (DM) have shown that patients who participate in such programs achieve better health status and make fewer emergency room visits. Private and government payers have recently increased their efforts to promote DM initiatives through financial incentives to healthcare providers. This article explores opportunities for administrators of health services organizations (HSO) to promote DM in the current political and economic environment. Our survey of professionals (DM leaders, physicians, and DM nurses) in six DM programs reveals these professionals' assessments of the key players and resources that they deem important to their respective DM programs. They view DM programs as heavily dependent on the support of physicians, nurses, and health plan leaders but relatively less so on the support of HSO administrators- a situation that may suggest opportunities for administrators to take on greater leadership in moving the HSO toward developing DM programs. Survey results also indicate a strong need for the integration of resources such as communication systems, electronic medical records, and DM reporting. Taken collectively, these needs suggest a number of strategies for the administrator to play a larger role in supporting the adoption and effective implementation of DM. In the article, we propose that DM programs can benefit substantially from an administrator who can demonstrate a thorough knowledge of DM-related government and private-payer initiatives and who has the ability to provide leadership to develop and implement viable DM programs. Valued contributions that the administrator should bring to the table include support of standardized DM processes, use of practice guidelines, and provision of pertinent information systems.

  6. Classic nursing management skills and disease management: something old, something new. (United States)

    Zander, K


    With the advent of managed care, nursing has the opportunity to shine through the current chaos in the health care industry because of its steadfast use and necessary expertise in the five classic management skills: planning, coordinating, controlling, delegating, and communicating. The new focus on disease management provides nursing with the best chance ever to position itself as the most skilled and pivotal player in an incredibly competitive arena. The five skills will be described in the new context of disease management, with the hope that nurses in diverse roles will demonstrate that excellent management of clinical care is a patient's best chance for achieving optimal outcomes and a health care system's best chance at achieving value.


    Directory of Open Access Journals (Sweden)

    Yu. B. Popova


    Full Text Available Using of information technologies and, in particular, learning management systems, increases opportunities of teachers and students in reaching their goals in education. Such systems provide learning content, help organize and monitor training, collect progress statistics and take into account the individual characteristics of each user. Currently, there is a huge inventory of both paid and free systems are physically located both on college servers and in the cloud, offering different features sets of different licensing scheme and the cost. This creates the problem of choosing the best system. This problem is partly due to the lack of comprehensive classification of such systems. Analysis of more than 30 of the most common now automated learning management systems has shown that a classification of such systems should be carried out according to certain criteria, under which the same type of system can be considered. As classification features offered by the author are: cost, functionality, modularity, keeping the customer’s requirements, the integration of content, the physical location of a system, adaptability training. Considering the learning management system within these classifications and taking into account the current trends of their development, it is possible to identify the main requirements to them: functionality, reliability, ease of use, low cost, support for SCORM standard or Tin Can API, modularity and adaptability. According to the requirements at the Software Department of FITR BNTU under the guidance of the author since 2009 take place the development, the use and continuous improvement of their own learning management system.

  8. Chagas disease: changes in knowledge and management. (United States)

    Lescure, François-Xavier; Le Loup, Guillaume; Freilij, Hector; Develoux, Michel; Paris, Luc; Brutus, Laurent; Pialoux, Gilles


    More than 100 years after the discovery of human American trypanosomiasis by Carlos Chagas, our knowledge and management of the disease are profoundly changing. Substantial progress made by disease control programmes in most endemic areas contrasts with persisting difficulties in the Gran Chaco region in South America and the recent emergence of the disease in non-endemic areas because of population movements. In terms of pathogenesis, major discoveries have been made about the life cycle and genomics of Trypanosoma cruzi, and the role of the parasite itself in the chronic phase of the disease. From a clinical perspective, a growing number of arguments have challenged the notion of an indeterminate phase, and suggest new approaches to manage patients. New methods such as standardised PCR will be necessary to ensure follow-up of this chronic infection. Although drugs for treatment of Chagas disease are limited, poorly tolerated, and not very effective, treatment indications are expanding. The results of the Benznidazole Evaluation For Interrupting Trypanosomiasis (BENEFIT) trial in 2012 will also help to inform treatment. Mobilisation of financial resources to fund research on diagnosis and randomised controlled trials of treatment are international health priorities.

  9. "It's not my problem" (yet). With readmissions under the microscope, CIOs know chronic disease management is moving front and center. (United States)

    Lawrence, Daphne


    Chronic disease management is a system initiative, not just for primary care or ambulatory. The business case is currently poor for chronic disease management, but may soon change due to reform. Chronic disease management can help prevent costly readmissions. Care management plans are often a component of an EMR.

  10. Resolution of Probabilistic Weather Forecasts with Application in Disease Management. (United States)

    Hughes, G; McRoberts, N; Burnett, F J


    Predictive systems in disease management often incorporate weather data among the disease risk factors, and sometimes this comes in the form of forecast weather data rather than observed weather data. In such cases, it is useful to have an evaluation of the operational weather forecast, in addition to the evaluation of the disease forecasts provided by the predictive system. Typically, weather forecasts and disease forecasts are evaluated using different methodologies. However, the information theoretic quantity expected mutual information provides a basis for evaluating both kinds of forecast. Expected mutual information is an appropriate metric for the average performance of a predictive system over a set of forecasts. Both relative entropy (a divergence, measuring information gain) and specific information (an entropy difference, measuring change in uncertainty) provide a basis for the assessment of individual forecasts.

  11. Kidney in systemic diseases

    Directory of Open Access Journals (Sweden)

    Marta Patricia Casanova González


    Full Text Available Renal function alterant, sodium and water retention with intravascular volume expansion, and augmentation of the cardiac preload are closely related to the main causes of mortality and morbidity in patients suffering from symptomatic cardiac insufficiency. A review of the renal function alterant in congestive cardiac insufficiency and chronic liver diseases is carried out in this bibliographical revision. Important therapeutic aspects of the patients suffering from cardiac insufficiency considering its renal function alterant are also presented.

  12. Shopping for outage management systems

    Energy Technology Data Exchange (ETDEWEB)

    Chou, Y.C.; Konneker, L.K.; Watkins, T.R.


    Customer service is becoming increasingly important to electric utilities. Outage management is an important part of customer service. Good outage management means quickly responding to outages and keeping customers informed about outages. Each outage equals lost customer satisfaction and lost revenue. Outage management is increasingly important because of new competition among utilities for customers, pressure from regulators, and internal pressure to cut costs. The market has several existing software products for outage management. How does a utility judge whether these products satisfy their specific needs? Technology is changing rapidly to support outage management. Which technology is proven and cost-effective? The purpose of this paper is to outline the procedure for evaluating outage management systems, and to discuss the key features to look for. It also gives our opinion of the features that represent state of the art. This paper will not discuss specific products or list vendors names.

  13. Lafora disease: epidemiology, pathophysiology and management.

    LENUS (Irish Health Repository)

    Monaghan, Thomas S


    Lafora disease is a rare, fatal, autosomal recessive, progressive myoclonic epilepsy. It may also be considered as a disorder of carbohydrate metabolism because of the formation of polyglucosan inclusion bodies in neural and other tissues due to abnormalities of the proteins laforin or malin. The condition is characterized by epilepsy, myoclonus and dementia. Diagnostic findings on MRI and neurophysiological testing are not definitive and biopsy or genetic studies may be required. Therapy in Lafora disease is currently limited to symptomatic management of the epilepsy, myoclonus and intercurrent complications. With a greater understanding of the pathophysiological processes involved, there is justified hope for future therapies.

  14. Management of autoimmune blistering diseases in pregnancy. (United States)

    McPherson, Tess; Venning, Vanessa V


    Autoimmune blistering disease (AIBD) in pregnancy raises several complex management issues associated with underlying pathogenesis and treatment options. This article considers the effects of the disease as well as its treatment for both mother and fetus. All AIBDs can occur in pregnancy but are relatively rare. Pemphigoid gestationis is a rare AIBD that is specific to pregnancy. The article considers each AIBD in turn and then looks at treatment options for the group as a whole, as there are many issues common to all.

  15. Surgical management of hepatic hydatid disease

    Directory of Open Access Journals (Sweden)

    Ketan Vagholkar


    Full Text Available Hydatidosis is strictly a zoonosis. Humans are an accidental host. The disease is endemic in rural agricultural areas. However if acquired by humans, it can cause extensive spread affecting a wide range of organs with predilection for the liver. Managing such cases requires a sound fundamental knowledge of the parasite and its pathogenicity. It is essential that surgeons who deal with such cases have a good working knowledge of the disease. The approaches to hepatic hydatids with respect to the principles of surgical treatment are presented in this article. [Int J Res Med Sci 2016; 4(6.000: 1834-1837

  16. Understanding Parkinson's disease: detection and early disease management. (United States)

    Mackin, L A


    Parkinson's disease (PD) is a common, debilitating, neurodegenerative disorder characterized by neuronal loss within the basal ganglia and insufficient levels of the neurotransmitter dopamine. Symptoms include resting tremor, rigidity, bradykinesia (slowness of voluntary movement), and postural disturbances. Exact cause is unknown, but theories surrounding environmental or endogenous toxicities have been suggested. Differential diagnoses include genetic and other neurologic disorders that may share symptoms similar to those seen in PD. Clinical progression has been categorized into three phases of the disease: early, nonfluctuating, and fluctuating. Medications generally offer good symptom relief during the early and nonfluctuating phases of the disease. Classifications of anti-PD medications include anticholinergics, dopamine agonists, amantadine, MAO-B inhibitors, levodopa-carbidopa, and Catechol-o-methyl transferase inhibitors. Surgical intervention may be an option for select patients whose conditions are not well controlled though medical management strategies. Primary care providers often can manage patients in the early stage of PD, but later stages require expert neurologic management. Patient/family education and anticipatory guidance is imperative.

  17. Electronic Resource Management Systems

    Directory of Open Access Journals (Sweden)

    Mark Ellingsen


    Full Text Available Computer applications which deal with electronic resource management (ERM are quite a recent development. They have grown out of the need to manage the burgeoning number of electronic resources particularly electronic journals. Typically, in the early years of e-journal acquisition, library staff provided an easy means of accessing these journals by providing an alphabetical list on a web page. Some went as far as categorising the e-journals by subject and then grouping the journals either on a single web page or by using multiple pages. It didn't take long before it was recognised that it would be more efficient to dynamically generate the pages from a database rather than to continually edit the pages manually. Of course, once the descriptive metadata for an electronic journal was held within a database the next logical step was to provide administrative forms whereby that metadata could be manipulated. This in turn led to demands for incorporating more information and more functionality into the developing application.

  18. Diagnosis and management of Crohn's disease. (United States)

    Wilkins, Thad; Jarvis, Kathryn; Patel, Jigneshkumar


    Crohn's disease is a chronic inflammatory condition affecting the gastrointestinal tract at any point from the mouth to the rectum. Patients may experience diarrhea, abdominal pain, fever, weight loss, abdominal masses, and anemia. Extraintestinal manifestations of Crohn's disease include osteoporosis, inflammatory arthropathies, scleritis, nephrolithiasis, cholelithiasis, and erythema nodosum. Acute phase reactants, such as C-reactive protein level and erythrocyte sedimentation rate, are often increased with inflammation and may correlate with disease activity. Levels of vitamin B12, folate, albumin, prealbumin, and vitamin D can help assess nutritional status. Colonoscopy with ileoscopy, capsule endoscopy, computed tomography enterography, and small bowel follow-through are often used to diagnose Crohn's disease. Ultrasonography, computed axial tomography, scintigraphy, and magnetic resonance imaging can assess for extraintestinal manifestations or complications (e.g., abscess, perforation). Mesalamine products are often used for the medical management of mild to moderate colonic Crohn's disease. Antibiotics (e.g., metronidazole, fluoroquinolones) are often used for treatment. Patients with moderate to severe Crohn's disease are treated with corticosteroids, azathioprine, 6-mercaptopurine, or anti-tumor necrosis factor agents (e.g., infliximab, adalimumab). Severe disease may require emergent hospitalization and a multidisciplinary approach with a family physician, gastroenterologist, and surgeon.

  19. Management of rheumatic diseases during pregnancy. (United States)

    Elliott, Amy B; Chakravarty, Eliza F


    Systemic rheumatic diseases commonly affect women during the childbearing years. Many women with these diseases may be contemplating pregnancy or discover an inadvertent pregnancy, leading to concerns regarding medication use, changes in disease activity during pregnancy, safety of lactation, and future ability to care for a child given the presence of chronic illnesses. There are outstanding reviews that summarize the safety and use of immunosuppressive medications during pregnancy. However, in addition to medication use, providers need to be aware of the available data regarding fertility, pregnancy outcomes, delivery, and lactation issues that may be specific to individual diseases. Optimally, women should plan pregnancies to occur around times of disease quiescence, several months after potentially teratogenic medications have been discontinued. The course of the underlying rheumatic disease during pregnancy is variable, and there are no specific clinical or laboratory variables that consistently predict disease improvement or worsening during pregnancy. Recent data suggest that increased disease activity in women with most autoimmune diseases during pregnancy may lead to increased risk of premature delivery, low-birth-weight infants, and other adverse pregnancy outcomes. Arthritis involving the cervical spine and hips may impact delivery and must be considered by both obstetricians and obstetric anesthesiologists. Data are mixed regarding the impact of breastfeeding on underlying autoimmune diseases; the choice to continue breastfeeding is a personal decision.

  20. Evaluating systemic semi-selective chemicals for the management of apple replant disease in fumigated and non-fumigated orchards systems (United States)

    Apple Replant Disease (ARD) is a phenomenon where apple trees are stunted when replanted onto old apple soil, as the result of apple monoculture resulting in soil microbial changes where pathogenic and parasitic organism s predominate. The main soilborne organisms that cause ARD include oomycetes, f...

  1. Impact Management System (United States)

    US Agency for International Development — IMS (developed w/Iraq mission) is a system for conducting quality portfolio impact analysis, linking projects to strategy through integration of context data. IMS...

  2. Automated Maintenance Management System - (United States)

    Department of Transportation — To achieve the to-be state of a modernized supply chain infrastructure and the NextGen Mission Service Requirements, the System Information Modernization initiative...

  3. NICA project management information system (United States)

    Bashashin, M. V.; Kekelidze, D. V.; Kostromin, S. A.; Korenkov, V. V.; Kuniaev, S. V.; Morozov, V. V.; Potrebenikov, Yu. K.; Trubnikov, G. V.; Philippov, A. V.


    The science projects growth, changing of the efficiency criteria during the project implementation require not only increasing of the management specialization level but also pose the problem of selecting the effective planning methods, monitoring of deadlines and interaction of participants involved in research projects. This paper is devoted to choosing the project management information system for the new heavy-ion collider NICA (Nuclotron based Ion Collider fAcility). We formulate the requirements for the project management information system with taking into account the specifics of the Joint Institute for Nuclear Research (JINR, Dubna, Russia) as an international intergovernmental research organization, which is developed on the basis of a flexible and effective information system for the NICA project management.

  4. Current management of urethral stricture disease

    Directory of Open Access Journals (Sweden)

    Thomas G Smith


    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.

  5. Implementation of integrated management system

    Energy Technology Data Exchange (ETDEWEB)

    Gaspar Junior, Joao Carlos A.; Fonseca, Victor Zidan da [Industrias Nucleares do Brasil (INB-RJ) Resende, RJ (Brazil)]. E-mail:;


    In present day exist quality assurance system, environment, occupational health and safety such as ISO9001, ISO14001 and OHSAS18001 and others standards will can create. These standards can be implemented and certified they guarantee one record system, quality assurance, documents control, operational control, responsibility definition, training, preparing and serve to emergency, monitoring, internal audit, corrective action, continual improvement, prevent of pollution, write procedure, reduce costs, impact assessment, risk assessment , standard, decree, legal requirements of municipal, state, federal and local scope. These procedure and systems when isolate applied cause many management systems and bureaucracy. Integration Management System reduce to bureaucracy, excess of documents, documents storage and conflict documents and easy to others standards implementation in future. The Integrated Management System (IMS) will be implemented in 2007. INB created a management group for implementation, this group decides planing, works, policy and advertisement. Legal requirements were surveyed, internal audits, pre-audits and audits were realized. INB is partially in accordance with ISO14001, OSHAS18001 standards. But very soon, it will be totally in accordance with this norms. Many studies and works were contracted to deal with legal requirements. This work have intention of show implementation process of ISO14001, OHSAS18001 and Integrated Management System on INB. (author)

  6. Management of diabetic foot disease and amputation in the Irish health system: a qualitative study of patients' attitudes and experiences with health services.

    LENUS (Irish Health Repository)

    Delea, Sarah


    Diabetes is an increasingly prevalent chronic illness that places a huge burden on the individual, the health system and society. Patients with active foot disease and lower limb amputations due to diabetes have a significant amount of interaction with the health care services. The purpose of this study was to explore the attitudes and experiences of foot care services in Ireland among people with diabetes and active foot disease or lower limb amputations.

  7. The complement system in systemic autoimmune disease

    NARCIS (Netherlands)

    Chen, Min; Daha, Mohamed R.; Kallenberg, Cees G. M.


    Complement is part of the innate immune system. Its major function is recognition and elimination of pathogens via direct killing and/or stimulation of phagocytosis. Activation of the complement system is, however, also involved in the pathogenesis of the systemic autoimmune diseases. Activation via

  8. Management systems efficiency estimation in tourism organizations


    Alexandra I. Mikheyeva


    The article is concerned with management systems efficiency estimation in tourism organizations, examines effective management systems requirements and characteristics in tourism organizations and takes into account principles of management systems formation.

  9. Site systems engineering: Systems engineering management plan

    Energy Technology Data Exchange (ETDEWEB)

    Grygiel, M.L. [Westinghouse Hanford Co., Richland, WA (United States)


    The Site Systems Engineering Management Plan (SEMP) is the Westinghouse Hanford Company (WHC) implementation document for the Hanford Site Systems Engineering Policy, (RLPD 430.1) and Systems Engineering Criteria Document and Implementing Directive, (RLID 430.1). These documents define the US Department of Energy (DOE), Richland Operations Office (RL) processes and products to be used at Hanford to implement the systems engineering process at the site level. This SEMP describes the products being provided by the site systems engineering activity in fiscal year (FY) 1996 and the associated schedule. It also includes the procedural approach being taken by the site level systems engineering activity in the development of these products and the intended uses for the products in the integrated planning process in response to the DOE policy and implementing directives. The scope of the systems engineering process is to define a set of activities and products to be used at the site level during FY 1996 or until the successful Project Hanford Management Contractor (PHMC) is onsite as a result of contract award from Request For Proposal DE-RP06-96RL13200. Following installation of the new contractor, a long-term set of systems engineering procedures and products will be defined for management of the Hanford Project. The extent to which each project applies the systems engineering process and the specific tools used are determined by the project`s management.

  10. Improving chronic disease management with mobile health platform. (United States)

    Lee, Do-Youn; Bae, Sungchul; Song, Joon Hyun; Yi, Byoung-Kee; Kim, Il Kon


    In modern society, aging and chronic disease is becoming common phenomenon due to the increasing numbers of elderly patients. To best treat this growing segment of the population, medical care should be based on constant vital sign monitoring. In this study, we propose a mobile vital sign measurement and data collection system for chronic disease management.. And we implemented a middle ware using Multi-Agent platform in SOS (Self-Organizing System) platform that transmits patient clinical data for services. We also implemented a HL7 messaging interface for interoperability of clinical data exchange. We propose health services on a self-organized software platform.

  11. Coeliac disease: review of diagnosis and management. (United States)

    Walker, Marjorie M; Ludvigsson, Jonas F; Sanders, David S


    Coeliac disease is an immune-mediated systemic disease triggered by exposure to gluten, and manifested by small intestinal enteropathy and gastrointestinal and extra-intestinal symptoms. Recent guidelines recommend a concerted use of clear definitions of the disease. In Australia, the most recent estimated prevalence is 1.2% in adult men (1:86) and 1.9% in adult women (1:52). Active case finding is appropriate to diagnose coeliac disease in high risk groups. Diagnosis of coeliac disease is important to prevent nutritional deficiency and long term risk of gastrointestinal malignancy. The diagnosis of coeliac disease depends on clinico-pathological correlation: history, presence of antitransglutaminase antibodies, and characteristic histological features on duodenal biopsy (when the patient is on a gluten-containing diet). Human leucocyte antigen class II haplotypes DQ2 or DQ8 are found in nearly all patients with coeliac disease, but are highly prevalent in the general population at large (56% in Australia) and testing can only exclude coeliac disease for individuals with non-permissive haplotypes. Adhering to a gluten free diet allows duodenal mucosal healing and alleviates symptoms. Patients should be followed up with a yearly review of dietary adherence and a health check. Non-coeliac gluten or wheat protein sensitivity is a syndrome characterised by both gastrointestinal and extra-intestinal symptoms related to the ingestion of gluten and possibly other wheat proteins in people who do not have coeliac disease or wheat allergy recognised by diagnostic tests.

