WorldWideScience

Sample records for growth management pilot

  1. Single-Pilot Workload Management

    Science.gov (United States)

    Rogers, Jason; Williams, Kevin; Hackworth, Carla; Burian, Barbara; Pruchnicki, Shawn; Christopher, Bonny; Drechsler, Gena; Silverman, Evan; Runnels, Barry; Mead, Andy

    2013-01-01

    Integrated glass cockpit systems place a heavy cognitive load on pilots (Burian Dismukes, 2007). Researchers from the NASA Ames Flight Cognition Lab and the FAA Flight Deck Human Factors Lab examined task and workload management by single pilots. This poster describes pilot performance regarding programming a reroute while at cruise and meeting a waypoint crossing restriction on the initial descent.

  2. 76 FR 47296 - Transit Asset Management (TAM) Pilot Program Funds

    Science.gov (United States)

    2011-08-04

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Transit Asset Management (TAM) Pilot Program Funds AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Transit Asset Management Pilot... Transit Administration (FTA) announces the selection of projects funded with Research funds and...

  3. Urban growth management

    DEFF Research Database (Denmark)

    Jørgensen, Gertrud; Alexander Sick Nielsen, Thomas; Grünfelder, Julien

    2011-01-01

    urban growth and curb urban sprawl in a wider sense. Methodology The main methodology of the paper is a desk-research based review of policy options supplemented with field study and interviews in selected cased study regions. This paper consists of two parts. The first part is based on literature...... there are contradictions in the evidence presented in the literature, we believe that it may be safely said that urban growth management policies have an influence on urban growth under certain preconditions including: sufficient time for implementation and continuity of efforts; choice of appropriate policy measures......, and finally urban attractivity policies. Effective regional bodies are needed to deal with urban expansion and peri-urbanisation at a relevant scale; European rural and agricultural policies makes up the main ‘policy complex’ targeting the non-urban area including its land uses; while lastly leverage of urban...

  4. Selecting pilots with crew resource management skills.

    Science.gov (United States)

    Hedge, J W; Bruskiewicz, K T; Borman, W C; Hanson, M A; Logan, K K; Siem, F M

    2000-10-01

    For years, pilot selection has focused primarily on the identification of individuals with superior flying skills and abilities. More recently, the aviation community has become increasingly aware that successful completion of a flight or mission requires not only flying skills but the ability to work well in a crew situation. This project involved development and validation of a crew resource management (CRM) skills test for Air Force transport pilots. A significant relation was found between the CRM skills test and behavior-based ratings of aircraft commander CRM performance, and the implications of these findings for CRM-based selection and training are discussed.

  5. TASKILLAN II - Pilot strategies for workload management

    Science.gov (United States)

    Segal, Leon D.; Wickens, Christopher D.

    1990-01-01

    This study focused on the strategies used by pilots in managing their workload level, and their subsequent task performance. Sixteen licensed pilots flew 42 missions on a helicopter simulation, and were evaluated on their performance of the overall mission, as well as individual tasks. Pilots were divided in four groups, defined by the presence or absence of scheduling control over tasks and the availability of intelligence concerning the type and stage of difficulties imposed during the flight. Results suggest that intelligence supported strategies that yielded significant higher performance levels, while scheduling control seemed to have no impact on performance. Both difficulty type and the stage of difficulty impacted performance significantly, with strongest effects for time stresss and difficulties imposed late in the flight.

  6. Intermittent Renewable Management Pilot Phase 2

    Energy Technology Data Exchange (ETDEWEB)

    Kiliccote, Sila [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Homan, Gregory [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Anderson, Robert [Olivine, Inc., San Ramon, CA (United States); Hernandez, John [Pacific Gas & Electric Company, San Francisco, CA (United States)

    2015-04-01

    The Intermittent Renewable Management Pilot - Phase 2 (IRM2) was designed to study the feasibility of demand-side resources to participate into the California Independent System Operator (CAISO) wholesale market as proxy demand resources (PDR). The pilot study focused on understanding the issues related with direct participation of third-parties and customers including customer acceptance; market transformation challenges (wholesale market, technology); technical and operational feasibility; and value to the rate payers, DR resource owners and the utility on providing an enabling mechanism for DR resources into the wholesale markets. The customer had the option of committing to either three contiguous hour blocks for 24 days or six contiguous hours for 12 days a month with day-ahead notification that aligned with the CAISO integrated forward market. As a result of their being available, the customer was paid $10/ kilowatt (kW)-month for capacity in addition to CAISO energy settlements. The participants were limited to no more than a 2 megawatt (MW) capacity with a six-month commitment. Four participants successfully engaged in the pilot. In this report, we provide the description of the pilot, participant performance results, costs and value to participants as well as outline some of the issues encountered through the pilot. Results show that participants chose to participate with storage and the value of CAISO settlements were significantly lower than the capacity payments provided by the utility as incentive payments. In addition, this pilot revealed issues both on the participant side and system operations side. These issues are summarized in the report.The Intermittent Renewable Management Pilot - Phase 2 (IRM2) was designed to study the feasibility of demand-side resources to participate into the California Independent System Operator (CAISO) wholesale market as proxy demand resources (PDR). The pilot study focused on understanding the issues related with

  7. Waste Isolation Pilot Plant, Land Management Plan

    Energy Technology Data Exchange (ETDEWEB)

    1993-12-01

    To reflect the requirement of section 4 of the Wastes Isolation Pilot Plant Land Withdrawal Act (the Act) (Public Law 102-579), this land management plan has been written for the withdrawal area consistent with the Federal Land Policy and Management Act of 1976. The objective of this document, per the Act, is to describe the plan for the use of the withdrawn land until the end of the decommissioning phase. The plan identifies resource values within the withdrawal area and promotes the concept of multiple-use management. The plan also provides opportunity for participation in the land use planning process by the public and local, State, and Federal agencies. Chapter 1, Introduction, provides the reader with the purpose of this land management plan as well as an overview of the Waste Isolation Pilot Plant. Chapter 2, Affected Environment, is a brief description of the existing resources within the withdrawal area. Chapter 3, Management Objectives and Planned Actions, describes the land management objectives and actions taken to accomplish these objectives.

  8. Waste Isolation Pilot Plant, Land Management Plan

    International Nuclear Information System (INIS)

    1993-01-01

    To reflect the requirement of section 4 of the Wastes Isolation Pilot Plant Land Withdrawal Act (the Act) (Public Law 102-579), this land management plan has been written for the withdrawal area consistent with the Federal Land Policy and Management Act of 1976. The objective of this document, per the Act, is to describe the plan for the use of the withdrawn land until the end of the decommissioning phase. The plan identifies resource values within the withdrawal area and promotes the concept of multiple-use management. The plan also provides opportunity for participation in the land use planning process by the public and local, State, and Federal agencies. Chapter 1, Introduction, provides the reader with the purpose of this land management plan as well as an overview of the Waste Isolation Pilot Plant. Chapter 2, Affected Environment, is a brief description of the existing resources within the withdrawal area. Chapter 3, Management Objectives and Planned Actions, describes the land management objectives and actions taken to accomplish these objectives

  9. THRMS: A pilot risk management system

    International Nuclear Information System (INIS)

    Xue, D.; Xu, Y.

    2000-01-01

    Daya Bay NPP is the first commercial nuclear power plant in China. This plant is interested in and pro-active towards the development and application of PSA and PSA tools. This, together with the support from the IAEA promoted the project 'THRMS: the pilot study of risk management system for NPP'. The objectives in development and implementation of THRMS includes: survey and discuss on the development of the approaches used in constructing plant risk models; design and study on the realization of a real-time risk management system. An overview of the project is presented in this paper. (author)

  10. NYC CV Pilot Deployment : Safety Management Plan : New York City.

    Science.gov (United States)

    2016-04-22

    This safety management plan identifies preliminary safety hazards associated with the New York City Connected Vehicle Pilot Deployment project. Each of the hazards is rated, and a plan for managing the risks through detailed design and deployment is ...

  11. Phipps Bend technical coordination and growth management pilot program: final report for fiscal year 1979. Report for 30 Sep 78-29 Sep 79

    International Nuclear Information System (INIS)

    Hernandez, R.Y.; Patillo, L.

    1979-01-01

    Specifically, the report explains the purpose and role of the Phipps Bend Energy Growth Coordination Committee's socio-economic impact mitigation program, subsequent to Tennessee Valley Authority's development of a nuclear energy power plant in Hawkins County, Tennessee. The committee has selected seven areas for mitigation purposes. Law enforcement; solid waste; Greene County; recreation; emergency services; industrial development; and medical services. This report provides follow up information on each of the delineated areas with recommendations for improvement

  12. Pilot Projects in Water Management : Practicing Change and Changing Practice

    NARCIS (Netherlands)

    Vreugdenhil, H.S.I.

    2010-01-01

    Pilot projects are widely applied in water management. They can be used to test risky innovations at confined scale, but can also be used to delay policy decisions or to advocate a particular innovation. In this book the phenomenon ‘pilot project’ is explored both theoretically and empirically. A

  13. Connected Vehicle Pilot Deployment Program Phase 2, Data Management Plan

    Science.gov (United States)

    2017-10-17

    This document represents a data management plan that delineates all of the data types and data treatment throughout the New York City Connected Vehicle Pilot Deployment (NYC CVPD). This plan includes an identification of the New York City connected v...

  14. Single-pilot workload management in entry-level jets.

    Science.gov (United States)

    2013-09-01

    Researchers from the NASA Ames Flight Cognition Lab and the FAAs Flight Deck Human Factors Research Laboratory at the Civil Aerospace Medical Institute (CAMI) examined task and workload management by single pilots in Very Light Jets (VLJs), also c...

  15. Single Pilot Workload Management During Cruise in Entry Level Jets

    Science.gov (United States)

    Burian, Barbara K.; Pruchnicki, Shawn; Christopher, Bonny; Silverman, Evan; Hackworth, Carla; Rogers, Jason; Williams, Kevin; Drechsler, Gena; Runnels, Barry; Mead, Andy

    2013-01-01

    Advanced technologies and automation are important facilitators of single pilot operations, but they also contribute to the workload management challenges faced by the pilot. We examined task completion, workload management, and automation use in an entry level jet (ELJ) flown by single pilots. Thirteen certificated Cessna Citation Mustang (C510-S) pilots flew an instrument flight rules (IFR) experimental flight in a Cessna Citation Mustang simulator. At one point participants had to descend to meet a crossing restriction prior to a waypoint and prepare for an instrument approach into an un-towered field while facilitating communication from a lost pilot who was flying too low for ATC to hear. Four participants experienced some sort of difficulty with regard to meeting the crossing restriction and almost half (n=6) had problems associated with the instrument approach. Additional errors were also observed including eight participants landing at the airport with an incorrect altimeter setting.

  16. Video - Personal Competence Manager (Digital Cinema pilot)

    NARCIS (Netherlands)

    Santos, Patricia

    2008-01-01

    Video demonstrating the PCM (version year 2007) in the context of the Digital Cinema pilot. Elaborated for a eLearning Seminar within the International Master on Communication and Education (Autonomous University of Barcelona, academic year 2008)

  17. An evaluation of the management system verification pilot at Hanford

    International Nuclear Information System (INIS)

    Briggs, C.R.; Ramonas, L.; Westendorf, W.

    1998-01-01

    The Chemical Management System (CMS), currently under development at Hanford, was used as the ''test program'' for pilot testing the value added aspects of the Chemical Manufacturers Association's (CMA) Management Systems Verification (MSV) process. The MSV process, which was developed by CMA's member chemical companies specifically as a tool to assist in the continuous improvement of environment, safety and health (ESH) performance, represents a commercial sector ''best practice'' for evaluating ESH management systems. The primary purpose of Hanford's MSV Pilot was to evaluate the applicability and utility of the MSV process in the Department of Energy (DOE) environment. However, because the Integrated Safety Management System (ISMS) is the framework for ESH management at Hanford and at all DOE sites, the pilot specifically considered the MSV process in the context of a possible future adjunct to Integrated Safety Management System Verification (ISMSV) efforts at Hanford and elsewhere within the DOE complex. The pilot involved the conduct of two-hour interviews with four separate panels of individuals with functional responsibilities related to the CMS including the Department of Energy Richland Operations (DOE-RL), Fluor Daniel Hanford (FDH) and FDH's major subcontractors (MSCS). A semi-structured interview process was employed by the team of three ''verifiers'' who directed open-ended questions to the panels regarding the development, integration and effectiveness of management systems necessary to ensure the sustainability of the CMS effort. An ''MSV Pilot Effectiveness Survey'' also was completed by each panel participant immediately following the interview

  18. DIRAC pilot framework and the DIRAC Workload Management System

    International Nuclear Information System (INIS)

    Casajus, Adrian; Graciani, Ricardo; Paterson, Stuart; Tsaregorodtsev, Andrei

    2010-01-01

    DIRAC, the LHCb community Grid solution, has pioneered the use of pilot jobs in the Grid. Pilot Jobs provide a homogeneous interface to an heterogeneous set of computing resources. At the same time, Pilot Jobs allow to delay the scheduling decision to the last moment, thus taking into account the precise running conditions at the resource and last moment requests to the system. The DIRAC Workload Management System provides one single scheduling mechanism for jobs with very different profiles. To achieve an overall optimisation, it organizes pending jobs in task queues, both for individual users and production activities. Task queues are created with jobs having similar requirements. Following the VO policy a priority is assigned to each task queue. Pilot submission and subsequent job matching are based on these priorities following a statistical approach.

  19. Assessing the Flipped Classroom in Operations Management: A Pilot Study

    Science.gov (United States)

    Prashar, Anupama

    2015-01-01

    The author delved into the results of a flipped classroom pilot conducted for an operations management course module. It assessed students' perception of a flipped learning environment after making them experience it in real time. The classroom environment was construed using a case research approach and students' perceptions were studied using…

  20. A queueing model of pilot decision making in a multi-task flight management situation

    Science.gov (United States)

    Walden, R. S.; Rouse, W. B.

    1977-01-01

    Allocation of decision making responsibility between pilot and computer is considered and a flight management task, designed for the study of pilot-computer interaction, is discussed. A queueing theory model of pilot decision making in this multi-task, control and monitoring situation is presented. An experimental investigation of pilot decision making and the resulting model parameters are discussed.

  1. Conservative Management of Mechanical Neck Pain in a Helicopter Pilot.

    Science.gov (United States)

    Alagha, Babak

    2015-10-01

    Acute and chronic spinal symptoms such as neck pain may limit flying performance significantly and disqualify the pilot from flight duty. Mechanical neck pain is very common among pilots because of their exposure to vibration, +GZ forces, helmet weight, poor neck posture during air combat maneuvers, previous neck injuries, and poor treatment plans for such injuries. Successful treatment of such injuries requires appropriate therapeutic procedures as well as an aeromedical assessment. The aim of this case study was to demonstrate the benefits of conservative procedures such as spinal manipulation and mobilization therapy (SMMT) and exercise therapy (ET) in treating chronic mechanical neck pain in an Iranian commercial helicopter pilot. A 36-yr-old male patient presented to the clinic with moderate, intermittent nonradicular chronic neck pain and limited range of motion over a 2-yr period. The patient was treated with cervical and upper thoracic SMMT followed by home ET for 5 wk. After this period, the patient reported significant recovery and improvement in range of motion in his neck. Mechanical neck pain is very common among helicopter pilots. Although Air Force and Navy waiver guides recommend nonsteroidal anti-inflammatory medications as well as SMMT and ET, there are currently very few published studies that examine the benefits of manual and exercise therapy for treating mechanical neck pain in commercial and military pilots. Based on the results of this study, it seems that SMMT and ET may be a safe and effective in treatment of uncomplicated mechanical neck pain in helicopter pilots. Alagha B. Conservative management of mechanical neck pain in a helicopter pilot.

  2. Connected vehicle pilot deployment program phase 1, safety management plan - Tampa (THEA).

    Science.gov (United States)

    2016-04-01

    This document presents the Safety Management Plan for the THEA Connected Vehicle (CV) Pilot Deployment. The THEA CV Pilot : Deployment goal is to advance and enable safe, interoperable, networked wireless communications among vehicles, the : infrastr...

  3. Participatory forest management in Ethiopia: learning from pilot projects.

    Science.gov (United States)

    Ameha, Aklilu; Larsen, H O; Lemenih, Mulugeta

    2014-04-01

    Different arrangements of decentralized forest management have been promoted as alternatives to centralized and top down approaches to halt tropical deforestation and forest degradation. Ethiopia is one of the countries piloting one of these approaches. To inform future programs and projects it is essential to learn from existing pilots and experiences. This paper analyses five of the pilot participatory forest management (PFM) programs undertaken in Ethiopia. The study is based on the Forest User Group (FUG) members' analyses of the programs using selected outcome variables: forest income, change in forest conditions, forest ownership feelings and effectiveness of FUGs as forest managing institutions. These variables were assessed at three points in time-before the introduction of PFM, during the project implementation and after the projects ended. Data were collected using group discussions, key informant interviews and transect walks through the PFM forests. The results show that in all of the five cases the state of the forest is perceived to have improved with the introduction of PFM, and in four of the cases the improvement was maintained after projects ended. Regulated access to the forests following introduction of PFM was not perceived to have affected forest income negatively. There are, however, serious concerns about the institutional effectiveness of the FUGs after projects ended, and this may affect the success of the PFM approach in the longer term.

  4. Waste Isolation Pilot Plant land management plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-05-01

    On October 30, 1992, the WIPP Land Withdrawal Act became law. This Act transferred the responsibility for the management of the WIPP Land Withdrawal Area (WILWA) from the Secretary of the Interior to the Secretary of Energy. In accordance with sections 3(a)(1) and (3) of the Act, these lands {open_quotes}{hor_ellipsis}are withdrawn from all forms of entry, appropriation, and disposal under the public land laws{hor_ellipsis}{close_quotes}and are reserved for the use of the Secretary of Energy {open_quotes}{hor_ellipsis}for the construction, experimentation, operation, repair and maintenance, disposal, shutdown, monitoring, decommissioning, and other activities, associated with the purposes of WIPP as set forth in the Department of Energy National Security and Military Applications of Nuclear Energy Act of 1980 and this Act.{close_quotes}. As a complement to this LMP, a MOU has been executed between the DOE and the BLM, as required by section 4(d) of the Act. The state of New Mexico was consulted in the development of the MOU and the associated Statement of Work (SOW).

  5. Waste Isolation Pilot Plant land management plan

    International Nuclear Information System (INIS)

    1996-01-01

    On October 30, 1992, the WIPP Land Withdrawal Act became law. This Act transferred the responsibility for the management of the WIPP Land Withdrawal Area (WILWA) from the Secretary of the Interior to the Secretary of Energy. In accordance with sections 3(a)(1) and (3) of the Act, these lands open-quotes hor-ellipsis are withdrawn from all forms of entry, appropriation, and disposal under the public land laws hor-ellipsis close quotesand are reserved for the use of the Secretary of Energy open-quotes hor-ellipsis for the construction, experimentation, operation, repair and maintenance, disposal, shutdown, monitoring, decommissioning, and other activities, associated with the purposes of WIPP as set forth in the Department of Energy National Security and Military Applications of Nuclear Energy Act of 1980 and this Act.close quotes. As a complement to this LMP, a MOU has been executed between the DOE and the BLM, as required by section 4(d) of the Act. The state of New Mexico was consulted in the development of the MOU and the associated Statement of Work (SOW)

  6. Pilot Testing of the NURSE Stress Management Intervention.

    Science.gov (United States)

    Delaney, Colleen; Barrere, Cynthia; Robertson, Sue; Zahourek, Rothlyn; Diaz, Desiree; Lachapelle, Leeanne

    2016-12-01

    Student nurses experience significant stress during their education, which may contribute to illness and alterations in health, poor academic performance, and program attrition. The aim of this pilot study was to evaluate the feasibility and potential efficacy of an innovative stress management program in two baccalaureate nursing programs in Connecticut, named NURSE (Nurture nurse, Use resources, foster Resilience, Stress and Environment management), that assists nursing students to develop stress management plans. An explanatory sequential mixed-methods design was used to evaluate the effects of the intervention with 40 junior nursing students. Results from this study provide evidence that the NURSE intervention is highly feasible, and support further testing to examine the effect of the intervention in improving stress management in nursing students. © The Author(s) 2015.

  7. Enterprise Digital Asset Management System Pilot: Lessons Learned

    Directory of Open Access Journals (Sweden)

    Yong-Mi Kim

    2007-12-01

    Full Text Available Enterprise digital asset management (DAM systems are beginning to be explored in higher education, but little information about their implementation issues is available. This article describes the University of Michigan’s investigation of managing and retrieving rich media assets in an enterprise DAM system. It includes the background of the pilot project and descriptions of its infrastructure and metadata schema. Two case studies are summarized—one in healthcare education, and one in teacher education and research. Experiences with five significant issues are summarized: privacy, intellectual ownership, digital rights management, uncataloged materials backlog, and user interface and integration with other systems.

  8. Focus on managing population growth.

    Science.gov (United States)

    Brown, S

    1995-01-01

    For the past 4 decades, the world's population growth has threatened to outstrip the planet's ability to sustain it. According to recent projections, an end to the growth of world population is finally in sight. Dr. Joseph van Arendonk, deputy executive director of the United Nations Population Fund, told an international press conference that population growth is likely to begin falling before the mid-21st century. Currently, some 87 million couples worldwide wish to use contraception but have no access to services. Van Arendonk argued that 4% of overseas aid set aside for population programs would satisfy this unmet need. He also predicted that the average family size in developing countries would stabilize at 2.1 children within the next 55 years if these needs were met. This would still mean a global population of 10 billion in the year 2050, rising to a plateau of 11.6 billion within the following century. In developing countries fertility rates fell from 6.1 to 3.3 children per woman between the mid-1960s and the mid-1980s, while use of contraception increased from 10% to 50%. However, contraceptive users in the developing world must increase from 446 million in 1994 to 603 million in 2005 to keep population growth within such projected limits. The costs of providing the contraception will increase from US $528 million to US $752 million. The contraceptive needs of 603 million users in 2005 will require: 196 million sterilizations, 436 million IUD insertions, 898 million injectables, 12.3 billion cycles of OCs, and 55 billion condoms. To this end, IPPF plans greater accessibility of services, a wider range of effective methods, and the involvement of the male partner.

  9. A remotely piloted aircraft system in major incident management: concept and pilot, feasibility study.

    Science.gov (United States)

    Abrahamsen, Håkon B

    2015-06-10

    Major incidents are complex, dynamic and bewildering task environments characterised by simultaneous, rapidly changing events, uncertainty and ill-structured problems. Efficient management, communication, decision-making and allocation of scarce medical resources at the chaotic scene of a major incident is challenging and often relies on sparse information and data. Communication and information sharing is primarily voice-to-voice through phone or radio on specified radio frequencies. Visual cues are abundant and difficult to communicate between teams and team members that are not co-located. The aim was to assess the concept and feasibility of using a remotely piloted aircraft (RPA) system to support remote sensing in simulated major incident exercises. We carried out an experimental, pilot feasibility study. A custom-made, remotely controlled, multirotor unmanned aerial vehicle with vertical take-off and landing was equipped with digital colour- and thermal imaging cameras, a laser beam, a mechanical gripper arm and an avalanche transceiver. We collected data in five simulated exercises: 1) mass casualty traffic accident, 2) mountain rescue, 3) avalanche with buried victims, 4) fisherman through thin ice and 5) search for casualties in the dark. The unmanned aerial vehicle was remotely controlled, with high precision, in close proximity to air space obstacles at very low levels without compromising work on the ground. Payload capacity and tolerance to wind and turbulence were limited. Aerial video, shot from different altitudes, and remote aerial avalanche beacon search were streamed wirelessly in real time to a monitor at a ground base. Electromagnetic interference disturbed signal reception in the ground monitor. A small remotely piloted aircraft can be used as an effective tool carrier, although limited by its payload capacity, wind speed and flight endurance. Remote sensing using already existing remotely piloted aircraft technology in pre

  10. Improving collaborative care in managing eating disorders: a pilot study.

    Science.gov (United States)

    Heath, Olga; English, Denise; Simms, Joanne; Ward, Pamela; Hollett, Ann; Dominic, Anna

    2013-01-01

    The purpose of this pilot study was to evaluate the impact of a continuing interprofessional educational workshop focused on eating disorders in a rural area in Newfoundland and Labrador (NL), Canada. The pilot study helped determine if the eating disorder workshop was feasible for implementation to a broader audience. A conceptual model developed by our eating disorder team and described in the article guided this innovative program. The intensive 2-day workshop was piloted in one community with 41 health and education professionals in attendance. A key element was the focus on creating and sustaining collaborative care for eating disorders. Participants completed pre-post workshop measures of interprofessional attitudes and skills, self-reported knowledge, confidence, and intention to change practice (post questionnaire only). A 6-month follow-up survey measured self-reported practice change. There were significant positive changes in interprofessional attitudes and skills as well as knowledge and confidence in collaborative management of eating disorders. Post-workshop, 69% (n = 24/35) of participants indicated intention to change practice, and on follow-up, 7 of 10 respondents reported implementing changes in practice as a result of the workshop. Low response rate at follow-up was a limitation. Results support the impact of the workshop in improving knowledge, confidence, and attitudes toward collaboration and changing practice and the value of implementing the program province-wide. Copyright © 2013 The Alliance for Continuing Education in the Health Professions, the Society for Academic Continuing Medical Education, and the Council on CME, Association for Hospital Medical Education.

  11. Waste Isolation Pilot Plant Groundwater Protection Management Program Plan

    International Nuclear Information System (INIS)

    Washington TRU Solutions

    2002-01-01

    U.S. Department of Energy (DOE) Order 5400.1, General Environmental Protection Program, requires each DOE site to prepare a Groundwater Protection Management Program Plan. This document fulfills the requirement for the Waste Isolation Pilot Plant (WIPP). This document was prepared by the Hydrology Section of the Westinghouse TRU Solutions LLC (WTS) Environmental Compliance Department, and it is the responsibility of this group to review the plan annually and update it every three years. This document is not, nor is it intended to be, an implementing document that sets forth specific details on carrying out field projects or operational policy. Rather, it is intended to give the reader insight to the groundwater protection philosophy at WIPP

  12. Waste Isolation Pilot Plant Groundwater Protection Management Program Plan

    Energy Technology Data Exchange (ETDEWEB)

    Washington TRU Solutions

    2002-09-24

    U.S. Department of Energy (DOE) Order 5400.1, General Environmental Protection Program, requires each DOE site to prepare a Groundwater Protection Management Program Plan. This document fulfills the requirement for the Waste Isolation Pilot Plant (WIPP). This document was prepared by the Hydrology Section of the Westinghouse TRU Solutions LLC (WTS) Environmental Compliance Department, and it is the responsibility of this group to review the plan annually and update it every three years. This document is not, nor is it intended to be, an implementing document that sets forth specific details on carrying out field projects or operational policy. Rather, it is intended to give the reader insight to the groundwater protection philosophy at WIPP.

  13. The Waste Isolation Pilot Plant (WIPP) integrated project management system

    International Nuclear Information System (INIS)

    Olona, D.; Sala, D.

    1993-01-01

    The Waste Isolation Pilot Plant (WIPP), located 26 miles east of Carlsbad, New Mexico, is a research and development project of the Department of Energy (DOE), tasked with the mission of demonstrating the safe disposal of transuranic (TRU) radioactive wastes. This unique project was authorized by Congress in 1979 in response to the national need for long-term, safe methods for disposing of radioactive by-products from our national defense programs. The WIPP was originally established in December of 1979, by Public Law 96-164, DOE National Security and Military Applications of Nuclear Energy Authorization Act of 1980. Since the inception of the WIPP Project, work has continued to prepare the facility to receive TRU wastes. Studies continue to be conducted to demonstrate the safety of the WIPP facility in accordance with federal and state laws, state agreements, environmental regulations, and DOE Orders. The objectives of implementing an integrated project management system are to assure compliance with all regulatory and federal regulations, identify areas of concern, provide justification for funding, provide a management tool for control of program workscope, and establish a project baseline from which accountability and performance will be assessed. Program management and project controls are essential for the success of the WIPP Project. The WIPP has developed an integrated project management system to establish the process for the control of the program which has an expected total dollar value of $2B over the ten-year period from 1990-2000. The implementation of this project management system was motivated by the regulatory requirements of the project, the highly public environment in which the project takes place, limited funding and resources, and the dynamic nature of the project. Specific areas to be addressed in this paper include strategic planning, project organization, planning and scheduling, fiscal planning, and project monitoring and reporting

  14. Design of a flight director/configuration management system for piloted STOL approaches

    Science.gov (United States)

    Hoh, R. H.; Klein, R. H.; Johnson, W. A.

    1973-01-01

    The design and characteristics of a flight director for V/STOL aircraft are discussed. A configuration management system for piloted STOL approaches is described. The individual components of the overall system designed to reduce pilot workload to an acceptable level during curved, decelerating, and descending STOL approaches are defined. The application of the system to augmentor wing aircraft is analyzed. System performance checks and piloted evaluations were conducted on a flight simulator and the results are summarized.

  15. Acquired brain injury self-management programme: a pilot study.

    Science.gov (United States)

    Kendrick, Denise; Silverberg, Noah D; Barlow, Susan; Miller, William C; Moffat, Jacqui

    2012-01-01

    Traditional rehabilitation is not well suited to individuals with chronic mild symptoms following an acquired brain injury. To address this, this study adapted a supported self-management programme (SMP) for this population. The aim of this study was to evaluate the potential effectiveness of this novel SMP. Retrospective case series with repeated measures. Fifty-three participants with chronic mild symptoms following an acquired brain injury (primarily mild traumatic brain injury) completed an SMP. The intervention involved eight coaching sessions with each an occupational therapist and psychologist, carried out in the community and based on SMP principles. The Canadian Occupational Performance Measure was administered at baseline, discharge and 3- and 9-month follow-up. This measure yielded scores for performance and satisfaction with daily functioning, covering the domains of self-care, productivity and leisure. A complete case analysis of programme completers revealed that participants' ratings of their occupational performance and satisfaction improved markedly between baseline and discharge from the SMP. This set of outcome measures remained stable between discharge and the two follow-up points. This pilot study suggests that SMPs may improve daily functioning in individuals with chronic mild ABI symptoms. More methodologically robust clinical trials are warranted.

  16. 75 FR 75725 - Financial Management Service; Proposed Collection of Information: Tax Time Card Account Pilot...

    Science.gov (United States)

    2010-12-06

    ... DEPARTMENT OF THE TREASURY Fiscal Service Financial Management Service; Proposed Collection of Information: Tax Time Card Account Pilot, Screening, Focus Groups, and Study AGENCY: Financial Management... collection. By this notice, the Financial Management Service solicits comments concerning the ``Tax Time Card...

  17. Form planning Control to growth management

    DEFF Research Database (Denmark)

    Enemark, Stig

    2016-01-01

    -right government decided to transfer national planning functions from the Ministry of the Environment (Miljøministeriet) to the Danish Business Authority (Erhvervsstyrelsen). This was done in the midst of an on-going political debate over ‘simplifying’ the Planning Act to facilitate more economic growth....... In this light, Danish spatial planning continues to align with prevailing neo-liberal minded government agendas and thereby ends up reflecting the ideologies and interests of the government in place. In contrast with the social welfarist objectives of the 1970s, these governmental preferences have indirectly...... caused that spatial planning be regarded more as a cost than an asset. Accordingly, it is evident that the Danish planning domain has progressively lost political clout and the focus is changed towards facilitation and management of economic growth....

  18. The big tent of growth management: smart growth as a movement

    Science.gov (United States)

    Edward G. Goetz

    2005-01-01

    Growth management policies in the U.S. have failed to gain significant political support in many regions, limiting efforts to manage development patterns and protect natural resources. The Smart Growth movement has brought new voices into the debate over growth management and has provided a "big tent" under which transportation groups, environmentalists,...

  19. Pilot oriental fruit fly management program in Guimaras island

    International Nuclear Information System (INIS)

    Manoto, E.C.; Obra, G.B.; Resilva, S.S.; Reyes, M.R.; Golez, H.G.; Covacha, S.A.; Bignayan, H.G.; Gaitan, E.G.; Zamora, N.F.; Maranon, R.P.

    1999-01-01

    The pilot project on the integrated fruit fly management program based on sterile insect technique (SIT) was conducted in Guimaras island. The first island-wide male annihilation treatment (MAT) was implemented from February to October 1997. A total of 6 applications consisting of 525,534 pieces of lured particle board squares (PBS) were distributed in Guimaras both by aerial and ground applications. There was a significant reduction in fruit fly population indicating fruit fly suppression through MAT. However, MAT only reduces the male fruit fly density so many fruits were still found infested with fruit flies. Hence, biweekly releases of sterile flies were conducted from November 1997 to April 1998. About 91.74 million sterile pupae were sent by the Philippine Nuclear Research Institute (PNRI) to Guimaras. A total of 34,490,888 sterile flies were released by aerial applications and 12,632,163 sterile flies were released by ground applications. An increase in the S/N ratio was observed from 0.37 in December 1997 to 4.19 in April 1998. However, since the eradication phase was discontinued due to budgetary constraints, the required S/N ratio of more than 10 for a successful application of SIT was not achieved. A second series of MAT application were again conducted from May to September 1998. A total of 4 applications consisting of 357,650 pcs. of lured PBS were distributed throughout the island. Interestingly, the results of fruit fly density estimation before (1995) and after application (1998) of MAT and SIT using Lincoln method showed that the number of fruit flies per hectare was significantly reduced in all areas in Guimaras. Continues biweekly releases of 25 million flies therefore have to be undertaken to eradicate the remaining population. (Author)

  20. Waste Isolation Pilot Plant Groundwater Protection Management Program Plan

    International Nuclear Information System (INIS)

    2005-01-01

    The DOE established the Groundwater Monitoring Program (GMP) (WP 02-1) to monitor groundwater resources at WIPP. In the past, the GMP was conducted to establish background data of existing conditions of groundwater quality and quantity in the WIPP vicinity, and to develop and maintain a water quality database as required by regulation. Today the GMP is conducted consistent with 204.1.500 NMAC (New Mexico Administrative Code), 'Adoption of 40 CFR [Code of Federal Regulations] Part 264,'specifically 40 CFR 264.90 through 264.101. These sections of 20.4.1 NMAC provide guidance for detection monitoring of groundwater that is, or could be, affected by waste management activities at WIPP. Detection monitoring at WIPP is designed to detect contaminants in the groundwater long before the general population is exposed. Early detection will allow cleanup efforts to be accomplished before any exposure to the general population can occur. Title 40 CFR Part 264, Subpart F, stipulates minimum requirements of Resource Conservation and Recovery Act of 1976 (42 United States Code [U.S.C.] 6901 et seq.) (RCRA) groundwater monitoring programs including the number and location of monitoring wells; sampling and reporting schedules; analytical methods and accuracy requirements; monitoring parameters; and statistical treatment of monitoring data. This document outlines how WIPP intends to protect and preserve groundwater within the WIPP Land Withdrawal Area (WLWA). Groundwater protection is just one aspect of the WIPP environmental protection effort. An overview of the entire environmental protection effort can be found in DOE/WIPP 99-2194, Waste Isolation Pilot Plant Environmental Monitoring Plan. The WIPP GMP is designed to statistically determine if any changes are occurring in groundwater characteristics within and surrounding the WIPP facility. If a change is noted, the cause will then be determined and the appropriate corrective action(s) initiated.

  1. Waste Isolation Pilot Plant Groundwater Protection Management Program Plan

    Energy Technology Data Exchange (ETDEWEB)

    Washington Regulatory and Environmental Services

    2005-07-01

    The DOE established the Groundwater Monitoring Program (GMP) (WP 02-1) to monitor groundwater resources at WIPP. In the past, the GMP was conducted to establish background data of existing conditions of groundwater quality and quantity in the WIPP vicinity, and to develop and maintain a water quality database as required by regulation. Today the GMP is conducted consistent with 204.1.500 NMAC (New MexicoAdministrative Code), "Adoption of 40 CFR [Code of Federal Regulations] Part 264,"specifically 40 CFR §264.90 through §264.101. These sections of 20.4.1 NMAC provide guidance for detection monitoring of groundwater that is, or could be, affected by waste management activities at WIPP. Detection monitoring at WIPP is designed to detect contaminants in the groundwater long before the general population is exposed. Early detection will allow cleanup efforts to be accomplished before any exposure to the general population can occur. Title 40 CFR Part 264, Subpart F, stipulates minimum requirements of Resource Conservation and Recovery Act of 1976 (42 United States Code [U.S.C.] §6901 et seq.) (RCRA) groundwater monitoring programs including the number and location of monitoring wells; sampling and reporting schedules; analytical methods and accuracy requirements; monitoring parameters; and statistical treatment of monitoring data. This document outlines how WIPP intends to protect and preserve groundwater within the WIPP Land Withdrawal Area (WLWA). Groundwater protection is just one aspect of the WIPP environmental protection effort. An overview of the entire environmental protection effort can be found in DOE/WIPP 99-2194, Waste Isolation Pilot Plant Environmental Monitoring Plan. The WIPP GMP is designed to statistically determine if any changes are occurring in groundwater characteristics within and surrounding the WIPP facility. If a change is noted, the cause will then be determined and the appropriate corrective action(s) initiated.

  2. Urban growth management and ecological sustainability: confronting the "smart growth" fallacy

    Science.gov (United States)

    Gabor Zovanyi

    2005-01-01

    Growth management and Smart Growth initiatives in the United States represent an ongoing process of growth accommodation. Because growth by definition constitutes unsustainable behavior in that it is incapable of being continued or maintained indefinitely, ongoing growth accommodation must be recognized as activity incongruous with advancing the goal of ecological...

  3. Managing systems faults on the commercial flight deck: Analysis of pilots' organization and prioritization of fault management information

    Science.gov (United States)

    Rogers, William H.

    1993-01-01

    In rare instances, flight crews of commercial aircraft must manage complex systems faults in addition to all their normal flight tasks. Pilot errors in fault management have been attributed, at least in part, to an incomplete or inaccurate awareness of the fault situation. The current study is part of a program aimed at assuring that the types of information potentially available from an intelligent fault management aiding concept developed at NASA Langley called 'Faultfinde' (see Abbott, Schutte, Palmer, and Ricks, 1987) are an asset rather than a liability: additional information should improve pilot performance and aircraft safety, but it should not confuse, distract, overload, mislead, or generally exacerbate already difficult circumstances.

  4. Case managers' experiences of personal growth: learning from consumers.

    Science.gov (United States)

    Stein, Catherine H; Craft, Scott A

    2007-04-01

    This study examines aspects of case managers' perceived personal growth in their work with consumers. Using a sample of 98 case managers, the psychometric properties of a brief self-report measure of personal growth of case managers were examined. The Case Manager Personal Growth Scale (CMPG) showed good reliability and construct validity as evidenced by negative correlations with scores on professional burnout and positive correlations with personal accomplishment and job satisfaction scores. CMPG scores were unrelated to social desirability scores or caseload size and positively related to age and tenure in the mental health system. Results suggest the strong relevance of the construct of personal growth for case managers.

  5. Enrollment of SME Managers to Growth-oriented Training Programs

    DEFF Research Database (Denmark)

    Bager, Torben; Jensen, Kent Wickstrøm; Schou Nielsen, Pia

    2015-01-01

    on the extent to which such programs result in additionality, i.e. improved growth performance compared to non-intervention. Design/methodology Selection and self-selection processes are explored through a study of a large-scale training program for growth oriented managers of small Danish firms. This program......Purpose: Entrepreneurial learning through formal growth-oriented training programs for SME managers promises to enhance the growth competences and growth intentions of the enrolled managers. The impact of such programs, however, depends on who enrolls since initial competence and growth...... has from 2012 to 2015 trained about 700 SME managers. Data are currently available for 366 of these participants. This evidence is compared with survey results from a randomly selected control group of 292 growth oriented SME managers in the same firm-size group. The data were analyzed through...

  6. Single-Pilot Workload Management in Entry-Level Jets

    Science.gov (United States)

    2013-09-01

    under Instrument Flight Rules ( IFR ) in a Cessna Citation Mustang ELJ level 5 flight training device at CAMI. Eight of the pilots were Mustang owner...8 Figure 7. Experimenter’s Station. The Simulator and Visual System can be Seen in the Background ...Instrument Landing System IFR ............Instrument Flight Rules IMC ...........Instrument Meteorological Conditions ISA

  7. Technical specification for the Quality Information Management System (QIMS) Pilot Project

    Energy Technology Data Exchange (ETDEWEB)

    Hall, R.C.; Claussen, L.M.; Thurston, I.

    1992-01-01

    This document contains implementation details for the Quality Information Management System (QIMS) Pilot Project, which has been released for VAX/VMS systems using the INGRES RDBMS. The INGRES Applications-By-Forms (ABF) software development tool was used to define the modules and screens which comprise the QIMS Pilot application. These specifications together with the QIMS information model and corresponding database definition constitute the QIMS technical specification and implementation description presented herein. The QIMS Pilot Project represents a completed software product which has been released for production use. Further extension projects are planned which will release new versions for QIMS. These versions will offer expanded and enhanced functionality to meet further customer requirements not accommodated by the QIMS Pilot Project.

  8. glideinWMS-a generic pilot-based workload management system

    International Nuclear Information System (INIS)

    Sfiligoi, I

    2008-01-01

    The Grid resources are distributed among hundreds of independent Grid sites, requiring a higher level Workload Management System (WMS) to be used efficiently. Pilot jobs have been used for this purpose by many communities, bringing increased reliability, global fair share and just in time resource matching. glideinWMS is a WMS based on the Condor glidein concept, i.e. a regular Condor pool, with the Condor daemons (startds) being started by pilot jobs, and real jobs being vanilla, standard or MPI universe jobs. The glideinWMS is composed of a set of Glidein Factories, handling the submission of pilot jobs to a set of Grid sites, and a set of VO Frontends, requesting pilot submission based on the status of user jobs. This paper contains the structural overview of glideinWMS as well as a detailed description of the current implementation and the current scalability limits

  9. Leadership and Management Education and Training (LMET) Effectiveness: A Pilot Study for Evaluation.

    Science.gov (United States)

    1981-06-01

    leadership / management theory complete with a specific vocabulary. This new vocabulary allows the graduate to be able to converse easier with...AD-AlG 9 NAVAL POSTGRADUATE SCHOOL MONTEREY CA F/S 5/1 LEADERSHIP AND MANAGEMENT EDUCATION AND TRAINING (LMET) EFFECTI-ECU UNLSIID JUN 81 D L...TITLE (A~d 8ItI. )o------~. .hss COVERED Leadership and Management Education and Training 198 (LMET) Effectiveness: A Pilot-Study for 6-- . *P.W..@*.On

  10. Generalist care managers for the treatment of depressed medicaid patients in North Carolina: A pilot study

    OpenAIRE

    Landis, Suzanne E; Gaynes, Bradley N; Morrissey, Joseph P; Vinson, Nina; Ellis, Alan R; Domino, Marisa E

    2007-01-01

    Abstract Background In most states, mental illness costs are an increasing share of Medicaid expenditures. Specialized depression care managers (CM) have consistently demonstrated improvements in patient outcomes relative to usual primary care (UC), but are costly and may not be fully utilized in smaller practices. A generalist care manager (GCM) could manage multiple chronic conditions and be more accepted and cost-effective than the specialist depression CM. We designed a pilot program to d...

  11. Physical growth, puberty and hormones in adolescents with Nodding Syndrome; a pilot study.

    Science.gov (United States)

    Piloya-Were, Theresa; Odongkara-Mpora, Beatrice; Namusoke, Hanifa; Idro, Richard

    2014-11-28

    Nodding syndrome is an epidemic symptomatic generalized epilepsy syndrome of unknown cause in Eastern Africa. Some patients have extreme short stature. We hypothesized that growth failure in nodding syndrome is associated with specific endocrine dysfunctions. In this pilot study, we examined the relationship between serum hormone levels and stature, bone age and sexual development. We recruited ten consecutive children, 13 years or older, with World Health Organization defined nodding syndrome and assessed physical growth, bone age, development of secondary sexual characteristics and serum hormone levels. Two children with incomplete results were excluded. Of the eight remaining, two had severe stunting (height for age Z [HAZ] scorebone age was delayed by a median 3(range 0-4) years. Serum growth hormone levels were normal in all eight but the two patients with severe stunting and one with moderate stunting had low levels of Somatomedin C (Insulin like Growth Factor [IGF1]) and/or IGF binding protein 3 (IGFBP3), mediators of growth hormone function. A linear relationship was observed between serum IGF1 level and HAZ score. With the exception of one child, all were either pre-pubertal or in early puberty (Tanner stages 1 and 2) and in the seven, levels of the gonadotrophins (luteinising and follicle stimulating hormone) and the sex hormones (testosterone/oestrogen) were all within pre-pubertal ranges or ranges of early puberty. Thyroid function, prolactin, adrenal, and parathyroid hormone levels were all normal. Patients with nodding syndrome may have dysfunctions in the pituitary growth hormone and pituitary gonadal axes that manifest as stunted growth, delayed bone age and puberty. Studies are required to determine if such endocrine dysfunction is a primary manifestation of the disease or a secondary consequence of chronic ill health and malnutrition and if so, whether targeted interventions can improve outcome.

  12. Implementing a Pharmacist-Led Medication Management Pilot to Improve Care Transitions

    Directory of Open Access Journals (Sweden)

    Rachel Root

    2012-01-01

    Full Text Available Purpose: The purpose of this project was to design and pilot a pharmacist-led process to address medication management across the continuum of care within a large integrated health-system. Summary: A care transitions pilot took place within a health-system which included a 150-bed community hospital. The pilot process expanded the pharmacist's medication management responsibilities to include providing discharge medication reconciliation, a patient-friendly discharge medication list, discharge medication education, and medication therapy management (MTM follow-up. Adult patients with a predicted diagnosis-related group (DRG of congestive heart failure or chronic obstructive pulmonary disease admitted to the medical-surgical and intensive care units who utilized a primary care provider within the health-system were included in the pilot. Forty patients met the inclusion criteria and thirty-four (85% received an intervention from an inpatient or MTM pharmacist. Within this group of patients, 88 drug therapy problems (2.6 per patient were identified and 75% of the drug therapy recommendations made by the pharmacist were accepted by the care provider. The 30-day all-cause readmission rates for the intervention and comparison groups were 30.5% and 35.9%, respectively. The number of patients receiving follow-up care varied with 10 (25% receiving MTM follow-up, 26 (65% completing a primary care visit after their first hospital discharge, and 23 (58% receiving a home care visit. Conclusion: Implementation of a pharmacist-led medication management pilot across the continuum of care resulted in an improvement in the quality of care transitions within the health-system through increased identification and resolution of drug therapy problems and MTM follow-up. The lessons learned from the implementation of this pilot will be used to further refine pharmacy care transitions programs across the health-system.   Type: Original Research

  13. Implementing a Pharmacist-Led Medication Management Pilot to Improve Care Transitions

    Directory of Open Access Journals (Sweden)

    Rachel Root, PharmD, MS

    2012-01-01

    Full Text Available Purpose: The purpose of this project was to design and pilot a pharmacist-led process to address medication management across the continuum of care within a large integrated health-system.Summary: A care transitions pilot took place within a health-system which included a 150-bed community hospital. The pilot process expanded the pharmacist’s medication management responsibilities to include providing discharge medication reconciliation, a patient-friendly discharge medication list, discharge medication education, and medication therapy management (MTM follow-up.Adult patients with a predicted diagnosis-related group (DRG of congestive heart failure or chronic obstructive pulmonary disease admitted to the medical-surgical and intensive care units who utilized a primary care provider within the health-system were included in the pilot. Forty patients met the inclusion criteria and thirty-four (85% received an intervention from an inpatient or MTM pharmacist. Within this group of patients, 88 drug therapy problems (2.6 per patient were identified and 75% of the drug therapy recommendations made by the pharmacist were accepted by the care provider. The 30-day all-cause readmission rates for the intervention and comparison groups were 30.5% and 35.9%, respectively. The number of patients receiving follow-up care varied with 10 (25% receiving MTM follow-up, 26 (65% completing a primary care visit after their first hospital discharge, and 23 (58% receiving a home care visit.Conclusion: Implementation of a pharmacist-led medication management pilot across the continuum of care resulted in an improvement in the quality of care transitions within the health-system through increased identification and resolution of drug therapy problems and MTM follow-up. The lessons learned from the implementation of this pilot will be used to further refine pharmacy care transitions programs across the health-system.

  14. Impact of Conflict Avoidance Responsibility Allocation on Pilot Workload in a Distributed Air Traffic Management System

    Science.gov (United States)

    Ligda, Sarah V.; Dao, Arik-Quang V.; Vu, Kim-Phuong; Strybel, Thomas Z.; Battiste, Vernol; Johnson, Walter W.

    2010-01-01

    Pilot workload was examined during simulated flights requiring flight deck-based merging and spacing while avoiding weather. Pilots used flight deck tools to avoid convective weather and space behind a lead aircraft during an arrival into Louisville International airport. Three conflict avoidance management concepts were studied: pilot, controller or automation primarily responsible. A modified Air Traffic Workload Input Technique (ATWIT) metric showed highest workload during the approach phase of flight and lowest during the en-route phase of flight (before deviating for weather). In general, the modified ATWIT was shown to be a valid and reliable workload measure, providing more detailed information than post-run subjective workload metrics. The trend across multiple workload metrics revealed lowest workload when pilots had both conflict alerting and responsibility of the three concepts, while all objective and subjective measures showed highest workload when pilots had no conflict alerting or responsibility. This suggests that pilot workload was not tied primarily to responsibility for resolving conflicts, but to gaining and/or maintaining situation awareness when conflict alerting is unavailable.

  15. FAA/NASA UAS Traffic Management Pilot Program (UPP)

    Science.gov (United States)

    Johnson, Ronald D.; Kopardekar, Parimal H.; Rios, Joseph L.

    2018-01-01

    NASA Ames is leading ATM R&D organization. NASA started working on UTM in 2012, it's come a long way primarily due to close relationship with FAA and industry. We have a research transition team between FAA and NASA for UTM. We have a few other RTTs as well. UTM is a great example of collaborative innovation, and now it's reaching very exciting stage of UTM Pilot Project (UPP). NASA is supporting FAA and industry to make the UPP most productive and successful.

  16. Setting-up nurse-led pilot clinics for the management of non ...

    African Journals Online (AJOL)

    Background: This article describes the setting-up process for nurse-led pilot clinics for the management of four chronic diseases: asthma, type 2 diabetes mellitus, epilepsy and hypertension at the primary health care level in urban and rural Cameroon. Methods: The Biyem-Assi urban and the Bafut rural health districts in ...

  17. Managing globally distributed expertise with new competence management solutions a big-science collaboration as a pilot case.

    CERN Document Server

    Ferguson, J; Livan, M; Nordberg, M; Salmia, T; Vuola, O

    2003-01-01

    In today's global organisations and networks, a critical factor for effective innovation and project execution is appropriate competence and skills management. The challenges include selection of strategic competences, competence development, and leveraging the competences and skills to drive innovation and collaboration for shared goals. This paper presents a new industrial web-enabled competence management and networking solution and its implementation and piloting in a complex big-science environment of globally distributed competences.

  18. Growth differences of male and female Gottingen minipigs during ad libitum feeding: a pilot study

    DEFF Research Database (Denmark)

    Bollen, P.J.A.; Madsen, L.W.; Meyer, Otto A.

    2005-01-01

    Even though minipigs have been used in biomedical research for nearly half a century now, no specific nutrient requirements are available. For that reason a series of studies into the nutrient requirements of Gottingen minipigs were carried out. Firstly, a pilot study was carried out to determine...... the ad libitum feed intake (FI) during growth, as a reference for later feed restriction studies. Four male and four female minipigs were fed two types of diet, one standard pig diet (20.6% crude protein; 11.7% crude fat; 13.5 mj/kg DM metabolizable energy) and one diet specially designed for minipigs...... backfat thickness. Relative backfat thickness ranged from 5 to 13 cm/100 kg. Females had thicker relative backfat layers than males. Remarkably, no large changes in haematology and clinical chemistry occurred in ad libitum fed Gottingen minipigs as compared to reference values, and no abnormalities other...

  19. GROWTH KINETIC STUDY OF CHLORELLA VULGARIS USING LAB-SCALE AND PILOT-SCALE PHOTOBIOREACTOR: EFFECT OF CO2 CONCENTRATION

    Directory of Open Access Journals (Sweden)

    MAN KEE LAM

    2016-07-01

    Full Text Available In the present study, growth kinetic of Chlorella vulgaris was performed when the microalgae was cultivated with different concentrations of CO2 . The experiments were carried out using lab-scale and pilot-scale photobioreactors, and the growth results were analyzed using POLYMATH 6.0 with different growth kinetic models. The growth of the microalgae was found fitted well to the Richards growth model with attainable high R2 values as demonstrated in all studied cases, in concert with low values of root mean squares deviation (RMSD and variance. In addition, the output from the plots of experimental values versus predicted values and residual plots further confirmed the good fit of Richards model. The predicted specific growth rate from Richards model was similar to the experimental specific growth rate with deviation lesser than 5%. The attained results paved a preliminary prediction of microalgae growth characteristic when the cultivation is scaled-up to commercial scale.

  20. “Cold” X5 Hairlaser™ used to treat male androgenic alopecia and hair growth: an uncontrolled pilot study

    Science.gov (United States)

    2014-01-01

    Background Various trials have been conducted on the management and treatment of androgenic alopecia (AGA) or male pattern hair loss using a variety of laser and light sources. Methods For this feasibility study, the population was composed of males between the ages of 20 and 60 years who have been experiencing active hair loss within the last 12 months and the diagnosis of AGA. They also had a Norwood-Hamilton classification of 3, 3A, 3 V, 4, 4A, or 5 for the hair thinning patterns and skin type I, II, III, or IV on the Fitzpatrick skin type scale. This two-arm randomized, parallel group study design employed stratifying randomization to balance treatment assignment within three investigational centers with at least 2 subjects enrolled in each Fitzpatrick skin type. Results A statistically significant positive trend in hair growth was observed from this pilot study, to evaluate the efficacy of the novel cold X5 hairlaser device for treating male androgenic alopecia. From the repeated measures analysis of variance, difference in mean hair counts over time was statistically significant (F = 7.70; p-value hair counts at each time point was performed, and post-hoc analysis found an increasing trend of hair growth over time that was statistically significant (p-value hair counts from the baseline to the end of the 26-week period were found to be strongly significant (p-value = 0.0003). Conclusion Albeit, sham device failure and resultant missing data from the control group, the positive trend hair growth, was observed due to the chronic use of X5hairlaser device. This positive benefit while in full agreement with other low laser hair devices requires intensive further investigation. Trial registration NCT02067260 PMID:24559020

  1. Flight management research utilizing an oculometer. [pilot scanning behavior during simulated approach and landing

    Science.gov (United States)

    Spady, A. A., Jr.; Kurbjun, M. C.

    1978-01-01

    This paper presents an overview of the flight management work being conducted using NASA Langley's oculometer system. Tests have been conducted in a Boeing 737 simulator to investigate pilot scan behavior during approach and landing for simulated IFR, VFR, motion versus no motion, standard versus advanced displays, and as a function of various runway patterns and symbology. Results of each of these studies are discussed. For example, results indicate that for the IFR approaches a difference in pilot scan strategy was noted for the manual versus coupled (autopilot) conditions. Also, during the final part of the approach when the pilot looks out-of-the-window he fixates on his aim or impact point on the runway and holds this point until flare initiation.

  2. Realizing Sustainability in Facilities Management: a pilot study at the Technical University of Denmark

    DEFF Research Database (Denmark)

    Nielsen, Susanne Balslev; Møller, Jacob Steen; Jäschke, Stefan

    2012-01-01

    shared value. The paper presents a pilot case study on sustainability in facilities management and is intended for a mixed audience of practitioners and researchers. It draws upon the case study findings to establish a baseline of performance and presents practical management implications of integrating...... from both practice and research. The lessons learned at the Technical University of Denmark (DTU) are particularly relevant for universities and other public building owners, their Facilities Managers and consultants. Research limitations and implications: The paper is based on literature studies...... and value: The paper is based on action research to establish a collaborative framework in late 2011 and the findings of the pilot study, and have not been published before....

  3. Resources to Support Faculty Writing Data Management Plans: Lessons Learned from an Engineering Pilot

    Directory of Open Access Journals (Sweden)

    Natsuko H. Nicholls

    2014-07-01

    Full Text Available Recent years have seen a growing emphasis on the need for improved management of research data. Academic libraries have begun to articulate the conceptual foundations, roles, and responsibilities involved in data management planning and implementation. This paper provides an overview of the Engineering data support pilot at the University of Michigan Library as part of developing new data services and infrastructure. Through this pilot project, a team of librarians had an opportunity to identify areas where the library can play a role in assisting researchers with data management, and has put forth proposals for immediate steps that the library can take in this regard. The paper summarizes key findings from a faculty survey and discusses lessons learned from an analysis of data management plans from accepted NSF proposals. A key feature of this Engineering pilot project was to ensure that these study results will provide a foundation for librarians to educate and assist researchers with managing their data throughout the research lifecycle.

  4. Can growth hormone treatment improve growth in children with severe growth failure due to anorexia nervosa? A preliminary pilot study

    Directory of Open Access Journals (Sweden)

    Juliane Léger

    2017-11-01

    Full Text Available Background/Aims: Growth failure is a difficult but key aspect of care in children with anorexia nervosa (AN. The effects of hGH therapy have not been studied. The aim was to investigate the effect of hGH treatment on height velocity (HV in children with AN. Methods: We carried out a retrospective observational study. Ten girls diagnosed with AN at 10.0 ± 1.9 years, with prolonged severe growth failure (HV < 2.5 cm/year for at least 18 months at the age of 13.3 ± 1.1 years and delayed puberty after nutritional rehabilitation, were treated with hGH (0.040 mg/kg/day from a bone age of 10.9 ± 1.7 years until they reached adult height. Height and HV were measured before treatment and at 12-month intervals during treatment. Results: Mean body mass index SDS remained unchanged, but HV increased significantly, from a median of 1.0 (0.7–2.1 to 7.1 (6.0–9.5 cm/year after one year (P < 0.002 and 5.6 (4.8–6.2 cm/year after two years of treatment. Height SDS increased from −2.2 ± 1.3 to −1.6 ± 1.3 after one year (P < 0.002 and −1.1 ± 1.5 after two years of GH treatment. Adult height (−0.1 ± 1.0 SDS was close to target height after 3.6 ± 1.4 years of GH treatment. Serum IGF-I levels increased significantly during treatment (P < 0.01. The treatment was well tolerated. Conclusions: This proof-of-concept study shows that hGH treatment is associated with significant improvements in linear growth in adolescents with AN and severe growth failure. A randomized placebo-controlled trial is required to determine the ultimate impact of GH treatment in patients with this severe, rare condition.

  5. An Individualized Representational Intervention to Improve Symptom Management (IRIS) in Older Breast Cancer Survivors: Three Pilot Studies

    Science.gov (United States)

    Heidrich, Susan M.; Brown, Roger L.; Egan, Judith J.; Perez, Oscar A.; Phelan, Cynthia H.; Yeom, Hyune; Ward, Sandra E.

    2009-01-01

    Purpose/Objectives To test the feasibility and acceptability of an individualized representational intervention to improve symptom management (IRIS) in older breast cancer survivors and test the short-term effects of an IRIS on symptom distress. Design Two small randomized clinical trials and one pre-experimental study. Setting Oncology clinic and community. Sample 41 women with breast cancer (aged 65 years and older) in pilot study 1, 20 in pilot study 2, and 21 in pilot study 3. Methods In pilot study 1, women were randomized to the IRIS or usual care control. In pilot study 2, women were randomized to the IRIS or delayed IRIS (wait list) control. In pilot study 3, all women received the IRIS by telephone. Measures were collected at baseline, postintervention, and follow-up (up to four months). Main Research Variables Feasibility, acceptability, symptom distress, symptom management behaviors, symptom management barriers, and quality of life. Findings Across three pilot studies, 76% of eligible women participated, 95% completed the study, 88% reported the study was helpful, and 91% were satisfied with the study. Some measures of symptom distress decreased significantly after the IRIS, but quality of life was stable. Women in the IRIS group changed their symptom management behaviors more than controls. Conclusions Preliminary evidence supports the need for and feasibility of an IRIS. Implications for Nursing Nurses may help older breast cancer survivors manage their numerous chronic symptoms more effectively by assessing women’s beliefs about their symptoms and their current symptom management strategies. PMID:19403441

  6. Low-dose growth hormone and human immunodeficiency virus-associated lipodystrophy syndrome: a pilot study

    DEFF Research Database (Denmark)

    Andersen, Ove; Haugaard, Steen B; Flyvbjerg, A

    2004-01-01

    BACKGROUND: Treatment with high doses (2-6 mg day(-1)) of human growth hormone (hGH) in patients with human immunodeficiency virus (HIV)-associated lipodystrophy syndrome (HALS) has been shown to increase concentrations of total insulin-like growth-factor-I (IGF-I) more than twofold greater than...... the normal upper range and is accompanied by adverse effects such as joint pain and glucose intolerance. MATERIALS AND METHODS: We performed a 16-week open-labelled prospective pilot study in six male HALS patients using a s.c. low-dose hGH, 0.7 mg day(-1), aiming to examine the impact on total and free IGF......' treatment of lipodystrophic HIV-infected patients with hGH, 0.7 mg day(-1), increased total and free IGF-I twofold and appeared safe and tolerable. The potential of low-dose hGH in the treatment of HIV-lipodystrophy awaits examination by placebo-controlled, randomized trials....

  7. Patient satisfaction with a pilot chronic pain management programme in Cape Town, South Africa

    Directory of Open Access Journals (Sweden)

    R. Parker

    2009-01-01

    Full Text Available Background: The goals of a chronic pain management clinic includeincreasing patient knowledge about pain, developing pain management skillsand increasing patients’ confidence in their pain management abilities.A  Chronic Pain Management Programme (CPMP based on evidence basedguidelines was developed at a chronic pain management clinic to facilitatepatient discharge to a primary healthcare level. Aim: The aim of this study was to explore patient satisfaction with, acceptability of and the perceived success which could be due to the CPMP developed at the Chronic Pain Management Clinic of Groote Schuur Hospital,Cape Town.Methods: Patients (n=14 were referred to the pilot study from the Chronic Pain Management Clinic. A s a pilot, four courses were run over a period ofone year. In order to reach the research aim, an eleven-question, structuredopen-ended interview was conducted with all participants. Results: Fourteen patients enrolled in the CPMP. Responses were favourable with participants emphasising the roleof increased knowledge about pain, the role of exercise and of stress management techniques. Participants also recog-nised a positive change in behaviours and attitudes following participation in the CPMP.Conclusions: Findings suggest that participants found the format of the course acceptable as regards course content,structure and delivery. Participant responses suggest that the course was acceptable and perceived as useful. However,future courses would benefit from refresher courses or structured support groups.

  8. Learning from urban growth management in the Pacific Northwest

    DEFF Research Database (Denmark)

    Fertner, Christian

    2010-01-01

    strategies to the trade of development rights is used to support the growth managements’ goals. The paper reviews the most important elements of the urban growth management in Washington and Oregon State. Based on several semi-structured interviews with planning experts done during a research stay in Seattle...

  9. Managing growth of microfinance institutions (MFIs): Balancing ...

    African Journals Online (AJOL)

    The specific interventions to increase the growth and sustainability of MFIs include: (a) Improving the institutional capacity of the MFIs by the implementing an efficient organizational structure, (changes in organization culture, structure and systems, for instance, decentralized lending decisions) with appropriate staff incentive ...

  10. Analysis of Tobyhanna Army Depot's Radio Frequency Identification (RFID) Pilot Program: RFID as an Asset Management Tool

    National Research Council Canada - National Science Library

    Miertschin, Keith W; Forrest, Brian D

    2005-01-01

    ...) used for inventory and asset management at the Tobyhanna Army Maintenance Depot. Tobyhanna Army Depot recently partnered with WhereNet Corporation for a pilot program to incorporate a real-time locating system that uses RFID...

  11. Development of an integrated configuration management/flight director system for piloted STOL approaches

    Science.gov (United States)

    Hoh, R. H.; Klein, R. H.; Johnson, W. A.

    1977-01-01

    A system analysis method for the development of an integrated configuration management/flight director system for IFR STOL approaches is presented. Curved descending decelerating approach trajectories are considered. Considerable emphasis is placed on satisfying the pilot centered requirements (acceptable workload) as well as the usual guidance and control requirements (acceptable performance). The Augmentor Wing Jet STOL Research Aircraft was utilized to allow illustration by example, and to validate the analysis procedure via manned simulation.

  12. Growth and yield model application in tropical rain forest management

    Science.gov (United States)

    James Atta-Boateng; John W., Jr. Moser

    2000-01-01

    Analytical tools are needed to evaluate the impact of management policies on the sustainable use of rain forest. Optimal decisions concerning the level of management inputs require accurate predictions of output at all relevant input levels. Using growth data from 40 l-hectare permanent plots obtained from the semi-deciduous forest of Ghana, a system of 77 differential...

  13. The effect of silvicultural management on regeneration, growth and ...

    African Journals Online (AJOL)

    With the objective of determining the effects of silvicultural management on regeneration and growth of mismanaged Arundinaria alpina stands, an experiment was conducted in the Choke Mountain, northwest Ethiopia. Eight soil and plant management techniques that comprise soil loosening, selective thinning and removal ...

  14. Waste management - cytokines, growth factors and cachexia.

    Science.gov (United States)

    Saini, Amarjit; Al-Shanti, Nasser; Nasser, Al-Shanti; Stewart, Claire E H

    2006-12-01

    Muscle damage with a lack of regeneration, manifests itself in several life-threatening diseases, including cancer cachexia, congestive heart failure, AIDS and sepsis. Often misdiagnosed as a condition simply of weight loss, cachexia is actually a highly complex metabolic disorder involving features of anorexia, anaemia, lipolysis and insulin resistance. A significant loss of lean body mass arises from such conditions, resulting in wasting of skeletal muscle. Unlike starvation, the weight loss seen in chronic illnesses arises equally from loss of muscle and of fat. The cachectic state is particularly problematic in cancer, typifying poor prognosis and often lowering responses to chemotherapy and radiation treatment. More than half of cancer patients suffer from cachexia, and strikingly, nearly one-third of cancer deaths are related to cachexia rather than the tumour burden. In considering this disorder, we are faced with a conundrum; how is it possible for uncontrolled growth to prevail in the tumour, in the face of unrestrained tissue loss in our muscles? Consistently, the catabolic state has been associated with a shift in the homeostatic balance between muscle synthesis and degradation mediated by the actions of growth factors and cytokines. Indeed, tumour necrosis factor-alpha (TNF-alpha) levels are raised in several animal models of cachectic muscle wasting, whereas the insulin-like growth factor (IGF) system acts potently to regulate muscle development, hypertrophy and maintenance. This concept of skeletal muscle homeostasis, often viewed as the net balance between two separate processes of protein synthesis and degradation has however changed. More recently, the view is that these two biochemical processes are not occurring independently of each other but in fact are finely co-ordinated by a web of intricate signalling networks. This review, therefore, aims to discuss data currently available regarding the mechanisms of degeneration and regeneration with

  15. Medication therapy management services in community pharmacy: a pilot programme in HIV specialty pharmacies.

    Science.gov (United States)

    Rosenquist, Ashley; Best, Brookie M; Miller, Teresa A; Gilmer, Todd P; Hirsch, Jan D

    2010-12-01

    Pharmacist-provided medication therapy management services (MTMS) have been shown to increase patient's adherence to medications, improve health outcomes and reduce overall medical costs. The purpose of this study was to describe a pilot programme that provided pharmacy-based MTMS for patients with HIV/AIDS in the state of California, USA. Pharmacists from the 10 pilot pharmacies were surveyed using an online data collection tool. Information was collected to describe the types of MTMS offered, proportion of patients actively using specific MTMS, pharmacist beliefs regarding effect on patient outcomes and barriers to providing MTMS, ability to offer MTMS without pilot programme funding and specialized pharmacist or staff training. Each responding pharmacy (7 of 10) varied in the number of HIV/AIDS patients served and prescription volume. All pharmacists had completed HIV/AIDS-related continuing education programmes, and some had other advanced training. The type of MTMS being offered varied at each pharmacy with 'individualized counselling by a pharmacist when overuse or underuse was detected' and 'refill reminders by telephone' being actively used by the largest proportion of patients. Most, but not all, pharmacists cited reimbursement as a barrier to MTMS provision. Pharmacists believed the MTMS they provide resulted in improved satisfaction (patient and provider), medication usage, therapeutics response and patient quality of life. The type of MTMS offered, and proportion of patients actively using, varied among participating pilot pharmacies. © 2010 Blackwell Publishing Ltd.