  12. The vital signs of chronic disease management. (United States)

    Harries, Anthony D; Zachariah, Rony; Kapur, Anil; Jahn, Andreas; Enarson, Donald A


    The vital signs of pulse rate, blood pressure, temperature and respiratory rate are the 'nub' of individual patient management. At the programmatic level, vital signs could also be used to monitor the burden and treatment outcome of chronic disease. Case detection and treatment outcome constitute the vital signs of tuberculosis control within the WHO's 'DOTS' framework, and similar vital signs could be adapted and used for management of chronic diseases. The numbers of new patients started on therapy in each month or quarter (new incident cases) are sensitive indicators for programme performance and access to services. Using similar reporting cycles, treatment outcomes for all patients can be assessed, the vital signs being: alive and retained on therapy at the respective facility; died; stopped therapy; lost to follow-up; and transferred out to another facility. Retention on treatment constitutes the prevalent number of cases, the burden of disease, and this provides important strategic information for rational drug forecasting and logistic planning. If case numbers and outcomes of chronic diseases were measured reliably and consistently as part of an integrated programmatic approach, this would strengthen the ability of resource-poor countries to monitor and assess their response to these growing epidemics.

  13. Social networks in cardiovascular disease management. (United States)

    Shaya, Fadia T; Yan, Xia; Farshid, Maryam; Barakat, Samer; Jung, Miah; Low, Sara; Fedder, Donald


    Cardiovascular disease remains the leading cause of death in the USA. Social networks have a positive association with obesity, smoking cessation and weight loss. This article summarizes studies evaluating the impact of social networks on the management of cardiovascular disease. The 35 studies included in the article describe the impact of social networks on a decreased incidence of cardiovascular disease, depression and mortality. In addition, having a large-sized social network is also associated with better outcomes and improved health. The role of pharmacists is beginning to play an important role in the patient-centered medical home, which needs to be incorporated into social networks. The patient-centered medical home can serve as an adaptive source for social network evolvement.

  14. Tennessee Offender Management Information System


    Beck, Tim


    This article describes the integration of a knowledge-based system with a large COBOL-DB2-based offender management system. The knowledge-based application, developed for the purpose of offender sentence calculation, is shown to provide several benefits, including a shortened development cycle, simplified maintenance, and improved accuracy over a previous COBOL-based application.

  15. Archetypes for Managing ERP Systems

    DEFF Research Database (Denmark)

    Kræmmergaard, Pernille; Hansen, Michael Fiil


    The ERP journey has taken us beyond implementation, into the second wave of ERP. One interesting question in this second wave is how the ERP system is managed and what role the ERP system plays in the organization after some years of implementation. These questions are addressed in this paper. In...

  16. DKIST facility management system integration (United States)

    White, Charles R.; Phelps, LeEllen


    The Daniel K. Inouye Solar Telescope (DKIST) Observatory is under construction at Haleakalā, Maui, Hawai'i. When complete, the DKIST will be the largest solar telescope in the world. The Facility Management System (FMS) is a subsystem of the high-level Facility Control System (FCS) and directly controls the Facility Thermal System (FTS). The FMS receives operational mode information from the FCS while making process data available to the FCS and includes hardware and software to integrate and control all aspects of the FTS including the Carousel Cooling System, the Telescope Chamber Environmental Control Systems, and the Temperature Monitoring System. In addition it will integrate the Power Energy Management System and several service systems such as heating, ventilation, and air conditioning (HVAC), the Domestic Water Distribution System, and the Vacuum System. All of these subsystems must operate in coordination to provide the best possible observing conditions and overall building management. Further, the FMS must actively react to varying weather conditions and observational requirements. The physical impact of the facility must not interfere with neighboring installations while operating in a very environmentally and culturally sensitive area. The FMS system will be comprised of five Programmable Automation Controllers (PACs). We present a pre-build overview of the functional plan to integrate all of the FMS subsystems.

  17. Use of a Business Approach to Improve Disease Surveillance Data Management Systems and Information Technology Process in Florida's Bureau of STD Prevention and Control. (United States)

    Shiver, Stacy A; Schmitt, Karla; Cooksey, Adrian


    The business of sexually transmitted disease (STD) prevention and control demands technology that is capable of supporting a wide array of program activities-from the processing of laboratory test results to the complex and confidential process involved in contact investigation. The need for a tool that enables public health officials to successfully manage the complex operations encountered in an STD prevention and control program, and the need to operate in an increasingly poor resource environment, led the Florida Bureau of STD to develop the Patient Reporting Investigation Surveillance Manager. Its unique approach, technical architecture, and sociotechnical philosophy have made this business application successful in real-time monitoring of disease burden for local communities, identification of emerging outbreaks, monitoring and assurance of appropriate treatments, improving access to laboratory data, and improving the quality of data for epidemiologic analysis. Additionally, the effort attempted to create and release a product that promoted the Centers for Disease Control and Prevention's ideas for integration of programs and processes.

  18. Library Management Systems

    Directory of Open Access Journals (Sweden)

    Ionel Enache


    Full Text Available Today’s libraries are faced with the innumerable challenges posed by an information universe on rapid expansion. The increasing expectations and the users’ needs to access faster and easier the relevant information is in a constant relation to the institutional demand for the increasing of operational efficiency. The library integrated systems enable all types of libraries with accessible instruments and the necessary assistance needed in the working flow in order to cope with personal and institutional demands both in present and in future times. The integrated system can be configured in order to meet every type of library policy or procedure thus allowing the creation of a sole working flow.

  19. Pisa syndrome in Parkinson's disease: diagnostic and management challenges

    Directory of Open Access Journals (Sweden)

    Miletić V


    Full Text Available Vladimir Miletić Department of Neurology, Movement Disorders Centre, University Hospital Centre Zagreb, Zagreb, Croatia Abstract: Pisa syndrome is a rare clinical entity characterized by marked lateral flexion of the trunk, which is typically mobile and resolves at supine position. When observed in clinical practice, it denotes an incapacitating symptom of underlying neurodegenerative disease such as Parkinson's disease, multiple system atrophy, and Alzheimer's disease. The underlying pathophysiological mechanisms responsible for the development of Pisa syndrome are poorly understood, and its management remains a challenge. In this review, we will focus our attention on Pisa syndrome in patients with Parkinson's disease, and provide an update on prevalence, pathophysiology, clinical manifestation, and treatment options. Keywords: Pisa syndrome, lateral trunk flexion, Parkinson's disease

  20. Integrated Systems Health Management for Intelligent Systems (United States)

    Figueroa, Fernando; Melcher, Kevin


    The implementation of an integrated system health management (ISHM) capability is fundamentally linked to the management of data, information, and knowledge (DIaK) with the purposeful objective of determining the health of a system. It is akin to having a team of experts who are all individually and collectively observing and analyzing a complex system, and communicating effectively with each other in order to arrive at an accurate and reliable assessment of its health. In this paper, concepts, procedures, and approaches are presented as a foundation for implementing an intelligent systems ]relevant ISHM capability. The capability stresses integration of DIaK from all elements of a system. Both ground-based (remote) and on-board ISHM capabilities are compared and contrasted. The information presented is the result of many years of research, development, and maturation of technologies, and of prototype implementations in operational systems.

  1. [Autoimmune Diseases of Digestive System]. (United States)

    Ivashkinl, V T; Sheptulina, A F; Raĭkhelson, K L; Losik, E A; Ivashkin, K V; Okhlobystin, A V; Baranskaia, E K; Polouvektova, E A; Shifrin, O S


    Autoimmune diseases of digestive system refer to pathological conditions, caused by autoimmune mechanisms, and their etiology remains unknown. This is a group of relatively rare diseases, however, during the last years a marked tendency towards the raise in incidence andprevalence is observed, which led to an increase in number of clinical investigations on etiology, pathogenesis, and, accordingly, development of new diagnostic methods and therapies. Results of such trials shown, for example, that the pathogenesis of chronic cholestatic liver diseases is associated with nuclear receptors function, while the main etiological and pathogenic factor of inflammatory bowel diseases represents gut microbiota. Despite new achievements in autoinmune diseases of digestive system research, therapies are low effective and are accompanied by a huge number of adverse events. The fact that these diseases may lead to malignant tumors is also worth noting. For example, patients with primary sclerosing cholangitis have a 160 times higher risk of cholangiocellular carcinoma, while 10-14% ofpatients with celiac disease may develop malignancies of esophagus, small and large intestine. Thus, these diseases require further investigation with a purpose of more accurate diagnostic methods for the detection of disease at early stages and new effective and safe therapies development.

  2. Managing risk in software systems

    Energy Technology Data Exchange (ETDEWEB)

    Fletcher, S.K.; Jansma, R.M.; Murphy, M.D. [and others


    A methodology for risk management in the design of software systems is presented. It spans security, safety, and correct operation of software within the context of its environment, and produces a risk analysis and documented risk management strategy. It is designed to be iteratively applied, to attain appropriate levels of detail throughout the analysis. The methodology and supporting tools are discussed. The methodology is critiqued relative to other research in the field. Some sample applications of the methodology are presented.

  3. Optimal Management of Power Systems


    Andreassi, Luca; Ubertini, Stefano


    The present chapter discusses the importance of energy systems proper management to reduce energy costs and environmental impact. A numerical model for the optimal management of a power plant in buildings and industrial plants is presented. The model allows evaluating different operating strategies for the power plant components. The different strategies are defined on the basis of a pure economic optimisation (minimisation of total cost) and/or of an energetic optimisation (minimisation of f...

  4. Introduction to Management Information system


    Mishra, Umakant


    A Management Information System (MIS) is a systematic organization and presentation of information that is generally required by the management of an organization for taking better decisions for the organization. The MIS data may be derived from various units of the organization or from other sources. However it is very difficult to say the exact structure of MIS as the structure and goals of different types of organizations are different. Hence both the data and structure of MIS is dependent...

  5. Tools for primary care management of inflammatory bowel disease

    DEFF Research Database (Denmark)

    Bennett, Alice L; Munkholm, Pia; Andrews, Jane M


    are helpful but they are not designed for the primary care setting. Few non-expert IBD management tools or guidelines exist compared with those used for other chronic diseases such as asthma and scant data have been published regarding the usefulness of such tools including IBD action plans and associated......Healthcare systems throughout the world continue to face emerging challenges associated with chronic disease management. Due to the likely increase in chronic conditions in the future it is now vital that cooperation and support between specialists, generalists and primary health care physicians...... affected by IBD in their caseload, the proportion of patients with IBD-related healthcare issues cared for in the primary care setting appears to be widespread. Data suggests however, that primary care physician's IBD knowledge and comfort in management is suboptimal. Current treatment guidelines for IBD...

  6. A System for Payroll Management

    Directory of Open Access Journals (Sweden)

    Pavitra R. Gautam


    Full Text Available Problem statement: This research had done the software design and database system model for Payroll Management System (PMS in Defense Institute of Physiology and Allied Sciences (DIPAS. The calculations are based on the user provided employees details like basic pay, house rent allowance, loan details and so on. Based on these user inputs the system automatically generates pay slip, pay bills, all schedules for debit and credit payments. This system is developed in such a way to suit for both new and old pension schemes of the central government employees of India. The use of Java Server Pages (JSP language for system development allows easy modification of the system design. So the system design can be directly implemented to any other central government organization with slight modifications. Approach: This study presented the database and software design for PMS. The software changes the manual operation into a computer-based system to automate study, provide efficiency, accuracy, timelessness, security and economy. Results: After undertaking an in-depth examination of the existing manual payroll management system and analyzing its short comings, it has been found necessary to remove its deficiencies and provide a suitable solution for presently encountered problem. Conclusion: The proposed system can help the organization to manage efficiently the employee pay related data as personal information, salary information, loan information and so on.

  7. Input management of production systems. (United States)

    Odum, E P


    Nonpoint sources of pollution, which are largely responsible for stressing regional and global life-supporting atmosphere, soil, and water, can only be reduced (and ultimately controlled) by input management that involves increasing the efficiency of production systems and reducing the inputs of environmentally damaging materials. Input management requires a major change, an about-face, in the approach to management of agriculture, power plants, and industries because the focus is on waste reduction and recycling rather than on waste disposal. For large-scale ecosystem-level situations a top-down hierarchical approach is suggested and illustrated by recent research in agroecology and landscape ecology.

  8. Managing Distributed Knowledge Systems

    DEFF Research Database (Denmark)

    Sørensen, Brian Vejrum; Gelbuda, Modestas


    . This paper contributes to the research on organizations as distributed knowledge systems by addressing two weaknesses of the social practice literature. Firstly, it downplays the importance of formal structure and organizational design and intervention efforts by key organizational members. Secondly, it does...... of integrating new people, building new units and adding activities to the existing organization. It is argued that knowledge is not a stable capacity that belongs to any actor alone, but that it is rather an ongoing social accomplishment, which is created and recreated as actors engage in mutual activities...

  9. The disease management approach to controlling asthma. (United States)

    Haahtela, T


    Asthma has become an important public health issue worldwide and certain groups, such as children, are at particular risk of the disease. Often asthma remains under-diagnosed and under-treated. Despite these worrying trends, the disease management approach to asthma control can help most asthma patients achieve a 'normal' way of life. The increased prevalence and greater diagnostic awareness of asthma have placed increased demands on healthcare resources, but effective asthma control can minimize the personal, social and economic burdens of asthma. Early diagnosis and immediate anti-inflammatory treatment is the first step in gaining control of symptoms. A stepwise approach is then used to classify asthma severity and treatment, with the number and frequency of medications increasing (step up) as asthma severity increases and decreasing (step down) when asthma is under control. This stepwise approach to asthma management necessitates regular review of treatment once asthma is under control. However, effective asthma management is dependent on successful patient education, adherence to prescribed medication and good doctor patient partnerships. Current treatment guidelines recommend the use of a written asthma management plan that should be agreed between the doctor and patient. These plans should cover all aspects of asthma treatment, including prevention steps for long-term control and action steps to stop attacks once a worsening in asthma has been recognized. This comprehensive approach to asthma management increases the likelihood of achieving asthma control, which in turn reduces the need for emergency visits to the hospital or clinic and reduces the limitations on physical activity previously imposed by the condition.

  10. Quality management systems in radiology

    Directory of Open Access Journals (Sweden)

    Geoffrey K. Korir


    Full Text Available Background: The use of X-ray imaging is ever increasing in proportion to the need for radiological services and technological capabilities. Quality management that includes patient radiation dose monitoring is fundamental to safety and quality improvement of radiological services.Objective: To assess the level of quality management systems in X-ray medical facilities in Kenya.Methods: Quality management inspection, quality control performance tests and patient radiation exposure were assessed in 54 representative X-ray medical facilities. Additionally, a survey of X-ray examination frequency was conducted in 140 hospitals across the country.Results: The overall findings placed the country’s X-ray imaging quality management systems at 61±3% out of a possible 100%. The most and the least quality assurance performance indicators were general radiography X-ray equipment quality control tests at 88±4%, and the interventional cardiology adult examinations below diagnostic reference level at 25±1%, respectively.Conclusions: The study used a systematic evidence-based approach for the assessment of national quality management systems in radiological practice in clinical application, technical conduct of the procedure, image quality criteria, and patient characteristics as part of the quality management programme.

  11. Laboratory information management system proposal

    Energy Technology Data Exchange (ETDEWEB)

    Brown, B.; Schweitzer, S.; Adams, C.; White, S. [Tennessee Univ., Knoxville, TN (United States)


    The objectives of this paper is design a user friendly information management system using a relational database in order to: allow customers direct access to the system; provide customers with direct sample tracking capabilities; provide customers with more timely, consistent reporting; better allocate costs for analyses to appropriate customers; eliminate cumbersome and costly papertrails; and enhance facility utilization by laboratory personnel. The resultant savings through increased efficiency provided by this system should more than offset its cost in the long-term.

  12. Laboratory information management system proposal

    Energy Technology Data Exchange (ETDEWEB)

    Brown, B.; Schweitzer, S.; Adams, C.; White, S. (Tennessee Univ., Knoxville, TN (United States))


    The objectives of this paper is design a user friendly information management system using a relational database in order to: allow customers direct access to the system; provide customers with direct sample tracking capabilities; provide customers with more timely, consistent reporting; better allocate costs for analyses to appropriate customers; eliminate cumbersome and costly papertrails; and enhance facility utilization by laboratory personnel. The resultant savings through increased efficiency provided by this system should more than offset its cost in the long-term.

  13. Dental health and management for children with congenital heart disease.

    LENUS (Irish Health Repository)

    FitzGerald, Kirsten


    Congenital heart disease (CHD) is one of the most common developmental anomalies. Children with CHD are at increased risk of developing oral disease, and are at increased risk from the systemic effects of oral disease. Recent changes in guidelines related to prophylaxis against infective endocarditis have highlighted the importance of establishing and maintaining oral health for this group of patients. The management of children with CHD can be complex and, unfortunately, many of these children do not receive the care they require. The challenges that these children pose are discussed, and suggestions are made for the appropriate management of these patients and the key role that all those working in primary dental care have to play.

  14. Dental health and management for children with congenital heart disease.

    LENUS (Irish Health Repository)

    FitzGerald, Kirsten


    Congenital heart disease (CHD) is one of the most common developmental anomalies. Children with CHD are at increased risk of developing oral disease, and are at increased risk from the systemic effects of oral disease. Recent changes in guidelines related to prophylaxis against infective endocarditis have highlighted the importance of establishing and maintaining oral health for this group of patients. The management of children with CHD can be complex and, unfortunately, many of these children do not receive the care they require. The challenges that these children pose are discussed, and suggestions are made for the appropriate management of these patients and the key role that all those working in primary dental care have to play.

  15. Operational Management System for Regulated Water Systems (United States)

    van Loenen, A.; van Dijk, M.; van Verseveld, W.; Berger, H.


    Most of the Dutch large rivers, canals and lakes are controlled by the Dutch water authorities. The main reasons concern safety, navigation and fresh water supply. Historically the separate water bodies have been controlled locally. For optimizating management of these water systems an integrated approach was required. Presented is a platform which integrates data from all control objects for monitoring and control purposes. The Operational Management System for Regulated Water Systems (IWP) is an implementation of Delft-FEWS which supports operational control of water systems and actively gives advice. One of the main characteristics of IWP is that is real-time collects, transforms and presents different types of data, which all add to the operational water management. Next to that, hydrodynamic models and intelligent decision support tools are added to support the water managers during their daily control activities. An important advantage of IWP is that it uses the Delft-FEWS framework, therefore processes like central data collection, transformations, data processing and presentation are simply configured. At all control locations the same information is readily available. The operational water management itself gains from this information, but it can also contribute to cost efficiency (no unnecessary pumping), better use of available storage and advise during (water polution) calamities.

  16. Diagnosis and management of polycystic liver disease. (United States)

    Gevers, Tom J G; Drenth, Joost P H


    Polycystic liver disease (PLD) is arbitrarily defined as a liver that contains >20 cysts. The condition is associated with two genetically distinct diseases: as a primary phenotype in isolated polycystic liver disease (PCLD) and as an extrarenal manifestation in autosomal dominant polycystic kidney disease (ADPKD). Processes involved in hepatic cystogenesis include ductal plate malformation with concomitant abnormal fluid secretion, altered cell-matrix interaction and cholangiocyte hyperproliferation. PLD is usually a benign disease, but can cause debilitating abdominal symptoms in some patients. The main risk factors for growth of liver cysts are female sex, exogenous oestrogen use and multiple pregnancies. Ultrasonography is very useful for achieving a correct diagnosis of a polycystic liver and to differentiate between ADPKD and PCLD. Current radiological and surgical therapies for symptomatic patients include aspiration-sclerotherapy, fenestration, segmental hepatic resection and liver transplantation. Medical therapies that interact with regulatory mechanisms controlling expansion and growth of liver cysts are under investigation. Somatostatin analogues are promising; several clinical trials have shown that these drugs can reduce the volume of polycystic livers. The purpose of this Review is to provide an update on the diagnosis and management of PLD with a focus on literature published in the past 4 years.

  17. Cassava virus diseases: biology, epidemiology, and management. (United States)

    Legg, James P; Lava Kumar, P; Makeshkumar, T; Tripathi, Leena; Ferguson, Morag; Kanju, Edward; Ntawuruhunga, Pheneas; Cuellar, Wilmer


    Cassava (Manihot esculenta Crantz.) is the most important vegetatively propagated food staple in Africa and a prominent industrial crop in Latin America and Asia. Its vegetative propagation through stem cuttings has many advantages, but deleteriously it means that pathogens are passed from one generation to the next and can easily accumulate, threatening cassava production. Cassava-growing continents are characterized by specific suites of viruses that affect cassava and pose particular threats. Of major concern, causing large and increasing economic impact in Africa and Asia are the cassava mosaic geminiviruses that cause cassava mosaic disease in Africa and Asia and cassava brown streak viruses causing cassava brown streak disease in Africa. Latin America, the center of origin and domestication of the crop, hosts a diverse set of virus species, of which the most economically important give rise to cassava frog skin disease syndrome. Here, we review current knowledge on the biology, epidemiology, and control of the most economically important groups of viruses in relation to both farming and cultural practices. Components of virus control strategies examined include: diagnostics and surveillance, prevention and control of infection using phytosanitation, and control of disease through the breeding and promotion of varieties that inhibit virus replication and/or movement. We highlight areas that need further research attention and conclude by examining the likely future global outlook for virus disease management in cassava.

  18. Electromagnetic spectrum management system (United States)

    Seastrand, Douglas R.


    A system for transmitting a wireless countermeasure signal to disrupt third party communications is disclosed that include an antenna configured to receive wireless signals and transmit wireless counter measure signals such that the wireless countermeasure signals are responsive to the received wireless signals. A receiver processes the received wireless signals to create processed received signal data while a spectrum control module subtracts known source signal data from the processed received signal data to generate unknown source signal data. The unknown source signal data is based on unknown wireless signals, such as enemy signals. A transmitter is configured to process the unknown source signal data to create countermeasure signals and transmit a wireless countermeasure signal over the first antenna or a second antenna to thereby interfere with the unknown wireless signals.

  19. Dermat - the dermoscopy management system

    Directory of Open Access Journals (Sweden)

    Grzegorz Surówka


    Full Text Available In order to recognize early symptoms of melanoma, the lethal cancer of the skin, our group is developing pattern recognition and machine learning tools that may help medical doctors in the melanoma diagnosis. Since in the machine learning approach data from diversified sources are required, in this article we present the Java-based Dermat 1.0 application, a medical software system for management of dermoscopy data and the patients follow-up documentation. The chief objective for this system is to integrate all the management activities (image acquisition, anamneses, medical documentation and annotations into a self-content optimal data base system. Such an integrated approach to digital dermoscopy and management of the patient data between the visits is crucial in comparing the results, storing/retrieving/transmitting dermoscopic images and making a proper and early diagnosis. The Dermat application is distributed among dermatological clinics and private practitioners in accordance to the 'tool-for-the-data' model.

  20. Archetypes for Managing ERP Systems

    DEFF Research Database (Denmark)

    Kræmmergaard, Pernille; Hansen, Michael Fiil


    The ERP journey has taken us beyond implementation, into the second wave of ERP. One interesting question in this second wave is how the ERP system is managed and what role the ERP system plays in the organization after some years of implementation. These questions are addressed in this paper....... In our research of 20 case-studies we found certain similarities and differences in the patterns which coalesced around three alternatives in the way organizations approach the managing of ERP in the second wave. We describe these archetypes, which we call the Calculators, the Co-players and the Drivers......, and we present illustrative cases of each of the archetypes. The archetypes are believed to play an important role in conveying the essential differences existing in alternative ways in which organizations manage their ERP system during the second wave....

  1. Cloud Database Management System (CDBMS

    Directory of Open Access Journals (Sweden)

    Snehal B. Shende


    Full Text Available Cloud database management system is a distributed database that delivers computing as a service. It is sharing of web infrastructure for resources, software and information over a network. The cloud is used as a storage location and database can be accessed and computed from anywhere. The large number of web application makes the use of distributed storage solution in order to scale up. It enables user to outsource the resource and services to the third party server. This paper include, the recent trend in cloud service based on database management system and offering it as one of the services in cloud. The advantages and disadvantages of database as a service will let you to decide either to use database as a service or not. This paper also will highlight the architecture of cloud based on database management system.

  2. Archetypes for Managing ERP Systems

    DEFF Research Database (Denmark)

    Kræmmergaard, Pernille; Fill, Michael; Simonsen, Martin


    The ERP journey has taken us beyond implementation, into the second wave of ERP. One interesting question in this second wave is how the ERP system is managed and what role the ERP system plays in the organization after some years of implementation. These questions are addressed in this paper......, and we present illustrative cases of each of the archetypes. The archetypes are believed to play an important role in conveying the essential differences existing in alternative ways in which organizations manage their ERP system during the second wave........ In our research of 20 case-studies we found certain similarities and differences in the patterns which coalesced around three alternatives in the way organizations approach the managing of ERP in the second wave. We describe these archetypes, which we call the Calculators, the Co-players and the Drivers...

  3. The CMS Data Management System (United States)

    Giffels, M.; Guo, Y.; Kuznetsov, V.; Magini, N.; Wildish, T.


    The data management elements in CMS are scalable, modular, and designed to work together. The main components are PhEDEx, the data transfer and location system; the Data Booking Service (DBS), a metadata catalog; and the Data Aggregation Service (DAS), designed to aggregate views and provide them to users and services. Tens of thousands of samples have been cataloged and petabytes of data have been moved since the run began. The modular system has allowed the optimal use of appropriate underlying technologies. In this contribution we will discuss the use of both Oracle and NoSQL databases to implement the data management elements as well as the individual architectures chosen. We will discuss how the data management system functioned during the first run, and what improvements are planned in preparation for 2015.

  4. System of Enterprise Reputation Management

    Directory of Open Access Journals (Sweden)

    Derevianko Olena. H.


    Full Text Available The article offers a system of enterprise reputation management directed at increase of economic benefits from formation and maintenance of high reputation in the result of maximisation of the volume of the incoming cash flows of the enterprise and also their duration and stability. It proves that reputation management, which allows achievement of economic goals of the enterprise, should be directed at key groups of stakeholders: growth of products sales is ensured by consumers, growth of internal stability – by enterprise personnel, growth of external stability – by society, including authority bodies, growth of business value – by investors, owners and partners. The article describes components of the system of enterprise reputation management, the degree of development of which are determined by three vectors: interaction with stakeholders and level of their feedback: messaging, informing, convincing and attracting; activity of the used instruments of reputation management, regularity and intensity, and also quantitative indicators of their application within the framework of directions of the product PR, corporate PR and IR, internal PR, GR and PR-CSR; level of organisational pre-requisites (functional, system and strategic of the system of reputation management.

  5. Auditing of environmental management system

    Directory of Open Access Journals (Sweden)

    Čuchranová Katarína


    Full Text Available Environmental auditing has estabilished itself as a valueable instrument to verify and help to improve the environmental performance.Organizations of all kinds may have a need to demonstrate the environmental responsibility. The concept of environmental management systems and the associated practice of environmental auditing have been advanced as one way to satisfy this need.These system are intended to help an organization to establish and continue to meet its environmental policies, objectives, standards and other requirements.Environmental auditing is a systematic and documented verification process of objectively obtaining and evaluating audit evidence to determine whether an organizations environmental management system conforms to the environmental management system audit criteria set by the organization and for the communication of the results of this process to the management.The following article intercepts all parts of preparation environmental auditing.The audit programme and procedures should cover the activities and areas to be considered in audits, the frequency of audits, the responsibilities associated with managing and conducting audits, the communication of audit results, auditor competence, and how audits will be conducted.The International Standard ISO 140011 estabilishes the audit procedures that determine conformance with EMS audit criteria.

  6. Management of Complications of End-Stage Liver Disease in the Intensive Care Unit. (United States)

    DellaVolpe, Jeffrey D; Garavaglia, Jeffrey M; Huang, David T


    The management of critically ill patients with end-stage liver disease can be challenging due to the vulnerability of this population and the wide-ranging complications of the disease. This review proposes an approach based on the major organ systems affected, to provide a framework for managing the most common complications. Although considerable practice variation exists, a focus on the evidence behind the most common practices will ensure the development of the optimal skillset to appropriately manage this disease.

  7. Management Information and Library Management Systems: An Overview. (United States)

    Fisher, Shelagh; Rowley, Jennifer


    Provides an overview of the facilities for management information in library management systems. Highlights include the relationship between transaction processing systems, management information systems, and decision support systems; a review of previous work; enquiries and standard reports relating to library operations; report generators; and…

  8. The SMAP Dictionary Management System (United States)

    Smith, Kevin A.; Swan, Christoper A.


    The Soil Moisture Active Passive (SMAP) Dictionary Management System is a web-based tool to develop and store a mission dictionary. A mission dictionary defines the interface between a ground system and a spacecraft. In recent years, mission dictionaries have grown in size and scope, making it difficult for engineers across multiple disciplines to coordinate the dictionary development effort. The Dictionary Management Systemaddresses these issues by placing all dictionary information in one place, taking advantage of the efficiencies inherent in co-locating what were once disparate dictionary development efforts.

  9. Archetypes for Managing ERP Systems


    Kræmmergaard, Pernille; Hansen, Michael Fiil


    The ERP journey has taken us beyond implementation, into the second wave of ERP. One interesting question in this second wave is how the ERP system is managed and what role the ERP system plays in the organization after some years of implementation. These questions are addressed in this paper. In our research of 20 case-studies we found certain similarities and differences in the patterns which coalesced around three alternatives in the way organizations approach the managing of ERP in the se...

  10. Targeting the vitamin D endocrine system (VDES) for the management of inflammatory and malignant skin diseases: An historical view and outlook. (United States)

    Reichrath, Jörg; Zouboulis, Christos C; Vogt, Thomas; Holick, Michael F


    relevance of the VDES for the management of inflammatory and malignant skin diseases.

  11. Managing complexity of aerospace systems (United States)

    Tamaskar, Shashank

    Growing complexity of modern aerospace systems has exposed the limits of conventional systems engineering tools and challenged our ability to design them in a timely and cost effective manner. According to the US Government Accountability Office (GAO), in 2009 nearly half of the defense acquisition programs are expecting 25% or more increase in unit acquisition cost. Increase in technical complexity has been identified as one of the primary drivers behind cost-schedule overruns. Thus to assure the affordability of future aerospace systems, it is increasingly important to develop tools and capabilities for managing their complexity. We propose an approach for managing the complexity of aerospace systems to address this pertinent problem. To this end, we develop a measure that improves upon the state-of-the-art metrics and incorporates key aspects of system complexity. We address the problem of system decomposition by presenting an algorithm for module identification that generates modules to minimize integration complexity. We demonstrate the framework on diverse spacecraft and show the impact of design decisions on integration cost. The measure and the algorithm together help the designer track and manage complexity in different phases of system design. We next investigate how complexity can be used as a decision metric in the model-based design (MBD) paradigm. We propose a framework for complexity enabled design space exploration that introduces the idea of using complexity as a non-traditional design objective. We also incorporate complexity with the component based design paradigm (a sub-field of MBD) and demonstrate it on several case studies. The approach for managing complexity is a small but significant contribution to the vast field of complexity management. We envision our approach being used in concert with a suite of complexity metrics to provide an ability to measure and track complexity through different stages of design and development. This will not

  12. International collaboration in health promotion and disease management: implications of U.S. health promotion efforts on Japan's health care system. (United States)

    Pelletier, Kenneth R


    For more than 25 years, health promotion and disease management interventions have been conducted by large employers in the United States. Today there are more than 100 studies of such multifactorial, comprehensive interventions that all demonstrate positive clinical outcomes. For those interventions that have also been evaluated for return on investment, all but one have demonstrated cost-effectiveness. This article is an evidence-based overview of the clinical and cost outcomes research to elaborate on the insights gained from this research in the areas of implementation and evaluation of such programs; integration of health promotion and disease management programs into conventional, occupational medicine; accessing difficult to reach populations, such as mobile workers, retirees, and/or dependents; areas of potential conflict of interest and privacy/confidentiality issues; health consequences of downsizing and job strain; and, finally, recommendations for improved integration and evaluation of such programs for both clinical and cost outcomes. With medical costs rapidly escalating again on a global scale, these interventions with evidence of both clinical and cost outcomes can provide the foundation to improve the health, performance, and productivity of both individuals and their corporations.

  13. Surgical Management of Ear Diseases in Rabbits. (United States)

    Csomos, Rebecca; Bosscher, Georgia; Mans, Christoph; Hardie, Robert


    Otitis externa and media are frequently diagnosed disorders in rabbits and are particularly common in lop-eared breeds because of the specific anatomy of the ear canal. Medical management for otitis externa and media often provides only a temporary improvement in clinical signs. Surgery by means of partial or total ear canal ablation (PECA or TECA) combined with lateral bulla osteotomy (LBO) represents a feasible approach that is well tolerated and provides a good clinical outcome. Short-term complications associated with PECA/TECA-LBO include facial nerve paralysis and vestibular disease.

  14. A systems engineering management approach to resource management applications (United States)

    Hornstein, Rhoda Shaller


    The author presents a program management response to the following question: How can the traditional practice of systems engineering management, including requirements specification, be adapted, enhanced, or modified to build future planning and scheduling systems for effective operations? The systems engineering management process, as traditionally practiced, is examined. Extensible resource management systems are discussed. It is concluded that extensible systems are a partial solution to problems presented by requirements that are incomplete, partially immeasurable, and often dynamic. There are positive indications that resource management systems have been characterized and modeled sufficiently to allow their implementation as extensible systems.

  15. Surgical management of polycystic liver disease

    Institute of Scientific and Technical Information of China (English)


    Adult polycystic liver disease (PCLD) is an autosomal dominant condition commonly associated with autosomal dominant polycystic kidney disease (ADPKD). However in the last decade, it has been recognized that there is a distinct form of autosomal dominant PCLD that arises without concomitant ADPKD. Early knowledge of the pathogenesis was gained from the study of hepatic cysts in patients with ADPKD. Bile duct overgrowth after embryogenesis results in cystic hepatic dilatations that are known as biliary microhamartomas or von Meyenburg complexes. Further dilatation arises from cellular proliferation and fluid secretion into these cysts.There is a variable, broad spectrum of manifestations of PCLD. Although PCLD is most often asymptomatic,massive hepatomegaly can lead to disabling symptoms of abdominal pain, early satiety, persistent nausea,dyspnea, ascites, biliary obstruction, and lower body edema. Complications of PCLD include cyst rupture and cyst infection. Also, there are associated medical problems, especially intracranial aneurysms and valvular heart disease, which clinicians need to be aware of and evaluate in patients with PCLD. In asymptomatic patients, no treatment is indicated for PCLD. In the symptomatic patient, surgical therapy is the mainstay of treatment tailored to the extent of disease for each patient. Management options include cyst aspiration and sclerosis, open or laparoscopic fenestration, liver resection with fenestration, and liver transplantation.The surgical literature discussing treatment of PCLD,including techniques, outcomes, and complication rates,are summarized in this review.

  16. Management of postoperative recurrence of Crohn's disease. (United States)

    van Lent, Anja U; D'Haens, Geert R


    The course of Crohn's disease (CD) is unpredictable and potentially destructive. The percentage of patients requiring surgery at some stage in their disease accumulates to over 70%. After resection of the affected intestine, reappearance of CD occurs in the majority of patients. Prophylactic medical therapy to reduce the rate of postoperative recurrence has been proven to be effective, yet the incidence of recurrence remains high. Patient profiling (risk stratification) is important in this postoperative setting. High-risk patients (associated with e.g. smoking, the need of repetitive surgery and penetrating disease) require strong immunosuppressive treatment, which should be commenced immediately after surgery, when recurrent disease activity begins. Additionally, early screening endoscopy should be performed to monitor treatment effect. The efficacy of thiopurines is shown to be higher than mesalazine or imidazole antibiotics alone for preventing and ameliorating endoscopic recurrence of CD postoperatively; however, anti-tumor necrosis factors (anti-TNFs) are increasingly considered the most potent agents. In patients with a risk factor for early postoperative recurrence, the first line of treatment is 6-mercaptopurine, in combination with imidazole antibiotics if tolerated, followed by anti-TNFs. When lesions are found at colonoscopy, therapy should be upscaled. We propose a treatment algorithm to direct therapeutic management of CD postoperatively. © 2013 S. Karger AG, Basel.

  17. Systemic diseases with cutaneous manifestations. (United States)

    Merchant, S R; Taboada, J


    The purpose of this article is to briefly discuss the following cutaneous manifestations of selected systemic diseases: poxvirus; feline leukemia virus (FeLV); feline immunodeficiency virus (FIV); herpesvirus; calcivirus; pseudorabies; plague; tularemia; toxoplasmosis; leishmania; hypothyroidism; hyperthyroidism; hyperadrenocorticism; diabetes mellitus; acromegaly; thallium poisoning; pancreatic disease; hypereosinophilic syndrome; mucopolysaccharidosis; and pansteatitis. Recognition of these cutaneous signs may help alert the clinician to the possibility of an internal disorder so that the appropriate diagnostic tests can be considered.

  18. Thermal management systems and methods (United States)

    Gering, Kevin L.; Haefner, Daryl R.


    A thermal management system for a vehicle includes a heat exchanger having a thermal energy storage material provided therein, a first coolant loop thermally coupled to an electrochemical storage device located within the first coolant loop and to the heat exchanger, and a second coolant loop thermally coupled to the heat exchanger. The first and second coolant loops are configured to carry distinct thermal energy transfer media. The thermal management system also includes an interface configured to facilitate transfer of heat generated by an internal combustion engine to the heat exchanger via the second coolant loop in order to selectively deliver the heat to the electrochemical storage device. Thermal management methods are also provided.

  19. Complement system in lung disease. (United States)

    Pandya, Pankita H; Wilkes, David S


    In addition to its established contribution to innate immunity, recent studies have suggested novel roles for the complement system in the development of various lung diseases. Several studies have demonstrated that complement may serve as a key link between innate and adaptive immunity in a variety of pulmonary conditions. However, the specific contributions of complement to lung diseases based on innate and adaptive immunity are just beginning to emerge. Elucidating the role of complement-mediated immune regulation in these diseases will help to identify new targets for therapeutic interventions.

  20. Information Security Management - Part Of The Integrated Management System (United States)

    Manea, Constantin Adrian


    The international management standards allow their integrated approach, thereby combining aspects of particular importance to the activity of any organization, from the quality management systems or the environmental management of the information security systems or the business continuity management systems. Although there is no national or international regulation, nor a defined standard for the Integrated Management System, the need to implement an integrated system occurs within the organization, which feels the opportunity to integrate the management components into a cohesive system, in agreement with the purpose and mission publicly stated. The issues relating to information security in the organization, from the perspective of the management system, raise serious questions to any organization in the current context of electronic information, reason for which we consider not only appropriate but necessary to promote and implement an Integrated Management System Quality - Environment - Health and Operational Security - Information Security

  1. Data management system performance modeling (United States)

    Kiser, Larry M.


    This paper discusses analytical techniques that have been used to gain a better understanding of the Space Station Freedom's (SSF's) Data Management System (DMS). The DMS is a complex, distributed, real-time computer system that has been redesigned numerous times. The implications of these redesigns have not been fully analyzed. This paper discusses the advantages and disadvantages for static analytical techniques such as Rate Monotonic Analysis (RMA) and also provides a rationale for dynamic modeling. Factors such as system architecture, processor utilization, bus architecture, queuing, etc. are well suited for analysis with a dynamic model. The significance of performance measures for a real-time system are discussed.

  2. Remotely Accessible Management System (RAMS). (United States)

    Wood, Rex

    Oakland Schools, an Intermediate School District for Administration, operates a Remotely Accessible Management System (RAMS). RAMS is composed of over 100 computer programs, each of which performs procedures on the files of the 28 local school districts comprising the constituency of Oakland Schools. This regional service agency covers 900 square…

  3. Grenada Education Management Information System


    Porta, Emilio; Klein, Jennifer; Arcia, Gustavo; Nannyonjo, Harriet


    The Education Management Information System (EMIS) country report for Grenada includes the following headings: background which includes education data in Grenada, EMIS staff, facilities and equipment, EMIS data, and publications; prerequisites of quality; assurances of integrity; methodological soundness; accuracy and reliability; serviceability; and accessibility.



    Demian Horia


    This paper presents traceability of a product if we are using a stock management system which uses FIFO or LIFO discharging methods. In the first part there is a little presentation regarding the four types of inputs and outputs and the side effect to the


    Directory of Open Access Journals (Sweden)

    Demian Horia


    Full Text Available This paper presents traceability of a product if we are using a stock management system which uses FIFO or LIFO discharging methods. In the first part there is a little presentation regarding the four types of inputs and outputs and the side effect to the

  6. Dermat - the dermoscopy management system


    Grzegorz Surówka; Paweł Janik; Maciej Ogorzałek; Piotr Kanas


    In order to recognize early symptoms of melanoma, the lethal cancer of the skin, our group is developing pattern recognition and machine learning tools that may help medical doctors in the melanoma diagnosis. Since in the machine learning approach data from diversified sources are required, in this article we present the Java-based Dermat 1.0 application, a medical software system for management of dermoscopy data and the patients follow-up documentation. The chief objective for this system i...

  7. Security ManagementSystems Approach

    Directory of Open Access Journals (Sweden)

    Milan Kný


    Full Text Available The aim of the contribution is the use of the systems approach to treat security management as a practical field and new scientific discipline. The philosophy of systems approach to the solution of problems generally is an adequate methodological basis even for the theory of management. The path to the real optimization of security situation leads only through the holistic and solid solution. Applications of systems analysis and synthesis back up the fact, that systems approach and systems thinking should not absent in security objects. The truthfulness of the claim, that security management is a well-established discipline, depends on ongoing discussion that represents useful process of development of new scientific discipline. At the same time the rationality of science and systematism works as a counterbalance to irrational fear of the whole society, too. Which questions of security remain open in relation to „our interests“? Current problems of Europe should be solved systematically. It is necessary to define the space of interest (territorially the border of the EU or the Schengen area, to implement the system to the object with respect to the borders of the space, to specify the structure and subjects of decision making and implementation.

  8. Automated Car Park Management System (United States)

    Fabros, J. P.; Tabañag, D.; Espra, A.; Gerasta, O. J.


    This study aims to develop a prototype for an Automated Car Park Management System that will increase the quality of service of parking lots through the integration of a smart system that assists motorist in finding vacant parking lot. The research was based on implementing an operating system and a monitoring system for parking system without the use of manpower. This will include Parking Guidance and Information System concept which will efficiently assist motorists and ensures the safety of the vehicles and the valuables inside the vehicle. For monitoring, Optical Character Recognition was employed to monitor and put into list all the cars entering the parking area. All parking events in this system are visible via MATLAB GUI which contain time-in, time-out, time consumed information and also the lot number where the car parks. To put into reality, this system has a payment method, and it comes via a coin slot operation to control the exit gate. The Automated Car Park Management System was successfully built by utilizing microcontrollers specifically one PIC18f4550 and two PIC16F84s and one PIC16F628A.