  16. Managing Ethical Problems in Qualitative Research Involving Vulnerable Populations, Using a Pilot Study

    Directory of Open Access Journals (Sweden)

    Evalina van Wijk RN, PhD

    2013-02-01

    Full Text Available The purpose of the researcher's study was to examine the meaning that intimate partners of female rape victims attached to their lived experiences after the rape. The conduct of qualitative research concerning non-offending partners of female rape victims, however, often involves multifaceted ethical and practical challenges, which can be managed through the use of pilot studies. The pilot study described in this report had three objectives. The first was to pretest and refine the proposed method for locating, accessing, and recruiting intimate partners of female rape victims, within the first two weeks after the rape, for participation in a six-month longitudinal study. The second objective was to identify and prevent all possible risk factors in the proposed recruitment and data collection methods that could harm the participants' safety during the main study. The third objective was to determine the feasibility of the main study, in terms of the limited financial and human resources available. The pilot phase was valuable in identifying ethical and methodological problems during the recruitment of participants and collection of data. It allowed for methodological adjustments prior to the main study and confirmed the feasibility of the overall research design. A pilot, pretesting phase is therefore seen as an essential component of a qualitative study involving a vulnerable population.

  17. A pilot study of a chiropractic intervention for management of chronic myofascial temporomandibular disorder

    DEFF Research Database (Denmark)

    DeVocht, James W; Goertz, Christine M; Hondras, Maria

    2013-01-01

    BACKGROUND: Temporomandibular pain has multiple etiologies and a range of therapeutic options. In this pilot study, the authors assessed the feasibility of conducting a larger trial to evaluate chiropractic treatment of temporomandibular disorders (TMDs). METHODS: The authors assigned 80...... at baseline and at month 2 and month 6, including use of the Research Diagnostic Criteria for Temporomandibular Disorders. RESULTS: The authors screened 721 potential participants and enrolled 80 people; 52 participants completed the six-month assessment. The adjusted mean change in current pain over six...... the study design and methodology to be manageable. They gained substantial knowledge to aid in conducting a larger study. AMCT, RIST and self-care should be evaluated in a future comparative effectiveness study. PRACTICAL IMPLICATIONS: This pilot study was a necessary step to prepare for a larger study...

  18. Environmental management assessment of the Waste Isolation Pilot Plant (WIPP), Carlsbad, New Mexico

    Energy Technology Data Exchange (ETDEWEB)

    1993-07-01

    This document contains the results of the Environmental Management Assessment of the Waste Isolation Pilot Plant (WIPP). This Assessment was conducted by EH-24 from July 19 through July 30, 1993 to advise the Secretary of Energy of the adequacy of management systems established at WIPP to ensure the protection of the environment and compliance with Federal, state, and DOE environmental requirements. The mission of WIPP is to demonstrate the safe disposal of transuranic (TRU) waste. During this assessment, activities and records were reviewed and interviews were conducted with personnel from the management and operating contractors. This assessment revealed that WIPP`s environmental safety and health programs are satisfactory, and that all levels of the Waste Isolation Division (WID) management and staff consistently exhibit a high level of commitment to achieve environmental excellence.

  19. Environmental management assessment of the Waste Isolation Pilot Plant (WIPP), Carlsbad, New Mexico

    International Nuclear Information System (INIS)

    1993-07-01

    This document contains the results of the Environmental Management Assessment of the Waste Isolation Pilot Plant (WIPP). This Assessment was conducted by EH-24 from July 19 through July 30, 1993 to advise the Secretary of Energy of the adequacy of management systems established at WIPP to ensure the protection of the environment and compliance with Federal, state, and DOE environmental requirements. The mission of WIPP is to demonstrate the safe disposal of transuranic (TRU) waste. During this assessment, activities and records were reviewed and interviews were conducted with personnel from the management and operating contractors. This assessment revealed that WIPP's environmental safety and health programs are satisfactory, and that all levels of the Waste Isolation Division (WID) management and staff consistently exhibit a high level of commitment to achieve environmental excellence

  20. Nuclear knowledge - Managing for preservation and growth

    International Nuclear Information System (INIS)

    Chidambaram, R.

    2002-01-01

    Full text: The attitude to nuclear energy development in any country is governed by its energy needs, nuclear fuel and human resource access, and its political inclinations and affiliations. Some countries with an already high level of electricity consumption based on fossil fuels or hydro resources and existing nuclear plants (either in their own country or in a neighbouring country), accompanied by a stable or even decreasing population, have not felt for some time the need for new nuclear plants, though this trend appears to be reversing. On the other hand, many developing countries including India consider the growth of nuclear power as essential and inevitable to satisfy their future energy needs. Nuclear reactors and the accompanying fuel cycle facilities constitute a complex technology ensemble, which cannot be handled on a stop-go basis. Also, some large nuclear-developed countries can perhaps get along on a self-reliant basis, but international cooperation is valuable for sharing of knowledge and resources. There is also the political aspect. Genuine proliferation concerns must be addressed but coercive guidelines for nuclear cooperation , which go beyond these concerns, are harmful for the preservation and growth of nuclear knowledge. There are nuclear reactor and fuel cycle technologies which have been around for some time but they still need continuous upgradation, in terms of improved performance or increased safety, and there are emerging advanced nuclear reactor designs, which require new technology generation and transfer to industry. Both of them require continuous inputs from R and D laboratories and these have to come from government-sponsored research because private sector industry generally tends to shy away from R and D with long-range pay-offs. There is another aspect. If nuclear industry is seen in a country to be stagnating - fortunately it is not happening in Asia - attraction to youth in a research career in nuclear technology in that

  1. A pilot study of distributed knowledge management and clinical decision support in the cloud.

    Science.gov (United States)

    Dixon, Brian E; Simonaitis, Linas; Goldberg, Howard S; Paterno, Marilyn D; Schaeffer, Molly; Hongsermeier, Tonya; Wright, Adam; Middleton, Blackford

    2013-09-01

    Implement and perform pilot testing of web-based clinical decision support services using a novel framework for creating and managing clinical knowledge in a distributed fashion using the cloud. The pilot sought to (1) develop and test connectivity to an external clinical decision support (CDS) service, (2) assess the exchange of data to and knowledge from the external CDS service, and (3) capture lessons to guide expansion to more practice sites and users. The Clinical Decision Support Consortium created a repository of shared CDS knowledge for managing hypertension, diabetes, and coronary artery disease in a community cloud hosted by Partners HealthCare. A limited data set for primary care patients at a separate health system was securely transmitted to a CDS rules engine hosted in the cloud. Preventive care reminders triggered by the limited data set were returned for display to clinician end users for review and display. During a pilot study, we (1) monitored connectivity and system performance, (2) studied the exchange of data and decision support reminders between the two health systems, and (3) captured lessons. During the six month pilot study, there were 1339 patient encounters in which information was successfully exchanged. Preventive care reminders were displayed during 57% of patient visits, most often reminding physicians to monitor blood pressure for hypertensive patients (29%) and order eye exams for patients with diabetes (28%). Lessons learned were grouped into five themes: performance, governance, semantic interoperability, ongoing adjustments, and usability. Remote, asynchronous cloud-based decision support performed reasonably well, although issues concerning governance, semantic interoperability, and usability remain key challenges for successful adoption and use of cloud-based CDS that will require collaboration between biomedical informatics and computer science disciplines. Decision support in the cloud is feasible and may be a reasonable

  2. Strengthening district health service management and delivery through internal contracting: lessons from pilot projects in Cambodia.

    Science.gov (United States)

    Khim, Keovathanak; Annear, Peter Leslie

    2013-11-01

    Following a decade of piloting different models of contracting, in mid-2009 the Cambodian Ministry of Health began to test a form of 'internal contracting' for health care delivery in selected health districts (including hospitals and health centers) contracted by the provincial health department as Special Operating Agencies (SOAs) and provided with greater management autonomy. This study assesses the internal contracting approach as a means for improving the management of district health services and strengthening service delivery. While the study may contribute to the emerging field now known as performance-based financing, the lessons deal more broadly with the impact of management reform and increased autonomy in contrast to traditional public sector line-management and budgeting. Carried out during 2011, the study was based on: (i) a review of the literature and of operational documents; (ii) primary data from semi-structured key informant interviews with 20 health officials in two provinces involved in four SOA pilot districts; and (iii) routine data from the 2011 SOA performance monitoring report. Five prerequisites were identified for effective contract management and improved service delivery: a clear understanding of roles and responsibilities by the contracting parties; implementation of clear rules and procedures; effective management of performance; effective monitoring of the contract; and adequate and timely provision of resources. Both the level and allocation of incentives and management bottlenecks at various levels continue to impede implementation. We conclude that, in contracted arrangements like these, the clear separation of contracting functions (purchasing, commissioning, monitoring and regulating), management autonomy where responsibilities are genuinely devolved and accepted, and the provision of resources adequate to meet contract demands are necessary conditions for success. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Management, Growth, and Carbon Storage in Miombo Woodlands of Tanzania

    Directory of Open Access Journals (Sweden)

    Z. J. Lupala

    2014-01-01

    Full Text Available Despite the local livelihoods support function provided by miombo woodlands of Tanzania under participatory forest management, its growth still has potential for carbon storage and sequestration attractive to REDD+ initiatives. This study has revealed the average growth to be significant, despite the local community livelihoods support function. However, climate change mitigation strategy needs to be more innovative to optimize carbon storage and local livelihoods’ potentials in forest-dependent communities like miombo woodlands. Carbon credits resulting from the increased carbon stock and sequestration should contribute to sustainable development. This should also help promote participatory forest management and secure miombo woodland products and services upon which billions of people depend.

  4. Pilot and Controller Evaluations of Separation Function Allocation in Air Traffic Management

    Science.gov (United States)

    Wing, David; Prevot, Thomas; Morey, Susan; Lewis, Timothy; Martin, Lynne; Johnson, Sally; Cabrall, Christopher; Como, Sean; Homola, Jeffrey; Sheth-Chandra, Manasi; hide

    2013-01-01

    Two human-in-the-loop simulation experiments were conducted in coordinated fashion to investigate the allocation of separation assurance functions between ground and air and between humans and automation. The experiments modeled a mixed-operations concept in which aircraft receiving ground-based separation services shared the airspace with aircraft providing their own separation service (i.e., self-separation). Ground-based separation was provided by air traffic controllers without automation tools, with tools, or by ground-based automation with controllers in a managing role. Airborne self-separation was provided by airline pilots using self-separation automation enabled by airborne surveillance technology. The two experiments, one pilot-focused and the other controller-focused, addressed selected key issues of mixed operations, assuming the starting point of current-day operations and modeling an emergence of NextGen technologies and procedures. In the controller-focused experiment, the impact of mixed operations on controller performance was assessed at four stages of NextGen implementation. In the pilot-focused experiment, the limits to which pilots with automation tools could take full responsibility for separation from ground-controlled aircraft were tested. Results indicate that the presence of self-separating aircraft had little impact on the controllers' ability to provide separation services for ground-controlled aircraft. Overall performance was best in the most automated environment in which all aircraft were data communications equipped, ground-based separation was highly automated, and self-separating aircraft had access to trajectory intent information for all aircraft. In this environment, safe, efficient, and highly acceptable operations could be achieved for twice today's peak airspace throughput. In less automated environments, reduced trajectory intent exchange and manual air traffic control limited the safely achievable airspace throughput and

  5. Pilot projects and their diffusion: a case study of integrated coastal management in South Africa

    CSIR Research Space (South Africa)

    Vreugdenhil, H

    2012-01-01

    Full Text Available Pilot projects are policy instruments mainly applied to introduce or test new practices, concepts or technologies. Pilot projects can lead to a broader policy transition. However, the diffusion process associated with the pilot projects is not well...

  6. Chronic pain management group psychotherapy for psychiatric inpatients: A pilot study.

    Science.gov (United States)

    Osborne, Patricia J; Jimenez-Torres, Gladys Janice; Landa, Yulia; Mahoney, Jane; Madan, Alok

    2017-01-01

    Individuals with serious mental illness (SMI) experience significant comorbid chronic pain (CP). Little is known about CP management in psychiatric inpatient settings. To address this gap in clinical practice, the authors developed CP management group psychotherapy for adult inpatients with SMI. In this report, the authors highlight (1) the theoretical underpinnings of and execution of the psychotherapy group, (2) the characteristics of participants in the pilot phase of the group, and (3) outcomes of group participants. Data were collected from 16 participants in the pain management psychotherapy group. The mean number of groups attended was two (SD = 1.7). Participants endorsed pain across five regions of the body with high pain intensity and severity. Improvements in depression, anxiety, somatic, and emotional regulation symptoms were evidenced during the course of treatment. CP group psychotherapy may be an effective modality to disseminate "best practices" and prevent diagnostic overshadowing for SMI patients.

  7. Results of a NASA Kennedy Space Center Earned Value Management Pilot Project

    Science.gov (United States)

    Delgado, Hector N.; Rhodeside, Glenn R.

    2004-01-01

    The Earn Value Management Pilot provided a tremendous amount of data on the strengths and weaknesses of the new financial system, the ability to support EVM from many viewpoints, the lack of tools for small to medium projects implementing EVM, and the training and environment necessary to successfully deploy EVM to all projects. This data along with other pilots will prove invaluable. Deploying EVM should not be taken lightly - a full assessment of capabilities and supporting infrastructure should be done prior to any deployment, and some very basic questions should be asked. For instance, will sufficient training be provided? Can the project managers readily and easily obtain all the necessary data? If EVM is to thrive in all projects regardless of cost, the transition should be as seamless as possible, minimizing cost and effort, and with the end user in mind. In setting up an EVM implementation, the question, "How does the project manager benefit from this process?" must remain at the forefront. Further research in this area is needed to answer the question,"Is EVM cost effective in small projects?" The authors welcome knowledge sharing with other organizations that are striving to gain the benefits of EVM on small projects.

  8. Integrated System Health Management: Pilot Operational Implementation in a Rocket Engine Test Stand

    Science.gov (United States)

    Figueroa, Fernando; Schmalzel, John L.; Morris, Jonathan A.; Turowski, Mark P.; Franzl, Richard

    2010-01-01

    This paper describes a credible implementation of integrated system health management (ISHM) capability, as a pilot operational system. Important core elements that make possible fielding and evolution of ISHM capability have been validated in a rocket engine test stand, encompassing all phases of operation: stand-by, pre-test, test, and post-test. The core elements include an architecture (hardware/software) for ISHM, gateways for streaming real-time data from the data acquisition system into the ISHM system, automated configuration management employing transducer electronic data sheets (TEDS?s) adhering to the IEEE 1451.4 Standard for Smart Sensors and Actuators, broadcasting and capture of sensor measurements and health information adhering to the IEEE 1451.1 Standard for Smart Sensors and Actuators, user interfaces for management of redlines/bluelines, and establishment of a health assessment database system (HADS) and browser for extensive post-test analysis. The ISHM system was installed in the Test Control Room, where test operators were exposed to the capability. All functionalities of the pilot implementation were validated during testing and in post-test data streaming through the ISHM system. The implementation enabled significant improvements in awareness about the status of the test stand, and events and their causes/consequences. The architecture and software elements embody a systems engineering, knowledge-based approach; in conjunction with object-oriented environments. These qualities are permitting systematic augmentation of the capability and scaling to encompass other subsystems.

  9. Piloting tailored teaching on nonpharmacologic enhancements for postoperative pain management in older adults.

    Science.gov (United States)

    Tracy, Susanne M

    2010-09-01

    Despite many advances in the pharmacologic treatment of pain, the issue of unresolved postoperative pain continues to plague patients and health care professionals. Little seems to be known about the reasons why nonpharmacologic methods are not more widely used, particularly as they are commonly low in cost, easy to use, and largely free of adverse side effects. A central question has to do with what patients are taught about nonpharmacologic methods and how a novel mode of teaching can be embedded in practice. A seven-step pre-posttest teaching intervention pilot study was deployed with older joint replacement patients within the context of a translational research model. Results of the teaching pilot showed significant post-teaching changes in subjects' knowledge and attitudes about nonpharmacologic methods for pain management, high satisfaction with the nonpharmacologic methods they chose, and incrementally greater use of the nonpharmacologic methods over the course of the hospital stay. A randomized controlled trial of the study is now in the early planning stages in an effort to obtain generalizable results that will help solidify evidence of the impact of music, imagery, and slow-stroke massage on pain management and confirm the value of patient teaching as an important means of offering patients more options for managing their own pain.

  10. Assessment and management of nutrition and growth in Rett syndrome

    Science.gov (United States)

    Leonard, Helen; Ravikumara, Madhur; Baikie, Gordon; Naseem, Nusrat; Ellaway, Carolyn; Percy, Alan; Abraham, Suzanne; Geerts, Suzanne; Lane, Jane; Jones, Mary; Bathgate, Katherine; Downs, Jenny

    2014-01-01

    Objectives We developed recommendations for the clinical management of poor growth and weight gain in Rett syndrome through evidence review and the consensus of an expert panel of clinicians. Methods Initial draft recommendations were created based upon literature review and 34 open-ended questions where the literature was lacking. Statements and questions were made available to an international, multi-disciplinary panel of clinicians in an online format and a Microsoft Word formatted version of the draft via email. Input was sought using a 2-stage modified Delphi process to reach consensus agreement. Items included clinical assessment of growth, anthropometry, feeding difficulties and management to increase caloric intake, decrease feeding difficulties and consideration of gastrostomy. Results Agreement was achieved on 101/112 statements. A comprehensive approach to the management of poor growth in Rett syndrome is recommended that takes into account factors such as feeding difficulties and nutritional needs. A BMI of approximately the 25th centile can be considered as a reasonable target in clinical practice. Gastrostomy is indicated for very poor growth, if there is risk of aspiration and if feeding times are prolonged. Conclusions These evidence- and consensus-based recommendations have the potential to improve care of nutrition and growth in a rare condition and stimulate research to improve the current limited evidence base. PMID:24084372

  11. Management and growth paradox of rural small-scale industrial ...

    African Journals Online (AJOL)

    The study shows that record keeping and banking, which are key ingredients of good management practices are largely influenced by the age of the firm, the type of technology used, how proprietors acquired their skills, the production level and the source of investment capital. Similarly, growth of firm is influenced by the ...

  12. Conventional Development Versus Managed Growth: The Costs of Sprawl

    Science.gov (United States)

    Burchell, Robert W.; Mukherji, Sahan

    2003-01-01

    Objectives. We examined the effects of sprawl, or conventional development, versus managed (or “smart”) growth on land and infrastructure consumption as well as on real estate development and public service costs in the United States. Methods. Mathematical impact models were used to produce US estimates of differences in resources consumed according to each growth scenario over the period 2000–2025. Results. Sprawl produces a 21% increase in amount of undeveloped land converted to developed land (2.4 million acres) and approximately a 10% increase in local road lane-miles (188 300). Furthermore, sprawl causes about 10% more annual public service (fiscal) deficits ($4.2 billion) and 8% higher housing occupancy costs ($13 000 per dwelling unit). Conclusions. Managed growth can save significant amounts of human and natural resources with limited effects on traditional development procedures. PMID:12948976

  13. Diabetes Text-Message Self-Management Support Program (SMS4BG): A Pilot Study.

    Science.gov (United States)

    Dobson, Rosie; Carter, Karen; Cutfield, Richard; Hulme, Ashley; Hulme, Richard; McNamara, Catherine; Maddison, Ralph; Murphy, Rinki; Shepherd, Matthew; Strydom, Johan; Whittaker, Robyn

    2015-03-25

    The increasing prevalence of diabetes and costly long-term complications associated with poor glycemic control are issues facing health services worldwide. Diabetes self-management, with the support of health care providers, is critical for successful outcomes, however, frequent clinical contact is costly. Text messages via short message service (SMS) have the advantage of instant transmission at low cost and, given the ubiquity of mobile phones, may be the ideal platform for the delivery of diabetes self-management support. A tailored text message-based diabetes support intervention called Self-Management Support for Blood Glucose (SMS4BG) was developed. The intervention incorporates prompts around diabetes education, management, and lifestyle factors (healthy eating, exercise, and stress management), as well as blood glucose monitoring reminders, and is tailored to patient preferences and clinical characteristics. To determine the usability and acceptability of SMS4BG among adults with poorly controlled diabetes. Adults (aged 17 to 69 years) with type 1 (n=12) or type 2 diabetes (n=30), a hemoglobin A1c (HbA1c) over 70 mmol/mol (8.6%), and who owned a mobile phone (n=42) were recruited to take part in a 3-month pilot study of SMS4BG. At registration, participants selected the modules they would like to receive and, where appropriate, the frequency and timing of blood glucose monitoring reminders. Patient satisfaction and perceptions of the usability of the program were obtained via semistructured phone interviews conducted at completion of the pilot study. HbA1c was obtained from patient records at baseline and completion of the pilot study. Participants received on average 109 messages during the 3-month program with 2 participants withdrawing early from the study. Follow-up interviews were completed with 93% of participants with all reporting SMS4BG to be useful and appropriate to their age and culture. Participants reported a range of perceived positive

  14. Can we talk? Communications management for the Waste Isolation Pilot Plant, a complex nuclear waste management project

    International Nuclear Information System (INIS)

    Goldstein, S.A.; Pullen, G.M.; Brewer, D.R.

    1995-01-01

    Sandia Nuclear Waste Management Program is pursuing for DOE an option for permanently disposing radioactive waste in deep geologic repositories. Included in the Program are the Waste Isolation Pilot Plant (WIPP) Project for US defense program mixed waste the Yucca Mountain Project (YMP) for spent power reactor fuel and vitrified high-level waste, projects for other waste types, and development efforts in environmental decision support technologies. WIPP and YMP are in the public arena, of a controversial nature, and provide significant management challenges. Both projects have large project teams, multiple organization participants, large budgets, long durations, are very complex, have a high degree of programmatic risk, and operate in an extremely regulated environment requiring legal defensibility. For environmental projects like these to succeed, SNL's Program is utilizing nearly all areas in PMI's Project Management Body of Knowledge (PMBOK) to manage along multiple project dimensions such as the physical sciences (e.g., geophysics and geochemistry; performance assessment; decision analysis) management sciences (controlling the triple constraint of performance, cost and schedule), and social sciences (belief systems; public participation; institutional politics). This discussion focuses primarily on communication challenges active on WIPP. How is the WIPP team meeting the challenges of managing communications?'' and ''How are you approaching similar challenges?'' will be questions for a dialog with the audience

  15. Can we talk? Communications management for the Waste Isolation Pilot Plant, a complex nuclear waste management project

    Energy Technology Data Exchange (ETDEWEB)

    Goldstein, S.A.; Pullen, G.M.; Brewer, D.R.

    1995-07-01

    Sandia Nuclear Waste Management Program is pursuing for DOE an option for permanently disposing radioactive waste in deep geologic repositories. Included in the Program are the Waste Isolation Pilot Plant (WIPP) Project for US defense program mixed waste the Yucca Mountain Project (YMP) for spent power reactor fuel and vitrified high-level waste, projects for other waste types, and development efforts in environmental decision support technologies. WIPP and YMP are in the public arena, of a controversial nature, and provide significant management challenges. Both projects have large project teams, multiple organization participants, large budgets, long durations, are very complex, have a high degree of programmatic risk, and operate in an extremely regulated environment requiring legal defensibility. For environmental projects like these to succeed, SNL`s Program is utilizing nearly all areas in PMI`s Project Management Body of Knowledge (PMBOK) to manage along multiple project dimensions such as the physical sciences (e.g., geophysics and geochemistry; performance assessment; decision analysis) management sciences (controlling the triple constraint of performance, cost and schedule), and social sciences (belief systems; public participation; institutional politics). This discussion focuses primarily on communication challenges active on WIPP. How is the WIPP team meeting the challenges of managing communications?`` and ``How are you approaching similar challenges?`` will be questions for a dialog with the audience.

  16. Operational water management of Rijnland water system and pilot of ensemble forecasting system for flood control

    Science.gov (United States)

    van der Zwan, Rene

    2013-04-01

    The Rijnland water system is situated in the western part of the Netherlands, and is a low-lying area of which 90% is below sea-level. The area covers 1,100 square kilometres, where 1.3 million people live, work, travel and enjoy leisure. The District Water Control Board of Rijnland is responsible for flood defence, water quantity and quality management. This includes design and maintenance of flood defence structures, control of regulating structures for an adequate water level management, and waste water treatment. For water quantity management Rijnland uses, besides an online monitoring network for collecting water level and precipitation data, a real time control decision support system. This decision support system consists of deterministic hydro-meteorological forecasts with a 24-hr forecast horizon, coupled with a control module that provides optimal operation schedules for the storage basin pumping stations. The uncertainty of the rainfall forecast is not forwarded in the hydrological prediction. At this moment 65% of the pumping capacity of the storage basin pumping stations can be automatically controlled by the decision control system. Within 5 years, after renovation of two other pumping stations, the total capacity of 200 m3/s will be automatically controlled. In critical conditions there is a need of both a longer forecast horizon and a probabilistic forecast. Therefore ensemble precipitation forecasts of the ECMWF are already consulted off-line during dry-spells, and Rijnland is running a pilot operational system providing 10-day water level ensemble forecasts. The use of EPS during dry-spells and the findings of the pilot will be presented. Challenges and next steps towards on-line implementation of ensemble forecasts for risk-based operational management of the Rijnland water system will be discussed. An important element in that discussion is the question: will policy and decision makers, operator and citizens adapt this Anticipatory Water

  17. [Risk management in the operation room. Results of a pilot project of interdisciplinary "incident reporting"].

    Science.gov (United States)

    Horstmann, R; Hofinger, G; Mäder, M; Gaidzik, P W; Waleczek, H

    2006-08-01

    Methods for error analysis are suitable to increase patients' safety as well as staff satisfaction and may avoid, in a sense of process control, financial damage to the hospital. The aim of the presented pilot study was to establish and evaluate an incident reporting system as a first step towards a new safety culture. In June 2003 an incident reporting system was introduced in the central surgical suite, in which the surgical and anaesthesiologic departments took part as well medical and nursing staff. Besides conceiving a report form, a "board of confidence" was elected, kick-off meetings were held and a baseline study on the basis of industrial psychological knowledge was initialised. The process of creating confidence is arduous and depends elementarily on sincere cooperation of management staff, especially of the heads of the departments. The exclusive participation of only two medical departments led to conflicts. Therefore, after finishing the pilot study, the system was expanded to the whole surgical suite including all operating departments. In order to increase the motivation for the strictly voluntarily participation, the frequency of regular echoes to the staff was optimised. To achieve high acceptance in the whole staff, the board of confidence needs a clearly defined position within the system of quality management. For the first time in Germany an incident reporting system under participation of several medical departments has been installed. After finishing the pilot project, in future we will be able to evaluate changes caused by this system. Simultaneously an electronic database for reported adverse events and strategies to avoid them are being developed based on similar systems in aviation industry. In near future, the system will be of increasing importance likewise for inpatient units and non-operative departments.

  18. PROJECT MANAGEMENT MATURITY: AN ASSESSMENT OF MATURITY FOR DEVELOPING PILOT PLANTS

    Directory of Open Access Journals (Sweden)

    H.K. Mittermaier

    2012-01-01

    Full Text Available

    ENGLISH ABSTRACT: Despite the current economic climate, the South African mining and engineering industry is experiencing a very promising future, with a large number of capital projects in the offing. It is inevitable that pilot plant development will form part of this future as a risk mitigation technique. This study found that, even though the terms ‘pilot plant’ and ‘project management maturity’ are familiar within the industry, no link between these two could be found in the literature. A number of maturity models exist; and one developed by PMSolutions was selected to perform an assessment of the current level of project management maturity within the South African mining and engineering industry pertaining to the development of pilot plants. The Delphi technique was used to determine the views of experts in the South African mining, mineral processing, petrochemical, nuclear, and mechanical sectors regarding this maturity. A significant difference was observed between the current level of maturity and the required level of maturity in all but one of the nine knowledge areas defined by the Project Management Institute. The two knowledge areas of project time and risk management showed significant differences between current and required maturity levels, and were identified as key areas for improvement.

    AFRIKAANSE OPSOMMING: Ten spyte van die huidige ekonomiese klimaat ondervind die Suid-Afrikaanse mynbou- en ingenieursbedryf ’n baie bemoedigende toekoms, met ’n groot aantal kapitaalprojekte in die vooruitsig. Ten einde risiko’s te verlaag, sal die ontwikkeling van loodsaanlegte noodwendig deel van hierdie toekoms uitmaak. Daar is gevind dat, alhoewel die terme ‘loodsaanleg’ en ‘projekbestuur volwassenheid’ in die nywerheid bekend is, geen skakeling van hierdie twee terme in die literatuur opgespoor kon word nie. ’n Aantal volwassenheid modelle bestaan; en een wat deur PMSolutions ontwikkel is, is gekies om

  19. Muskellunge growth potential in northern Wisconsin: implications for trophy management

    Science.gov (United States)

    Faust, Matthew D.; Isermann, Daniel A.; Luehring, Mark A.; Hansen, Michael J.

    2015-01-01

    The growth potential of Muskellunge Esox masquinongy was evaluated by back-calculating growth histories from cleithra removed from 305 fish collected during 1995–2011 to determine whether it was consistent with trophy management goals in northern Wisconsin. Female Muskellunge had a larger mean asymptotic length (49.8 in) than did males (43.4 in). Minimum ultimate size of female Muskellunge (45.0 in) equaled the 45.0-in minimum length limit, but was less than the 50.0-in minimum length limit used on Wisconsin's trophy waters, while the minimum ultimate size of male Muskellunge (34.0 in) was less than the statewide minimum length limit. Minimum reproductive sizes for both sexes were less than Wisconsin's trophy minimum length limits. Mean growth potential of female Muskellunge in northern Wisconsin appears to be sufficient for meeting trophy management objectives and angler expectations. Muskellunge in northern Wisconsin had similar growth potential to those in Ontario populations, but lower growth potential than Minnesota's populations, perhaps because of genetic and environmental differences.

  20. Results of the Medicare Health Support disease-management pilot program.

    Science.gov (United States)

    McCall, Nancy; Cromwell, Jerry

    2011-11-03

    In the Medicare Modernization Act of 2003, Congress required the Centers for Medicare and Medicaid Services to test the commercial disease-management model in the Medicare fee-for-service program. The Medicare Health Support Pilot Program was a large, randomized study of eight commercial programs for disease management that used nurse-based call centers. We randomly assigned patients with heart failure, diabetes, or both to the intervention or to usual care (control) and compared them with the use of a difference-in-differences method to evaluate the effects of the commercial programs on the quality of clinical care, acute care utilization, and Medicare expenditures for Medicare fee-for-service beneficiaries. The study included 242,417 patients (163,107 in the intervention group and 79,310 in the control group). The eight commercial disease-management programs did not reduce hospital admissions or emergency room visits, as compared with usual care. We observed only 14 significant improvements in process-of-care measures out of 40 comparisons. These modest improvements came at substantial cost to the Medicare program in fees paid to the disease-management companies ($400 million), with no demonstrable savings in Medicare expenditures. In this large study, commercial disease-management programs using nurse-based call centers achieved only modest improvements in quality-of-care measures, with no demonstrable reduction in the utilization of acute care or the costs of care.

  1. Effectiveness of case management in the prevention of COPD re-admissions: a pilot study.

    Science.gov (United States)

    van Eeden, Annelies E; van de Poll, Ingrid; van Vulpen, Gertrud; Roldaan, Tim; Wagenaar, Wies; Boland, Melinde R S; Wolterbeek, Ron; Chavannes, Niels H

    2017-11-25

    Chronic obstructive pulmonary disease (COPD) exacerbations are associated with high disease burden and costs, especially in the case of hospitalizations. The overall number of hospital admissions due to exacerbations of COPD has increased. It is remarkable that re-admissions account for a substantial part of these hospitalizations. This pilot study investigates the use of case management to reduce re-admissions due to COPD. COPD patients with more than one hospitalization per year due to an exacerbation were included. The participants (n = 10) were closely monitored and intensively coached for 20 weeks after hospitalization. The case manager provided care in a person-focused manner. The case manager informed and supported the patient, took action when relapse threatened, coordinated and connected primary and secondary care. Data of 12 months before and after start of the intervention were compared. Primary outcome was the difference in number of hospitalizations. Secondary outcomes were health-related quality of life (measured by the Clinical COPD Questionnaire, CCQ) and dyspnoea (measured by the MRC Dyspnoea Scale). The incidence rate of hospitalizations was found to be 2.25 times higher (95% confidence interval [CI] 1.3-3.9; P = 0.004) 12 months before compared with 12 months after the start of case management. COPD patients had a mean CCQ score of 3.3 (95% CI 2.8-3.8) before and 2.4 (95% CI 1.9-2.8) after 20 weeks of case management; a difference of 1.0 (95% CI 0.4-1.6; P = 0.001). The mean MRC scores showed no significant differences before (4.3; 95% CI 3.7-4.9) and after the case management period (3.9; 95% CI 3.2-4.6); a difference of 0.4 (95% CI - 0.1 to 0.9; P = 0.114). This pilot study shows that the number of COPD hospital re-admissions decreased significantly after the introduction of a case manager. Moreover, there was an improvement in patient-reported health-related quality of life.

  2. A pilot Croatian survey of risk factor (CRO-SURF) management in patients with cardiovascular disease.

    Science.gov (United States)

    Pećin, Ivan; Milicić, Davor; Jurin, Hrvoje; Reiner, Zeljko

    2012-06-01

    A pilot survey was performed to determine the presence of known risk factors for cardiovascular disease in Croatian patients with diagnosed coronary heart disease (CHD) using a new questionnaire. The idea was to test this new and very simple questionnaire but also to compare the data collected in this pilot survey with the results of the last Croatian national survey (TASPIC-CRO V) and so to obtain the information whether secondary prevention has improved between 2003 and 2010. 122 patients with established CHD (88 men, 34 women, mean age 66.3 years) treated in Zagreb University Hospital Center were included. Data collection was based on filling the SURF questionnaire right after the clinical exam or later using review of medical records. Patients were hospitalized because of CABG (1%), PCI (8%), ACS (35%) or chronic stable angina (56%). The history of arterial hypertension had 95%patients (however, on admission mean systolic pressure was 130.1 mmHg, diastolic 76.8 mmHg), 90% had dyslipidaemia (total cholesterol 1.2 mmol/L (women) or >1.0 mmol/L (men) had 67%), 25% had diabetes which was poorly regulated (mean HbA1c 8.2%), 18% were active smokers. After discharge only 24% performed cardiac rehabilitation. Mean body mass index of the patients was 28.3 kg/m2 (32% were obese, 72% overweight). Compared to TASPIC-CRO V there was lower usage of aspirin than recommended on discharge. This was also true for statin therapy. More patients were taking beta blockers, calcium antagonists and diuretics than 7 years ago. This pilot survey showed that CRO-SURF questionnaire is short, quick, effective and simple to use. It is a good and cost effective tool to collect data on CVD risk factors and their management. The results obtained by using it indicate that there is still a high prevalence of modifiable risk factors in Croatian patients with CHD.

  3. Kangaroo care versus incubator care in the management of well preterm infants--a pilot study.

    Science.gov (United States)

    Kambarami, R A; Chidede, O; Kowo, D T

    1998-06-01

    This pilot study was conducted to compare the effectiveness of the kangaroo care method with current, mainly incubator-based care in managing well preterm infants in a tertiary level hospital in a developing country. Altogether, 74 infants (37 per group) were consecutively allocated to receive either kangaroo care or incubator care. After adjusting for age and weight on admission to the study, we found that infants in the kangaroo care group gained twice as much weight per day (20.8 vs 10.2 g, p = 0.0001), had a shorter stay in hospital (16.6 vs 20.7 days, p = 0.0457) and had a better survival rate (0% vs 9% deaths). Also, they were ill less frequently, but after adjusting for age and weight this difference was not significant. This pilot study suggests that the kangaroo care method has major advantages over incubator care of preterm infants in our hospital. Hospitals which cannot use incubators optimally may find kangaroo care to be a better method of improving perinatal and neonatal morbidity and mortality.

  4. Development and pilot of Case Manager: a virtual-patient experience for veterinary students.

    Science.gov (United States)

    Byron, Julie K; Johnson, Susan E; Allen, L Clare V; Brilmyer, Cheryl; Griffiths, Robert P

    2014-01-01

    There is an increasing demand in veterinary education to engage students, teach and reinforce clinical reasoning, and provide access anytime/anywhere to quality learning opportunities. In addition, accrediting bodies are asking for more concrete documentation of essential clinical-skills outcomes. Unfortunately, during the clinical year in a referral hospital setting, students are at the mercy of chance regarding the types of cases they will encounter and the opportunities they will have to participate. Patient- and case-simulation technology is becoming more popular as a way to achieve these objectives in human and veterinary medical education. Many of the current options available to the veterinary medical education community to develop virtual-patient cases are too time-consuming, cost prohibitive, or difficult for the instructor or learner to use. In response, we developed a learning tool, Case Manager, which is low-cost and user-friendly. Case Manager was designed to meet the demands of veterinary education by providing students with an opportunity to cultivate clinical reasoning skills and allowing for real-time student feedback. We launched a pilot test with 37 senior veterinary medical students as part of their Small Animal Internal Medicine clinical rotation. Students reported that Case Manager increased their engagement with the material, improved diagnostic and problem-solving skills, and broadened their exposure to a variety of cases. In addition, students felt that Case Manager was superior to a more traditional, less interactive case presentation format.

  5. Changing Parent's Mindfulness, Child Management Skills and Relationship Quality with Their Youth: Results from a Randomized Pilot Intervention Trial

    Science.gov (United States)

    Coatsworth, J. Douglas; Duncan, Larissa G.; Greenberg, Mark T.; Nix, Robert L.

    2010-01-01

    We evaluated the efficacy of a mindful parenting program for changing parents' mindfulness, child management practices, and relationships with their early adolescent youth and tested whether changes in parents' mindfulness mediated changes in other domains. We conducted a pilot randomized trial with 65 families and tested an adapted version of the…

  6. Stress Management-Augmented Behavioral Weight Loss Intervention for African American Women: A Pilot, Randomized Controlled Trial

    Science.gov (United States)

    Cox, Tiffany L.; Krukowski, Rebecca; Love, ShaRhonda J.; Eddings, Kenya; DiCarlo, Marisha; Chang, Jason Y.; Prewitt, T. Elaine; West, Delia Smith

    2013-01-01

    The relationship between chronic stress and weight management efforts may be a concern for African American (AA) women, who have a high prevalence of obesity, high stress levels, and modest response to obesity treatment. This pilot study randomly assigned 44 overweight/obese AA women with moderate to high stress levels to either a 12-week…

  7. Referral to a Commercial Weight Management Program in Patients With Coronary Heart Disease: A PILOT STUDY IN THE NETHERLANDS

    NARCIS (Netherlands)

    Minneboo, Madelon; Peters, Ron J. G.; Miller-Kovach, Karen; Lemmens, Jeanine; Bucx, Jeroen J. J.

    2015-01-01

    To quantify the impact of a commercial weight management program on weight change in obese patients with coronary heart disease. An observational, single-center pilot study in the Netherlands. Forty-five patients diagnosed with a recent acute coronary syndrome and a body mass index of >30 kg/m2 were

  8. Progress in long-lived radioactive waste management and disposal at the waste isolation pilot plant

    International Nuclear Information System (INIS)

    Triay, I.R.; Matthews, M.L.; Eriksson, L.G.

    2001-01-01

    The Salado Formation is buried more than 350 m beneath the sands and cacti of the Chihuahuan Desert and hosts the Waste Isolation Pilot Plant (WIPP) deep geological repository at a depth of approximately 650 m. Since the WIPP repository is at least 10 years ahead of any other repository development for long-lived radioactive waste, other radioactive waste management organizations and institutions could benefit both scientifically and politically from sharing the lessons learned at WIPP. Benefits would include using existing expertise and facilities to cost-effectively address and solve program-specific issues and to train staff. The characteristics of the WIPP repository and infrastructure are described in this paper. (author)

  9. Pilot studies on management of ageing of nuclear power plant components: Results of Phase 1

    International Nuclear Information System (INIS)

    1992-10-01

    To facilitate cooperation between the IAEA Member States and thus to enhance the safety and reliability of operating nuclear plants the IAEA has initiated pilot studies on the management of ageing of four representative plant components: the primary nozzle of the reactor pressure vessel, a motor operated valve, the concrete containment building and instrumentation and control cables. Phase 1 of the studies has been completed and its results are presented in this report. The report documents current understanding of ageing and methods for monitoring and mitigation of this ageing for the above components, identifies existing knowledge and technology gaps and defines follow-up work to deal with these gaps. Refs, figs and tabs

  10. Review article: the use of remotely piloted aircraft systems (RPASs) for natural hazards monitoring and management

    Science.gov (United States)

    Giordan, Daniele; Hayakawa, Yuichi; Nex, Francesco; Remondino, Fabio; Tarolli, Paolo

    2018-04-01

    The number of scientific studies that consider possible applications of remotely piloted aircraft systems (RPASs) for the management of natural hazards effects and the identification of occurred damages strongly increased in the last decade. Nowadays, in the scientific community, the use of these systems is not a novelty, but a deeper analysis of the literature shows a lack of codified complex methodologies that can be used not only for scientific experiments but also for normal codified emergency operations. RPASs can acquire on-demand ultra-high-resolution images that can be used for the identification of active processes such as landslides or volcanic activities but can also define the effects of earthquakes, wildfires and floods. In this paper, we present a review of published literature that describes experimental methodologies developed for the study and monitoring of natural hazards.

  11. Piloting a stress management and mindfulness program for undergraduate nursing students: student feedback and lessons learned.

    Science.gov (United States)

    van der Riet, Pamela; Rossiter, Rachel; Kirby, Dianne; Dluzewska, Teresa; Harmon, Charles

    2015-01-01

    Widespread reports of high stress levels and mental health problems among university student populations indicate the use of interventions to facilitate stress reduction and support student resilience and wellbeing. There is growing evidence that regular mindfulness practice may confer positive health benefits and reduced stress levels. The aim of this pilot project was to explore the impact of a seven-week stress management and mindfulness program as a learning support and stress reduction method for nursing and midwifery students. The program was conducted at a large regional university in Australia. Fourteen first-year undergraduate nursing and midwifery students agreed to attend the program and to participate in a follow-up focus group. A descriptive qualitative design was utilised to examine the impact of the program. A semi-structured focus group interview was conducted with a thematic analysis undertaken of the transcript and process notes. Ten students completed the research component of this project by participating in the focus group interview. Three main themes capture the participants' experience: attending to self, attending to others and attending to program related challenges. Data indicate a positive impact on sleep, concentration, clarity of thought and a reduction in negative cognitions. Participants also identified challenges related to timetabling, program structure and venue. Overall, this pilot program enhanced the participants' sense of well-being. Despite the challenges, benefits were identified on a personal and professional level. Valuable feedback was provided that will be used to further develop and expand stress management and mindfulness programs offered to students attending this university. Copyright © 2014. Published by Elsevier Ltd.

  12. 7 CFR 1948.78 - Growth management and housing planning projects.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 13 2010-01-01 2009-01-01 true Growth management and housing planning projects. 1948... Impacted Area Development Assistance Program § 1948.78 Growth management and housing planning projects. (a) Existing plans for growth management and housing may be used to meet the planning requirements of this...

  13. Navigating the Road to Recovery: Assessment of the Coordination, Communication, and Financing of the Disaster Case Management Pilot in Louisiana

    OpenAIRE

    Acosta, Joie; Chandra, Anita; Feeney, Kevin Carter

    2011-01-01

    In 2009, individuals heavily affected by Hurricanes Katrina and Rita were still in need of social services. The Federal Emergency Management Agency (FEMA) provided funding to the Louisiana Recovery Authority to implement the Disaster Case Management Pilot (DCMP) in order to help people still living in FEMA temporary housing units in April 2009 move to permanent and secure housing and access services. Despite concerted effort by participating agencies, the implementation of the DCMP was fraugh...

  14. Improved Gout Outcomes in Primary Care Using a Novel Disease Management Program: A Pilot Study.

    Science.gov (United States)

    Bulbin, David; Denio, Alfred E; Berger, Andrea; Brown, Jason; Maynard, Carson; Sharma, Tarun; Kirchner, H Lester; Ayoub, William T

    2018-02-13

    To pilot a primary care gout management improvement intervention. Two large primary care sites were selected: one underwent the intervention, the other, a control, underwent no intervention. The intervention consisted of: engagement of intervention site staff, surveys of provider performance improvement preferences, and onsite live and enduring online education. Electronic Health Record reminders were constructed. Both the intervention and control sites had 3 quality measures assessed monthly: percent of gout patients treated with urate lowering therapy, percent of treated patients monitored with serum urate, and percent of treated patients at target serum urate ≤ 6.0 mg/dl. The intervention site providers received monthly reports comparing their measures against their peers. By 6 months, the intervention site significantly improved all 3 gout performance measures. Percentage treated increased from 54.4 to 61.1%, OR 1.19 (95% CI 1.08, 1.31 and p-value management program can significantly improve primary care gout management performance. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  15. Developing a Web-Based Nursing Practice and Research Information Management System: A Pilot Study.

    Science.gov (United States)

    Choi, Jeeyae; Lapp, Cathi; Hagle, Mary E

    2015-09-01

    Many hospital information systems have been developed and implemented to collect clinical data from the bedside and have used the information to improve patient care. Because of a growing awareness that the use of clinical information improves quality of care and patient outcomes, measuring tools (electronic and paper based) have been developed, but most of them require multiple steps of data collection and analysis. This necessitated the development of a Web-based Nursing Practice and Research Information Management System that processes clinical nursing data to measure nurses' delivery of care and its impact on patient outcomes and provides useful information to clinicians, administrators, researchers, and policy makers at the point of care. This pilot study developed a computer algorithm based on a falls prevention protocol and programmed the prototype Web-based Nursing Practice and Research Information Management System. It successfully measured performance of nursing care delivered and its impact on patient outcomes successfully using clinical nursing data from the study site. Although Nursing Practice and Research Information Management System was tested with small data sets, results of study revealed that it has the potential to measure nurses' delivery of care and its impact on patient outcomes, while pinpointing components of nursing process in need of improvement.

  16. Managing mobility outcomes in vulnerable seniors ( MMOVeS): a randomized controlled pilot study.

    Science.gov (United States)

    Figueiredo, Sabrina; Morais, Jose A; Mayo, Nancy

    2017-12-01

    To estimate feasibility and potential for efficacy of an individualized, exercise-focused, self-management program (i.e. Managing Mobility Outcomes In Vulnerable Seniors ( MMOVeS)), in comparison to exercise information in improving mobility after six months among seniors recently discharged from hospital. Randomized pilot study. Two McGill University-teaching hospitals. Community dwelling seniors, aged 70 years and older, recently discharged from either participating hospitals. The physiotherapy-facilitated intervention consisted of (1) evaluation of mobility capacity, (2) setting short- and long-term goals, (3) delineation of an exercise treatment plan, (4) an educational booklet to enhance mobility self-management skills, and (5) six monthly telephone calls. Control group received a booklet with information on exercises targeting mobility limitations in seniors. Mobility, pain, and health status were assessed at baseline and at six months using multiple indicators drawn from Disabilities of the Arm, Shoulder, and Hand (DASH) Score, Lower Extremity Functional Scale (LEFS) and Short-Form (SF)-36. In all, 26 people were randomized to the intervention (mean age: 81 ± 8; 39% women), and 23 were randomized to the control (mean age: 79 ± 7; 33% women). The odds ratio for the mobility outcomes combined was 3.08 and the 95% confidence interval excluded 1 (1.65-5.77). The odds ratio for pain and health perception favored the MMOVeS group, but the 95% confidence interval included the null value. This feasibility study highlights the potential for efficacy of an individualized, exercise-focused, self-management program in comparison to exercise information in improving mobility outcome for seniors. Furthermore, a home-program combining self-management skills and exercise taught with minimal supervision prove to be feasible. Finally, data from this study can be used to estimate sample size for a confirmatory trial.

  17. Urban strategies for Waste Management in Tourist Cities. D2.7 : Compendium of waste management practices in pilot cities and best practices in touristic cities

    NARCIS (Netherlands)

    Gruber, Iris; Mayerhofer, Johannes; Obersteiner, Gudrun; Ramusch, Roland; Romein, A.; Eriksson, Mattias; Grosse, Juliane; MC. Nascimento, Gisela; Bjorn Olsen, Trine; de Luca, Claudia; Zapata Aranda, Pilar; Kazeroni, Marie; Kovacs, Ernest

    2017-01-01

    This report (Deliverable D2.7) refers to URBANWASTE Work Package 2, Task 2.8. Under this Task the current waste prevention and management practices in the URBANWASTE pilot cases are investigated and best practices coming from the EU context (focussing on touristic processes) are identified. This

  18. Managing for Old Growth in Frequent-fire Landscapes

    Directory of Open Access Journals (Sweden)

    Carl E. Fiedler

    2007-12-01

    Full Text Available There is no one-size-fits-all approach to managing frequent-fire, old-growth forests. However, there are general guidelines to follow: 1 set objectives for both structure (tree density, diameter distribution, tree species composition, spatial arrangement, amount of coarse woody debris and function (nutrient cycling, desired tree species regeneration; 2 prioritize treatments according to ecological, economic, and social needs and risks; 3 identify the potential treatments (natural fire, prescribed fire, silvicultural cutting that best meet the objectives and scale of the project; and 4 implement the treatment(s. We discuss each of these guidelines in this article.

  19. Urban strategies for Waste Management in Tourist Cities. D2.7: Compendium of waste management practices in pilot cities and best practices in touristic cities

    OpenAIRE

    Gruber, Iris; Mayerhofer, Johannes; Obersteiner, Gudrun; Ramusch, Roland; Romein, A.; Eriksson, Mattias; Grosse, Juliane; MC. Nascimento, Gisela; Bjorn Olsen, Trine; de Luca, Claudia; Zapata Aranda, Pilar; Kazeroni, Marie; Kovacs, Ernest

    2017-01-01

    This report (Deliverable D2.7) refers to URBANWASTE Work Package 2, Task 2.8. Under this Task the current waste prevention and management practices in the URBANWASTE pilot cases are investigated and best practices coming from the EU context (focussing on touristic processes) are identified. This document shall support the selection of innovative strategies to be carried out within Work Package WP 4. A comparative policy review of national waste management strategies and targets in the Europea...

  20. Cardiovascular Disease Self-Management: Pilot Testing of an mHealth Healthy Eating Program

    Directory of Open Access Journals (Sweden)

    Leila Pfaeffli Dale

    2014-03-01

    Full Text Available Cardiac rehabilitation (CR is crucial in the management of cardiovascular disease (CVD, yet attendance is poor. Mobile technology (mHealth offers a potential solution to increase reach of CR. This paper presents two development studies to determine mobile phone usage in adults with CVD and to evaluate the acceptability of an mHealth healthy eating CR program. Methods: CR attendees were surveyed to determine mobile phone usage rates. A second single-subject pilot study investigated perceptions of a 4-week theory-based healthy eating mHealth program and explored pre-post changes in self-efficacy. Results: 74 adults with CVD completed the survey (50/74 male; mean age 63 ± 10. Nearly all had mobile phones (70/74; 95% and used the Internet (69/74; 93%, and most were interested in receiving CR by text message (57/74; 77%. 20 participants took part in the healthy eating pilot study. Participants read all/most of the text messages, and most (19/20 thought using mobile technology was a good way to deliver the program. The website was not widely used as visiting the website was reported to be time consuming. Exploratory t-tests revealed an increase in heart healthy eating self-efficacy post program, in particular the environmental self-efficacy subset (Mean = 0.62, SD = 0.74, p = 0.001. Conclusions: Text messaging was seen as a simple and acceptable way to deliver nutrition information and behavior change strategies; however, future research is needed to determine the effectiveness of such programs.

  1. Cardiovascular Disease Self-Management: Pilot Testing of an mHealth Healthy Eating Program.

    Science.gov (United States)

    Dale, Leila Pfaeffli; Whittaker, Robyn; Eyles, Helen; Mhurchu, Cliona Ni; Ball, Kylie; Smith, Natasha; Maddison, Ralph

    2014-03-19

    Cardiac rehabilitation (CR) is crucial in the management of cardiovascular disease (CVD), yet attendance is poor. Mobile technology (mHealth) offers a potential solution to increase reach of CR. This paper presents two development studies to determine mobile phone usage in adults with CVD and to evaluate the acceptability of an mHealth healthy eating CR program. CR attendees were surveyed to determine mobile phone usage rates. A second single-subject pilot study investigated perceptions of a 4-week theory-based healthy eating mHealth program and explored pre-post changes in self-efficacy. 74 adults with CVD completed the survey (50/74 male; mean age 63 ± 10). Nearly all had mobile phones (70/74; 95%) and used the Internet (69/74; 93%), and most were interested in receiving CR by text message (57/74; 77%). 20 participants took part in the healthy eating pilot study. Participants read all/most of the text messages, and most (19/20) thought using mobile technology was a good way to deliver the program. The website was not widely used as visiting the website was reported to be time consuming. Exploratory t-tests revealed an increase in heart healthy eating self-efficacy post program, in particular the environmental self-efficacy subset (Mean = 0.62, SD = 0.74, p = 0.001). Text messaging was seen as a simple and acceptable way to deliver nutrition information and behavior change strategies; however, future research is needed to determine the effectiveness of such programs.

  2. Phase II Water Rental Pilot Project: Snake River Resident Fish and Wildlife Resources and Management Recommendations.

    Energy Technology Data Exchange (ETDEWEB)

    Stovall, Stacey H.

    1994-08-01

    The Idaho Water Rental Pilot Project was implemented in 1991 as part of the Non-Treaty Storage Fish and Wildlife Agreement between Bonneville Power Administration and the Columbia Basin Fish and Wildlife Authority. The goal of the project is to quantify resident fish and wildlife impacts resulting from salmon flow augmentation releases made from the upper Snake River Basin. Phase I summarized existing resource information and provided management recommendations to protect and enhance resident fish and wildlife habitat resulting from storage releases for the I improvement of an adromous fish migration. Phase II includes the following: (1) a summary of recent biological, legal, and political developments within the basin as they relate to water management issues, (2) a biological appraisal of the Snake River between American Falls Reservoir and the city of Blackfoot to examine the effects of flow fluctuation on fish and wildlife habitat, and (3) a preliminary accounting of 1993--1994 flow augmentation releases out of the upper Snake, Boise, and Payette river systems. Phase III will include the development of a model in which annual flow requests and resident fish and wildlife suitability information are interfaced with habitat time series analysis to provide an estimate of resident fish and wildlife resources.

  3. Pilot climate data system: A state-of-the-art capability in scientific data management

    Science.gov (United States)

    Smith, P. H.; Treinish, L. A.; Novak, L. V.

    1983-01-01

    The Pilot Climate Data System (PCDS) was developed by the Information Management Branch of NASA's Goddard Space Flight Center to manage a large collection of climate-related data of interest to the research community. The PCDS now provides uniform data catalogs, inventories, access methods, graphical displays and statistical calculations for selected NASA and non-NASA data sets. Data manipulation capabilities were developed to permit researchers to easily combine or compare data. The current capabilities of the PCDS include many tools for the statistical survey of climate data. A climate researcher can examine any data set of interest via flexible utilities to create a variety of two- and three-dimensional displays, including vector plots, scatter diagrams, histograms, contour plots, surface diagrams and pseudo-color images. The graphics and statistics subsystems employ an intermediate data storage format which is data-set independent. Outside of the graphics system there exist other utilities to select, filter, list, compress, and calculate time-averages and variances for any data of interest. The PCDS now fully supports approximately twenty different data sets and is being used on a trial basis by several different in-house research grounds.

  4. Cultural Dance Program Improves Hypertension Management for Native Hawaiians and Pacific Islanders: a Pilot Randomized Trial.

    Science.gov (United States)

    Kaholokula, Joseph Keawe'aimoku; Look, Mele; Mabellos, Tricia; Zhang, Guangxiang; de Silva, Mapuana; Yoshimura, Sheryl; Solatorio, Cappy; Wills, Thomas; Seto, Todd B; Sinclair, Ka'imi A

    2017-02-01

    Native Hawaiians and Pacific Islanders (NHPI) bear an unequal burden of hypertension and cardiovascular disease. Hula, the traditional dance of Hawaii, has shown to be a culturally meaningful form of moderate-vigorous physical activity for NHPI. A pilot study was done in Honolulu, Hawaii, to test a 12-week hula-based intervention, coupled with self-care education, on blood pressure management in NHPI with hypertension in 2013. NHPI with a systolic blood pressure (SBP) ≥140 mmHg were randomized to the intervention (n = 27) or a wait-list control (n = 28). Blood pressure, physical functioning, and eight aspects of health-related quality of life (HRQL) were assessed. The intervention resulted in a reduction in SBP compared to control (-18.3 vs. -7.6 mmHg, respectively, p ≤ 0.05) from baseline to 3-month post-intervention. Improvements in HRQL measures of bodily pain and social functioning were significantly associated with SBP improvements in both groups. Using hula as the physical activity component of a hypertension intervention can serve as a culturally congruent strategy to blood pressure management in NHPI with hypertension. clinicaltrials.gov Identifier: NCT01995812.

  5. Reiki Therapy for Symptom Management in Children Receiving Palliative Care: A Pilot Study.

    Science.gov (United States)

    Thrane, Susan E; Maurer, Scott H; Ren, Dianxu; Danford, Cynthia A; Cohen, Susan M

    2017-05-01

    Pain may be reported in one-half to three-fourths of children with cancer and other terminal conditions and anxiety in about one-third of them. Pharmacologic methods do not always give satisfactory symptom relief. Complementary therapies such as Reiki may help children manage symptoms. This pre-post mixed-methods single group pilot study examined feasibility, acceptability, and the outcomes of pain, anxiety, and relaxation using Reiki therapy with children receiving palliative care. A convenience sample of children ages 7 to 16 and their parents were recruited from a palliative care service. Two 24-minute Reiki sessions were completed at the children's home. Paired t tests or Wilcoxon signed-rank tests were calculated to compare change from pre to post for outcome variables. Significance was set at P Reiki therapy did decrease pain, anxiety, heart, and respiratory rates, but small sample size deterred statistical significance. This preliminary work suggests that complementary methods of treatment such as Reiki may be beneficial to support traditional methods to manage pain and anxiety in children receiving palliative care.

  6. Optimizing Patient Management and Adherence for Children Receiving Growth Hormone

    Directory of Open Access Journals (Sweden)

    Carlo L. Acerini

    2017-11-01

    Full Text Available Poor adherence with growth hormone (GH therapy has been associated with worse clinical outcomes, which in children relates specifically to their linear growth and loss of quality of life. The “360° GH in Europe” meeting, held in Lisbon, Portugal, in June 2016 and funded by Merck KGaA (Germany, examined many aspects of GH diseases. The three sessions, entitled “Short Stature Diagnosis and Referral,” “Optimizing Patient Management,” and “Managing Transition,” each benefited from three guest speaker presentations, followed by an open discussion and are reported as a manuscript, authored by the speakers. Reported here is a summary of the proceedings of the second session, which reviewed the determinants of GH therapy response, factors affecting GH therapy adherence and the development of innovative technologies to improve GH treatment in children. Response to GH therapy varies widely, particularly in regard to the underlying diagnosis, although there is little consensus on the definition of a poor response. If the growth response is seen to be less than expected, the possible reasons should be discussed with patients and their parents, including compliance with the therapy regimen. Understanding and addressing the multiple factors that influence adherence, in order to optimize GH therapy, requires a multi-disciplinary approach. Because therapy continues over many years, various healthcare professionals will be involved at different periods of the patient’s journey. The role of the injection device for GH therapy, frequent monitoring of response, and patient support are all important for maintaining adherence. New injection devices are incorporating electronic technologies for automated monitoring and recording of clinically relevant information on injections. Study results are indicating that such devices can at least maintain GH adherence; however, acceptance of novel devices needs to be assessed and there remains an on

  7. Optimizing Patient Management and Adherence for Children Receiving Growth Hormone.

    Science.gov (United States)

    Acerini, Carlo L; Wac, Katarzyna; Bang, Peter; Lehwalder, Dagmar

    2017-01-01

    Poor adherence with growth hormone (GH) therapy has been associated with worse clinical outcomes, which in children relates specifically to their linear growth and loss of quality of life. The "360° GH in Europe" meeting, held in Lisbon, Portugal, in June 2016 and funded by Merck KGaA (Germany), examined many aspects of GH diseases. The three sessions, entitled " Short Stature Diagnosis and Referral ," " Optimizing Patient Management ," and " Managing Transition ," each benefited from three guest speaker presentations, followed by an open discussion and are reported as a manuscript, authored by the speakers. Reported here is a summary of the proceedings of the second session, which reviewed the determinants of GH therapy response, factors affecting GH therapy adherence and the development of innovative technologies to improve GH treatment in children. Response to GH therapy varies widely, particularly in regard to the underlying diagnosis, although there is little consensus on the definition of a poor response. If the growth response is seen to be less than expected, the possible reasons should be discussed with patients and their parents, including compliance with the therapy regimen. Understanding and addressing the multiple factors that influence adherence, in order to optimize GH therapy, requires a multi-disciplinary approach. Because therapy continues over many years, various healthcare professionals will be involved at different periods of the patient's journey. The role of the injection device for GH therapy, frequent monitoring of response, and patient support are all important for maintaining adherence. New injection devices are incorporating electronic technologies for automated monitoring and recording of clinically relevant information on injections. Study results are indicating that such devices can at least maintain GH adherence; however, acceptance of novel devices needs to be assessed and there remains an on-going need for innovations.

  8. Managing multiple projects: a literature review of setting priorities and a pilot survey of healthcare researchers in an academic setting.

    Science.gov (United States)

    Hopkins, Robert Borden; Campbell, Kaitryn; O'Reilly, Daria; Tarride, Jean-Eric; Bowen, Jim; Blackhouse, Gord; Goerre, Ron

    2007-05-16

    To summarize and then assess with a pilot study the use of published best practice recommendations for priority setting during management of multiple healthcare research projects, in a resource-constrained environment. Medical, economic, business, and operations literature was reviewed to summarize and develop a survey to assess best practices for managing multiple projects. Fifteen senior healthcare research project managers, directors, and faculty at an urban academic institution were surveyed to determine most commonly used priority rules, ranking of rules, characteristics of their projects, and availability of resources. Survey results were compared to literature recommendations to determine use of best practices. Seven priority-setting rules were identified for managing multiple projects. Recommendations on assigning priorities by project characteristics are presented. In the pilot study, a large majority of survey respondents follow best practice recommendations identified in the research literature. However, priority rules such as Most Total Successors (MTS) and Resource Scheduling Method (RSM) were used "very often" by half of the respondents when better performing priority rules were available. Through experience, project managers learn to manage multiple projects under resource constraints. Best practice literature can assist project managers in priority setting by recommending the most appropriate priority given resource constraints and project characteristics. There is room for improvement in managing multiple projects.

  9. Managing Transition in Patients Treated with Growth Hormone

    Directory of Open Access Journals (Sweden)

    Berthold P. Hauffa

    2017-12-01

    Full Text Available Growth hormone (GH promotes growth in children, but is also essential for bone strength, body composition, metabolic factors, such as lipid profile, and maintenance of quality of life. The Merck KGaA (Germany funded “360° GH in Europe” meeting, held in Lisbon, Portugal, in June 2016, comprised three sessions entitled “Short Stature Diagnosis and Referral,” “Optimizing Patient Management and Adherence,” and “Managing Transition.” The scientific program covered all stages of pediatric GH treatment, and reported here are the outcomes of the third session of the meeting, which considered transition from pediatric GH treatment to teenage and young adult GH therapy. A large number of patients with chronic diseases, including GH deficiency, drop out of therapy during the transition period. Multiple factors are associated with this, such as lack of understanding of the disease process, insufficient knowledge of treatment options, the patient becoming more independent, and requirement for interaction with a new set of health-care workers. Education regarding disease management and treatment options should be provided from an early age and right through the transition period. However, endocrine specialists will view the transition period differently, depending on whether they are pediatric endocrinologists who mainly deal with congenital diseases, in which auxology is important, or adult endocrinologists who are more concerned with body composition and metabolic factors. View points of both a pediatric and an adult endocrine specialist are presented, together with a case study outlining practical aspects of transition. It was noted in the meeting discussion that having one person to guide a patient through transition from an early age is important, but may be constrained by various factors such as finances, and options will differ by country.

  10. Behavior management approach for agitated behavior in Japanese patients with dementia: a pilot study

    Directory of Open Access Journals (Sweden)

    Sato J

    2012-12-01

    Full Text Available Junko Sato,1 Shutaro Nakaaki,2 Katsuyoshi Torii,1 Mizuki Oka,2 Atsushi Negi,1 Hiroshi Tatsumi,3 Jin Narumoto,4 Toshi A Furukawa,5 Masaru Mimura21Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, 2Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, 3Department of Health Science, Faculty of Psychological and Physical Science, Aichi Gakuin University, Nagoya, 4Department of Psychiatry, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, 5Department of Health Promotion and Human Behavior (Cognitive-Behavioral Medicine, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, JapanBackground: Agitated behaviors are frequently observed in patients with dementia and can cause severe distress to caregivers. However, little evidence of the efficacy of nonpharmacological interventions for agitated behaviors exists for patients with dementia. The present pilot study aimed to evaluate a behavioral management program developed by the Seattle Protocols for patients with agitated behaviors in Japan.Methods: Eighteen patients with dementia (Alzheimer’s disease, n = 14; dementia with Lewy bodies, n = 4 participated in an open study testing the effectiveness of a behavioral management program. The intervention consisted of 20 sessions over the course of 3 months. The primary outcomes were severity of agitation in dementia, as measured using the Agitated Behavior in Dementia scale (ABID and the Cohen-Mansfield Agitation Inventory (CMAI.Results: The behavioral management program resulted in significant reductions in total scores on both the ABID and CMAI. Although both physically agitated and verbally agitated behavior scores on the ABID improved significantly, symptoms of psychosis did not improve after the intervention.Conclusion: The behavioral management technique may be beneficial to distressed caregivers of

  11. Optimizing management of Crohn's disease within a project management framework: results of a pilot study.

    Science.gov (United States)

    Keefer, Laurie; Doerfler, Bethany; Artz, Caroline

    2012-02-01

    Psychotherapy for Crohn's disease (CD) has focused on patients with psychological distress. Another approach to optimize management of CD is to target patients who do not exhibit psychological distress but engage in behaviors that undermine treatment efficacy / increase risk for flare. We sought to determine the feasibility/acceptability and estimate the effects of a program framed around Project Management (PM) principles on CD outcomes. Twenty-eight adults with quiescent CD without a history of psychiatric disorder were randomized to PM (n = 16) or treatment as usual (TAU; n = 12). Baseline and follow-up measures were Inflammatory Bowel Disease Questionnaire (IBDQ), Medication Adherence Scale (MAS), Perceived Stress Questionnaire (PSQ), and IBD Self-Efficacy Scale (IBD-SES). There were significant group × time effects favoring PM on IBDQ-Total Score (F(1) = 15.2, P = 0.001), IBDQ-Bowel (F(1) = 6.5, P = 0.02), and IBDQ-Systemic (F(1) = 9.3, P = 0.007) but not IBDQ-Emotional (F(1) = 1.9, P = ns) or IBDQ-Social (F(1) = 2.4, P = ns). There was a significant interaction effect favoring PM with respect to PSQ (F(1) = 8.4, P = 0.01) and IBD-SES (F(1) = 12.2, P = 0.003). There was no immediate change in MAS (F(1) = 4.3, P = ns). Moderate effect sizes (d > 0.30) were observed for IBDQ total score (d = 0.45), IBDQ bowel health (d = 0.45), and systemic health (d = 0.37). Effect sizes for PSQ (d = 0.13) and IBDSES (d = 0.17) were smaller. Behavioral programs that appeal to patients who may not seek psychotherapy for negative health behaviors may improve quality of life and potentially disease course and outcomes. Copyright © 2011 Crohn's & Colitis Foundation of America, Inc.