  9. Systemic diseases and the elderly.

    LENUS (Irish Health Repository)

    McCreary, Christine


    Although systemic diseases can occur at any age, they are more common in older patients. Accurate and detailed medical and drug histories are important in dental practice as many conditions and medications can influence oral health and dental care in patients. Not only can these conditions influence patient care in the surgery and oral hygiene at home, but access to dental services may also be adversely affected. Clinical Relevance: The systemic diseases can impact upon oral care or can have oral manifestations. Many of the pharmacological interventions prescribed for chronic conditions can have multiple and diverse adverse effects on the oral environment.

  10. Dermatologic Manifestations of Systemic Diseases. (United States)

    Valdez, Maryn Anne; Isamah, Nwamaka; Northway, Rebecca M


    Dermatologic complaints are encountered frequently by the primary care provider. Patients often are required as well as want to see their primary care provider before referral to a specialist. Therefore, primary care providers must be skilled in a variety of topics including dermatology. Certain dermatologic manifestations are associated with, or indicative of, systemic diseases. Primary care providers must be knowledgeable in diagnosis, evaluation, and treatment of dermatologic conditions, as well as when to appropriately refer. This article reviews common dermatologic manifestations of systemic diseases. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Integrated Computer System of Management in Logistics (United States)

    Chwesiuk, Krzysztof


    This paper aims at presenting a concept of an integrated computer system of management in logistics, particularly in supply and distribution chains. Consequently, the paper includes the basic idea of the concept of computer-based management in logistics and components of the system, such as CAM and CIM systems in production processes, and management systems for storage, materials flow, and for managing transport, forwarding and logistics companies. The platform which integrates computer-aided management systems is that of electronic data interchange.

  12. The complement system in systemic autoimmune disease. (United States)

    Chen, Min; Daha, Mohamed R; Kallenberg, Cees G M


    Complement is part of the innate immune system. Its major function is recognition and elimination of pathogens via direct killing and/or stimulation of phagocytosis. Activation of the complement system is, however, also involved in the pathogenesis of the systemic autoimmune diseases. Activation via the classical pathway has long been recognized in immune complex-mediated diseases such as cryoglobulinemic vasculitis and systemic lupus erythematosus (SLE). In SLE, the role of complement is somewhat paradoxical. It is involved in autoantibody-initiated tissue damage on the one hand, but, on the other hand, it appears to have protective features as hereditary deficiencies of classical pathway components are associated with an increased risk for SLE. There is increasing evidence that the alternative pathway of complement, even more than the classical pathway, is involved in many systemic autoimmune diseases. This is true for IgA-dominant Henoch Schönlein Purpura, in which additional activation of the lectin pathway contributes to more severe disease. In anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis the complement system was considered not to be involved since immunoglobulin deposition is generally absent in the lesions. However, recent studies, both in human and animal models, demonstrated complement activation via the alternative pathway as a major pathogenic mechanism. Insight into the role of the various pathways of complement in the systemic autoimmune diseases including the vasculitides opens up new ways of treatment by blocking effector pathways of complement. This has been demonstrated for monoclonal antibodies to C5 or C5a in experimental anti-phospholipid antibody syndrome and ANCA-associated vasculitis.

  13. Integrated Knowledge Based Expert System for Disease Diagnosis System (United States)

    Arbaiy, Nureize; Sulaiman, Shafiza Eliza; Hassan, Norlida; Afizah Afip, Zehan


    The role and importance of healthcare systems to improve quality of life and social welfare in a society have been well recognized. Attention should be given to raise awareness and implementing appropriate measures to improve health care. Therefore, a computer based system is developed to serve as an alternative for people to self-diagnose their health status based on given symptoms. This strategy should be emphasized so that people can utilize the information correctly as a reference to enjoy healthier life. Hence, a Web-based Community Center for Healthcare Diagnosis system is developed based on expert system technique. Expert system reasoning technique is employed in the system to enable information about treatment and prevention of the diseases based on given symptoms. At present, three diseases are included which are arthritis, thalassemia and pneumococcal. Sets of rule and fact are managed in the knowledge based system. Web based technology is used as a platform to disseminate the information to users in order for them to optimize the information appropriately. This system will benefit people who wish to increase health awareness and seek expert knowledge on the diseases by performing self-diagnosis for early disease detection.

  14. ESRD in the geriatric population: the crisis of managed care and the opportunity of disease management. (United States)

    Steinman, Theodore I


    The geriatric population with end-stage renal disease (ESRD) is placed at risk with regards to the quality and extent of medical coverage because of the rapidly changing financial environment. Managed care organizations (MCOs) are generally for-profit companies that must focus on the bottom line. While the verbal commitment to quality care is voiced, the financial pressures on MCOs have led to a decrease in coverage of many services and outright denial for some necessary treatments. While denying services, the MCOs have also reduced payments to providers for services rendered. The coverage crisis is compounded by health maintenance organizations (HMOs) quitting Medicare because the reimbursement from the Health Care Financing Administration (HCFA) is less than their costs. Because of the above issues which can potentially impact on the quality of care delivered to the ESRD geriatric population, a new approach to disease management has created the opportunity to improve total patient care to a level not yet achieved in the United States. Disease management encompasses integrated care across all disciplines. Every component of care can be tracked by a dedicated information system. Improvement in outcomes has far exceeded the U.S. Renal Data System (USRDS) benchmark performance measurements with a disease management model approach. The key to success is the health service coordinator (HSC), a senior nurse with many years of ESRD experience. This individual coordinates care across all disciplines and expedites necessary referrals. With rapid attention to patient needs there has been a significant reduction in hospital admissions, hospital length of stay, and emergency room visits. Patient care will steadily improve as the disease management system matures as a consequence of understanding the patients total physical and psychosocial needs.

  15. Stepwise Approach to Myopathy in Systemic Disease

    Directory of Open Access Journals (Sweden)

    Jasvinder eChawla


    Full Text Available Muscle diseases can constitute a large variety of both acquired and hereditary disorders. Myopathies in systemic disease results from several different disease processes including endocrine, inflammatory, paraneoplastic, infectious, drug and toxin-induced, critical illness myopathy, metabolic and myopathies with other systemic disorders. Patients with systemic myopathies often present acutely or sub acutely. On the other hand, familial myopathies or dystrophies generally present in a chronic fashion with exceptions of metabolic myopathies where symptoms on occasion can be precipitated acutely. Most of the inflammatory myopathies can have a chance association with malignant lesions; the incidence appears to be specifically increased only in patients with dermatomyositis. In dealing with myopathies associated with systemic illnesses, the focus will be on the acquired causes. Management is beyond the scope of this chapter. Prognosis is based upon the underlying cause and, most of the time, carries a good prognosis. In order to approach a patient with suspected myopathy from systemic disease, a stepwise approach is utilized.


    Frankowski, J. W.


    MIMS, Medical Information Management System is an interactive, general purpose information storage and retrieval system. It was first designed to be used in medical data management, and can be used to handle all aspects of data related to patient care. Other areas of application for MIMS include: managing occupational safety data in the public and private sectors; handling judicial information where speed and accuracy are high priorities; systemizing purchasing and procurement systems; and analyzing organizational cost structures. Because of its free format design, MIMS can offer immediate assistance where manipulation of large data bases is required. File structures, data categories, field lengths and formats, including alphabetic and/or numeric, are all user defined. The user can quickly and efficiently extract, display, and analyze the data. Three means of extracting data are provided: certain short items of information, such as social security numbers, can be used to uniquely identify each record for quick access; records can be selected which match conditions defined by the user; and specific categories of data can be selected. Data may be displayed and analyzed in several ways which include: generating tabular information assembled from comparison of all the records on the system; generating statistical information on numeric data such as means, standard deviations and standard errors; and displaying formatted listings of output data. The MIMS program is written in Microsoft FORTRAN-77. It was designed to operate on IBM Personal Computers and compatibles running under PC or MS DOS 2.00 or higher. MIMS was developed in 1987.


    Frankowski, J. W.


    MIMS, Medical Information Management System is an interactive, general purpose information storage and retrieval system. It was first designed to be used in medical data management, and can be used to handle all aspects of data related to patient care. Other areas of application for MIMS include: managing occupational safety data in the public and private sectors; handling judicial information where speed and accuracy are high priorities; systemizing purchasing and procurement systems; and analyzing organizational cost structures. Because of its free format design, MIMS can offer immediate assistance where manipulation of large data bases is required. File structures, data categories, field lengths and formats, including alphabetic and/or numeric, are all user defined. The user can quickly and efficiently extract, display, and analyze the data. Three means of extracting data are provided: certain short items of information, such as social security numbers, can be used to uniquely identify each record for quick access; records can be selected which match conditions defined by the user; and specific categories of data can be selected. Data may be displayed and analyzed in several ways which include: generating tabular information assembled from comparison of all the records on the system; generating statistical information on numeric data such as means, standard deviations and standard errors; and displaying formatted listings of output data. The MIMS program is written in Microsoft FORTRAN-77. It was designed to operate on IBM Personal Computers and compatibles running under PC or MS DOS 2.00 or higher. MIMS was developed in 1987.

  18. Metrics for border management systems.

    Energy Technology Data Exchange (ETDEWEB)

    Duggan, Ruth Ann


    There are as many unique and disparate manifestations of border systems as there are borders to protect. Border Security is a highly complex system analysis problem with global, regional, national, sector, and border element dimensions for land, water, and air domains. The complexity increases with the multiple, and sometimes conflicting, missions for regulating the flow of people and goods across borders, while securing them for national security. These systems include frontier border surveillance, immigration management and customs functions that must operate in a variety of weather, terrain, operational conditions, cultural constraints, and geopolitical contexts. As part of a Laboratory Directed Research and Development Project 08-684 (Year 1), the team developed a reference framework to decompose this complex system into international/regional, national, and border elements levels covering customs, immigration, and border policing functions. This generalized architecture is relevant to both domestic and international borders. As part of year two of this project (09-1204), the team determined relevant relative measures to better understand border management performance. This paper describes those relative metrics and how they can be used to improve border management systems.

  19. Interstitial lung disease in systemic sclerosis. (United States)

    Wells, Athol U


    Based on international collaborative data, interstitial lung disease is now the most frequent cause of death in systemic sclerosis (SSc), having supplanted renal crisis in that regard. Despite detailed explorations of candidate mediators, no primary pathway in the pathogenesis of interstitial lung disease associated with SSc (SSc-ILD) has been definitively identified and, therefore, treatment with current agents is only partially successful. However, as immunomodulatory agents do, on average, retard progression of lung disease, early identification of SSc-ILD, using thoracic high resolution computed tomography (HRCT), is highly desirable. The decision whether to introduce therapy immediately is often difficult as the balance of risk and benefit favours a strategy of careful observation when lung disease is very limited, especially in long-standing SSc. The threshold for initiating treatment is substantially reduced when lung disease is severe, systemic disease is short in duration or ongoing progression is evident, based on pulmonary function tests and symptoms. This review summarises epidemiology, pathogenesis, difficult clinical problems and management issues in SSc-ILD.

  20. PROMIS (Procurement Management Information System) (United States)


    The PROcurement Management Information System (PROMIS) provides both detailed and summary level information on all procurement actions performed within NASA's procurement offices at Marshall Space Flight Center (MSFC). It provides not only on-line access, but also schedules procurement actions, monitors their progress, and updates Forecast Award Dates. Except for a few computational routines coded in FORTRAN, the majority of the systems is coded in a high level language called NATURAL. A relational Data Base Management System called ADABAS is utilized. Certain fields, called descriptors, are set up on each file to allow the selection of records based on a specified value or range of values. The use of like descriptors on different files serves as the link between the falls, thus producing a relational data base. Twenty related files are currently being maintained on PROMIS.

  1. Evaluation and Management of Pulmonary Disease in Ataxia-Telangiectasia (United States)

    McGrath-Morrow, Sharon A.; Gower, W. Adam; Rothblum-Oviatt, Cynthia; Brody, Alan S.; Langston, Claire; Fan, Leland L.; Lefton-Greif, Maureen A.; Crawford, Thomas O.; Troche, Michelle; Sandlund, John T; Auwaerter, Paul G.; Easley, Blaine; Loughlin, Gerald M.; Carroll, John L.; Lederman, Howard M.


    Summary Ataxia-telangiectasia (A-T) is a rare autosomal recessive disorder caused by mutations in the ATM gene, resulting in faulty repair of breakages in double-stranded DNA. The clinical phenotype is complex, and is characterized by neurologic abnormalities, immunodeficiencies, susceptibility to malignancies, recurrent sinopulmonary infections, and cutaneous abnormalities. Lung disease is common in patients with A-T and often progresses with age and neurological decline. Diseases of the respiratory system cause significant morbidity and are a frequent cause of death in the A-T population. Lung disease in this population is thought to exhibit features of one or more of the following phenotypes: recurrent sinopulmonary infections with bronchiectasis, interstitial lung disease, and lung disease associated with neurological abnormalities. Here, we review available evidence and present expert opinion on the diagnosis, evaluation, and management of lung disease in A-T, as discussed in a recent multidisciplinary workshop. Although more data are emerging on this unique population, many recommendations are made based on similarities to other more well-studied diseases. Gaps in current knowledge and areas for future research in the field of pulmonary disease in A-T are also outlined. PMID:20583220

  2. Decision Aids for Multiple-Decision Disease Management as Affected by Weather Input Errors (United States)

    Many disease management decision support systems (DSS) rely, exclusively or in part, on weather inputs to calculate an indicator for disease hazard. Error in the weather inputs, typically due to forecasting, interpolation or estimation from off-site sources, may affect model calculations and manage...

  3. Multinational corporations and infectious disease: Embracing human rights management techniques. (United States)

    Salcito, Kendyl; Singer, Burton H; Weiss, Mitchell G; Winkler, Mirko S; Krieger, Gary R; Wielga, Mark; Utzinger, Jürg


    Global health institutions have called for governments, international organisations and health practitioners to employ a human rights-based approach to infectious diseases. The motivation for a human rights approach is clear: poverty and inequality create conditions for infectious diseases to thrive, and the diseases, in turn, interact with social-ecological systems to promulgate poverty, inequity and indignity. Governments and intergovernmental organisations should be concerned with the control and elimination of these diseases, as widespread infections delay economic growth and contribute to higher healthcare costs and slower processes for realising universal human rights. These social determinants and economic outcomes associated with infectious diseases should interest multinational companies, partly because they have bearing on corporate productivity and, increasingly, because new global norms impose on companies a responsibility to respect human rights, including the right to health. We reviewed historical and recent developments at the interface of infectious diseases, human rights and multinational corporations. Our investigation was supplemented with field-level insights at corporate capital projects that were developed in areas of high endemicity of infectious diseases, which embraced rights-based disease control strategies. Experience and literature provide a longstanding business case and an emerging social responsibility case for corporations to apply a human rights approach to health programmes at global operations. Indeed, in an increasingly globalised and interconnected world, multinational corporations have an interest, and an important role to play, in advancing rights-based control strategies for infectious diseases. There are new opportunities for governments and international health agencies to enlist corporate business actors in disease control and elimination strategies. Guidance offered by the United Nations in 2011 that is widely embraced

  4. OSH management systems in enterprises

    Directory of Open Access Journals (Sweden)

    B. Kalandyk


    Full Text Available Nowadays, in modern companies and enterprises, safety means much more than only the evaluation of risk and analysis of accidents. Theactivities in the area of the occupational health and safety should form an integral part of the enterprise management system. According toa framework directive no 89/391/EEC the EU member states are obliged to implement standards related with the occupational health andsafety systems. The standard most popular and used most commonly, as applicable to enterprises of any type, is the international OHSAS18001 system and in Poland Polish Standards PN-N-18001.

  5. Breast manifestations of systemic diseases

    Directory of Open Access Journals (Sweden)

    Dilaveri CA


    Full Text Available Christina A Dilaveri, Maire Brid Mac Bride, Nicole P Sandhu, Lonzetta Neal, Karthik Ghosh, Dietlind L Wahner-RoedlerDivision of General Internal Medicine, Mayo Clinic, Rochester, MN, USAAbstract: Although much emphasis has been placed on the primary presentations of breast cancer, little focus has been placed on how systemic illnesses may affect the breast. In this article, we discuss systemic illnesses that can manifest in the breast. We summarize the clinical features, imaging, histopathology, and treatment recommendations for endocrine, vascular, systemic inflammatory, infectious, and hematologic diseases, as well as for the extramammary malignancies that can present in the breast. Despite the rarity of these manifestations of systemic disease, knowledge of these conditions is critical to the appropriate evaluation and treatment of patients presenting with breast symptoms.Keywords: breast, endocrine, hematologic, infectious, vascular

  6. Radiology information management system, TOSRIM

    Energy Technology Data Exchange (ETDEWEB)

    Tani, Yuichiro; Uchiyama, Akira; Kimura, Hirohito (Toshiba Corp., Kawasaki, Kanagawa (Japan))


    This is a report on a new type of distributed computer system for radiology departments named 'TOSRIM' (Toshiba radiology information management system), which is designed to be installed between medical diagnosis equipment and a host computer system in a hospital. Recently, a new type of host computer system has been developed which enables doctors to order any of the hospital's entire activities using terminals. By connecting 'TOSRIM' to this type of host computer system, many of the activities of a radiology department can be carried out via terminals without the use of examination requirement forms. As well as being connected to medical diagnosis equipment, 'TOSRIM' can also be connected to a medical imaging system which stores and displays medical images. By means of these connections, doctors will be able to diagnose medical images using display terminals without the need for films. (author).

  7. Parkinson's Disease and Systemic Inflammation (United States)

    Ferrari, Carina C.; Tarelli, Rodolfo


    Peripheral inflammation triggers exacerbation in the central brain's ongoing damage in several neurodegenerative diseases. Systemic inflammatory stimulus induce a general response known as sickness behaviour, indicating that a peripheral stimulus can induce the synthesis of cytokines in the brain. In Parkinson's disease (PD), inflammation was mainly associated with microglia activation that can underlie the neurodegeneration of neurons in the substantia nigra (SN). Peripheral inflammation can transform the “primed” microglia into an “active” state, which can trigger stronger responses dealing with neurodegenerative processes. Numerous evidences show that systemic inflammatory processes exacerbate ongoing neurodegeneration in PD patient and animal models. Anti-inflammatory treatment in PD patients exerts a neuroprotective effect. In the present paper, we analyse the effect of peripheral infections in the etiology and progression in PD patients and animal models, suggesting that these peripheral immune challenges can exacerbate the symptoms in the disease. PMID:21403862

  8. Management Information Systems for Colleges and Universities. (United States)

    Schroeder, Roger G.

    A management information system (MIS) is embedded in the management and operating system of the organization. An MIS exists to provide information for management and operating purposes. The MIS must meet the information needs of management and operating users. The MIS consists of two components--a processor and a data base. Packaged systems have…

  9. 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...

  10. Hybrid Power Management System and Method (United States)

    Eichenberg, Dennis J. (Inventor)


    A system and method for hybrid power management. The system includes photovoltaic cells, ultracapacitors, and pulse generators. In one embodiment, the hybrid power management system is used to provide power for a highway safety flasher.


    Directory of Open Access Journals (Sweden)

    Tomescu Ada Mirela


    Full Text Available The relevance of management as significant factor of business activity can be established on various management systems. These will help to obtain, organise, administrate, evaluate and control particulars: information, quality, environmental protection, health and safety, various resources (time, human, finance, inventory etc. The complexity of nowadays days development, forced us to think ‘integrated’. Sustainable development principles require that environment management policies and practices are not good in themselves but also integrate with all other environmental objectives, and with social and economic development objectives. The principles of sustainable development involve that environment management policies and practices. These are not sound in them-self but also integrate with all other environmental objectives, and with social and economic development objectives. Those objectives were realized, and followed by development of strategies to effects the objective of sustainable development. Environmental management should embrace recent change in the area of environmental protection, and suit the recently regulations of the field -entire legal and economic, as well as perform management systems to meet the requirements of the contemporary model for economic development. These changes are trailed by abandon the conventional approach of environmental protection and it is replaced by sustainable development (SD. The keys and the aims of Cleaner Productions (CP are presented being implemented in various companies as a non-formalised environmental management system (EMS. This concept is suggested here as a proper model for practice where possible environmental harmful technologies are used -e.g. Rosia Montana. Showing the features and the power of CP this paper is a signal oriented to involve the awareness of policy-makers and top management of diverse Romanian companies. Many companies in European countries are developing

  12. The relation of periodontal diseases to systemic diseases

    Directory of Open Access Journals (Sweden)

    Melanie Sadono Djamil


    Full Text Available Background: The relationship between systemic disorders and periodontal disease has been studied extensively. With few exceptions, it is more accurate to consider systemic diseases to be contributing factors in the pathogenesis of periodontal disease rather than the primary etiologic factors. The development of periodontal disease cannot be separated from the weakening of immunologic and immunopathological responses. Periodontal disease may enhance susceptibility to certain systemic diseases in several ways. Lipopolysaccharide (LPS and Gram-positive bacteria in the biofilm and proinflammatory cytokines produced from inflamed periodontal tissues may enter the circulation system causing the development of certain systemic diseases. On the other hand, through immunologic mediators, certain systemic disease may enhance susceptibility to periodontal disease caused by the decrease of immune responses and the increase of proinflammatory cytokines. Purpose: The Purpose of this article is to review the immunologic aspect of two way relationship between systemic diseases and periodontal diseases. Review: This review studied the relationship between general health status, systemic diseases, and periodontal diseases through immunopathological responses and the weakening of the immune system in the periodontal tissue. Conclusion: there is a two-way relationship between periodontal diseases and systemic diseases.

  13. The management of rheumatic diseases in pregnancy


    Mitchell, K; Kaul, M; Clowse, MEB


    Pregnancy can create a challenge for physicians caring for women with rheumatic diseases. For many women with rheumatoid arthritis (RA), pregnancy can provide a reprieve from long-term joint pain and inflammation, but others will not experience remission and will continue to need medication. Systemic lupus erythematosus (SLE) may remain quiet in some women, but in others may become more aggressive during pregnancy, putting both mother and foetus at risk. Women with limited scleroderma can do ...

  14. Open source electronic health records and chronic disease management. (United States)

    Goldwater, Jason C; Kwon, Nancy J; Nathanson, Ashley; Muckle, Alison E; Brown, Alexa; Cornejo, Kerri


    To study and report on the use of open source electronic health records (EHR) to assist with chronic care management within safety net medical settings, such as community health centers (CHC). The study was conducted by NORC at the University of Chicago from April to September 2010. The NORC team undertook a comprehensive environmental scan, including a literature review, a dozen key informant interviews using a semistructured protocol, and a series of site visits to CHC that currently use an open source EHR. Two of the sites chosen by NORC were actively using an open source EHR to assist in the redesign of their care delivery system to support more effective chronic disease management. This included incorporating the chronic care model into an CHC and using the EHR to help facilitate its elements, such as care teams for patients, in addition to maintaining health records on indigent populations, such as tuberculosis status on homeless patients. The ability to modify the open-source EHR to adapt to the CHC environment and leverage the ecosystem of providers and users to assist in this process provided significant advantages in chronic care management. Improvements in diabetes management, controlled hypertension and increases in tuberculosis vaccinations were assisted through the use of these open source systems. The flexibility and adaptability of open source EHR demonstrated its utility and viability in the provision of necessary and needed chronic disease care among populations served by CHC.

  15. XCPU2 process management system

    Energy Technology Data Exchange (ETDEWEB)

    Ionkov, Latchesar [Los Alamos National Laboratory; Van Hensbergen, Eric [IBM AUSTIN RESEARCH LAB


    Xcpu2 is a new process management system that allows the users to specify custom file system for a running job. Most cluster management systems enforce single software distribution running on all nodes. Xcpu2 allows programs running on the cluster to work in environment identical to the user's desktop, using the same versions of the libraries and tools the user installed locally, and accessing the configuration file in the same places they are located on the desktop. Xcpu2 builds on our earlier work with the Xcpu system. Like Xcpu, Xcpu2's process management interface is represented as a set of files exported by a 9P file server. It supports heterogeneous clusters and multiple head nodes. Unlike Xcpu, it uses pull instead of push model. In this paper we describe the Xcpu2 clustering model, its operation and how the per-job filesystem configuration can be used to solve some of the common problems when running a cluster.

  16. Electronic integrated disease surveillance system and pathogen asset control system. (United States)

    Wahl, Tom G; Burdakov, Aleksey V; Oukharov, Andrey O; Zhilokov, Azamat K


    Electronic Integrated Disease Surveillance System (EIDSS) has been used to strengthen and support monitoring and prevention of dangerous diseases within One Health concept by integrating veterinary and human surveillance, passive and active approaches, case-based records including disease-specific clinical data based on standardised case definitions and aggregated data, laboratory data including sample tracking linked to each case and event with test results and epidemiological investigations. Information was collected and shared in secure way by different means: through the distributed nodes which are continuously synchronised amongst each other, through the web service, through the handheld devices. Electronic Integrated Disease Surveillance System provided near real time information flow that has been then disseminated to the appropriate organisations in a timely manner. It has been used for comprehensive analysis and visualisation capabilities including real time mapping of case events as these unfold enhancing decision making. Electronic Integrated Disease Surveillance System facilitated countries to comply with the IHR 2005 requirements through a data transfer module reporting diseases electronically to the World Health Organisation (WHO) data center as well as establish authorised data exchange with other electronic system using Open Architecture approach. Pathogen Asset Control System (PACS) has been used for accounting, management and control of biological agent stocks. Information on samples and strains of any kind throughout their entire lifecycle has been tracked in a comprehensive and flexible solution PACS.Both systems have been used in a combination and individually. Electronic Integrated Disease Surveillance System and PACS are currently deployed in the Republics of Kazakhstan, Georgia and Azerbaijan as a part of the Cooperative Biological Engagement Program (CBEP) sponsored by the US Defense Threat Reduction Agency (DTRA).

  17. Electronic Integrated Disease Surveillance System and Pathogen Asset Control System

    Directory of Open Access Journals (Sweden)

    Tom G. Wahl


    Full Text Available Electronic Integrated Disease Surveillance System (EIDSS has been used to strengthen and support monitoring and prevention of dangerous diseases within One Health concept by integrating veterinary and human surveillance, passive and active approaches, case-based records including disease-specific clinical data based on standardised case definitions and aggregated data, laboratory data including sample tracking linked to each case and event with test results and epidemiological investigations. Information was collected and shared in secure way by different means: through the distributed nodes which are continuously synchronised amongst each other, through the web service, through the handheld devices. Electronic Integrated Disease Surveillance System provided near real time information flow that has been then disseminated to the appropriate organisations in a timely manner. It has been used for comprehensive analysis and visualisation capabilities including real time mapping of case events as these unfold enhancing decision making. Electronic Integrated Disease Surveillance System facilitated countries to comply with the IHR 2005 requirements through a data transfer module reporting diseases electronically to the World Health Organisation (WHO data center as well as establish authorised data exchange with other electronic system using Open Architecture approach. Pathogen Asset Control System (PACS has been used for accounting, management and control of biological agent stocks. Information on samples and strains of any kind throughout their entire lifecycle has been tracked in a comprehensive and flexible solution PACS.Both systems have been used in a combination and individually. Electronic Integrated Disease Surveillance System and PACS are currently deployed in the Republics of Kazakhstan, Georgia and Azerbaijan as a part of the Cooperative Biological Engagement Program (CBEP sponsored by the US Defense Threat Reduction Agency (DTRA.

  18. Essentials of Project and Systems Engineering Management

    CERN Document Server

    Eisner, Howard S


    The Third Edition of Essentials of Project and Systems Engineering Management enables readers to manage the design, development, and engineering of systems effectively and efficiently. The book both defines and describes the essentials of project and systems engineering management and, moreover, shows the critical relationship and interconnection between project management and systems engineering. The author's comprehensive presentation has proven successful in enabling both engineers and project managers to understand their roles, collaborate, and quickly grasp and apply all the basic princip

  19. Managing Parkinson's disease with continuous dopaminergic stimulation. (United States)

    Wolters, Erik; Lees, Andrew J; Volkmann, Jens; van Laar, Teus; Hovestadt, Ad


    The pathophysiology of Parkinson's disease is marked by the loss of dopaminergic neurons, which leads to striatal dopaminergic deficiency. This causes resting tremor, hypokinesia, rigidity, bradykinesia, and loss of postural reflexes. Most current treatments for Parkinson's disease aim to restore striatal dopamine signaling by increasing the supply of dopamine with oral levodopa (L-dopa), stimulating dopamine receptors directly using dopamine agonists, or inhibiting the reuptake of endogenous dopamine. L-dopa is standard therapy for patients with Parkinson's disease. However, with continued treatment and disease progression, the response to oral dopaminergic drugs becomes unstable and motor fluctuations emerge, including off periods and dyskinesia. Direct duodenal-administered infusible L-dopa/carbidopa is effective for the management of refractory motor fluctuations in some patient populations. However, enteral infusions cannot mimic the function of the normal dopaminergic brain, and around-the-clock constant-rate administration carries the risk of causing refractory off periods associated with severe immobility and hyperpyrexia. Subthalamic nucleus (STN) deep brain stimulation (DBS) is also a promising treatment. DBS passes a high-frequency electrical current into the target area, mimicking the effect of lesioning the stimulated area. However, this treatment requires invasive surgery and is appropriate for a limited segment of the patient population. This supplement provides a rationale for the use of continuous dopaminergic receptor stimulation and offers guidelines on the individualization of treatment decisions, with special focus on continuous L-dopa infusion and STN DBS. Erik Wolters, MD, PhD, offers an introduction to the impact of continuous L-dopa infusion. Andrew J. Lees, MD, FRCP, provides an overview of the physiologic response to L-dopa and reviews clinical pharmacologic studies of intravenous and intraduodenal L-dopa. Jens Volkmann, MD, discusses

  20. Data management system DIU test system (United States)


    An operational and functional description is given of the data management system. Descriptions are included for the test control unit, analog stimulus panel, discrete stimulus panel, and the precision source. The mechanical configuration is defined and illustrated to provide card and component location for modification or repair. The unit level interfaces are mirror images of the DIU interfaces and are described in the Final Technical Report for NASA-MSFC contract NAS8-29155.

  1. The Data Quality Management System

    Energy Technology Data Exchange (ETDEWEB)

    Augustyn, J.R.; Nelson, E. [Augustyn + Co. Consulting Engineers, Albany, CA (United States); Maxwell, E. [National Renewable Energy Lab., Golden, CO (United States)


    The Data Quality Management System (DQMS) is software which provides a systematic and comprehensive means to assess and control the quality of time sequence data collected in measurement and monitoring programs. It was designed to support single and multi-site solar resource measurement and energy and environmental monitoring projects, where end-use data quality is a strong concern, and growth and changes in the monitoring network must be accommodated. DQMS also provides features to assist the network operator in day to day management of monitoring network operation. DQMS was initially developed internally at Augustyn + Company as the Data Verification System by Augustyn and Nelson (1993), and later enhanced under contract to the US National Renewable Energy Laboratory (NREL) for use in several internal research and development programs.

  2. 传染病监测技术平台信息管理系统开发与应用%Development and Application of Information Management System for Infection Disease Monitor Technique Platform

    Institute of Scientific and Technical Information of China (English)

    张业武; 赵自雄; 郭岩; 刘冬云; 李言飞; 肖革新; 苏雪梅; 马家奇


    The information system for monitor network platform in infection disease lab is designed to enhance the collection, management, integration, sharing and utilization of monitor information of the five syndromes and emerging infectious diseases, and to meet the information management demand of infection disease monitor technique platform in major national infection disease project. It introduced the constructing background, system architecture, and technique characteristics of information management system for infection disease monitor technique platform, and besides, it also briefly described the main functions and applications. Through system development, it not only realized the integrated management, real-time sharing, dynamic tracking and query, online analysis and visual display of syndromes, cases, samples, lab testing, seed germs and so on in infection disease monitor technique platform, but also can warn and predict emerging infection diseases. Through system application, it not only improved the ability of infection disease prevention and control and adaption of emergent infectious diseases, but provided scientific supporting and technique service for disease control, infection disease analysis, and making early warning and prevention strategies.%传染病实验室监测网络平台信息系统旨在加强对五大症候群和新发突发传染病的监测信息的采集、管理、整合、共享与利用,满足国家传染病重大专项“传染病监测技术平台”的信息管理需要.介绍了传染病监测技术平台信息管理系统建设背景、系统架构与技术特点,简要描述了系统主要功能和应用情况.通过系统开发实现了对传染病监测技术平台的症候群、病例、样本、实验室检测、毒菌种株等信息综合集成管理、实时共享、动态追踪与查询、在线分析和可视化展示,以及对新发、突发传染病的预警、预测等功能;通过系统应用提升了传染病防控

  3. Managing patients for zoonotic disease in hospitals (United States)

    Warwick, Clifford; Corning, Susan


    Zoonoses involve infections and infestations transmissible from animals to humans. Zoonoses are a major global threat. Exposure to zoonotic pathogens exists in various settings including encroachment on nature; foreign travel; pet keeping; bushmeat consumption; attendance at zoological parks, petting zoos, school ‘animal contact experiences’, wildlife markets, circuses, and domesticated and exotic animal farms. Under-ascertainment is believed to be common and the frequency of some zoonotic disease appears to be increasing. Zoonoses include direct, indirect and aerosolized transmission. Improved awareness of zoonoses in the hospital environment may be important to the growing need for prevention and control. We reviewed relevant literature for the years 2000 to present and identified a significant need for the promotion of awareness and management of zoonoses in the hospital environment. This article provides a new decision-tree, as well as staff and patient guidance on the prevention and control of zoonoses associated with hospitals. PMID:24040497

  4. Heart Failure Update: Chronic Disease Management Programs. (United States)

    Fountain, Lorna B


    With high mortality and readmission rates among patients with heart failure (HF), multiple disease management models have been and continue to be tested, with mixed results. Early postdischarge care improves outcomes for patients. Telemonitoring also can assist in reducing mortality and HF-related hospitalizations. Office-based team care improves patient outcomes, with important components including rapid access to physicians, partnerships with clinical pharmacists, education, monitoring, and support. Pay-for-performance measures developed for HF, primarily use of angiotensin-converting enzyme inhibitors and beta blockers, also improve patient outcomes, but the influence of adherence to other measures has been minimal. Evaluating comorbid conditions, including diabetes and hypertension, and making drug adjustments for patients with HF to include blood pressure control and use of metformin, when possible, can reduce mortality and morbidity.

  5. The potential of disease management for neuromuscular hereditary disorders. (United States)

    Chouinard, Maud-Christine; Gagnon, Cynthia; Laberge, Luc; Tremblay, Carmen; Côté, Charlotte; Leclerc, Nadine; Mathieu, Jean


    Neuromuscular hereditary disorders require long-term multidisciplinary rehabilitation management. Although the need for coordinated healthcare management has long been recognized, most neuromuscular disorders are still lacking clinical guidelines about their long-term management and structured evaluation plan with associated services. One of the most prevalent adult-onset neuromuscular disorders, myotonic dystrophy type 1, generally presents several comorbidities and a variable clinical picture, making management a constant challenge. This article presents a healthcare follow-up plan and proposes a nursing case management within a disease management program as an innovative and promising approach. This disease management program and model consists of eight components including population identification processes, evidence-based practice guidelines, collaborative practice, patient self-management education, and process outcomes evaluation (Disease Management Association of America, 2004). It is believed to have the potential to significantly improve healthcare management for neuromuscular hereditary disorders and will prove useful to nurses delivering and organizing services for this population.

  6. Management of pregnancy in systemic lupus erythematosus. (United States)

    Lateef, Aisha; Petri, Michelle


    Systemic lupus erythematosus (SLE) is an autoantibody-mediated systemic autoimmune disease, predominantly affecting young females. Pregnancy is increasingly common in the setting of SLE, as survival and quality of life of patients improve. Although live births can be achieved in the most cases, pregnancy in patients with SLE remains a high-risk condition. Maternal and fetal mortality and morbidity are considerably increased, compared with the general population. Aberrations in pregnancy-related maternal immune adaptations are likely contributors. Active maternal disease, renal involvement, specific autoantibody subsets and advanced organ damage are predictors of poor outcome. Therapeutic options are limited during pregnancy as maternal benefit has to be weighed against fetal risk. Prevention of preterm birth and refractory pregnancy loss, as well as management of established neonatal heart block remain unmet needs. Further research should address these important issues that affect young patients with SLE and their babies.

  7. Cutaneous manifestations of systemic tropical parasitic diseases. (United States)

    Fernandes, Neil F; Kovarik, Carrie L


    Tropical diseases continue to cause significant health problems in developing nations. An overview of illnesses with notable cutaneous findings caused by protozoans and helminthes is provided. The role of the health care provider in disease management is described.

  8. ISO 9001 quality management systems

    CERN Document Server

    Natarajan, Dhanasekharan


    This book explains the requirements of ISO 9001 for establishing quality management system (QMS) for an organization. The requirements are illustrated with examples from industries for understanding the requirements and preparing the documents of QMS with high clarity. Methods of integrating ISO 9001 requirements with enterprise resource planning (ERP) software are presented. The software integrated approach enables process owners to focus on their core tasks of achieving the planned outputs of processes and the software generates quality records automatically.

  9. ISO 9000 Quality Management System (United States)

    Hadjicostas, Evsevios

    The ISO 9000 series describes a quality management system applicable to any organization. In this chapter we present the requirements of the standard in a way that is as close as possible to the needs of analytical laboratories. The sequence of the requirements follows that in the ISO 9001:2008 standard. In addition, the guidelines for performance improvement set out in the ISO 9004 are reviewed. Both standards should be used as a reference as well as the basis for further elaboration.

  10. Environmental asset management: Risk management systems

    CSIR Research Space (South Africa)

    Naudé, Brian


    Full Text Available Environmental Asset Management (EAM) includes Environmental Asset Protection (EAP). Rare, important, and valuable natural assets need protection from vandalism and criminal syndicates determined to exploit these assets, for commercial gain or other...

  11. The use of a portable digital thoracic suction Thopaz drainage system for the management of a persistent spontaneous secondary pneumothorax in a patient with underlying interstitial lung disease. (United States)

    Jenkins, William S A; Hall, David P; Dhaliwal, Kev; Hill, Adam T; Hirani, Nik


    We present the case of a 68-year-old woman who presented in extremis with a secondary pneumothorax with a past history of severe idiopathic pulmonary fibrosis. Following insertion of a 32F intercostal drain, she developed a persistent broncho-pleural fistula and became dependent on negative-pressure wall-mounted suction to prevent respiratory compromise. She declined definitive surgical intervention and was therefore managed conservatively. After adhering to the wall-mounted suction method for 49 days, we obtained for use a portable digital thoracic drainage system previously used only in the cardiothoracic postoperative patient. This electronically delivered, negative-pressure drainage system induced radiographic improvement within 24 h, and allowed the patient to mobilise for the first time since admission. The patient was discharged home with the Thopaz drain in situ 8 weeks after placing it, and the drain was removed successfully with a resolved pneumothorax 20 weeks after her initial presentation.

  12. Asthma Management in Sickle Cell Disease

    Directory of Open Access Journals (Sweden)

    Esteban Gomez


    Full Text Available Asthma is a common comorbid factor in sickle cell disease (SCD. However, the incidence of asthma in SCD is much higher than expected compared to rates in the general population. Whether “asthma” in SCD is purely related to genetic and environmental factors or rather is the consequence of the underlying hemolytic and inflammatory state is a topic of recent debate. Regardless of the etiology, hypoxemia induced by bronchoconstriction and inflammation associated with asthma exacerbations will contribute to a cycle of sickling and subsequent complications of SCD. Recent studies confirm that asthma predisposes to complications of SCD such as pain crises, acute chest syndrome, and stroke and is associated with increased mortality. Early recognition and aggressive standard of care management of asthma may prevent serious pulmonary complications and reduce mortality. However, data regarding the management of asthma in SCD is very limited. Clinical trials are needed to evaluate the effectiveness of current asthma therapy in patients with SCD and coincident asthma, while mechanistic studies are needed to delineate the underlying pathophysiology.

  13. Managing juvenile Huntington’s disease (United States)

    Quarrell, Oliver W. J.; Nance, Martha A.; Nopoulos, Peggy; Paulsen, Jane S.; Smith, Jonathan A.; Squitieri, Ferdinando


    SUMMARY Huntington’s disease (HD) is a well-recognized progressive neurodegenerative disorder that follows an autosomal dominant pattern of inheritance. Onset is insidious and can occur at almost any age, but most commonly the diagnosis is made between the ages of 35 and 55 years. Onset ≤20 years of age is classified as juvenile HD (JHD). This age-based definition is arbitrary but remains convenient. There is overlap between the clinical pathological and genetic features seen in JHD and more traditional adult-onset HD. Nonetheless, the frequent predominance of bradykinesia and dystonia early in the course of the illness, more frequent occurrence of epilepsy and myoclonus, more widespread pathology, and larger genetic lesion means that the distinction is still relevant. In addition, the relative rarity of JHD means that the clinician managing the patient is often doing so for the first time. Management is, at best, symptomatic and supportive with few or no evidence-based guidelines. In this article, the authors will review what is known of the condition and present some suggestions based on their experience. PMID:24416077

  14. Integrated disease management: a critical review of foreign and Portuguese experience. (United States)

    Coelho, Anabela; Leone, Cláudia; Ribeiro, Vanessa; Sá Moreira, Pedro; Dussault, Gilles


    The present article reviews findings from empirical evaluations of integrated disease management programmes. The objective is to provide insights on integration levels, priority interventions and their effect on patient outcomes. The literature review identified 1 251 articles, published from 2006 to 2011. Upon a detailed screening 61 articles were selected for bibliometric analysis and critical discussion. Among several findings, it can be noted that United States of America is the country with the highest amount of published evidence on the subject under study. The most frequently referred disease is diabetes mellitus and the main reported issue of integrated disease management is self-management support. The majority of the studies were developed and exclusively managed by managed care organizations, organized family doctors or hospitals. From a total of 360 interventions reported in studies, patient interventions are the most frequently used across all disease groups, followed by professional interventions. To monitor the effectiveness of the disease programmes, the most frequently used outcomes are patient physiological measures, service use and patient health status. Every country has its own way to implement the integrated disease management strategy. The focus of practice lies on patient empowerment, particularly through self-management. Physiological measures and service use are the outcomes with the highest rate of assessment, which are also the indicators that show higher impact among all integrated disease management programmes. The Portuguese health care system still faces challenges in the coordination and integration of care for patients with chronic disease thus improvements at integrated disease management programmes should be incorporate.