  12. Human Factors: FAA's Guidance and Oversight of Pilot Crew Resource Management Training Can Be Improved

    National Research Council Canada - National Science Library

    1997-01-01

    .... The current level of airline safety has been achieved, in part, because the airline industry and government regulatory agencies have implemented rigorous pilot training and evaluation programs...

  13. Innovation Practice Using Pervasive Mobile Technology Solutions to Improve Population Health Management: A Pilot Study of Gestational Diabetes Patient Care in Australia.

    Science.gov (United States)

    Wickramasinghe, Nilmini; Gururajan, Raj

    2016-01-01

    Healthcare service delivery is moving forward from individual care to population health management, because of the fast growth of health records. However, to improve population health performance, it is necessary to leverage relevant data and information using new technology solutions, such as pervasive diabetes mobile technology solution of Inet International Inc., which offers the potential to facilitate patient empowerment with gestational diabetic care. Hence, this article examines the pilot study outcomes of a small clinical trial focusing on pregnant patients affected by gestational diabetes mellitus, in an Australian not for profit healthcare context. The aims include establishing proof of concept and also assessing the usability, acceptability, and functionality of this mobile solution and thereby generate hypotheses to be tested in a large-scale confirmatory clinical trial.

  14. Generalist care managers for the treatment of depressed medicaid patients in North Carolina: A pilot study

    Directory of Open Access Journals (Sweden)

    Ellis Alan R

    2007-03-01

    Full Text Available Abstract Background In most states, mental illness costs are an increasing share of Medicaid expenditures. Specialized depression care managers (CM have consistently demonstrated improvements in patient outcomes relative to usual primary care (UC, but are costly and may not be fully utilized in smaller practices. A generalist care manager (GCM could manage multiple chronic conditions and be more accepted and cost-effective than the specialist depression CM. We designed a pilot program to demonstrate the feasibility of training/deploying GCMs into primary care settings. Methods We randomized depressed adult Medicaid patients in 2 primary care practices in Western North Carolina to a GCM intervention or to UC. GCMs, already providing services in diabetes and asthma in both study arms, were further trained to provide depression services including self-management, decision support, use of information systems, and care management. The following data were analyzed: baseline, 3- and 6-month Patient Health Questionnaire (PHQ9 scores; baseline and 6-month Short Form (SF 12 scores; Medicaid claims data; questionnaire on patients' perceptions of treatment; GCM case notes; physician and office staff time study; and physician and office staff focus group discussions. Results Forty-five patients were enrolled, the majority with preexisting depression. Both groups improved; the GCM group did not demonstrate better clinical and functional outcomes than the UC group. Patients in the GCM group were more likely to have prescriptions of correct dosing by chart data. GCMs most often addressed comorbid conditions (36%, then social issues (27% and appointment reminders (14%. GCMs recorded an average of 46 interactions per patient in the GCM arm. Focus group data demonstrated that physicians valued using GCMs. A time study documented that staff required no more time interacting with GCMs, whereas physicians spent an average of 4 minutes more per week. Conclusion GCMs

  15. Development and pilot testing of a mobile health solution for asthma self-management: asthma action plan smartphone application pilot study.

    Science.gov (United States)

    Licskai, Christopher; Sands, Todd W; Ferrone, Madonna

    2013-01-01

    Collaborative self-management is a core recommendation of national asthma guidelines; the written action plan is the knowledge tool that supports this objective. Mobile health technologies have the potential to enhance the effectiveness of the action plan as a knowledge translation tool. To design, develop and pilot a mobile health system to support asthma self-management. The present study was a prospective, single-centre, nonrandomized, pilot preintervention-postintervention analysis. System design and development were guided by an expert steering committee. The network included an agnostic web browser-based asthma action plan smartphone application (SPA). Subjects securely transmitted symptoms and peak flow data daily, and received automated control assessment, treatment advice and environmental alerts. Twenty-two adult subjects (mean age 47 years, 82% women) completed the study. Biophysical data were received on 84% of subject days (subject day = 1 subject × 1 day). Subjects viewed their action plan current zone of control on 54% and current air quality on 61% of subject days, 86% followed self-management advice and 50% acted to reduce exposure risks. A large majority affirmed ease of use, clarity and timeliness, and 95% desired SPA use after the study. At baseline, 91% had at least one symptom criterion for uncontrolled asthma and 64% had ≥2, compared with 45% (P=0.006) and 27% (P=0.022) at study close. Mean Asthma Quality of Life Questionnaire score improved from 4.3 to 4.8 (P=0.047). A dynamic, real-time, interactive, mobile health system with an integrated asthma action plan SPA can support knowledge translation at the patient and provider levels.

  16. Visualization of individual growth-related craniofacial changes based on cephalometric landmark data: a pilot study.

    Science.gov (United States)

    Lux, Christopher J; Starke, Jens; Rübel, Jan; Stellzig, Angelika; Komposch, Gerda

    2002-05-01

    An approach based on Euclidean distances between cephalometric landmarks is presented (1) to visualize and localize the individual shape changes of the complex craniofacial skeleton during growth and (2) to depict the individual dynamic behavior of developmental size and shape changes. Growth-related craniofacial changes were investigated exemplarily for two male orthodontically untreated subjects from the Belfast Growth Study on the basis of lateral cephalograms at 7, 9, 11, 13, and 15 years. The interlandmark distances among seven skeletal cephalometric landmarks served as a database for the study. A modified Karhunen-Loève decomposition based on orthogonal modes and time-dependent scalar amplitudes was used to describe the growth process. The individual shape changes of the various craniofacial regions were visualized by allocation of colors to the respective distances, and overdrawn representations were reconstructed by means of multidimensional scaling. This visualization technique allows anatomical regions to be characterized with respect to reduced or strengthened growth, compared with pure size changes. The clinically relevant mechanisms of craniofacial changes are visualized (e.g., shifts in the anteroposterior or vertical dimensions of the jaws in relation to cranial base and structural imbalances during development). In addition, overdrawing the effects of shape change on the skeletal structures gives a more readily comprehensible impression of the growth process. Taking account of the methodical limitations of this approach (e.g., the restrictions concerning the number of landmarks), the clinician may take advantage of this technique in orthodontic or surgical diagnostics to gain additional insight into the individual complex size and shape changes during development along with their dynamic behavior.

  17. Property value management aimed at promoting economic growth

    Directory of Open Access Journals (Sweden)

    Sandra Odobašić

    2013-12-01

    Full Text Available Managing the property value at the micro level of individuals, households, businesses and other orga - nisations on one hand, and the government at the macro level is a key factor in achieving a faster GDP growth and getting closer to the developed countries. Natural resources of a country are important, as is the structure, dynamics, education and culture, traditions, working habits, consumption habits and savings of the population. A key factor, however, is the way in which property is treated. Available property must constantly generate revenue. Ignoring the way in which the population treats property might hold back the development. An adequate government policy plays a crucial role in increasing the value of property, and should include the introduction of property tax.

  18. The significance of the pilot conditioning plant (PKA) for spent fuel management

    International Nuclear Information System (INIS)

    Willax, H.O.

    1996-01-01

    The pilot conditioning plant (PKA) is intended as a multi-purpose facility and thus may serve various purposes involved in the conditioning or disposal of spent fuel elements or radwaste. Its design as a pilot plant permits development and trial of various methods and processes for fuel element conditioning, as well as for radwaste conditioning. (orig./DG) [de

  19. Conceptual design study for heat exhaust management in the ARC fusion pilot plant

    Science.gov (United States)

    Dennett, C. A.; Cao, N. M.; Creely, A. J.; Hecla, J.; Hoffman, H.; Kuang, A. Q.; Major, M.; Ruiz Ruiz, J.; Tinguely, R. A.; Tolman, E. A.; Brunner, D.; Labombard, B.; Sorbom, B. N.; Whyte, D. G.; Grover, P.; Laughman, C.

    2017-10-01

    The ARC pilot plant conceptual design study has been extended to explore solutions for managing heat exhaust resulting from 525 MW of fusion power in a compact (R 3.3 m) tokamak. Superconducting poloidal field coils are configured to produce double-null equilibria that support X-point target divertors while maintaining the original core plasma shape and toroidal field coil size. Long outer divertor legs are appended to the original vacuum vessel, providing both large surface areas for surface dissipation of radiative heat and significantly reduced neutron damage for divertor components. A molten salt FLiBe blanket adequately shields all superconductors and functions as a tritium breeder, with advanced neutronics calculations indicating a tritium breeding ratio of 1.08. In addition, FLiBe is used as the active coolant for the entire vessel. A tungsten swirl-tube cooling channel is implemented in the divertor, capable of exhausting 12 MW/m2, heat flux while keeping total FliBe pumping power below 1% of fusion power. Finally, three novel diagnostics are explored: Cherenkov radiation emitted in FLiBe to measure fusion reaction rate, microwave interferometry to measure divertor detachment front location, and IR imaging through the FLiBe blanket to monitor selected divertor ``hotspots.''

  20. Spirituality, Religiosity, and Weight Management Among African American Adolescent Males: The Jackson Heart KIDS Pilot Study.

    Science.gov (United States)

    Bruce, Marino A; Beech, Bettina M; Griffith, Derek M; Thorpe, Roland J

    2016-01-01

    Spirituality and religion have been identified as important determinants of health for adults; however, the impact of faith-oriented factors on health behaviors and outcomes among African American adolescent males has not been well studied. The purpose of this study is to examine the relationship between religiosity and spirituality and obesity-related behaviors among 12-19 year old African American males (N = 105) in the Jackson Heart KIDS Pilot Study. Key variables of interest are church attendance, prayer, daily spirituality, weight status, attempts to lose weight, nutrition, physical activity, and stress. Daily spirituality is associated with whether an individual attempts to lose weight. The results from logistic regression models suggest that daily spirituality increases the odds that African American male adolescents attempt to lose weight (OR = 1.22, CI: 1.07-1.41) and have a history of diet-focused weight management (OR = 1.13, CI: 1.02-1.26). Future studies are needed to further explore the association between religion, spirituality, and obesity-related behaviors.

  1. Optimizing arousal to manage aggression: a pilot study of sensory modulation.

    Science.gov (United States)

    Sutton, Daniel; Wilson, Michael; Van Kessel, Kirsten; Vanderpyl, Jane

    2013-12-01

    The dominant model that informs clinical training for preventing violence and managing aggression posits arousal as mediated downwards from higher cortical structures. This view results in an often-misplaced reliance on verbal and cognitive techniques for de-escalation. The emergence of sensory modulation, via the Six Core Strategies, is an alternative or complementary approach that is associated with reduced rates of seclusion and restraint. Sensory-based interventions are thought to promote adaptive regulation of arousal and emotion, but this connection has had limited theoretical and empirical development. This paper presents results of a pilot trial of sensory-based interventions in four inpatient mental health units in New Zealand. Narrative analysis of interview and focus group data suggest that modifications to the environment and the use of soothing stimuli moderate or optimize arousal and promote an ability to adaptively regulate emotion. Findings are discussed in light of recent advances in the neurophysiology of emotional regulation and the General Aggression Model that posits arousal and maladaptive emotional regulation as precursors to aggression. © 2013 The Authors; International Journal of Mental Health Nursing © 2013 Australian College of Mental Health Nurses Inc.

  2. Economic growth and welfare of the population in Russia: historical overview and management solutions

    OpenAIRE

    DANILOV K.D.

    2016-01-01

    The article deals with the issues of economic growth in Russia and other countries, the relationship between economic growth and welfare of the population, a mismatch of high results of economic development and the rate of growth of national income. Historical overview of the theories of economic growth and appropriate management decisions is given.

  3. Pilot Survey of Breast Cancer Management in Sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Verna D.N.K. Vanderpuye

    2017-06-01

    Full Text Available Purpose: To understand the current state of breast cancer management in sub-Saharan Africa. Methods: We conducted an anonymous online survey of breast cancer management among African Organization for Research and Treatment in Cancer (AORTIC members by using a 42-question structured questionnaire in both English and French in 2013. Results: Twenty members from 19 facilities in 14 countries responded to the survey. Twelve members (60% belonged to a multidisciplinary breast cancer team. Radiotherapy equipment was available in seven facilities (36%, but equipment had down time at least once a week in four facilities. Available chemotherapy drugs included methotrexate, cyclophosphamide, fluorouracil, anthracyclines, and vincristine, whereas trastuzumab, taxanes, vinorelbine, and gemcitabine were available in few facilities. Core-needle biopsy was available in 16 facilities (84%; mammogram, in 17 facilities (89%; computed tomography scan, in 15 facilities (79%; magnetic resonance imaging, in 11 facilities (58%; and bone scans, in nine facilities (47%. It took an average of 1 to 3 weeks to report histopathology. Immunohistochemistry was available locally in eight facilities (42%, outside hospitals but within the country in seven facilities (37%, and outside the country in four facilities (21%. Thirteen facilities (68% performed axillary node dissections as part of a breast protocol. Neoadjuvant chemotherapy was the most common therapy for locally advanced breast cancer in 13 facilities (68%. In three facilities (16%, receptor status did not influence the prescription of hormone treatment. Conclusion: This pilot survey suggests that AORTIC members in sub-Saharan Africa continue to make gains in the provision of access to multidisciplinary breast cancer care, but the lack of adequate pathology and radiotherapy services is a barrier. Focused attention on in-country and regional training needs and improvement of health systems deliverables is urgently

  4. The efficacy of peloid therapy in management of hand osteoarthritis: a pilot study

    Science.gov (United States)

    Kasapoğlu Aksoy, Meliha; Altan, Lale; Eröksüz, Rıza; Metin Ökmen, Burcu

    2017-12-01

    Hand osteoarthritis (OA) is associated with pain, reduced grip strength, loss of range of motion (ROM), and joint stiffness, leading to impaired hand function and difficulty in performance of daily living activities. Mud bath therapy has been reported to play a primary role in the prevention and management of OA. Thus, we planned to conduct a study aimed at investigating the effects of peloid therapy on pain, functional state, grip strength, and the quality of life and performing a comparative analysis of the outcomes of peloid therapy. In this randomized, controlled, single-blind, pilot study, patients ( n = 33) underwent peloid therapy over 2 weeks, 5 sessions a week, for a total of 10 sessions and home exercise program in group 1. Patients in group 2 (control, n = 30) received only the same home exercise program as in group 1. Patients were evaluated just before, and 2 and 6 weeks after the start of the study with Visual Analogue Scale (VAS), Australian/Canadian Hand Osteoarthritis Index (AUSCAN), Health Assessment Questionnaire (HAQ), hand grip strength (HGS), and pinch strength (PS). Statistically significant improvements were observed in all parameters assessed at week 2 and week 6 in the group 1 ( p < 0.05). Statistically significant differences were observed in HGS scores in the group 2 at week 2 and in AUSCAN scores at week 6 ( p < 0.05). Intergroup comparisons of the scores revealed significant differences between the peloid therapy group and control group in VAS, HAQ, AUSCAN, HGS, and PS scores at week 2 and week 6 ( p < 0.05). This study demonstrates that peloid therapy might be an effective and confident treatment modality in the management of symptomatic osteoarthritis of the hand and may provide effective pain control and improvements in the hand functions, quality of life, and grip strength.

  5. Management of resources at major incidents and disasters in relation to patient outcome: a pilot study of an educational model.

    Science.gov (United States)

    Nilsson, Heléne; Rüter, Anders

    2008-06-01

    Organizations involved in disaster response often have a defined operative level of management (command and control) that can take the overall decisions regarding the mobilization and distribution of resources and distribution of casualties. This level of management can be referred to as strategic management. The aim of this pilot study was to show the possibility, in simulation exercises, to relate decisions made regarding resources to patient outcome. The simulation system used measures to determine if lifesaving interventions are performed in time or not in relation to patient outcome. Evaluation was made with sets of performance indicators as templates and all management groups were evaluated not only as to how the decisions were made (management skills), but also how staff work was performed (staff procedure skills). Owing to inadequate response and insufficient distribution of patients to hospitals, 11 'patients' died in the simulated incident, a fire at a football stand with subsequent collapse. The strategic level of management received 16 points out of a possible 22 according to a predesigned template of performance indicators. The pilot study demonstrated the possibility to, in simulation exercises, relate decisions made regarding resources to patient outcome. This training technique could possibly lead to increased knowledge in what decisions are crucial to make in an early phase to minimize mortality and morbidity.

  6. The impact on sleep of a multidisciplinary cognitive behavioural pain management programme: a pilot study

    Directory of Open Access Journals (Sweden)

    Horan Sheila

    2011-01-01

    Full Text Available Abstract Background Reduced sleep quality is a common complaint among patients with chronic pain, with 50-80% of patients reporting sleep disturbance. Improvements in pain and quality of life measures have been achieved using a multidisciplinary cognitive behavioural therapy pain management programme (CBT-PMP that aims to recondition attitudes to pain, and improve patients' self-management of their condition. Despite its high prevalence in patients with chronic pain, there is very limited objective evidence for the effect of this intervention on sleep quality. The primary research objective is to investigate the short-term effect of a multidisciplinary CBT-PMP on subjective (measured by Pittsburg Sleep Quality Index and objective sleep quality (measured by Actigraphy in patients with chronic pain by comparison with a control group. The secondary objectives will investigate changes in function and mood, and then explore the relationship between objective and subjective sleep quality and physical and psychological outcome measures. Methods/Design Patients who fulfil the inclusion criteria for attendance on the multidisciplinary CBT-PMP in the Adelaide and Meath Hospital, Tallaght, Dublin and are currently listed on the PMP waiting list will be invited to participate in this pilot study. Potential patients will be screened for sleep disturbance [determined by the Pittsburgh Sleep Quality Index (PSQI]. Those patients with a sleep disturbance (PSQI >5 will be assigned to either the intervention group (immediate treatment, or control group (deferred treatment, i.e. the PMP they are listed for is more than six months away based on where they appear on the waiting list. Baseline measures of sleep, function, and mood will be obtained using a combination of self-report questionnaires (the Hospital Anxiety and Depression Scale, the Short Form 36 health survey, the Pittsburgh Sleep Quality Index, the Tampa Scale for Kinesiophobia, and functional outcome

  7. Readiness to manage arthritis: a pilot study using a stages-of-change measure for arthritis rehabilitation.

    Science.gov (United States)

    Arthur, A Barbara; Kopec, Jacek A; Klinkhoff, Alice V; Adam, Paul M; Carr, Susan L; Prince, Jane M; Dumont, Kelly E; Nigg, Claudio R

    2009-01-01

    The purpose of this pilot study was to evaluate the Readiness to Manage Arthritis Questionnaire (RMAQ), a new multibehavior measure of readiness for change in arthritis management. Data were obtained from 46 patients with chronic inflammatory arthritis admitted for intensive treatment. Test-retest reliability, correlations with clinical variables and theoretically related constructs, and responsiveness to change were assessed. Test-retest reliability indicated reasonable stability, with intraclass correlation coefficients ranging from 0.30 to 0.75. A significant association was observed between psychological well-being and readiness status. Clinical variables of disease duration, disease severity, pain, and function were not related to readiness status. Correlations between stages-of-change scores and self-efficacy for managing arthritis symptoms were mostly nonsignificant, with the exception of modest agreement between readiness to engage in physical activity and exercise self-efficacy (0.43). Significant changes were observed in mean RMAQ scores from initial assessment to 12 weeks posttreatment for the behaviors of using joint protection, dealing with frustration, learning about arthritis, engaging in physical activity, and stress management. Findings from this pilot study suggest that the RMAQ has adequate psychometric properties in patients with chronic inflammatory arthritis and can be used to assess an individual's readiness to adopt important arthritis self-management behaviors.

  8. Navigating the Road to Recovery: Assessment of the Coordination, Communication, and Financing of the Disaster Case Management Pilot in Louisiana.

    Science.gov (United States)

    Acosta, Joie; Chandra, Anita; Feeney, Kevin Carter

    2011-01-01

    In 2009, individuals heavily affected by Hurricanes Katrina and Rita were still in need of social services. The Federal Emergency Management Agency (FEMA) provided funding to the Louisiana Recovery Authority to implement the Disaster Case Management Pilot (DCMP) in order to help people still living in FEMA temporary housing units in April 2009 move to permanent and secure housing and access services. Despite concerted effort by participating agencies, the implementation of the DCMP was fraught with challenges. As a result, the pilot could not be implemented as intended, leaving the needs of many clients not fully met. This article shares details of a study that documents some of the key challenges in coordination, communication, and financing of the program and offers recommendations for future state and FEMA implementation of disaster case management. In light of these challenges, the authors recommend that federal and state governments review the systems used to identify and locate residents in need of disaster case management; these systems performed poorly in the DCMP, making it difficult to appropriately plan services. The stop and start of recovery initiatives led to serious discontinuities in client recovery, so the authors also recommend that federal and state governments consider a single, longer-term recovery initiative that seamlessly acknowledges the stages of human recovery. Improvements in how federal and state governments identify and locate affected residents, consider needs and vulnerabilities in planning, and ensure continuity of services are critical to ensure high-quality disaster case management.

  9. Optimization of Arthrospira platensis (Spirulina Growth: From Laboratory Scale to Pilot Scale

    Directory of Open Access Journals (Sweden)

    Florian Delrue

    2017-11-01

    Full Text Available Arthrospira platensis (Spirulina is the most cultivated microalga worldwide. Improving its cultivation in terms of biomass productivity, quality, or production cost could significantly impact the Spirulina industry. The objectives of this paper were defined as to contribute to this goal. Spirulina biomass productivity was investigated through medium choice. A modified Zarrouk’s medium was selected as it gave higher final dry weights and longer sustained growth than Hiri’s and Jourdan’s media. Then, in order to reduce Spirulina production cost, modified Zarrouk’s medium was rationalized by testing different dilutions. It was found that modified Zarrouk’s medium could be diluted up to five times without impacting the growth rates in a 28-days batch cultivation. Higher dry weights were even observed after 21 days of batch cultivation (1.21 g/L for 20%-modified Zarrouk’s medium in comparison to 0.84 g/L for modified Zarrouk’s medium. Iron uptake was then investigated as one of the major contributors to Spirulina nutritional quality. An increase in iron content was obtained by replacing iron sulfate by iron EDTA at a concentration of 10 mgFe/L (2.11 ± 0.13 mgFe/gbiomass for EDTA-FeNa, 3 H2O at 10 mgFe/L compared to 0.18 ± 0.13 for FeSO4,6H2O at 2 mgFe/L. Impact of light intensity on Spirulina biomass productivity was also investigated in a 2 L Photobioreactor (PBR. Specific growth rates were calculated for Photosynthetically Photon Flux Densities (PPFD from 85 to 430 µmol/m2/s. At 430 µmol/m2/s, photoinhibition was not observed and the specific growth rate was maximum (0.12/day. Finally, a 40-day cultivation experiment was conducted in a 1000 L PBR giving a maximum daily areal productivity of 58.4 g/m2/day. A techno-economic analysis gave production cost two to 20 times higher for PBR (from 18.71 to 74.29 €/kg than for open ponds (from 3.86 to 9.59 €/kg depending on Spirulina productivity.

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

    Directory of Open Access Journals (Sweden)

    F. Sh. Fedorova

    2016-01-01

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

  11. Connected vehicle pilot deployment program phase 1, security management operational concept : ICF/Wyoming.

    Science.gov (United States)

    2016-03-14

    The Wyoming Department of Transportations (WYDOT) Connected Vehicle (CV) Pilot Deployment Program is intended to develop a suite of applications that utilize vehicle to infrastructure (V2I) and vehicle to vehicle (V2V) communication technology to ...

  12. Human factors : FAA's guidance and oversight of pilot crew resource management training can be improved

    Science.gov (United States)

    1997-11-01

    Of the 169 accidents that involved the major airlines and that were : investigated and reported on in detail by the National Transportation : Safety Board from 1983 through 1995, about 30 percent were caused in : part by the pilots performance, ac...

  13. Connected vehicle pilot deployment program phase 1, safety management plan - ICF/Wyoming.

    Science.gov (United States)

    2016-03-14

    The Wyoming Department of Transportations (WYDOT) Connected Vehicle (CV) Pilot Deployment Program is intended to develop a suite of applications that utilize vehicle to infrastructure (V2I) and vehicle to vehicle (V2V) communication technology to ...

  14. Computer-assisted school-based asthma management: a pilot study.

    Science.gov (United States)

    Arnold, Renée Jg; Stingone, Jeanette A; Claudio, Luz

    2012-11-13

    The high prevalence of asthma among children continues to be a major public health issue. In particular, low-income African-American and Hispanic children often receive asthma care in the emergency department and lack access to continuity of care. The aim of the current study was to test the feasibility of implementing a computerized program for empowering low-income children with asthma to manage their own disease. This pilot program consisted of a guided, personalized, Web-based computer program as the main component of a school-based asthma intervention. The Automated Live E-Health Response Tracking System (ALERTS), a computer-assisted, Web-based tracking program, was tested for implementation in a school in East Harlem, New York. The program required children with asthma, assisted by trained researchers, to routinely measure their peak flow meter readings and answer a symptom questionnaire. The program provided individualized feedback on their disease status based on peak flow meter input. The computer program sent reports to the child's physician and the nurse practitioner at the on-site school health center. The children were also encouraged to bring the reports home to their parents. A pre/post study design was employed such that each participant acted as his/her own control. Comparisons of preintervention and postintervention outcomes were calculated using the paired t-test and the McNemar test for dichotomous data. Twenty-four children (6 to 12 years) participated in the program over 2 to 15 months. Improvements in health outcomes showed the greatest significance among the group of participants who were enrolled for 8 months or longer. Statistically significant improvements were seen in the average physical health score of the children (from 65.64 preintervention to 76.28 postintervention, P = .045). There was a significant decrease in the number of participants experiencing wheezing episodes (n = 9 to n = 2, P = .03), and in the average number of

  15. Phase I Water Rental Pilot Project : Snake River Resident Fish and Wildlife Resources and Management Recommendations.

    Energy Technology Data Exchange (ETDEWEB)

    Riggin, Stacey H.; Hansen, H. Jerome

    1992-10-01

    The Idaho Water Rental Pilot Project was implemented as a part of the Non-Treaty Storage Fish and Wildlife Agreement (NTSA) between Bonneville Power Administration and the Columbia Basin Fish and Wildlife Authority. The goal of the project is to improve juvenile and adult salmon and steelhead passage in the lower Snake River with the use of rented water for flow augmentation. The primary purpose of this project is to summarize existing resource information and provide recommendations to protect or enhance resident fish and wildlife resources in Idaho with actions achieving flow augmentation for anadromous fish. Potential impacts of an annual flow augmentation program on Idaho reservoirs and streams are modeled. Potential sources of water for flow augmentation and operational or institutional constraints to the use of that water are identified. This report does not advocate flow augmentation as the preferred long-term recovery action for salmon. The state of Idaho strongly believes that annual drawdown of the four lower Snake reservoirs is critical to the long-term enhancement and recovery of salmon (Andrus 1990). Existing water level management includes balancing the needs of hydropower production, irrigated agriculture, municipalities and industries with fish, wildlife and recreation. Reservoir minimum pool maintenance, water quality and instream flows are issues of public concern that will be directly affected by the timing and quantity of water rental releases for salmon flow augmentation, The potential of renting water from Idaho rental pools for salmon flow augmentation is complicated by institutional impediments, competition from other water users, and dry year shortages. Water rental will contribute to a reduction in carryover storage in a series of dry years when salmon flow augmentation is most critical. Such a reduction in carryover can have negative impacts on reservoir fisheries by eliminating shoreline spawning beds, reducing available fish habitat

  16. Piloting laboratory quality system management in six health facilities in Nigeria.

    Directory of Open Access Journals (Sweden)

    Henry Mbah

    Full Text Available Achieving accreditation in laboratories is a challenge in Nigeria like in most African countries. Nigeria adopted the World Health Organization Regional Office for Africa Stepwise Laboratory (Quality Improvement Process Towards Accreditation (WHO/AFRO- SLIPTA in 2010. We report on FHI360 effort and progress in piloting WHO-AFRO recognition and accreditation preparedness in six health facility laboratories in five different states of Nigeria.Laboratory assessments were conducted at baseline, follow up and exit using the WHO/AFRO- SLIPTA checklist. From the total percentage score obtained, the quality status of laboratories were classified using a zero to five star rating, based on the WHO/AFRO quality improvement stepwise approach. Major interventions include advocacy, capacity building, mentorship and quality improvement projects.At baseline audit, two of the laboratories attained 1- star while the remaining four were at 0- star. At follow up audit one lab was at 1- star, two at 3-star and three at 4-star. At exit audit, four labs were at 4- star, one at 3-star and one at 2-star rating. One laboratory dropped a 'star' at exit audit, while others consistently improved. The two weakest elements at baseline; internal audit (4% and occurrence/incidence management (15% improved significantly, with an exit score of 76% and 81% respectively. The elements facility and safety was the major strength across board throughout the audit exercise.This effort resulted in measurable and positive impact on the laboratories. We recommend further improvement towards a formal international accreditation status and scale up of WHO/AFRO- SLIPTA implementation in Nigeria.

  17. Evaluating algal growth performance and water use efficiency of pilot-scale revolving algal biofilm (RAB) culture systems.

    Science.gov (United States)

    Gross, Martin; Mascarenhas, Vernon; Wen, Zhiyou

    2015-10-01

    A Revolving Algal Biofilm (RAB) growth system in which algal cells are attached to a flexible material rotating between liquid and gas phases has been developed. In this work, different configurations of RAB systems were developed at pilot-scale by retrofitting the attachment materials to a raceway pond (2000-L with 8.5 m(2) footprint area) and a trough reservoir (150 L with 3.5 m(2) footprint area). The algal growth performance and chemical composition, as well as the water evaporative loss and specific water consumption were evaluated over a period of nine months in a greenhouse environment near Boone, Iowa USA. Additionally a raceway pond was run in parallel, which served as a control. On average the raceway-based RAB and the trough-based RAB outperformed the control pond by 309% and 697%, respectively. A maximum productivity of 46.8 g m(-2) day(-1) was achieved on the trough-based RAB system. The evaporative water loss of the RAB system was modeled based on an energy balance analysis and was experimentally validated. While the RAB system, particularly the trough-based RAB, had higher water evaporative loss, the specific water consumption per unit of biomass produced was only 26% (raceway-based RAB) and 7% (trough-based RAB) of that of the control pond. Collectively, this research shows that the RAB system is an efficient algal culture system and has great potential to commercially produce microalgae with high productivity and efficient water use. © 2015 Wiley Periodicals, Inc.

  18. Urban sprawl and growth management - drivers, impacts and responses in selected European and US cities

    DEFF Research Database (Denmark)

    Fertner, Christian; Jørgensen, Gertrud; Nielsen, Thomas Alexander Sick

    2016-01-01

    Urban growth management has become a common term to circumscribe strategies and tools to regulate urban land use in metropolitan areas. It is particularly used to counteract negative impacts of urban sprawl but also to frame future urban development. We discuss recent challenges of urban growth....... The cities have different success in dealing with urban growth pressure - some can accommodate most growth in existing urban areas and densify, others expand or sprawl. Urban growth management is no guarantee to contain urban growth, but the case studies offer some innovative ways how to deal with particular...... in 6 European and 2 US American city-regions. The paper compares the urban development focusing on a quantification of drivers and effects of urban growth and a qualitative analysis of the applied urban growth management tools. We build our analysis on findings from the EU-FP6 project PLUREL...

  19. EcoPrinciples Connect: A Pilot Project Matching Ecological Principles with Available Data to Promote Ecosystem-Based Management

    Science.gov (United States)

    Martone, R. G.; Erickson, A.; Mach, M.; Hale, T.; McGregor, A.; Prahler, E. E.; Foley, M.; Caldwell, M.; Hartge, E. H.

    2016-12-01

    Ocean and coastal practitioners work within existing financial constraints, jurisdictions, and legislative authorities to manage coastal and marine resources while seeking to promote and maintain a healthy and productive coastal economy. Fulfilling this mandate necessitates incorporation of best available science, including ecosystem-based management (EBM) into coastal and ocean management decisions. To do this, many agencies seek ways to apply lessons from ecological theory into their decision processes. However, making direct connections between science and management can be challenging, in part because there is no process for linking ecological principles (e.g., maintaining species diversity, habitat diversity, connectivity and populations of key species) with available data. Here we explore how incorporating emerging data and methods into resource management at a local scale can improve the overall health of our coastal and marine ecosystems. We introduce a new web-based interface, EcoPrinciples Connect, that links marine managers to scientific and geospatial information through the lens of these ecological principles, ultimately helping managers become more efficient, more consistent, and advance the integration of EBM. The EcoPrinciples Connect tool grew directly out of needs identified in response to a Center for Ocean Solutions reference guide, Incorporating Ecological Principles into California Ocean and Coastal Management: Examples from Practice. Here we illustrate how we have worked to translate the information in this guide into a co-developed, user-centric tool for agency staff. Specifically, we present a pilot project where we match publicly available data to the ecological principles for the California San Francisco Bay Conservation and Development Commission. We will share early lessons learned from pilot development and highlight opportunities for future transferability to an expanded group of practitioners.

  20. SIMULTANEOUS PRODUCTIVE GROWTH GROUPS (SPGG: INNOVATION ON PAPAYA MITE MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Marycruz Abato-Zárate

    2011-11-01

    Full Text Available Grower’s previous experience and their ability to communicate technical information to other growers, allows greater adoption of technologies. Thus, appropriation of technologies of mite management and sampling was evaluated, based on the “Simultaneous Productive Growth Groups (SPGG” technology transfer model. A preliminary diagnosis was made, evaluating the technology transfer achieved by six leading growers showing up continuously to seven meetings carried out from March to July 2010, and also by 19 growers showing up on a more irregular basis. All growers were from the municipality of Cotaxtla and belonged to the Papaya-Product-System of Veracruz, Mexico. Participation, attitude and efficacy of training were evaluated with a survey. Forty-two percent of growers considered the papaya ring spot virus as the main problem and 48 % revealed spider mites as the second one; 96 % used pesticides on spider mites. Participation of the SPGG basic group was 71 %, who agreed on sampling, recording data in sampling forms and using selective acaricides. Seventy percent were able to recognize spider mites from predatory mites and 83 % recognized selective acaricides. Growers considered that sampling can help reduce control costs. The SPGG model allowed building collective knowledge and better decision making by the working group.

  1. The women's heart health programme: a pilot trial of sex-specific cardiovascular management.

    Science.gov (United States)

    Low, Ting Ting; Chan, Siew Pang; Wai, Shin Hnin; Ang, Zhou; Kyu, Kyu; Lee, Kim Yee; Ching, Anne; Comer, Sarah; Tan, Naomi Qiu Pin; Thong, Elizabeth Grace Hui En; Nang, Tracy; Dutta, Mohan; Lam, Carolyn S P

    2018-04-16

    There is increasing knowledge of sex-specific differences in cardiovascular disease and recognition of sex disparities in management. In our study, we investigated whether a cardiovascular programme tailored to the specific needs of women could lead to improved outcomes. We randomised 100 female patients to receive cardiology follow-up with the conventional sex-neutral cardiac programme (control), or the sex-tailored Women's Heart Health Programme (intervention). The intervention group was managed by an all-women multidisciplinary team and received culture-centred health intervention workshops, designed through in-depth interviews with the participants. The primary outcome was cardiovascular risk factor improvement at 1 year. Secondary outcomes include cardiovascular event rates, quality of life scores, and self-reported improvement in knowledge, attitudes, intentions and practices. Generalised structural equation model analysis was used to determine if the intervention group had better outcomes at alpha level 0.1. The mean age was 67.3 ± 12.7 years, with an ethnic distribution of 70% Chinese, 18% Malays, and 12% Indians. The majority of these patients had no formal or primary level of education (63%), and were mostly unemployed (78%). Patients in intervention group had better control of diabetes mellitus (lower HbA1c of 0.63% [CI 0.21-1.04], p = 0.015) and lower body-mass-index (0.74 kg/m 2 [CI 0.02-1.46], p = 0.092) at 1 year, but there was no significant difference in blood pressure or lipid control. Overall, there was a trend towards better risk factor control, 31.6% of intervention group versus 26.5% of control group achieved improvement in at least 1 CV risk factor control to target range. There was no significant difference in incidence of cardiovascular events, quality of life, or domains in knowledge, attitudes, intention and practices. This pilot study is the first of its kind evaluating a new model of care for women with heart disease

  2. Model for Team Training Using the Advanced Trauma Operative Management Course: Pilot Study Analysis.

    Science.gov (United States)

    Perkins, R Serene; Lehner, Kathryn A; Armstrong, Randy; Gardiner, Stuart K; Karmy-Jones, Riyad C; Izenberg, Seth D; Long, William B; Wackym, P Ashley

    2015-01-01

    Education and training of surgeons has traditionally focused on the development of individual knowledge, technical skills, and decision making. Team training with the surgeon's operating room staff has not been prioritized in existing educational paradigms, particularly in trauma surgery. We aimed to determine whether a pilot curriculum for surgical technicians and nurses, based on the American College of Surgeons' Advanced Trauma Operative Management (ATOM) course, would improve staff knowledge if conducted in a team-training environment. Between December 2012 and December 2014, 22 surgical technicians and nurses participated in a curriculum complementary to the ATOM course, consisting of 8 individual 8-hour training sessions designed by and conducted at our institution. Didactic and practical sessions included educational content, hands-on instruction, and alternating role play during 5 system-specific injury scenarios in a simulated operating room environment. A pre- and postcourse examination was administered to participants to assess for improvements in team members' didactic knowledge. Course participants displayed a significant improvement in didactic knowledge after working in a team setting with trauma surgeons during the ATOM course, with a 9-point improvement on the postcourse examination (83%-92%, p = 0.0008). Most participants (90.5%) completing postcourse surveys reported being "highly satisfied" with course content and quality after working in our simulated team-training setting. Team training is critical to improving the knowledge base of surgical technicians and nurses in the trauma operative setting. Improved communication, efficiency, appropriate equipment use, and staff awareness are the desired outcomes when shifting the paradigm from individual to surgical team training so that improved patient outcomes, decreased risk, and cost savings can be achieved. Determine whether a pilot curriculum for surgical technicians and nurses, based on the

  3. Regional growth management policies: Toward reducing global warming at state and local levels

    International Nuclear Information System (INIS)

    Purdie, J.

    1995-01-01

    State and local governments in the United States are accepting mandates to coordinate legislated land use and growth management planning with vigorous environmental protection and resource conservation. These mandates, implemented or planned in states with populations totaling over 100 million, will directly impact growth patterns and ultimately affect the level of atmospheric gases and particulates generated within their borders. This paper addresses the issues of growth management and land use planning at the local, state and regional levels and identifies areas impacting global warming. A review of existing systems will be presented, and recommendations will be made to improve monitoring of growth management mechanisms and organizational structures with the goal of global atmospheric improvement. The issues discussed include urban sprawl, transportation, and growth patterns as managed by policies also designed to protect environments and provide for sustainable growth. Areas for improved coordination between jurisdictions to ease global warming will also be examined

  4. Weight management including dietary and physical activity advice provided by Australian physiotherapists: a pilot cross-sectional survey.

    Science.gov (United States)

    Snodgrass, Suzanne J; Carter, Amy E; Guest, Maya; Collins, Clare E; James, Carole; Kable, Ashley K; Ashby, Samantha E; Plotnikoff, Ronald C

    2014-08-01

    Physiotherapists may have an impact on obesity prevention and treatment by providing nutrition and physical activity advice to overweight or obese clients; yet little is known about physiotherapists' beliefs and practices related to client weight management. The aim of this pilot study was to determine the practices, beliefs, attitudes and knowledge of physiotherapists regarding the provision of weight management advice to overweight or obese clients. Physiotherapists (n = 65) working in multiple practice settings completed a self-administered questionnaire. Logistic regression determined factors associated with the provision of dietary and physical activity advice for weight management. The majority of physiotherapists (n = 53 [81.5%]) believed providing weight management advice was within their scope of practice, yet only a minority had received training during their professional entry level education (n = 13 [20%]) or through professional development (n = 7 [11%]). Most physiotherapists (n = 55 [84.6%]) provided physical activity advice for weight management, but a minority (n = 27 [41.5%]) provided dietary advice. Having received training in weight management during their professional entry level education was associated with providing dietary advice (Odds ratio 8.8, 95% confidence interval 2.0-38.9, p = 0.004). Training in weight management may increase the likelihood of physiotherapists providing dietary advice, improving physiotherapists' management of obesity.

  5. Assurance of Myeloid Growth Factor Administration in an Infusion Center: Pilot Quality Improvement Initiative.

    Science.gov (United States)

    Ramirez, Pamela Maree; Peterson, Barry; Holtshopple, Christine; Borja, Kristina; Torres, Vincent; Valdivia-Peppers, Lucille; Harriague, Julio; Joe, Melanie D

    2017-12-01

    Four incident reports involving missed doses of myeloid growth factors (MGFs) triggered the need for an outcome-driven initiative. From March 1, 2015, to February 29, 2016, at University of California Irvine Health Chao Infusion Center, 116 of 3,300 MGF doses were missed (3.52%), including pegfilgrastim, filgrastim, and sargramostim. We hypothesized that with the application of Lean Six Sigma methodology, we would achieve our primary objective of reducing the number of missed MGF doses to < 0.5%. This quality improvement initiative was conducted at Chao Infusion Center as part of a Lean Six Sigma Green Belt Certification Program. Therefore, Lean Six Sigma principles and tools were used throughout each phase of the project. Retrospective and prospective medical record reviews and data analyses were performed to evaluate the extent of the identified problem and impact of the process changes. Improvements included systems applications, practice changes, process modifications, and safety-net procedures. Preintervention, 24 missed doses (20.7%) required patient supportive care measures, resulting in increased hospital costs and decreased quality of care. Postintervention, from June 8, 2016, to August 7, 2016, zero of 489 MGF doses were missed after 2 months of intervention ( P < .001). Chao Infusion Center reduced missed doses from 3.52% to 0%, reaching the goal of < 0.5%. The establishment of simplified and standardized processes with safety checks for error prevention increased quality of care. Lean Six Sigma methodology can be applied by other institutions to produce positive outcomes and implement similar practice changes.

  6. The present status and future growth of maintenance in US manufacturing: results from a pilot survey

    Directory of Open Access Journals (Sweden)

    Jin Xiaoning

    2016-01-01

    Full Text Available A research study was conducted (1 to examine the practices employed by US manufacturers to achieve productivity goals and (2 to understand what level of intelligent maintenance technologies and strategies are being incorporated into these practices. This study found that the effectiveness and choice of maintenance strategy were strongly correlated to the size of the manufacturing enterprise; there were large differences in adoption of advanced maintenance practices and diagnostics and prognostics technologies between small and medium-sized enterprises (SMEs. Despite their greater adoption of maintenance practices and technologies, large manufacturing organizations have had only modest success with respect to diagnostics and prognostics and preventive maintenance projects. The varying degrees of success with respect to preventative maintenance programs highlight the opportunity for larger manufacturers to improve their maintenance practices and use of advanced prognostics and health management (PHM technology. The future outlook for manufacturing PHM technology among the manufacturing organizations considered in this study was overwhelmingly positive; many manufacturing organizations have current and planned projects in this area. Given the current modest state of implementation and positive outlook for this technology, gaps, future trends, and roadmaps for manufacturing PHM and maintenance strategy are presented.

  7. The present status and future growth of maintenance in US manufacturing: results from a pilot survey.

    Science.gov (United States)

    Jin, Xiaoning; Siegel, David; Weiss, Brian A; Gamel, Ellen; Wang, Wei; Lee, Jay; Ni, Jun

    A research study was conducted (1) to examine the practices employed by US manufacturers to achieve productivity goals and (2) to understand what level of intelligent maintenance technologies and strategies are being incorporated into these practices. This study found that the effectiveness and choice of maintenance strategy were strongly correlated to the size of the manufacturing enterprise; there were large differences in adoption of advanced maintenance practices and diagnostics and prognostics technologies between small and medium-sized enterprises (SMEs). Despite their greater adoption of maintenance practices and technologies, large manufacturing organizations have had only modest success with respect to diagnostics and prognostics and preventive maintenance projects. The varying degrees of success with respect to preventative maintenance programs highlight the opportunity for larger manufacturers to improve their maintenance practices and use of advanced prognostics and health management (PHM) technology. The future outlook for manufacturing PHM technology among the manufacturing organizations considered in this study was overwhelmingly positive; many manufacturing organizations have current and planned projects in this area. Given the current modest state of implementation and positive outlook for this technology, gaps, future trends, and roadmaps for manufacturing PHM and maintenance strategy are presented.

  8. Estimation of Hydraulic Parameters and Aquifer Properties for a Managed Aquifer Recharge Pilot Study in The Lower Mississippi River Basin

    Science.gov (United States)

    Ozeren, Y.; Rigby, J.; Holt, R. M.

    2017-12-01

    Mississippi River Valley Alluvial Aquifer (MRVAA) is the major irrigation water resource in the in the lower Mississippi River basin. MRVAA has been significantly depleted in the last two decades due to excessive pumping. A wide range of measures to ensure sustainable groundwater supply in the region is currently under investigation. One of the possible solution under consideration is to use Managed Aquifer Recharge (MAR) by artificial recharge. The proposed artificial recharge technique in this study is to collect water through bank filtration, transfer water via pipeline to the critically low groundwater areas by a set of injection wells. A pilot study in the area is underway to investigate the possibility of artificial recharge in the area. As part of this study, a pumping test was carried out on an existing irrigation well along banks of Tallahatchie River near Money, MS. Geophysical surveys were also carried out in the pilot study area. Hydraulic response of the observation wells was used to determine stream bed conductance and aquifer parameters. The collected hydraulic parameters and aquifer properties will provide inputs for small-scale, high-resolution engineering model for abstraction-injection hydraulics along river. Here, preliminary results of the pilot study is presented.

  9. Long-term growth responses of ash addition and liming - Preliminary results from a pilot study; Laangtidseffekter paa skogsproduktion efter askaaterfoering och kalkning - Preliminaera resultat fraan en pilotstudie

    Energy Technology Data Exchange (ETDEWEB)

    Sikstroem, Ulf; Jacobson, Staffan (Skogsbrukets Forskningsinstitut (Skogforsk), Uppsala Science Park, SE-751 83 Uppsala (Sweden)); Johansson, Ulf (Swedish University of Agricultural Sciences, The Unit for field-based forest research, Box 17, SE-310 38 Simlaangsdalen (Sweden)); Kukkola, Mikko; Saarsalmi, Anna (Metla, P.O. Box 18, FIN-01301 Vantaa (Finland)); Holt-Hansen, Kjersti (Norsk Institutt for skog og landskap, P.B. 115, NO-1431 Aas (Norway))

    2009-04-15

    Under this pilot study with preliminary results revealed trends in the experimental material which indicated that the addition of ashes or lime in the coniferous forest on mineral soil can lead to reduced stem growth on land with low fertility, unchanged stem growth in medium productive land, while growth may increase land with high fertility. This applied to both periods of 5-15 years and in the longer term (17-23 years; lime). Hence, the hypothesis, regarding the growth being dependent on soil fertility expressed as fertility, could not be rejected. However, previously reported indications of a similar connection with the C/N ratio in the humus was not confirmed in this first evaluation of the material

  10. Referral to a Commercial Weight Management Program in Patients With Coronary Heart Disease: A PILOT STUDY IN THE NETHERLANDS.

    Science.gov (United States)

    Minneboo, Madelon; Peters, Ron J G; Miller-Kovach, Karen; Lemmens, Jeanine; Bucx, Jeroen J J

    2015-01-01

    To quantify the impact of a commercial weight management program on weight change in obese patients with coronary heart disease. An observational, single-center pilot study in the Netherlands. Forty-five patients diagnosed with a recent acute coronary syndrome and a body mass index of >30 kg/m2 were recruited. The commercial weight management intervention (Weight Watchers) promotes a hypoenergetic and balanced diet, increased physical activity, and group support. The program included weekly 30-minute in-hospital meetings with an experienced coach. The program was offered in parallel with a cardiac rehabilitation program. Thirty-five patients completed the program. Of these patients, 32 patients (91%) decreased body weight. Mean weight change was -5.8 kg (range: +0.6 kg to -15.4 kg), and 20 patients (57%) achieved the target of 5% weight loss of their initial weight. Twenty-seven patients continued the commercial weight loss program after 14 weeks, the mean followup of these patients was 34 weeks and their mean weight change was -9.1 kg (range: 0.0-23.0 kg). Obese patients, discharged after an acute coronary syndrome, who were referred to a commercial weight management program, achieved significant weight loss. Although this is a nonrandomized pilot study with patients who were selected by motivation and by the ability to participate in the program, the proportion of weight loss is significant and promising.

  11. Piloting the development of a cost-effective evidence-informed clinical pathway: managing hypertension in Jordanian primary care.

    Science.gov (United States)

    Chalkidou, Kalipso; Lord, Joanne; Obeidat, Nour A; Alabbadi, Ibriham A; Stanley, Adrian G; Bader, Rania; Momani, Aiman; O'Mahony, Rachel M; Qatami, Lara; Cutler, Derek

    2011-04-01

    The UK's National Institute for Health and Clinical Excellence (NICE) and the Jordan office of the Medicines Transparency Alliance embarked on a pilot project to design an evidence-based guideline for cost-effective pharmacological treatment of essential hypertension in Jordan. The project's objectives were to directly address a major health problem for Jordan by producing a guideline; and to delineate the strengths and weaknesses of Jordan's healthcare process to allow similar future efforts to be planned more efficiently. The pilot spanned a period of approximately 8 months. Activities were overseen by local technical and guideline development teams, as well as experts from NICE. NICE's hypertension guidelines and economic model were used as a starting point. Parameters in the economic model were adjusted according to input and feedback from local experts with regards to Jordanian physician and patient practices, resource costs, and quality of life estimates. The results of the economic model were integrated with the updated available clinical trial literature. The outputs of the economic model were used to inform recommendations, in the form of a clinical algorithm. A report of the process and the strengths and weaknesses observed was developed, and recommendations for improvements were made. The pilot represented the start of what is intended to be a healthcare process change for the country of Jordan. Issues emerged which can inform strategies to ensure a more cohesive and comprehensive approach to the cost-effective use of appropriate drugs in managing chronic disease in Jordan and countries operating in a similarly resource-constrained environment. Furthermore, our pilot highlights how richer countries with relevant experience in evidence-informed healthcare policy making can assist others in strengthening their decision-making methods and processes.

  12. Project Management Plan for the Idaho National Engineering Laboratory Waste Isolation Pilot Plant Experimental Test Program

    International Nuclear Information System (INIS)

    Connolly, M.J.; Sayer, D.L.

    1993-11-01

    EG ampersand G Idaho, Inc. and Argonne National Laboratory-West (ANL-W) are participating in the Idaho National Engineering Laboratory's (INEL's) Waste Isolation Pilot Plant (WIPP) Experimental Test Program (WETP). The purpose of the INEL WET is to provide chemical, physical, and radiochemical data on transuranic (TRU) waste to be stored at WIPP. The waste characterization data collected will be used to support the WIPP Performance Assessment (PA), development of the disposal No-Migration Variance Petition (NMVP), and to support the WIPP disposal decision. The PA is an analysis required by the Code of Federal Regulations (CFR), Title 40, Part 191 (40 CFR 191), which identifies the processes and events that may affect the disposal system (WIPP) and examines the effects of those processes and events on the performance of WIPP. A NMVP is required for the WIPP by 40 CFR 268 in order to dispose of land disposal restriction (LDR) mixed TRU waste in WIPP. It is anticipated that the detailed Resource Conservation and Recovery Act (RCRA) waste characterization data of all INEL retrievably-stored TRU waste to be stored in WIPP will be required for the NMVP. Waste characterization requirements for PA and RCRA may not necessarily be identical. Waste characterization requirements for the PA will be defined by Sandia National Laboratories. The requirements for RCRA are defined in 40 CFR 268, WIPP RCRA Part B Application Waste Analysis Plan (WAP), and WIPP Waste Characterization Program Plan (WWCP). This Project Management Plan (PMP) addresses only the characterization of the contact handled (CH) TRU waste at the INEL. This document will address all work in which EG ampersand G Idaho is responsible concerning the INEL WETP. Even though EG ampersand G Idaho has no responsibility for the work that ANL-W is performing, EG ampersand G Idaho will keep a current status and provide a project coordination effort with ANL-W to ensure that the INEL, as a whole, is effectively and

  13. Effect of oral sodium bicarbonate on fibroblast growth factor-23 in patients with chronic kidney disease: a pilot study.

    Science.gov (United States)

    Chen, Wei; Melamed, Michal L; Hostetter, Thomas H; Bauer, Carolyn; Raff, Amanda C; Almudevar, Anthony L; Lalonde, Amy; Messing, Susan; Abramowitz, Matthew K

    2016-08-05

    The regulation of fibroblast growth factor-23 (FGF23) secretion in patients with chronic kidney disease (CKD) is incompletely understood. An in vitro study showed that metabolic acidosis increased FGF23 in mouse bone. The objective of this study is to evaluate the effect of oral sodium bicarbonate on circulating FGF23 levels in patients with CKD. This was a single-blind pilot study. Twenty adults with estimated glomerular filtration rate between 15-45 mL/min/1.73 m(2) and serum bicarbonate between 20-24 mEq/L were treated with placebo for 2 weeks, followed by increasing doses of oral sodium bicarbonate (0.3, 0.6 and 1.0 mEq/kg/day) in 2 week intervals for a total of 6 weeks. C-terminal FGF23 levels were measured at the initial visit, after 2 weeks of placebo and after 6 weeks of bicarbonate therapy. Wilcoxon matched-pairs signed-rank test was used to compare FGF23 before and after sodium bicarbonate. After 6 weeks of oral sodium bicarbonate, the median FGF23 increased significantly from 150.9 RU/mL (IQR 107.7-267.43) to 191.4 RU/mL (IQR 132.6-316.9) (p = 0.048) and this persisted after excluding participants who received activated vitamin D. FGF23 increased after short-term oral sodium bicarbonate therapy in patients with CKD and mild metabolic acidosis. It is unclear whether this was due to the alkalinizing effect of sodium bicarbonate or other factors. The study was registered at ClinicalTrials.gov ( NCT00888290 ) on April 23, 2009.

  14. Connected vehicle pilot deployment program phase 2 : data management plan - Tampa (THEA).

    Science.gov (United States)

    2017-10-01

    The Tampa Hillsborough Expressway Authority (THEA) Connected Vehicle (CV) Pilot Deployment Program is intended to develop a suite of applications that utilize vehicle-to-infrastructure (V2I) and vehicle-to-vehicle (V2V) communication technology to re...

  15. An Empirical Examination of Ownership Structure, Earnings Management and Growth Opportunities in Mexican Market

    Directory of Open Access Journals (Sweden)

    Juan Manuel San Martín Reyna

    2013-07-01

    Full Text Available This paper analyses the influence of ownership structure, board and leverage on the earnings management when companies either face, or do not face, profitable growth opportunities for a sample of 90 listed Mexican firms during the period 2005-2009. The results confirm the relevance of debt and board of directors in terms of earnings management by showing a positive relationship between earnings management and both board of directors and leverage in the presence of growth opportunities. In contrast, this relationship becomes negative when firms have no profitable investment projects. The results also demonstrate the relevance of controlling shareholders on earnings management under a growth opportunity setting.Therefore, our results show that ownership structure, composition and size of board and leverage play a dual role: reduce the earnings management when there are no investments projects, but impact positively in presence of growth opportunities.

  16. [Evaluation of a pilot health promotion and stress management program for Pharmacy and Biochemistry students and professionals].

    Science.gov (United States)

    Iglesias, S L; Granchetti, H; Azzara, S; Carpineta, M; Pappalardo, M; Argibay, J C; Lagomarsino, E

    2014-01-01

    The beneficial results of a theory-practice pilot stress management program for Pharmacy and Biochemistry professionals and students. Its importance as a complement of traditional academic education, as well as its potential for Pharmaceutical Care is also discussed. A total of 27 students and 26 professionals took part in a program of 10 sessions, aimed at improving stress management. Ten of the students and 10 professionals were randomly assigned to control groups. Salivary cortisol levels and anxiety level tests before and after the program were used to assess efficacy. Both the cortisol and the anxiety levels significantly decreased among students and professionals after the program, whereas it significantly increased in the student control group. Anxiety levels significantly decreased in both students and professionals. This type of pilot program proved effective for students. In the case of health professionals, the sample size needs to be increased in order to achieve an acceptable level of statistical power. Considering the shift of the pharmaceutical profession towards Pharmaceutical Care, the training of competences and attitudes like those described in this work could be of value. Copyright © 2013 SECA. Published by Elsevier Espana. All rights reserved.

  17. Management of business economic growth as function of resource rents

    Science.gov (United States)

    Prljić, Stefan; Nikitović, Zorana; Stojanović, Aleksandra Golubović; Cogoljević, Dušan; Pešić, Gordana; Alizamir, Meysam

    2018-02-01

    Economic profit could be influenced by economic rents. However natural resource rents provided different impact on the economic growth or economic profit. The main focus of the study was to evaluate the economic growth as function of natural resource rents. For such a purpose machine learning approach, artificial neural network, was used. The used natural resource rents were coal rents, forest rents, mineral rents, natural gas rents and oil rents. Based on the results it is concluded that the machine learning approach could be used as the tool for the economic growth evaluation as function of natural resource rents. Moreover the more advanced approaches should be incorporated to improve more the forecasting accuracy.

  18. Pilot Implementation of Human-Centered Model in Disaster Management: A Report From Landslides Area in Semarang City

    Directory of Open Access Journals (Sweden)

    Thomas Triadi Putranto

    2017-12-01

    Full Text Available Semarang has a high potential of landslides occurrences in its almost area that should be noted by the stakeholders. Consider this fact, human as the part of the system should be used as a center of the disaster management system to reduce the risk caused by the disaster. An adapted model of human factor toolkits is developed to represent a specific phase of human-centered disaster management. This model presents four phases including major disaster scenario, human error analysis, safety critical task and performance influence factors (PIFs. As the preliminary implementation, this study takes the pilot implementation of each phase of the model to examine the reliability of the concept in the landslide cases, especially in Semarang city. The result shows that there is quite a high deviation between expected and observed behavior of the community and the government institution regarding the awareness states of the system.

  19. Self-managed loaded exercise versus usual physiotherapy treatment for rotator cuff tendinopathy: a pilot randomised controlled trial.

    Science.gov (United States)

    Littlewood, Chris; Malliaras, Peter; Mawson, Sue; May, Stephen; Walters, Stephen J

    2014-03-01

    Rotator cuff tendinopathy is a common source of shoulder pain characterised by persistent and/or recurrent problems for a proportion of sufferers. The aim of this study was to pilot the methods proposed to conduct a substantive study to evaluate the effectiveness of a self-managed loaded exercise programme versus usual physiotherapy treatment for rotator cuff tendinopathy. A single-centre pragmatic unblinded parallel group pilot randomised controlled trial. One private physiotherapy clinic, northern England. Twenty-four participants with rotator cuff tendinopathy. The intervention was a programme of self-managed loaded exercise. The control group received usual physiotherapy treatment. Baseline assessment comprised the Shoulder Pain and Disability Index (SPADI) and the Short-Form 36, repeated three months post randomisation. The recruitment target was met and the majority of participants (98%) were willing to be randomised. 100% retention was attained with all participants completing the SPADI at three months. Exercise adherence rates were excellent (90%). The mean change in SPADI score was -23.7 (95% CI -14.4 to -33.3) points for the self-managed exercise group and -19.0 (95% CI -6.0 to -31.9) points for the usual physiotherapy treatment group. The difference in three month SPADI scores was 0.1 (95% CI -16.6 to 16.9) points in favour of the usual physiotherapy treatment group. In keeping with previous research which indicates the need for further evaluation of self-managed loaded exercise for rotator cuff tendinopathy, these methods and the preliminary evaluation of outcome offer a foundation and stimulus to conduct a substantive study. Copyright © 2013 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  20. Growth Versus Government Management Improvement During Economic Downturn

    Science.gov (United States)

    Podobnik, Boris; Baaquie, Belal E.; Bishop, Steven; Njavro, Djuro; Li, Baowen

    2013-04-01

    In estimating how economic growth depends on various inputs, economists commonly use long periods of data encompassing both main extremes to fluctuations in the economy: recession and expansion. Here we focus on recession years because during expansion even countries with bad economic policies may experience large growth. Specifically, we study how growth depends on the proportion of public-sector workforce, p and competitiveness, quantified by the Global Competitiveness Index, GCI. For the 2008-2011 economic downturn and for 57 countries, we find that the growth rate of GDP per capita, g, decreases with p, and increases with ΔGCI. Further, more competitive countries attract more foreign direct investments per capita, I, than less competitive countries, where I ~ GCIα. We propose a production function, divided into the private and public sectors, where GDP depends on market capitalization, the public (private)-sector workforce, and competitiveness level, used to quantify the public sector efficiency.

  1. Development of pilot model of virtual nuclear power plant and its application to radiation management

    International Nuclear Information System (INIS)

    Kang, K. D.; Sin, S. W.

    2002-01-01

    Using Virtual Reality (VR) technique, a real model for radiation controlled area in nuclear power plant was developed and a feasibility study to develop a computational program to estimate radiation dose was performed. For this purpose a pilot model with an dynamic function and bi-directional communication was developed. This model was enhanced from the existing 3-D single-directional communication. In this pilot model, a plant visitor needs a series of security checking process initially. If he(she) enters the controlled area and approaches radiation hazard area, the alarms with warning lamp will be initiated automatically. Throughout the test to connect this model from both domestic and international sites in various time zones it has proven that it showed a sufficient performance. Therefore this model can be applied to broad fields as radiation protection procedures photographic data, on-line dose program

  2. Relationships between growth, quality, and stocking within managed old-growth northern hardwoods

    Science.gov (United States)

    Chris Gronewold; Anthony W. D' Amato; Brian J. Palik

    2012-01-01

    An understanding of long-term growth dynamics is central to the development of sustainable uneven-aged silvicultural systems for northern hardwood forests in eastern North America. Of particular importance are quantitative assessments of the relationships between stocking control and long-term growth and quality development. This study examined these relationships in a...

  3. Spirituality, Religiosity, and Weight Management among African American Adolescent Males: The Jackson Heart KIDS Pilot Study

    OpenAIRE

    Bruce, Marino A.; Beech, Bettina M.; Griffith, Derek M.; Thorpe, Roland J.

    2016-01-01

    Spirituality and religion have been identified as important determinants of health for adults; however, the impact of faith-oriented factors on health behaviors and outcomes among African American adolescent males has not been well studied. The purpose of this study is to examine the relationship between religiosity and spirituality and obesity-related behaviors among 12–19 year old African American males (N=105) in the Jackson Heart Kids Pilot Study. Key variables of interest are church atte...

  4. Type 2 Diabetes and Depression: A Pilot Trial of an Integrated Self-management Intervention for Latino Immigrants.

    Science.gov (United States)

    Kaltman, Stacey; Serrano, Adriana; Talisman, Nicholas; Magee, Michelle F; Cabassa, Leopoldo J; Pulgar-Vidal, Olga; Peraza, Dorys

    2016-02-01

    The purpose of the current study was to determine the feasibility, acceptability, and preliminary effectiveness of an integrated self-management intervention that simultaneously targets diabetes and depression self-management in a primary care clinic that serves the Latino immigrant community. The integrated intervention included behavioral activation and motivational interviewing techniques. It was developed with patient, family member, and provider stakeholders, and it comprised 6 individual sessions, followed by 2 monthly booster sessions. Eighteen Latino immigrants participated in an open trial of the intervention. A1C levels were examined at baseline and postintervention. Participants also completed measures of depression, diabetes self-management behaviors, patient activation, and diabetes-related self-efficacy and gave open-ended feedback about the intervention. Feasibility of delivering the intervention in the primary care setting and acceptability to the target population were demonstrated. Among participants completing the intervention, A1C levels decreased significantly from baseline. A significant reduction in depressive symptoms and an improvement in diabetes self-management behaviors, patient activation, and diabetes-related self-efficacy were observed. Qualitative responses from participants indicated unilateral positive responses to the intervention and endorsed its continuation in the clinic. This pilot trial demonstrated the feasibility and acceptability of an integrated self-management intervention for diabetes and depression. In addition, preliminary data suggest that the intervention may have a positive impact on diabetes and depression-related outcomes. Further evaluation is warranted. © 2015 The Author(s).

  5. Assessing the Feasibility of a Social Media to Promote Weight Management Engagement in Adolescents with Severe Obesity: Pilot Study.

    Science.gov (United States)

    Prout Parks, Elizabeth; Moore, Reneé H; Li, Ziyi; Bishop-Gilyard, Chanelle T; Garrett, Andrew R; Hill, Douglas L; Bruton, Yasmeen P; Sarwer, David B

    2018-03-19

    Severe obesity in adolescents has deleterious physical and psychological complications necessitating frequent multi-disciplinary clinic visits. Greater treatment engagement has been equated with weight-loss. However, traditional medical weight-loss programs for adolescents have high attrition rates. Social media is widely used by adolescents and may enhance medical weight management engagement and success. The first objective was to examine the acceptability and feasibility of using a private social media group as an adjunct to medical weight management in youth ages 14 to 20 years with severe obesity [body mass index (BMI) ≥ 35 kg/m2]. The second objective was to pilot test the use of social media to improve treatment engagement and decrease attrition rates. In this single arm, 12 week pre-post study, participants attended individual clinic visits and participated in a moderated private social media group that received nutrition, exercise, and behavior change social media communications or "posts" 3 to 4 times/week. Youth commented and/or liked posts from the moderator and each other. Social media engagement was measured with the number of likes and comments on social media. Clinic attrition was compared, measuring clinic visit attendance 12 weeks prior, during, and after the intervention with mixed linear regression models. Correlations of social media engagement with changes from baseline for BMI, BMI-z score, and psychosocial measures were fit. All 13 enrolled youth completed the study and reported that the group was enjoyable, helpful, reinforced their weight management program, and would recommend using social media to support other youth. The pilot trial was acceptable and feasible. Youth mean weekly engagement (likes + comments) in social media was greater than once a day (8.6 ±3.6). Compared to 12 weeks prior to the intervention, there was no significant decrease in clinic visit attendance at the end of the intervention (M=.231, P=.69) or 12 weeks at

  6. Reinventing project management the diamond approach to successful growth & innovation

    CERN Document Server

    Shenhar, Aaron J.

    2007-01-01

    Projects are the engines that drive innovation from idea to commercialization. In fact, the number of projects in most organizations today is expanding while operations is shrinking. Yet, since many companies still focus on operational excellence and efficiency, most projects fail--largely because conventional project management concepts cannot adapt to a dynamic business environment. Moreover, top managers neglect their company's project activity, and line managers treat all their projects alike--as part of operations. Based on an unprecedented study of more than 600 projects in a variety of businesses and organizations around the globe, "Reinventing Project Management" provides a new and highly adaptive model for planning and managing projects to achieve superior business results.