  15. Myeloma bone disease: Pathophysiology and management (United States)

    Silbermann, Rebecca; Roodman, G. David


    Multiple myeloma bone disease is marked by severe dysfunction of both bone formation and resorption and serves as a model for understanding the regulation of osteoblasts (OBL) and osteoclasts (OCL) in cancer. Myeloma bone lesions are purely osteolytic and are associated with severe and debilitating bone pain, pathologic fractures, hypercalcemia, and spinal cord compression, as well as increased mortality. Interactions within the bone marrow microenvironment in myeloma are responsible for the abnormal bone remodeling in myeloma bone disease. Myeloma cells drive bone destruction that increases tumor growth, directly stimulates the OCL formation, and induces cells in the marrow microenvironment to produce factors that drive OCL formation and suppress OBL formation. Factors produced by marrow stromal cells and OCL promote tumor growth through direct action on myeloma cells and by increasing angiogenesis. Current therapies targeting MMBD focus on preventing osteoclastic bone destruction; however regulators of OBL inhibition in MMBD have also been identified, and targeted agents with a potential anabolic effect in MMBD are under investigation. This review will discuss the mechanisms responsible for MMBD and therapeutic approaches currently in use and in development for the management of MMBD. PMID:26909272

  16. Faecal calprotectin: Management in inflammatory bowel disease

    Institute of Scientific and Technical Information of China (English)

    José; Manuel; Benítez; Valle; García-Sánchez


    Inflammatory bowel disease(IBD) is a chronic and relapsing disorder which leads to an inflammation of the gastrointestinal tract. A tailored therapy to achieve mucosal healing with the less adverse events has become a key issue in the management of IBD. In the past, the clinical remission was the most important factor to consider for adapting diagnostic procedures and therapeutic strategies. However, there is no a good correlation between symptoms and intestinal lesions, so currently the goals of treatment are to achieve not only the control of symptoms, but deep remission, which is related with a favourable prognosis. Thus, the determination of biological markers or biomarkers of intestinal inflammation play a crucial role. Many biomarkers have been extensively evaluated in IBD showing significant correlation with endoscopic lesions, risk of recurrence and response to treatment. One of the most important markers is faecal calprotectin(FC). Despite calprotectin limitations, this biomarker represents a reliable and noninvasive alternative to reduce the need for endoscopic procedures. FC has demonstrated its performance for regular monitoring of IBD patients, not only to the diagnosis for discriminating IBD from non-IBD diagnosis, but for assessing disease activity, relapse prediction and response to therapy. Although, FC provides better results than other biomarkers such as C-reactive protein and erythrocyte sedimentation rate, these surrogate markers of intestinal inflammation should not be used isolation but in combination with other clinical, endoscopic, radiological or/and histological parameters enabling a comprehensive assessment of IBD patients.

  17. Interdisciplinary Management of Patient with Advanced Periodontal Disease. (United States)

    Kochar, Gagan Deep; Jayan, B; Chopra, S S; Mechery, Reenesh; Goel, Manish; Verma, Munish


    This case report describes the interdisciplinary management of an adult patient with advanced periodontal disease. Treatment involved orthodontic and periodontal management. Good esthetic results and dental relationships were achieved by the treatment.

  18. System safety management lessons learned

    Energy Technology Data Exchange (ETDEWEB)

    Piatt, J.A.


    The Assistant Secretary of the Army for Research, Development and Acquisition directed the Army Safety Center to provide an audit of the causes of accidents and safety of use restrictions on recently fielded systems by tracking residual hazards back through the acquisition process. The objective was to develop ''lessons learned'' that could be applied to the acquisition process to minimize mishaps in fielded systems. System safety management lessons learned are defined as Army practices or policies, derived from past successes and failures, that are expected to be effective in eliminating or reducing specific systemic causes of residual hazards. They are broadly applicable and supportive of the Army structure and acquisition objectives. 29 refs., 7 figs.

  19. Integrated Building Management System (IBMS)

    Energy Technology Data Exchange (ETDEWEB)

    Anita Lewis


    This project provides a combination of software and services that more easily and cost-effectively help to achieve optimized building performance and energy efficiency. Featuring an open-platform, cloud- hosted application suite and an intuitive user experience, this solution simplifies a traditionally very complex process by collecting data from disparate building systems and creating a single, integrated view of building and system performance. The Fault Detection and Diagnostics algorithms developed within the IBMS have been designed and tested as an integrated component of the control algorithms running the equipment being monitored. The algorithms identify the normal control behaviors of the equipment without interfering with the equipment control sequences. The algorithms also work without interfering with any cooperative control sequences operating between different pieces of equipment or building systems. In this manner the FDD algorithms create an integrated building management system.

  20. Risk of postoperative recurrence and postoperative management of Crohn's disease

    Institute of Scientific and Technical Information of China (English)

    Antonino Spinelli; Matteo Sacchi; Gionata Fiorino; Silvio Danese; Marco Montorsi


    Crohn's disease (CD) is a chronic inflammatory disease of the digestive tract with systemic manifestations. Etiology is unknown, even if immunological, genetic and environmental factors are involved. The majority of CD patients require surgery during their lifetime due to progressive bowel damage, but, even when all macroscopic lesions have been removed by surgery, the disease recurs in most cases. Postoperative management represents therefore a crucial mean for preventing recurrence. Several drugs and approaches have been proposed to achieve this aim. Endoscopic inspection of the ileocolic anastomosis within 1 year from surgery is widely encouraged, given that endoscopic recurrence is one of the greatest predictors for clinical recurrence. A strategy should be planned only after stratifying patients according to their individual risk of recurrence, avoiding unnecessary therapies when possible benefits are reduced, and selecting high-risk patients for more aggressive intervention.

  1. Electric vehicle energy management system (United States)

    Alaoui, Chakib

    This thesis investigates and analyzes novel strategies for the optimum energy management of electric vehicles (EVs). These are aimed to maximize the useful life of the EV batteries and make the EV more practical in order to increase its acceptability to market. The first strategy concerns the right choice of the batteries for the EV according to the user's driving habits, which may vary. Tests conducted at the University of Massachusetts Lowell battery lab show that the batteries perform differently from one manufacturer to the other. The second strategy was to investigate the fast chargeability of different batteries, which leads to reduce the time needed to recharge the EV battery pack. Tests were conducted again to prove that only few battery types could be fast charged. Test data were used to design a fast battery charger that could be installed in an EV charging station. The third strategy was the design, fabrication and application of an Electric Vehicle Diagnostic and Rejuvenation System (EVDRS). This system is based on Mosfet Controlled Thyristors (MCTs). It is capable of quickly identifying any failing battery(s) within the EV pack and rejuvenating the whole battery pack without dismantling them and unloading them. A novel algorithm to rejuvenate Electric Vehicle Sealed Lead Acid Batteries is described. This rejuvenation extends the useful life of the batteries and makes the EV more competitive. The fourth strategy was to design a thermal management system for EV, which is crucial to the safe operation, and the achievement of normal/optimal performance of, electric vehicle (EV) batteries. A novel approach for EV thermal management, based on Pettier-Effect heat pumps, was designed, fabricated and tested in EV. It shows the application of this type of technology for thermal management of EVs.

  2. The management of refractory coeliac disease (United States)


    A significant proportion of patients with coeliac disease are ‘nonresponsive’ to gluten withdrawal. Most cases of nonresponsive coeliac disease are due to persisting gluten ingestion. Refractory coeliac disease (RCD) is currently defined by persistent symptoms and signs of malabsorption after gluten exclusion for 12 months with ongoing intestinal villous atrophy. Primary (without initial response to diet) and secondary (relapse following response to diet) RCD is recognized. RCD is further classified as type I or type II based on the absence or presence of a population of aberrant intestinal lymphocytes. Quality of dietetic advice and support is fundamental, and lack of objective corroboration of gluten exclusion may result in over-identification of RCD I, particularly in those cases with persisting antibody responses. Over-reliance on lymphocyte clonality similarly may result in over-diagnosis of RCD II which requires careful quantification of aberrant lymphocyte populations. Management of RCD should be undertaken in specialist centres. It requires initial intensive dietary supervision, strict gluten exclusion and subsequent re-evaluation. There is currently insufficient evidence to recommend specific treatments. Steroids are often used in both RCD I and II (albeit with little objective evidence of benefit in RCD II), and azathioprine as steroid-sparing therapy in RCD I. There is growing evidence for the use of cladribine in RCD II with autologous stem cell transplantation in nonresponders, but this requires further multicentre evaluation. There remains considerable controversy regarding the diagnosis, treatment and surveillance of RCD: international consensus in these areas is urgently required to facilitate future therapeutic advances. PMID:23556127

  3. Management of Hotel Dining Information System


    Liu, Fangyi


    Dining hotel management is more completed, more accurately, and effectively method for hotel and dining industries. It is an application based on modern hotel market. The information management system is already widely used in many fields at moment. Nowadays, with the dining hotel industries development, an advanced and scientific management system that could be more detailed and secure is needed. Hotel Dining Management system is extremely practical in the present hotel industry dining manag...

  4. Managing marine disease emergencies in an era of rapid change. (United States)

    Groner, Maya L; Maynard, Jeffrey; Breyta, Rachel; Carnegie, Ryan B; Dobson, Andy; Friedman, Carolyn S; Froelich, Brett; Garren, Melissa; Gulland, Frances M D; Heron, Scott F; Noble, Rachel T; Revie, Crawford W; Shields, Jeffrey D; Vanderstichel, Raphaël; Weil, Ernesto; Wyllie-Echeverria, Sandy; Harvell, C Drew


    Infectious marine diseases can decimate populations and are increasing among some taxa due to global change and our increasing reliance on marine environments. Marine diseases become emergencies when significant ecological, economic or social impacts occur. We can prepare for and manage these emergencies through improved surveillance, and the development and iterative refinement of approaches to mitigate disease and its impacts. Improving surveillance requires fast, accurate diagnoses, forecasting disease risk and real-time monitoring of disease-promoting environmental conditions. Diversifying impact mitigation involves increasing host resilience to disease, reducing pathogen abundance and managing environmental factors that facilitate disease. Disease surveillance and mitigation can be adaptive if informed by research advances and catalysed by communication among observers, researchers and decision-makers using information-sharing platforms. Recent increases in the awareness of the threats posed by marine diseases may lead to policy frameworks that facilitate the responses and management that marine disease emergencies require. © 2016 The Author(s).

  5. Managing marine disease emergencies in an era of rapid change (United States)

    Maynard, Jeffrey; Breyta, Rachel; Carnegie, Ryan B.; Dobson, Andy; Friedman, Carolyn S.; Froelich, Brett; Garren, Melissa; Gulland, Frances M. D.; Heron, Scott F.; Noble, Rachel T.; Revie, Crawford W.; Shields, Jeffrey D.; Vanderstichel, Raphaël; Weil, Ernesto; Wyllie-Echeverria, Sandy; Harvell, C. Drew


    Infectious marine diseases can decimate populations and are increasing among some taxa due to global change and our increasing reliance on marine environments. Marine diseases become emergencies when significant ecological, economic or social impacts occur. We can prepare for and manage these emergencies through improved surveillance, and the development and iterative refinement of approaches to mitigate disease and its impacts. Improving surveillance requires fast, accurate diagnoses, forecasting disease risk and real-time monitoring of disease-promoting environmental conditions. Diversifying impact mitigation involves increasing host resilience to disease, reducing pathogen abundance and managing environmental factors that facilitate disease. Disease surveillance and mitigation can be adaptive if informed by research advances and catalysed by communication among observers, researchers and decision-makers using information-sharing platforms. Recent increases in the awareness of the threats posed by marine diseases may lead to policy frameworks that facilitate the responses and management that marine disease emergencies require. PMID:26880835

  6. Risk Management Programs for Defense Acquisition Systems (United States)


    The audit objective was to evaluate the effectiveness of risk management programs for Defense acquisition systems. Specifically, we determined whether DoD risk management policies and procedures for Defense acquisition systems were effectively implemented and what impact risk management programs bad on reducing program risks and costs. We also reviewed management controls as they applied to the audit objectives.

  7. Perioperative corticosteroid management for patients with inflammatory bowel disease. (United States)

    Hicks, Caitlin W; Wick, Elizabeth C; Salvatori, Roberto; Ha, Christina Y


    Guidelines on the appropriate use of perioperative steroids in patients with inflammatory bowel disease (IBD) are lacking. As a result, corticosteroid supplementation during and after colorectal surgery procedures has been shown to be highly variable. A clearer understanding of the indications for perioperative corticosteroid administration relative to preoperative corticosteroid dosing and duration of therapy is essential. In this review, we outline the basic tenets of the hypothalamic-pituitary-adrenal (HPA) axis and its normal response to stress, describe how corticosteroid use is thought to affect this system, and provide an overview of the currently available data on perioperative corticosteroid supplementation including the limited evidence pertaining to patients with inflammatory bowel disease. Based on currently existing data, we define "adrenal suppression," and propose a patient-based approach to perioperative corticosteroid management in the inflammatory bowel disease population based on an individual's historical use of corticosteroids, the type of surgery they are undergoing, and HPA axis testing when applicable. Patients without adrenal suppression (corticosteroid supplementation in the perioperative period; patients with adrenal suppression (>20 mg prednisone per day) should be treated with additional perioperative corticosteroid coverage above their baseline home regimen; and patients with unclear HPA axis function (>5 and <20 mg prednisone per day) should undergo preoperative HPA axis testing to determine the best management practices. The proposed management algorithm attempts to balance the risks of adrenal insufficiency and immunosuppression.

  8. Development of Information Management System for Plant Life Cycle Management

    Energy Technology Data Exchange (ETDEWEB)

    Byon, SuJin; Lee, SangHyun; Kim, WooJoong [KOREA HYDRO and NUCLEAR POWER CO. LTD, Daejeon (Korea, Republic of)


    The study subjects are S. Korean NPP(Nuclear Power Plant) construction projects. Design, construction, operations companies have different nuclear power plant construction project structures, and each company has its own Information Management System. In this study, the end user developed an Information Management System early in the project, and developed a management structure that systematically integrates and interfaces with information in each lifecycle phase. The main perspective of Information Management is moving from the existent document-centric management to the data-centric management. To do so, we intend to integrate information with interfaces among systems. Integrated information management structure and management system are essential for an effective management of the lifecycle information of nuclear power plants that have a lifespan over as much as 80 years. The concept of integration management adopted by the defence, ocean industries or various PLM solution providers is important. Although the NPP project has application systems in each key lifecycle phase, it is more effective to develop and use PLIMS in consideration of the interface and compatibility of information among systems. As an initial study for development of that integrated information management structure, this study is building the system and has interfaced it with a design-stage system.

  9. Information systems in food safety management. (United States)

    McMeekin, T A; Baranyi, J; Bowman, J; Dalgaard, P; Kirk, M; Ross, T; Schmid, S; Zwietering, M H


    Information systems are concerned with data capture, storage, analysis and retrieval. In the context of food safety management they are vital to assist decision making in a short time frame, potentially allowing decisions to be made and practices to be actioned in real time. Databases with information on microorganisms pertinent to the identification of foodborne pathogens, response of microbial populations to the environment and characteristics of foods and processing conditions are the cornerstone of food safety management systems. Such databases find application in: Identifying pathogens in food at the genus or species level using applied systematics in automated ways. Identifying pathogens below the species level by molecular subtyping, an approach successfully applied in epidemiological investigations of foodborne disease and the basis for national surveillance programs. Predictive modelling software, such as the Pathogen Modeling Program and Growth Predictor (that took over the main functions of Food Micromodel) the raw data of which were combined as the genesis of an international web based searchable database (ComBase). Expert systems combining databases on microbial characteristics, food composition and processing information with the resulting "pattern match" indicating problems that may arise from changes in product formulation or processing conditions. Computer software packages to aid the practical application of HACCP and risk assessment and decision trees to bring logical sequences to establishing and modifying food safety management practices. In addition there are many other uses of information systems that benefit food safety more globally, including: Rapid dissemination of information on foodborne disease outbreaks via websites or list servers carrying commentary from many sources, including the press and interest groups, on the reasons for and consequences of foodborne disease incidents. Active surveillance networks allowing rapid dissemination


    Directory of Open Access Journals (Sweden)

    Melia Damayanti


    Full Text Available Tramway systems, which can carry more passengers than buses at one haul, are now being proposed to meet Indonesia’s public transport requirement. The objective of this research is to analyze the management structures for operating tram in different countries and then propose a suitable organizational structure for operating trams, if re-introduced, in Indonesia. The author chose France (Montpellier tramway, Germany (Karlsruhe tram-train and the UK (Nottingham Express Transit as the role model countries for investigation. From the analysis, the most appropriate organizational structure and suitable tramway management structure for operating tramways implementation in Indonesia. The key features of the research are to establish public transport company by local government to manage all public transport systems, propose tramway construction and operation to exist as separate departments under the tramway team division of the public company, recommend the public transport company to have responsibility for overseeing construction of the trams, operating, and maintaining the trams, suggest local government to own them and have responsibility for tramway strategic policy, control regulation as well as supervision and coordination of the performance of the public transport company, propose joint working between public and private sectors.

  11. The Data Quality Management System

    Energy Technology Data Exchange (ETDEWEB)

    Augustyn, J.R.; Nelson, R.J. [Augustyn + Co. Consulting Engineers, Albany, CA (United States); Maxwell, E. [National Renewable Energy Lab., Golden, CO (United States)


    The Data Quality Management System (DQMS) is software which provides a systematic and comprehensive means to assess and control the quality of time sequence data collected in measurement and monitoring programs. It was designed to support single and multi-site solar resource measurement and energy and environmental monitoring projects, where end-use data quality is a strong concern, and growth and changes in the monitoring network must be accommodated. It contains features for importing, exporting, testing, modifying, archiving, summarizing, and condensing collected data. It assigns and manages a two component data quality flag associated with each data value, and maintains complete traceability of all changes made to data values after initial collection. DQMS also provides features to assist the network operator in day to day management of monitoring network operation. DQMS was initially developed internally at Augustyn + Company as the Data Verification System by Augustyn and Nelson (1993), and later enhanced under contract to the US National Renewable Energy Laboratory (NREL) for use in several internal research and development programs.

  12. Automated Periodontal Diseases Classification System

    Directory of Open Access Journals (Sweden)

    Aliaa A. A. Youssif


    Full Text Available This paper presents an efficient and innovative system for automated classification of periodontal diseases, The strength of our technique lies in the fact that it incorporates knowledge from the patients' clinical data, along with the features automatically extracted from the Haematoxylin and Eosin (H&E stained microscopic images. Our system uses image processing techniques based on color deconvolution, morphological operations, and watershed transforms for epithelium & connective tissue segmentation, nuclear segmentation, and extraction of the microscopic immunohistochemical features for the nuclei, dilated blood vessels & collagen fibers. Also, Feedforward Backpropagation Artificial Neural Networks are used for the classification process. We report 100% classification accuracy in correctly identifying the different periodontal diseases observed in our 30 samples dataset.

  13. Chronic disease management: improving care for people with osteoarthritis. (United States)

    Brand, Caroline A; Ackerman, Ilana N; Tropea, Joanne


    Chronic disease management (CDM) service models are being developed for many conditions; however, there is limited evidence to support their effectiveness in osteoarthritis (OA). A systematic review was undertaken to examine effectiveness, cost effectiveness and barriers to the use of osteoarthritis-chronic disease management (OA-CDM) service models. Thirteen eligible studies (eight randomised controlled trial (RCTs)) were identified. The majority focussed on delivery system design (n = 9) and/or providing self-management support (SMS) (n = 8). Overall, reported model effectiveness varied, and where positive impacts on process or health outcomes were observed, they were of small to moderate effect. There was no information about cost effectiveness. There is some evidence to support the use of collaborative care/multidisciplinary case management models in primary and community care and evidence-based pathways/standardisation of care in hospital settings. Multiple barriers were identified. Future research should focus on identifying the effective components of multi-faceted interventions and evaluating cost-effectiveness to support clinical and policy decision-making.

  14. Senior Management Use of Management Control Systems in Large Companies

    DEFF Research Database (Denmark)

    Willert, Jeanette; Israelsen, Poul; Rohde, Carsten


    Ferreira and Otley’s (2009) conceptual and holistic framework for performance management systems, supplemented by elements of contextual factors and organisational culture. Further, selected researchers’ perceptions of the purpose of using management control systems are related to practitioners’ ideas......The use of management control systems in large companies remains relatively unexplored. Indeed, only a few studies of senior managers’ use of management control systems consider multiple controls in companies. This paper explores data from a comprehensive survey of the use of management control...... systems in 120 strategic business units at some of the largest companies in Denmark. The paper identifies how senior management guides and controls their subordinates to meet their companies’ objectives. The presentation and discussion of the results, including citations from executive managers, use...

  15. Soliton Management in Periodic Systems

    CERN Document Server

    Malomed, Boris A


    During the past ten years, there has been intensive development in theoretical and experimental research of solitons in periodic media. This book provides a unique and informative account of the state-of-the-art in the field. The volume opens with a review of the existence of robust solitary pulses in systems built as a periodic concatenation of very different elements. Among the most famous examples of this type of systems are the dispersion management in fiber-optic telecommunication links, and (more recently) photonic crystals. A number of other systems belonging to the same broad class of spatially periodic strongly inhomogeneous media (such as the split-step and tandem models) have recently been identified in nonlinear optics, and transmission of solitary pulses in them was investigated in detail. Similar soliton dynamics occurs in temporal-domain counterparts of such systems, where they are subject to strong time-periodic modulation (for instance, the Feshbach-resonance management in Bose-Einstein conde...