  7. Pain Self-Management for Veterans: Development and Pilot Test of a Stage-Based Mobile-Optimized Intervention.

    Science.gov (United States)

    Johnson, Sara S; Levesque, Deborah A; Broderick, Lynne E; Bailey, Dustin G; Kerns, Robert D

    2017-10-17

    Chronic pain is a significant public health burden affecting more Americans than cardiovascular disease, diabetes, and cancer combined. Veterans are disproportionately affected by chronic pain. Among previously deployed soldiers and veterans, the prevalence of chronic pain is estimated between 44% and 60%. The objective of this research was to develop and pilot-test Health eRide: Your Journey to Managing Pain, a mobile pain self-management program for chronic musculoskeletal pain for veterans. Based on the transtheoretical model of behavior change, the intervention is tailored to veterans' stage of change for adopting healthy strategies for pain self-management and their preferred strategies. It also addresses stress management and healthy sleep, two components of promising integrated treatments for veterans with pain and co-occurring conditions, including posttraumatic stress disorder (PTSD) and traumatic brain injury. In addition, Health eRide leverages gaming principles, text messaging (short message service, SMS), and social networking to increase engagement and retention. Pilot test participants were 69 veterans recruited in-person and by mail at a Veterans Health Administration facility, by community outreach, and by a Web-based survey company. Participants completed a mobile-delivered baseline assessment and Health eRide intervention session. During the next 30 days, they had access to a Personal Activity Center with additional stage-matched activities and information and had the option of receiving tailored text messages. Pre-post assessments, administered at baseline and the 30-day follow-up, included measures of pain, pain impact, use of pain self-management strategies, PTSD, and percentage in the Action or Maintenance stage for adopting pain self-management, managing stress, and practicing healthy sleep habits. Global impressions of change and program acceptability and usability were also assessed at follow-up. Among the 44 veterans who completed the 30

  8. Development and pilot test of a new set of good practice indicators for chronic cancer pain management.

    Science.gov (United States)

    Saturno, P J; Martinez-Nicolas, I; Robles-Garcia, I S; López-Soriano, F; Angel-García, D

    2015-01-01

    Pain is among the most important symptoms in terms of prevalence and cause of distress for cancer patients and their families. However, there is a lack of clearly defined measures of quality pain management to identify problems and monitor changes in improvement initiatives. We built a comprehensive set of evidence-based indicators following a four-step model: (1) review and systematization of existing guidelines to list evidence-based recommendations; (2) review and systematization of existing indicators matching the recommendations; (3) development of new indicators to complete a set of measures for the identified recommendations; and (4) pilot test (in hospital and primary care settings) for feasibility, reliability (kappa), and usefulness for the identification of quality problems using the lot quality acceptance sampling (LQAS) method and estimates of compliance. Twenty-two indicators were eventually pilot tested. Seventeen were feasible in hospitals and 12 in all settings. Feasibility barriers included difficulties in identifying target patients, deficient clinical records and low prevalence of cases for some indicators. Reliability was mostly very good or excellent (k > 0.8). Four indicators, all of them related to medication and prevention of side effects, had acceptable compliance at 75%/40% LQAS level. Other important medication-related indicators (i.e., adjustment to pain intensity, prescription for breakthrough pain) and indicators concerning patient-centred care (i.e., attention to psychological distress and educational needs) had very low compliance, highlighting specific quality gaps. A set of good practice indicators has been built and pilot tested as a feasible, reliable and useful quality monitoring tool, and underscoring particular and important areas for improvement. © 2014 European Pain Federation - EFIC®

  9. Searching new strategies for managing and controlling urban land growth: a preliminary outlook on Indonesia

    OpenAIRE

    Hadi Sabari Yunus

    2013-01-01

    This article is a result of an intensive study of literatures concerning urban growth management. It tries to examine the specific character of existing techniques for managing and controlling urban land growth and tries to match them to the Indonesian situation. The techniques can be categorized into two major types, i.e. urban and urral (urban-rural) orientation. Indonesian .urban sprawl can be distinguished into two models, i.e. the Java and Outer Islands model. Java model is characterized...

  10. Nutritional management and growth in children with chronic kidney disease.

    Science.gov (United States)

    Rees, Lesley; Jones, Helen

    2013-04-01

    Despite continuing improvements in our understanding of the causes of poor growth in chronic kidney disease, many unanswered questions remain: why do some patients maintain a good appetite whereas others have profound anorexia at a similar level of renal function? Why do some, but not all, patients respond to increased nutritional intake? Is feed delivery by gastrostomy superior to oral and nasogastric routes? Do children who are no longer in the 'infancy' stage of growth benefit from enteral feeding? Do patients with protein energy wasting benefit from increased nutritional input? How do we prevent obesity, which is becoming so prevalent in the developed world? This review will address these issues.

  11. Agricultural growth and external debt management in developing ...

    African Journals Online (AJOL)

    International Journal of Development and Management Review. Journal Home · ABOUT · Advanced Search · Current Issue · Archives · Journal Home > Vol 4, No 1 (2009) >. Log in or Register to get access to full text downloads.

  12. Organic Growth Improvement of Indonesian Logistics Companies (A Conceptual Model: Contribution of Strategic Management, Transformational Leadership, and Knowledge Management to Corporate Entrepreneurship and Its Impact on Organic Growth

    Directory of Open Access Journals (Sweden)

    Darjat Sudrajat

    2015-05-01

    Full Text Available Indonesian logistics companies needed performance improvement (particularly in organic growth for increasing their competitiveness. Based on previous researches that in order to increase organic growth, it could be conducted through developing corporate entrepreneurship, namely the activities that enhance company’s ability to innovate, take risk and seize market opportunities. The purpose of this paper tried to explore the relationships among variables, namely organic growth (OG, corporate entrepreneurship (CE, transformational leadership (TL, knowledge management (KM, and strategic management (SM. Therefore, this research used causal-explanatory study to explain relationships among the variables. The results of this research were concluded that TL, KM, and SM have contributions to corporate entrepreneurship and organicgrowth. The relationships could be constructed in a conceptual model that could be verified through further research.

  13. SMS for Life: a pilot project to improve anti-malarial drug supply management in rural Tanzania using standard technology

    Science.gov (United States)

    2010-01-01

    Background Maintaining adequate supplies of anti-malarial medicines at the health facility level in rural sub-Saharan Africa is a major barrier to effective management of the disease. Lack of visibility of anti-malarial stock levels at the health facility level is an important contributor to this problem. Methods A 21-week pilot study, 'SMS for Life', was undertaken during 2009-2010 in three districts of rural Tanzania, involving 129 health facilities. Undertaken through a collaborative partnership of public and private institutions, SMS for Life used mobile telephones, SMS messages and electronic mapping technology to facilitate provision of comprehensive and accurate stock counts from all health facilities to each district management team on a weekly basis. The system covered stocks of the four different dosage packs of artemether-lumefantrine (AL) and quinine injectable. Results Stock count data was provided in 95% of cases, on average. A high response rate (≥ 93%) was maintained throughout the pilot. The error rate for composition of SMS responses averaged 7.5% throughout the study; almost all errors were corrected and messages re-sent. Data accuracy, based on surveillance visits to health facilities, was 94%. District stock reports were accessed on average once a day. The proportion of health facilities with no stock of one or more anti-malarial medicine (i.e. any of the four dosages of AL or quinine injectable) fell from 78% at week 1 to 26% at week 21. In Lindi Rural district, stock-outs were eliminated by week 8 with virtually no stock-outs thereafter. During the study, AL stocks increased by 64% and quinine stock increased 36% across the three districts. Conclusions The SMS for Life pilot provided visibility of anti-malarial stock levels to support more efficient stock management using simple and widely available SMS technology, via a public-private partnership model that worked highly effectively. The SMS for Life system has the potential to alleviate

  14. Management of growth plate injuries in puppies and kittens

    International Nuclear Information System (INIS)

    Prieur, W.D.

    1989-01-01

    Injuries to the growth plate may cause complex problems. Veterinary surgeons dealing with these orthopaedic cases need to understand the aetiology and different problems that may occur. Experience with a number of difficult surgical techniques is desirable and a guarded prognosis is always recommended

  15. Design of an mHealth app for the self-management of adolescent type 1 diabetes: a pilot study.

    Science.gov (United States)

    Cafazzo, Joseph A; Casselman, Mark; Hamming, Nathaniel; Katzman, Debra K; Palmert, Mark R

    2012-05-08

    The use of mHealth apps has shown improved health outcomes in adult populations with type 2 diabetes mellitus. However, this has not been shown in the adolescent type 1 population, despite their predisposition to the use of technology. We hypothesized that a more tailored approach and a strong adherence mechanism is needed for this group. To design, develop, and pilot an mHealth intervention for the management of type 1 diabetes in adolescents. We interviewed adolescents with type 1 diabetes and their family caregivers. Design principles were derived from a thematic analysis of the interviews. User-centered design was then used to develop the mobile app bant. In the 12-week evaluation phase, a pilot group of 20 adolescents aged 12-16 years, with a glycated hemoglobin (HbA(1c)) of between 8% and 10% was sampled. Each participant was supplied with the bant app running on an iPhone or iPod Touch and a LifeScan glucometer with a Bluetooth adapter for automated transfers to the app. The outcome measure was the average daily frequency of blood glucose measurement during the pilot compared with the preceding 12 weeks. Thematic analysis findings were the role of data collecting rather than decision making; the need for fast, discrete transactions; overcoming decision inertia; and the need for ad hoc information sharing. Design aspects of the resultant app emerged through the user-centered design process, including simple, automated transfer of glucometer readings; the use of a social community; and the concept of gamification, whereby routine behaviors and actions are rewarded in the form of iTunes music and apps. Blood glucose trend analysis was provided with immediate prompting of the participant to suggest both the cause and remedy of the adverse trend. The pilot evaluation showed that the daily average frequency of blood glucose measurement increased 50% (from 2.4 to 3.6 per day, P = .006, n = 12). A total of 161 rewards (average of 8 rewards each) were distributed to

  16. Discourse segmentation and the management of multiple tasks in single episodes of air traffic controller-pilot spoken radio communication

    Directory of Open Access Journals (Sweden)

    Paul A. Falzon

    2009-06-01

    Full Text Available Episodes of VHF radio-mediated pilot-controller spoken communication in which multiple tasks are conducted are engendered in and through the skilful deployment and combination, by the parties to the talk, of multiple orders of discourse segmentation. These orders of segmentation are manifest at the levels of transmission design and sequential organisation. Both of these features are analysed from a Conversation Analytic standpoint in order to track their segment by segment genesis, development and completion. From the analysis it emerges that in addition to the serial type of sequential organisations described by Schegloff (1986, there exists an alternative form of organisation that enables tasks to be managed in a quasi-parallel manner, and which affords controllers and pilots a number of practical advantages in the conduct of their radio-mediated service encounters.Cet article présente des extraits d’échanges oraux entre pilots et contrôleurs du ciel via la radio VHF. On peut y voir comment le déploiement et la combinaison habile de plusieurs ordres de segmentation discursive, engageant les deux coénonciateurs de la conversation, leur permet d’accomplir des tâches multiples. Ces ordres de segmentation se manifestent aux niveaux du plan de la transmission et de l’organisation séquentielle. Ces deux niveaux sont envisagées du point de vue de l’analyse conversationnelle dans le but d’examiner, segment après segment, comment ils se mettent en place, se développent puis prennent fin. Notre étude montre que, outre le type sériel d’organisations séquentielles décrit par Schegloff (1986, il existe une forme alternative d’organisation qui permet de gérer les tâches de manière quasi parallèle, et qui fournit aux contrôleurs aériens ainsi qu’aux pilotes de nombreux avantages pratiques dans la conduite de leurs radio.

  17. An Integrated Diagnostic Framework to Manage Organization Sustainable Growth: An Empirical Case

    Directory of Open Access Journals (Sweden)

    Jingxiao Zhang

    2016-03-01

    Full Text Available This research aims to develop a quantitative diagnostic framework by combining the Weisbord six-box model with the growth management model to focus on an organization’s internally driven sustainable management system. The research adopted an instrument developed by Preziosi and an extended Weisbord six-box model. The research employed a survey to collect 180 samples in a Chinese petrol company and applied the comparative method: (a the average score method; and (b the entropy method to confirm the growth level of the company. The survey also attempted to identify corresponding top growth influence factors using the obstacle degree formula. The results showed that the integrated diagnostic framework worked well to diagnose a regional but large Chinese petroleum company. In other words, the research successfully quantified the growth position and top influence factors and helped put forward specific suggestions to drive the organization of sustainable development. The method confirmed this organization during the fourth phase of five phases. In addition, top influence factors hindering the internal growth were (a the lack of task engagement with energy and time; (b the lack of personal work units; and (c a poor division of labor for reaching sustainable growth rates. The research provides a generic theoretical framework support to incorporate growth management models into an organizational diagnosis to obtain sustainable growth. It further highlights and practices guidelines in examining actual growth management levels in companies and discusses top influence factors to design efficient management systems to pursue organizational growth in a multitude of industrial contexts.

  18. Growth, Yield and Fruit Quality of Grapevines under Organic and Biodynamic Management.

    Directory of Open Access Journals (Sweden)

    Johanna Döring

    Full Text Available The main objective of this study was to determine growth, yield and fruit quality of grapevines under organic and biodynamic management in relation to integrated viticultural practices. Furthermore, the mechanisms for the observed changes in growth, yield and fruit quality were investigated by determining nutrient status, physiological performance of the plants and disease incidence on bunches in three consecutive growing seasons. A field trial (Vitis vinifera L. cv. Riesling was set up at Hochschule Geisenheim University, Germany. The integrated treatment was managed according to the code of good practice. Organic and biodynamic plots were managed according to Regulation (EC No 834/2007 and Regulation (EC No 889/2008 and according to ECOVIN- and Demeter-Standards, respectively. The growth and yield of the grapevines differed strongly among the different management systems, whereas fruit quality was not affected by the management system. The organic and the biodynamic treatments showed significantly lower growth and yield in comparison to the integrated treatment. The physiological performance was significantly lower in the organic and the biodynamic systems, which may account for differences in growth and cluster weight and might therefore induce lower yields of the respective treatments. Soil management and fertilization strategy could be responsible factors for these changes. Yields of the organic and the biodynamic treatments partially decreased due to higher disease incidence of downy mildew. The organic and the biodynamic plant protection strategies that exclude the use of synthetic fungicides are likely to induce higher disease incidence and might partially account for differences in the nutrient status of vines under organic and biodynamic management. Use of the biodynamic preparations had little influence on vine growth and yield. Due to the investigation of important parameters that induce changes especially in growth and yield of

  19. Optimizing patient management and adherence for children receiving growth hormone

    DEFF Research Database (Denmark)

    Acerini, Carlo L.; Wac, Katarzyna; Bang, Peter

    2017-01-01

    of the patient's journey. The role of the injection device for GH therapy, frequent monitoring of response, and patient support are all important for maintaining adherence. New injection devices are incorporating electronic technologies for automated monitoring and recording of clinically relevant information......© 2017 Acerini, Wac, Bang and Lehwalder. Poor adherence with growth hormone (GH) therapy has been associated with worse clinical outcomes, which in children relates specifically to their linear growth and loss of quality of life. The "360° GH in Europe" meeting, held in Lisbon, Portugal, in June...... and are reported as a manuscript, authored by the speakers. Reported here is a summary of the proceedings of the second session, which reviewed the determinants of GH therapy response, factors affecting GH therapy adherence and the development of innovative technologies to improve GH treatment in children...

  20. Growth and Conflict: The Views of Chinese Private Higher Education Managers

    Science.gov (United States)

    Ma, Xiaoying; Abbott, Malcom

    2016-01-01

    Purpose: The purpose of this paper is to report the findings of a series of interviews conducted with a number of managers of Chinese private higher education institutions on the growth of the private higher education sector in China and the relationship it has with the government. Private higher education managers in China do seem concerned with…

  1. Error Detection-Based Model to Assess Educational Outcomes in Crisis Resource Management Training: A Pilot Study.

    Science.gov (United States)

    Bouhabel, Sarah; Kay-Rivest, Emily; Nhan, Carol; Bank, Ilana; Nugus, Peter; Fisher, Rachel; Nguyen, Lily Hp

    2017-06-01

    Otolaryngology-head and neck surgery (OTL-HNS) residents face a variety of difficult, high-stress situations, which may occur early in their training. Since these events occur infrequently, simulation-based learning has become an important part of residents' training and is already well established in fields such as anesthesia and emergency medicine. In the domain of OTL-HNS, it is gradually gaining in popularity. Crisis Resource Management (CRM), a program adapted from the aviation industry, aims to improve outcomes of crisis situations by attempting to mitigate human errors. Some examples of CRM principles include cultivating situational awareness; promoting proper use of available resources; and improving rapid decision making, particularly in high-acuity, low-frequency clinical situations. Our pilot project sought to integrate CRM principles into an airway simulation course for OTL-HNS residents, but most important, it evaluated whether learning objectives were met, through use of a novel error identification model.

  2. Risk Management and Disaster Recovery in Public Libraries in South Australia: A Pilot Study

    Science.gov (United States)

    Velasquez, Diane L.; Evans, Nina; Kaeding, Joanne

    2016-01-01

    Introduction: This paper reports the findings of a study of risk management in public libraries. The focus of the research was to determine whether the libraries had a risk management and disaster plan for major disasters. Method: A qualitative study was done to investigate risk management and disaster recovery in public libraries in South…

  3. Gabapentin for the Management of Chronic Pelvic Pain in Women (GaPP1: A Pilot Randomised Controlled Trial.

    Directory of Open Access Journals (Sweden)

    Steff C Lewis

    Full Text Available Chronic pelvic pain (CPP affects 2.1-24% of women. Frequently, no underlying pathology is identified, and the pain is difficult to manage. Gabapentin is prescribed for CPP despite no robust evidence of efficacy. We performed a pilot trial in two UK centres to inform the planning of a future multicentre RCT to evaluate gabapentin in CPP management. Our primary objective was to determine levels of participant recruitment and retention. Secondary objectives included estimating potential effectiveness, acceptability to participants of trial methodology, and cost-effectiveness of gabapentin. Women with CPP and no obvious pelvic pathology were assigned to an increasing regimen of gabapentin (300-2700mg daily or placebo. We calculated the proportion of eligible women randomised, and of randomised participants who were followed up to six months. The analyses by treatment group were by intention-to-treat. Interviews were conducted to evaluate women's experiences of the trial. A probabilistic decision analytical model was used to estimate cost-effectiveness. Between September 2012-2013, 47 women (34% of those eligible were randomised (22 to gabapentin, 25 to placebo, and 25 (53% completed six-month follow-up. Participants on gabapentin had less pain (BPI difference 1.72 points, 95% CI:0.07-3.36, and an improvement in mood (HADS difference 4.35 points, 95% CI:1.97-6.73 at six months than those allocated placebo. The majority of participants described their trial experience favorably. At the UK threshold for willingness-to-pay, the probabilities of gabapentin or no treatment being cost-effective are similar. A pilot trial assessing gabapentin for CPP was feasible, but uncertainty remains, highlighting the need for a large definitive trial.

  4. Intradermal injections of a hair growth factor formulation for enhancement of human hair regrowth - safety and efficacy evaluation in a first-in-man pilot clinical study.

    Science.gov (United States)

    Kapoor, Rinky; Shome, Debraj

    2018-02-26

    Research has shown the efficacy of hair growth factors in hair regrowth. We describe the intradermal injections of a recombinant, bioengineered hair formulation, containing growth factors, into the scalp skin, for enhancement of hair regrowth and evaluate its efficacy. The objective of this study was to assess the efficacy and safety of the hair growth factor formulation in reducing hair loss and enhancing hair growth. This was an open-label, prospective, single-arm interventional pilot study in which 1000 patients were given intradermal injections of a hair formulation into the scalp skin. The formulation contains vascular endothelial growth factor, basic fibroblast growth factor, insulin-like growth factor, keratinocyte growth factor, thymosin β4, and copper tripeptide-1 suspended in a sterile injectable vehicle. Intradermal injections of this hair formulation were injected into the scalp once every 3 weeks for a total of eight such sessions. Hair pull test was performed before every session. Videomicroscopic and global images were taken at baseline, fourth session, eighth session, and 2 months after the completion of the eight sessions. Relevant safety assessments through physical examination, questionnaires, and appropriate laboratory examination were conducted throughout the study. Significant reduction in hair fall was seen in 83% of the patients on hair pull test. Videomicroscopic image evaluation showed that most patients had a decrease in the number of vellus hairs, increase in number of terminal hairs, and increase in shaft diameter. Seventy-five percent of the patients believed that the hair injections were aiding the treatment of their hair loss, and it was also beneficial in post-hair transplant patients. At 1 year, a statistically significant increase in total hair count (P = 0.002) continued to be seen. Treatment was well tolerated. Intradermal injections of this hair formulation may be a promising option for treating male as well as female

  5. Effect of different weed management techniques on growth ...

    African Journals Online (AJOL)

    The weed management techniques included slashing at 8-weekly intervals, mulching alone, glyphosate + slashing, glyphosate + mulching, glyphosate alone and a weed-free control. Glyphosate + mulching proved to have the greatest positive influence on plant height, plant girth, leaf area and number of leaves throughout ...

  6. Financial Management Competence of Founding Teams and Growth of New Technology-Based Firms

    DEFF Research Database (Denmark)

    Brinckmann, Jan; Gemuenden, Hans Georg; Salomo, Søren

    2009-01-01

    firms. We explore the relevance of strategic financial planning competence, external financing competence, competence in financing from cash flow, and controlling competence of entrepreneurial teams for the growth of new technology-based firms. A total of 212 founding teams provided self......This article draws on the resource-based view to analyze the role founding teams' financial management competencies play for firm growth. Prior research stressed the importance of acquiring external financial resources. In this study, we broaden the understanding of financial management in new......-assessments of their financial management competencies at start-up. We apply the partial least squares approach to determine the effects of the different financial management competencies on firm growth....

  7. Computational environment and software configuration management of the 1996 performance assessment for the Waste Isolation Pilot Plant

    International Nuclear Information System (INIS)

    Froehlich, Gary K.; Williamson, Charles Michael; Ogden, Harvey C.

    2000-01-01

    The US Department of Energy (DOE) Waste Isolation Pilot Plant (WIPP), located in southeast New Mexico, is a deep geologic repository for the permanent disposal of transuranic waste generated by DOE defense-related activities. Sandia National Laboratories (SNL), in its role as scientific advisor to the DOE, is responsible for evaluating the long-term performance of the WIPP. This risk-based Performance Assessment (PA) is accomplished in part through the use of numerous scientific modeling codes, which rely for some of their inputs on data gathered during characterization of the site. The PA is subject to formal requirements set forth in federal regulations. In particular, the components of the calculation fall under the configuration management and software quality assurance aegis of the American Society of Mechanical Engineers (ASME) Nuclear Quality Assurance (NQA) requirements. This paper describes SNL's implementation of the NQA requirements regarding configuration management. The complexity of the PA calculation is described, and the rationale for developing a flexible, robust run-control process is discussed. The run-control implementation is described, and its integration with the configuration-management system is then explained, to show how a calculation requiring 37,000 CPU-hours, and involving 225,000 output files totaling 95 Gigabytes, was accomplished in 5 months by 2 individuals, with full traceability and reproducibility

  8. Development and Pilot Study of Group-Based Dietary Self-Management Program for Community Dwellers with Hypertension

    Directory of Open Access Journals (Sweden)

    Arfiza Ridwan

    2012-08-01

    Full Text Available Background: In most countries worldwide, hypertension is considered as an important problem. Moreover, an increasing trend in the prevalence and incidence has been reported in most countries. This increasing trend requires an innovative approach to improve the lifestyle modification of hypertensive sufferers including their dietary behaviors. Objective: This developmental research aims to develop a program for improving the dietary behaviors of community dwellers with hypertension. Method: The process of this program development includes a literature review related to the self-management programs for hypertension, and dietary behavior outcomes, expert validation, and pilot testing. Result: The setting, strategies, duration, and outcome measurement from the literature review were taken into consideration to develop the new program. The newly developed group-based self-management program consists of: 1 the sharing and reflecting of individual current dietary behavior, 2 group educational session, 3 individual comparison of behavior and reflection of obstacles, 4 individual goal setting, and 5 follow up. In the educational session, the DASH eating plan is used as the reference as it is commonly used in studies about diet for hypertension. Key words: hypertension, self-management, group based program, dietary behaviors.

  9. Computational environment and software configuration management of the 1996 performance assessment for the Waste Isolation Pilot Plant

    Energy Technology Data Exchange (ETDEWEB)

    FROEHLICH,GARY K.; WILLIAMSON,CHARLES MICHAEL; OGDEN,HARVEY C.

    2000-05-23

    The US Department of Energy (DOE) Waste Isolation Pilot Plant (WIPP), located in southeast New Mexico, is a deep geologic repository for the permanent disposal of transuranic waste generated by DOE defense-related activities. Sandia National Laboratories (SNL), in its role as scientific advisor to the DOE, is responsible for evaluating the long-term performance of the WIPP. This risk-based Performance Assessment (PA) is accomplished in part through the use of numerous scientific modeling codes, which rely for some of their inputs on data gathered during characterization of the site. The PA is subject to formal requirements set forth in federal regulations. In particular, the components of the calculation fall under the configuration management and software quality assurance aegis of the American Society of Mechanical Engineers (ASME) Nuclear Quality Assurance (NQA) requirements. This paper describes SNL's implementation of the NQA requirements regarding configuration management. The complexity of the PA calculation is described, and the rationale for developing a flexible, robust run-control process is discussed. The run-control implementation is described, and its integration with the configuration-management system is then explained, to show how a calculation requiring 37,000 CPU-hours, and involving 225,000 output files totaling 95 Gigabytes, was accomplished in 5 months by 2 individuals, with full traceability and reproducibility.

  10. Using Remote Sensing Mapping and Growth Response to Environmental Variability to Aide Aquatic Invasive Plant Management

    Science.gov (United States)

    Bubenheim, David L.; Schlick, Greg; Genovese, Vanessa; Wilson, Kenneth D.

    2018-01-01

    Management of aquatic weeds in complex watersheds and river systems present many challenges to assessment, planning and implementation of management practices for floating and submerged aquatic invasive plants. The Delta Region Areawide Aquatic Weed Project (DRAAWP), a USDA sponsored area-wide project, is working to enhance planning, decision-making and operational efficiency in the California Sacramento-San Joaquin Delta. Satellite and airborne remote sensing are used map (area coverage and biomass density), direct operations, and assess management impacts on plant communities. Archived satellite records enable review of results following previous climate and management events and aide in developing long-term strategies. Examples of remote sensing aiding effectiveness of aquatic weed management will be discussed as well as areas for potential technological improvement. Modeling at local and watershed scales using the SWAT modeling tool provides insight into land-use effects on water quality (described by Zhang in same Symposium). Controlled environment growth studies have been conducted to quantify the growth response of invasive aquatic plants to water quality and other environmental factors. Environmental variability occurs across a range of time scales from long-term climate and seasonal trends to short-term water flow mediated variations. Response time for invasive species response are examined at time scales of weeks, day, and hours using a combination of study duration and growth assessment techniques to assess water quality, temperature (air and water), nitrogen, phosphorus, and light effects. These provide response parameters for plant growth models in response to the variation and interact with management and economic models associated with aquatic weed management. Plant growth models are to be informed by remote sensing and applied spatially across the Delta to balance location and type of aquatic plant, growth response to altered environments and

  11. A MANAGEMENT APPROACH TO RELIABILITY GROWTH FOR COMPLEX ELECTROMECHANICAL SYSTEMS

    Directory of Open Access Journals (Sweden)

    A.C. Rooney

    2012-01-01

    Full Text Available

    ENGLISH ABSTRACT: This paper proposes a reliability management process for the development of complex electromechanical systems. Specific emphasis is the development of these systems in an environment of limited development resources, and where small production quantities are envisaged.
    The results of this research provides a management strategy for reliability engineering activities, within a systems engineering environment, where concurrent engineering techniques are used to reduce development cycles and costs.

    AFRIKAANSE OPSOMMING: Hierdie artikel stel 'n proses, vir die bestuur van die betroubaarheid gedurende die ontwikkeling van komplekse elektromeganiese stelsels voor. Die omgewing van beperkte ontwikkelingshulpbronne en klein produksie hoeveelhede word beklemtoon.
    Die resultate van hierdie navorsing stel 'n bestuurstrategie, vir betroubaarheidsbestuur in n stelselsingenieurswese omgewing waar gelyktydige ingenieurswese tegnieke gebruik word am die ontwikkelingsiklus en -kostes te beperk, voor.

  12. A randomized pilot trial of a telephone-based collaborative care management program for caregivers of individuals with dementia.

    Science.gov (United States)

    Mavandadi, Shahrzad; Wright, Erin M; Graydon, Meagan M; Oslin, David W; Wray, Laura O

    2017-02-01

    Dementia care is largely provided in primary care settings. This article describes a pilot project aimed at evaluating the effectiveness of an accessible, telephone-based, patient- and caregiver (CG)-centered, collaborative care management program that involves CG education and psychosocial support in improving CG and patient outcomes. CGs (n = 75) of older veterans with dementia receiving care from Veterans Affairs (VA) Medical Center primary care practices were randomized to receive either dementia care management or usual care (UC). Of interest in this study were the frequency and severity of patients' dementia-related symptom, CG distress related to patients' behavioral and neuropsychiatric symptoms (primary outcomes), and CG coping and mastery (secondary outcomes). Adjusted, intention-to-treat longitudinal models suggest that CGs receiving care management reported significantly greater reductions in distress due to patients' dementia-related (p = .05) and neuropsychiatric (p = .01) symptoms compared with CGs in UC. Additionally, CGs in the intervention reported significantly larger improvements in their ability to cope (p = .03) and caregiving mastery (p = .03). No significant group differences were found in CG burden or patients' dementia-related symptom frequency or severity over time. Findings suggest that CGs of veterans with dementia may benefit from a telephone-delivered, care management program in improving CG-related outcomes. Further research of care management programs for CG of veterans with dementia in addressing barriers to care and reducing CG burden is warranted. These findings highlight the potential for such programs as adjuncts to dementia care offered in primary care practices. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  13. Managing xerostomia in nursing homes: pilot testing of the Sorbet Increases Salivation intervention.

    Science.gov (United States)

    Crogan, Neva L

    2011-03-01

    The purpose of this article was to describe the pilot testing of the Sorbet Increases Salivation (SIS) intervention and describe its impact on salivation and subsequent resident food intake. Using a repeated treatment design with each elder serving as his or her own control, 12 elders were served 2 ounces of sugar-free lemon-lime sorbet just before the lunch meal for two 3-week periods separated by a 6-week observation (no treatment) period. A plate waste protocol was used to determine actual food intake. Before the initiation of the intervention, salivation was measured (using a Modified Schirmer Test [MST] strip) at baseline and then at 1, 2, and 3 minutes of consuming 2 oz of sugar-free lemon-lime sorbet or 2 oz of water. Summary statistics (means, standard deviations, proportions) were used to describe the study sample. Bivariate statistics determined whether there were significant differences between MST measures or food intake within subjects. Salivation significantly increased after consuming sorbet or water. Most importantly, residents who consumed sorbet salivated more on average in comparison with residents who consumed water. During pilot testing, most residents consumed more food on average during treatment weeks in comparison with observation weeks. The intervention has the potential to increase salivation, decrease complaints of xerostomia, and increase food intake in institutionalized elders with drug-induced xerostomia. The new knowledge gained from this study will lead to further research and testing of the intervention with the long-term goal of transforming the "care-as-usual" approach to meal service in nursing homes. Copyright © 2011 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

  14. Effects of shiatsu in the management of fibromyalgia symptoms: a controlled pilot study.

    Science.gov (United States)

    Yuan, Susan L K; Berssaneti, Ana A; Marques, Amelia P

    2013-09-01

    This pilot study aimed to evaluate the potential effects of Shiatsu massage on the symptoms of adult patients with primary fibromyalgia, propose a Shiatsu treatment protocol, verify patient acceptability, and evaluate the feasibility for a larger study. Thirty-four patients aged 33 to 62 years were divided into a Shiatsu group (SG; n = 17), who received full-body Shiatsu twice a week for 8 weeks, and a control group (n = 17), who received an educational booklet. The patients were assessed at baseline and after 8 weeks. Pain intensity was evaluated by the visual analog scale, pressure pain threshold by dolorimetry, anxiety by the State-Trait Anxiety Inventory, sleep by the Pittsburgh Sleep Quality Index, and symptoms impact on patient's health by the Fibromyalgia Impact Questionnaire. The SG was also questioned about adverse effects and level of satisfaction. After treatment, the SG presented statistically significant differences (P < .05) for the change scores of all variables, except state anxiety, compared with the control group. Relative percentage changes were considered clinically relevant for visual analog scale (40.6%), pressure pain threshold (76.4%), Pittsburgh Sleep Quality Index (34.4%), and Fibromyalgia Impact Questionnaire (22.30%). No clinically relevant effects were observed for anxiety after treatment. No adverse effects were reported during the treatment, and about 94% of the patients demonstrated satisfaction with Shiatsu. This pilot study showed the potential of Shiatsu in the improvement of pain intensity, pressure pain threshold, sleep quality, and symptoms impact on health of patients with fibromyalgia. The proposed Shiatsu treatment protocol was feasible and well accepted by the patients. Copyright © 2013 National University of Health Sciences. Published by Mosby, Inc. All rights reserved.

  15. Parental separation anxiety and diabetes self-management of older adolescents: a pilot study.

    Science.gov (United States)

    Morrison, Shannon; Dashiff, Carol; Abdullatif, Hussein; Moreland, Elaine

    2012-01-01

    Parents of high school seniors with type 1 diabetes mellitus are faced with many concerns and fears as their adolescent prepares to assume primary disease management responsibility and leave the parental residence. The purpose of this study was to explore the relationship between parental separation anxiety and adolescent self-management and glycemic control. A second aim was to assess the relationship between adolescent self-management and glycemic control. Twenty-three families who had adolescents 16 to 18 years of age in or entering in their senior year of high school were recruited. Adolescents from higher income families reported better self-management skills than those from poorer families (r = 0.410, p = 0.05). Length of time since diabetes diagnosis was inversely related to glycemic control (r = 0.448, p = 0.02), indicating that adolescents who had the disease longer had poorer control. Parental separation anxiety was not related to adolescent self-management. Adolescent self-management was negatively related to glycemic control (r = -0.370, p = 0.08), suggesting that adolescents who demonstrated better self-management skills had improved glycemic control in comparison to adolescents who did not demonstrate effective self-management skills. Paternal, not maternal, separation anxiety demonstrated a significant relationship with glycemic control (r = 0.639, p < 0.001).

  16. A pilot study on the quality of data management in a cancer clinical trial.

    Science.gov (United States)

    van der Putten, E; van der Velden, J W; Siers, A; Hamersma, E A

    1987-06-01

    Twelve institutional data managers were asked to independently code the data from a patient chart of one patient in an ovarian cancer trial. They abstracted data from the medical record and filled out three types of trial forms (on-study, chemotherapy, and summary forms). The analysis of the processed data revealed that the median rate of errors was 13% for the 12 data managers. The error rate differed among the types of trial forms. The factors causing these errors were mistakes in interpretation, documentation, and coding. The level of experience of the data managers proved to be an important factor. It became clear that the documentation in the medical record was inadequate. We conclude that data managers as well as physicians involved in cancer clinical trials need specific training and that the quality of data management in cancer clinical trials is an important issue for further investigation.

  17. Pilot, Multicenter, Open-Label Evaluation of Safety, Tolerability and Efficacy of a Novel, Topical Multipotent Growth Factor Formulation for the Periorbital Region.

    Science.gov (United States)

    Sundaram, Hema; Gold, Michael; Waldorf, Heidi; Lupo, Mary; Nguyen, Vivien L; Karnik, Jwala

    2015-12-01

    This multicenter, open-label pilot study evaluated safety, efficacy and tolerability of a topical formulation containing a multipotent growth factor resignaling complex (MRCx), when applied to infraorbital and lateral canthal skin. Thirty-nine female subjects with mean age of 56.8 years who had periorbital lines and wrinkles, uneven skin texture, puffiness, and lack of skin firmness were enrolled, and 38 completed the study. All subjects applied the multipotent growth factor formulation bilaterally to the periorbital area, twice daily for 60 days. Efficacy and treatment-related adverse events were evaluated at Baseline and days 14, 30, and 60. Investigators rated the periorbital areas based on 10-point scales. Subjects' self-reported compliance with treatment was greater than 99% throughout the study. At day 60, all subjects had improvement in infraorbital brightness (≥ 2 points), moistness (≥ 2 points), wrinkles (≥ 1 point), sallowness (≥ 1 point), crepiness (≥ 1 point), smooth texture (≥ 1 point), skin tightness (≥ 1 point), and skin tone (≥ 1 point). Investigator-rated assessments showed ≥ 1-point improvement for lateral canthal wrinkles, dyschromia/mottled pigmentation, skin tone, overall brightness, and moistness. Investigator-rated scoring on the Global Aesthetic Improvement Scale (GAIS) demonstrated that 67.6% of subjects were much improved/improved at day 14, and 63.1% remained improved at day 60. Overall, 76.2% and 79.0% of subjects were very pleased/pleased/mostly pleased with the appearance of their infraorbital and lateral canthal areas at day 60. Adverse events comprised one case of mild canthal erythema, and one case of mild eye irritation, both of which were respectively resolved. This pilot study demonstrated that the topical multipotent growth factor formulation was safe, effective and well tolerated for periorbital skin rejuvenation.

  18. STRUCTURAL FUNDS ABSORPTION GROWTH BY IMPROVING THEIR MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Pautu Sorina

    2012-12-01

    Full Text Available Grant project management is now a trend in the institutions of various types in Romania due to the opportunities offered by the EU through structural Instruments. Absorbing European funds is a challenge for Romania. The Managing Authority for Structural Instruments, together with the subordinated institutions present deficiencies in their coordination and implementation, the effect being a slow process of absorption of structural and cohesion funds. Taking action to enhance absorption of Structural and Cohesion Funds was done later; some measures are neither effective nor efficient. One of the major problems in implementing the Structural Funds is the continuous change of their national legislation. Therefore it is necessary to take measures to increase the absorption of structural funds and also the national adoption of a stable legal framework applicable to Structural Funds, guides of the applicant and clearly established project calls, without any latest changes, creating a transparent system of project proposals assessment and results communication of assessments to their beneficiaries, the payments required by the reimbursement requests within 45 days specified in the contract and not just their validation, terms compliance in approval notifications and addenda to the contract funding, proper training of the personnel from the intermediate organizations and linking information provided by their staff.

  19. An observational pilot study on the effect of Gomutra Haritaki, diet control and exercise in the management of Sthaulya (obesity).

    Science.gov (United States)

    Gujarathi, Ritesh A; Dwivedi, Rambabu; Vyas, Mahesh Kumar

    2014-04-01

    India is currently witnessing rising numbers of people in the middle-class who are obese. A lot of the Indian population has started relying on processed foods that contain a huge percentage of trans-fat, sugars, and other unhealthy and artificial ingredients. Obesity is considered the core of many diseases. Increased weight carries significant health risks for some cancers, diabetes, heart diseases and strokes. Junk food, alcohol and sedentary lifestyle are leading us to silent self destruction, making one in every five Indian men and women either obese or overweight. To determine the effect of Gomutra Haritaki on Sthaulya. An observational pilot study on the effect of Gomutra Haritaki, diet control and exercise in the management of Sthaulya (obesity) was conducted on 21 patients. Enrolled patients were screened on the basis of clinical findings and allocated into two groups. Trial group received Gomutra Haritaki (6 g/day in three divided doses) while control group received placebo capsules in the same dose for 8 weeks. Statistically highly significant relief was found in weight reduction (P < 0.001), and body mass index (BMI) (P < 0.01) in both groups. Control group has shown better results against trial group. These results prove the impact of diet and exercise in the management of Sthaulya.

  20. Combined topical and systemic clonazepam therapy for the management of burning mouth syndrome: a retrospective pilot study.

    Science.gov (United States)

    Amos, Kate; Yeoh, Sue-Ching; Farah, Camile S

    2011-01-01

    To evaluate retrospectively the efficacy of administering an anticonvulsant medication, clonazepam, by dissolving tablets slowly orally before swallowing, for the management of burning mouth syndrome (BMS). A retrospective clinical records audit was performed of patients diagnosed with BMS between January 2006 and June 2009. Patients were prescribed 0.5 mg clonazepam three times daily, and changes were made to this regimen based on their individual response. Patients were asked to dissolve the tablet orally before swallowing and were reviewed over a 6-month period. Pain was assessed by patients on an 11-point numerical scale (0 to 10). A nonparametric (Spearman) two-tailed correlation matrix and a two-tailed Mann-Whitney test were performed. A total of 36 patients (27 women, 9 men) met the criteria for inclusion. The mean (± SEM) pain score reduction between pretreatment and final appointment was 4.7 ± 0.4 points. A large percentage (80%) of patients obtained more than a 50% reduction in pain over the treatment period. One patient reported no reduction in pain symptoms, and one third of the patients had complete pain resolution. Approximately one third of patients experienced side effects that were transient and mild. This pilot study provides preliminary evidence that the novel protocol of combined topical and systemic clonazepam administration provides an effective BMS management tool.

  1. A pilot health information management system for public health midwives serving in a remote area of Sri Lanka.

    Science.gov (United States)

    Rodrigo, E Shan S; Wimalaratne, Samantha R U; Marasinghe, Rohana B; Edirippulige, Sisira

    2012-04-01

    We developed an electronic Health Information Management System (HIMS) for Public Health Midwives (PHMs) in Sri Lanka. We conducted a needs analysis amongst 16 PHMs, which found that they spent most of their time managing health records. The HIMS was designed so that it could accept data from the PHMs, and generate reports which could be used by the PHMs themselves as well as by their supervisors. The HIMS was trialled by a group of 16 PHMs in a remote area of the Ratnapura district of Sri Lanka. Mini-laptops with the software were distributed to the PHMs and they were given the necessary training. They started entering historical data from the registers into the system by themselves. Nearly 10,000 public health records were generated in the first three months. In a subsequent survey, the PHMs all gave positive answers indicating that they were happy with the pilot system, they would like to continue using it to enhance their service and they wanted to see it expanded across the whole of Ratnapura district. The system seems to be a practical solution for the field activities of PHMs in Sri Lanka.

  2. A psychosocial intervention for the management of functional dysphonia: complex intervention development and pilot randomised trial.

    Science.gov (United States)

    Deary, Vincent; McColl, Elaine; Carding, Paul; Miller, Tracy; Wilson, Janet

    2018-01-01

    Medically unexplained loss or alteration of voice-functional dysphonia-is the commonest presentation to speech and language therapists (SLTs). Besides the impact on personal and work life, functional dysphonia is also associated with increased levels of anxiety and depression and poor general health. Voice therapy delivered by SLTs improves voice but not these associated symptoms. The aims of this research were the systematic development of a complex intervention to improve the treatment of functional dysphonia, and the trialling of this intervention for feasibility and acceptability to SLTs and patients in a randomised pilot study. A theoretical model of medically unexplained symptoms (MUS) was elaborated through literature review and synthesis. This was initially applied as an assessment format in a series of patient interviews. Data from this stage and a small consecutive cohort study were used to design and refine a brief cognitive behavioural therapy (CBT) training intervention for a SLT. This was then implemented in an external pilot patient randomised trial where one SLT delivered standard voice therapy or voice therapy plus CBT to 74 patients. The primary outcomes were of the acceptability of the intervention to patients and the SLT, and the feasibility of changing the SLT's clinical practice through a brief training. This was measured through monitoring treatment flow and through structured analysis of the content of intervention for treatment fidelity and inter-treatment contamination. As measured by treatment flow, the intervention was as acceptable as standard voice therapy to patients. Analysis of treatment content showed that the SLT was able to conduct a complex CBT formulation and deliver novel treatment strategies for fatigue, sleep, anxiety and depression in the majority of patients. On pre-post measures of voice and quality of life, patients in both treatment arms improved. These interventions were acceptable to patients. Emotional

  3. Pilot In Command: A Feasibility Assessment of Autonomous Flight Management Operations

    Science.gov (United States)

    Wing, David J.; Ballin, Mark G.; Krishnamurthy, Karthik

    2004-01-01

    Several years of NASA research have produced the air traffic management operational concept of Autonomous Flight Management with high potential for operational feasibility, significant system and user benefits, and safety. Among the chief potential benefits are demand-adaptive or scalable capacity, user flexibility and autonomy that may finally enable truly successful business strategies, and compatibility with current-day operations such that the implementation rate can be driven from within the user community. A concept summary of Autonomous Flight Management is provided, including a description of how these operations would integrate in shared airspace with existing ground-controlled flight operations. The mechanisms enabling the primary benefits are discussed, and key findings of a feasibility assessment of airborne autonomous operations are summarized. Concept characteristics that impact safety are presented, and the potential for initially implementing Autonomous Flight Management is discussed.

  4. Positioning and Priorities of Growth Management in Construction Industrialization: Chinese Firm-Level Empirical Research

    Directory of Open Access Journals (Sweden)

    Jingxiao Zhang

    2017-06-01

    Full Text Available The purpose of this research is to quantitatively evaluate the growth phase, position, and priorities of the industrialization policy management of the construction industry at firm level. The goal is to integrate quantitative dynamics into the policy-making process for sustainable policy development in future China. This research proposes an integrated framework, including growth management model and industrial policy evaluation method, to identify the challenges of construction industrialization and policy management. The research applies the mixed system method, which includes entropy method and average score method, to analyze the growth stage and major impact indexes targeting 327 survey samples. The empirical results show that the proposed conceptual framework and policy evaluation method could effectively determine the growth position and directions of the construction industrialization. For verification purpose, the study uses the local industry data from Shaanxi Province, China. The calculation results substantiate that the construction industry is in the middle section of the third growth phase. The comparison of the results from statistical methods shows that the local construction industry still needs substantial effort in policy management to improve its sustainable industrialization level. As countermeasures, the policy priorities should concentrate on: (1 enhancing effective cooperation among universities, research institutions and enterprises; (2 improving actions towards technology transfer into productivity; and (3 encouraging market acceptance of construction industrialization. This research complements the existing literature of policy evaluation of construction industrialization. Moreover, it provides theoretical and operational steps on industry policy evaluation and growth management framework, with accurate and ample data analysis on firm-level survey. Researchers and policy makers can use this research for further

  5. Pilot Program to Improve Self-Management of Patients with Heart Failure by Redesigning Care Coordination

    Directory of Open Access Journals (Sweden)

    Jessica D. Shaw

    2014-01-01

    Full Text Available Objectives. We tested both an educational and a care coordination element of health care to examine if better disease-specific knowledge leads to successful self-management of heart failure (HF. Background. The high utilization of health care resources and poor patient outcomes associated with HF justify tests of change to improve self-management of HF. Methods. This prospective study tested two components of the Chronic Care Model (clinical information systems and self-management support to improve outcomes in the self-management of HF among patients who received intensive education and care coordination during their acute care stay. A postdischarge follow-up phone call assessed their knowledge of HF self-management compared to usual care patients. Results. There were 20 patients each in the intervention and usual care groups. Intervention patients were more likely to have a scale at home, write down their weight, and practice new or different health behaviors. Conclusion. Patients receiving more intensive education knew more about their disease and were better able to self-manage their weight compared to patients receiving standard care.

  6. Exploring barriers to pain management in newborn intensive care units: a pilot survey of NICU nurses.

    Science.gov (United States)

    Byrd, Patricia J; Gonzales, Irene; Parsons, Virgil

    2009-12-01

    To explore barriers that NICU nurses face when attempting to optimally manage newborn pain. Ninety California NICU nurses with current membership in the National Association of Neonatal Nurses (NANN) voluntarily participated. A descriptive survey study. A researcher-developed survey consisting of 37 questions was mailed to 300 NICU nurses; 102 were returned and 90 were usable. Probability sampling from a listing of California registered nurses with current membership in the NANN was used to obtain the study's sampling frame. Less than half of the nurses felt that newborn pain is well managed within the NICUs where they are employed. Barriers identified related to physicians' pain management practices, lack of evidence-based pain management protocols, nurses' and physicians' resistance to change practice, infant pain assessment tools, and inadequate staff training regarding pain assessment and management. A knowledge-practice gap still exists within newborn pain management. Increased caregiver education remains a necessity, but strategies that address resistance to change practice within healthcare settings must also be considered.

  7. Management-changing errors in the recall of radiologic results — A pilot study

    International Nuclear Information System (INIS)

    Brus-Ramer, M.; Yerubandi, V.; Newhouse, J.H.

    2012-01-01

    Aim: To evaluate the occurrence of alterations to diagnostic information from radiological studies, which are altered by person-to-person communication and/or faulty recall, and whether they affect patient management Materials and methods: A structured telephone survey was conducted at a large tertiary care medical centre of house staff managing inpatients who had undergone chest, abdominal, or pelvic computed tomography (CT) or magnetic resonance imaging (MRI) and remained in the hospital at least 2 days later. Fifty-six physicians were surveyed regarding 98 patient cases. Each physician was asked how he or she first became aware of the results of the study. Each was then asked to recall the substance of radiological interpretation and to compare it with the radiology report. Each was then asked to assess the level of difference between the interpretations and whether management was affected. Results were correlated with the route by which interviewees became aware of the report, the report length, and whether the managing service was medical or surgical. Results: In nearly 15% (14/98) of cases, differences between the recalled and official results were such that patient management could have been (11.2%) or had already been affected (3.1%). There was no significant correlation between errors and either the route of report communication or the report length. Conclusion: There was a substantial rate of error in the recall and/or transmission of diagnostic radiological information, which was sufficiently severe to affect patient management.

  8. Stress management in children: a pilot study in 7 to 9 year olds.

    Science.gov (United States)

    Lozada, Mariana; Carro, Natalia; Dʼadamo, Paola; Barclay, Carlos

    2014-01-01

    At present, school-age children suffer high levels of chronic stress that could produce potentially long-lasting effects. The aim of this pilot study was to evaluate the effects of mind-body integration practices and cooperative activities on stress levels and social interaction in 7- to 9-year-old children. We performed an intervention program once a week during 2 months in which children performed mind-body integration practices and cooperative activities. Our findings showed that these practices reduced cortisol levels and increased social connectedness. Moreover, we found that most of the children used the learned mind-body integration practices in stressful situations in their homes, even 5 months after the intervention. Our results demonstrated the positive impact of these helpful tools and the great plasticity of children's behavior, which enabled them to incorporate healthy habits. Overall, the intervention enhanced health at an individual level and favored social network diversity at a group level. Our research illustrates how children can incorporate techniques that help them cope with stressful moments and reveals the effectiveness of this experience in reducing cortisol levels. This study contributes to the understanding of how mind-body integration practices and social connectedness can be helpful in reducing chronic stress, a topic that, to the best of our knowledge, has been little studied in children.

  9. 33 CFR 385.12 - Pilot projects.

    Science.gov (United States)

    2010-07-01

    ... 33 Navigation and Navigable Waters 3 2010-07-01 2010-07-01 false Pilot projects. 385.12 Section... Processes § 385.12 Pilot projects. (a) The Plan includes pilot projects to address uncertainties associated... management, and wastewater reuse. The purpose of the pilot projects is to develop information necessary to...

  10. Empowerment of diabetic patients through mHealth technologies and education: development of a pilot self-management application

    Science.gov (United States)

    Gustin, G.; Macq, B.; Gruson, D.; Kieffer, S.

    2017-11-01

    Diabetes is a major, global and increasing condition that occurs when the insulin-glucagon regulatory mechanism is affected, leading to uncontrolled hyper- and hypoglycaemia events that may be life-threatening. However, it has been shown that through daily monitoring, appropriate patient-specific empowerment, lifestyle behavior of diabetics can be positively influenced and the associated and costly diabetes complications significantly reduced. As personal face-to-face coaching is costly and hard to scale, mobile applications and services have now become a key driver of mobile Health (mHealth) deployment, especially as a helpful way for self-management. Despite the huge mHealth market, a major limitation of many diabetes apps is that they do not use inputted data to help patients determine their daily insulin doses. On the other hand, the majority of existing insulin dose calculator apps provide no protection against - or even may actively contribute to - incorrect or inappropriate dose recommendations that put users at risk. Besides, there is clear evidence that lack of education on insulinotherapy and carbohydrate counting is associated with higher blood glucose variability with type 1 diabetes. Hence, there is a need for an accurate modelling of glucose-insulin dynamics together as well as providing adequate educational support. The aims of this paper are: a) to highlight the usefulness of mHealth technologies in chronic disease management; b) to describe and discuss the development of an insulin bolus calculator integrated into a pilot mHealth app; c) to underline the importance of diabetes self-management education.

  11. Feasibility and Efficacy of an mHealth Game for Managing Anxiety: "Flowy" Randomized Controlled Pilot Trial and Design Evaluation.

    Science.gov (United States)

    Pham, Quynh; Khatib, Yasmin; Stansfeld, Stephen; Fox, Simon; Green, Tobias

    2016-02-01

    Meeting the complex needs of patients with chronic common mental health disorders (CMHDs) may be the greatest challenge facing organized medical practice. On the basis of a well-established and proven theoretical foundation for controlled respiration as a behavioral intervention for CMHDs, as well as preliminary evidence that gamification can improve health outcomes through increasing patient engagement, this randomized controlled pilot study evaluated the feasibility and clinical efficacy of a mobile health game called "Flowy" ( www.flowygame.com ) that digitally delivered breathing retraining exercises for anxiety, panic, and hyperventilation symptom management. We designed an unblinded, Web-based, parallel-group randomized controlled trial focusing on feasibility, clinical efficacy, and design proof of concept. In the intervention condition (n = 31), participants received free access to "Flowy" for 4 weeks. In the control condition (n = 32), participants were placed on a waitlist for 4 weeks before being offered free access to "Flowy." Online measurements using psychological self-report questionnaires were made at 2 and 4 weeks post-baseline. At trial conclusion, participants found "Flowy" acceptable as an anxiety management intervention. "Flowy" engaged participants sufficiently to endorse proactive gameplay. Intent-to-treat analysis revealed a reduction in anxiety, panic, and self-report hyperventilation scores in both trial arms, with the intervention arm experiencing greater quality of life. Participants perceived "Flowy" as a fun and useful intervention, proactively used "Flowy" as part of their care, and would recommend "Flowy" to family and friends. Our results suggest that a digital delivery of breathing retraining exercises through a mobile health game can manage anxiety, panic, and hyperventilation symptoms associated with CMHDs.

  12. An Integrated Diagnostic Framework to Manage Organization Sustainable Growth: An Empirical Case

    OpenAIRE

    Jingxiao Zhang; Klaus Schmidt; Hui Li

    2016-01-01

    This research aims to develop a quantitative diagnostic framework by combining the Weisbord six-box model with the growth management model to focus on an organization’s internally driven sustainable management system. The research adopted an instrument developed by Preziosi and an extended Weisbord six-box model. The research employed a survey to collect 180 samples in a Chinese petrol company and applied the comparative method: (a) the average score method; and (b) the entropy method to conf...

  13. A controlled pilot study of stress management training of elderly patients with congestive heart failure.

    Science.gov (United States)

    Luskin, Frederic; Reitz, Megan; Newell, Kathryn; Quinn, Thomas Gregory; Haskell, William

    2002-01-01

    The purpose of this study was to evaluate the effect of stress management training on quality of life, functional capacity, and heart rate variability in elderly patients with New York Heart Association class I-III congestive heart failure (CHF). While substantial research exists on stress management training for patients with coronary heart disease, there are few data on the value of psychosocial training on patients with CHF. Thirty-three multiethnic patients (mean age, 66+/-9 years) were assigned through incomplete randomization to one of two treatment groups or a wait-listed control group. The 14 participants who completed the treatment attended eight training sessions during a 10-week period. The training consisted of 75-minute sessions adapted from the Freeze-Frame stress management program developed by the Institute of HeartMath. Subjects were assessed at baseline and again at the completion of the training. Depression, stress management, optimism, anxiety, emotional distress, and functional capacity were evaluated, as well as heart rate variability. Significant improvements (pstress, emotional distress, 6-minute walk, and depression, and positive trends were noted in each of the other psychosocial measures. The 24-hour heart rate variability showed no significant changes in autonomic tone. The authors noted that CHF patients were willing study participants and their emotional coping and functional capacity were enhanced. This program offers a simple and cost-effective way to augment medical management of CHF. Given the incompleteness of CHF medical management and the exploding interest in complementary medical intervention, it seems imperative that further work in psychosocial treatment be undertaken. Copyright 2002 CHF, Inc.

  14. Pilot study of the psychological factors in the professional health of managers.

    Directory of Open Access Journals (Sweden)

    Shingaev S.M.

    2015-07-01

    Full Text Available The main research problems and tasks of a new scientific field in Russia—the psychology of professional health — are formulated. A definition of professional health as the abilities of a person successfully to cope with the demands and requirements in a professional environment is offered. A psychological vision for professional health with four basic provisions is proposed. The aim of the research was to study the extent of the influence on the professional health of managers of such psychological factors as systems of values, stress in professional activity, individual and psychological features, strategies for overcoming stressful situations. Data are provided from research conducted in 2002-2012 on managers in Russian companies. Taking part in the research were 651 managers of various organizations in St. Petersburg, Moscow, Yekaterinburg, Veliky Novgorod, and Kharkov. For collecting empirical material on methods of supervision, I used polls, tests, interviews, content analysis, self-reports of participants in training programs, and a method for forming the experiment. In addition I employed psychodiagnostic techniques intended for studying the cognitive, behavioral, and emotional components of health, a technique for revealing the personal potentials (regulatory, communicative, intellectual of the managers, and also my own techniques. The study positively correlated health with such values as having interesting work, having a happy family life, being financially secure, having an active life, and giving and receiving love. Connections between the behavioral manifestations of type A behavior and the managers’ values were revealed. The greatest negative impact on the managers was made by such factors of professional activity as an excessive workload, emotional pressure at work, difficulty in carrying out activity, and insufficient time. Health is important in the structure of the professional activity of managers; it acts as a strategic

  15. University woodwind students’ experiences with playing-related injuries and their management: a pilot study

    Directory of Open Access Journals (Sweden)

    Stanhope J

    2014-03-01

    Full Text Available Jessica Stanhope,1 Steve Milanese,2 Karen Grimmer1 1International Centre for Allied Health Evidence, 2School of Health Sciences, University of South Australia, Adelaide, SA, Australia Background: This study aimed to determine the experiences of university classical woodwind students with playing-related injuries (PRIs, the impact of these PRIs, the management selected by students with PRIs, and the perceived effectiveness of this management. Materials and methods: All classical woodwind students enrolled in vocational education training or undergraduate courses at a university were sent an email with a link to an online survey. Only those aged 18 years and older were eligible. The survey obtained data regarding demographic information, details of PRI experienced (location, if they lasted for more than 3 months, and if they were current, and the impact of these, as well as the types of management strategies tried and their perceived effectiveness. Data were analyzed using descriptive statistics, and comments were reported descriptively. Results: Fourteen students returned the survey; however, one of these only completed the questions regarding demographics, and was therefore excluded. A total of 62% of participants reported having experienced a PRI. Common locations for PRI were the wrist/hand/fingers, lower back, and neck. Reducing practice time by half and missing playing commitments were the most commonly reported consequences of PRIs. Playing-related management strategies were most frequently trialed, with these and passive nonplaying-related strategies perceived to be the most effective. Conclusion: PRIs are common in this population, with a range of consequences reported. While it is encouraging that students had tried and found effective playing-related management strategies, active nonplaying-related strategies should be encouraged, particularly in preference to passive nonplaying-related strategies. This was a small-scale study, and the

  16. A pilot study on the quality of data management in a cancer clinical trial

    OpenAIRE

    Putten, E. van der; Velden, J.W. van der; Siers, A.; Hamersma, E.A.M.

    1987-01-01

    Twelve institutional data managers were asked to independently code the data from a patient chart of one patient in an ovarian cancer trial. They abstracted data from the medical record and filled out three types of trial forms (on-study, chemotherapy, and summary forms). The analysis of the processed data revealed that the median rate of errors was 13% for the 12 data managers. The error rate differed among the types of trial forms. The factors causing these errors were mistakes in interpret...

  17. Weight management for overweight and obese men delivered through professional football clubs: a pilot randomized trial

    NARCIS (Netherlands)

    Gray, C.M.; Hunt, K.; Mutrie, N.; Anderson, A.S.; Treweek, S.; Wyke, S.

    2013-01-01

    BACKGROUND: The prevalence of male obesity is increasing, but men are less likely than women to attend existing weight management programmes. We have taken a novel approach to reducing perceived barriers to weight loss for men by using professional football (soccer) clubs to encourage participation

  18. Manipulation of the wrist for management of lateral epicondylitis: A randomized pilot study

    NARCIS (Netherlands)

    Struijs, Peter A. A.; Damen, Pieter-Jan; Bakker, Eric W. P.; Blankevoort, Leendert; Assendelft, Willem J. J.; van Dijk, C. Niek

    2003-01-01

    Background and Purpose. Lateral epicondylitis ("tennis elbow") is a common entity. Several nonoperative interventions, with varying success rates, have been described. The aim of this study was to compare the effectiveness of 2 protocols for the management of lateral epicondylitis: (1) manipulation

  19. Improving nitrogen management on grassland on commercial pilot dairy farms in the Netherlands

    NARCIS (Netherlands)

    Oenema, J.; Ittersum, van M.K.; Keulen, van H.

    2012-01-01

    Nitrogen (N) use efficiency (NUE), the ratio of N output and N input, is rather low on dairy farms with high stocking densities and high N input on grassland resulting in high N losses to the environment. This study describes and analyses the development and variation in N management on grassland on

  20. A pilot study on the quality of data management in a cancer clinical trial

    NARCIS (Netherlands)

    Putten, E. van der; Velden, J.W. van der; Siers, A.; Hamersma, E.A.M.

    Twelve institutional data managers were asked to independently code the data from a patient chart of one patient in an ovarian cancer trial. They abstracted data from the medical record and filled out three types of trial forms (on-study, chemotherapy, and summary forms). The analysis of the

  1. ODM2 Admin Pilot Project- a Data Management Application for Observations of the Critical Zone.

    Science.gov (United States)

    Leon, M.; McDowell, W. H.; Mayorga, E.; Setiawan, L.; Hooper, R. P.

    2017-12-01

    ODM2 Admin is a tool to manage data stored in a relational database using the Observation Data Model 2 (ODM2) information model. Originally developed by the Luquillo Critical Zone Observatory (CZO) to manage a wide range of Earth observations, it has now been deployed at 6 projects: the Catalina Jemez CZO, the Dry Creek Experimental Forest, Au Sable and Manistee River sites managed by Michigan State, Tropical Response to Altered Climate Experiment (TRACE) and the Critical Zone Integrative Microbial Ecology Activity (CZIMEA) EarthCube project; most of these deployments are hosted on a Microsoft Azure cloud server managed by CUAHSI. ODM2 Admin is a web application built on the Python open-source Django framework and available for download from GitHub and DockerHub. It provides tools for data ingestion, editing, QA/QC, data visualization, browsing, mapping and documentation of equipment deployment, methods, and citations. Additional features include the ability to generate derived data values, automatically or manually create data annotations and create datasets from arbitrary groupings of results. Over 22 million time series values for more than 600 time series are being managed with ODM2 Admin across the 6 projects as well as more than 12,000 soil profiles and other measurements. ODM2 Admin links with external identifier systems through DOIs, ORCiDs and IGSNs, so cited works, details about researchers and earth sample meta-data can be accessed directly from ODM2 Admin. This application is part of a growing open source ODM2 application ecosystem under active development. ODM2 Admin can be deployed alongside other tools from the ODM2 ecosystem, including ODM2API and WOFpy, which provide access to the underlying ODM2 data through a Python API and Water One Flow web services.

  2. How Does Top Managers' Cognition about Corporate Resources Influence Firm Growth?

    DEFF Research Database (Denmark)

    Distel, Andreas Philipp

    ’s technology- and market-related resources. Using multi-source data of firms operating in a dynamic industry, we investigate how resource cognition affects firm growth. We also explore the contingent role of decentralization and top management team size as important structural elements determining...

  3. DASEES: A Tripartite Decision Analysis Framework to Achieve Sustainable Environment, Economy & Society Growth and Management Goals

    Science.gov (United States)

    Many of Societies management and growth decisions are often made without a balanced consideration of pertinent factors from environmental, economic and societal perspectives. All three of these areas are key players in many of the decisions facing societies as they strive to ope...

  4. Strategies for Low-Carbon Green Growth and Urban Management in Korea

    Directory of Open Access Journals (Sweden)

    Jichung Yang

    Full Text Available ABSTRACT: National policies and strategies for low-carbon green growth in Korea are reviewed in this study. Providing standards and guidelines for urban comprehensive planning and management plans is necessary so that the series of plans can deal with possible effects from climate changes. Urban planning guidelines for management and improvements to achieve low carbon green growth were set up and implemented, focusing on institutional and regulatory foundations. These deal with climate change influences on urban planning, reduction of green house gas emissions and elevation of energy efficiency based on plans of land use units. In the case of Seoul city, transit-oriented compact development, public transportation-oriented structure, green space expansion, and pleasant living spaces are implemented in relation to urban structure and land use. We should suggest systematic and comprehensive countermeasures against greenhouse gas emissions and climate changes in terms of spatial structure, transportation systems, natural resource conservation, environment management, energy and open spaces. For the Seoul mega-city, plans show the capabilities of the policy department including many policy tools. Reflecting smart city, ubiquitous city, and U-Eco city concepts and human behavior, we should move towards increasing efficiency and maintaining sustainable economic growth. KEYWORDS: Low-carbon green growth, urban management, Korea, Seoul

  5. Nematode communities of natural and managed beech forests - a pilot study

    DEFF Research Database (Denmark)

    Strandmark, Lisa Bjørnlund; Madsen, Mette Vestergård; Johansson, Sanne

    2002-01-01

    was found in a Canonical Community Ordination (CANOCO) that related nematode data and various soil parameters in each sample. Beech forests of Mid-Zealand (Suserup) had significantly lower sand content, higher pH, higher PPI and higher nematode diversity according to the Shannon-index than the forests...... of North Zealand (Farum and Rankeskov). A distinct difference in the distribution of families was observed between sites, which could be governed by differences in texture and pH. The MI of the two old natural forest sites (Farum and Suserup) was significantly higher than the comparable managed sites......, while this was not the case for Rankeskov, which is in a less mature state. There was a significantly higher adult/juvenile ratio and higher relative abundance of bacterial feeders in the natural forests compared to the managed forests. The apparent relation between pH and Maturity Index in beech...

  6. HYPNOSIS FOR SYMPTOM MANAGEMENT IN WOMEN WITH BREAST CANCER: A Pilot Study

    Science.gov (United States)

    Jensen, Mark P.; Gralow, Julie R.; Braden, Alan; Gertz, Kevin J.; Fann, Jesse R.; Syrjala, Karen L.

    2018-01-01

    Eight women who were in treatment for breast cancer (n = 4) or breast cancer survivors (n = 4), presenting with 1 or more of 4 symptoms (chronic pain, fatigue, hot flashes, and sleep difficulties), were given 4 to 5 sessions of self-hypnosis training for symptom management. Analyses revealed (a) significant pre- to posttreatment decreases in pain intensity, fatigue, and sleep problems and (b) that pain intensity continued to decrease from posttreatment to 6-month follow-up. Although there was a slight increase in fatigue severity and sleep problems from posttreatment to 6-month follow-up, the follow-up scores did not return to pretreatment levels. The findings provide initial support for using hypnosis to manage symptoms in women who are breast cancer survivors. Clinical trials evaluating hypnosis efficacy over and above other treatments are warranted. PMID:22443523

  7. A Pilot Study to Assess the Feasibility of the Spanish Diabetes Self-Management Program in the Basque Country

    Directory of Open Access Journals (Sweden)

    Estibaliz Gamboa Moreno

    2016-01-01

    Full Text Available Purpose. The purpose of this study was to assess the feasibility of the Spanish Diabetes Self-Management Program (SDSMP in the primary care setting of the Basque Health Service and offer initial estimations of the randomized controlled trial (RCT effects. Methods. Ten health centers (HCs participated in a single-arm pilot study with a 6-month follow-up period between February 2011 and June 2012. Recruitment was performed via invitation letters, health professionals, and the local media. Each intervention group consisted of 8–15 people. The ability of each HC in forming up to 2 groups, participants’ compliance with the course, and coordination and data collection issues were evaluated. Glycated haemoglobin (HbA1c was the main outcome variable. Secondary outcomes were cardiovascular risk factors, drugs consumption, medical visits, quality of life, self-efficacy, physical exercise, and diet. Results. Two HCs did not organize a course. A total of 173 patients initiated the program, 2 dropped out without baseline data, and 90% completed it. No pre-post HbA1c differences existed. Certain improvements were observed in blood pressure control, self-efficacy, physical activity, and some dietary habits. Conclusion. The SDSMP is feasible in our setting. Our experience can be of interest when planning and conducting this program in similar health settings. The trial is registered with ClinicalTrials.gov identifier NCT01642394.

  8. Auricular Point Acupressure to Manage Chronic Low Back Pain in Older Adults: A Randomized Controlled Pilot Study

    Directory of Open Access Journals (Sweden)

    Chao Hsing Yeh

    2014-01-01

    Full Text Available This prospective, randomized clinical trial (RCT pilot study was designed to (1 assess the feasibility and tolerability of an easily administered, auricular point acupressure (APA intervention and (2 provide an initial assessment of effect size as compared to a sham treatment. Thirty-seven subjects were randomized to receive either the real or sham APA treatment. All participants were treated once a week for 4 weeks. Self-report measures were obtained at baseline, weekly during treatment, at end-of-intervention (EOI, and at a 1-month follow-up. A dropout rate of 26% in the real APA group and 50% in the sham group was observed. The reduction in worst pain from baseline to EOI was 41% for the real and 5% for the sham group with a Cohen’s effect size of 1.22 P<0.00. Disability scores on the Roland Morris Disability Questionnaire (RMDQ decreased in the real group by 29% and were unchanged in the sham group (+3% P<0.00. Given the high dropout rate, results must be interpreted with caution; nevertheless, our results suggest that APA may provide an inexpensive and effective complementary approach for the management of back pain in older adults, and further study is warranted.

  9. Effectiveness of a stress management pilot program aimed at reducing the incidence of sports injuries in young football (soccer) players.

    Science.gov (United States)

    Olmedilla-Zafra, Aurelio; Rubio, Victor J; Ortega, Enrique; García-Mas, Alexandre

    2017-03-01

    Several attempts to reduce the incidence of sport injuries using psychosocial interventions produced fruitful, although inconclusive results. This paper presents the effectiveness and implementation issues of a pilot 3-month stress-management and muscle relaxation program aimed at reducing sport injury incidence. Pre-post treatment-non treatment group comparison. The program was administered by a trained psychologist on a once-a-week, 1-h session basis. Seventy-four male soccer players from four National Youth league teams voluntarily participated. Teams were randomly assigned to either treatment/non-treatment group. Injury protocol, Self-monitoring cards, Athletes' satisfaction and commitment survey, Coaches' interview. Group main effect and Time-Group interaction effect were both statistically significant, F(1,60) = 8.30, p = 0.005, η 2 p  = 0.121, with the average number of injuries larger in the post-treatment phase of non-treatment group (p = 0.005, η 2 p  = 0.077). There was a significant decrease in the average number of injuries for the intervention group before and after implementing the program (p sport injuries, with a high level of satisfaction and commitment from the athletes, as well as high acceptance from the coaches. Copyright © 2016 Elsevier Ltd. All rights reserved.

  10. A new progestogen-only medical therapy for outpatient management of acute, abnormal uterine bleeding: a pilot study.

    Science.gov (United States)

    Ammerman, Stacy R; Nelson, Anita L

    2013-06-01

    The objective of this investigation was to study short-term efficacy and feasibility of a new progestogen-only treatment for outpatient management of acute abnormal uterine bleeding. This was a prospective, single-arm, pilot clinical trial of a progestogen-only bridging treatment for acute abnormal uterine bleeding in nonpregnant, premenopausal women in the Gynecologic Urgent Care Clinic at Harbor-UCLA Medical Center. Subjects were administered a depo-medroxyprogesterone acetate 150 mg intramuscular injection and given medroxyprogesterone acetate 20 mg to be taken orally every 8 hours for 3 days. The primary outcome measures included a percentage of women who stopped bleeding in 5 days, time to bleeding cessation, reduction in numbers of pads used, side effects, and patient satisfaction. All 48 women stopped bleeding within 5 days; 4 women had spotting only at the time of their last contact during the 5 day follow-up. Mean time to bleeding cessation was 2.6 days. Side effects were infrequent and patient satisfaction was high. Injection of depo-medroxyprogesterone acetate 150 mg intramuscularly combined with 3 days of oral medroxyprogesterone acetate 20 mg every 8 hours for 9 doses is an effective outpatient therapy for acute abnormal uterine bleeding. Copyright © 2013 Mosby, Inc. All rights reserved.

  11. [The Effectiveness of a Strategy for the Flexible Management of Nursing Human Resources: A Pilot Study].

    Science.gov (United States)

    Huang, Chung-I; Lu, Meei-Shiow

    2017-12-01

    The flexibility of a hospital's nursing-related human resource management policies affects the working willingness and retention of nurses. To explore the effectiveness of a flexible nursing-related human resource management strategy. This quasi-experimental research used a one group pretest-posttest design. Supervisors at participating hospitals attended the "Application of Flexible Nursing Human Resources Management Strategies" workshop, which introduced the related measures and assessed nurses' pretest satisfaction. After these measures were implemented at the participating hospitals, implementation-related problems were investigated and appropriate consultation was provided. The posttest was implemented after the end of the project. Data were collected from nurses at the participating hospitals who had served in their present hospital for more than three months. The participating hospitals were all nationally certified healthcare providers, including 13 medical centers, 17 regional hospitals, and 3 district hospitals. A total of nurses 2,810 nurses took the pretest and 2,437 took the posttest. The research instruments included the "Satisfaction with working conditions and system flexibility" scale and the "Flexible nursing human resource management strategies". The effectiveness of the implemented strategy was assessed using independent samples t-test and variance analysis. The result of implementing the flexible strategies shows that the total mean of pretest satisfaction (Likert 5 scores) was 3.47 (SD = 0.65), and the posttest satisfaction was 3.52 (SD = 0.65), with significant statistical differences in task, numerical, divisional, and leading flexibility. Due to the good implementation effectiveness, the authors strongly suggest that all of the participating hospitals continue to apply this strategic model to move toward a more flexible nursing system and work.

  12. The Polyp Manager: a new tool for optimal polyp documentation during colonoscopy. A pilot study.

    OpenAIRE

    van de Meeberg, Maartje M.; Ouwendijk, Rob J. Th.; ter Borg, Pieter C. J.; van den Hazel, Sven J.; van de Meeberg, Paul C.

    2016-01-01

    Background and study aims: Conventional reporting of polyps is often incomplete. We tested the Polyp Manager (PM), a new software application permitting the endoscopist to document polyps in real time during colonoscopy. We studied completeness of polyp descriptions, user-friendliness and the potential time benefit. Patients and methods: In two Dutch hospitals colonoscopies were performed with PM (as a touchscreen endoscopist-operated device or nurse-operated desktop application). Completenes...

  13. COST-SHARE INCENTIVES AND BEST MANAGEMENT PRACTICES IN A PILOT WATER QUALITY PROGRAM

    OpenAIRE

    Houston, Jack E.; Sun, Henglun

    1999-01-01

    This study integrates three biophysical simulators to predict crop yields, water-soil pollution emissions, and farmers' net returns under uncertain weather and market conditions. Multiple-objective programming incorporates farmer attitudes toward voluntary participation under alternate rates of government cost-share subsidies to search for efficient pollution abatement solutions as best management practices (BMPs). Net returns decline an estimated 9.6% when farmers adopt a cost-share program ...

  14. Stress management can facilitate weight loss in Greek overweight and obese women: a pilot study.

    Science.gov (United States)

    Christaki, E; Kokkinos, A; Costarelli, V; Alexopoulos, E C; Chrousos, G P; Darviri, C

    2013-07-01

    Stress and negative emotions have been shown to be critical factors in inducing overeating as a form of maladaptive coping in obese people. The present study aimed to evaluate the efficacy of an 8-week stress management programme that includes progressive muscle relaxation (PMR) and diaphragmatic breathing on weight loss and eating behaviour in a sample of overweight and obese women who started a weight-loss programme. A total of 34 women with a mean (SD) body mass index of 38.17 (7.19) kg m(-) ² and mean (SD) age 47.35 (11.64) years were recruited from the outpatients Obesity Clinic of a public hospital in Athens. Participants were randomly assigned into a Stress Management (SM) and a control group. Anthropometric measurements were taken before and after the intervention, and the participants completed the following questionnaires: Dutch Eating Behaviour Questionnaire (DEBQ), Eating Attitudes Test (Eat-26), Health Locus of Control (HLC) and Perceived Stress Scale (PSS) before and after the intervention. The findings indicated a significant improvement in weight loss in the SM group [4.44 (0.83) kg] after intervention compared to the control group [1.38 (0.78) kg] (P stress levels. The intervention group showed greater weight reduction, possibly because of the stress management programme, and a greater dietary restraint was demonstrated by them compared to the control group. It is likely that stress management could facilitate weight loss in obese women; however, more studies are needed to confirm this hypothesis. © 2013 The Authors Journal of Human Nutrition and Dietetics © 2013 The British Dietetic Association Ltd.

  15. An 8-week stress management program in pathological gamblers: a pilot randomized controlled trial.

    Science.gov (United States)

    Linardatou, C; Parios, A; Varvogli, L; Chrousos, G; Darviri, C

    2014-09-01

    Stress plays a major role at the onset and relapse of pathological gambling (PG), but at the same time it can also be the aftermath of gambling behavior, thus revealing a reciprocal relationship. Although the role of stress has been well-documented, there is a paucity of studies investigating the effect of an adjunctive stress management program on PG. In this 8-week parallel randomized waitlist controlled trial pathological gamblers, already in the gamblers anonymous (GA) group, were assigned randomly in two groups, with the intervention group (n = 22) receiving an additional stress management program (consisting of education on diet and exercise, stress coping methods, relaxation breathing -RB- and progressive muscle relaxation -PMR). Self-reported measures were used in order to evaluate stress, depression, anxiety, sleep quality/disturbances, life-satisfaction and daily routine. The statistical analyses for the between group differences concerning the main psychosocial study outcomes revealed a statistically significant amelioration of stress, depression, anxiety symptoms and an increase of life-satisfaction and a better daily routine in participants of the intervention group. We hope that these will encourage researchers and clinicians to adopt stress management in their future work. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Reflexology in the management of chemotherapy induced peripheral neuropathy: A pilot randomized controlled trial.

    Science.gov (United States)

    Kurt, Seda; Can, Gulbeyaz

    2018-02-01

    The current experimental study aimed to evaluate the effectiveness of reflexology on the management of symptoms and functions of chemotherapy-induced peripheral neuropathy (CIPN) in cancer patients. This study was conducted as a randomized controlled trial in 60 patients (30 experimental and 30 control patients) who had chemotherapy-induced Grade II-IV peripheral neuropathy complaints from July 2013 to November 2015. Data were collected using the patient identification form, European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire Chemotherapy-Induced Peripheral Neuropathy (EORTC-CIPN-20) form, and BPI (used for related chemotherapy-induced peripheral neuropathy symptoms). The majority of the patients were being treated for gastrointestinal or breast cancer and were primarily receiving Eloxatine- or taxane-based treatment. It was found that reflexology applications did not lead to differences in either group in terms of peripheral neuropathy severity and incidence (p > 0.05) and only led to improvement in sensory functions in the experimental group (p < 0.05). It was determined that reflexology is not an effective method in the management of patients' activity levels, walking ability etc. and motor, autonomic functions related CIPN, but reflexology is effective method in the management of patients' sensory functions related CIPN. Key Words: Peripheral neuropathy, reflexology, chemotherapy, EORTC QLQ-CIPN-20, BPI. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. The impact of fetal growth restriction on latency in the setting of expectant management of preeclampsia.

    Science.gov (United States)

    McKinney, David; Boyd, Heather; Langager, Amanda; Oswald, Michael; Pfister, Abbey; Warshak, Carri R

    2016-03-01

    Fetal growth restriction is a common complication of preeclampsia. Expectant management for qualifying patients has been found to have acceptable maternal safety while improving neonatal outcomes. Whether fetal growth restriction influences the duration of latency during expectant management of preeclampsia is unknown. The objective of the study was to determine whether fetal growth restriction is associated with a reduced interval to delivery in women with preeclampsia being expectantly managed prior to 34 weeks. We performed a retrospective cohort of singleton, live-born, nonanomalous deliveries at the University of Cincinnati Medical Center between 2008 and 2013. Patients were included in our analysis if they were diagnosed with preeclampsia prior to 34 completed weeks and if the initial management plan was to pursue expectant management beyond administration of steroids for fetal lung maturity. Two study groups were determined based on the presence or absence of fetal growth restriction. Patients were delivered when they developed persistent neurological symptoms, severe hypertension refractory to medical therapy, renal insufficiency, nonreassuring fetal status, pulmonary edema, or hemolysis elevated liver low platelet syndrome or when they reached 37 weeks if they remained stable without any other indication for delivery. Our primary outcome was the interval from diagnosis of preeclampsia to delivery, measured in days. Secondary outcomes included indications for delivery, rates of induction and cesarean delivery, development of severe morbidities of preeclampsia, and select neonatal outcomes. We performed a multivariate logistic regression analysis comparing those with fetal growth restriction with those with normally grown fetuses to determine whether there is an association between fetal growth restriction and a shortened interval to delivery, neonatal intensive care unit admission, prolonged neonatal stay, and neonatal mortality. A total of 851 patients met

  18. Incorporating the Six Core Elements of Health Care Transition Into a Medicaid Managed Care Plan: Lessons Learned From a Pilot Project.

    Science.gov (United States)

    McManus, Margaret; White, Patience; Pirtle, Robin; Hancock, Catina; Ablan, Michael; Corona-Parra, Raquel

    2015-01-01

    This pediatric-to-adult health care transition pilot project describes the process and results of incorporating the "Six Core Elements of Health Care Transition (2.0)" into a Medicaid managed care plan with a group of 35 18-23 year olds who have chronic mental health, developmental, and complex medical conditions. The pilot project demonstrated an effective approach for customizing and delivering recommended transition services. At the start of the 18-month project, the Medicaid plan was at the basic level (1) of transition implementation of the Six Core Elements with no transition policy, member transition readiness assessment results, health care transition plans of care, updated medical summaries, transfer package for the adult-focused provider, and assurance of transfer completion and consumer feedback. At the conclusion of the pilot project, the plan scored at level 3 on each core element. The primary reason for not scoring at the highest level (4) was because the transition elements have not been incorporated into services for all enrollees within the plan. Future efforts in managed care will benefit from starting the transition process much earlier (ages 12-14), expanding the role of nurse care managers and participating pediatric and adult-focused clinicians in transition, and offering payment incentives to clinicians to implement the Six Core Elements of Health Care Transition. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. Elephant population growth in Kruger National Park, South Africa, under a landscape management approach

    Directory of Open Access Journals (Sweden)

    Sam M. Ferreira

    2017-08-01

    Full Text Available South African National Parks (SANParks manage landscapes rather than numbers of elephants (Loxodonta africana to mitigate the effects that elephants may have on biodiversity, tourism and stakeholder conservation values associated with protected areas. This management philosophy imposes spatial variability of critical resources on elephants. Restoration of such ecological processes through less intensive management predicts a reduction in population growth rates from the eras of intensive management. We collated aerial survey data since 1995 and conducted an aerial total count using a helicopter observation platform during 2015. A minimum of 17 086 elephants were resident in the Kruger National Park (KNP in 2015, growing at 4.2% per annum over the last generation of elephants (i.e. 12 years, compared to 6.5% annual population growth noted during the intensive management era ending in 1994. This may come from responses of elephants to density and environmental factors manifested through reduced birth rates and increased mortality rates. Authorities should continue to evaluate the demographic responses of elephants to landscape scale interventions directed at restoring the limitation of spatial variance in resource distribution on elephant spatiotemporal dynamics and the consequences that may have for other conservation values. Conservation implications: Conservation managers should continue with surveying elephants in a way that allows the extraction of key variables. Such variables should focus on measures that reflect on how theory predicts elephants should respond to management interventions.

  20. Integration of Ambulatory Clinical Pharmacy Services in a Gastroenterology Clinic for Management of Hepatitis C Infection: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Erika Bower

    2017-05-01

    Full Text Available Purpose: The purpose of this study is to describe implementation of comprehensive medication management (CMM services in a gastroenterology (GI clinic for HCV patients on direct acting antivirals (DAAs, and to evaluate services in terms of identification of medication related problems (MRPs, patient satisfaction, and provider satisfaction. Methods: Six months of visit data was retrospectively collected to determine demographic data and to analyze pharmacist’s identification of MRPs. Patient satisfaction surveys were collected using a thirteen question validated pharmacist-satisfaction survey. After pilot completion, a twelve-question survey was sent to all GI clinic staff members to evaluate overall staff satisfaction with services. Results: Ninety-four CMM visits were completed. A total of 246 MRPs were identified with an average of 2.6 MRPs per visit. Seventy-eight MRPs were related to appropriate indication, 27 to efficacy, 30 to safety, and 109 to adherence. Forty MRPs were related to drug-drug interactions. Patient satisfaction surveys revealed that 86% of respondents rated the quality of care and services from the clinical pharmacist as "Excellent". Patients better understood and felt confident with therapy. All staff satisfaction survey respondents strongly agreed or agreed that the pharmacist made valuable contributions to the clinic and patient care. All also strongly agreed that pharmacy’s CMM services were an essential component to the management of HCV. Conclusion: Data supports continued involvement of clinical pharmacists within the clinic to promote safety and efficacy of DAAs. Patient and staff satisfaction survey results further illustrate the importance and value that CMM provided by clinical pharmacists can provide. Conflict of Interest We declare no conflicts of interest or financial interests that the authors or members of their immediate families have in any product or service discussed in the manuscript, including

  1. Environmental management for the control of Triatoma dimidiata (Latreille, 1811, (Hemiptera: Reduviidae in Costa Rica: a pilot project

    Directory of Open Access Journals (Sweden)

    Rodrigo Zeledón

    2006-06-01

    Full Text Available An ecological control method, using environmental management operations, based on biological and behavioral characteristics of Triatoma dimidiata (Latreille, 1811, was implemented as a pilot project in an area of Costa Rica where the bug is prevalent. The sample was represented by 20 houses with peridomestic colonies (two also had indoor infestation, divided in two equivalent groups of 10 each. In one group we intervened the houses, i.e. all objects or materials that were serving as artificial ecotopes for the bugs were removed, and the second group was used as control houses. After a year of periodic follow up, it became evident that in those houses with a modified environment the number of insects had decreased notoriously even after the first visits and this was more evident after a period of 12.5 to 13.5 months in which no insects were detected in eight of the houses. It also became clear that in this group of houses, recolonization by wild bugs from the surrounding areas, became more difficult, probably due to the absence of protection from bug predators. In the control houses, with the exception of three in which the inhabitants decided to intervene on their own, and another house with a peculiar situation, the insect populations remained the same or even showed a tendency to increase, as confirmed at the end of the experiment. We believe that the method is feasible, low costing and non contaminating. It could be used successfully in other places where T. dimidiata is common and also in countries where other species colonize peridomestic areas of homes. Environmental management of this kind should seek the participation of the members of the communities, in order to make it a more permanent control measure.

  2. Distraction Kits for Pain Management of Children Undergoing Painful Procedures in the Emergency Department: A Pilot Study.

    Science.gov (United States)

    Ballard, Ariane; Le May, Sylvie; Khadra, Christelle; Lachance Fiola, Jacinthe; Charette, Sylvie; Charest, Marie-Claude; Gagnon, Hélène; Bailey, Benoit; Villeneuve, Edith; Tsimicalis, Argerie

    2017-12-01

    To assess the feasibility, usefulness, and acceptability of using distraction kits, tailored to age, for procedural pain management of young children visiting the emergency department and requiring a needle-related procedure. A pre-experimental design was piloted. A kit, tailored to age (infants-toddlers: 3 months-2 years; preschoolers: 3-5 years), was provided to parents before their child's needle-related procedure. Data was collected to assess feasibility, usefulness, and acceptability of the kits by parents and nurses. Pain was measured pre-, peri-, and postprocedure using the Face, Legs, Activity, Cry, Consolability scale. A total of 25 infants and toddlers (mean age: 1.4 ± .7 years) and 25 preschoolers (mean age: 4.0 ± .9) participated in the study. Parents and nurses considered the kits useful and acceptable for distraction in the emergency department, especially in the postprocedural period. Addition of more animated and interactive toys to the kits was suggested. In the infants-toddlers group, mean pain scores were 1.6 ± 2.5 preprocedure, 7.1 ± 3.0 periprocedure, and 2.5 ± 2.5 postprocedure. In the preschoolers group, mean pain scores were 1.6 ± 3.0 preprocedure, 4.8 ± 3.4 periprocedure, and 2.0 ± 3.2 postprocedure. Distraction kits were deemed useful and acceptable by parents and emergency nurses. They are an interesting nonpharmacologic option for nurses to distract children, giving them a sense of control over their pain and improving their hospital experience. Future research should address the feasibility of distraction kits for a broader population of patients and a variety of painful procedures. Copyright © 2017 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  3. Stress Management in Patients Undergoing Carotid Endarterectomy for Carotid Artery Stenosis: A Pilot Randomized Controlled Trial.

    Science.gov (United States)

    Vasdekis, Spyros N; Roussopoulou, Andromachi; Lazaris, Andreas; Antonopoulos, Constantine N; Voumvourakis, Kostas; Darviri, Christina; Tsivgoulis, Georgios

    2015-10-01

    Psychological stress is common to patients submitted to cardiovascular operations. The purpose of this pilot, single-center, open-label, randomized controlled trial was to investigate the effects of a stress management program (SMP) on patients undergoing carotid endarterectomy (CEA). A sample of 24 patients with significant (>70%) carotid stenosis was finally randomized to SMP (intervention group; n = 12) or no-stress management intervention (control group; n = 12) before CEA. SMP consisted of 2 relaxation techniques (relaxation-breathing and guided imagery) before and 8 weeks after CEA. Measurements included Perceived Stress Scale (PSS), Hospital Anxiety and Depression Scale (HADS), Health Locus of Control Scale (HLC), and blood pressure and heart rate. The 2 groups did not differ in terms of demographic characteristics, vascular risk factors, and baseline psychometric measurements. No delay on the time of surgery was caused by the practice of the relaxation techniques. Both perceived stress and anxiety improved within the intervention group at the end of the program (P = 0.005 and P = 0.007, respectively). No improvement in PSS-14, HLC, and HADS scores were documented in control group at the end of the 8-week follow-up period. The intervention group had lower PSS-14 scores at 8 weeks after CEA (median PSS-14 score, 20 points; range, 10-28) compared with control group (median PSS, 25 points; range, 11-47; P = 0.026). No significant effect of SMP was found for blood pressure and heart rate measurements. Our results indicate that relaxation techniques appear to be beneficial in terms of stress and anxiety reduction in patients undergoing CEA. These findings require independent confirmation in the setting of a larger, double-blind randomized controlled trial. Copyright © 2015 Elsevier Inc. All rights reserved.

  4. Anticipating and managing the cutaneous side effects of epidermal growth factor receptor inhibitors.

    Science.gov (United States)

    Sinclair, Rod

    2014-03-01

    Epidermal growth factor receptor inhibitor (EGFRi) therapy for tumor suppression produces significant cutaneous toxicity that may necessitate dose reduction or treatment cessation. This manuscript aims to describe the skin toxicity associated with these agents and equip oncologists with the tools to best manage these patients. A literature review of skin toxicity associated with EGFRi was conducted by a clinical dermatologist experienced in the management of these patients and a management strategy developed for EGFRi skin toxicity The sequence of development of EGFRi cutaneous toxicity is predictable. Many skin side effects can be ameliorated by prophylactic therapy. Management of established skin toxicity is complex and needs to be continued throughout the period of EGFRi drug treatment. Early referral to a dermatologist experienced in the management of these patients is recommended. © 2014 Wiley Publishing Asia Pty Ltd.

  5. Finding safety: a pilot study of managed alcohol program participants' perceptions of housing and quality of life.

    Science.gov (United States)

    Pauly, Bernadette Bernie; Gray, Erin; Perkin, Kathleen; Chow, Clifton; Vallance, Kate; Krysowaty, Bonnie; Stockwell, Timothy

    2016-05-09

    There is a higher prevalence of alcohol use and severe alcohol dependence among homeless populations. The combination of alcohol use and lack of housing contributes to increased vulnerability to the harms of substance use including stigma, injury, illness, and death. Managed alcohol programs (MAPs) administer prescribed doses of alcohol at regular intervals to people with severe and chronic alcohol dependence and homelessness. As a pilot for a larger national study of MAPs, we conducted an in-depth evaluation of one program in Ontario, Canada. In this paper, we report on housing and quality of life outcomes and experiences of the MAP participants and staff. We conducted a pilot study using mixed methods. The sample consisted of 38 people enrolled in or eligible for entry into a MAP who completed a structured quantitative survey that included measures related to their housing and quality of life. All of the participants self-identified as Indigenous. In addition, we conducted 11 in-depth qualitative interviews with seven MAP residents and four program staff and analyzed the interviews using constant comparative analysis. The qualitative analysis was informed by Rhodes' risk environment framework. When compared to controls, MAP participants were more likely to retain their housing and experienced increased safety and improved quality of life compared to life on the streets, in jails, shelters, or hospitals. They described the MAP as a safe place characterized by caring, respect, trust and a nonjudgmental approach with a sense of family and home as well as opportunities to reconnect with family members. The MAP was, as described by participants, a safer environment and a home with feelings of family and a sense of community that countered stigma, loss, and dislocation with potential for healing and recovery. The MAP environment characterized by caring, respect, trust, a sense of home, "feeling like family", and the opportunities for family and cultural

  6. Weight-management interventions in primary care: a pilot randomised controlled trial.

    Science.gov (United States)

    Nanchahal, Kiran; Townsend, Joy; Letley, Louise; Haslam, David; Wellings, Kaye; Haines, Andy

    2009-05-01

    There is a paucity of randomised controlled trials of weight management in primary care. To ascertain the feasibility of a full trial of a nurse-led weight-management programme in general practice. Factorial randomised control trial. Primary care, UK. A total of 123 adults (80.3% women, mean age 47.2 years) with body mass index > or =27 kg/m(2), recruited from eight practices, were randomised to receive structured lifestyle support (n = 30), structured lifestyle support plus pedometer (n = 31), usual care (n = 31), or usual care plus pedometer (n = 31) for a 12-week period. A total of 103 participants were successfully followed up. The adjusted mean difference in weight in structured support compared to usual care groups was -2.63 kg (95% confidence interval [CI] = -4.06 to -1.20 kg), and for pedometer compared to no pedometer groups it was -0.11 kg (95% CI = -1.52 to 1.30 kg). One in three participants in the structured-support groups (17/50, 34.0%) lost 5% or more of their initial weight, compared to less than one in five (10/53, 18.9%) in usual-care groups; provision of a pedometer made little difference (14/48, 29.2% pedometer; 13/55, 23.6% no pedometer). Difference in waist circumference change between structured-support and usual-care groups was -1.80 cm (95% CI = -3.39 to -0.20 cm), and between the pedometer and no pedometer groups it was -0.84 cm (95% CI = -2.42 to 0.73 cm). When asked about their experience of study participation, most participants found structured support helpful. The structured lifestyle support package could make substantial contributions to improving weight-management services. A trial of the intervention in general practice is feasible and practicable.

  7. Acceleration training for managing nonalcoholic fatty liver disease: a pilot study.

    Science.gov (United States)

    Oh, Sechang; Shida, Takashi; Sawai, Akemi; Maruyama, Tsuyoshi; Eguchi, Kiyoshi; Isobe, Tomonori; Okamoto, Yoshikazu; Someya, Noriko; Tanaka, Kiyoji; Arai, Emi; Tozawa, Akiko; Shoda, Junichi

    2014-01-01

    While aerobic training is generally recommended as therapeutic exercise in guidelines, the effectiveness of resistance training has recently been reported in the management of nonalcoholic fatty liver disease (NAFLD). Acceleration training (AT) is a new training method that provides a physical stimulation effect on skeletal muscles by increasing gravitational acceleration with vibration. AT has recently been indicated as a component of medicine. In this study, we evaluated the effectiveness of AT in the management of NAFLD in obese subjects. A total of 18 obese patients with NAFLD who had no improvement in liver function test abnormalities and/or steatosis grade after 12 weeks of lifestyle counseling were enrolled in an AT program. These patients attended a 20-minute session of AT twice a week for 12 consecutive weeks. During the AT program, the NAFLD patients showed a modest increase in the strength (+12.6%) and cross-sectional area (+3.1%) of the quadriceps, coupled with a significant reduction in intramyocellular lipids (-26.4%). Notably, they showed a modest reduction in body weight (-1.9%), abdominal visceral fat area (-3.4%), and hepatic fat content (-8.7%), coupled with a significant reduction in levels of aminotransferase (-15.7%), γ-glutamyltransferase (-14.4%), leptin (-9.7%), interleukin-6 (-26.8%), and tumor necrosis factor-α (-17.9%), and a significant increase of adiponectin (+8.7%). On a health-related quality of life survey, the patients showed an improvement in physical functioning (+17.3%), physical role (+9.7%), general health (+22.1), and social functioning (+6.0%). AT reduced hepatic and intramyocellular fat contents and ameliorated liver function test abnormalities in obese patients with NAFLD, which was coupled with improved physical function and body adiposity. AT is clinically beneficial for the management of NAFLD.

  8. Integrated Analysis Capability pilot computer program. [large space structures and data management

    Science.gov (United States)

    Vos, R. G.

    1981-01-01

    An integrated analysis capability (IAC) computer software package was developed for the design analysis and performance evaluation of large space systems. The IAC aids the user in coupling the required technical disciplines (initially structures, thermal and controls), providing analysis solution paths which reveal critical interactive effects in order to study loads, stability and mission performance. Existing technical software modules, having a wide existing user community, are combined with the interface software to bridge between the different technologies and mathematical modeling techniques. The package is supported by executive, data management and interactive graphics software, with primary development within the superminicomputer environment.

  9. Policies for managing urban growth and landscape change: a key to conservation in the 21st century

    Science.gov (United States)

    David N., tech. ed. Bengston

    2005-01-01

    Protecting natural areas in the face of urbanization is one of the most important challenges for conservation in the 21st century. The papers in this collection examine key issues related to growth management and selected approaches to managing urban growth and minimizing its social and environmental costs. They were presented at the 2004 annual meeting of the Society...

  10. Acceleration training for managing nonalcoholic fatty liver disease: a pilot study

    Directory of Open Access Journals (Sweden)

    Oh S

    2014-11-01

    Full Text Available Sechang Oh,1 Takashi Shida,1 Akemi Sawai,1 Tsuyoshi Maruyama,2 Kiyoshi Eguchi,2 Tomonori Isobe,1 Yoshikazu Okamoto,3 Noriko Someya,4 Kiyoji Tanaka,4 Emi Arai,1 Akiko Tozawa,5 Junichi Shoda1 1Department of Medical Sciences, Faculty of Medicine, University of Tsukuba, 2Department of Rehabilitation, Tsukuba University Hospital, 3Department of Diagnostic Radiology, 4Department of Sports Medicine, Faculty of Health and Sport Sciences, University of Tsukuba, Ibaraki, 5Protea Japan Co Ltd, Chiyoda, Tokyo, Japan Background: While aerobic training is generally recommended as therapeutic exercise in guidelines, the effectiveness of resistance training has recently been reported in the management of nonalcoholic fatty liver disease (NAFLD. Acceleration training (AT is a new training method that provides a physical stimulation effect on skeletal muscles by increasing gravitational acceleration with vibration. AT has recently been indicated as a component of medicine. In this study, we evaluated the effectiveness of AT in the management of NAFLD in obese subjects.Methods: A total of 18 obese patients with NAFLD who had no improvement in liver function test abnormalities and/or steatosis grade after 12 weeks of lifestyle counseling were enrolled in an AT program. These patients attended a 20-minute session of AT twice a week for 12 consecutive weeks.Results: During the AT program, the NAFLD patients showed a modest increase in the strength (+12.6% and cross-sectional area (+3.1% of the quadriceps, coupled with a significant reduction in intramyocellular lipids (−26.4%. Notably, they showed a modest reduction in body weight (−1.9%, abdominal visceral fat area (−3.4%, and hepatic fat content (−8.7%, coupled with a significant reduction in levels of aminotransferase (−15.7%, γ-glutamyltransferase (−14.4%, leptin (−9.7%, interleukin-6 (−26.8%, and tumor necrosis factor-α (−17.9%, and a significant increase of adiponectin (+8.7%. On a health

  11. Ground beetles as indicators of past management of old-growth forests

    Directory of Open Access Journals (Sweden)

    Mazzei A

    2017-06-01

    Full Text Available Old-growth forests are terrestrial ecosystems with the highest level of biodiversity and the main environments for the study of conservation and dynamics of the forest system. In Mediterranean Europe, two millennia of human exploitation deeply altered the structural complexity of the native forests. Some animal groups, including insects, may be used as a proxy of such changes. In this paper we explored the possible effects of forest management on the functional diversity (species traits of carabid beetle communities. Three old-growth forests of the Sila National Park were sampled by pitfall traps set up in pure beech, beech-silver fir and Calabrian black pine forests. In each forest, five managed vs. five unmanaged stands were considered. Managed sites were exploited until the sixties of the past century and then left unmanaged. More than 6000 carabid specimens belonging to 23 species were collected. The functional diversity in carabid groups is influenced by forest management especially in beech and beech-silver fir stands. Body size, specialized predators, endemic species and forest species were negatively affected by stand management. On the contrary, omnivorous ground beetles populations (or species with a high dispersal power (macropterous and large geographic distribution were positively influenced by stand management. In pine forests the old-growth community seems less sensitive to past management and more affected by soil evolution. Soil erosion and disturbance may reduce species diversity of ground beetles. Anyway, the composition of the carabid community shows that 50-60 years of forest restoration are enough for the reconstruction of a fairly diverse assemblage reflecting a “subclimax” situation.

  12. Risk management in a large-scale CO2 geosequestration pilot project, Illinois, USA

    Science.gov (United States)

    Hnottavange-Telleen, K.; Chabora, E.; Finley, R.J.; Greenberg, S.E.; Marsteller, S.

    2011-01-01

    Like most large-scale infrastructure projects, carbon dioxide (CO 2) geological sequestration (GS) projects have multiple success criteria and multiple stakeholders. In this context "risk evaluation" encompasses multiple scales. Yet a risk management program aims to maximize the chance of project success by assessing, monitoring, minimizing all risks in a consistent framework. The 150,000-km2 Illinois Basin underlies much of the state of Illinois, USA, and parts of adjacent Kentucky and Indiana. Its potential for CO2 storage is first-rate among basins in North America, an impression that has been strengthened by early testing of the injection well of the Midwest Geological Sequestration Consortium's (MGSC's) Phase III large scale demonstration project, the Illinois Basin - Decatur Project (IBDP). The IBDP, funded by the U.S. Department of Energy's National Energy Technology Laboratory (NETL), represents a key trial of GS technologies and project-management techniques. Though risks are specific to each site and project, IBDP risk management methodologies provide valuable experience for future GS projects. IBDP views risk as the potential for negative impact to any of these five values: health and safety, environment, financial, advancing the viability and public acceptability of a GS industry, and research. Research goals include monitoring one million metric tonnes of injected CO2 in the subsurface. Risk management responds to the ways in which any values are at risk: for example, monitoring is designed to reduce uncertainties in parameter values that are important for research and system control, and is also designed to provide public assurance. Identified risks are the primary basis for risk-reduction measures: risks linked to uncertainty in geologic parameters guide further characterization work and guide simulations applied to performance evaluation. Formally, industry defines risk (more precisely risk criticality) as the product L*S, the Likelihood multiplied

  13. Development of a Pilot Program for Human Factors Management in Operating Nuclear Power plants

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Jung-Woon; Lee, Yong-Hee; Jang, Tong-Il; Kim, Dae-Ho [Korea Atomic Energy Research Institute, Daejeon (Korea, Republic of)

    2007-07-01

    The human factors of operating NPPs have been reviewed as a part of Periodic Safety Reviews (PSRs). This human factors PSR covers a wide range of human factors including control room man-machine interfaces (MMIs), procedures, working conditions, qualification, training, information requirements and workload. Korea Atomic Energy Research Institute (KAERI) has performed human factors PSRs from the first PSR for Kori 1. It was determined in 2005 that for a Continuous Operation of the Korean NPPs an enhanced PSR should be performed and issues raised from the PSRs should be resolved. From the results of the PSR for Kori 1, several safety enhancement issues related to human factors were raised. KAERI is working on a resolution of some of the human factors issues for the Korea Hydro and Nuclear Power Co. (KHNP). As a part of the resolution, we are developing a human factors management program (HFMP) for Kori 1. This paper introduces the status of our development of HFMP.

  14. Improving childcare staff management of acute asthma exacerbation - An Australian pilot study.

    Science.gov (United States)

    Soo, Yien Yien; Luckie, Kate Helen; Saini, Bandana; Kritikos, Vicky; Brannan, John D; Moles, Rebekah Jane

    2017-09-01

    This study aimed to evaluate the effectiveness of an asthma first-aid training tool for childcare staff in Australia. The effects of training on both asthma knowledge and skills were assessed. A pre/post-study design was utilised to assess changes in asthma knowledge and asthma first-aid skills in childcare staff before and after an educational intervention. Asthma first-aid skills were assessed from the participant's response to two scenarios in which a child was having a severe exacerbation of asthma. Asthma knowledge and asthma skills scores were collected at base-line and 3 weeks post the education session, which involved feedback on each individual's skills and a brief lecture on asthma delivered via PowerPoint presentation. There was a significant improvement after intervention in asthma knowledge (Z = -3.638, p < 0.001) and asthma first-aid skills for both scenario 1 (Z = -6.012, p < 0.001) and scenario 2 (Z = -6.018, p < 0.001). In scenario 1 and 2, first-aid skills improved by 65% (p < 0.001) and 57% (p < 0.001), respectively. Asthma knowledge was high at baseline (79%) and increased by 7% (p < 0.001) after the educational intervention. These asthma knowledge results were not significant when adjusted for prior knowledge. Results suggest that knowledge assessment alone may not predict the practical skills needed for asthma first-aid. Skills assessment is a useful adjunct to knowledge assessment when gauging the ability of childcare staff to manage acute asthma exacerbation. Skills assessment could be considered for incorporation into future educational interventions to improve management of acute asthma exacerbation.

  15. ENVIRONMENTAL MANAGEMENT SYSTEMS IN THE AUTOMOTIVE SUPPLY CHAIN IN SOUTH AFRICA: A PILOT STUDY

    Directory of Open Access Journals (Sweden)

    A.C. Brent

    2012-01-01

    Full Text Available

    ENGLISH ABSTRACT: Automobile Original Equipment Manufacturers (OEMs have implemented formal Environmental Management Systems (EMSs globally that require the OEMs to consider the environmental performance and potential liabilities in the supply chain. However, in South Africa, OEMs typically experience resistance from suppliers to focus on environmental issues, compliance with regulations, and OEM requirements. Although the responses from many OEMs have been an attempt to enforce the formal EMS certification and accreditation of suppliers, a case study reveals that such certification and accreditation does not necessarily imply good environmental performance, nor indeed environmental compliance with the national legislation. Apart from general environmental management and compliance information, basic cleaner production process parameters, i.e. water and energy usage, and waste generated, were used to compare the environmental performances of different sized suppliers, with and without formal EMSs, and with variance of financial dependency on an OEM. In order to improve the environmental performance of the entire supply chain, a conceptual model is introduced, which is currently under investigation in the automotive sector of South Africa.

    AFRIKAANSE OPSOMMING:Oorspronklike Toerusting Vervaardigers (OTVs in die motorbedryf het internasionaal formele Omgewingsbestuursisteme (OBS geïmplementeer wat vereis dat die omgewingsprestasie en potensiële aanspreeklikhede van die verskaffingsketting in ag geneem moet word. Nieteenstaande ondervind OTVs in Suid-Afrika weerstand van verskaffers wanneer gefokus word op omgewingsaspekte, voldoening aan regulasies en OTV-verwagtinge. Alhoewel die meerderheid OTVs formele OBS akkreditering probeer afdwing, toon ’n gevallestudie dat dit nie noodwendig omgewingsprestasie, en voldoening aan nasionale omgewingswetgewing, impliseer nie. Afgesien van algemene omgewingsbestuur en regsvoldoening, was

  16. Evaluation of a pilot medication therapy management project within the North Carolina State Health Plan.

    Science.gov (United States)

    Christensen, Dale B; Roth, Mary; Trygstad, Troy; Byrd, John

    2007-01-01

    To assess the feasibility of a pharmacist-based medication therapy management (MTM) service for North Carolina State Health Plan enrollees. Before/after design with two control groups. Community pharmacies and an ambulatory care clinic in North Carolina serving patients from October 2004 to March 2005. 67 patients who used a large number of prescription drugs, 10 community/ambulatory care pharmacists, and more than 600 participants from two control groups. Pharmacist-conducted MTM reviews for volunteering patients. Process measures (type and frequency of drug therapy problems detected and services performed), economic measures (number and cost of medications dispensed), and humanistic measures (patient satisfaction with services). Pharmacists identified an average of 3.6 potential drug therapy problems (PDTPs) per patient at the first visit. The most common PDTP categories were "potential underuse" and "more cost-effective drug available." Pharmacist actions were divided nearly equally between activities that would result in increased and decreased drug use. Pharmacists recommended a drug therapy change in about 50% of patients and contacted the prescriber more than 85% of the time. About 50% of patients with PDTPs had a change in drug therapy. Prescription use during the postintervention period decreased in both the study and control groups but was statistically significant only among the control groups. No significant differences were observed in patient co-payment or insurer prescription costs. Pharmacists provided the following educational services: medication use (90%), disease management (88%), adherence, and self-care (60%). Survey results indicated that patients highly valued the service. A voluntary MTM program targeted at ambulatory patients using a large number of medications reduced the number of PDTPs but did not necessarily result in reductions in prescription drug use or cost. Nearly all patients received some form of medication adherence or disease

  17. Denitrification and biofilm growth in a pilot-scale biofilter packed with suspended carriers for biological nitrogen removal from secondary effluent.

    Science.gov (United States)

    Shi, Yunhong; Wu, Guangxue; Wei, Nan; Hu, Hongying

    2015-06-01

    Tertiary denitrification is an effective method for nitrogen removal from wastewater. A pilot-scale biofilter packed with suspended carriers was operated for tertiary denitrification with ethanol as the organic carbon source. Long-term performance, biokinetics of denitrification and biofilm growth were evaluated under filtration velocities of 6, 10 and 14 m/hr. The pilot-scale biofilter removed nitrate from the secondary effluent effectively, and the nitrate nitrogen (NO3-N) removal percentage was 82%, 78% and 55% at the filtration velocities of 6, 10 and 14 m/hr, respectively. At the filtration velocities of 6 and 10 m/hr, the nitrate removal loading rate increased with increasing influent nitrate loading rates, while at the filtration velocity of 14 m/hr, the removal loading rate and the influent loading rate were uncorrelated. During denitrification, the ratio of consumed chemical oxygen demand to removed NO3-N was 3.99-4.52 mg/mg. Under the filtration velocities of 6, 10 and 14 m/hr, the maximum denitrification rate was 3.12, 4.86 and 4.42 g N/(m2·day), the half-saturation constant was 2.61, 1.05 and 1.17 mg/L, and the half-order coefficient was 0.22, 0.32 and 0.24(mg/L)1/2/min, respectively. The biofilm biomass increased with increasing filtration velocity and was 2845, 5124 and 7324 mg VSS/m2 at filtration velocities of 6, 10 and 14 m/hr, respectively. The highest biofilm density was 44 mg/cm3 at the filtration velocity of 14 m/hr. Due to the low influent loading rate, biofilm biomass and thickness were lowest at the filtration velocity of 6m/hr. Copyright © 2015. Published by Elsevier B.V.

  18. The effects of massage therapy on physical growth and gastrointestinal function in premature infants: A pilot study.

    Science.gov (United States)

    Choi, HyeJeong; Kim, Shin-Jeong; Oh, Jina; Lee, Myung-Nam; Kim, SungHee; Kang, Kyung-Ah

    2016-09-01

    To promote the growth and development of premature infants, effective and tender care is required in neonatal intensive care units (NICUs). The purpose of this study was to test the potential effects of massage therapy on increasing physical growth and promoting gastrointestinal function in premature infants. Twenty subjects were divided into two groups in the NICU of one general hospital located in South Korea. The experimental group (n = 10) were given massage therapy and the control group (n = 10) received routine care. Massage therapy was performed twice daily for 14 days, for 15 minutes per session. In the physical growth, height and chest circumference were significantly increased in the experimental group. In assessing gastrointestinal function, frequency of pre-feed gastric residual was significantly decreased and numbers of bowel movements were significantly increased in the experimental group. This study showed massage therapy has the potential effects on increasing physical growth and gastrointestinal function in premature infants. The massage in the NICU might be utilized as a part of developmental care, but more research needs to be done. NICU nurses need to be trained in massage therapy techniques to provide more effective clinical care for premature infants. © The Author(s) 2015.

  19. Development and evaluation of a dietary self-management programme for older adults with low literacy and heart disease: pilot study of feasibility and acceptability.

    Science.gov (United States)

    Shao, Jung-Hua; Chen, Su-Hui

    2016-12-01

    To develop a dietary self-management programme for salt-, fluid-, fat- and cholesterol-intake behaviours for older adults with low literacy and heart disease and evaluate the feasibility and acceptability of the programme. Eating behaviours such as fluid, salt, fat and cholesterol intake are an important factor related to heart disease outcomes. People with low literacy have difficulty following recommended health behaviours, but limited research has investigated intervention programmes for this population. Programme development and pilot testing its feasibility and acceptability. Recommendations were also collected from participants and the research assistant for future large-scale interventions. The study had two phases. Phase I consisted of programme development based on previous qualitative findings, a systematic review of the literature, clinical practice experience and expert opinion. In Phase II, we pilot tested the programme from January - June 2014 in a convenience sample of 10 older adults with low literacy, heart disease and recruited from a medical centre in northern Taiwan. Pilot testing showed that our programme was feasible and acceptable to older adults with low literacy and heart disease. Moreover, the final version of the programme was revised based on participants' and the research assistant's recommendations. Our study results suggest that with guidance and assistance, older adults with low literacy and heart disease can be motivated to take action for their health and are empowered by learning how to self-manage their heart-healthy eating behaviours. © 2016 John Wiley & Sons Ltd.

  20. Community Health Managers: A Pilot Pedagogic Experience in theUniversity of Rosario

    Directory of Open Access Journals (Sweden)

    Carolina Amaya*

    2006-10-01

    Full Text Available The “Grupo de Estudios en Sistemas Tradicionalesde Salud” from the School of Medicineof Universidad del Rosario, in agreement withthe “Instituto de Etnobiología”, has designed atraining course for a new health agent (the communityhealth manager meant to consider inits curriculum the difficulties, deficiencies andsuccesses of the Primary Health Care Program.In particular, we have attended OMS suggestionsin terms of adequate training of local leaderswho should look for self-responsibility and selfdeterminationin health care coverage. account diverse cultures and traditions in orderto offer health care models able to consider culturalparticularities, epidemiological profiles,and contextual possibilities, with an interculturalpoint of view. Hence, the training course’s objectiveis to offer working tools so that communityleaders be able to value and promote traditionalhealth knowledge and practices; seek for foodsecurity by means of recovery of traditionalproductive systems or adaptation of appropriatetechnologies; environment conservation; use ofmedicinal plants especially in self-care, andstimulation of community and institutionalhealth promotion activities.Preliminary evaluation suggests that thisnew health agent will be able to set bridgesbetween communities and health care offersavailable, always looking for healthy ways oflife, culturally and environmentally friendly

  1. Use of the Grindcare® device in the management of nocturnal bruxism: a pilot study.

    Science.gov (United States)

    Needham, R; Davies, S J

    2013-07-01

    Bruxism may be described as a diurnal or nocturnal parafunction, characterised by clenching, bracing, gnashing or grinding of the teeth and jaws. The aim of the management of bruxism should be to control or reduce the level of activity where possible. A variety of treatment strategies have been employed to achieve this including hypnosis, occlusal equilibration, splint therapy, physiotherapy and acupuncture. A more recent approach is the use of biofeedback. Nineteen consecutive patients were recruited from the temporomandibular joint dysfunction (TMD) clinic at Manchester Dental Hospital, all of whom were known bruxists. They were supplied with the Grindcare® device (Medotech) and instructed to wear it every night over the five-week observation period. By monitoring electromyographic (EMG) muscle activity, the device is able to emit low-voltage electrical impulses as it senses a clenching or grinding episode, bringing about muscle relaxation. Eleven of the nineteen patients (58%) reported a major reduction in the occurrence of headaches and discomfort of the masticatory muscles on waking. Female and younger subjects responded more favourably than male and older subjects respectively. The use of biofeedback could reduce the level of parafunctional activity and bring about meaningful symptomatic improvement. No adverse effects occurred throughout the study period.

  2. Pilot study risk assessment for selected problems at the Fernald Environmental Management Project (FEMP)

    Energy Technology Data Exchange (ETDEWEB)

    Hamilton, L.D.; Meinhold, A.F.; Baxter, S.L.; Holtzman, S.; Morris, S.C.; Pardi, R.; Rowe, M.D.; Sun, C. (Brookhaven National Lab., Upton, NY (United States)); Anspaugh, L.; Layton, D. (Lawrence Livermore National Lab., CA (United States))

    1993-03-01

    Two important environmental problems at the USDOE Fernald Environmental Management Project (FEMP) facility in Fernald, Ohio were studied in this human health risk assessment. The problems studied were radon emissions from the K-65 waste silos, and offsite contamination of ground water with uranium. Waste from the processing of pitchblende ore is stored in the K-65 silos at the FEMP. Radium-226 in the waste decays to radon gas which escapes to the outside atmosphere. The concern is for an increase in lung cancer risk for nearby residents associated with radon exposure. Monitoring data and a gaussian plume transport model were used to develop a source term and predict exposure and risk to fenceline residents, residents within 1 and 5 miles of the silos, and residents of Hamilton and Cincinnati, Ohio. Two release scenarios were studied: the routine release of radon from the silos and an accidental loss of one silo dome integrity. Exposure parameters and risk factors were described as distributions. Risks associated with natural background radon concentrations were also estimated.

  3. Disease management of early childhood caries: results of a pilot quality improvement project.

    Science.gov (United States)

    Ng, Man Wai; Torresyap, Gay; White, Alex; Melvin, Patrice; Graham, Dionne; Kane, Daniel; Scoville, Richard; Ohiomoba, Henry

    2012-08-01

    The purpose is to report findings of a quality improvement (QI) project implemented at two hospital-based dental clinics that care for children with early childhood caries (ECC). We tested a disease management (DM) approach in children younger than age 60 months with ECC. After 30 months, for the 403 and 234 DM patients at Children's Hospital Boston (CHB) and Saint Joseph Hospital (SJH) who returned for at least two visits, rates of new cavitation, pain, and referrals to the OR were 26.1, 13.4 and 10.9% for CHB and 41.0, 7.3 and 14.9% for SJH. Rates of new cavitation, pain, and referrals to the OR for historical controls were 75.2, 21.7, and 20.9% for CHB and 71.3, 31.3, and 25.0% for SJH. A risk-based DM approach utilizing QI strategies to address ECC can be implemented into practice and has the potential to improve care and health outcomes.

  4. Painful temporomandibular disorders and central sensitization: implications for management-a pilot study.

    Science.gov (United States)

    Campi, L B; Jordani, P C; Tenan, H L; Camparis, C M; Gonçalves, D A G

    2017-01-01

    The objective was to investigate the presence of cutaneous allodynia and hyperalgesia in the trigeminal and extra-trigeminal areas, as a surrogate for central sensitization (CS), in women with a painful temporomandibular disorder (TMD) and without other painful conditions. Painful TMDs, depression, and non-specific physical symptoms (NSPS) were classified according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The amount of pain in the trigeminal and extra-trigeminal areas was determined using a visual analogue scale (0-100mm) after the application of a vibrotactile stimulus and assessment of the pressure pain threshold (PPT). Statistical tests (Fisher's, χ 2 , and Mann-Whitney) were performed, with a significance level of 5%. The sample comprised 45 women (mean age 37.5 years; 16 with a painful TMD) who were free of any headache, fibromyalgia, or other painful condition. Painful TMD was associated with higher pain sensitivity and lower PPT values in the trigeminal (Psensitivity. The presence of hyperalgesia and allodynia in both the trigeminal and extra-trigeminal regions among women with a painful TMD indicated the presence of CS. Changes involving the central nervous system should be considered during the evaluation and management of patients with a painful TMD. Copyright © 2016 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  5. [Psychological processes of stress management and neuroendocrine regulation in incarcerated adolescent offenders: A pilot study].

    Science.gov (United States)

    Guillod, L; Habersaat, S; Suter, M; Jeanneret, T; Bertoni, C; Stéphan, P; Urben, S

    2018-04-01

    Adolescence is a stressful period where important biological, psychological and social changes occur. Adolescents are particularly vulnerable during this developmental period and can use various strategies to deal with daily stress, such as substance use or externalizing behaviors. In previous studies, stress in adolescents with externalizing behaviors was often linked to ineffective cognitive coping strategies (i.e., constructive thinking) and overlooking the biological aspects involved in stress management such as neuroendocrine regulation. Indeed, repeated activation of the hypothalamic-pituitary-adrenal (HPA) axis in chronic stress situations may have long-term effects on subsequent cortisol regulation and lead to psychological difficulties. It was also shown that basal cortisol levels are lower in adolescents with externalizing behaviors. This study aims to assess the links between constructive thinking and neuroendocrine regulation in adolescent offenders and their association with externalizing symptoms (e.g., aggression, delinquency, psychopathic traits, substance use). Identifying particular biopsychological patterns can help to better understand stress management in youth with externalizing behaviors and to improve clinical treatments. Sixteen adolescent males aged from 12 to 18 years were recruited in an institution for juvenile offenders. Exclusion criteria were insufficient reasoning abilities assessed using the Raven Matrices Test. Regarding psychological dimensions, constructive thinking was assessed through the Constructive thinking inventory (CTI), psychopathic traits through the Youth psychopathic traits inventory (YPI), externalizing behaviors through 30 items (out of 113) and 2 subscales (aggressive behavior and delinquency problems) from the Child behavior checklist-youth self-report (CBCL), and substance use through the Dep-ado. Regarding biological dimensions, cortisol daily secretion and regulation were assessed through saliva samples

  6. Pilot study risk assessment for selected problems at the Fernald Environmental Management Project (FEMP)

    International Nuclear Information System (INIS)

    Hamilton, L.D.; Meinhold, A.F.; Baxter, S.L.; Holtzman, S.; Morris, S.C.; Pardi, R.; Rowe, M.D.; Sun, C.; Anspaugh, L.; Layton, D.

    1993-03-01

    Two important environmental problems at the USDOE Fernald Environmental Management Project (FEMP) facility in Fernald, Ohio were studied in this human health risk assessment. The problems studied were radon emissions from the K-65 waste silos, and offsite contamination of ground water with uranium. Waste from the processing of pitchblende ore is stored in the K-65 silos at the FEMP. Radium-226 in the waste decays to radon gas which escapes to the outside atmosphere. The concern is for an increase in lung cancer risk for nearby residents associated with radon exposure. Monitoring data and a gaussian plume transport model were used to develop a source term and predict exposure and risk to fenceline residents, residents within 1 and 5 miles of the silos, and residents of Hamilton and Cincinnati, Ohio. Two release scenarios were studied: the routine release of radon from the silos and an accidental loss of one silo dome integrity. Exposure parameters and risk factors were described as distributions. Risks associated with natural background radon concentrations were also estimated

  7. Evaluation of bridge decks using non-destructive evaluation (NDE) at near highway speeds for effective asset management - pilot project.

    Science.gov (United States)

    2016-09-29

    This project piloted the findings from an initial research and development project pertaining to the detection, : quantification, and visualization of bridge deck distresses through the use of remote sensing techniques, specifically : combining optic...

  8. Web-based nursing intervention for self-management of pain after cardiac surgery: pilot randomized controlled trial.

    Science.gov (United States)

    Martorella, Géraldine; Côté, José; Racine, Mélanie; Choinière, Manon

    2012-12-14

    Most adults undergoing cardiac surgery suffer from moderate to severe pain for up to 6 days after surgery. Individual barriers and attitudes regarding pain and its relief make patients reluctant to report their pain and ask for analgesic medication, which results in inadequate pain management. More innovative educational interventions for postoperative pain relief are needed. We developed a Web-based nursing intervention to influence patient's involvement in postoperative pain management. The intervention (SOULAGE-TAVIE) includes a preoperative 30-minute Web-based session and 2 brief face-to-face postoperative booster sessions. The Web application generates reflective activities and tailored educational messages according to patients' beliefs and attitudes. The messages are transmitted through videos of a virtual nurse, animations, stories, and texts. The aim of this single-blinded pilot randomized trial was to investigate the preliminary effects of a virtual nursing intervention (SOULAGE-TAVIE) to improve pain relief in patients undergoing cardiac surgery. Participants (N = 60) were adults scheduled for their first cardiac surgery. They were randomly assigned to the experimental group using SOULAGE-TAVIE (n = 30) or the control group using usual care, including an educational pamphlet and postoperative follow-up (n = 30). Data were collected through questionnaires at the time of admission and from day 1 to day 7 after surgery with the help of a blinded research assistant. Outcomes were pain intensity, pain interference with daily activities, patients' pain barriers, tendency to catastrophize in face of pain, and analgesic consumption. The two groups were comparable at baseline across all demographic measures. Results revealed that patients in the experimental group did not experience less intense pain, but they reported significantly less pain interference when breathing/coughing (P = .04). A severe pain interference with breathing/coughing (pain ranked ≥ 7

  9. Evaluation of the first year of a pilot program in community pharmacy: HIV/AIDS medication therapy management for Medi-Cal beneficiaries.

    Science.gov (United States)

    Hirsch, Jan D; Rosenquist, Ashley; Best, Brookie M; Miller, Teresa Ann; Gilmer, Todd P

    2009-01-01

    The advent of combined antiretroviral therapy (ART) has increased treatment effectiveness but created new challenges for patients infected with human immunodeficiency virus (HIV) and for community pharmacists managing patients' drug therapy. The ability of pharmacist-provided medication therapy management (MTM) services to increase medication adherence, improve health outcomes, and reduce overall medical costs has been demonstrated in community pharmacies for chronic diseases such as diabetes and hypertension. However, the effectiveness of pharmacist-provided MTM services in HIV/acquired immune deficiency syndrome (AIDS) has not been well studied. In January 2005, a pilot program to evaluate MTM services for patients with HIV/AIDS began in California, allowing 10 HIV/AIDS specialty pharmacies to receive compensation for the MTM services that they provided to HIV/AIDS patients. To examine the first year of the HIV/AIDS pharmacy MTM compensation pilot program, which described and compared pilot and nonpilot pharmacies with respect to (a) patient characteristics; (b) intermediate outcomes including type and number of ART medication regimens used, rates of adherence and excess medication fills for ART, use of contraindicated ART regimens, and occurrence of opportunistic infections; and (c) pharmacy and medical costs. This was a cohort study examining 2005 Medi-Cal pharmacy and medical claims data for patients with HIV/AIDS who were served by pilot pharmacies versus other pharmacies. The HIV/AIDS patients were Medi-Cal beneficiaries aged 18 years or older as of January 1, 2005, who were continuously enrolled from January 1, 2004, through December 31, 2005, and diagnosed with HIV/AIDS, identified by receipt of at least 1 ART prescription and at least 1 medical claim with a diagnosis (primary or secondary) of HIV/AIDS (ICD-9-CM code 042.0) during both the index period (the year before pilot program implementation, 2004) and the intervention period (the study year, 2005

  10. Behavioral activation for smoking cessation and mood management following a cardiac event: results of a pilot randomized controlled trial.

    Science.gov (United States)

    Busch, Andrew M; Tooley, Erin M; Dunsiger, Shira; Chattillion, Elizabeth A; Srour, John Fani; Pagoto, Sherry L; Kahler, Christopher W; Borrelli, Belinda

    2017-04-17

    Smoking cessation following hospitalization for Acute Coronary Syndrome (ACS) significantly reduces subsequent mortality. Depressed mood is a major barrier to cessation post-ACS. Although existing counseling treatments address smoking and depression independently in ACS patients, no integrated treatment addresses both. We developed an integrated treatment combining gold standard cessation counseling with behavioral activation-based mood management; Behavioral Activation Treatment for Cardiac Smokers (BAT-CS). The purpose of this pilot randomized controlled trial was to test feasibility, acceptability, and preliminary efficacy of BAT-CS vs. Standard of Care (SC). Participants were recruited during hospitalization for ACS and were randomly assigned to BAT-CS or SC. The nicotine patch was offered in both conditions. Smoking, mood, and stress outcomes were collected at end-of-treatment and 24-week follow-up. Fifty-nine participants (28 BAT-CS, 31 SC) were recruited over 42 weeks, and assessment completion was above 80% in both conditions. Treatment acceptability and fidelity were high. At 24 week follow-up adjusted odds ratios favoring BAT-CS were 1.27 (95% CI: 0.41-3.93) for 7-day point prevalence abstinence and 1.27 (95% CI: 0.42-3.82) for continuous abstinence. Time to first smoking lapse was significantly longer in BAT-CS (62.4 vs. 31.8 days, p = 0.03). At 24-weeks, effect sizes for mood and stress outcomes ranged from η 2 partial of.07-.11, with significant between treatment effects for positive affect, negative affect, and stress. The design of this study proved feasible and acceptable. Results provide preliminary evidence that combining behavioral activation with standard smoking cessation counseling could be efficacious for this high risk population. A larger trial with longer follow-up is warranted. NCT01964898 . First received by clinicaltrials.gov October 15, 2013.

  11. The Polyp Manager: a new tool for optimal polyp documentation during colonoscopy. A pilot study.

    Science.gov (United States)

    van de Meeberg, Maartje M; Ouwendijk, Rob J Th; Ter Borg, Pieter C J; van den Hazel, Sven J; van de Meeberg, Paul C

    2016-05-01

    Conventional reporting of polyps is often incomplete. We tested the Polyp Manager (PM), a new software application permitting the endoscopist to document polyps in real time during colonoscopy. We studied completeness of polyp descriptions, user-friendliness and the potential time benefit. In two Dutch hospitals colonoscopies were performed with PM (as a touchscreen endoscopist-operated device or nurse-operated desktop application). Completeness of polyp descriptions was compared to a historical group with conventional reporting (CRH). Prospectively, we compared user-friendliness (VAS-scores) and time benefit of the endoscopist-operated PM to conventional reporting (CR) in one hospital. Duration of colonoscopy and time needed to report polyps and provide a pathology request were measured. Provided that using PM does not prolong colonoscopy, the sum of the latter two was considered as a potential time-benefit if the PM were fully integrated into a digital reporting system. A total of 144 regular colonoscopies were included in the study. Both groups were comparable with regard to patient characteristics, duration of colonoscopy and number of polyps. Using the PM did reduce incomplete documentation of the following items in CRH-reports: location (96 % vs 82 %, P = 0.01), size (95 % vs 89 %, P = 0.03), aspect (71 % vs 36 %, P report was 01:27 ± 01:43 minutes (median + interquartile range) in the entire group (PM as CR), reflecting potential time benefit per colonoscopy. The PM is a user-friendly tool that seems to improve completeness of polyp reporting. Once integrated with digital reporting systems, it is probably time saving as well.

  12. Massage therapy in the management of myogenic TMD: a pilot study.

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    Capellini, Verena Kise; de Souza, Gisela Soares; de Faria, Cláudia Regina Sgobbi

    2006-01-01

    The Temporomandibular disorder (TMD) is greatly prevalent in the population and can be associated with bruxism. This disorder produces several signs and symptoms. Among them, pain is one of the most important because it reduces life quality and productivity of people who have such disorder. The aim of this research was to study if massage causes pain relief and/or electromyographic (EMG) changes. The subjects were chosen by a questionnaire and divided into 2 different groups. Their ages varied from 19 to 22 years. The experimental group consisted of 6 TMD patients, who were submitted to the massage treatment and 4 EMG-sessions (the 1st EMG-session occurred before the treatment and the others in the 1st, 15th and 30th days after the treatment). The control group consisted of 6 TMD patients, who were submitted to the same 4 EMG-sessions. While EMG activity was recorded, subjects were asked to keep mandibular rest position (MRP) and to perform maximal voluntary clenching (MVC). The treatment consisted of 15 massage-sessions on face and neck and in application of Visual Analogue Scale (VAS) for measuring pain level. The massage sessions had 30 minutes of duration and were performed daily. The EMG data were processed to obtain the Root Mean Square (RMS), which were normalized by MVC. It was demonstrated that (1) RMS-MRP of the right masseter in experimental group at the 1st EMG-session was higher than at the 2nd EMG-session and (2) statistically significant reduction was found for VAS values after massage session. Unfortunately the sample is insufficient to draw any conclusions, therefore, more studies regarding the use of massage in the management of myogenic TMD are necessary.

  13. Automated Heuristic Defect Classification (AHDC) for haze-induced defect growth management and mask requalification

    Science.gov (United States)

    Munir, Saghir; Qidwai, Gul

    2012-03-01

    This article presents results from a heuristic automated defect classification algorithm for reticle inspection that mimics the classification rules. AHDC does not require CAD data, thus it can be rapidly deployed in a high volume production environment without the need for extensive design data management. To ensure classification consistency a software framework tracks every defect in repeated inspections. Through its various image based derived metrics it is shown that such a system manages and tracks repeated defects in applications such as haze induced defect growth.

  14. Impact of combinatory growth factor application on rabbit Achilles tendon injury with operative versus conservative treatment: a pilot study.

    Science.gov (United States)

    Konerding, Moritz A; Arlt, Friederike; Wellmann, Axel; Li, Vincent; Li, William

    2010-02-01

    Acute Achilles tendon (AT) rupture is a common injury with a comparatively high complication rate. Presently, surgical treatments compete with nonoperative treatment modalities. The aim of this study was to elucidate the possible beneficial effects of short-term combinatory application of growth factors on tendon healing during operative or conservative treatment. In this controlled laboratory study, the left ATs of 40 adult New Zealand White rabbits were transected and either sutured or treated conservatively. Half of the animals from each treatment modality group repetitively received a mixture of VEGF165, bFGF, and rPDGF which was administered peritendineally. The left legs were immobilized with external fixateurs for 6 weeks. The ATs were harvested 3 months after intervention. Tensile strength tests revealed no significant differences between operative and conservative treatments. Compared to the normal right ATs, 60% of the average breaking strength was reached 3 months after surgery. Growth factor application did not result in significant improvements. Only a tendency towards higher blood vessel densities was noted in the groups treated with the factors. Collagen type I/III ratios also displayed no significant differences. This study indicates that there is no difference in the biomechanical outcome of conservative versus operative AT rupture treatment and only a marginal impact of short-term combinatory growth and angiogenesis factor application.