  16. Extraintestinal manifestations of inflammatory bowel disease: epidemiology, diagnosis, and management

    DEFF Research Database (Denmark)

    Larsen, Signe; Bendtzen, Klaus; Nielsen, Ole Haagen


    Abstract Extraintestinal manifestations occur rather frequently in inflammatory bowel disease (IBD), e.g. ulcerative colitis (UC) and Crohn's disease (CD). The present paper provides an overview of the epidemiology, clinical characteristics, diagnostic process, and management of rheumatic, metabo...

  17. Rehabilitation in vestibular system diseases

    Directory of Open Access Journals (Sweden)

    Maksim Valeryevich Zamergrad


    Full Text Available Vestibular rehabilitation is an important component of combination treatment in a patient with vertigo. Vestibular rehabilitation is indicated for different diseases of the central or peripheral vestibular system. The goal of vestibular rehabilitation is to ensure gaze stabilization, to train postural stability, and to reduce subjective vertigo. Vestibular rehabilitation is based on the stimulation of vestibular adaptation, sensory substitution, and habituation. Vestibular suppressants, inadequate mobility, anxiety, and depression decelerate vestibular compensation whereas early activation, mobility, and betaserc use accelerate it.

  18. Strategic management of health care information systems: nurse managers' perceptions. (United States)

    Lammintakanen, Johanna; Kivinen, Tuula; Saranto, Kaija; Kinnunen, Juha


    The aim of this study is to describe nurse managers' perceptions of the strategic management of information systems in health care. Lack of strategic thinking is a typical feature in health care and this may also concern information systems. The data for this study was collected by eight focus group interviews including altogether 48 nurse managers from primary and specialised health care. Five main categories described the strategic management of information systems in health care; IT as an emphasis of strategy; lack of strategic management of information systems; the importance of management; problems in privacy protection; and costs of IT. Although IT was emphasised in the strategies of many health care organisations, a typical feature was a lack of strategic management of information systems. This was seen both as an underutilisation of IT opportunities in health care organisations and as increased workload from nurse managers' perspective. Furthermore, the nurse managers reported that implementation of IT strengthened their managerial roles but also required stronger management. In conclusion, strategic management of information systems needs to be strengthened in health care and nurse managers should be more involved in this process.

  19. Healthcare decision support system for administration of chronic diseases. (United States)

    Woo, Ji-In; Yang, Jung-Gi; Lee, Young-Ho; Kang, Un-Gu


    A healthcare decision-making support model and rule management system is proposed based on a personalized rule-based intelligent concept, to effectively manage chronic diseases. A Web service was built using a standard message transfer protocol for interoperability of personal health records among healthcare institutions. An intelligent decision service is provided that analyzes data using a service-oriented healthcare rule inference function and machine-learning platform; the rules are extensively compiled by physicians through a developmental user interface that enables knowledge base construction, modification, and integration. Further, screening results are visualized for the self-intuitive understanding of personal health status by patients. A recommendation message is output through the Web service by receiving patient information from the hospital information recording system and object attribute values as input factors. The proposed system can verify patient behavior by acting as an intellectualized backbone of chronic diseases management; further, it supports self-management and scheduling of screening. Chronic patients can continuously receive active recommendations related to their healthcare through the rule management system, and they can model the system by acting as decision makers in diseases management; secondary diseases can be prevented and health management can be performed by reference to patient-specific lifestyle guidelines.

  20. Patient web portals, disease management, and primary prevention. (United States)

    Coughlin, Steven S; Prochaska, Judith J; Williams, Lovoria B; Besenyi, Gina M; Heboyan, Vahé; Goggans, D Stephen; Yoo, Wonsuk; De Leo, Gianluca


    Efforts aimed at health care reform and continued advances in information technologies have prompted interest among providers and researchers in patient web portals. Patient web portals are password-protected online websites that offer the patients 24-hour access to personal health information from anywhere with an Internet connection. This article, which is based upon bibliographic searches in PubMed, reviews important developments in web portals for primary and secondary disease prevention, including patient web portals tethered to electronic medical records, disease-specific portals, health disparities, and health-related community web portals. Although findings have not been uniformly positive, several studies of the effectiveness of health care system patient portals in chronic disease management have shown promising results with regard to patient outcomes. Patient web portals have also shown promising results in increasing adherence with screening recommendations. Racial and ethnic minorities, younger persons, and patients who are less educated or have lower health literacy have been found to be less likely to use patient portals. Additional studies are needed of the utility and effectiveness of different elements of web portals for different patient populations. This should include additional diseases and health topics such as smoking cessation and weight management.

  1. Water quality management system; Suishitsu kanri system

    Energy Technology Data Exchange (ETDEWEB)

    Tsugura, H.; Hanawa, T.; Hatano, K.; Fujiu, M. [Meidensha Corp., Tokyo (Japan)


    Water quality management system designed in consideration of compliance with the environmental ISO is outlined. The water quality management system is positioned at the center, connected to water quality monitors that are deployed at various parts of the water supply facility, and performs the real-time display of information about water quality and the operating status of the water quality monitors for every one of the monitoring locations. The communication software run on this system supports 30 water quality monitors and performs uninterrupted surveillance using dedicated lines. It can also use public lines for periodic surveillance. Errors in communication if any are remedied automatically. A pipeline diagnosing/estimating function is provided, which utilizes water quality signals from received water quality monitors for estimating the degree of corrosion of pipelines in the pipeline network. Another function is provided of estimating water quality distribution throughout the pipeline network, which determines the residual chlorine concentration, conductivity, pH level, water temperature, etc., for every node in the pipeline network. A third function estimates water quality indexes, evaluating the trihalomethane forming power through measuring the amounts of low-concentration organic matters and utilizing signals from low-concentration UV meters in the water purification process. 3 refs., 7 figs.

  2. [Pregnancy in systemic autoimmune diseases: Myths, certainties and doubts]. (United States)

    Danza, Álvaro; Ruiz-Irastorza, Guillermo; Khamashta, Munther


    Systemic autoimmune diseases especially affect young women during childbearing age. The aim of this review is to update systemic lupus erythematosus, antiphospholipid syndrome and systemic sclerosis management during pregnancy. These diseases present variable maternal and fetal risks. Studies show that an appropriate disease control and a reasonable remission period prior to pregnancy are associated with satisfactory obstetric outcomes. Antiphospholipid autoantibodies profile, anti-Ro/anti-La antibodies, pulmonary pressure and activity evaluation are crucial to assess the pregnancy risk. Monitoring requires a multidisciplinary team, serial analytic controls and Doppler ultrasound of maternal and fetal circulation. Evaluation of the activity of the disease is essential.

  3. "We're Almost Guests in Their Clinical Care": Inpatient Provider Attitudes Toward Chronic Disease Management. (United States)

    Blecker, Saul; Meisel, Talia; Dickson, Victoria Vaughan; Shelley, Donna; Horwitz, Leora I


    Many hospitalized patients have at least 1 chronic disease that is not optimally controlled. The purpose of this study was to explore inpatient provider attitudes about chronic disease management and, in particular, barriers and facilitators of chronic disease management in the hospital. We conducted a qualitative study of semi-structured interviews of 31 inpatient providers from an academic medical center. We interviewed attending physicians, resident physicians, physician assistants, and nurse practitioners from various specialties about attitudes, experiences with, and barriers and facilitators towards chronic disease management in the hospital. Qualitative data were analyzed using constant comparative analysis. Providers perceived that hospitalizations offer an opportunity to improve chronic disease management, as patients are evaluated by a new care team and observed in a controlled environment. Providers perceived clinical benefits to in-hospital chronic care, including improvements in readmission and length of stay, but expressed concerns for risks related to adverse events and distraction from the acute problem. Barriers included provider lack of comfort with managing chronic diseases, poor communication between inpatient and outpatient providers, and hospital-system focus on patient discharge. A strong relationship with the outpatient provider and involvement of specialists were facilitators of inpatient chronic disease management. Providers perceived benefits to in-hospital chronic disease management for both processes of care and clinical outcomes. Efforts to increase inpatient chronic disease management will need to overcome barriers in multiple domains. Journal of Hospital Medicine 2017;12:162-167.

  4. Learning Management Systems and Comparison of Open Source Learning Management Systems and Proprietary Learning Management Systems

    Directory of Open Access Journals (Sweden)

    Yücel Yılmaz


    Full Text Available The concept of learning has been increasingly gaining importance for individuals, businesses and communities in the age of information. On the other hand, developments in information and communication technologies take effect in the field of learning activities. With these technologies, barriers of time and space against the learning activities largely disappear and these technologies make it easier to carry out these activities more effectively. There remain a lot of questions regarding selection of learning management system (LMS to be used for the management of e-learning processes by all organizations conducing educational practices including universities, companies, non-profit organizations, etc. The main questions are as follows: Shall we choose open source LMS or commercial LMS? Can the selected LMS meet existing needs and future potential needs for the organization? What are the possibilities of technical support in the management of LMS? What kind of problems may be experienced in the use of LMS and how can these problems be solved? How much effective can officials in the organization be in the management of LMS? In this study, primarily e-learning and the concept of LMS will be discussed, and in the next section, as for answers to these questions, open source LMSs and centrally developed LMSs will be examined and their advantages and disadvantages relative to each other will be discussed.

  5. 慢病管理对系统性红斑狼疮治疗效果的评价%Chronic disease management for the evaluation of systemic lupus erythematosus treatment

    Institute of Scientific and Technical Information of China (English)



    目的观察慢病管理对系统性红斑狼疮治疗的干预效果。方法将120例系统红斑狼疮患者随机分为观察组60例和对照组60例。对观察组进行慢病管理干预,对照组未进行干预。采用疾病认知、依从性、生活方式测定量表对患者进行评价。结果观察组干预后疾病认知度、治疗依从性及生活方式积分较干预前明显提高,干预前后比较,差异均有显著统计学意义(p0.05)。结论实施慢病管理干预可以提高系统红斑狼疮患者对系统红斑狼疮的认知度及治疗依从性,改善不良的生活方式。%Objective: To observe the chronic disease management of systemic lupus erythematosus treatment intervention. Methods: 120 cases of systemic lupus erythematosus were randomly divided into group 60 patients and a control group of 60 cases. The observation group chronic disease management intervention in the control group did not intervene. The use of disease awareness, compliance, measured way of life scale for patients evaluated. Results: Observationgroup after the intervention disease awareness,treatmentcomplianceand lifestyle intervention was significantlyincreased compared with points, before and after intervention, the differenceswere statisticallysignificant (p0.05).Conclusion: The implementation of the intervention can improve chronic disease management in patients with systemic lupus erythematosus systemic lupus erythematosus awareness and treatment compliance, improvement of poor lifestyle.

  6. Environmental Management System ISO 14001

    CERN Document Server

    Haider, Syed


    This is a must-have tool for any company in the process of adopting and incorporating the ISO 14001:2004 requirements, this book and accompanying CD-ROM provides the latest updates and amendments and translates the ISO language into actionable strategy. Offering administrative solutions to managers of all sorts, it includes practical examples of policies with objectives, targets, and action plans applicable to any process related industry or an ordinary organization. With template formats and hands-on flow charts to describe step-by-step system development, documentation, and implementation ph

  7. Smart Garbage Monitoring System for Waste Management

    Directory of Open Access Journals (Sweden)

    Mohd Yusof Norfadzlia


    Full Text Available Piles of rubbish are one of the major problems faced by most people in Malaysia, especially those who live in flats, as the number of bins is limited and shared among all residents. It may cause pollutions, which may lead to sanitary issues and diseases. This project presents the development of a smart garbage monitoring system in order to measure waste level in the garbage bin in real-time and to alert the municipality, in particular cases, via SMS. The proposed system is consisted by the ultrasonic sensor to measure the waste level, the GSM module to send the SMS, and an Arduino Uno which controls the system operation. It supposes to generate and send the warning messages to the municipality via SMS when the waste bin is full or almost full, so the garbage can be collected immediately. Furthermore, it is expected to contribute to improving the efficiency of the solid waste disposal management.

  8. Design and Data Management System (United States)

    Messer, Elizabeth; Messer, Brad; Carter, Judy; Singletary, Todd; Albasini, Colby; Smith, Tammy


    The Design and Data Management System (DDMS) was developed to automate the NASA Engineering Order (EO) and Engineering Change Request (ECR) processes at the Propulsion Test Facilities at Stennis Space Center for efficient and effective Configuration Management (CM). Prior to the development of DDMS, the CM system was a manual, paper-based system that required an EO or ECR submitter to walk the changes through the acceptance process to obtain necessary approval signatures. This approval process could take up to two weeks, and was subject to a variety of human errors. The process also requires that the CM office make copies and distribute them to the Configuration Control Board members for review prior to meetings. At any point, there was a potential for an error or loss of the change records, meaning the configuration of record was not accurate. The new Web-based DDMS eliminates unnecessary copies, reduces the time needed to distribute the paperwork, reduces time to gain the necessary signatures, and prevents the variety of errors inherent in the previous manual system. After implementation of the DDMS, all EOs and ECRs can be automatically checked prior to submittal to ensure that the documentation is complete and accurate. Much of the configuration information can be documented in the DDMS through pull-down forms to ensure consistent entries by the engineers and technicians in the field. The software also can electronically route the documents through the signature process to obtain the necessary approvals needed for work authorization. The workflow of the system allows for backups and timestamps that determine the correct routing and completion of all required authorizations in a more timely manner, as well as assuring the quality and accuracy of the configuration documents.

  9. Information management system for KNGR

    Energy Technology Data Exchange (ETDEWEB)

    Moon, Chankook; Yoo, Keunbae; Lee, Jinkie [Korea Electric Power Corporation, Seoul (Korea, Republic of); Park, Jaemoon [Korea Power Engineering Co., Inc., Daejeon (Korea, Republic of)


    Information management system(IMS) is under development by Korea Electric Power COrporation(KEPCO) joined with KOrea Power Engineering Company(KOPEC) since early 1993 in accordance with Korean Next Generation Reactor(KNGR) project schedule, which is divided into three phases: Phase I(1993-1994), Phase II(1995-Feb.1998), Phase III(1998-2001). Necessity of creating IMS comes from two main purposes: one is from client requirement as described on Electric Power Research Institute(EPRI) Utility Requirement Document(URD) top-tier, the other is from supplier's need to improve productivity whatever it is motivated by management or working group. To satisfy both consumer's and producer's requirements we have set up goals of IMS, to provide configuration management based on network and reliable integrated data base through KNGR's life cycle: i.e.,chronologically, siting, designing, construction, operation and maintenance, and decommissioning. This paper will show what we have done to make the concept during Phase I, and what is a current problem and what will be done through Phase II and III.

  10. Ischemic heart disease in systemic inflammatory diseases. An appraisal. (United States)

    Gargiulo, Paola; Marsico, Fabio; Parente, Antonio; Paolillo, Stefania; Cecere, Milena; Casaretti, Laura; Pellegrino, Angela Maria; Formisano, Tiziana; Fabiani, Irma; Soricelli, Andrea; Trimarco, Bruno; Perrone-Filardi, Pasquale


    Systemic inflammatory diseases are inflammatory syndromes that are associated with increased cardiovascular morbidity and mortality. The link between inflammatory and cardiovascular diseases can be attributed to coexistence of classical risk factors and of inflammatory mechanisms activated in systemic inflammatory diseases and involving the immune system. Yet, clinical implications of these findings are not entirely clear and deeper knowledge and awareness of cardiac involvement in inflammatory diseases are necessary. The aims of this review are to summarize cardiac involvement in systemic inflammatory diseases and to identify areas where evidence is currently lacking that deserve further investigation in the future.

  11. Transition Office Management and Accounting System (United States)

    US Agency for International Development — TOMAS combined over 20 previously separate systems into one fully integrated management system covering budget, finance, procurement, travel, and emergency contact...

  12. Establishment and management of nonalcoholic fatty liver disease biobank

    Directory of Open Access Journals (Sweden)

    CHEN Lizhen


    Full Text Available ObjectiveTo investigate the collection and preservation of blood specimens from patients with nonalcoholic fatty liver disease (NAFLD and the establishment and information management of biobank. MethodsWhole blood samples were collected from 1226 patients who were diagnosed with NAFLD based on B-mode ultrasound and blood tests from October 2009 to October 2013. Biochemical parameters were measured. Plasma and whole-blood genomic DNA was extracted from the samples, and the purity and concentration of DNA were determined. Specimens were preserved in a refrigerator (-80℃. An information management system for NAFLD biobank was established. ResultsSpecimens of 1226 NAFLD patients, including those of 83 twins and 100 families, were collected. The success rate was 100% for extraction of plasma and whole-blood genomic DNA. One hundred DNA samples were randomly selected for testing, and the results showed that the collected specimens met the requirements of following experiments. ConclusionThe NAFLD Biobank has been successfully established in this study. It has the standard information management system and enables the quality control and information management of specimens, laying a solid foundation for further research on NAFLD.

  13. Ocular Involvement in Systemic Autoimmune Diseases. (United States)

    Generali, Elena; Cantarini, Luca; Selmi, Carlo


    Eye involvement represents a common finding in patients with systemic autoimmune diseases, particularly rheumatoid arthritis, Sjogren syndrome, seronegative spondyloarthropathy, and antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis. The eye is a privileged immune site but commensal bacteria are found on the ocular surface. The eye injury may be inflammatory, vascular or infectious, as well as iatrogenic, as in the case of hydroxychloroquine, chloroquine, corticosteroids, and bisphosphonates. Manifestations may affect different components of the eye, with episcleritis involving the episclera, a thin layer of tissue covering the sclera; scleritis being an inflammation of the sclera potentially leading to blindness; keratitis, referring to corneal inflammation frequently associated with scleritis; and uveitis as the inflammation of the uvea, including the iris, ciliary body, and choroid, subdivided into anterior, posterior, or panuveitis. As blindness may result from the eye involvement, clinicians should be aware of the possible manifestations and their management also independent of the ophthalmologist opinion as the therapeutic approach generally points to the underlying diseases. In some cases, the eye involvement may have a diagnostic implication, as for episcleritis in rheumatoid arthritis, or acute anterior uveitis in seronegative spondyloarthritis. Nonetheless, some conditions lack specificity, as in the case of dry eye which affects nearly 30 % of the general population. The aim of this review is to elucidate to non-ophthalmologists the major ocular complications of rheumatic diseases and their specific management and treatment options.

  14. Slope stability hazard management systems

    Institute of Scientific and Technical Information of China (English)


    Weather-related geo-hazards are a major concern for both natural slopes and man-made slopes and embankments.Government agencies and private companies are increasingly required to ensure that there is adequate protection of sloping surfaces in order that interaction with the climate does not produce instability. Superior theoretical formulations and computer tools are now available to address engineering design issues related to the near ground surface soil-atmospheric interactions. An example is given in this paper that illustrates the consequences of not paying adequate attention to the hazards of slope stability prior to the construction of a highway in South America. On the other hand, examples are given from Hong Kong and Mainland China where significant benefits are derived from putting in place a hazard slope stability management system. Some results from a hazard management slope stability study related to the railway system in Canada are also reported. The study took advantage of recent research on unsaturated soil behaviour and applied this information to real-time modelling of climatic conditions. The quantification of the water balance at the ground surface, and subsequent infiltration, is used as the primary tool for hazard level assessment. The suggested hazard model can be applied at either specific high risk locations or in a more general, broad-based manner over large areas. A more thorough understanding of unsaturated soil behaviour as it applies to near ground surface soils,along with the numerical computational power of the computer has made it possible for new approaches to be used in slope hazard management engineering.

  15. Managing complex systems: performance management in public health. (United States)

    Landrum, Laura B; Baker, Stacy L


    The complexity of mobilizing and managing systems-wide public health responses has prompted Turning Point's Performance Management National Excellence Collaborative, funded by the Robert Wood Johnson Foundation, to develop a conceptual framework for performance management in public health. The framework has four integrated parts: (1) performance standards, (2) performance measures, (3) reporting of progress, and (4) a quality improvement process. The Collaborative based its framework on evidence gathered through a survey of current state performance management practices, a literature review, and its investigation of current practice models. This balanced and cohesive management model can be constructively used by public health programs, organizations, and community and state public health systems.

  16. The Stress Management in the Enterprise Management System

    Directory of Open Access Journals (Sweden)

    Kuzmin Oleh Ye.


    Full Text Available The article systematizes the classification of the type of management by a number of attributes: horizon of ambition, priority style of interaction between management and managed systems, level of centralization, orientation, consideration of environmental impact, contents, type of activity, and response to deviation. Within terms of the attribute of response to deviations, place of the stress management is allocated near to the harmonic and the risk management. It has been substantiated that the stress management is the enterprise management system aimed at overcoming unwanted deviations that are significant, extreme, and have a significant negative impact on the operation of enterprise. In the structure of the stress management, the following integral components have been allocated and characterized: crisis, adaptive, reactive, fears, and anticipative.

  17. Managing Abiotic Factors of Compost to Increase Soilborne Disease Suppression (United States)

    Griffin, Deirdre E.


    Soilborne pathogens can devastate crops, causing economic losses for farmers due to reduced yields and expensive management practices. Fumigants and fungicides have harmful impacts on the surrounding environment and can be toxic to humans. Therefore, alternative methods of disease management are important. The disease suppressive abilities of…

  18. Managing Abiotic Factors of Compost to Increase Soilborne Disease Suppression (United States)

    Griffin, Deirdre E.