  15. Accounts Receivable Risk Management Practices and Growth of SMEs in Kakamega County, Kenya

    Directory of Open Access Journals (Sweden)

    Mary Nelima LYANI (SINDANI

    2016-10-01

    Full Text Available Accounts receivable risk management is a structured approach to managing uncertainties through risk assessment, developing strategies to manage it, and mitigation of risk using managerial resources (Gakure et al., 2012 Although there has been a considerable interest by government to promote SMEs by encouraging owners to take up government tenders, in Kenya the number of SMEs capable of sustaining themselves is still low. Studies show credit risk as an important variable affecting firms. Nonetheless, these risks’ influence on SMEs has not received as much attention as it should. This study’s main objective was to examine the influence of credit risk assessment practices on growth of SMEs. The objective of the study was to evaluate the effect of credit risk assessment practices on growth of SMEs in Kakamega County, in Kenya. Causal research design was applied to show the influence of credit risk assessment practice on growth. Using the sampling technique of purposive stratified random, a sample size of 359 out of 5401 SMEs was used from Kakamega Central Sub-County that had been in operation between 2013 and 2015. Secondary data was acquired from the Kakamega County Revenue Department, for the period under study. The hypotheses that form the premises for a regression model using analysis techniques like homoscedasticity and autocorrelation. Ordinary Least Square method was utilized to establish the relationship of cause-effect between variables while hypothesis was tested at 5% significance level. The overall model was discovered to be significant considering the F=14.918 and p-value (0.00 < 0.05. The findings revealed that good credit risk assessment practices when adopted by SMEs lead to growth. The study recommended that owners and managers should be trained and made to understand the various techniques risk management to well manage them so as to increase growth. The findings would form a basis for government and policy makers to formulate

  16. Shining light in dark corners: diagnosis and management of late-onset fetal growth restriction.

    Science.gov (United States)

    MacDonald, Teresa M; McCarthy, Elizabeth A; Walker, Susan P

    2015-02-01

    Fetal growth restriction (FGR) is the single biggest risk factor for stillbirth. In the absence of any effective treatment for fetal growth restriction, the mainstay of management is close surveillance and timely delivery. While such statements are almost self-evident, the daily clinical challenge of late-onset fetal growth restriction remains; the competing priorities of minimising stillbirth risk, while avoiding excessive obstetric intervention and the neonatal sequelae of iatrogenic preterm birth. This dilemma is made harder because the tools for late-onset FGR diagnosis and surveillance compare poorly to those used in early-onset FGR; screening tests in early pregnancy have limited predictive value; most cases escape clinical detection, a phenomenon set to worsen given the obesity epidemic; there is a failure of consensus on the definition of small for gestational age, and ancillary tools, such as umbilical artery Doppler--of value in identification of preterm FGR--are less useful in the late-preterm period and at term. Most importantly, the problem is common; 96% of all births occur after 32 weeks. This means a poor noise/signal ratio of any test or management algorithm will inevitably have large clinical consequences. Into such a dark corner, we cast some light; a summary on diagnostic criteria, new developments to improve the diagnosis of late-onset FGR and a suggested approach to management. © 2015 The Royal Australian and New Zealand College of Obstetricians and Gynaecologists.

  17. Eye Movement Desensitization and Reprocessing to Facilitate Posttraumatic Growth: A Prospective Clinical Pilot Study on Ferry Disaster Survivors.

    Science.gov (United States)

    Jeon, Sang Won; Han, Changsu; Choi, Joonho; Ko, Young-Hoon; Yoon, Ho-Kyoung; Kim, Yong-Ku

    2017-11-30

    The purpose of this study was to investigate the therapeutic effects of eye movement desensitization and reprocessing (EMDR) on post-traumatic growth (PTG). This study was conducted using a sample of ten survivors of a large-scale maritime disaster that occurred in the Yellow Sea, South Korea, in April 2014. A total of eight EMDR sessions were administered by a psychiatrist at two-week intervals over a period of five months, starting two or three months after the accident. Post-Traumatic Growth Inventory (PTGI), Stress-Related Growth Scale (SRGS), Clinician-Administered PTSD Scale (CAPS), and Connor-Davidson Resilience Scale (CD-RISC) were measured before treatment, after sessions 4 and 8, and at three months after treatment completion. After three months from treatment completion, significant increases were observed in PTG (PTGI: Z(8)=-2.380, p =0.017; SRGS: Z(8)=-2.380, p =0.017) and resilience (CD-RISC: Z(8)=-2.386, p =0.017). A decrease in post-traumatic stress disorder (PTSD) level was also significant (CAPS: Z(8)=-2.176, p =0.030). The reduction of CAPS scores was correlated with increases of PTGI (rho=0.78, p =0.023) and SRGS (rho=0.79, p =0.020) scores. The changes in CAPS, PTGI, and SRGS scores between time point of end 8-session and three months follow-up was not significant (all p 〉0.05). Subjects with higher pre-treatment CD-RISC scores showed more significant improvements in PTGI (rho=0.88, p =0.004) and SRGS (rho=0.83, p =0.010) scores after treatment than did those with lower pre-treatment CD-RISC scores. EMDR therapy using standard protocol for trauma processing helped facilitating PTG in disaster survivors. To generalize these findings, further controlled studies comparing with other treatment modalities for PTSD are needed.

  18. Energy balance concept in the evaluation of water table management effects on corn growth: experimental investigation

    International Nuclear Information System (INIS)

    Kalita, P.K.; Kanwar, R.S.

    1992-01-01

    The effects of water table management practices (WTMP) on corn growth in 1989 and 1990 at two field sites, Ames and Ankeny, Iowa, were evaluated by calculating crop water stress index (CWSI) and monitoring plant physiological parameters during the growing seasons. Experiments were conducted on field lysimeters at the Ames site by maintaining water tables at 0.3-, 0.6-, and 0.9-m depths and in a subirrigation field at the Ankeny site with 0.2-, 0.3-, 0.6-, 0.9-, and 1.1-m water table depths, and periodically measuring leaf and air temperature, transpiration rate, stomatal conductance, and photosynthetically active radiation (PAR) using leaf chamber techniques. Net radiation of canopy was estimated using the leaf energy balance equation and leaf chamber measurements and then correlated with PAR. Analysis of data revealed that net radiation, leaf air temperature differential, transpiration rate, stomatal conductance, and CWSI were strongly related to WTMP during vegetative and flowering stages of corn growth. Excess water in the root zone with a water table depth of 0.2 m caused the maximum crop water stress and ceased crop growth. Both water and oxygen could be adequately maintained for favorable crop growth by adopting the best WTMP. Results indicate that plant physiological parameters and CWSI could be used to evaluate the effectiveness of WTMP and develop the best WTMP for corn growth in the humid region

  19. Influence of strategic management in Czech SMEs and their growth rate

    Directory of Open Access Journals (Sweden)

    Jaroslav Vrchota

    2016-12-01

    Full Text Available The aim of the managers in SMEs is to have a competitive enterprise on the market, to develop and achieve some positive results. The successful strategic management has to adapt to the external environment, analyse emerging issues in time and react quickly and flexibly to changes. With the increasing amounts of business entities, strategic analysis and strategy as such acquire their importance. The basic data for the creation of strategy includes information about the external environment, i.e. about the market and its surroundings and internal business environment. Those managers, who can use the advantages of their enterprise and market opportunities and reduce the effect of weaknesses and threats, may ensure their enterprise prosperity and increase their growth rate. However, they must choose a competitive strategy, with which it is possible to succeed on the market. Such strategy provides SMEs the possibility of differentiation, setting a higher level of services offered to enhance customer satisfaction which is the most important. The paper deals with finding whether the strategic management of SME influences the growth rate of an enterprise. Data were gathered as questionnaires and interviews from 183 enterprises operating in the Czech Republic. The research was made in the period of 2014-15.

  20. Growth hormone receptor antagonism with pegvisomant in insulin resistant non-diabetic men: A phase II pilot study [version 1; referees: 2 approved

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    Ada P. Lee

    2017-05-01

    Full Text Available Background: Growth hormone (GH is known to affect insulin and glucose metabolism.  Blocking its effects in acromegalic patients improves diabetes and glucose metabolism. We aimed to determine the effect of pegvisomant, a GH receptor antagonist, on insulin resistance, endogenous glucose production (EGP and lipolysis in insulin resistant non-diabetic men.  Methods: Four men between the ages of 18-62 with a BMI of 18-35kg/m2, with insulin resistance as defined by a HOMA-IR > 2.77, were treated for four weeks with pegvisomant 20 mg daily.  Inpatient metabolic assessments were performed before and after treatment. The main outcome measurements were: change after pegvisomant therapy in insulin sensitivity as measured by hyperinsulinemic euglycemic clamp; and EGP and lipolysis assessed by stable isotope tracer techniques. Results: Insulin like growth factor-1 (IGF-1 concentrations decreased from 134.0 ± 41.5 (mean ± SD to 72.0 ± 11.7 ng/mL (p = 0.04 after 4 weeks of therapy. Whole body insulin sensitivity index (M/I 3.2 ± 1.3 vs. 3.4 ± 2.4; P = 0.82, as well as suppression of EGP (89.7 ± 26.9 vs. 83.5 ± 21.6%; p = 0.10 and Ra glycerol (59.4 ± 22.1% vs. 61.2 ± 14.4%; p = 0.67 during the clamp were not changed significantly with pegvisomant treatment. Conclusions: Blockade of the GH receptor with pegvisomant for four weeks had no significant effect on insulin/glucose metabolism in a small phase II pilot study of non-diabetic insulin resistant participants without acromegaly.

  1. The Effect of Cigarette Smoking during Pregnancy on Endocrine Pancreatic Function and Fetal Growth: A Pilot Study

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    Fatima Lockhart

    2017-11-01

    Full Text Available IntroductionCigarette smoking in pregnancy is a common cause of fetal growth restriction. We aimed to investigate endocrine pancreatic function of mother–infant dyads in relation to cigarette smoking, as a possible mechanism for the poor fetal growth.MethodsProspective study of smoking mothers (10 cigarettes or more per day, self-reported to the midwife and non-smoker control mothers during their first pregnancy. Insulin, glucose, C-peptide, HbA1C, fructosamine, prolactin, serotonin, and cortisol were measured in maternal blood at 24–26 weeks and in umbilical cord blood at birth. Cotinine was also measured in cord blood.ResultsOf 37 smokers and 36 non-smokers recruited, cord blood was obtainable from 38 babies (19 in each group. In utero cigarette exposure was associated with lower birthweight (3,035 ± 490 versus 3,405 ± 598 g, p = 0.005, with linear modeling of the smoking cohort showing a 41 g reduction for every increase of one cigarette smoked per day (95% CI −71 to −11 g, p = 0.010. There were no differences between groups in indices of maternal or perinatal endocrine pancreatic dysfunction. Heavier smoking independently correlated with higher maternal fasting levels of glucose (p = 0.044 and C-peptide (p = 0.011. We did not observe any significant associations between the daily number of cigarettes and any of the cord blood parameters. We also looked for differences between cohorts based on infant gender. Serotonin levels were higher in smoking mothers with male fetuses (p = 0.01 to p = 0.004.ConclusionEndocrine pancreatic dysfunction does not appear to be a major contributing factor to nicotine-associated fetal growth restriction. The higher serotonin levels in smoking mothers carrying male infants is of uncertain significance but could be a manifestation of gender differences in susceptibility to the long-term effects of cigarette smoking.

  2. Climate and Management Controls on Forest Growth and Forest Carbon Balance in the Western United States

    Science.gov (United States)

    Kelsey, Katharine Cashman

    Climate change is resulting in a number of rapid changes in forests worldwide. Forests comprise a critical component of the global carbon cycle, and therefore climate-induced changes in forest carbon balance have the potential to create a feedback within the global carbon cycle and affect future trajectories of climate change. In order to further understanding of climate-driven changes in forest carbon balance, I (1) develop a method to improve spatial estimates forest carbon stocks, (2) investigate the effect of climate change and forest management actions on forest recovery and carbon balance following disturbance, and (3) explore the relationship between climate and forest growth, and identify climate-driven trends in forest growth through time, within San Juan National Forest in southwest Colorado, USA. I find that forest carbon estimates based on texture analysis from LandsatTM imagery improve regional forest carbon maps, and this method is particularly useful for estimating carbon stocks in forested regions affected by disturbance. Forest recovery from disturbance is also a critical component of future forest carbon stocks, and my results indicate that both climate and forest management actions have important implications for forest recovery and carbon dynamics following disturbance. Specifically, forest treatments that use woody biomass removed from the forest for electricity production can reduce carbon emissions to the atmosphere, but climate driven changes in fire severity and forest recovery can have the opposite effect on forest carbon stocks. In addition to the effects of disturbance and recovery on forest condition, I also find that climate change is decreasing rates of forest growth in some species, likely in response to warming summer temperatures. These growth declines could result in changes of vegetation composition, or in extreme cases, a shift in vegetation type that would alter forest carbon storage. This work provides insight into both

  3. Performance of Circulating Placental Growth Factor as A Screening Marker for Diagnosis of Ovarian Endometriosis: A Pilot Study

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    Cinzia Zucchini

    2016-12-01

    Full Text Available Background: The aim of this study is to compare the circulating placental growth factor (PlGF concentration in women with and without endometrioma to verify the performance of this marker to diagnose the disease. Materials and Methods: In this case-control study, thirteen women with histological diagnosis of ovarian endometriosis were compared with women without endometriosis disease. PlGF plasma levels of endometriotic patients and controls were investigated using a fluorescence immunoassay technique. Results: PlGF showed a direct correlation with body mass index (BMI only in the control group (P=0.013. After adjustment for BMI values, PlGF median value in endometriosis group (14.7 pg/mL resulted higher than in control group (13.8 pg/ mL, P=0.004. Conclusion: PlGF is a promising peripheral blood marker that can discriminate between patients with and without ovarian endometriosis.

  4. Depression, inflammation, and epidermal growth factor receptor (EGFR) status in metastatic non-small cell lung cancer: A pilot study.

    Science.gov (United States)

    Jacobs, Jamie M; Traeger, Lara; Eusebio, Justin; Simon, Naomi M; Sequist, Lecia V; Greer, Joseph A; Temel, Jennifer S; Pirl, William F

    2017-08-01

    Patients with stage IV non-small cell lung cancer (NSCLC) have high risk for depressive symptoms and major depressive disorder (MDD); however, those with epidermal growth factor receptor (EGFR) mutations may have decreased risk. The biological underpinning of this relationship is unknown. We examined differences in depression severity and MDD in patients with newly diagnosed stage IV NSCLC based on EGFR mutation status, and examined proinflammatory cytokines and growth factors known to play a role in cancer progression and depression. Fifty-five patients with newly diagnosed stage IV NSCLC completed self-report and clinician-administered depression assessments prior to receiving results of tumor genotyping. We measured serum levels of circulating biological markers of inflammation: IL-1β, IL-6, TGF-α, and TNF-α. We examined differences in depression severity, MDD, and inflammatory biomarkers in patients with and without EGFR mutations. Patients with EGFR mutations (n=10) had lower depression severity (t[43]=2.38, p=0.03) than those without EGFR mutations (n=38) and fewer patients with EGFR mutations had concurrent MDD (2.08%) relative to those without mutations (27.08%). Patients with MDD had higher levels of TNF-α than those without MDD (t[40]=2.95, p=0.005). Those with EGFR mutations exhibited higher levels of TNF-α relative to those without EGFR mutations (t[35]=2.17, p=0.04). Patients with stage IV NSCLC harboring an EGFR mutation exhibited elevated proinflammatory marker TNF-α, yet had lower depression severity than patients without EGFR mutations. More work is warranted to examine the interaction between tumor genotyping and inflammatory cytokines in the context of depression. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Developing Policy Scenarios for Sustainable Urban Growth Management: A Delphi Approach

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    Sajida Perveen

    2017-10-01

    Full Text Available In many parts of the world, a rapid urbanization process is taking place at an unprecedented scale, and its drastic impacts on societies and the environment are evident. To combat the externalities of such rapid, and to a degree uncontrolled, development, many cities around the globe introduced various urban growth management policies. However, policy making—to provide sustainable outcomes, while generating growth opportunities—has been a daunting task for urban administrators. To ease the task, scenario-based planning methods are introduced to produce alternative visions for managing urban growth in sustainable ways by incorporating various socio-environmental issues. However, even though modelling urban growth and associated impacts based on these scenarios have emerged to strengthen and quantify the future of urban policies and related planning actions, this process has a number of glitches. Major issues include the uncertainties associated with the selection of suitable methods to generate scenarios, identify indicators to be used to assess scenarios, evaluate scenarios to prioritize for policy formulation, and assess the impacts of policy scenarios. This paper aims to address the challenge of developing suitable policy scenarios for sustainable urban growth. As for the methodological approach, the study undertakes a thorough review of the literature and current practices, and conducts a two-round Delphi survey—involving experts from public, private and academic sectors specialized in the fields of urban planning, environmental planning, social planning, transportation modelling, and economic development. The expert driven policy scenarios are validated in a local context by comparing findings against the policy options as proposed in the South East Queensland Regional Plan 2017 (Australia. The findings offer valuable guidelines for planners, modellers, and policy makers in adopting suitable methods, indicators, and policy priorities

  6. Telecommunications energy and greenhouse gas emissions management for future network growth

    International Nuclear Information System (INIS)

    Chan, Chien Aun; Gygax, André F.; Leckie, Christopher; Wong, Elaine; Nirmalathas, Ampalavanapillai; Hinton, Kerry

    2016-01-01

    Highlights: • Model to evaluate key interdependencies of a fast growing telecommunications network. • Network growth analysis using real data and Monte Carlo simulation. • Importance of both operational and embodied energy efficiency improvements. • Embodied energy expected to dominate in the future under current energy efficiency trends. • Carbon footprint and energy management through optimum network replacement cycle. - Abstract: A key aspect of greener network deployment is how to achieve sustainable growth of a telecommunications network, both in terms of operational and embodied energy. Hence, in this paper we investigate how the overall energy consumption and greenhouse gas emissions of a fast growing telecommunications network can be minimized. Due to the complexities in modeling the embodied energy of networks, this aspect of energy consumption has received limited attention by network operators. Here, we present the first model to evaluate the interdependencies of the four main contributing factors in managing the sustainable growth of a telecommunications network: (i) the network’s operational energy consumption; (ii) the embodied energy of network equipment; (iii) network traffic growth; and (iv) the expected energy efficiency improvements in both the operational and embodied phases. Using Monte Carlo techniques with real network data, our results demonstrate that under the current trends in overall energy efficiency improvements the network embodied energy will account for over 40% of the total network energy in 2025 compared to 20% in 2015. Further, we find that the optimum equipment replacement cycle, which will result in the lowest total network life cycle energy, is directly dependent on the technological progress in energy efficiency improvements of both operational and embodied phases. Our model and analysis highlight the need for a comprehensive approach to better understand the interactions between network growth, technological

  7. The development and pilot testing of the self-management programme of activity, coping and education for chronic obstructive pulmonary disease (SPACE for COPD).

    Science.gov (United States)

    Apps, Lindsay D; Mitchell, Katy E; Harrison, Samantha L; Sewell, Louise; Williams, Johanna E; Young, Hannah Ml; Steiner, Michael; Morgan, Mike; Singh, Sally J

    2013-01-01

    There is no independent standardized self-management approach available for chronic obstructive pulmonary disease (COPD). The aim of this project was to develop and test a novel self-management manual for individuals with COPD. Participants with a confirmed diagnosis of COPD were recruited from primary care. A novel self-management manual was developed with health care professionals and patients. Five focus groups were conducted with individuals with COPD (N = 24) during development to confirm and enhance the content of the prototype manual. The Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease (SPACE for COPD) manual was developed as the focus of a comprehensive self-management approach facilitated by health care professionals. Preference for delivery was initial face-to-face consultation with telephone follow-up. The SPACE for COPD manual was piloted with 37 participants in primary care. Outcome measures included the Self-Report Chronic Respiratory Questionnaire, Incremental Shuttle Walk Test, and Endurance Shuttle Walking Test (ESWT); measurements were taken at baseline and 6 weeks. The pilot study observed statistically significant improvements for the dyspnea domain of the Self-Report Chronic Respiratory Questionnaire and ESWT. Dyspnea showed a mean change of 0.67 (95% confidence interval 0.23-1.11, P = 0.005). ESWT score increased by 302.25 seconds (95% confidence interval 161.47-443.03, P COPD. The program, incorporating the SPACE for COPD manual, appears to provoke important changes in exercise capacity and breathlessness for individuals with COPD managed in primary care.

  8. Behavioral activation for smoking cessation and mood management following a cardiac event: results of a pilot randomized controlled trial

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    Andrew M. Busch

    2017-04-01

    Full Text Available Abstract Background Smoking cessation following hospitalization for Acute Coronary Syndrome (ACS significantly reduces subsequent mortality. Depressed mood is a major barrier to cessation post-ACS. Although existing counseling treatments address smoking and depression independently in ACS patients, no integrated treatment addresses both. We developed an integrated treatment combining gold standard cessation counseling with behavioral activation-based mood management; Behavioral Activation Treatment for Cardiac Smokers (BAT-CS. The purpose of this pilot randomized controlled trial was to test feasibility, acceptability, and preliminary efficacy of BAT-CS vs. Standard of Care (SC. Methods Participants were recruited during hospitalization for ACS and were randomly assigned to BAT-CS or SC. The nicotine patch was offered in both conditions. Smoking, mood, and stress outcomes were collected at end-of-treatment and 24-week follow-up. Results Fifty-nine participants (28 BAT-CS, 31 SC were recruited over 42 weeks, and assessment completion was above 80% in both conditions. Treatment acceptability and fidelity were high. At 24 week follow-up adjusted odds ratios favoring BAT-CS were 1.27 (95% CI: 0.41–3.93 for 7-day point prevalence abstinence and 1.27 (95% CI: 0.42–3.82 for continuous abstinence. Time to first smoking lapse was significantly longer in BAT-CS (62.4 vs. 31.8 days, p = 0.03. At 24-weeks, effect sizes for mood and stress outcomes ranged from η2 partial of.07–.11, with significant between treatment effects for positive affect, negative affect, and stress. Conclusions The design of this study proved feasible and acceptable. Results provide preliminary evidence that combining behavioral activation with standard smoking cessation counseling could be efficacious for this high risk population. A larger trial with longer follow-up is warranted. Trial registration NCT01964898 . First received by clinicaltrials.gov October 15, 2013.

  9. Placental Growth Factor Levels in Populations with High Versus Low Risk for Cardiovascular Disease and Stressful Physiological Environments such as Microgravity: A Pilot Study

    Science.gov (United States)

    Sundaresan, Alamelu; Mehta, Satish K.; Schlegel, Todd. T.; Russomano, Thais; Pierson, Duane L.; Mann, Vivek; Mansoor, Elvedina; Olamigoke, Loretta; Okoro, Elvis

    2017-02-01

    This pilot study compared placental growth factor (PIGF) levels in populations with high versus low risk for cardiovascular disease. Previous experiments from our laboratory (Sundaresan et al. 2005, 2009) revealed that the angiogenic factor PIGF was up regulated in modeled microgravity conditions in human lymphocytes leading to possible atherogenesis and pathogenesis in microgravity. Since the findings came from microgravity analog experiments, there is a strong link to its usefulness in the microgravity field as a biomarker. It is important to understand, that these findings came from both studies on expression levels of this cardiovascular marker in human lymphocytes in microgravity ( in vitro microgravity analog), and a follow up gene expression study in hind limb suspended mice ( in vivo microgravity analog). The relevance is enhanced because in life on earth, PIGF is an inflammatory biomarker for cardiovascular disease. Studies on the levels of PIGF would help to reduce the risk and prevention of heart failures in astronauts. If we can use this marker to predict and reduce the risk of cardiac events in astronauts and pilots, it would significantly help aerospace medicine operations. The investigations here confirmed that in a cardiovascular stressed population such as coronary artery disease (CAD) and acute coronary syndrome (ACS) patients, PIGF could be overexpressed. We desired to re-evaluate this marker in patients with cardiovascular disease in our own study. PIGF is a marker of inflammation and a predictor of short-term and long-term adverse outcome in ACS. In addition, elevated PIGF levels may be associated with increased risk for CAD.PIGF levels were determined in thirty-one patients undergoing cardiovascular catheterization for reasons other than ACS and in thirty-three low-risk asymptomatic subjects. Additional data on traditional cardiovascular risk factors for both populations were also compiled and compared. We found that PIGF levels were

  10. The Validation of the Mixedwood Growth Model (MGM for Use in Forest Management Decision Making

    Directory of Open Access Journals (Sweden)

    Mike Bokalo

    2013-01-01

    Full Text Available We evaluated the Mixedwood Growth Model (MGM at a whole model scale for pure and mixed species stands of aspen and white spruce in the western boreal forest. MGM is an individual tree-based, distance-independent growth model, designed to evaluate growth and yield implications relating to the management of white spruce, black spruce, aspen, lodgepole pine, and mixedwood stands in Alberta, British Columbia, Saskatchewan, and Manitoba. Our validation compared stand-level model predictions against re-measured data (volume, basal area, diameter at breast height (DBH, average and top height and density from permanent sample plots using combined analysis of residual plots, bias statistics, efficiency and an innovative application of the equivalence test. For state variables, the model effectively simulated juvenile and mature stages of stand development for both pure and mixed species stands of aspen and white spruce in Alberta. MGM overestimates increment in older stands likely due to age-related pathology and weather-related stand damage. We identified underestimates of deciduous density and volume in Saskatchewan. MGM performs well for increment in postharvest stands less than 30 years of age. These results illustrate the comprehensive application of validation metrics to evaluate a complex model, and provide support for the use of MGM in management planning.

  11. Development and pilot testing of a mobile health solution for asthma self-management: Asthma action plan smartphone application pilot study

    Directory of Open Access Journals (Sweden)

    Christopher J Licskai

    2013-01-01

    Full Text Available BACKGROUND: Collaborative self-management is a core recommendation of national asthma guidelines; the written action plan is the knowledge tool that supports this objective. Mobile health technologies have the potential to enhance the effectiveness of the action plan as a knowledge translation tool.

  12. Pilot project as enabler?

    DEFF Research Database (Denmark)

    Neisig, Margit; Glimø, Helle; Holm, Catrine Granzow

    This article deals with a systemic perspective on transition. The field of study addressed is a pilot project as enabler of transition in a highly complex polycentric context. From a Luhmannian systemic approach, a framework is created to understand and address barriers of change occurred using...... pilot projects as enabler of transition. Aspects of how to create trust and deal with distrust during a transition are addressed. The transition in focus is the concept of New Public Management and how it is applied in the management of the Employment Service in Denmark. The transition regards...

  13. Gestational diabetes and fetal growth acceleration: induction of labour versus expectant management.

    Science.gov (United States)

    Alberico, S; Businelli, C; Wiesenfeld, U; Erenbourg, A; Maso, G; Piccoli, M; Ronfani, L

    2010-12-01

    The aim of the study was to compare elective induction of labour at 38 weeks versus expectant management in A1 and A2 gestational diabetes (GDM) pregnancies with fetal growth acceleration. Primary outcome of the study was C-section (CS) rate, while secondary outcomes were macrosomia incidence and adverse perinatal outcomes. A retrospective cohort study was carried out. Data were collected between 1996 and 2006 and evaluated through patients' records analysis. Differences between the two study groups were investigated using non-parametric tests for continuous variables and χ2 test for categorical ones. There was no significant difference between induction and expectant management in terms of caesarean section rate. A trend favoring women in the induction group in terms of incidence of macrosomia and neonatal outcomes was identified, but results were not statistically significant. Labour induction at 38 weeks in GDM patients with fetal growth acceleration does not seem to determine an increased incidence of C-section in comparison to expectant management, particularly in case of maternal obesity.

  14. Growth Trajectories and Detrended Intraindividual Variability to Assess Case Managers' Competency in Continuing Education.

    Science.gov (United States)

    Park, Claire Su-Yeon; Kang, Kyong-Hwa; Yun, Soon-Nyoung

    2017-05-01

    Tracking the effectiveness of CE over time beyond simply confirming its efficacy in continuing education (CE) in nursing is crucial. However, research evidence on the analysis of change of the effectiveness of CE over time is limited, particularly in the context of case management. This methodological study aimed to introduce both a growth curve modeling and an intra-individual variability index and demonstrate step-by-step procedures and interpretations of those analyses to assess case manager competency over time, using secondary data analysis. Data were collected from 22 case managers affiliated with the Korean National Health Insurance Corporation who attended three series of CE to improve their competency between May 2008 and August 2009. Unexpected results revealed a negative fixed effect of education level in the overall estimation of case managers' competency trajectory and a negative correlation between education level and case managers' intra-individual competency inconsistency over time. J Contin Nurs Educ. 2017;48(5):230-238. Copyright 2017, SLACK Incorporated.

  15. Supply chain management using fp-growth algorithm for medicine distribution

    Science.gov (United States)

    Wahana, A.; Maylawati, D. S.; Irfan, M.; Effendy, H.

    2018-03-01

    Distribution of drugs evenly in accordance with the needs of Public Health Center (Puskesmas) become one of the responsibilities by the Health Office in Indonesia. This study aims to provide recommendations for distribution of drugs from the Department of Health according to the needs of each Puskesmas. Because often the distribution of drugs is not in accordance with the needs of medicines stock of each Puskesmas. This causes the possibility of drug stock void in Puskesmas in need, while there is excess stock of drugs in Puskesmas that do not need. Supply Chain Management (SCM) is applied as a controlling drug stock at Puskesmas in order to avoid drug vacuum or excess drug that eventually unused. In addition, the Frequent Pattern Growth (FP-Growth) algorithm that generates frequent item sets is used to provide drug distribution recommendations by looking at the highest frequency of drug occurrences and frequent drug frequencies. Based on testing black box system conducted in Health Office Purwakarta regency of Indonesia which oversees 20 Puskesmas with 100 data of drug distribution transactions, it can be concluded that system functionality is running well and SCM successfully implemented to arrange distribution process of medicine well. Furthermore FP-Growth algorithm was able to provide recommendations for distribution of drugs with a high success rate. This is evidenced by the test results with various combinations of input parameters, FP-Growth is able to produce the right frequent item sets.

  16. Development and Pilot Testing of a Food Safety Curriculum for Managers and Staff of Residential Childcare Institutions (RCCIs)

    Science.gov (United States)

    Pivarnik, Lori F.; Patnoad, Martha S.; Nyachuba, David; McLandsborough, Lynne; Couto, Stephen; Hagan, Elsina E.; Breau, Marti

    2013-01-01

    Food safety training materials, targeted for residential childcare institution (RCCI) staff of facilities of 20 residents or less, were developed, piloted, and evaluated. The goal was to assist in the implementation of a Hazard Analysis Critical Control Points (HACCP)-based food safety plan as required by Food and Nutrition Service/United States…

  17. Determination of Waste Isolation Pilot Plant (WIPP) management and institutional requirements documents for contact-handled (CH) critical systems

    International Nuclear Information System (INIS)

    1990-01-01

    This document lists the critical requirements documents applicable to the receipt of contact-handled waste at the Waste Isolation Pilot Plant. It also describes the processes used to determine the applicability of each document. This analysis is based on the applicable documents that were in effect in the February 1988 time frame. 2 refs

  18. Growth hormone and tesamorelin in the management of HIV-associated lipodystrophy

    Directory of Open Access Journals (Sweden)

    Bedimo R

    2011-07-01

    Full Text Available Roger BedimoInfectious Disease section, VA North Texas Health Care System, TX, USAAbstract: HIV-infected patients on highly active antiretroviral therapy (HAART develop a complex of body composition changes known, including peripheral fat loss (lipoatrophy and central fat accumulation (lipohypertrophy. These changes may cause significant patient distress, which could in turn interfere with adherence to antiretroviral therapy. Treatment options – including antiretroviral switch, insulin sensitizers, and surgical approaches – have been associated with limited success and potential complications. The observation that low growth hormone levels are associated with central fat accumulation among HIV patients has led to the development of tesamorelin (a growth hormone releasing hormone analog for the management of central fat accumulation. Randomized controlled trials have shown that administration of tesamorelin is safe and effective in reducing central fat accumulation among HIV-infected patients. This effect is transient, however, and its association with improved cardiovascular risk remains unclear.Keywords: HAART, HIV, tesamorelin, lipodystrophy

  19. Improvement of Atrophic Acne Scars in Skin of Color Using Topical Synthetic Epidermal Growth Factor (EGF) Serum: A Pilot Study.

    Science.gov (United States)

    Stoddard, Marie Alexia; Herrmann, Jennifer; Moy, Lauren; Moy, Ronald

    2017-04-01

    BACKGROUND: Atrophic scarring in skin of color is a common, permanent, and distressing result of uncontrolled acne vulgaris. Ablative lasers and chemical peels are frequently used to improve the appearance of atrophic scars, primarily through the stimulation of collagen and elastin; however, these treatment modalities are associated with risks, such as dyspigmentation and hypertrophic scarring, especially in patients with darker skin. OBJECTIVE: We evaluated the efficacy of topically applied synthetic epidermal growth factor (EGF) serum in reducing the appearance of atrophic acne scars in skin of color. METHODS: A single-center clinical trial was performed on twelve healthy men and women (average age 32.5) with Fitzpatrick Type IV-V skin and evidence of facial grade II-IV atrophic acne scars. Subjects applied topical EGF serum to the full-face twice daily for 12 weeks. Scar improvement was investigated at each visit using an Investigator Global Assessment (IGA), a Goodman grade, clinical photography, and patient self-assessment. RESULTS: Eleven subjects completed the trial. Compared to baseline, there was an improvement in mean IGA score from 3.36 (SEM = 0.15) to 2.18 (SEM = 0.33). Mean Goodman grade was reduced from 2.73 (SEM = 0.19) to 2.55 (SEM = 0.21). Of the eleven pairs of before and after photographs, nine were correctly chosen as the post-treatment image by a blind investigator. On self-assessment, 81% reported a "good" to "excellent" improvement in their scars compared to baseline (P = 0.004). CONCLUSION: Topical EGF may improve the appearance of atrophic acne scars in skin of color. Additional, larger studies should be conducted to better characterize improvement. J Drugs Dermatol. 2017;16(4):322-326..

  20. 7 CFR 1955.132 - Pilot projects.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 14 2010-01-01 2009-01-01 true Pilot projects. 1955.132 Section 1955.132 Agriculture... REGULATIONS (CONTINUED) PROPERTY MANAGEMENT Disposal of Inventory Property General § 1955.132 Pilot projects. FmHA or its successor agency under Public Law 103-354 may conduct pilot projects to test policies and...

  1. Microbial field pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, R.M.; McInerney, M.J.; Menzie, D.E.; Coates, J.D.; Chisholm, J.L.

    1993-05-01

    A multi-well microbially enhanced oil recovery field pilot has been performed in the Southeast Vassar Vertz Sand Unit in Payne County, Oklahoma. The primary emphasis of the experiment was preferential plugging of high permeability zones for the purpose of improving waterflood sweep efficiency. Studies were performed to determine reservoir chemistry, ecology, and indigenous bacteria populations. Growth experiments were used to select a nutrient system compatible with the reservoir that encouraged growth of a group of indigenous nitrate-using bacteria and inhibit growth of sulfate-reducing bacteria. A specific field pilot area behind an active line drive waterflood was selected. Surface facilities were designed and installed. Injection protocols of bulk nutrient materials were prepared to facilitate uniform distribution of nutrients within the pilot area. By the end of December, 1991, 82.5 tons (75.0 tonnes) of nutrients had been injected in the field. A tracer test identified significant heterogeneity in the SEVVSU and made it necessary to monitor additional production wells in the field. The tracer tests and changes in production behavior indicate the additional production wells monitored during the field trial were also affected. Eighty two and one half barrels (13.1 m[sup 3]) of tertiary oil have been recovered. Microbial activity has increased CO[sub 2] content as indicated by increased alkalinity. A temporary rise in sulfide concentration was experienced. These indicate an active microbial community was generated in the field by the nutrient injection. Pilot area interwell pressure interference test results showed that significant permeability reduction occurred. The interwell permeabilities in the pilot area between the injector and the three pilot production wells were made more uniform which indicates a successful preferential plugging enhanced oil recovery project.

  2. Low literacy self-care management patient education for a multi-lingual heart failure population: Results of a pilot study.

    Science.gov (United States)

    Dickson, Victoria Vaughan; Chyun, Deborah; Caridi, Cristina; Gregory, Jill K; Katz, Stuart

    2016-02-01

    The purpose of this pilot study was to test the impact of language-free, low literacy self-care management patient education materials in an ethnically diverse multilingual heart failure (HF) population. A one group pre-test-post-test design measured changes in self-care, knowledge and health-related quality of life (HRQL) after a 1 month intervention using language-free, low literacy self-care management patient education materials and delivered by a health educator. The ethnically diverse sample (n=21) was predominately male (72%), 48% Black, 42% Hispanic, and 28% marginal/inadequate literacy. There were significant improvements in self-care and knowledge but not HRQL. Language-free, low literacy self-care patient education may facilitate improved self-care and knowledge in diverse populations who are at risk for poor HF outcomes. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. Managing heart rot in live trees for wildlife habitat in young-growth forests of coastal Alaska

    Science.gov (United States)

    Paul E. Hennon; Robin L. Mulvey

    2014-01-01

    Stem decays of living trees, known also as heart rots, are essential elements of wildlife habitat, especially for cavity-nesting birds and mammals. Stem decays are common features of old-growth forests of coastal Alaska, but are generally absent in young, managed forests. We offer several strategies for maintaining or restoring fungal stem decay in these managed...

  4. Piloting a manualised weight management programme (Shape Up-LD) for overweight and obese persons with mild-moderate learning disabilities: study protocol for a pilot randomised controlled trial.

    Science.gov (United States)

    Beeken, Rebecca J; Spanos, Dimitrios; Fovargue, Sally; Hunter, Rachael; Omar, Rumana; Hassiotis, Angela; King, Michael; Wardle, Jane; Croker, Helen

    2013-03-12

    National obesity rates have dramatically risen over the last decade. Being obese significantly reduces life expectancy, increases the risk of a range of diseases, and compromises quality of life. Costs to both the National Health Service and society are high. An increased prevalence of obesity in people with learning disabilities has been demonstrated. The consequences of obesity are particularly relevant to people with learning disabilities who are already confronted by health and social inequalities. In order to provide healthcare for all, and ensure equality of treatment for people with learning disabilities, services must be developed specifically with this population in mind. The aim of this project is to pilot the evaluation of a manualised weight management programme for overweight and obese persons with mild-moderate learning disabilities (Shape Up-LD). An individually randomised, controlled pilot trial in 60 overweight and obese (body mass index ≥ 25) adults (age ≥ 18) with mild-moderate learning disabilities and their carers will be carried out, comparing "Shape Up-LD" with usual care. The manualised Shape Up-LD intervention will involve 12 weekly sessions, which include healthy eating messages, advice on physical activity and use of behaviour change techniques to help people manage their weight. Assessments of participants will be conducted at baseline, 12 weeks and 6 months. Service users and their carers and service providers will also give their perspectives on the experience of Shape Up-LD in qualitative interviews at 12 weeks. Feasibility outcomes will include recruitment rates, loss to follow-up, compliance rates, completion rates, collection of information for a cost-effectiveness analysis and an estimation of the treatment effect on weight. The findings from this study will inform our preparation for a definitive randomised controlled trial to test the efficacy of the programme with respect to weight loss and maintenance in this population

  5. PC11 PILOT Reference Manual,

    Science.gov (United States)

    1986-05-01

    file management , text editing and other features of the EXEC were used to prepare PILOT programs. These features of the EXEC are described in the...on the EXEC and ECL commands. Section 2.1.2 describes ECL commands pertinent to PCIIT PILOT. 2.1.1 Executive Control Language Fundamantals 2.1.1.1...some microcomputers compatible with it. The file management , text editing and other features of the IBM Disk Operating System (DOS) were used to

  6. POSITIONING KNOWLEDGE MANAGEMENT AS KEY SUCCESS FACTOR IN THE GROWTH OF COOPERATIVES IN MALAYSIA

    Directory of Open Access Journals (Sweden)

    Yeop Hussin Bidin

    2007-01-01

    Full Text Available Economic and business challenges in the new millennium have shaped the manner cooperative movement in Malaysia charts its future outlook. After almost 82 years, a national policy was launched by the Government on January 2004 to assist in the comprehensive development of the cooperative movement. The National CooperativePolicy (NCP will ensure that the huge resources of the cooperatives can be harnessed to generate and contribute to the economic growth of the country. However, in the light of many issues such as weak structure and the absence of good corporate governance in some cooperatives, the present Cooperative Act 1993 is being reviewed and several new provisions would be added to increase supervision, monitoring and enforcement against existing cooperatives in alaysia. It is quite imperative that by regulating the operation of cooperatives will require also the managing of intellectual and human capital assets that exist in the movement. Through establishing a framework and terms of reference such that fundamental elements of knowledge management can be instilled areprerequisites to developing innovativeness in this growing economic sector. The sharing of knowledge among the cooperatives will eventually produce better and more educated human resources that are able to experience greater control over the works and the administration of their quality working life. Structural analysis of the cooperative movement indicates the significant influence of knowledge management in sustaining its future growth given the timely introduction of the NCP. Thus, measures taken to underline this influence will also be addressed to represent the cooperative movement's readiness to face economic and business challenges in Malaysia.

  7. Growth curves for intracranial volume in normal Asian children fortify management of craniosynostosis.

    Science.gov (United States)

    Kamochi, Hideaki; Sunaga, Ataru; Chi, Daekwan; Asahi, Rintaro; Nakagawa, Shiho; Mori, Masanori; Uda, Hirokazu; Sarukawa, Shunji; Sugawara, Yasushi; Yoshimura, Kotaro

    2017-11-01

    Although the charting of normal intracranial volume (ICV) is fundamental for managing craniosynostosis, Asian norms in this regard are unknown. The purpose of this study was to establish a growth curve for ICVs in a large series of normal Asian children, providing reference values to guide corrective surgery. A total of 124 normal children (male, 63; female, 61) and 41 children diagnosed with craniosynostoses were analyzed. Patients aged 0-8 years presenting to the emergency room and subjected to computed tomography (CT) for head trauma served as the reference cohort. Axial CT head scan data were obtained from radiographic archives at Jichi Medical University. Imaging was done on a Siemens CT scanner (5-mm slice thickness), using a DICOM viewer to measure ICVs. ICVs were plotted against age, and best-fit logarithmic curves for normal subjects were generated, without and with gender stratification. Male and female growth curves were similar in shape but diverged past the age of 1 year (male > female). ICVs of patients with craniosynostoses were plotted to male and female growth curves by disease subset, revealing the following: sagittal synostosis, near normal (or marginally larger); metopic synostosis, below normal; other non-syndromic synostoses (unilateral, bilateral, and lambdoidal) and Crouzon syndrome, near normal; Apert syndrome, above normal; and Pfeiffer syndrome, variable. ICVs of early childhood were investigated in Asian subjects, creating growth curves that set criteria for timing, planning and goalsetting in surgical correction of craniosynostosis. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  8. Febrile illness management in children under five years of age: a qualitative pilot study on primary health care workers' practices in Zanzibar.

    Science.gov (United States)

    Baltzell, Kimberly; Elfving, Kristina; Shakely, Deler; Ali, Abdullah S; Msellem, Mwinyi; Gulati, Shilpa; Mårtensson, Andreas

    2013-01-28

    In Zanzibar, malaria prevalence dropped substantially in the last decade and presently most febrile patients seen in primary health care facilities (PHCF) test negative for malaria. The availability of rapid diagnostic tests (RDTs) allows rural health workers to reliably rule out malaria in fever patients. However, additional diagnostic tools to identify alternative fever causes are scarce, often leaving RDT-negative patients without a clear diagnosis and management plan. This pilot study aimed to explore health workers' practices with febrile children and identify factors influencing their diagnostic and management decisions in non-malarial fever patients. Semi-structured key informant interviews were conducted with 12 health workers in six PHCFs in North A district, Zanzibar, April to June 2011. Interviews were coded using Atlas.ti to identify emerging themes that play a role in the diagnosis and management of febrile children. The following themes were identified: 1) health workers use caregivers' history of illness and RDT results for initial diagnostic and management decisions, but suggest caregivers need more education to prevent late presentation and poor health outcomes; 2) there is uncertainty regarding viral versus bacterial illness and health workers feel additional point-of-care diagnostic tests would help with differential diagnoses; 3) stock-outs of medications and limited caregivers' resources are barriers to delivering good care; 4) training, short courses and participation in research as well as; 5) weather also influences diagnostic decision-making. This pilot study found that health workers in Zanzibar use caregiver history of fever and results of malaria RDTs to guide management of febrile children. However, since most febrile children test negative for malaria, health workers believe additional training and point-of-care tests would improve their ability to diagnose and manage non-malarial fevers. Educating caregivers on signs and symptoms of

  9. Effective energy data management for low-carbon growth planning: An analytical framework for assessment

    Energy Technology Data Exchange (ETDEWEB)

    Liu, Bo; Evans, Meredydd; Yu, Sha; Roshchanka, Volha; Dukkipati, Srihari; Sreenivas, Ashok

    2017-08-01

    Readily available and reliable energy data is fundamental to effective analysis and policymaking for the energy sector. Energy statistics of high quality, systematically compiled and effectively disseminated, not only support governments to ensure national security and evaluate energy policies, but they also guide investment decisions in both the private and public sectors. Because of energy’s close link to greenhouse gas emissions, energy data has a particularly important role in assessing emissions and strategies to reduce emissions. In this study, energy data management in four countries – Canada, Germany, the United Kingdom and the United States – are examined from both organizational and operational perspectives. With insights from these best practices, we present a framework for the evaluation of national energy data management systems. It can be used by national statistics compilers to assess their chosen model and to identify areas for improvement. We then use India as a test case for this framework. Its government is working to enhance India’s energy data management to improve sustainable growth planning.

  10. Management of Very Early-onset Fetal Growth Restriction: Results from 92 Consecutive Cases.

    Science.gov (United States)

    Hoellen, Friederike; Beckmann, Annika; Banz-Jansen, Constanze; Weichert, Jan; Rody, Achim; Bohlmann, Michael K

    2016-01-01

    To evaluate management of early-onset intrauterine growth restriction (IUGR) and to define outcome according to obstetric setting. During an 11-year period (2000-2011), data of patients presenting with IUGR and preterm delivery of less than 30 weeks of gestation at a tertiary perinatal center were retrospectively reviewed. A total of 92 pregnancies were investigated. Delivery was indicated for fetal reasons in 38 out of 92 patients. Sixteen children of our cohort died within one year post partum, out of which eight had suffered from severe early-onset IUGR causing iatrogenic preterm delivery. Concerning the fetal outcome, gestational age at delivery and antenatal exposure to corticosteroids were found to be crucial. In some cases, respiratory distress syndrome prophylaxis and a "wait and see" approach to management in favor of a prolongation of the pregnancy might be favorable. Randomized prospective trials in early-onset IUGR with threatened preterm deliveries are needed in order to define guidelines for an individually tailored management of early-onset preterm infants. Copyright © 2016 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.

  11. Pilot implementation

    DEFF Research Database (Denmark)

    Hertzum, Morten; Bansler, Jørgen P.; Havn, Erling C.

    2012-01-01

    be difficult to plan and conduct. It is sometimes assumed that pilot implementations are less complicated and risky than ordinary implementations. Pilot implementations are, however, neither prototyping nor small-scale versions of full-scale implementations; they are fundamentally different and have their own...

  12. Recall of intensive care unit stay in patients managed with a sedation protocol or a sedation protocol with daily sedative interruption: a pilot study.

    Science.gov (United States)

    Ethier, Cheryl; Burry, Lisa; Martinez-Motta, Carlos; Tirgari, Sam; Jiang, Depeng; McDonald, Ellen; Granton, John; Cook, Deborah; Mehta, Sangeeta

    2011-04-01

    Analgesics and sedatives are integral for the relief of pain and anxiety in critically ill patients. However, these agents may contribute to amnesia for intensive care unit (ICU) events; which has been associated with development of posttraumatic stress disorder. Drug administration strategies that minimize sedative use have been associated with less amnesia. The objective of this pilot study was to evaluate recall of ICU stay in patients managed with 2 sedation strategies: a sedation protocol or a combination of sedation protocol and daily sedative/analgesic interruption. A questionnaire was administered on day 3 following ICU discharge to evaluate patients' recollections of pain, anxiety, fear, and sleep, as well as memories for specific ICU procedures. Participants were ICU survivors who had been enrolled in SLEAP - a randomized pilot trial comparing two sedation strategies, at 3 university-affiliated medical/surgical ICUs. Twenty-one patients who regained orientation within 72 hours of ICU discharge completed the questionnaire. More than 50% of patients recalled experiencing pain, anxiety, and fear to a moderate or extreme extent; and 57% reported inadequate sleep while in the ICU. Of the 21 patients, 48%, 33%, and 29% had no memories of endotracheal tube suctioning, being on a "breathing machine," and being bathed, respectively. A notable percentage of patients discharged from the ICU report moderate to extreme pain, anxiety, and fear, and inability to sleep during their ICU stay; and 29% to 48% have no recall of specific ICU events. Copyright © 2011 Elsevier Inc. All rights reserved.

  13. Evaluation of a Community Health Worker Pilot Intervention to Improve Diabetes Management in Bangladeshi Immigrants with Type 2 Diabetes in New York City

    Science.gov (United States)

    Islam, Nadia S.; Wyatt, Laura C.; Patel, Shilpa D.; Shapiro, Ephraim; Tandon, S.Darius; Mukherji, B. Runi; Tanner, Michael; Rey, Mariano J.; Trinh-Shevrin, Chau

    2014-01-01

    Purpose The purpose of this study is to explore the impact and feasibility of a pilot Community Health Worker (CHW) intervention to improve diabetes management among Bangladeshi-American individuals with Type 2 diabetes living in New York City. Methods Participants were recruited at clinic- and community-based venues. The intervention consisted of six monthly, CHW facilitated group sessions on topics related to management of diabetes. Surveys were collected at baseline and follow-up time points. Study outcomes included clinical, behavioral, and satisfaction measures for participants, as well as qualitative measures from CHWs. Results Improvements were seen in diabetes knowledge, exercise and diet to control diabetes, frequency of checking feet, medication compliance, and self-efficacy of health and physical activity from baseline to 12 months. Additionally, there were decreases in A1C, weight, and BMI. Program evaluation revealed a high acceptability of the intervention, and qualitative findings indicated that CHWs helped overcome barriers and facilitated program outcomes through communal concordance, trust and leadership. Conclusions The intervention demonstrated high acceptability and suggested efficacy in improving diabetes management outcomes among Bangladeshi immigrants in an urban setting. The U.S. Bangladeshi population will continue to increase, and given the high rates of diabetes, as well as linguistic and economic barriers faced by this community, effective and culturally-tailored health interventions are needed to overcome barriers and provide support for diabetes management. PMID:23749774

  14. Pilot study of a cluster randomised trial of a guided e-learning health promotion intervention for managers based on management standards for the improvement of employee well-being and reduction of sickness absence: GEM Study.

    Science.gov (United States)

    Stansfeld, Stephen A; Kerry, Sally; Chandola, Tarani; Russell, Jill; Berney, Lee; Hounsome, Natalia; Lanz, Doris; Costelloe, Céire; Smuk, Melanie; Bhui, Kamaldeep

    2015-10-26

    To investigate the feasibility of recruitment, adherence and likely effectiveness of an e-learning intervention for managers to improve employees' well-being and reduce sickness absence. The GEM Study (guided e-learning for managers) was a mixed methods pilot cluster randomised trial. Employees were recruited from four mental health services prior to randomising three services to the intervention and one to no-intervention control. Intervention managers received a facilitated e-learning programme on work-related stress. Main outcomes were Warwick Edinburgh Mental Wellbeing Scale (WEMWBS), 12-item GHQ and sickness absence sickness absence (n=393) showed no evidence of effect. There were no effects on GHQ score or work characteristics. Online quiz knowledge scores increased across the study in adherent managers. Qualitative data provided a rich picture of the context within which the intervention took place and managers' and employees' experiences of it. A small benefit from the intervention on well-being was explained by the mixed methods approach, implicating a low intervention uptake by managers and suggesting that education alone may be insufficient. A full trial of the guided e-learning intervention and economic evaluation is feasible. Future research should include more active encouragement of manager motivation, reflection and behaviour change. ISRCTN58661009. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  15. The value of volume and growth measurements in timber sales management of the National Forests

    Science.gov (United States)

    Lietzke, K. R.

    1977-01-01

    This paper summarizes work performed in the estimation of gross social value of timber volume and growth rate information used in making regional harvest decisions in the National Forest System. A model was developed to permit parametric analysis. The problem is formulated as one of finding optimal inventory holding patterns. Public timber management differs from other inventory holding problems in that the inventory, itself, generates value over time in providing recreational, aesthetic and environmental goods. 'Nontimber' demand estimates are inferred from past Forest Service harvest and sales levels. The solution requires a description of the harvest rates which maintain the optimum inventory level. Gross benefits of the Landsat systems are estimated by comparison with Forest Service information gathering models. Gross annual benefits are estimated to be $5.9 million for the MSS system and $7.2 million for the TM system.

  16. GestationaL Obesity Weight management: Implementation of National Guidelines (GLOWING): a pilot cluster randomised controlled trial of a guideline implementation intervention for the management of maternal obesity by midwives.

    Science.gov (United States)

    Heslehurst, Nicola; Rankin, Judith; McParlin, Catherine; Sniehotta, Falko F; Howel, Denise; Rice, Stephen; McColl, Elaine

    2018-01-01

    Weight management in pregnancy guidelines exist, although dissemination alone is an ineffective means of implementation. Midwives identify the need for support to overcome complex barriers to practice. An evaluation of an intervention to support midwives' guideline implementation would require a large-scale cluster randomised controlled trial. A pilot study is necessary to explore the feasibility of delivery and evaluation prior to a definitive trial. The GestationaL Obesity Weight management: Implementation of National Guidelines (GLOWING) trial aims to test whether it is feasible and acceptable to deliver a behaviour change intervention to support midwives' implementation of weight management guidelines. GLOWING is a multi-centre parallel group pilot cluster randomised controlled trial comparing the delivery of a behaviour change intervention for midwives versus usual practice. Four NHS Trusts (clusters) will be randomised to intervention and control arms, stratified by size of maternity services. The intervention uses social cognitive theory and consists of face-to-face midwifery training plus information resources for routine practice. The main outcomes are whether the intervention and trial procedures are feasible and acceptable to participants and the feasibility of recruitment and data collection for a definitive trial. Target recruitment involves all eligible midwives in the intervention arm recruited to receive the intervention, 30 midwives and pregnant women per arm for baseline and outcome questionnaire data collection and 20 midwives and women to provide qualitative data. All quantitative and qualitative analyses will be descriptive with the purpose of informing the development of the definitive trial. This pilot study has been developed to support community midwives' implementation of guidelines. Community midwives have been selected as they usually carry out the booking appointment which includes measuring and discussing maternal body mass index. A

  17. A wireless sensor network-based ubiquitous paprika growth management system.

    Science.gov (United States)

    Hwang, Jeonghwan; Shin, Changsun; Yoe, Hyun

    2010-01-01

    Wireless Sensor Network (WSN) technology can facilitate advances in productivity, safety and human quality of life through its applications in various industries. In particular, the application of WSN technology to the agricultural area, which is labor-intensive compared to other industries, and in addition is typically lacking in IT technology applications, adds value and can increase the agricultural productivity. This study attempts to establish a ubiquitous agricultural environment and improve the productivity of farms that grow paprika by suggesting a 'Ubiquitous Paprika Greenhouse Management System' using WSN technology. The proposed system can collect and monitor information related to the growth environment of crops outside and inside paprika greenhouses by installing WSN sensors and monitoring images captured by CCTV cameras. In addition, the system provides a paprika greenhouse environment control facility for manual and automatic control from a distance, improves the convenience and productivity of users, and facilitates an optimized environment to grow paprika based on the growth environment data acquired by operating the system.

  18. Rangelands Vegetation under Different Management Systems and Growth Stages in North Darfur State, Sudan (Range Attributes

    Directory of Open Access Journals (Sweden)

    Mohamed AAMA Mohamed

    2014-09-01

    Full Text Available This study was conducted at Um Kaddada, North Darfur State, Sudan, at two sites (closed and open for two consecutive seasons 2008 and 2009 during flowering and seed setting stages to evaluate range attributes at the locality. A split plot design was used to study vegetation attributes. Factors studied were management systems (closed and open and growth stages (flowering and seed setting. Vegetation cover, plant density, carrying capacity, and biomass production were assessed. Chemical analyses were done for selected plants to determine their nutritive values. The results showed high significant differences in vegetation attributes (density, cover and biomass production between closed and open areas. Closed areas had higher carrying capacity compared to open rangelands. Crude protein (CP and ash contents of range vegetation were found to decrease while Crude fiber (CF and Dry matter yield (DM had increased with growth. The study concluded that closed rangelands are better than open rangelands because it fenced and protected. Erosion index and vegetation degradation rate were very high. Future research work is needed to assess rangelands characteristics and habitat condition across different ecological zones in North Darfur State, Sudan.DOI: http://dx.doi.org/10.3126/ije.v3i3.11093 International Journal of Environment Vol.3(3 2014: 332-343

  19. Sildenafil citrate for the management of fetal growth restriction and oligohydramnios

    Directory of Open Access Journals (Sweden)

    Choudhary R

    2016-08-01

    Full Text Available Rana Choudhary,1 Kavita Desai,2 Hetal Parekh,3 Kedar Ganla1 1Department of Reproductive Medicine, Ankoor Fertility Clinic, 2Department of Radiology, Dadar Imaging and Diagnostic Centre, 3IVF Department, Hiranandani Hospital, Mumbai, India Abstract: Fetal growth restriction (FGR and preeclampsia are the major causes of neonatal morbidity and mortality, which affect up to 8% of all pregnancies. The pathogenesis in FGR is an abnormal trophoblastic invasion leading to compromised uteroplacental circulation. However, in spite of this understanding and identification of high-risk patients, the management options are limited. There are some new studies which have demonstrated the role of sildenafil citrate in improving vasodilatation of small myometrial vessels and therefore improvement in amniotic fluid index, fetal weight, and even uterine and umbilical artery Doppler patterns. We report here the case of a 31-year-old female with infertility and preconceptional thin endometrium responding well to sildenafil citrate, followed by conception. However, she presented with an early-onset FGR at 26 weeks of gestation, and again after treatment with sildenafil citrate, showed improvement in amniotic fluid index and fetal weight, finally resulting in delivery of a full-term healthy baby with uneventful neonatal course. Keywords: sildenafil citrate, fetal growth restriction, oligohydramnios, thin endometrium

  20. A Wireless Sensor Network-Based Ubiquitous Paprika Growth Management System

    Directory of Open Access Journals (Sweden)

    Jeonghwan Hwang

    2010-12-01

    Full Text Available Wireless Sensor Network (WSN technology can facilitate advances in productivity, safety and human quality of life through its applications in various industries. In particular, the application of WSN technology to the agricultural area, which is labor-intensive compared to other industries, and in addition is typically lacking in IT technology applications, adds value and can increase the agricultural productivity. This study attempts to establish a ubiquitous agricultural environment and improve the productivity of farms that grow paprika by suggesting a ‘Ubiquitous Paprika Greenhouse Management System’ using WSN technology. The proposed system can collect and monitor information related to the growth environment of crops outside and inside paprika greenhouses by installing WSN sensors and monitoring images captured by CCTV cameras. In addition, the system provides a paprika greenhouse environment control facility for manual and automatic control from a distance, improves the convenience and productivity of users, and facilitates an optimized environment to grow paprika based on the growth environment data acquired by operating the system.

  1. The effect of a urinary incontinence self-management program for older women in South Korea: A pilot study

    Directory of Open Access Journals (Sweden)

    Jennie C. De Gagne

    2015-03-01

    Conclusions: Implementation of a urinary incontinence self-management program was accompanied by improved outcomes for Korean older women living in rural communities who have scarce resources for urinary incontinence management and treatment. Urinary incontinence self-management education approaches have potential for widespread implementation in nursing practice.

  2. DIRAC universal pilots

    Science.gov (United States)

    Stagni, F.; McNab, A.; Luzzi, C.; Krzemien, W.; Consortium, DIRAC

    2017-10-01

    In the last few years, new types of computing models, such as IAAS (Infrastructure as a Service) and IAAC (Infrastructure as a Client), gained popularity. New resources may come as part of pledged resources, while others are in the form of opportunistic ones. Most but not all of these new infrastructures are based on virtualization techniques. In addition, some of them, present opportunities for multi-processor computing slots to the users. Virtual Organizations are therefore facing heterogeneity of the available resources and the use of an Interware software like DIRAC to provide the transparent, uniform interface has become essential. The transparent access to the underlying resources is realized by implementing the pilot model. DIRAC’s newest generation of generic pilots (the so-called Pilots 2.0) are the “pilots for all the skies”, and have been successfully released in production more than a year ago. They use a plugin mechanism that makes them easily adaptable. Pilots 2.0 have been used for fetching and running jobs on every type of resource, being it a Worker Node (WN) behind a CREAM/ARC/HTCondor/DIRAC Computing element, a Virtual Machine running on IaaC infrastructures like Vac or BOINC, on IaaS cloud resources managed by Vcycle, the LHCb High Level Trigger farm nodes, and any type of opportunistic computing resource. Make a machine a “Pilot Machine”, and all diversities between them will disappear. This contribution describes how pilots are made suitable for different resources, and the recent steps taken towards a fully unified framework, including monitoring. Also, the cases of multi-processor computing slots either on real or virtual machines, with the whole node or a partition of it, is discussed.

  3. Individual differences in regulatory mode moderate the effectiveness of a pilot mHealth trial for diabetes management among older veterans.

    Directory of Open Access Journals (Sweden)

    Michelle Dugas

    Full Text Available mHealth tools to help people manage chronic illnesses have surged in popularity, but evidence of their effectiveness remains mixed. The aim of this study was to address a gap in the mHealth and health psychology literatures by investigating how individual differences in psychological traits are associated with mHealth effectiveness. Drawing from regulatory mode theory, we tested the role of locomotion and assessment in explaining why mHealth tools are effective for some but not everyone. A 13-week pilot study investigated the effectiveness of an mHealth app in improving health behaviors among older veterans (n = 27 with poorly controlled Type 2 diabetes. We developed a gamified mHealth tool (DiaSocial aimed at encouraging tracking of glucose control, exercise, nutrition, and medication adherence. Important individual differences in longitudinal trends of adherence, operationalized as points earned for healthy behavior, over the course of the 13-week study period were found. Specifically, low locomotion was associated with unchanging levels of adherence during the course of the study. In contrast, high locomotion was associated with generally stronger adherence although it exhibited a quadratic longitudinal trend. In addition, high assessment was associated with a marginal, positive trend in adherence over time while low assessment was associated with a marginal, negative trend. Next, we examined the relationship between greater adherence and improved clinical outcomes, finding that greater adherence was associated with greater reductions in glycated hemoglobin (HbA1c levels. Findings from the pilot study suggest that mHealth technologies can help older adults improve their diabetes management, but a "one size fits all" approach may yield suboptimal outcomes.

  4. 'Real-world' atrial fibrillation management in Europe: observations from the 2-year follow-up of the EURObservational Research Programme-Atrial Fibrillation General Registry Pilot Phase.

    Science.gov (United States)

    Proietti, Marco; Laroche, Cécile; Opolski, Grzegorz; Maggioni, Aldo P; Boriani, Giuseppe; Lip, Gregory Y H

    2017-05-01

    Atrial fibrillation (AF) is commonly associated with a high risk of stroke, thromboembolism, and mortality. The 1-year follow-up of the EURObservational Research Programme-Atrial Fibrillation (EORP-AF) Pilot Registry demonstrated a high mortality but good outcomes with European Society of Cardiology guideline-adherent therapy. Whether these 'real-world' observations on patients managed by European cardiologists extend to 2 years remains uncertain. In this report from the EORP-AF General Registry Pilot Phase, we provide data on the 2-year follow-up outcomes. Consistent with the 1-year follow-up report, only a small proportion of patients were symptomatic (24.9%), with minor differences between the different AF subtypes. Persistence of oral anticoagulant (OAC) therapy remains high at 2-years, with ∼80% of patients treated with OAC. The prescribing rates of non-vitamin K antagonist oral anticoagulants are progressively increasing (13.7% at 2 years). Rate and rhythm control approaches remained consistent across the entire follow-up observation. Overall mortality rates remained high, with 5.0% of patients dead during the 2-year follow-up, mostly due to cardiovascular causes (61.8%). Atrial fibrillation readmissions were frequent, particularly related to arrhythmias and heart failure. On multivariate analyses, any cardiovascular reason for admission rather than AF was significantly associated with increased mortality during the 2-year follow-up. In this 2-year follow-up report from EORP-AF, mortality rates with AF remain high from cardiovascular causes, despite the high prevalent use of OAC. Improved management strategies to reduce major adverse outcomes in AF patients are needed. Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For permissions please email: journals.permissions@oup.com.

  5. Pilot project as enabler?

    DEFF Research Database (Denmark)

    Neisig, Margit; Glimø, Helle; Holm, Catrine Granzow

    pilot projects as enabler of transition. Aspects of how to create trust and deal with distrust during a transition are addressed. The transition in focus is the concept of New Public Management and how it is applied in the management of the Employment Service in Denmark. The transition regards......This article deals with a systemic perspective on transition. The field of study addressed is a pilot project as enabler of transition in a highly complex polycentric context. From a Luhmannian systemic approach, a framework is created to understand and address barriers of change occurred using...... the systemic change from a very control based and detailed regulated version of New Public Management towards a system allowing more flexibility and decentralized decision making empowering municipalities as well as employees own decision making...

  6. Functional and Radiographic Outcomes Following Growth-Sparing Management of Early-Onset Scoliosis.

    Science.gov (United States)

    Johnston, Charles E; Tran, Dong-Phuong; McClung, Anna

    2017-06-21

    In this study, we sought to evaluate radiographic, functional, and quality-of-life outcomes of patients who have completed growth-sparing management of early-onset scoliosis. This prospective study involved patients with early-onset scoliosis who underwent growth-sparing treatment and either "final" fusion or observation for ≥2 years since the last lengthening procedure. Demographics, radiographic parameters, pulmonary function test (PFT) values, and scores of patient-reported assessments (Early-Onset Scoliosis Questionnaire [EOSQ] and Scoliosis Research Society [SRS]-30) were obtained. At the most recent follow-up, patients performed 2 additional functional outcome tests: step-activity monitoring and a treadmill exercise-tolerance test. Twelve patients were evaluated as "graduates" of growth-sparing management of early-onset scoliosis (mean of 37 months since the most recent surgery). The major scoliosis curve measurement averaged 88° before treatment and 47° at the most recent follow-up. T1-S1 height increased from a mean of 22.3 cm to 34.7 cm and T1-T12 height, from 13.3 to 22.3 cm. At the most recent follow-up, the mean forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) as a percentage of the predicted volume were 52.1% and 55.3%, respectively, and were essentially unchanged from the earliest PFT that patients could perform (FEV1 = 53.8% of predicted and FVC = 53.5% of predicted). There was no difference between graduates and controls with respect to activity time or total steps in step-activity monitoring, and in the exercise-tolerance test, graduates walked at the same speed but at a higher heart rate and at a significantly higher (p scoliosis appears to be spine elongation and maintenance of pulmonary function at a level that is no less than the percentage of normal at initial presentation. Functional testing and patient-reported outcomes at a mean of 3 years from the last surgery suggest that activity levels were generally equal

  7. Ecological factors influencing growth of the endangered Hawaiian fern Marsilea villosa (Marsileaceae) and implications for conservation management.