    Soilborne pathogens can devastate crops, causing economic losses for farmers due to reduced yields and expensive management practices. Fumigants and fungicides have harmful impacts on the surrounding environment and can be toxic to humans. Therefore, alternative methods of disease management are important. The disease suppressive abilities of…

  19. Drug-Free Correction of the Tone of the Autonomic Nervous System in the Management of Cardiac Arrhythmia in Coronary Artery Disease

    Directory of Open Access Journals (Sweden)

    Sergey V. Popov, PhD, ScD


    Full Text Available Background: The aim of our study was to examine the possibility of ventricular extrasystole (VES management in CAD (coronary artery disease patients by attenuating the sympathetic activity with a course of electrical stimulation of the vagus nerve. Methods: A decrease in sympathetic tone was achieved via vagus nerve electrical stimulation (VNES. VNES was performed in 48 male CAD patients, mean age 53.5±4.1 years. Antiarrhythmic drug therapy was canceled prior to VNES therapy. The effect of VNES on heart rate variability (HRV and VES were carefully studied. All the patients received a 24-hour ECG monitoring. HRV was calculated for high frequency (HF and low frequency (LF bands and the LF/HF index was determined. Results: Immediately following VNES therapy, 30 patients (group 1 reported alleviation of angina signs and the LF/HF index was significantly decreased (p=0.001. Eighteen patients (group 2 showed no change either in health or the LF/HF index. According to ECG and echocardiography, the VES number did not significantly change immediately after VNES therapy. One month after the VNES course, group 1 reported further improvement in health; the LF/HF index approached normal values. In group 2, the LF/HF significantly decreased (p=0.043. However, in the entire study sample, the VES number significantly decreased overall (p=0.025. Conclusion: VNES attenuated the cardiac effects of hypersympathicotonia decreased the ischemic impact on the myocardium, alleviated the cardiac angina signs, and beneficially influenced the VES number in CAD patients.

  20. Impact Evaluation of a System-Wide Chronic Disease Management Program on Health Service Utilisation: A Propensity-Matched Cohort Study.

    Directory of Open Access Journals (Sweden)

    Laurent Billot


    Full Text Available The New South Wales Health (NSW Health Chronic Disease Management Program (CDMP delivers interventions to adults at risk of hospitalisation for five target chronic conditions that respond well to ambulatory care: diabetes, hypertension, chronic obstructive pulmonary disease, congestive heart failure, and coronary artery disease. The intervention consists of two main components: (1 care coordination across sectors (acute, ambulatory, and community care from both public and private sectors and clinical specialties, facilitated by program care coordinators, and (2 health coaching including management of lifestyle risk factors and medications and self-management. These components were broadly prescribed by the head office of NSW Health, which funded the program, and were implemented by regional health services (local health districts in ways that best suited their own history, environment, workforce, and patient need. We used a propensity-matched cohort study to evaluate health service utilisation after enrolment in the CDMP.The evaluation cohort included 41,303 CDMP participants enrolled between 1 January 2011 and 31 December 2013 who experienced at least one hospital admission or emergency department (ED presentation for a target condition in the 12 mo preceding enrolment. Potential controls were selected from patients not enrolled in the CDMP but experiencing at least one hospital admission or ED presentation over the same period. Each CDMP patient in the evaluation cohort was matched to one control using 1:1 propensity score matching. The primary outcome was avoidable hospitalisations. Secondary outcomes included avoidable readmissions, avoidable bed days, unplanned hospitalisations, unplanned readmissions, unplanned bed days, ED presentations, and all-cause death. The primary analysis consisted of 30,057 CDMP participants and 30,057 matched controls with a median follow-up of 15 mo. Of those, 25,638 (85.3% and 25,597 (85.2% were alive by the




    A quality management recently has been the concepts that using a great mass of information flow. The unique function of information in quality management has become the driver of this study. There is a need of building the model for quality management information system before designing the information system. This paper will show two points that important for the information system. The points, database model and expert system, will be explained as the part of the information system for qual...

  2. Designing an oil spill information management system

    Energy Technology Data Exchange (ETDEWEB)

    Douligeris, C.; Collins, J.; Iakovou, E.; Sun, P.; Riggs, K.R. [Univ. of Miami, Coral Gables, FL (United States)


    This paper presents the architectural design of OSIMS, an Oil Spill Information Management System, which is an integrated information management tool that consists of an object-relational database management system, an adaptive decision support system, an advanced visualization system (AVS) and a geographic information system (GIS). OSIMS will handle large and diverse databases of environmental, ecological, geographical, engineering, and regulatory information and will be used for risk analysis and contingency planning.

  3. Bone disease in multiple myeloma: pathophysiology and management. (United States)

    Hameed, Abdul; Brady, Jennifer J; Dowling, Paul; Clynes, Martin; O'Gorman, Peter


    Myeloma bone disease (MBD) is a devastating complication of multiple myeloma (MM). More than 80% of MM patients suffer from destructive bony lesions, leading to pain, fractures, mobility issues, and neurological deficits. MBD is not only a main cause of disability and morbidity in MM patients but also increases the cost of management. Bone destruction and lack of bone formation are main factors in the development of MBD. Some novel factors are found to be involved in the pathogenesis of MBD, eg, receptor activator of nuclear factor kappa-B ligand (RANKL), osteoprotegerin (OPG) system (RANKL/OPG), Wingless (Wnt), dickkopf-1 (Wnt/DKK1) pathway. The addition of novel agents in the treatment of MM, use of bisphosphonates and other supportive modalities such as radiotherapy, vertebroplasty/kyphoplasty, and surgical interventions, all have significant roles in the treatment of MBD. This review provides an overview on the pathophysiology and management of MBD.

  4. Disease management. A global cost-containing initiative? (United States)

    Bloor, K; Maynard, A


    Disease management has been marketed by healthcare industry providers as a way of improving resource allocation in healthcare and containing costs. However, to achieve improved efficiency in healthcare requires the guidelines and protocols in the disease management process to be based on sound evidence of effectiveness and cost effectiveness. This has not always been the case. The approach itself has an inadequate evidence base in terms of randomised controlled trials, other rigorous methods of evaluation and the results of economic evaluation. Disease management can be viewed as an attempt by pharmaceutical companies to undertake forward vertical integration into other parts of the healthcare process. This could reduce uncertainty for purchasers and reduce transaction costs, thereby potentially facilitating both healthcare expenditure control and efficiency. However, such cost savings may be outweighed by a concentration of power in disease management (pharmaceutical) companies, and the exploitation of such power to inflate expenditure and misallocate resources. Disease management must be appraised with care.

  5. Photodynamic therapy: A new vista in management of periodontal diseases

    Directory of Open Access Journals (Sweden)

    Yogesh Doshi


    Full Text Available Aim: The purpose of this review was to evaluate the effectiveness of photodynamic therapy (PDT for periodontitis. This review also elucidates application of photodynamic therapy for noninvasive management of periodontitis without leading to bacterial resistance. Background: Periodontal diseases are one of the major causes of tooth loss in adults and are considered primarily an anaerobic bacterial infections caused by the so-called red complex species. Bacteria present in a biofilm community, enzymes, endotoxins, and other cytotoxic factors lead to tissue destruction and initiate chronic inflammation. Since many years pioneers have been working to provide logical and cost-effective therapy for management of periodontitis. Periodontal researchers have found that PDT is advantageous to suppress anaerobic bacteria. Clinical Significance: Applications of PDT in dentistry are growing rapidly. PDT application has an adjunctive benefit besides mechanical treatment at sites with difficult access. Necessity for flap surgery may be reduced, patient comfort may increase, and treatment time may decrease. The application of photosensitizing dyes and their excitation by visible light enables effective killing of periodonto-pathogens. The introduction of laser along with photosensitizers has brought a revolutionary change. Conclusion: The application of photodynamic therapy in management of periodontal diseases is very valuable. The therapy should be combined with nonsurgical periodontal therapy. Proper clinical application of photodynamic therapy can and will help patients who are systemically compromised and cannot undergo surgical therapy.

  6. ARN Supply Chain Management System for OCIE (United States)


    Module (IRM), Clothing Initial Issue Point ( CIIP ); Supply Chain Management; Virtual Item Manager/Wholesale Local; Quality Logistics Management...DLA successfully assumed retail inventory at five Army Clothing Initial Issue Points ( CIIPs ), two United Stated Marine Corps Recruit Depots (MCRDs...system provides a “local” capability to manage wholesale inventory assets located at the CIIP including receipt and inventory adjustment processing

  7. Diagnosis of Skin Diseases using Online Expert System

    Directory of Open Access Journals (Sweden)

    Muhammad Zubair Asghar


    Full Text Available This paper describes Expert System (ES for diagnosis and management of skin diseases. More than 13 types of skin diseases can be diagnosed and treated by our system. It is rule based web-supported expert system, assisting skin specialists, medical students doing specialization in dermatology, researchers as well as skin patients having computer know-how. System was developed with Java Technology. The expert rules were developed on the symptoms of each type of skin disease, and they were presented using tree-graph and inferred using forward-chaining with depth-first search method. User interaction with system is enhanced with efficient user interfaces. The web based expert system described in this paper can detect and give early diagnosis of thirteen plus skin diseases. This ES can be extended to diagnose all types of skin-diseases.

  8. Evaluation of the hypertension disease management program in Korea. (United States)

    Kim, Younmi; Lee, Kunsei; Shin, Eunyoung; Kim, Hyeongsu; June, Kyung Ja


    This study evaluated how the Hypertension Disease Management Program (HDMP) affects patient's blood pressure, knowledge, health behaviors, and use of medical services. Evaluation was performed by 2 measures, which were before and after comparison within the management group (n = 210) and comparison between the management group and control group (n = 1050) in 2005. Systolic and diastolic blood pressure of management group significantly decreased from 137.5 and 86.0 mm Hg to 131.2 and 83.8 mm Hg (P management techniques significantly increased after HDMP. However, there was no significant difference in the use of medical service between the disease management group and the control group. This study showed that the HDMP improved lifestyle and reduced blood pressure on the disease management group, but changed neither medical costs nor use of medical services. Long-term evaluation should be performed to determine if the HDMP reduce medical costs and use of medical services.

  9. Use of multiline cultivars and cultivar mixtures for disease management. (United States)

    Mundt, C C


    The usefulness of mixtures (multiline cultivars and cultivar mixtures) for disease management has been well demonstrated for rusts and powdery mildews of small grain crops. Such mixtures are more useful under some epidemiological conditions than under others, and experimental methodology, especially problems of scale, may be crucial in evaluating the potential efficacy of mixtures on disease. There are now examples of mixtures providing both low and high degrees of disease control for a wide range of pathosystems, including crops with large plants, and pathogens that demonstrate low host specificity, or are splash dispersed, soilborne, or insect vectored. Though most analyses of pathogen evolution in mixtures consider static costs of virulence to be the main mechanism countering selection for pathogen complexity, many other potential mechanisms need to be investigated. Agronomic and marketing considerations must be carefully evaluated when implementing mixture approaches to crop management. Practical difficulties associated with mixtures have often been overestimated, however, and mixtures will likely play an increasingly important role as we develop more sustainable agricultural systems.

  10. Physiopathology and Management of Gluten-Induced Celiac Disease. (United States)

    Kumar, Jitendra; Kumar, Manoj; Pandey, Rajesh; Chauhan, Nar Singh


    Proline- and glutamine-rich gluten proteins are one of the major constituents of cereal dietary proteins, which are largely resistant to complete cleavage by the human gastrointestinal (GI) digestive enzymes. Partial digestion of gluten generates approximately 35 amino acids (aa) immunomodulatory peptides which activate T-cell-mediated immune system, followed by immunological inflammation of mucosa leading to the onset of celiac disease (CD). CD is an autoimmune disease associated with HLA-DQ2/DQ8 polymorphism and dysbiosis of gut microbiota. CD is either diagnosed using duodenal mucosal biopsis or serological testing for transglutaminase 2 (TG2) specific antibodies (IgA and IgG). Current therapy for CD management is gluten-free diet, while other therapies like glutenase, probiotics, immunomodulation, jamming of HLA-DQ2, inhibition of TG2, and gluten tolerance aided by gluten tolerizing vaccines are being developed. © 2017 Institute of Food Technologists®.

  11. Managers’ Use of Multiple Management Control Systems

    DEFF Research Database (Denmark)

    Willert, Jeanette

    executive managers in large companies, a survey that investigates the subject: Effective Management and Control Systems. The focus in the survey is to explore how executive management in large companies design and use their management control systems package. Further, this study is supplemented...... with archival data on the participating companies’ performance. The dissertation presents three papers, each of which introduces knowledge within studying managers’ use of MCS as a package. The first paper presents executive managers’ use of management control systems as a package in large companies. With basis......This dissertation addresses the topic Management Control Systems (MCS) as a Package. Many research studies investigate management and control systems individually, whereas fewer research studies take a holistic view and include a larger part of all the MCS managers use to guide and direct...

  12. 中西医肾脏疾病综合管理系统的研究与设计%Study and Design of Comprehensive Management System for Traditional Chinese and Western Medicine Kidney Diseases

    Institute of Scientific and Technical Information of China (English)

    李宏斌; 雷根平; 仝武宁


    目的:设计一种中西医肾脏疾病综合管理系统,为医生的诊疗和科研提供支持.方法:使用Microsoft公司的VC作为前台开发工具,使用Microsoft SQL server 2000数据库管理系统开发后台数据库,采用无重复节点的树形表分类方法处理中医药学的症、病、证、法、方、药6类元数据.结果:设计了一套能参与诊疗、辅助科研的中西医肾脏疾病综合管理系统.结论:该系统的建立极大地方便了肾脏病科的中西医临床医生开展临床诊疗与科学研究.%Objective To design a comprehensive management system of traditional Chinese and western medicine kidney diseases so as to provide support for the doctor's diagnosis and treatment and scientific research. Methods With VC Language from Microsoft Corporation as the foreground development tool and Microsoft SQL server 2000 to develop the background database, tree-table sorting without overlapped nodes was used to process six kinds of meta data of symptom, disease, syndrome, therapeutic method, recipe and medicine. Results A comprehensive management system of traditional Chinese and western medicine kidney diseases was designed for the diagnosis, treatment and research assistance. Conclusion The system benefits clinical doctors of traditional Chinese and western medicine of kidney department.

  13. Managing refractory Crohn's disease: challenges and solutions

    Directory of Open Access Journals (Sweden)

    Tanida S


    Full Text Available Satoshi Tanida, Keiji Ozeki, Tsutomu Mizoshita, Hironobu Tsukamoto, Takahito Katano, Hiromi Kataoka, Takeshi Kamiya, Takashi Joh Department of Gastroenterology and Metabolism, Nagoya City University Graduate School of Medical Sciences, Aichi Prefecture, Japan Abstract: The goals of treatment for active Crohn's disease (CD are to achieve clinical remission and improve quality of life. Conventional therapeutics for moderate-to-severe CD include 5-aminosalicylic acid, corticosteroids, purine analogs, azathioprine, and 6-mercaptopurine. Patients who fail to respond to conventional therapy are treated with tumor necrosis factor (TNF-α inhibitors such as infliximab and adalimumab, but their efficacy is limited due to primary nonresponse or loss of response. It is suggested that this requires switch to another TNF-α inhibitor, a combination therapy with TNF-α blockade plus azathioprine, or granulocyte and monocyte adsorptive apheresis, and that other therapeutic options having different mechanisms of action, such as blockade of inflammatory cytokines or adhesion molecules, are needed. Natalizumab and vedolizumab are neutralizing antibodies directed against integrin a4 and a4ß7, respectively. Ustekinumab is a neutralizing antibody directed against the receptors for interleukin-12 and interleukin-23. Here, we provide an overview of therapeutic treatments that are effective and currently available for CD patients, as well as some that likely will be available in the near future. We also discuss the advantages of managing patients with refractory CD using a combination of TNF-α inhibitors plus azathioprine or intensive monocyte adsorptive apheresis. Keywords: adalimumab, granulocyte and monocyte adsorptive apheresis, combination therapy, complete remission

  14. Conceptual model for heart failure disease management. (United States)

    Andrikopoulou, Efstathia; Abbate, Kariann; Whellan, David J


    The objective of this review is to propose a conceptual model for heart failure (HF) disease management (HFDM) and to define the components of an efficient HFDM plan in reference to this model. Articles that evaluated 1 or more of the following aspects of HFDM were reviewed: (1) outpatient clinic follow-up; (2) self-care interventions to enhance patient skills; and (3) remote evaluation of worsening HF either using structured telephone support (STS) or by monitoring device data (telemonitoring). The success of programs in reducing readmissions and mortality were mixed. Outpatient follow-up programs generally resulted in improved outcomes, including decreased readmissions. Based on 1 meta-analysis, specialty clinics improved outcomes and nonspecialty clinics did not. Results from self-care programs were inconsistent and might have been affected by patient cognitive status and educational level, and intervention intensity. Telemonitoring, despite initially promising meta-analyses demonstrating a decrease in the number and duration of HF-related readmissions and all-cause mortality rates at follow-up, has not been shown in randomized trials to consistently reduce readmissions or mortality. However, evidence from device monitoring trials in particular might have been influenced by technology and design issues that might be rectified in future trials. Results from the literature suggest that the ideal HFDM plan would include outpatient follow-up at an HF specialty clinic and continuous education to improve patient self-care. The end result of this plan would lead to better understanding on the part of the patient and improved patient ability to recognize and respond to signs of decompensation. Copyright © 2014 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  15. School Management Information Systems in Primary Schools (United States)

    Demir, Kamile


    Developments in information technologies have been impacting upon educational organizations. Principals have been using management information systems to improve the efficiency of administrative services. The aim of this research is to explore principals' perceptions about management information systems and how school management information…

  16. Self-management education and support in chronic disease management. (United States)

    McGowan, Patrick T


    With the changing health care environment, prevalence of chronic health conditions, and burgeoning challenges of health literacy, obesity, and homelessness, self-management support provides an opportunity for clinicians to enhance effectiveness and, at the same time, to engage patients to participate in managing their own personal care. This article reviews the differences between patient education and self-management and describes easy-to-use strategies that foster patient self-management and can be used by health care providers in the medical setting. It also highlights the importance of linking patients to nonmedical programs and services in the community.

  17. Managing Acute Complications Of Sickle Cell Disease In Pediatric Patients. (United States)

    Subramaniam, Sathyaseelan; Chao, Jennifer H


    Sickle cell disease is a chronic hematologic disease with a variety of acute, and often recurring, complications. Vaso-occlusive crisis, a unique but common presentation in sickle cell disease, can be challenging to manage. Acute chest syndrome is the leading cause of death in patients with sickle cell disease, occurring in more than half of patients who are hospitalized with a vaso-occlusive crisis. Uncommon diagnoses in children, such as stroke, priapism, and transient red cell aplasia, occur more frequently in patients with sickle cell disease and necessitate a degree of familiarity with the disease process and its management. Patients with sickle cell trait generally have a benign course, but are also subject to serious complications. This issue provides a current review of evidence-based management of the most common acute complications of sickle cell disease seen in pediatric patients in the emergency department.

  18. Business Management System Support Analysis (United States)

    Parikh, Jay


    The purpose of this research project was to develop a searchable database compiled with internal and external audit findings/observations. The data will correspond to the findings and observations from the date of Center-wide implementation of the ISO 9001-2000 standard to the present (2003-2008). It was derived and extracted from several sources and was in multiple formats. Once extracted, categorization of the findings/observations would be possible. The final data was mapped to the ISO 9001-2000 standard with the understanding that it will be displayed graphically. The data will be used to verify trends, associate risks, and establish timelines to identify strengths and weaknesses to determine areas of improvement in the Kennedy Space Center Business Management System Internal Audit Program.

  19. Potential of Computerized Maintenance Management System in Facilities Management

    Directory of Open Access Journals (Sweden)

    Noor Farisya Azahar


    Full Text Available For some time it has been clear that managing buildings or estates has been carried out in the context of what has become known as facilities management. British Institute of Facilities Management defined facilities management is the integration of multi-disciplinary activities within the built environment and the management of their impact upon people and the workplace. Effective facilities management is vital to the success of an organisation by contributing to the delivery of its strategic and operational objectives. Maintenance of buildings should be given serious attention before (stage design, during and after a building is completed. But total involvement in building maintenance is after the building is completed and during its operations. Residents of and property owners require their building to look attractive, durable and have a peaceful indoor environment and efficient. The objective of the maintenance management system is to stream line the vast maintenance information system to improve the productivity of an industrial plant. a good maintenance management system makes equipment and facilities available. This paper will discuss the fundamental steps of maintenance management program and Computerized Maintenance Management System (CMMS


    Directory of Open Access Journals (Sweden)

    Farag Azzedin


    Full Text Available Disease outbreak detection, monitoring and notification systems play an important role in assessing threats to public health since disease outbreaks are becoming increasingly common world-wide. There are several systems in use around the world, with coverage of national, international and global disease outbreaks. These systems use different taxonomies and classifications for the detection and prioritization of potential disease outbreaks. In this paper, we study and analyze the current disease outbreak systems. Subsequently, we extract features and functions of typical and generic disease outbreak systems. We then propose a generic model for disease outbreak notification systems. Our effort is directed towards standardizing the design process for typical disease outbreak systems.