    Science.gov (United States)

    Chau, Marian M; Reyes, Whitney R; Ranker, Tom A

    2013-08-01

    Conserving endangered plants is a complex task, and practitioners must often use a "triage" approach, addressing only immediate needs. Ecologists can improve this process by conducting sound science upon which to base management. Marsilea villosa is an endangered, endemic Hawaiian fern with seven remaining populations in ephemerally flooding drylands. Among its uncommon traits are long-lived sporocarps, requiring flood and drought to complete its sexual life cycle, and extensive vegetative growth. We conducted a 3-yr ecological field study, measuring percent cover of M. villosa and associated species, flooding depth, and canopy cover, to identify ecological factors with the greatest impact on M. villosa growth. Maximum flooding depth and canopy cover had strong positive relationships with M. villosa growth, and all plots with >50% threshold of either variable reached 100% cover of M. villosa by the end of the study. Interaction effects explained nuances of these relationships, including synergy between the two variables. Percent cover of nonnative functional groups (graminoids and nongraminoids) each had negative relationships with M. villosa growth, but interactions showed that nongraminoid cover was driven by particular species, and that time since flooding had greater influence on M. villosa growth than graminoid cover. We recommend planting reintroduced populations in flood-prone areas with moderate shade, experimental outplanting of native plants with M. villosa, and management of graminoids as a functional group, while nongraminoid management should be species-specific. These practices will promote self-sustaining populations and reduce the need for labor-intensive management.

  8. Going for growth: improvement in the infrastructural and management support for clinical academic research.

    Science.gov (United States)

    Fowler Davis, Sally

    2015-01-01

    Our objective was to implement a directorate research strategy to improve and grow clinical academic capacity and capability and ensure that the organisational systems and processes enabled clinical staff and managers to increase grant capture, undertake clinically relevant research, including the adoption of NIHR portfolio sites and established a culture in which research was an accepted part of professional practice. An initial evaluation of senior and middle manager attitudes and understanding of the research infrastructure and benefits of research identified that the directorate had a deeply segmented view of research and only a partial view of how research could benefit patients and improve their services. A significant number of staff claimed to be research active but this activity was not contributing to the service knowledge or being translated into grant capture, leading to income that could be used to invest in patient facing research. Few managers had appreciated the challenge of implementing the research strategy or the potential of enabling research active staff to generate clinical academic careers. A quality improvement methodology was adopted, based on four equally important elements [1]; involving people (staff and patients) in research, developing people's research knowledge and skills, promoting an understanding of the complex systems and processes associated with research, and using an organisational research strategy with leadership to drive change. This improvement method suggests an equal and proportional range of activity to engage staff, amend and adapt processes and systems, carry out organisational change and "make it a habit". The improvement measures were selected by a number of managers who acted as "research champions" and shared these with all staff across the directorate; the focus was on delivering sustained improvements in performance targets agreed with the organisation. The interventions were introduced to assist managers in

  9. Case management for at-risk elderly patients in the English integrated care pilots: observational study of staff and patient experience and secondary care utilisation

    Directory of Open Access Journals (Sweden)

    Martin Roland

    2012-07-01

    Full Text Available Introduction: In 2009, the English Department of Health appointed 16 integrated care pilots which aimed to provide better integrated care. We report the quantitative results from a multi-method evaluation of six of the demonstration projects which used risk profiling tools to identify older people at risk of emergency hospital admission, combined with intensive case management for people identified as at risk. The interventions focused mainly on delivery system redesign and improved clinical information systems, two key elements of Wagner's Chronic Care Model. Methods: Questionnaires to staff and patients. Difference-in-differences analysis of secondary care utilisation using data on 3,646 patients and 17,311 matched controls, and changes in overall secondary care utilisation. Results: Most staff thought that care for their patients had improved. More patients reported having a care plan but they found it significantly harder to see a doctor or nurse of their choice and felt less involved in decisions about their care. Case management interventions were associated with a 9% increase in emergency admissions. We found some evidence of imbalance between cases and controls which could have biased this estimate, but simulations of the possible effect of unobserved confounders showed that it was very unlikely that the sites achieved their goal of reducing emergency admissions. However, we found significant reductions of 21% and 22% in elective admissions and outpatient attendance in the six months following an intervention, and overall inpatient and outpatient costs were significantly reduced by 9% during this period. Area level analyses of whole practice populations suggested that overall outpatient attendances were significantly reduced by 5% two years after the start of the case management schemes. Conclusion: Case management may result in improvements in some aspects of care and has the potential to reduce secondary care costs. However, to improve

  10. Case management for at-risk elderly patients in the English integrated care pilots: observational study of staff and patient experience and secondary care utilisation

    Directory of Open Access Journals (Sweden)

    Martin Roland

    2012-07-01

    Full Text Available Introduction: In 2009, the English Department of Health appointed 16 integrated care pilots which aimed to provide better integrated care. We report the quantitative results from a multi-method evaluation of six of the demonstration projects which used risk profiling tools to identify older people at risk of emergency hospital admission, combined with intensive case management for people identified as at risk. The interventions focused mainly on delivery system redesign and improved clinical information systems, two key elements of Wagner's Chronic Care Model.Methods: Questionnaires to staff and patients. Difference-in-differences analysis of secondary care utilisation using data on 3,646 patients and 17,311 matched controls, and changes in overall secondary care utilisation.Results: Most staff thought that care for their patients had improved. More patients reported having a care plan but they found it significantly harder to see a doctor or nurse of their choice and felt less involved in decisions about their care. Case management interventions were associated with a 9% increase in emergency admissions. We found some evidence of imbalance between cases and controls which could have biased this estimate, but simulations of the possible effect of unobserved confounders showed that it was very unlikely that the sites achieved their goal of reducing emergency admissions. However, we found significant reductions of 21% and 22% in elective admissions and outpatient attendance in the six months following an intervention, and overall inpatient and outpatient costs were significantly reduced by 9% during this period. Area level analyses of whole practice populations suggested that overall outpatient attendances were significantly reduced by 5% two years after the start of the case management schemes.Conclusion: Case management may result in improvements in some aspects of care and has the potential to reduce secondary care costs. However, to improve

  11. A pilot randomized controlled trial of a self-management group intervention for people with early-stage dementia (The SMART study).

    Science.gov (United States)

    Quinn, Catherine; Toms, Gill; Jones, Carys; Brand, Andrew; Edwards, Rhiannon Tudor; Sanders, Fiona; Clare, Linda

    2016-05-01

    Self-management equips people to manage the symptoms and lifestyle changes that occur in long-term health conditions; however, there is limited evidence about its effectiveness for people with early-stage dementia. This pilot randomized controlled trial (RCT) explored the feasibility of a self-management intervention for people with early-stage dementia. The participants were people with early-stage dementia (n = 24) and for each participant a caregiver also took part. Participants were randomly allocated to either an eight-week self-management group intervention or treatment as usual (TAU). Assessments were conducted at baseline, three months and six months post-randomization by a researcher blind to group allocation. The primary outcome measure was self-efficacy score at three months. Thirteen people with dementia were randomized to the intervention and 11 to TAU. Two groups were run, the first consisting of six people with dementia and the second of seven people with dementia. There was a small positive effect on self-efficacy with the intervention group showing gains in self-efficacy compared to the TAU group at three months (d = 0.35), and this was maintained at six months (d = 0.23). In terms of intervention acceptability, attrition was minimal, adherence was good, and satisfaction ratings were high. Feedback from participants was analyzed with content analysis. The findings suggest the positive aspects of the intervention were that it fostered independence and reciprocity, promoted social support, offered information, and provided clinician support. This study has provided preliminary evidence that self-management may be beneficial for people with early-stage dementia.

  12. Influence of dietary component manipulation and feed management strategies on growth and rumen development of weaned dairy heifers

    OpenAIRE

    Dennis, Tana Shea

    2016-01-01

    Well-developed replacement heifers provide a central foundation for the continued success of the dairy industry. Emphasis on improving pre-weaned calf nutrition has predominated in the industry, but opportunities exist to improve post-weaning heifer nutrition and management. We aimed to evaluate common feed management strategies seen in the industry and their effects on growth, feed efficiency (G:F), and rumen development of calves from birth to 8 mo of age using pen- and individually-fed ani...

  13. Hospital management practices and availability of surgery in sub-Saharan Africa: a pilot study of three hospitals.

    Science.gov (United States)

    Funk, Luke M; Conley, Dante M; Berry, William R; Gawande, Atul A

    2013-11-01

    Sub-Saharan Africa has a high surgical burden of disease but performs a disproportionately low volume of surgery. Closing this surgical gap will require increased surgical productivity of existing systems. We examined specific hospital management practices in three sub-Saharan African hospitals that are associated with surgical productivity and quality. We conducted 54 face-to-face, structured interviews with administrators, clinicians, and technicians at a teaching hospital, district hospital, and religious mission hospital across two countries in sub-Saharan Africa. Questions focused on recommended general management practices within five domains: goal setting, operations management, talent management, quality monitoring, and financial oversight. Records from each interview were analyzed in a qualitative fashion. Each hospital's management practices were scored according to the degree of implementation of the management practices (1 = none; 3 = some; 5 = systematic). The mission hospital had the highest number of employees per 100 beds (226), surgeons per operating room (3), and annual number of operations per operating room (1,800). None of the three hospitals had achieved systematic implementation of management practices in all 14 measures. The mission hospital had the highest total management score (44/70 points; average = 3.1 for each of the 14 measures). The teaching and district hospitals had statistically significantly lower management scores (average 1.3 and 1.1, respectively; p hospital management practices in low resource settings. We observed substantial variation in implementation of basic management practices at the three hospitals. Future research should focus on whether enhancing management practices can improve surgical capacity and outcomes.

  14. Pilot Implementations

    DEFF Research Database (Denmark)

    Manikas, Maria Ie

    This PhD dissertation engages in the study of pilot (system) implementation. In the field of information systems, pilot implementations are commissioned as a way to learn from real use of a pilot system with real data, by real users during an information systems development (ISD) project and before...... the final system is implemented. Among others, their use is argued to investigate the fit between the technical design and the organisational use. But what is a pilot implementation really? In this dissertation, I set out to address this conceptual question. I initially investigate this question....... The analysis is conducted by means of a theoretical framework that centres on the concept infrastructure. With infrastructure I understand the relation between organised practice and the information systems supporting this practice. Thus, infrastructure is not a thing but a relational and situated concept...

  15. Efficacy and Safety of a Novel Autologous Wound Matrix in the Management of Complicated, Chronic Wounds: A Pilot Study.

    Science.gov (United States)

    Kushnir, Igal; Kushnir, Alon; Serena, Thomas E; Garfinkel, Doron

    2016-09-01

    The objective of this pilot study was to evaluate the efficacy and safety of a novel method using an autologous whole blood clot formed with the RedDress Wound Care System (RD1, RedDress Ltd, Israel), a provisional whole blood clot matrix used in the treatment of chronic wounds of various etiologies. Patients were treated at the bedside with the whole blood clot matrix. Blood was withdrawn from each patient using citrate, mixed with a calcium gluconate/kaolin suspension, and injected into an RD1 clotting tray. Within 10 minutes, a clot was formed, placed upon the wound, and fixed with primary and secondary dressings. Wounds were redressed weekly with a whole blood clot matrix. Treatment was terminated when complete healing was achieved, or when the clinician determined that the wound could not further improve without additional invasive procedures. Seven patients with multiple and serious comorbidities and 9 chronic wounds were treated with 35 clot matrices. Complete healing was achieved in 7 of 9 wounds (78%). In 1 venous ulcer with a nonhealing fistula, 77% healing was achieved. Treatment was terminated in 1 pressure ulcer at 82% closure, because an unexpected mechanical trauma resulted in deterioration; this was the only adverse event reported, unrelated to the product. No systemic adverse events occurred. This pilot study demonstrates the in vitro autologous whole blood clot matrix is effective and safe for treating patients with chronic wounds of different etiologies. A larger clinical trial is needed to assess the relative success rate of the matrix in different types of wounds in a diverse population with comorbidities.

  16. Pilot study on growth parameters and nutritional biochemical markers in very low birth weight preterm infants fed human milk fortified with either human milk fortifier or post discharge formula.

    Science.gov (United States)

    Khorana, Meera; Jiamsajjamongkhon, Chanin

    2014-06-01

    Nutrition is an important aspect in the care of very low birth weight (VLBW) preterm infants. Human milk fortified with human milk fortifiers (HMF) is best for enteral feeding of premature infants. HMF is expensive and not easily available in Thailand. Post discharge formula (PDF) has been routinely used to fortify human milk at Queen Sirikit National Institute of Child Health (QSNICH) but there is lack of supportive data regarding efficacy and safety. To study and compare anthropometrics, biochemical markers and complications in VLBW infants fed human milk fortified with either HMF or PDF. This was a prospective, randomized pilot study conducted in the neonatal unit of QSNICH from 1 March 2010 to 28 February 2011. Very low birth weight neonates, whose mothers had adequate breast milk within 96 hours of birth, were enrolled in the study and received parenteral nutrition and enteral feeding as per protocol. Once the babies were feeding 100 cc/kg/day of human milk, they were randomly divided into two groups: the human milk fortified group (HMF group) and the post discharge formula fortified group (PDF group). Body weight was recorded daily while head circumference and length were recorded weekly. Hematocrit, Blood Urea Nitrogen (BUN), creatinine, electrolytes (including phosphorus and calcium), alkaline phosphatase and albumin were checked at the beginning of the study (feeding 100 cc/kg/day), 3 weeks later and when on full oral breast feeding or reached a weight of 2,000 grams, which ever came first. Thirty-eight infants were enrolled in the study but eventually only 33 remained (18 in HMF group, 15 in PDF group). Both groups had similar baseline demographic data, nutritional management, postnatal morbidities and length of stay. There were no statistically significant differences in growth parameters and serum biochemical markers between the groups. Definite NEC was not different between the groups. Other complications of prematurity including osteopenia of

  17. Supporting Regional Aged Care Nursing Staff to Manage Residents' Behavioural and Psychological Symptoms of Dementia, in Real Time, Using the Nurses' Behavioural Assistant (NBA): A Pilot Site 'End-User Attitudes' Trial.

    Science.gov (United States)

    Klein, Britt; Clinnick, Lisa; Chesler, Jessica; Stranieri, Andrew; Bignold, Adam; Dazeley, Richard; McLaren, Suzanne; Lauder, Sue; Balasubramanian, Venki

    2018-01-01

    This regional pilot site 'end-user attitudes' study explored nurses' experiences and impressions of using the Nurses' Behavioural Assistant (NBA) (a knowledge-based, interactive ehealth system) to assist them to better respond to behavioural and psychological symptoms of dementia (BPSD) and will be reported here. Focus groups were conducted, followed by a four-week pilot site 'end-user attitudes' trial of the NBA at a regional aged care residential facility (ACRF). Brief interviews were conducted with consenting nursing staff. Focus group feedback (N = 10) required only minor cosmetic changes to the NBA prototype. Post pilot site end-user interview data (N = 10) indicated that the regional ACRF nurses were positive and enthusiastic about the NBA, however several issues were also identified. Overall the results supported the utility of the NBA to promote a person centred care approach to managing BPSD. Slight modifications may be required to maximise its uptake across all ACRF nursing staff.

  18. Effect of water management and silicon on germination, growth, phosphorus and arsenic uptake in rice.

    Science.gov (United States)

    Zia, Zahida; Bakhat, Hafiz Faiq; Saqib, Zulfiqar Ahmad; Shah, Ghulam Mustafa; Fahad, Shah; Ashraf, Muhammad Rizwan; Hammad, Hafiz Mohkum; Naseem, Wajid; Shahid, Muhammad

    2017-10-01

    Silicon (Si) is the 2nd most abundant element in soil which is known to enhance stress tolerance in wide variety of crops. Arsenic (As), a toxic metalloid enters into the human food chain through contaminated water and food or feed. To alleviate the deleterious effect of As on human health, it is a need of time to find out an effective strategy to reduce the As accumulation in the food chain. The experiments were conducted during September-December 2014, and 2016 to optimize Si concentration for rice (Oryza sativa L.) exposed to As stress. Further experiment were carried out to evaluate the effect of optimum Si on rice seed germination, seedling growth, phosphorus and As uptake in rice plant. During laboratory experiment, rice seeds were exposed to 150 and 300µM As with and without 3mM Si supplementation. Results revealed that As application, decreased the germination up to 40-50% as compared to control treatment. Arsenic stress also significantly (P management, significantly (P˂0.05) affected the plant growth, Si and As concentrations in the plant. Arsenic uptake was relatively less under aerobic conditions. The maximum As concentration (9.34 and 27.70mgkg DW -1 in shoot and root, respectively) was found in plant treated with 300µM As in absence of Si under anaerobic condition. Similarly, anaerobic condition resulted in higher As uptake in the plants. The study demonstrated that aerobic cultivation is suitable to decrease the As uptake and in rice exogenous Si supply is beneficial to decrease As uptake under both anaerobic and aerobic conditions. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. Conflicts in urban fringe in the transformation era : An examination of performance of the metropolitan growth management in Beijing

    NARCIS (Netherlands)

    Zhao, Pengjun; Lue, Bin; Woltjer, Johan

    2009-01-01

    The performances of urban growth management are often criticized because their original objectives are frequently inconsistent with local development facts. Underlying the many reasons for this are the political and institutional contexts that influence policy-making and development activities. The

  20. The growth of academic spin-offs : the management team’s absorptive capacity and facilitator support

    NARCIS (Netherlands)

    Khodaei, H.

    2015-01-01

    The Growth of Academic Spin-offs The Management Team’s Absorptive Capacity and Facilitator Support Academic spin-offs are defined as new start-up firms that commercially exploit research developed within an academic environment to the benefit of economic,

  1. Public policies for managing urban growth and protecting open space: policy instruments and lessons learned in the United States

    Science.gov (United States)

    David N. Bengston; Jennifer O. Fletcher

    2003-01-01

    The public sector in the United States has responded to growing concern about the social and environmental costs of sprawling development patterns by creating a wide range of policy instruments designed to manage urban growth and protect open space. These techniques have been implemented at the local, regional, state and, to a limited extent, national levels. This...

  2. Ecological weed management by cover cropping : effects on weed growth in autumn and weed establishment in spring

    NARCIS (Netherlands)

    Kruidhof, H.M.; Bastiaans, L.; Kropff, M.J.

    2008-01-01

    Cover crops grown in the period between two main crops have potential as an important component of a system-oriented ecological weed management strategy. In late summer and autumn, the cover crop can suppress growth and seed production of weeds, whereas the incorporation of cover crop residues in

  3. Managing the Environmental Impacts of Growth Under Climate Change: A Workshop for State and Local Decision-Makers--Workshop Summary

    Science.gov (United States)

    From November 8/9, 2011, the U.S. Environmental Protection Agency (EPA) hosted a workshop titled "Managing the Environmental Impacts of Growth Under Climate Change." The Office of Research and Development (ORD) organized the meeting, which was held in Research Triangle Park, Nort...

  4. A pilot study on potential plasma hypoxia markers in the radiotherapy of non-small cell lung cancer. Osteopontin, carbonic anhydrase IX and vascular endothelial growth factor

    Energy Technology Data Exchange (ETDEWEB)

    Ostheimer, C.; Bache, M.; Guettler, A.; Vordermark, D. [Martin-Luther-University Halle-Wittenberg, Department of Radiation Oncology, Halle (Saale) (Germany); Kotzsch, M. [Technical University Dresden, Department of Pathology, Dresden (Germany)

    2014-03-15

    Hypoxic radioresistance plays a critical role in the radiotherapy of cancer and adversely impacts prognosis and treatment response. This prospective study investigated the interrelationship and the prognostic significance of several hypoxia-related proteins in non-small cell lung cancer (NSCLC) patients treated by radiotherapy ± chemotherapy. Pretreatment osteopontin (OPN), vascular endothelial growth factor (VEGF) and carbonic anhydrase IX (CA IX) plasma levels were determined by ELISA in 55 NSCLC (M0) patients receiving 66 Gy curative-intent radiotherapy or chemoradiation. Marker correlation, association with clinicopathological parameters and the prognostic value of a biomarker combination was evaluated. All biomarkers were linearly correlated and linked to different clinical parameters including lung function, weight loss (OPN), gross tumor volume (VEGF) and T stage (CA IX). High OPN (p = 0.03), VEGF (p = 0.02) and CA IX (p = 0.04) values were significantly associated with poor survival. Double marker combination additively increased the risk of death by a factor of 2 and high plasma levels of the triple combination OPN/VEGF/CA IX yielded a 5.9-fold risk of death (p = 0.009). The combined assessment of OPN/VEGF/CA IX correlated independently with prognosis (p = 0.03) in a multivariate Cox regression model including N stage, T stage and GTV. This pilot study suggests that a co-detection augments the prognostic value of single markers and that the integration of OPN, VEGF and CA IX into a hypoxic biomarker profile for the identification of patients with largely hypoxic and radioresistant tumors should be further evaluated. (orig.) [German] Hypoxische Radioresistenz spielt eine kritische Rolle in der Radiotherapie maligner Tumoren und beeinflusst Prognose und Therapieansprechen negativ. Diese prospektive Studie untersuchte den Zusammenhang und die prognostische Bedeutung einiger hypoxieassoziierter Proteine bei Patienten mit nicht-kleinzelligem Bronchialkarzinom

  5. An open-label pilot study of an intervention using mobile phones to deliver contingency management of tobacco abstinence to high school students.

    Science.gov (United States)

    Kong, Grace; Goldberg, Alissa L; Dallery, Jesse; Krishnan-Sarin, Suchitra

    2017-10-01

    This pilot study assessed the feasibility, acceptability, and preliminary efficacy of a smoking cessation intervention that used mobile phones to remotely deliver reinforcements contingent on tobacco abstinence (contingency management [CM]) and weekly in-person cognitive-behavioral therapy to adolescent smokers. Daily adolescent smokers (N = 15; 12 completed study procedures, 3 dropped out) were recruited to participate in a 4-week study. During the first 2 weeks, daily text messages sent at random times prompted participants to transmit a video of themselves providing a carbon monoxide (CO) sample. During the last 2 weeks, text messages sent on 3 randomly chosen days each week prompted participants to transmit a video of themselves providing a saliva sample. Negative samples (CO ≤8 ppm; cotinine ≤100 ng/ml) were reinforced with monetary incentives. Feasibility was assessed using the number of on-time, valid videos, and acceptability was determined using participant perceptions of the intervention. Seven-day point-prevalence (PP) abstinence (self-reported abstinence, cotinine mobile phones was feasible (85.8% of the CO videos and 67% of the saliva cotinine videos were on time) and acceptable (positive perceptions of the CM procedures). Seven-day PP was 60% at EOT and 46.7% at the follow-up. Although larger randomized controlled trials are needed to evaluate efficacy, this pilot study suggests that the use of mobile phones to deliver CM for smoking cessation among adolescent smokers was acceptable and feasible. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. An ICT and mobile health integrated approach to optimize patients' education on hypertension and its management by physicians: The Patients Optimal Strategy of Treatment(POST) pilot study.

    Science.gov (United States)

    Albini, Fabio; Xiaoqiu Liu; Torlasco, Camilla; Soranna, Davide; Faini, Andrea; Ciminaghi, Renata; Celsi, Ada; Benedetti, Matteo; Zambon, Antonella; di Rienzo, Marco; Parati, Gianfranco

    2016-08-01

    Uncontrolled hypertension is largely attributed to unsatisfactory doctor's engagement in its optimal management and to poor patients' compliance to therapeutic interventions. ICT and mobile Health solutions might improve these conditions, being widely available and providing highly effective communication strategies. To evaluate whether ICT and mobile Health tools are able to improve hypertension control by improving doctors' engagement and by increasing patients' education and involvement, and their compliance to lifestyle modification and prescribed drug therapy. In a pilot study, we have included 690 treated hypertensive patients with uncontrolled office blood pressure (BP), consecutively recruited by 9 general practitioners over 3 months. Patients were alternatively assigned to routine management based on repeated office visits or to an integrated ICT-based Patients Optimal Strategy for Treatment (POST) system including Home BP monitoring teletransmission, a dedicated web-based platform for patients' management by physicians (Misuriamo platform), and a smartphone mobile application (Eurohypertension APP, E-APP), over a follow-up of 6 months. BP values, demographic and clinical data were collected at baseline and at all follow-up visits (at least two). BP control and cardiovascular risk level have been evaluated at the beginning and at the end of the study. 89 patients did not complete the follow-up, thus data analysis was carried out in 601 of them (303 patients in the POST group and 298 in the control group). Office BP control (ICT based tools might be effective in improving hypertension management, implementing positive patients' involvement with better adherence to treatment prescriptions and providing the physicians with dynamic control of patients' home BP measurements, resulting in lesser clinical inertia.

  7. Land management on soil physical properties and maize (Zea mays L. var. BIMA) growth (An adaptation strategy of climate change)

    Science.gov (United States)

    Zaki, M. K.; Komariah; Pujiasmanto, B.; Noda, K.

    2018-03-01

    Water deficit is a problem on rainfed maize production but can be solved by proper land management. The objective of the study to determine the soil physical properties and maize yield affected by land management to adapt to drought. The experimental design was a randomized complete block using 5 treatments with 4 repetitions, including: (i) Control (KO), (ii) Rice Straw Mulched (MC), (iii) Compost Fertilizer (CF), (iv) In-Organic Fertilizer (AF), (v) Legume Cover crop (CC). Soil physical and maize growth properties namely soil moisture, soil texture, soil bulk density, plant height, biomass, and yield were investigated. The results showed that composting land increased soil water availability and provided nutrient to crops and thus increase soil physical properties, maize growth and yield. Although inorganic fertilizer also increased plant growth and yield, but it did not improve soil physical properties.

  8. Lay Health Trainers Supporting Self-Management amongst Those with Low Heath Literacy and Diabetes: Lessons from a Mixed Methods Pilot, Feasibility Study.

    Science.gov (United States)

    Bartlam, Bernadette; Rathod, Trishna; Rowlands, Gillian; Protheroe, Joanne

    2016-01-01

    This article reports a mixed methods process evaluation of a pilot feasibility randomised controlled trial comparing a Lay Health Trainer (LHT) intervention and usual care for those with poorly controlled Type 2 Diabetes Melitus (T2DM). Set in a deprived area in the UK, this research explores patient and health care practitioner (HCP) views on whether a structured interview between a patient and a Lay Health Trainer (LHT), for the purpose of developing a tailored self-management plan for patients, is acceptable and likely to change health behaviours. In doing so, it considers the implications for a future, randomised controlled trial (RCT). Participants were patients, LHTs delivering the intervention, service managers, and practice nurses recruiting patients to the study. Patients were purposively sampled on their responses to a baseline survey, and semistructured interviews were conducted within an exploratory thematic analysis framework. Findings indicate that the intervention is acceptable to patients and HCPs. However, LHTs found it challenging to work with older patients with long-term and/or complex conditions. In order to address this, given an ageing population and concomitant increases in those with such health needs, LHT training should develop skills working with these populations. The design of any future RCT intervention should take account of this.

  9. Pilot study investigating the utility of a specialized online symptom management program for individuals with myalgic encephalomyelitis/chronic fatigue syndrome as compared to an online meditation program

    Directory of Open Access Journals (Sweden)

    Arroll MA

    2014-09-01

    Full Text Available Megan A Arroll, Elizabeth A Attree, Claire L Marshall, Christine P DanceyChronic Illness Research Team, School of Psychology, University of East London, London, UKBackground: Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS is a long-term, debilitating condition that impacts numerous areas of individuals' lives. The two predominant treatment options for ME/CFS are cognitive behavioral therapy and graded exercise therapy; however, many people have found these techniques unacceptable or even damaging. This pilot study aimed to evaluate the utility of a specialized online symptom management program for ME/CFS in comparison to an online meditation program in an effort to ascertain whether this tool could be a further option for those with ME/CFS.Methods: This experimental design consisted of two interventions: a specialized online symptoms management program (N=19 and a control intervention based on an online meditation website (N=9. A battery of questionnaires, including measures of multidimensional fatigue, illness-specific symptoms, perceived control, and mindful awareness, were completed before the participants commenced use of the programs and following 8 weeks' use.Results: Significant differences were found in the areas of chance and powerful others' locus of control, and sleeping difficulties, but not in ME/CFS symptomatology overall.Conclusion: The specialized online program described in this study warrants further investigation, as it appears to influence perceived control and key ME/CFS symptoms over time.Keywords: ME/CFS, perceived control, sleep, outcomes, online intervention

  10. Pilot study to assess measures to be used in the prospective audit of the management of foot ulcers in people with diabetes.

    Science.gov (United States)

    Holman, N; Young, B; Stephens, H; Jeffcoate, W

    2015-01-01

    To design and test a methodology for assessing aspects of the management of foot disease in diabetes. A national working group devised pilot datasets that may be used to document the process of management of active ulceration. Participating volunteer specialist units throughout England were required to characterize newly presenting people with diabetic foot ulcers using a standard questionnaire comprising the dataset and to document outcomes at 6 and 12 months. Semi-structured interviews were later conducted with the volunteers at the units. A total of 23 units recorded baseline data on 652 people with incident foot ulcers; valid outcome data were available for 541 people (83.0%). Of the 541 index ulcers, 351 (64.9%) healed within 24 weeks, with a median time to healing of 63 days. Ulcer site and depth and peripheral arterial disease were associated with differing ulcer healing rates. By contrast, baseline demographic characteristics were not independently associated with healing. These were used to calculate a standardized case-mix adjusted healing ratio. In most units data collection took foot in diabetes, including the generation of meaningful service reports, but for general use the burden of local data collection will need to be reduced (e.g. by using linkage to existing national data collections). © 2014 The Authors. Diabetic Medicine © 2014 Diabetes UK.

  11. Effect of management factors and blood metabolites during the rearing period on growth in dairy heifers on UK farms.

    Science.gov (United States)

    Brickell, J S; McGowan, M M; Wathes, D C

    2009-02-01

    Growth rates during rearing affect the age and body weight (BW) of replacement heifers at first calving. Diet and disease can affect growth via altered metabolic hormone concentrations, but are difficult to monitor accurately on commercial farms. This study investigated the effect of management and metabolic indices (IGF-I, insulin, glucose and urea) on the growth rate of 509 Holstein-Friesian heifers on 19 UK dairy farms. Size (BW, heart girth, height and crown-rump length) was measured at approximately 1, 6 and 15 months. The mean daily weight gain up to 6 months for all calves was 0.77kg/day, with extreme variability both between cohorts of calves (range 0.49-1.02kg/day) and between individual calves within farms (range 0.45-1.13kg/day). Growth was enhanced by supplemental colostrum, by milk replacer as opposed to whole milk and by ad libitum milk feeding and was reduced by gradual weaning and dehorning after weaning. Larger group size slowed growth before weaning (>6 calves) but increased it post-weaning (>20 calves). These management differences were reflected in altered plasma IGF-I concentrations, which were positively associated with growth throughout the rearing period. Larger calves at 1 month had a greater weight gain up to 6 months. Sub-optimum growth of some heifers within each cohort was established at an early age and resulted in animals reaching the start of breeding at an inadequate size (BW range 209-498kg at 15 months). This could be alleviated by altered management strategies and improved monitoring of growing heifers.

  12. A social media intervention to improve hypoglycemia management at a multicenter hospital: a quality improvement pilot for clinical nurses.

    Science.gov (United States)

    De Sousa, Filomena; Jackson, Jennifer; Knight, Ruth; Cloutier, Edith; Basa, Rosemary; Fourney, Anne; Devecseri, Kathleen

    2018-02-01

    Hypoglycemia poses significant risk to inpatients. Nursing management of hypoglycemia is a challenge, despite established best practice guidelines. Social media is an effective tool for sharing information and could overcome barriers to clinical education at a multicenter hospital. The purpose of this quality improvement intervention was to create and disseminate social media posts about best practices in hypoglycemia management. An unmatched pre-and post-survey assessed nursing knowledge of hypoglycemia management. Social media posts were created to visually outline the steps for hypoglycemia management over 2 weeks, across a nursing social media platform. We assessed the reach of the posts via Facebook and a survey. The posts reached 2962 users during the first week, and 1491 users the second week. A social media intervention can have a substantial reach and distribute information across a multicenter hospital. Additional study is needed to determine what factors could support an increase in nursing knowledge through a social media campaign.

  13. Soil Salinity: Effect on Vegetable Crop Growth. Management Practices to Prevent and Mitigate Soil Salinization

    Directory of Open Access Journals (Sweden)

    Rui Manuel Almeida Machado

    2017-05-01

    Full Text Available Salinity is a major problem affecting crop production all over the world: 20% of cultivated land in the world, and 33% of irrigated land, are salt-affected and degraded. This process can be accentuated by climate change, excessive use of groundwater (mainly if close to the sea, increasing use of low-quality water in irrigation, and massive introduction of irrigation associated with intensive farming. Excessive soil salinity reduces the productivity of many agricultural crops, including most vegetables, which are particularly sensitive throughout the ontogeny of the plant. The salinity threshold (ECt of the majority of vegetable crops is low (ranging from 1 to 2.5 dS m−1 in saturated soil extracts and vegetable salt tolerance decreases when saline water is used for irrigation. The objective of this review is to discuss the effects of salinity on vegetable growth and how management practices (irrigation, drainage, and fertilization can prevent soil and water salinization and mitigate the adverse effects of salinity.

  14. The incidence and management of cutaneous adverse events of the epidermal growth factor receptor inhibitors

    Directory of Open Access Journals (Sweden)

    Witold Owczarek

    2017-10-01

    Full Text Available Overexpression of the epidermal growth factor receptor (EGFR is found in many cancers, including those of the head and neck area, non-small-cell lung cancer, and colorectal, cervical, prostate, breast, ovary, stomach, and pancreatic cancer. The EGFR inhibitors are used at present in the treatment of such cancers. Skin lesions that develop during and after cancer treatment may be due to specific cytostatics, molecular-targeted drugs, radiation therapy, complementary therapy, or the cancer itself, and hence knowledge is essential to distinguish between them. The mechanism through which skin toxicity arises during treatment with EGFR inhibitors is not well known, but seems to be due to the modification of the RAS/RAF/MEK/ERK signal path associated with its activation, which results in the similarity between the adverse effects of EGFR inhibitors and the treatment of melanoma with BRAF and MEK inhibitors. The most common side effects are pruritus, xerosis, papulopustular rash, hand-foot skin reaction, alopecia and dystrophy of the hair, and paronychia. This work presents options for prevention and suggestions for managing these adverse events, which are of importance in the care of patients undergoing oncological treatment.

  15. Management of adverse events during treatment of gastrointestinal cancers with epidermal growth factor inhibitors.

    Science.gov (United States)

    Hofheinz, Ralf-Dieter; Segaert, Siegfried; Safont, María José; Demonty, Gaston; Prenen, Hans

    2017-06-01

    The epidermal growth factor receptor (EGFR) is involved in development and progression of some gastrointestinal cancers, and is targeted by monoclonal antibodies (mAbs) and tyrosine kinase inhibitors (TKIs) used to treat these conditions. Targeted agents are generally better tolerated than conventional chemotherapy, but have characteristic toxicities that can affect adherence, dosing, and outcomes. Skin conditions are the most common toxicities associated with EGFR inhibitors, particularly papulopustular rash. Other common toxicities include mucosal toxicity, electrolyte imbalances (notably hypomagnesaemia), and diarrhoea, while the chimaeric mAb cetuximab is also associated with increased risk of infusion reactions. With appropriate prophylaxis, the incidence and severity of these events can be reduced, while management strategies tailored to the patient and the degree of toxicity can help to ensure continuation of anti-cancer therapy. Here, we review the main toxicities associated with EGFR-inhibiting mAbs and TKIs in patients with gastrointestinal cancers, and provide recommendations for prophylaxis and treatment. Copyright © 2017 The Authors. Published by Elsevier B.V. All rights reserved.

  16. Effects on Water Management and Quality Characteristics of Ozone Application in Chicory Forcing Process: A Pilot System

    Directory of Open Access Journals (Sweden)

    Carlo Nicoletto

    2017-04-01

    Full Text Available Agriculture is the largest user of world water resources, accounting for 70% of all consumption. Reducing water consumption and increasing water use efficiency in agriculture are two of the main challenges that need to be faced in the coming decades. Radicchio Rosso di Treviso Tardivo (RTT is a vegetable that requires a water forcing process prior to final commercialization which presents a significant environmental impact due to the high water volumes used and then dispersed into the environment. The experiment was aimed at reducing the water use in the forcing process of RTT, by developing a pilot system with recycled water in a closed loop through ozone treatment. Concerning water quality, the redox potential value was higher in the ozonized system, whereas turbidity, pH and electrical conductivity of the ozonized system did not change significantly from the control. Yield and quality of plants obtained in the ozonized system did not significantly differ from the control plants except for the antioxidant activity that was higher in plants forced using the water treated with ozone. Our initial results suggest that the ozone treatment could be applied in the forcing process and is suitable for growers, saving up to 95% of water volumes normally used for this cultivation practice.

  17. Post-fire wood management alters water stress, growth, and performance of pine regeneration in a Mediterranean ecosystem

    Science.gov (United States)

    Maranon-Jimenez, Sara; Castro, Jorge; Querejeta, José Ignacio; Fernandez-Ondono, Emilia; Allen, Craig D.

    2013-01-01

    Extensive research has focused on comparing the impacts of post-fire salvage logging versus those of less aggressive management practices on forest regeneration. However, few studies have addressed the effects of different burnt-wood management options on seedling/sapling performance, or the ecophysiological mechanisms underlying differences among treatments. In this study, we experimentally assess the effects of post-fire management of the burnt wood on the growth and performance of naturally regenerating pine seedlings (Pinus pinaster). Three post-fire management treatments varying in degree of intervention were implemented seven months after a high-severity wildfire burned Mediterranean pine forests in the Sierra Nevada, southeast Spain: (a) “No Intervention” (NI, all burnt trees left standing); (b) “Partial Cut plus Lopping” (PCL, felling most of the burnt trees, cutting off branches, and leaving all the biomass on site without mastication); and (c) “Salvage Logging” (SL, felling the burnt trees, piling up the logs and masticating the fine woody debris). Three years after the fire, the growth, foliar nutrient concentrations, and leaf carbon, nitrogen and oxygen isotopic composition (δ13C, δ18O and δ15N) of naturally regenerating seedlings were measured in all the treatments. Pine seedlings showed greatest vigor and size in the PCL treatment, whereas growth was poorest in SL. The nutrient concentrations were similar among treatments, although greater growth in the two treatments with residual wood present indicated higher plant uptake. Seedlings in the SL treatment showed high leaf δ13C and δ18O values indicating severe water stress, in contrast to significantly alleviated water stress indications in the PCL treatment. Seedling growth and physiological performance in NI was intermediate between that of PCL and SL. After six growing seasons, P. pinaster saplings in PCL showed greater growth and cone production than SL saplings. In summary

  18. Aging and Cardiometabolic Risk in European HEMS Pilots: An Assessment of Occupational Old-Age Limits as a Regulatory Risk Management Strategy.

    Science.gov (United States)

    Bauer, Hans; Nowak, Dennis; Herbig, Britta

    2017-12-11

    Old-age limits are imposed in some occupations in an effort to ensure public safety. In aviation, the "Age 60 Rule" limits permissible flight operations conducted by pilots aged 60 and over. Using a retrospective cohort design, we assessed this rule's validity by comparing age-related change rates of cardiometabolic incapacitation risk markers in European helicopter emergency medical service (HEMS) pilots near age 60 with those in younger pilots. Specifically, individual clinical, laboratory, and electrocardiogram (ECG)-based risk markers and an overall cardiovascular event risk score were determined from aeromedical examination records of 66 German, Austrian, Polish, and Czech HEMS pilots (average follow-up 8.52 years). Risk marker change rates were assessed using linear mixed models and generalized additive models. Body mass index increases over time were slower in pilots near age 60 compared to younger pilots, and fasting glucose levels increased only in the latter. Whereas the lipid profile remained unchanged in the latter, it improved in the former. An ECG-based arrhythmia risk marker increased in younger pilots, which persisted in the older pilots. Six-month risk of a fatal cardiovascular event (in or out of cockpit) was estimated between 0% and 0.3%. Between 41% and 95% of risk marker variability was due to unexplained time-stable between-person differences. To conclude, the cardiometabolic risk marker profile of HEMS pilots appears to improve over time in pilots near age 60, compared to younger pilots. Given large stable interindividual differences, we recommend individualized risk assessment of HEMS pilots near age 60 instead of general grounding. © 2017 Society for Risk Analysis.

  19. Training opioid addiction treatment providers to adopt contingency management: A prospective pilot trial of a comprehensive implementation science approach.

    Science.gov (United States)

    Becker, Sara J; Squires, Daniel D; Strong, David R; Barnett, Nancy P; Monti, Peter M; Petry, Nancy M

    2016-01-01

    Few prospective studies have evaluated theory-driven approaches to the implementation of evidence-based opioid treatment. This study compared the effectiveness of an implementation model (Science to Service Laboratory; SSL) to training as usual (TAU) in promoting the adoption of contingency management across a multisite opioid addiction treatment program. We also examined whether the SSL affected putative mediators of contingency management adoption (perceived innovation characteristics and organizational readiness to change). Sixty treatment providers (39 SSL, 21 TAU) from 15 geographically diverse satellite clinics (7 SSL, 8 TAU) participated in the 12-month study. Both conditions received didactic contingency management training and those in the predetermined experimental region received 9 months of SSL-enhanced training. Contingency management adoption was monitored biweekly, whereas putative mediators were measured at baseline, 3 months, and 12 months. Relative to providers in the TAU region, treatment providers in the SSL region had comparable likelihood of contingency management adoption in the first 20 weeks of the study, and then significantly higher likelihood of adoption (odds ratios = 2.4-13.5) for the remainder of the study. SSL providers also reported higher levels of one perceived innovation characteristic (Observability) and one aspect of organizational readiness to change (Adequacy of Training Resources), although there was no evidence that the SSL affected these putative mediators over time. Results of this study indicate that a fully powered randomized trial of the SSL is warranted. Considerations for a future evaluation are discussed.

  20. Evaluation of a train-the-trainer program for stable coronary artery disease management in community settings: A pilot study.

    Science.gov (United States)

    Shen, Zhiyun; Jiang, Changying; Chen, Liqun

    2018-02-01

    To evaluate the feasibility and effectiveness of conducting a train-the-trainer (TTT) program for stable coronary artery disease (SCAD) management in community settings. The study involved two steps: (1) tutors trained community nurses as trainers and (2) the community nurses trained patients. 51 community nurses attended a 2-day TTT program and completed questionnaires assessing knowledge, self-efficacy, and satisfaction. By a feasibility and non-randomized control study, 120 SCAD patients were assigned either to intervention group (which received interventions from trained nurses) or control group (which received routine management). Pre- and post-intervention, patients' self-management behaviors and satisfaction were assessed to determine the program's overall impact. Community nurses' knowledge and self-efficacy improved (PSCAD management in community settings in China was generally feasible and effective, but many obstacles remain including patients' noncompliance, nurses' busy work schedules, and lack of policy supports. Finding ways to enhance the motivation of community nurses and patients with SCAD are important in implementing community-based TTT programs for SCAD management; further multicenter and randomized control trials are needed. Copyright © 2017 Elsevier B.V. All rights reserved.

  1. A pilot study using "apps" as a novel strategy for the management of challenging behaviors seen in people living in residential care.

    Science.gov (United States)

    Loi, Samantha M; Mazur, Angela; Huppert, David; Hoy, Bernadette; Swan, Jodie; Lautenschlager, Nicola T

    2017-04-01

    Many adults living in residential care will demonstrate challenging behaviors. Non-pharmacological strategies are recommended as first-line treatment. Using applications (apps) is a novel approach to managing these behaviors, and has yet to be assessed in this group. This paper describes a pilot study to test apps as a novel non-pharmacological strategy to manage challenging behaviors in adults living in residential care. A non-blinded, non-randomized crossover trial design was implemented which compared apps to a control situation and usual care to determine whether apps were able to decrease challenging behaviors. The primary outcome measure was the Neuropsychiatric Inventory (NPI) that measures the frequency and severity of these behaviors. Fifteen residents participated whose mean age was 78.5 years. There were a range of diagnoses and comorbidities, including dementia and schizophrenia. IPads were used as the medium for delivering the apps and residential care staff implemented the interventions. There was a significant decrease in the total NPI score using the apps intervention (10.6 points) compared to the control (17.7 points) and to usual care (21.1 points). There was positive qualitative feedback from the staff who were involved in the study, but they also cited barriers such as lack of confidence using the apps and lack of time. Although this was a small and limited study, results suggest that using apps may be a feasible and personalized approach to managing challenging behaviors. A more rigorous study design that includes larger sample sizes and staff training may enable further research and benefits in this area.

  2. Physical Activity Self-Management and Coaching Compared to Social Interaction in Huntington Disease: Results From the ENGAGE-HD Randomized, Controlled Pilot Feasibility Trial.

    Science.gov (United States)

    Busse, Monica; Quinn, Lori; Drew, Cheney; Kelson, Mark; Trubey, Rob; McEwan, Kirsten; Jones, Carys; Townson, Julia; Dawes, Helen; Tudor-Edwards, Rhiannon; Rosser, Anne; Hood, Kerenza

    2017-06-01

    Self-management and self-efficacy for physical activity is not routinely considered in neurologic rehabilitation. This study assessed feasibility and outcomes of a 14-week physical activity self-management and coaching intervention compared with social contact in Huntington disease (HD) to inform the design of a future full-scale trial. Assessor blind, multisite, randomized pilot feasibility trial. Participants were recruited and assessed at baseline, 16 weeks following randomization, and then again at 26 weeks in HD specialist clinics with intervention delivery by trained coaches in the participants' homes. People with HD were allocated to the ENGAGE-HD physical activity coaching intervention or a social interaction intervention. Eligibility, recruitment, retention, and intervention participation were determined at 16 weeks. Other outcomes of interest included measures of mobility, self-efficacy, physical activity, and disease-specific measures of motor and cognition. Fidelity and costs for both the physical activity and social comparator interventions were established. Forty percent ( n = 46) of eligible patients were enrolled; 22 were randomized to the physical intervention and 24 to social intervention. Retention rates in the physical intervention and social intervention were 77% and 92%, respectively. Minimum participation criteria were achieved by 82% of participants in the physical intervention and 100% in the social intervention. There was no indication of between-group treatment effects on function; however, increases in self-efficacy for exercise and self-reported levels of physical activity in the physical intervention lend support to our predefined intervention logic model. The use of self-report measures may have introduced bias. An HD physical activity self-management and coaching intervention is feasible and worthy of further investigation. © 2017 American Physical Therapy Association

  3. A study protocol for a pilot randomised trial of a structured education programme for the self-management of type 2 diabetes for adults with intellectual disabilities.

    Science.gov (United States)

    Taggart, Laurence; Coates, Vivien; Clarke, Mike; Bunting, Brendan; Davies, Melanie; Carey, Marian; Northway, Ruth; Brown, Michael; Truesdale-Kennedy, Maria; Martin-Stacey, Lorraine; Scott, Gillian; Karatzias, Thanos

    2015-04-10

    The need for structured education programmes for type 2 diabetes is a high priority for many governments around the world. One such national education programme in the United Kingdom is the DESMOND Programme, which has been shown to be robust and effective for patients in general. However, these programmes are not generally targeted to people with intellectual disabilities (ID), and robust evidence on their effects for this population is lacking. We have adapted the DESMOND Programme for people with ID and type 2 diabetes to produce an amended programme known as DESMOND-ID. This protocol is for a pilot trial to determine whether a large-scale randomised trial is feasible, to test if DESMOND-ID is more effective than usual care in adults with ID for self-management of their type 2 diabetes, in particular as a means to reduce glycated haemoglobin (Hb1Ac), improve psychological wellbeing and quality of life and promote a healthier lifestyle. This protocol describes the rationale, methods, proposed analysis plan and organisational and administrative details. This trial is a two arm, individually randomised, pilot trial for adults with ID and type 2 diabetes, and their family and/or paid carers. It compares the DESMOND-ID programme with usual care. Approximately 36 adults with mild to moderate ID will be recruited from three countries in the United Kingdom. Family and/or paid carers may also participate in the study. Participants will be randomly assigned to one of two conditions using a secure computerised system with robust allocation concealment. A range of data will be collected from the adults with ID (biomedical, psychosocial and self-management strategies) and from their carers. Focus groups with all the participants will assess the acceptability of the intervention and the trial. The lack of appropriate structured education programmes and educational materials for this population leads to secondary health conditions and may lead to premature deaths. There are

  4. Randomized controlled pilot study of an educational video plus telecare for the early outpatient management of musculoskeletal pain among older emergency department patients.

    Science.gov (United States)

    Platts-Mills, Timothy F; Hollowell, Allison G; Burke, Gary F; Zimmerman, Sheryl; Dayaa, Joseph A; Quigley, Benjamin R; Bush, Montika; Weinberger, Morris; Weaver, Mark A

    2018-01-05

    Musculoskeletal pain is a common reason for emergency department (ED) visits. Following discharge from the ED, patients, particularly older patients, often have difficulty controlling their pain and managing analgesic side effects. We conducted a pilot study of an educational video about pain management with and without follow-up telephone support for older adults presenting to the ED with musculoskeletal pain. ED patients aged 50 years and older with musculoskeletal pain were randomized to: (1) usual care, (2) a brief educational video only, or (3) a brief educational video plus a protocol-guided follow-up telephone call from a physician 48-72 hours after discharge (telecare). The primary outcome was the change from the average pain severity before the ED visit to the average pain severity during the past week assessed one month after the ED visit. Pain was assessed using a 0-10 numerical rating scale. Of 75 patients randomized (mean age 64 years), 57 (76%) completed follow up at one month. Of the 18 patients lost to follow up, 12 (67%) had non-working phone numbers. Among patients randomized to the video (arms 2 and 3), 46/50 viewed the entire video; among the 25 patients randomized to the video plus telecare (arm 3), 23 were reached for telecare. Baseline pain scores for the usual care, video, and video plus telecare groups were 7.3, 7.1, and 7.5. At one month, pain scores were 5.8, 4.9, and 4.5, corresponding to average decreases in pain of -1.5, -2.2, and -3.0, respectively. In the pairwise comparison between intervention groups, the video plus telecare group had a 1.7-point (95% CI 1.2, 2.1) greater decrease in pain compared to usual care, and the video group had a 1.1-point (95% CI 0.6, 1.6) greater decrease in pain compared to usual care after adjustment for baseline pain, age, and gender. At one month, clinically important differences were also observed between the video plus telecare and usual care groups for analgesic side effects, ongoing opioid use

  5. Assessing the effects of management on forest growth across France: insights from a new functional-structural model.

    Science.gov (United States)

    Guillemot, Joannès; Delpierre, Nicolas; Vallet, Patrick; François, Christophe; Martin-StPaul, Nicolas K; Soudani, Kamel; Nicolas, Manuel; Badeau, Vincent; Dufrêne, Eric

    2014-09-01

    The structure of a forest stand, i.e. the distribution of tree size features, has strong effects on its functioning. The management of the structure is therefore an important tool in mitigating the impact of predicted changes in climate on forests, especially with respect to drought. Here, a new functional-structural model is presented and is used to assess the effects of management on forest functioning at a national scale. The stand process-based model (PBM) CASTANEA was coupled to a stand structure module (SSM) based on empirical tree-to-tree competition rules. The calibration of the SSM was based on a thorough analysis of intersite and interannual variability of competition asymmetry. The coupled CASTANEA-SSM model was evaluated across France using forest inventory data, and used to compare the effect of contrasted silvicultural practices on simulated stand carbon fluxes and growth. The asymmetry of competition varied consistently with stand productivity at both spatial and temporal scales. The modelling of the competition rules enabled efficient prediction of changes in stand structure within the CASTANEA PBM. The coupled model predicted an increase in net primary productivity (NPP) with management intensity, resulting in higher growth. This positive effect of management was found to vary at a national scale across France: the highest increases in NPP were attained in forests facing moderate to high water stress; however, the absolute effect of management on simulated stand growth remained moderate to low because stand thinning involved changes in carbon allocation at the tree scale. This modelling approach helps to identify the areas where management efforts should be concentrated in order to mitigate near-future drought impact on national forest productivity. Around a quarter of the French temperate oak and beech forests are currently in zones of high vulnerability, where management could thus mitigate the influence of climate change on forest yield.

  6. Successful long-term management of spasticity in patients with multiple sclerosis using a software application (APP): A pilot study.

    Science.gov (United States)

    Ehling, Rainer; Edlinger, Michael; Hermann, Kay; Dröge, Kerstin; Seidinger, Yvonne; Miller, Ursula; Alber, Hannes Franz; Brenneis, Christian

    2017-10-01

    Spasticity is a very common syndrome in patients with multiple sclerosis (pwMS), but available treatments lead to sufficient symptom control only in one third. To investigate the impact of an individualized training program on improving spasticity in a prospective pilot trial in pwMS suffering from moderate spasticity (defined as ≥ 4 on a normative rating scale; NRS). PwMS were familiarized with predefined exercises targeting spasticity while undergoing inpatient rehabilitation (IR). After IR, 20 pwMS were 1:1 randomized either to a newly designed APP-based home therapy program providing suitable exercises on a daily basis or to a paper-based home therapy program for 3 months. At month 3, all patients received the APP-based home program for another 3 months. Degree of spasticity was rated on the NRS. Undergoing inpatient rehabilitation for a mean of 32 days led to a significant reduction in spasticity in pwMS (p = 0.00). Further self-training with the APP-based home program for 3 months led to 1.2 lower mean NRS as compared to training with the conventional paper-based program (p = 0.09). Spasticity was found to be on low levels again in both groups after 6 months. In pwMS, an individually tailored anti-spasticity program delivered by a software APP is a feasible tool for increasing long-term adherence to self-training thereby positively impacting spasticity in pwMS. Copyright © 2017 Elsevier B.V. All rights reserved.

  7. Hands-free image capture, data tagging and transfer using Google Glass: a pilot study for improved wound care management.

    Science.gov (United States)

    Aldaz, Gabriel; Shluzas, Lauren Aquino; Pickham, David; Eris, Ozgur; Sadler, Joel; Joshi, Shantanu; Leifer, Larry

    2015-01-01

    Chronic wounds, including pressure ulcers, compromise the health of 6.5 million Americans and pose an annual estimated burden of $25 billion to the U.S. health care system. When treating chronic wounds, clinicians must use meticulous documentation to determine wound severity and to monitor healing progress over time. Yet, current wound documentation practices using digital photography are often cumbersome and labor intensive. The process of transferring photos into Electronic Medical Records (EMRs) requires many steps and can take several days. Newer smartphone and tablet-based solutions, such as Epic Haiku, have reduced EMR upload time. However, issues still exist involving patient positioning, image-capture technique, and patient identification. In this paper, we present the development and assessment of the SnapCap System for chronic wound photography. Through leveraging the sensor capabilities of Google Glass, SnapCap enables hands-free digital image capture, and the tagging and transfer of images to a patient's EMR. In a pilot study with wound care nurses at Stanford Hospital (n=16), we (i) examined feature preferences for hands-free digital image capture and documentation, and (ii) compared SnapCap to the state of the art in digital wound care photography, the Epic Haiku application. We used the Wilcoxon Signed-ranks test to evaluate differences in mean ranks between preference options. Preferred hands-free navigation features include barcode scanning for patient identification, Z(15) = -3.873, p Haiku, the SnapCap System was preferred for sterile image-capture technique, Z(16) = -3.873, p < 0.001, r = 0.68. Responses were divided with respect to image quality and overall ease of use. The study's results have contributed to the future implementation of new features aimed at enhancing mobile hands-free digital photography for chronic wound care.

  8. Macrophyte growth module for the SWAT model – impact of climate change and management on stream ecology

    DEFF Research Database (Denmark)

    Lu, Shenglan; Trolle, Dennis; Erfurt, Jytte

    To access how multiple stressors affect the water quantity and quality and stream ecology at catchment scale under various management and climate change scenarios, we implemented macrophyte growth modules for the Soil and Water Assessment Tool version 2012 (SWAT). The macrophyte growth module...... originates from the INCA-P model (Wade et al. 2002) with an addition of nitrogen stress. In addition, a benthic sediment layer and interaction of nutrients between sediment layer and water column were implemented. The new modules were validated against macrophyte biomass measurements in several Danish...

  9. Sustainable rangeland management, economic growth, and a cautious role for the SRM

    Science.gov (United States)

    Interest in the art and science of rangeland management increased dramatically during the 20th century and it was out of this interest that the profession of rangeland management was born. As public interest in rangeland management grew, so did the number, breadth, and depth of rangeland management ...

  10. Promoting Service User Inclusion in Risk Assessment and Management: A Pilot Project Developing a Human Rights-Based Approach

    Science.gov (United States)

    Greenhill, Beth; Whitehead, Richard

    2011-01-01

    Recent reports highlight the extent to which many people with learning disabilities are not afforded access to their basic human rights. In addition, traditional approaches to risk management often focus on professional assessments of risks and challenging behaviour and exclude service user perspectives. In this paper, we outline what we believe…

  11. A virtual reality apartment as a measure of medication management skills in patients with schizophrenia: a pilot study.

    Science.gov (United States)

    Kurtz, Matthew M; Baker, Elizabeth; Pearlson, Godfrey D; Astur, Robert S

    2007-09-01

    Performance on a novel, virtual reality (VR) assessment of medication management skills, the Virtual Reality Apartment Medication Management Assessment (VRAMMA), was investigated in 25 patients with schizophrenia and 18 matched healthy controls. The VRAMMA is a virtual 4-room apartment consisting of a living room with an interactive clock and TV, a bedroom, a kitchen, and a bathroom with an interactive medicine cabinet. After an exploratory phase, participants were given a mock prescription regimen to be taken 15 minutes later from pill bottles located in the medicine cabinet in the bathroom of the virtual environment. The VRAMMA was administered with a validated measure of medication management skills, several neurocognitive tests, and a symptom scale. Results revealed that (1) schizophrenic patients made significantly more quantitative errors in the number of pills taken, were less accurate at taking the prescribed medications at the designated time, and checked the interactive clock less frequently than healthy controls; (2) in patients with schizophrenia, there was significant agreement in classification of adherence vs nonadherence between a validated measure of medication management skills and the VRAMMA; and (3) in patients with schizophrenia, years of education and a measure of verbal learning and memory were linked to quantitative errors on the VRAMMA, while positive symptoms, specifically delusional symptoms, were inversely linked to distance traveled within the VRAMMA. This is the first study, to our knowledge, to provide evidence for the utility of VR technology in the assessment of instrumental role functioning in patients with schizophrenia.

  12. A Pilot Competency Matrix for Data Management Skills: A Step toward the Development of Systematic Data Information Literacy Programs

    Directory of Open Access Journals (Sweden)

    Megan R. Sapp Nelson

    2017-02-01

    Full Text Available Initial work in identifying data management or data information literacy skills generally went as far as identifying a list of proposed competencies without further differentiation between those competencies, whether by discipline, complexity, or use case. This article describes a significant innovation upon existing competencies by identifying a scaffolding (built upon existing competencies that moves students progressively from undergraduate training through post graduate coursework and research to post-doctoral work and into the early years of data stewardship. The scaffolding ties together existing research that has been completed in research data management skills and data information literacy with research into the outcomes that are desirable for individuals to present in data management at each of the levels of education. Competencies are aligned according to application (personal, team, research enterprise in such a way that the skills attained at the undergraduate level give students moving on to graduate work greater familiarity with data management and therefore greater likelihood of success at the graduate and then post graduate and data steward levels.

  13. Mobile Phone Short Message Service (SMS for Weight Management in Iranian Overweight and Obese Women: A Pilot Study

    Directory of Open Access Journals (Sweden)

    Somayeh Faghanipour

    2013-01-01

    Full Text Available We conducted a text message-based intervention for weight management over three months by two months intervention and one month wash-out period. In a quasi-experimental study with control ( and experimental group (, 80 overweight and obese employed women were entered. Participants were recruited via announcement. All subjects attended a face-to-face information session and received a booklet that contained food calorie chart and strategies and recommendations for weight management. The experimental group received text messages (SMS about weight management twice a day for two months, in addition to the information and the booklet which they had received in the information session. Also, the experimental group was instructed to weekly self-weight and to send the data to the principle researcher. All subjects were measured for baseline and secondary weight in a standardized manner by a nurse, and the data were compared between the two groups. Experimental group lost more weight than the control group (1.5 kg difference, . Text messaging seems to be an effective channel of communication for weight management in Iranian overweight and obese women. The clinical trial registration number is IRCT201204029360N1.

  14. [Extended medical quality management exemplified by the tracer diagnosis multiple trauma. Pilot study in the air rescue service].

    Science.gov (United States)

    Helm, M; Hauke, J; Schlafer, O; Schlechtriemen, T; Lampl, L

    2012-02-01

    Adequate prehospital and inhospital primary care is a decisive factor in the successful treatment of multiple trauma patients. For optimization of treatment algorithms the implementation of a medical quality management is of utmost importance. The aim of this study was to extend quality management by including data on process quality. A retrospective study of primary rescue missions of the Helicopter Emergency Medical Service (HEMS) Christoph 22 in Ulm over a period of 2.5 years was performed. In a detailed analysis of filter criteria, in which relevant deviations from the recommendations (not fulfilled in  > 10% of the cases) occurred, process data was included (vital data, measurements and events). In the study population (n = 298, males 71.8%, mean age 39.8 ± 21.8 years) 2 filter criteria were identified in which relevant deviations where observed: time management where prehospital treatment time  ≤ 60 min in 36% of the cases was not fulfilled and circulatory management where the systolic blood pressure, detected with Riva-Rocci method (RR(sys))  ≥ 120 mmHg on hospital admission in patients with severe head trauma was not fulfilled in 45% of the cases. In patients with deviations in time management, prehospital treatment time was prolonged (75.6 ± 18.3 min versus 50.5 ± 6.7 min; p < 0.01) caused by a prolonged on scene attendance time (34.1 ± 22.1 min versus 20.6 ± 9.2 min; p < 0.01) and transport time (17.3 ± 9.4 min versus 13.3 ± 4.8 min; p < 0.01). In entrapment trauma prehospital treatment time was expanded (44% versus 10%; p < 0.01). Patients in whom circulatory management deviations were observed were more often in shock on arrival at the scene (RR(sys)  ≤ 90 mmHg: 60% versus 30%; p < 0.01), more often hypoxemic [pulse oximeter oxygen saturation (S(p)O(2)) ≤ 90%: 36% versus 19%; p < 0.05] and more often sustained a trauma to the chest as well as to chest and abdomen/pelvis (69% versus 52% and 42% versus 28%, respectively; p < 0

  15. Store manager performance and satisfaction: effects on store employee performance and satisfaction, store customer satisfaction, and store customer spending growth.

    Science.gov (United States)

    Netemeyer, Richard G; Maxham, James G; Lichtenstein, Donald R

    2010-05-01

    Based on emotional contagion theory and the value-profit chain literatures, the present study posits a number of hypotheses that show how managers in the small store, small number of employees retail context may affect store employees, customers, and potentially store performance. With data from 306 store managers, 1,615 store customer-contact employees, and 57,656 customers of a single retail chain, the authors examined relationships among store manager job satisfaction and job performance, store customer-contact employee job satisfaction and job performance, customer satisfaction with the retailer, and a customer-spending-based store performance metric (customer spending growth over a 2-year period). Via path analysis, several hypothesized direct and interaction relations among these constructs are supported. The results suggest implications for academic researchers and retail managers. PsycINFO Database Record (c) 2010 APA, all rights reserved.

  16. Hands-free image capture, data tagging and transfer using Google Glass: a pilot study for improved wound care management.

    Directory of Open Access Journals (Sweden)

    Gabriel Aldaz

    Full Text Available Chronic wounds, including pressure ulcers, compromise the health of 6.5 million Americans and pose an annual estimated burden of $25 billion to the U.S. health care system. When treating chronic wounds, clinicians must use meticulous documentation to determine wound severity and to monitor healing progress over time. Yet, current wound documentation practices using digital photography are often cumbersome and labor intensive. The process of transferring photos into Electronic Medical Records (EMRs requires many steps and can take several days. Newer smartphone and tablet-based solutions, such as Epic Haiku, have reduced EMR upload time. However, issues still exist involving patient positioning, image-capture technique, and patient identification. In this paper, we present the development and assessment of the SnapCap System for chronic wound photography. Through leveraging the sensor capabilities of Google Glass, SnapCap enables hands-free digital image capture, and the tagging and transfer of images to a patient's EMR. In a pilot study with wound care nurses at Stanford Hospital (n=16, we (i examined feature preferences for hands-free digital image capture and documentation, and (ii compared SnapCap to the state of the art in digital wound care photography, the Epic Haiku application. We used the Wilcoxon Signed-ranks test to evaluate differences in mean ranks between preference options. Preferred hands-free navigation features include barcode scanning for patient identification, Z(15 = -3.873, p < 0.001, r = 0.71, and double-blinking to take photographs, Z(13 = -3.606, p < 0.001, r = 0.71. In the comparison between SnapCap and Epic Haiku, the SnapCap System was preferred for sterile image-capture technique, Z(16 = -3.873, p < 0.001, r = 0.68. Responses were divided with respect to image quality and overall ease of use. The study's results have contributed to the future implementation of new features aimed at enhancing mobile hands-free digital

  17. Hands-Free Image Capture, Data Tagging and Transfer Using Google Glass: A Pilot Study for Improved Wound Care Management

    Science.gov (United States)

    Aldaz, Gabriel; Shluzas, Lauren Aquino; Pickham, David; Eris, Ozgur; Sadler, Joel; Joshi, Shantanu; Leifer, Larry

    2015-01-01

    Chronic wounds, including pressure ulcers, compromise the health of 6.5 million Americans and pose an annual estimated burden of $25 billion to the U.S. health care system. When treating chronic wounds, clinicians must use meticulous documentation to determine wound severity and to monitor healing progress over time. Yet, current wound documentation practices using digital photography are often cumbersome and labor intensive. The process of transferring photos into Electronic Medical Records (EMRs) requires many steps and can take several days. Newer smartphone and tablet-based solutions, such as Epic Haiku, have reduced EMR upload time. However, issues still exist involving patient positioning, image-capture technique, and patient identification. In this paper, we present the development and assessment of the SnapCap System for chronic wound photography. Through leveraging the sensor capabilities of Google Glass, SnapCap enables hands-free digital image capture, and the tagging and transfer of images to a patient’s EMR. In a pilot study with wound care nurses at Stanford Hospital (n=16), we (i) examined feature preferences for hands-free digital image capture and documentation, and (ii) compared SnapCap to the state of the art in digital wound care photography, the Epic Haiku application. We used the Wilcoxon Signed-ranks test to evaluate differences in mean ranks between preference options. Preferred hands-free navigation features include barcode scanning for patient identification, Z(15) = -3.873, p < 0.001, r = 0.71, and double-blinking to take photographs, Z(13) = -3.606, p < 0.001, r = 0.71. In the comparison between SnapCap and Epic Haiku, the SnapCap System was preferred for sterile image-capture technique, Z(16) = -3.873, p < 0.001, r = 0.68. Responses were divided with respect to image quality and overall ease of use. The study’s results have contributed to the future implementation of new features aimed at enhancing mobile hands-free digital

  18. Growth performance, carcass yield and gait score of Marshal broiler chicken reared on intensive and semi intensive management systems

    Directory of Open Access Journals (Sweden)

    Oluwadiya, B. O.

    2017-06-01

    Full Text Available The rearing system used in highly productive farms is often subjected to harsh criticism, one of the reasons being its failure to provide adequate welfare. A number of attempts have been made to introduce new technologies in rearing poultry for meat production aiming at improving rearing conditions, protecting the environment and enhancing the quality of poultry products. Given the above, one hundred and sixty eight unsexed 14-day old Marshall broiler chicks were used in a completely randomized design study to compare the effect of management systems (intensive and semi intensive on the growth performance, carcass characteristics and gait score of broiler chickens. The experiment lasted for 42 d. Data were collected on weight gain, feed intake, feed conversion ratio, carcass yield and gait score. Result showed that birds on the intensive management system recorded higher weight gain (P 0.05; 66.94%, 11.44% than those in semi-intensive system (54.55%, 10.92%, respectively. For the gait score broiler birds on semi intensive management system recorded reduced number of cases of severe and slight leg problems (P < 0.05, 25.76% vs 49.3%. It was concluded that broiler birds should be reared on intensive management system for better growth performance and carcass yield. However, birds reared on semi intensive management system had fewer leg problems compared to birds reared on intensive management system. The fewer severe leg problems observed in birds on semi intensive management system will help improve their market value thereby making birds more profitable to rear on semi intensive management system.

  19. Pilot Greenhouse

    CERN Multimedia

    1983-01-01

    This pilot greenhouse was built in collaboration with the "Association des Maraichers" of Geneva in the frame of the study for making use of the heat rejected as warm water by CERN accelerators and experiments. Among other improvements, more automated and precise regulation systems for heating and ventilation were developed. See also 8305598X.

  20. Advanced Growth Factor Delivery Systems in Wound Management and Skin Regeneration.

    Science.gov (United States)

    Park, Jin Woo; Hwang, Seung Rim; Yoon, In-Soo

    2017-07-27

    Growth factors are endogenous signaling molecules that regulate cellular responses required for wound healing processes such as migration, proliferation, and differentiation. However, exogenous application of growth factors has limited effectiveness in clinical settings due to their low in vivo stability, restricted absorption through skin around wound lesions, elimination by exudation prior to reaching the wound area, and other unwanted side effects. Sophisticated systems to control the spatio-temporal delivery of growth factors are required for the effective and safe use of growth factors as regenerative treatments in clinical practice, such as biomaterial-based drug delivery systems (DDSs). The current review describes the roles of growth factors in wound healing, their clinical applications for the treatment of chronic wounds, and advances in growth factor-loaded DDSs for enhanced wound healing, focusing on micro- and nano-particulate systems, scaffolds, hydrogels, and other miscellaneous systems.

  1. The Feasibility of Health Trainer Improved Patient Self-Management in Patients with Low Health Literacy and Poorly Controlled Diabetes: A Pilot Randomised Controlled Trial

    Directory of Open Access Journals (Sweden)

    Joanne Protheroe

    2016-01-01

    Full Text Available Type 2 diabetes mellitus is most prevalent in deprived communities and patients with low health literacy have worse glycaemic control and higher rates of diabetic complications. However, recruitment from this patient population into intervention trials is highly challenging. We conducted a study to explore the feasibility of recruitment and to assess the effect of a lay health trainer intervention, in patients with low health literacy and poorly controlled diabetes from a socioeconomically disadvantaged population, compared with usual care. Methods. A pilot RCT comparing the LHT intervention with usual care. Patients with HbA1c > 7.5 (58 mmol/mol were recruited. Baseline and 7-month outcome data were entered directly onto a laptop to reduce patient burden. Results. 76 patients were recruited; 60.5% had low health literacy and 75% were from the most deprived areas of England. Participants in the LHT arm had significantly improved mental health (p=0.049 and illness perception (p=0.040. The intervention was associated with lower resource use, better patient self-care management, and better QALY profile at 7-month follow-up. Conclusion. This study describes successful recruitment strategies for hard-to-reach populations. Further research is warranted for this cost-effective, relatively low-cost intervention for a population currently suffering a disproportionate burden of diabetes, to demonstrate its sustained impact on treatment effects, health, and health inequalities.

  2. A hybrid froth flotation-filtration system as a pretreatment for oil sands tailings pond recycle water management: Bench- and pilot-scale studies.

    Science.gov (United States)

    Loganathan, Kavithaa; Bromley, David; Chelme-Ayala, Pamela; Gamal El-Din, Mohamed

    2015-09-15

    Through sustainable water management, oil sands companies are working to reduce their reliance on fresh water by minimizing the amount of water required for their operations and by recycling water from tailings ponds. This study was the first pilot-scale testing of a hybrid technology consisting of froth flotation combined with filtration through precoated submerged stainless steel membranes used to treat recycle water from an oil sands facility. The results indicated that the most important factor affecting the performance of the hybrid system was the influent water quality. Any rise in the levels of suspended solids or total organic carbon of the feed water resulted in changes of chemical consumption rates, flux rates, and operating cycle durations. The selections of chemical type and dosing rates were critical in achieving optimal performance. In particular, the froth application rate heavily affected the overall recovery of the hybrid system as well as the performance of the flotation process. Optimum surfactant usage to generate froth (per liter of treated water) was 0.25 mL/L at approximately 2000 NTU of influent turbidity and 0.015 mL/L at approximately 200 NTU of influent turbidity. At the tested conditions, the optimal coagulant dose was 80 mg/L (as Al) at approximately 2000 NTU of influent turbidity and recycle water. Copyright © 2015 Elsevier Ltd. All rights reserved.

  3. Self-management in early-stage dementia: a pilot randomised controlled trial of the efficacy and cost-effectiveness of a self-management group intervention (the SMART study).

    Science.gov (United States)

    Quinn, Catherine; Anderson, Daniel; Toms, Gill; Whitaker, Rhiannon; Edwards, Rhiannon Tudor; Jones, Carys; Clare, Linda

    2014-03-08

    The possibility of living well with a long-term condition has been identified as centrally relevant to the needs of people living with dementia. Growing numbers of people with early-stage dementia are contributing accounts that emphasise the benefits of actively engaging in managing the condition. Self-management interventions share the common objectives of educating about the condition, optimising well-being, enhancing control over the situation and enabling people to take more responsibility for managing the condition. Benefits of such an approach can include improved knowledge, self-efficacy, health status, and better performance of self-management behaviours. However, there is only preliminary evidence that people with early-stage dementia can benefit from such interventions. This feasibility study involves the development of a self-management group intervention for people with early-stage Alzheimer's disease, vascular dementia or mixed Alzheimer's and vascular dementia. This study is a single-site pilot randomised-controlled trial. Forty-two people with early stage dementia, each with a caregiver (family member/friend), will be randomised to either the self-management group intervention or to treatment as usual.The self-management group intervention will involve eight weekly sessions, each lasting 90 minutes, held at a memory clinic in North Wales. All participants will be re-assessed three and six months post-randomisation. This study is intended to supply an early evaluation of the self-management intervention so that a full scale trial may be powered from the best available evidence. It will assess the feasibility of the intervention, the study design and the recruitment strategies. It will estimate the parameters and confidence intervals for the research questions of interest. The primary outcome of interest is the self-efficacy score of the person with dementia at three months post-randomisation. Secondary outcomes for the person with dementia are self

  4. Pilot study comparing sepsis management with and without electronic clinical practice guidelines in an academic emergency department.

    Science.gov (United States)

    Bond, Christopher M; Djogovic, Dennis; Villa-Roel, Cristina; Bullard, Michael J; Meurer, David P; Rowe, Brian H

    2013-03-01

    Sepsis is a potentially life-threatening condition that requires urgent management in an Emergency Department (ED). Evidence-based guidelines for managing sepsis have been developed; however, their integration into routine practice is often incomplete. Care maps may help clinicians meet guideline targets more often. To determine if electronic clinical practice guidelines (eCPGs) improve management of patients with severe sepsis and septic shock (SS/SS). The impact of an eCPG on the management of patients presenting with SS/SS over a 3-year period at a tertiary care ED was evaluated using retrospective case-control design and chart review methods. Cases and controls, matched by age and sex, were chosen from an electronic database using physician sepsis diagnoses. Data were compared using McNemar tests or paired t-tests, as appropriate. Overall, 51 cases and controls were evaluated; the average age was 62 years, and 60% were male. eCPG patients were more likely to have a central venous pressure and central venous oxygen saturation measured; however, lactate measurement, blood cultures, and other investigations were similarly ordered (all p > 0.05). The administration of antibiotics within 3 h (63% vs. 41%; p = 0.03) and vasopressors (45% vs. 20%; p = 0.02) was more common in the eCPG group; however, use of corticosteroids and other interventions did not differ between the groups. Overall, survival was high and similar between groups. A sepsis eCPG experienced variable use; however, physicians using the eCPG achieved more quality-of-care targets for SS/SS. Strategies to increase the utilization of eCPGs in Emergency Medicine seem warranted. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Are They Fit For Purpose? Exploring Managers' Experiences of UK HR Graduates & Employability Implications: A Pilot Study

    OpenAIRE

    Mullen, Emma

    2014-01-01

    The purpose of this research is to expand on existing understandings of graduate employability through exploring the lived experiences and perceptions of key informants, in this case, those with direct line management responsibilities for graduates. The context of this research is focused on Human Resources (HR) graduates, a discipline that has seen little qualitative inquiry across the Higher Education (HE), employability and HR literature, and which is currently dominated by skills-led appr...

  6. Lao PDF Economic Monitor, September 2010 Update : Managing Macroeconomic Balances to Sustain High Economic Growth

    OpenAIRE

    World Bank

    2010-01-01

    Lao PDR economic growth continues to be strong in 2010, against the backdrop of a fragile global recovery yet dynamic regional demand. Growth is projected at 8.5 percent in 2010, from 7.5 percent in 2009. The resources sector is projected to contribute about 4 percentage points of economic growth, of which electricity, water and gas about 3.2 percentage points. This update reports mainly on ...

  7. Mating system, population growth, and management scenario for Kalanchoe pinnata in an invaded seasonally dry tropical forest.

    Science.gov (United States)

    González de León, Salvador; Herrera, Ileana; Guevara, Roger

    2016-07-01

    Ecological invasions are a major issue worldwide, where successful invasion depends on traits that facilitate dispersion, establishment, and population growth. The nonnative succulent plant Kalanchoe pinnata, reported as invasive in some countries, is widespread in remnants of seasonally dry tropical forest on a volcanic outcrop with high conservation value in east-central Mexico where we assessed its mating system and demographic growth and identified management strategies. To understand its local mating system, we conducted hand-pollination treatments, germination, and survival experiments. Based on the experimental data, we constructed a life-stage population matrix, identified the key traits for population growth, weighted the contributions of vegetative and sexual reproduction, and evaluated management scenarios. Hand-pollination treatments had slight effects on fruit and seed setting, as well as on germination. With natural pollination treatment, the successful germination of seeds from only 2/39 fruit suggests occasional effective natural cross-pollination. The ratios of the metrics for self- and cross-pollinated flowers suggest that K. pinnata is partially self-compatible. Most of the pollinated flowers developed into fruit, but the seed germination and seedling survival rates were low. Thus, vegetative propagation and juvenile survival are the main drivers of population growth. Simulations of a virtual K. pinnata population suggest that an intense and sustained weeding campaign will reduce the population within at least 10 years. Synthesis and applications. The study population is partially self-compatible, but sexual reproduction by K. pinnata is limited at the study site, and population growth is supported by vegetative propagation and juvenile survival. Demographic modeling provides key insights and realistic forecasts on invasion process and therefore is useful to design management strategies.

  8. The Pilot Staffing Conundrum: A Delphi Study

    Science.gov (United States)

    2009-06-01

    Project, AFIT/ GMO /LAL/98J-2. School of Logistics and Acquisition Management, Air Force Institute of Technology (AU), Wright Patterson AFB, OH, June...Kafer, John H. Relationship of Airline Pilot Demand and Air Force Pilot Retention. Graduate Research Project, AFIT/ GMO /LAL/98J-11. School of Logistics

  9. Reengineering Joint Specialized Undergraduate Pilot Training

    Science.gov (United States)

    2009-06-01

    involved the high-quality end-product. T-1 pilots flow into the heavy community with a heightened sense of Crew Resource Management ( CRM ) as well as...in the future and can be an investment for a 20 year career. Pilot training is a relatively safe environment, comparatively cheap , and instructor

  10. Pilot projects in Evidence Based Policy Making

    NARCIS (Netherlands)

    Vreugdenhil, H.S.I.; Ker Rault, P.A.

    2010-01-01

    In Evidence Based Policy Making, pilot projects have been recognized as important tools to develop ‘evidence’ of policy innovations. This paper presents a theoretical and empirical study of three water management pilot projects in the Rhine basin to deepen understanding of how they can contri-bute

  11. 77 FR 6619 - Community Advantage Pilot Program

    Science.gov (United States)

    2012-02-08

    ...-Site Examinations. SBA's Office of Credit Risk Management (OCRM) will evaluate the CA Lender's level of... Community Advantage Pilot Program loan applications (or requests for loan numbers submitted under a lender's... Advantage Lenders (``CA Lenders'') to pledge loans made under the CA Pilot Program (``CA loans'') as...

  12. Comparison of tissue plasminogen activator administration management between Telestroke Network hospitals and academic stroke centers: the Telemedical Pilot Project for Integrative Stroke Care in Bavaria/Germany.

    Science.gov (United States)

    Audebert, Heinrich J; Kukla, Christian; Vatankhah, Bijan; Gotzler, Berthold; Schenkel, Johannes; Hofer, Stephan; Fürst, Andrea; Haberl, Roman L

    2006-07-01

    Systemic thrombolysis is the only therapy proven to be effective for ischemic stroke. Telemedicine may help to extend its use. However, concerns remain whether management and safety of tissue plasminogen activator (tPA) administration after telemedical consultation are equivalent in less experienced hospitals compared with tPA administration in academic stroke centers. During the second year of the ongoing Telemedical Pilot Project for Integrative Stroke Care, all systemic thrombolyses in stroke patients of the 12 regional clinics and the 2 stroke centers were recorded prospectively. Patients' demographics, stroke severity (National Institutes of Health Stroke Scale), frequency of administration, time management, protocol violations, and safety were included in the analysis. In 2004, 115 of 4727 stroke or transient ischemic attack patients (2.4%) in the community hospitals and 110 of 1889 patients in the stroke centers (5.8%) received systemic thrombolysis. Prehospital latencies were shorter in the regional hospitals despite longer distances. Door to needle times were shorter in the stroke centers. Although blood pressure was controlled more strictly in community hospitals, symptomatic intracerebral hemorrhage rate (7.8%) was higher (P=0.14) than in stroke centers (2.7%) but still within the range of the National Institute of Neurological Disorders and Stroke trial. In-hospital mortality rate was low in community hospitals (3.5%) and in stroke centers (4.5%). Although with a lower rate of systemic thrombolysis, there was no evidence of lower treatment quality in the remote hospitals. With increasing numbers of tPA administration and growing training effects, the telestroke concept promises better coverage of systemic thrombolysis in nonurban areas.

  13. The state - local regulatory nexus in US growth management: claims of property and participation in the localist resistance

    OpenAIRE

    T A Clark

    1994-01-01

    Influenced possibly more by volume than substance, some scholars have concluded that significant progress is being realized in state-level land-use regulation in the United States. In truth, more time must pass before a definitive evaluation of the more comprehensive efforts can be made. In this critical paper I examine the statewide growth-management legislation of the four states having tripartite (local - regional - state) administrative hierarchies: Florida, Vermont, Maine, and Georgia. T...

  14. Establishing the natural history and growth rate of ameloblastoma with implications for management: systematic review and meta-analysis.

    Science.gov (United States)

    Chae, Michael P; Smoll, Nicolas R; Hunter-Smith, David J; Rozen, Warren Matthew

    2015-01-01

    Ameloblastoma is the second most common odontogenic tumor, known to be slow-growing, persistent, and locally aggressive. Recent data suggests that ameloblastoma is best treated with wide resection and adequate margins. Following primary excision, bony reconstruction is often necessary for a functional and aesthetically satisfactory outcome, making early diagnosis paramount. Despite earlier diagnosis potentially limiting the extent of resection and reconstruction, an understanding of the growth rate and natural history of ameloblastoma has been notably lacking from the literature. A systematic review of the literature was conducted by reviewing relevant articles from PubMed and Web of Science databases. Each article's level of evidence was formally appraised according to the Centre of Evidence Based Medicine (CEBM), with data from each utilized in a meta-analysis of growth rates for ameloblastoma. Literature regarding the natural history of ameloblastoma is limited since the tumor is immediately acted upon at its initial detection, unless the patient voluntarily refuses a surgical intervention. From the limited data, it is derived that the highest estimated growth rate is associated with solid, multicystic type and the lowest rate with peripheral ameloblastomas. After meta-analysis, the calculated mean specific grow rate is 87.84% per year. The growth rate of ameloblastoma has been demonstrated, offering prognostic and management information, particularly in cases where a delay in management is envisaged.

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

    Directory of Open Access Journals (Sweden)

    Abdullah S. Al Herbish

    2016-09-01

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

  16. Management of Maternal Cardiac Arrest in the Third Trimester of Pregnancy: A Simulation-Based Pilot Study

    Directory of Open Access Journals (Sweden)

    Jacquelyn Adams

    2016-01-01

    Full Text Available Objective. To evaluate confidence, knowledge, and competence after a simulation-based curriculum on maternal cardiac arrest in an Obstetrics & Gynecologic (OBGYN residency program. Methods. Four simulations with structured debriefing focusing on high yield causes and management of maternal cardiac arrest were executed. Pre- and post-individual knowledge tests (KT and confidence surveys (CS were collected along with group scores of critical performance steps evaluated by content experts for the first and final simulations. Results. Significant differences were noted in individual KT scores (pre: 58.9±8.9 versus post: 72.8±6.1, p=0.01 and CS total scores (pre: 22.2±6.4 versus post: 29.9±3.4, p=0.007. Significant differences were noted in airway management, p=0.008; appropriate cycles of drug/shock-CPR, p=0.008; left uterine displacement, p=0.008; and identifying causes of cardiac arrest, p=0.008. Nonsignificant differences were noted for administration of appropriate drugs/doses, p=0.074; chest compressions, p=0.074; bag-mask ventilation before intubation, p=0.074; and return of spontaneous circulation identification, p=0.074. Groups remained noncompetent in team leader tasks and considering therapeutic hypothermia. Conclusion. This study demonstrated improved OBGYN resident knowledge, confidence, and competence in the management of third trimester maternal cardiac arrest. Several skills, however, will likely require more longitudinal curricular exposure and training to develop and maintain proficiency.

  17. Soil-Site Factors Affecting Southern Upland Oak Managment and Growth

    Science.gov (United States)

    John K. Francis

    1980-01-01

    Soil supplies trees with physical support, moisture, oxygen, and nutrients. Amount of moisture most limits tree growth; and soil and topographic factors such as texture and aspect, which influence available soil moisture. are most useful in predicting growth. Equations that include soil and topographic variables can be used to predict site index. Foresters can also...

  18. Investigation of a growth model incorporating density dependence for the mackerel management plan simulations

    NARCIS (Netherlands)

    Brunel, T.P.A.

    2015-01-01

    This report presents a framework to model density dependent growth for the North East Atlantic mackerel. The model used is the classical von Bertalanffy equation, but modified so that growth is reduced when stock size increases. The model developed was able to reproduce quite closely the trends in

  19. Forming a Stress Management and Health Promotion Program for Women Undergoing Chemotherapy for Breast Cancer: A Pilot Randomized Controlled Trial.

    Science.gov (United States)

    Pelekasis, Panagiotis; Zisi, Georgia; Koumarianou, Anna; Marioli, Androniki; Chrousos, George; Syrigos, Konstantinos; Darviri, Christina

    2016-06-01

    To assess the effects of an 8-week stress management and health promotion program on women undergoing breast cancer chemotherapy treatment. Patients and methods A total of 61 patients were recruited in 2 cancer centers and were randomly assigned to the intervention program (n = 30) or control group (n = 31). The intervention program consisted of different stress management techniques, which were combined with instructions for lifestyle modification. Assessments were carried out through questionnaires and measurement of body mass index (BMI) at baseline and at the end of the 8-week program. In all, 25 participants completed the intervention program, whereas 28 participants completed the observational control program. The intervention program resulted in a small effect size on internal dimension of Health Locus of Control (HLC) and a medium effect size on stress, depression, anxiety, night sleep duration, and chance dimension of HLC. A strong effect size was recorded for BMI and sleep onset latency. Self-rated health, spiritual well-being, and powerful others dimension of HLC were not significantly affected. Additionally, some of the participants reported a reduction in the side effects caused by chemotherapy. The intervention resulted in several benefits for the general health status of patients. Therefore, it should be considered as feasible and potentially beneficial for women undergoing breast cancer chemotherapy. However, it is necessary for this intervention to be tested through a randomized controlled trial in a larger sample of patients before adopting this program in standard cancer care. © The Author(s) 2015.

  20. Functional Management Competence and Growth of Young Technology-Based Firms

    DEFF Research Database (Denmark)

    Salomo, Søren; Brinckmann, Jan; Talke, Katrin

    2008-01-01

    Acknowledging an increased research interest into the success factors for young technology-based firms in the last decade, the present study serves two main purposes. First, we aim at developing a comprehensive concept of functional management competence in young technology-based firms. Functional...... management competence covers the understanding of and proficiency in managing specific functional tasks (Katz, 1974). As we focus on young technology-based firms, it is suggested that marketing, financial and technology management tasks are at the core of functional management competence. Second, we aim...... based on partial least squares modelling to investigate the performance effects. The results suggest that functional management competences generally are significant drivers of firm development speed. In particular, technology and marketing management competences are shown to impact development speed...

  1. Pilot Implementation of Health Information Systems

    DEFF Research Database (Denmark)

    Bansler, Jørgen P.; Havn, Erling C.

    2009-01-01

    Pilot implementation is a powerful and widely used approach in identifying design flaws and implementation issues before the full-scale deployment of new health information systems. However, pilot implementations often fail in the sense that they say little about the usability and usefulness...... information system. Based on the findings from this study, we identify three main challenges: (1) defining an appropriate scope for pilot implementation, (2) managing the implementation process, and (3) ensuring commitment to the pilot. Finally, recommendations for future research and implications...... of the proposed system designs. This calls for studies that seek to uncover and analyze the reasons for failure, so that guidelines for conducting such pilots can be developed. In this paper, we present a qualitative field study of an ambitious, but unsuccessful pilot implementation of a Danish healthcare...

  2. The role of strategic management on small business growth in Kosova

    Directory of Open Access Journals (Sweden)

    Enver Kutllovci, Ph.D

    2013-07-01

    Full Text Available Small and medium enterprises (SMEs are considered to be the engine of economic growth through employment generation, contribution to GDP, technological innovations and other aspects of economic and social development. SMEs are also important because they are key drivers of employment and economic growth. The growth of SMEs depends on ability of those firms to apply strategic planning. In that context, strategic planning is very important for small and medium enterpriese in the time of global competition, technological change and increased dynamics in markets. Even if many entrepreneurs do not formulate business plans, the strategic planning and systematic decision-making can be considered a key determinant of survival and success of small firms. The paper examines the relationship between strategic planning and small and medium enterprises (SME growth in terms of empirical analyses that include various strategic planning elements.The study has practical implications. Entrepreneurs need to be aware that strategic planning practices, processes and techniques can be beneficial for growth of the firm. In order to enable their firms to grow, entrepreneurs may like to consider exactly formulating strategy, focusing on growth, profit, and market, among strategic analysis techniques paying special attention to analysis of market and competition and exactly formulating generic business strategies The key implication of this study for research is that the assessment of the relationship between strategic planning and small firm growth needs to be done across various elements or dimensions.

  3. Assessment of community pharmacists’ counselling skills on headache management by using the simulated patient approach: a pilot study

    Directory of Open Access Journals (Sweden)

    Lyra DP Jr

    2013-03-01

    Full Text Available Background: Headache, or cephalalgia, is one of the 20 most disabling diseases in the world and affects a large portion of the world’s population. People generally use over-the-counter medications to treat headaches and other minor symptoms. A pharmacist should help patients choose the most effective, safe, and convenient pharmacotherapeutic option. Objective: To assess the counselling skills of community pharmacists for headache management by using the simulated patient approach. Methods: A cross-sectional study was conducted from March 2010 to July 2010. Data were obtained from a convenience sample consisting of one pharmacist from each of the 24 participating community pharmacies. In order to evaluate the pharmacists’ counselling skills, a simulated patient role played a standardized headache case requesting self-medication. The interactions of the simulated patient with the pharmacists were audiovisually recorded using a hidden micro camera, and these recordings were analysed using a validated questionnaire. Results: Of the 24 evaluated pharmacists, 19 (79.1% were women. Information was spontaneously provided by 15 (62.5% pharmacists. At least one question was asked by the pharmacist to assess the signs and symptoms. Most pharmacists (n=17, 70.8% recommended sodium dipyrone, either alone or in combination with other drugs. The most discussed items in the simulation visits were contraindications (n=17, 70.8%, indications (n=10, 41.6%, and drug administration times (n=8, 33.3%. None of the pharmacists recommended any non-pharmacological therapeutic alternatives. The overall impressions of the pharmacists’ professional counselling skills ranged from poor to fair. Conclusion: This study showed that the pharmacists’ counselling skills and the guidance provided by the pharmacists to the simulated patient were insufficient for the satisfactory management of headache.

  4. A Pilot Study to Compare Oxidative Status between Organically and Conventionally Managed Dairy Cattle During the Transition Period.

    Science.gov (United States)

    Abuelo, A; Hernández, J; Benedito, J L; Castillo, C

    2015-08-01

    The aim of this study was to assess the redox balance of organically managed dairy cattle (OMC; n = 40) during the transition period and to compare this with conventionally managed cattle (CMC; n = 22). Serum samples of dairy cows from two organic and one conventional farm were taken. Markers of oxidants production [reactive oxygen species] and total serum antioxidant capacity were measured in four different production stages: (i) far-off dry (2 to 1 months before calving; 44 samples in CMC and 48 in OMC); (ii) close-up dry (1 month until 3 days before calving; 44 CMC; 54 OMC); (iii) fresh (3 days to +1 month after calving; 44 CMC; 49 OMC); and (iv) peak of lactation (+1 to +3 months; 71 CMC; 78 OMC). Values were compared between production stages and against a metabolic baseline status (4th-5th month of pregnancy; 40 CMC; 30 OMC). Our results indicated that throughout the periparturient period, OMC had lower concentrations of reactive oxygen species, but also a lower antioxidant capacity than CMC. Indeed, when the two components of the redox balance were assessed together through the Oxidative Stress index, the values of this parameter were higher for OMC than for CMC, thereby implying a higher risk of oxidative stress. Therefore, further larger studies are needed to confirm the current observations, as organically reared animals might be exposed to a lack of antioxidants supply. © 2015 Blackwell Verlag GmbH.

  5. A WebGIS service for managing, sharing and communicating information on mountain risks: a pilot study at the Barcelonnette Basin (South French Alps)

    Science.gov (United States)

    Frigerio, Simone; Skupinski, Grzegorz; Kappes, Melanie; Malet, Jean-Philippe; Puissant, Anne

    2010-05-01

    Integrative analysis, assessment and management of mountain hazards and risks require (1) the intense cooperation among scientists, local practitioners and stakeholders, (2) the compilation of multi-source GIS database on both the sources of the dangers and their impacts, and (3) the communication of scientific results which is still a challenge. Within the European project Mountain Risks and the French-research initiative OMIV (Multi-disciplinary Observatory on Slope Instabilities; http://eost.u-strasbg.fr/omiv), several approaches are under development aiming at a coherent communication of scientific results to the population in order to inform about hazards and risks and support practical risk management measures. A simple and user-friendly approach with a visual-web-based interface is proposed, able (1) to incorporate geographical information on past events and on controlling factors, (2) to include administrative boundaries and official risk regulation maps, and(3) to integrate all modeling results obtained in the study area (already performed or in progress). The possibility to share information by means of web services offers a double utility: firstly it is a way to decrease the gap between scientific community's results and stakeholders' practical needs (simple interface, easy-to-use buttons in a generally user-friendly approach). Secondly the wide collection of diverse information (records of historical events, conditioning and triggering factors, information on elements at risk and their vulnerability, modeling results) in combination with the possibility of comparison among the data offers a great support in the decision-making process. As first case study, the Barcelonnette Basin (South French Alps) has been chosen for the pilot development of the interface. The objective is to organize, manage and share a wide range of information and calibrate a correct web-service solution. Several steps are planned to achieve this goal: the creation of a

  6. The growth of a Society: a journey in the development of governance, management, and administration.

    Science.gov (United States)

    McIlroy, Russell F; Barr, David C A M

    2012-04-01

    A review of the history and development of the Urological Society of Australasia now the Urological Society of Australia and New Zealand. What's known on the subject? and What does the study add? The history of The Urological Society of Australasia was written by Sally Wilde and published by Hyland House in 1999.Whilst this documented geographical and numerical growth along with some structural changes, it did not discuss the change in and development of organisational structure. This paper describes how the growth of an organisation can at times proceed at a rate not matched by concurrent growth in organisational skill. The need for review of structure and the mechanism to affect change that matches and facilitates growth, together with some of the consequences are discussed. © 2012 THE AUTHORS. BJU INTERNATIONAL © 2012 BJU INTERNATIONAL.

  7. Active Job Monitoring in Pilots

    Science.gov (United States)

    Kuehn, Eileen; Fischer, Max; Giffels, Manuel; Jung, Christopher; Petzold, Andreas

    2015-12-01

    Recent developments in high energy physics (HEP) including multi-core jobs and multi-core pilots require data centres to gain a deep understanding of the system to monitor, design, and upgrade computing clusters. Networking is a critical component. Especially the increased usage of data federations, for example in diskless computing centres or as a fallback solution, relies on WAN connectivity and availability. The specific demands of different experiments and communities, but also the need for identification of misbehaving batch jobs, requires an active monitoring. Existing monitoring tools are not capable of measuring fine-grained information at batch job level. This complicates network-aware scheduling and optimisations. In addition, pilots add another layer of abstraction. They behave like batch systems themselves by managing and executing payloads of jobs internally. The number of real jobs being executed is unknown, as the original batch system has no access to internal information about the scheduling process inside the pilots. Therefore, the comparability of jobs and pilots for predicting run-time behaviour or network performance cannot be ensured. Hence, identifying the actual payload is important. At the GridKa Tier 1 centre a specific tool is in use that allows the monitoring of network traffic information at batch job level. This contribution presents the current monitoring approach and discusses recent efforts and importance to identify pilots and their substructures inside the batch system. It will also show how to determine monitoring data of specific jobs from identified pilots. Finally, the approach is evaluated.

  8. Management of small and medium size enterprises as a carrier of economic growth

    Directory of Open Access Journals (Sweden)

    Ožegović Lazar

    2012-01-01

    Full Text Available Numerous studies in the world of market economy show that the share of small and medium size enterprises is constantly increasing compared to large enterprises. This does not decrease the significance of large enterprises, but the dependence between them gets larger every day. National economies which manage to find the optimal combination between small, medium size and large enterprises are more successful than the others. Management of small and medium size enterprises (SMEs in conceptual terms is similar to the process of management of large enterprises. An organization must be managed in order to function and this rule applies to small and medium size enterprises.

  9. Ozone therapy as add-on treatment in fibromyalgia management by rectal insufflation: an open-label pilot study.

    Science.gov (United States)

    Hidalgo-Tallón, Javier; Menéndez-Cepero, Silvia; Vilchez, Juan S; Rodríguez-López, Carmen M; Calandre, Elena P

    2013-03-01

    The objectives of this study were to evaluate the effectiveness and tolerability of ozone therapy by rectal insufflation as add-on therapy in fibromyalgia management. Patients with fibromyalgia received 24 sessions of ozone therapy during a 12-week period. At each session, the administered dose of ozone was 8 mg (200 mL of gas, at a concentration of 40 μg/mL). Ozone sessions were given 5 days a week during the first 2 weeks, twice a week from weeks 3-6, and weekly from weeks 7-12. Fibromyalgia Impact Questionnaire (FIQ) was the main outcome measure, and was administered at baseline and at weeks 4, 8, and 12. Secondary outcome measures, administered at baseline and at endpoint, were the Pittsburgh Sleep Quality Index, the Beck Depression Inventory, the State and Trait Anxiety Inventory, and the SF-12, the abbreviated form of the Short Form Health Survey. Emergent adverse reactions to treatment were recorded. FIQ total scores decreased significantly during the study period, with the decrease being observed in the first 4 weeks of the study. Significant improvement was also seen both in depression scores and in the Physical Summary Score of the SF-12. Transient meteorism after ozone therapy sessions was the most frequently reported side-effect. At the dose and number of sessions used in this study, ozone therapy by rectal insufflation seems to be beneficial for physical symptoms and depression of fibromyalgia.

  10. Autonomous real-time adaptive management of soil salinity using a receding horizon control algorithm: a pilot-scale demonstration.

    Science.gov (United States)

    Park, Yeonjeong; Harmon, Thomas C

    2011-10-01

    Soil salinization is a potentially negative side effect of irrigation with reclaimed water. While optimization schemes have been applied to soil salinity control, these have typically failed to take advantage of real-time sensor feedback. This study incorporates current soil observation technologies into the optimal feedback-control scheme known as Receding Horizon Control (RHC) to enable successful autonomous control of soil salinization. RHC uses real-time sensor measurements, physically-based state prediction models, and optimization algorithms to drive field conditions to a desired environmental state by manipulating application rate or irrigation duration/frequency. A simulation model including the Richards equation coupled to energy and solute transport equations is employed as a state estimator. Vertical multi-sensor arrays installed in the soil provide initial conditions and continuous feedback to the control scheme. An optimization algorithm determines the optimal irrigation rate or frequency subject to imposed constraints protective of soil salinization. A small-scale field test demonstrates that the RHC scheme is capable of autonomously maintaining specified salt levels at a prescribed soil depth. This finding suggests that, given an adequately structured and trained simulation model, sensor networks, and optimization algorithms can be integrated using RHC to autonomously achieve water reuse and agricultural objectives while managing soil salinization. Copyright © 2011 Elsevier Ltd. All rights reserved.

  11. Connected Vehicle Pilot Deployment Program phase 1 : comprehensive deployment plan : New York City : volume 1 : technical application : part I : technical and management approach.

    Science.gov (United States)

    2016-08-01

    This document describes the Deployment Plan for the New York City Department of Transportation (NYC) Connected Vehicle Pilot Deployment (CVPD) Project. This plan describes the approach to complete Phase 2 Design/Build/Test, and Phase 3 Operate and Ma...

  12. Portfolio management: Finding growth opportunities in a restructured electricity marketplace. Final report

    International Nuclear Information System (INIS)

    Staley, J.; Patterson, A.; Gardner, T.

    1997-12-01

    Energy services companies are rapidly creating a wide array of new products and services for their customers. To penetrate the marketplace most effectively, however, these new offerings should be integrated into cohesive portfolios that meet the needs of key customer segments. This report explores the techniques of portfolio management and describes how this tool can help bring greater balance and focus to an energy provider's product and service portfolios. Portfolio management provides a process for initiating, overseeing, and exiting from diverse investments on the basis of not only the merits of each individual investment, but also the merits of those investments in combination. The principles of portfolio management can be applied to various types of investments, including those involving lines of business, new product initiatives, and project commitments. With the rapid transition to a more competitive environment, these types of market-oriented investments are receiving greater scrutiny in the energy services industry. Accordingly, portfolio management techniques are becoming increasingly important business tools. The project team considers three different categories of portfolio management within the context of the energy services industry. Passive portfolio management focuses on choosing the combination of products/services that will provide the most favorable trade-off of risk and return for a given risk tolerance. Balanced portfolio management provides a more aggressive set of techniques that look broadly at a company's multiple objectives and assist in deploying resources to achieve balance along multiple dimensions. Strategic portfolio management goes even further by helping to define a set of synergistic offerings that reinforce one another and the company's strategic direction. In this report the team also documents case studies of companies that profited from their portfolio management efforts and presents a project design for developing and

  13. An Interprofessional Learning Workshop for Mammography and Sonography Students Focusing on Breast Cancer Care and Management Via Simulation: A Pilot Study.

    Science.gov (United States)

    Giles, Eileen M; Parange, Nayana; Knight, Bronwyn

    2017-08-01

    The literature surrounding interprofessional education claims that students who learn with, from, and about one another in well-designed interprofessional programs will practice together collaboratively upon graduation, given the skills to do so. The objective of this study was to examine attitudes to interprofessional practice before and after an interprofessional learning (IPL) activity. A total of 35 postgraduate medical imaging students attended a week-long mammography workshop. The sessions provided a range of didactic sessions related to diagnosis and management of breast cancer. An IPL session was incorporated on completion of the workshop to consolidate learning. Props and authentic resources were used to increase the fidelity of the simulation. Participants completed pre- and post-workshop questionnaires comprising an interprofessional education and collaboration scale and a quiz to gauge knowledge of specific content related to professional roles. Responses to each statement in the scale and quiz score, pre or post workshop, were compared, whereas responses to open-ended questions in post-workshop survey were thematically analyzed. Seventeen paired surveys were received. There was a significant total improvement of 10.66% (P = .036). After simulation, there was a statistically significant improvement in participants' understanding (P < .05) that IPL offers holistic care to the patient and that teamwork is useful for reducing errors in patient care. Simulation helped participants develop more awareness of their role within the profession, improve their understanding of other professionals, and gain more realistic expectations of team members. This pilot study confirmed learning within an IPL simulation improved attitudes toward shared learning, teamwork, and communication. Simulation provides opportunities for learning in a safe environment, and technology can be used in diverse ways to provide authentic learning. Copyright © 2017 The Association

  14. Hormone-dependent bacterial growth, persistence and biofilm formation--a pilot study investigating human follicular fluid collected during IVF cycles.

    Directory of Open Access Journals (Sweden)

    Elise S Pelzer

    Full Text Available Human follicular fluid, considered sterile, is aspirated as part of an in vitro fertilization (IVF cycle. However, it is easily contaminated by the trans-vaginal collection route and little information exists in its potential to support the growth of microorganisms. The objectives of this study were to determine whether human follicular fluid can support bacterial growth over time, whether the steroid hormones estradiol and progesterone (present at high levels within follicular fluid contribute to the in vitro growth of bacterial species, and whether species isolated from follicular fluid form biofilms. We found that bacteria in follicular fluid could persist for at least 28 weeks in vitro and that the steroid hormones stimulated the growth of some bacterial species, specifically Lactobacillus spp., Bifidobacterium spp. Streptococcus spp. and E. coli. Several species, Lactobacillus spp., Propionibacterium spp., and Streptococcus spp., formed biofilms when incubated in native follicular fluids in vitro (18/24, 75%. We conclude that bacteria aspirated along with follicular fluid during IVF cycles demonstrate a persistent pattern of growth. This discovery is important since it can offer a new avenue for investigation in infertile couples.

  15. Role of WhatsApp-based discussions in improving residents' knowledge of post-operative pain management: a pilot study.

    Science.gov (United States)

    Bakshi, Sumitra G; Bhawalkar, Pranay

    2017-10-01

    To provide a platform for the dissemination of basic knowledge of pain management, a WhatsApp group was created by residents and consultants. Common clinical scenarios, resident queries, and important instructions to be followed by residents with respect to running the Acute Pain Service were discussed in the group. This study evaluates the benefits of this interaction. This study was approved by the hospital ethics board and was registered with the Clinical Trial Registry of India. Second- and third-year anesthesia residents were included in a WhatsApp group, along with consultants (board certified anesthesiologists with a special interest in pain). Pain knowledge assessment was performed pre- and post-discussion using a standard 22-point questionnaire. A feedback form, which included self-rated confidence scores (1-10, 10-most confident) and opinions about the 3-month WhatsApp discussion, was collected. Improvements in the documentation in clinical sheets post-discussion were also analyzed. A total of 38 residents were included in the WhatsApp group. An improvement in the percentage of correct answers from 69.1% (pre-discussion) to 73.6% (post-discussion) was observed (P = 0.031). Improvements in the self-rated residents' confidence levels were also noted (P WhatsApp-based discussion was useful. Documentation of the details of epidural blockade in clinical sheets improved from 30% to 100%. The WhatsApp discussion improved residents' knowledge and confidence levels, and also resulted in improved documentation of essential details in the clinical notes. This form of education is promising and should be explored in future studies.

  16. Residential Consumer-Centric Demand-Side Management Based on Energy Disaggregation-Piloting Constrained Swarm Intelligence: Towards Edge Computing.

    Science.gov (United States)

    Lin, Yu-Hsiu; Hu, Yu-Chen

    2018-04-27

    The emergence of smart Internet of Things (IoT) devices has highly favored the realization of smart homes in a down-stream sector of a smart grid. The underlying objective of Demand Response (DR) schemes is to actively engage customers to modify their energy consumption on domestic appliances in response to pricing signals. Domestic appliance scheduling is widely accepted as an effective mechanism to manage domestic energy consumption intelligently. Besides, to residential customers for DR implementation, maintaining a balance between energy consumption cost and users’ comfort satisfaction is a challenge. Hence, in this paper, a constrained Particle Swarm Optimization (PSO)-based residential consumer-centric load-scheduling method is proposed. The method can be further featured with edge computing. In contrast with cloud computing, edge computing—a method of optimizing cloud computing technologies by driving computing capabilities at the IoT edge of the Internet as one of the emerging trends in engineering technology—addresses bandwidth-intensive contents and latency-sensitive applications required among sensors and central data centers through data analytics at or near the source of data. A non-intrusive load-monitoring technique proposed previously is utilized to automatic determination of physical characteristics of power-intensive home appliances from users’ life patterns. The swarm intelligence, constrained PSO, is used to minimize the energy consumption cost while considering users’ comfort satisfaction for DR implementation. The residential consumer-centric load-scheduling method proposed in this paper is evaluated under real-time pricing with inclining block rates and is demonstrated in a case study. The experimentation reported in this paper shows the proposed residential consumer-centric load-scheduling method can re-shape loads by home appliances in response to DR signals. Moreover, a phenomenal reduction in peak power consumption is achieved

  17. Evaluating the impact of mobile telephone technology on type 2 diabetic patients' self-management: the NICHE pilot study.

    Science.gov (United States)

    Faridi, Zubaida; Liberti, Lauren; Shuval, Kerem; Northrup, Veronika; Ali, Ather; Katz, David L

    2008-06-01

    Utilizing information technology, such as Internet and cellphones, holds great promise in enhancing diabetic care. Yet few studies have examined the impact of cellphone technology on type 2 diabetics' self-care. The primary aim of the study is to examine the feasibility of utilizing this technology to assist with diabetes self-care in a clinic population as well as its impact on clinical outcomes. Thirty patients with a diagnosis of type 2 diabetes at two Community Health Centers were randomized to intervention or control. Intervention patients participated in a brief intervention and received tailored daily messages via cellphone prompting them to enhance their diabetic self-care behaviour. Patients at the control site continued with their standard diabetes self-management. A mean improvement in HbA1c levels was apparent (-0.1, SD = 0.3%; P = 0.1534) in the intervention group, compared with a mean deterioration in the control (0.3, SD = 1.0%; P = 0.3813), yet without statistical significance. Self-efficacy scores improved significantly in the intervention group (-0.5, SD = 0.6; P = 0.0080) compared with no improvement in the control (0.0, SD = 1.0; P = 0.9060). Participants encountered numerous technological barriers when attempting to adhere to the intervention protocol. The results indicate the intervention had a positive impact on some clinical outcome and self-efficacy. Although the technology appears feasible in a clinical setting technology must be made more user-friendly before a larger phase II trial is conducted.

  18. Pilot-scale continuous recycling of growth medium for the mass culture of a halotolerant Tetraselmis sp. in raceway ponds under increasing salinity: a novel protocol for commercial microalgal biomass production.

    Science.gov (United States)

    Fon Sing, S; Isdepsky, A; Borowitzka, M A; Lewis, D M

    2014-06-01

    The opportunity to recycle microalgal culture medium for further cultivation is often hampered by salinity increases from evaporation and fouling by dissolved and particulate matter. In this study, the impact of culture re-use after electro-flocculation of seawater-based medium on growth and biomass productivity of the halotolerant green algal strain Tetraselmis sp., MUR 233, was investigated in pilot-scale open raceway ponds over 5months. Despite a salinity increase from 5.5% to 12% (w/v) NaCl, Tetraselmis MUR 233 grown on naturally DOC-enriched recycled medium produced 48-160% more ash free dry weight (AFDW) biomass daily per unit pond area than when grown on non-recycled medium. A peak productivity of 37.5±3.1gAFDWm(-2)d(-1) was reached in the recycled medium upon transition from ∼14% to ∼7% NaCl. The combination of high biomass-yielding mixotrophic growth under high salinity has been proven to be a successful sustainable cultivation strategy. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. The Geo-strategies and Global Peace of Technology on Customer Relationship Management Performance: A Pilot Study among SME’s Logistic Operators

    Directory of Open Access Journals (Sweden)

    Muhamad Fairos Mohamad Shah

    2017-12-01

    Full Text Available Small and medium enterprises (SMEs are playing an increasingly important role in sustaining geo strategies and global peace economic growth and logistic system in Malaysia. SMEs also play a very crucial role in customer relationship as they may serve the roles of customer, distributor producer and supplier. However, adaption of customer relationship in Malaysian SMEs has not been fully explored. CRMP model for logistic service presents the combination of technology strategy in term of geo strategies and global peace. The goal of this study is to investigate customer relationship management performance and technology strategy. The dimensions for technology factors are Support information system, information sharing, Usefulness, care/help, ease of use, service portfolio, security and Update System. The populations of study were customers from a logistic company located in Pulau Pinang. Simple random sampling was selected from the target populations. Data collection resulted in 100 respondents to answers questionnaire from the customers of logistic company. Based on the finding, the result showed that, technology strategies are anchor factors in determining geo strategies and global peace on customer relationship management performance. Further study has important managerial implications as the findings will enable management of SMEs to understand progressive and highly varied CRMP practices and contextual factors that contribute to the CRMP as well as geo strategies and global peace and innovative implementation.

  20. Forest growth and timber quality: crown models and simulation methods for sustainable forest management

    Science.gov (United States)

    Dennis P. Dykstra; Robert A. Monserud

    2009-01-01

    The purpose of the international conference from which these proceedings are drawn was to explore relationships between forest management activities and timber quality. Sessions were organized to explore models and simulation methodologies that contribute to an understanding of tree development over time and the ways that management and harvesting activities can...

  1. Microbial Field Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, R.M.; McInerney, M.J.; Menzie, D.E.; Chisholm, J.L.

    1990-11-01

    This report covers progress made during the first year of the Microbial Field Pilot Study project. Information on reservoir ecology and characterization, facility and treatment design, core experiments, bacterial mobility, and mathematical modeling are addressed. To facilitate an understanding of the ecology of the target reservoir analyses of the fluids which support bacteriological growth and the microbiology of the reservoir were performed. A preliminary design of facilities for the operation of the field pilot test was prepared. In addition, procedures for facilities installation and for injection treatments are described. The Southeast Vassar Vertz Sand Unit (SEVVSU), the site of the proposed field pilot study, is described physically, historically, and geologically. The fields current status is presented and the ongoing reservoir simulation is discussed. Core flood experiments conducted during the last year were used to help define possible mechanisms involved in microbial enhanced oil recovery. Two possible mechanisms, relative permeability effects and changes in the capillary number, are discussed and related to four Berea core experiments' results. The experiments were conducted at reservoir temperature using SEVVSU oil, brine, and bacteria. The movement and activity of bacteria in porous media were investigated by monitoring the growth of bacteria in sandpack cores under no flow conditions. The rate of bacteria advancement through the cores was determined. A mathematical model of the MEOR process has been developed. The model is a three phase, seven species, one dimensional model. Finite difference methods are used for solution. Advection terms in balance equations are represented with a third- order upwind differencing scheme to reduce numerical dispersion and oscillations. The model is applied to a batch fermentation example. 52 refs., 26 figs., 21 tabs.

  2. USE OF HEMATOPOIETIC GROWTH FACTOR IN THE MANAGEMENT OF HEMATOLOGICAL SIDE EFFECTS ASSOCIATED TO ANTIVIRAL TREATMENT FOR HCV HEPATITIS

    Directory of Open Access Journals (Sweden)

    Paola Mancino

    2010-03-01

    Full Text Available Haematological abnormalities are common during combination antiviral therapy for chronic hepatitis C. Although dose reduction or discontinuation can easily treat these side effects, they can adversely affect the efficacy of combination antiviral therapy reducing the likelihood of a sustained viral response (SVR. To avoid potentially diminishing a patient’s chance of response, many physicians have begun using growth factors off-label to manage anaemia and neutropenia in hepatitis C. Haematopoietic growth factors are generally well tolerated and they may be useful for managing haematological side effects of anti-HCV therapy improving patients’ quality of life. To date, the role and benefit of these agents during anti-HCV therapy and their positive impact on SVR have not conclusively determined in the published studies. However, the possibility of a benefit to individual outpatients remains, and an individualized approach is recommended. This review explores the incidence, clinical significance, and management of anaemia, neutropenia and thrombocytopenia associated with combination therapy for HCV infection.

  3. Monitoring marine heavy metal contamination via the chemical analysis of foraminifera and growth increments in bivalves - a pilot study from a Pb and Zn mining region in western Greenland

    Science.gov (United States)

    Jessen, C.; Asmund, G.; Elberling, B.; Frei, D.; Knudsen, C.; Rasmussen, P.

    2011-12-01

    Annual monitoring of heavy metal concentrations in the fjords (sea water, seaweed, lichens, blue mussels, shorthorn sculpin and Northern prawn) adjacent to the Black Angel lead-zinc mine (active 1973-1990) at Maarmorilik, western Greenland was initiated during operation of the mine and continues through to today. This pilot study tests whether the calcareous shells of bivalves and foraminifera register these known variations in heavy metal concentrations. Live individuals of Mytilus edulis were collected through a transect of monitoring stations in 2009 and PB-Zn concentrations were measured at multiple points within the yearly increments using LA-ICP-MS. Individuals aged between 12 and 28 years were measured and demonstrated a clear signal of mine closure even at 40 km distance from the plant. Foraminifera (Melonis barleeanus) from a sediment core dating from 1880 AD to present have previously been shown to display a greater percentage of deformities during the period of mining activity (Elberling et al. 2003) possibly suggesting a correlation between heavy metal concentrations in sea water and morphological development. LA-ICP-MS analysis of individual foraminifera confirms an increase in Pb-Zn uptake during mining operations. Although it could therefore be expected that Pb-Zn concentrations would be enhanced in the 'deformed' foraminifera relative to the 'non-deformed', no difference in Pb-Zn was concentrations was detected. This short pilot study (Jessen et al.2010) demonstrates the potential of calcareous material as indicators of environmental pollution and their applicability as a monitoring tool in remote regions. Jessen CA, Asmund G, Elberling B, Frei D, Knudsen C and Rasmussen P. 2010 Monitoring marine heavy metal contamination via the chemical analysis of growth increments in bivalves - a pilot study. Danmarks og Grønlands Geologiske Undersøgelse Rapport 2010/86. 1-20 Elberling, B., Knudsen, K. L., Kristensen, P. H., and Asmund, G. (2003) Applying

  4. Insulin-like growth factor I (IGF-I) replacement therapy increases albumin concentration in liver cirrhosis : Results of a pilot randomized controlled clinical trial

    NARCIS (Netherlands)

    Conchillo, M; de Knegt, RJ; Payeras, M; Quiroga, J; Sangro, B; Herrero, JI; Castilla-Cortazar, [No Value; Frystyk, J; Flyvbjerg, A; Yoshizawa, C; Jansen, PLM; Scharschmidt, B; Prieto, J

    2005-01-01

    Background/Aims: Insulin-like growth factor I (IGF-I) is an anabolic hormone synthesized in the liver whose levels decrease sharply in liver cirrhosis. Methods: We conducted a randomized double-blind placebo-controlled clinical trial to evaluate the effect of subcutaneous administration of IGF-I (20

  5. Changes in serum somatomedin and growth hormone concentrations after 3 weeks oestrogen substitution in post-menopausal women; a pilot study

    NARCIS (Netherlands)

    Duursma, S. A.; Bijlsma, J. W.; van Paassen, H. C.; van Buul-Offers, S. C.; Skottner-Lundin, A.

    1984-01-01

    Oestrogens have a preventive effect on bone loss in post-menopausal women; however, little is known about their mechanism of action. The aim of this study was to investigate the changes in somatomedins (SM) and growth hormone (GH) concentrations in serum in post-menopausal women after 3 weeks of

  6. Monitoring African savanna water use and water stress from local to regional scale: supporting rangeland management (pilot experience in Kruger National Park, South Africa).

    Science.gov (United States)

    Andreu, Ana; Dube, Timothy; Nieto, Hector; González-Dugo, Maria P.; Hülsmann, Stephan

    2017-04-01

    Drought periods and erratic rainfall patterns across large parts of Africa result in water-limited environments like savannas, highly sensitive to land management practices and changes in climate. Over the Southern part of the continent, savannas are key productive landscapes supporting livestock, crops and rural livelihoods. Monitoring water use and the natural vegetation stress over these semi-arid complex ecosystems can support rangeland management, to maintain long-term productivity. However, the precision/resolution/accuracy of the information required for management will differ at each scale: farm-local (e.g. evaluating the effect of management practices, livestock densities, crop production and grazing), to watershed (e.g. evaluating the effect of fire, detection of vulnerable areas) and regional (e.g. early prediction of drought). To overcome these constrains, TIGER project 401 combines two approaches that take advantage of different conceptual and operational capabilities of Earth Observation data sources. Sentinel 2 high spatial (10 m) and temporal ( 5 days) resolution VIS/NIR images are used for a continuous monitoring of vegetation cover and unstressed evapotranspiration (ET - using Kc-FAO56 method). This methodology will provide the required resolution for farm-local scales, tracking separately the seasonal variations of each canopy layer growth (grass and trees). Meanwhile, lower spatial resolution (1 km) MODIS thermal data allow to determine a regional water stress index (ratio between actual ET, estimated using Two Source Energy Balance-TSEB, and potential ET), supporting the detection of vulnerable areas. The model framework was tested and validated over savanna-type experimental areas (Skukuza & Malopeni), and later applied over the whole Kruger National Park during 2015-2016.

  7. Perspectives of Urban Growth Management and Sustainable Development In West Bank, Hebron District as a case Study

    OpenAIRE

    Talahma, Ismail

    2011-01-01

    The main objective of this PhD research study is to provide a perspective on the urban growth management and sustainable development in Palestine, and more specifically in Hebron district as a case study. Hebron is located 36 km south of Jerusalem, with an overall population size of around 600,000 people living in a total area around1246km2. Hebron is the biggest Palestinian district that has 16 municipalities and 154 localities. The research discusses and analyzes the urban planning system, ...

  8. Leading change with Agile : How Agile Project Management can affect an organisation’s growth prospects

    OpenAIRE

    Yliperttula, Oula

    2017-01-01

    The purpose of this thesis was to investigate if implementing agile methods can lead change in an organisation, if Agile Project Management can help the company grow and what are the consequences of applying agile methods to companies’ project management processes. As businesses seek for agility and strive for a more unique competitive advantage, being organisationally agile (able to adapt to changing market conditions and reacting to changing stakeholder requirements) is important. This pape...

  9. Interdisciplinary management of infantile short bowel syndrome: resource consumption, growth, and nutrition

    NARCIS (Netherlands)

    Olieman, Joanne F.; Poley, Marten J.; Gischler, Saskia J.; Penning, Corine; Escher, Johanna C.; van den Hoonaard, Thelma L.; van Goudoever, Johannes B.; Bax, Nikolaas M. A.; Tibboel, Dick; Ijsselstijn, Hanneke

    2010-01-01

    To date, there are hardly any data on the treatment costs of infantile short bowel syndrome (SBS), despite growing interest in evidence-based and cost-effective medicine. Therefore, the aim of the study was to evaluate resource consumption and costs, next to studying nutritional and growth outcomes,

  10. Growth patterns of Tsuga canadensis in managed uneven-aged northern conifer stands

    Science.gov (United States)

    Laura S. Kenefic; Robert S. Seymour

    2000-01-01

    This study reports patterns of regeneration and growth for 100 eastern hemlock (Tsuga canadensis (L.) Carr.) up to 20 inches (50 cm) dbh in two mixed-species selection stands on the Penobscot Experimental Forest in east-central Maine. The study stands are part of a U.S.D.A. Forest Service experiment in which eastern hemlock has remained stable over a...

  11. Human and behavioral factors contributing to spine-based neurological cockpit injuries in pilots of high-performance aircraft: recommendations for management and prevention

    Science.gov (United States)

    Jones, J. A.; Hart, S. F.; Baskin, D. S.; Effenhauser, R.; Johnson, S. L.; Novas, M. A.; Jennings, R.; Davis, J.

    2000-01-01

    In high-performance aircraft, the need for total environmental awareness coupled with high-g loading (often with abrupt onset) creates a predilection for cervical spine injury while the pilot is performing routine movements within the cockpit. In this study, the prevalence and severity of cervical spine injury are assessed via a modified cross-sectional survey of pilots of multiple aircraft types (T-38 and F-14, F-16, and F/A-18 fighters). Ninety-five surveys were administered, with 58 full responses. Fifty percent of all pilots reported in-flight or immediate post-flight spine-based pain, and 90% of fighter pilots reported at least one event, most commonly (> 90%) occurring during high-g (> 5 g) turns of the aircraft with the head deviated from the anatomical neutral position. Pre-flight stretching was not associated with a statistically significant reduction in neck pain episodes in this evaluation, whereas a regular weight training program in the F/A-18 group approached a significant reduction (mean = 2.492; p < 0.064). Different cockpit ergonomics may vary the predisposition to cervical injury from airframe to airframe. Several strategies for prevention are possible from both an aircraft design and a preventive medicine standpoint. Countermeasure strategies against spine injury in pilots of high-performance aircraft require additional research, so that future aircraft will not be limited by the human in control.

  12. Outdoor pilot-scale cultivation of Spirulina sp. LEB-18 in different geographic locations for evaluating its growth and chemical composition.

    Science.gov (United States)

    de Jesus, Cristiane Santos; da Silva Uebel, Lívia; Costa, Samantha Serra; Miranda, Andréa Lobo; de Morais, Etiele Greque; de Morais, Michele Greque; Costa, Jorge Alberto Vieira; Nunes, Itaciara Larroza; de Souza Ferreira, Ederlan; Druzian, Janice Izabel

    2018-05-01

    This study evaluated whether outdoor cultivation of Spirulina sp. in different geographical locations affected its growth and biomass quality, with respect to the chemical composition, volatile compound and heavy metal content, and thermal stability. The positive effect of solar radiation and temperature on biomass productivity in Spirulina sp. cultivated in the northeast was directly related to its improved nutritional characteristics, which occurred with an increase in protein, phycocyanin, and polyunsaturated fatty acid (mainly γ-linolenic) content. The biomass produced in Northeast and South Brazil showed high thermal stability and had volatile compounds that could be used as biomarkers of Spirulina, and their parameters were within the limits of internationally recognized standards for food additives; hence, they have been considered safe foods. However, the growth of crops in south Brazil occurred at lower rates due to low temperatures and luminous intensities, indicative of the robustness of microalgae in relation to these parameters. Copyright © 2018 Elsevier Ltd. All rights reserved.

  13. Pilot scale land-based cultivation of Saccharina latissima Linnaeus at southern European climate conditions: Growth and nutrient uptake at high temperatures

    DEFF Research Database (Denmark)

    Azevedo, Isabel C.; Silva Marinho, Goncalo; Silva, Diogo M.

    2016-01-01

    column vs attached to fixed ropes at the bottom of the tank. S. latissima cultivated in tumble culture presented the best results, reaching growth rates of 10.6 ± 0.9% day− 1 and 0.9 ± 0.1 cm day− 1, with a weekly yield around 120 g DW m− 2. Cultivation using this method was continued over the summer...

  14. Research on oligochitosan production by gamma radiation degradation techniques in pilot scale for application in disease control and growth performance of chickens

    International Nuclear Information System (INIS)

    Tran Thi Thuy; Nguyen Duy Hang; Nguyen Tan Man; Nguyen Trong Hoanh Phong; Pham Thi Sam; Nguyen Tuong Ly Lan; Le Hai; Le Huu Tu; Pham Thi Le Ha; Phan Van Anh

    2015-01-01

    Degradation of chitosan to prepare the low molecular weight chitosan has been carried out by gamma irradiation of chitosan in H 2 O 2 solution. The effects of radiation dose, dose rate, ratio of CTS:H 2 O and H 2 O 2 concentration to the degrading efficiency of chitosan have been investigated. The obtained results showed the chitosan molecular weight reduced with the increase of radiation dose. Chitosan was irradiated at radiation dose 10 kGy in the presence of H 2 O 2 1% its molecular weight achieved 45 kDa. The effect of irradiated chitosan on the growth development and the survival ratio of breeding chickens in the process were also studied. The results shown that low molecular weight chitosan supplement in diets had positive effect of the resistant ability, growth performance and reduced chick mortality. With supplement ratio of 100 mg/kg diets, chitosan 45 kDa had positive affect on growth performance of chicks, the weight of chickens increased 6% and survival ratio was 94.8% while the normal survival ratio was only 92.6%. (author)

  15. Effect of Water Deficit Stress on Peach Growth under Commercial Orchard Management Conditions

    Directory of Open Access Journals (Sweden)

    M. Rahmati

    2015-06-01

    Full Text Available In order to study the sensitivity of vegetative growth to water deficit stress of a late-maturing peach (Prunus persica L. cv. Elberta under orchard conditions, an experiment was conducted as randomized complete-block design with three treatments and four repetitions in Shahdiran commercial orchard in Mashhad during 2011. Three irrigation treatments including 360 (low stress, 180 (moderate stress and 90 (severe stress m3ha-1week-1 using a drip irrigation system (minimum stem water potential near harvest: -1.2, -1.5 and -1.7 MPa, respectively from the mid-pit hardening stage (12th of June until harvest (23rd of Sep. applied. Predawn, stem and leaf water potentials, leaf photosynthesis, transpiration, stomatal conductance and leaf temperature, the number of new shoots on fruit bearing shoots and vegetative shoots lengths during growing season as well as leaf area at harvest were measured. The results showed that water deficit stress had negative effects on peach tree water status, thereby resulting in decreased leaf gas exchange and tree vegetative growth. As significant decreased assimilate production of tree was resulted from both decreased leaf assimilation rate (until about 23 % and 50 %, respectively under moderate and severe stress conditions compared to low stress conditions and decreased leaf area of tree (until about 57% and 79%, respectively under moderate and severe stress conditions compared to low stress conditions at harvest. The significant positive correlation between leaf water potential and vegetative growth of peach revealed that shoot growth would decrease by 30% and 50% of maximum at leaf water potential of –1.56 and –2.30 MPa, respectively.

  16. High-content screening data management for drug discovery in a small- to medium-size laboratory: results of a collaborative pilot study focused on user expectations as indicators of effectiveness.

    Science.gov (United States)

    Berlinicke, Cynthia A; Ackermann, Christopher F; Chen, Steve H; Schulze, Christoph; Shafranovich, Yakov; Myneni, Sahiti; Patel, Vimla L; Wang, Jian; Zack, Donald J; Lindvall, Mikael; Bova, G Steven

    2012-08-01

    High-content screening (HCS) technology provides a powerful vantage point to approach biological problems; it allows analysis of cell parameters, including changes in cell or protein movement, shape, or texture. As part of a collaborative pilot research project to improve bioscience research data integration, we identified HCS data management as an area ripe for advancement. A primary goal was to develop an integrated data management and analysis system suitable for small- to medium-size HCS programs that would improve research productivity and increase work satisfaction. A system was developed that uses Labmatrix, a Web-based research data management platform, to integrate and query data derived from a Cellomics STORE database. Focusing on user expectations, several barriers to HCS productivity were identified and reduced or eliminated. The impact of the project on HCS research productivity was tested through a series of 18 lab-requested integrated data queries, 7 of which were fully enabled, 7 partially enabled, and 4 enabled through data export to standalone data analysis tools. The results are limited to one laboratory, but this pilot suggests that through an "implementation research" approach, a network of small- to medium-size laboratories involved in HCS projects could achieve greater productivity and satisfaction in drug discovery research.

  17. The Determination of National Growth Charts to Prevent and Manage Malnutrition in Iranian Children: Necessity and Importance

    International Nuclear Information System (INIS)

    Abtahi, Mitra; Doustmohammadian, Aazam; Pouraram, Hamed

    2014-01-01

    Full text: Objectives: Standard height and weight charts are the most important evaluation tools for the assessment of growth and development of children which could be further used to develop preventive interventions both in individual and epidemiologic assessments in the community. Children of different populations differ a lot in size and shape, resulting from differences in their genetic pattern, their needs and interaction of these two. Regarding the existence of different standards, it seems that a national standard can provide a more accurate functional individual and social evaluation tool and many problems will be solved in case of availability of an Iranian standard for comparison of children’s height, weight, and their growth follow-ups. One of these problems is the abnormal results regarding mal nourishment, overweight, or obesity in Iranian children. Considerable rate of childhood malnutrition in Iran and other countries necessitates the implementation of interventional programs including development of local growth charts to prevent and manage malnutrition in the community. This study was undertaken with the aim of reviewing different current growth curves, their advantages and disadvantages, and performing a review of the studies conducted in Iran and other countries on determination of weight and height standards. Methods: In order to collect materials for this review, a detailed search of Scientific Information Database (SID), Iran Medex, MEDLINE, Pub Med, and Web of Science was carried out for the time period 2005-2011 using the keywords: national standard, height, weight, children, and growth chart. Initially, we reviewed international standards of weight and height. Results: The results of performed studies in European and Asian countries showed that the height and weight curves of these children were different from WHO and NCHS growth standards. The finding of growth trend study of Iranian children showed that the mean height and weight of

  18. Supply Chain Management in The Brazilian Automobile Industry: Bottlenecks for Steadier Growth

    Directory of Open Access Journals (Sweden)

    W. F. Sorte Junior

    2011-06-01

    Full Text Available Taking the Lean Production System as the reference model, this paper analyses the supply chain management approach and the relationship between private and public sectors in the Brazilian automobile industry. Through a case study conducted from October 2006 to October 2008 in a private owned automaker, two bottlenecks in this Brazilian industrial sector are identified: (1 Emphasis on coordination rather than integration in supply chain management; and (2 Insufficient channels of communication between private and public sectors, resulting in inefficient policies to nurture automakers with low production volume.

  19. Vineyard floor management influences 'Pinot noir' vine growth and productivity more than cluster thinning

    Science.gov (United States)

    Vigor and crop level management are important practices for premium wine grape production. The implications of crop thinning ‘Pinot noir’ (Vitis vinifera L.) vines of varying vigor were investigated in the Willamette Valley of Oregon in 2011 to 2013, to better understand the relationship between can...

  20. A Co-Creation Shift in Learning Management: Work Design for Institutional Commitment and Personal Growth

    Science.gov (United States)

    Wardley, Leslie J.; Bélanger, Charles H.; Nadeau, John

    2017-01-01

    Some higher education management departments have started to implement customer service orientation strategies in their marketing activities in order to solidify value exchange perceptions, differentiate themselves, and improve retention rates. However, if students are to get the most out of their academic experiences, they need to become…

  1. Integrating forest growth and harvesting cost models to improve forest management planning

    Science.gov (United States)

    J.E. Baumgras; C.B. LeDoux

    1991-01-01

    Two methods of estimating harvesting revenue--reported stumpage prices - and delivered prices minus estimated harvesting and haul costs were compared by estimating entry cash flows and rotation net present value for three simulated even-aged forest management options that included 1 to 3 thinnings over a 90 year rotation. Revenue estimates derived from stumpage prices...

  2. Factors Associated With Post-Traumatic Growth, Quality of Life, and Spiritual Well-Being in Outpatients Undergoing Bone Marrow Transplantation: A Pilot Study.

    Science.gov (United States)

    Sinclair, Shane; Booker, Reanne; Fung, Tak; Raffin-Bouchal, Shelley; Enns, Bert; Beamer, Kate; Ager, Naree

    2016-11-01

    To examine the relationships between spiritual, religious, and sociodemographic factors and post-traumatic growth, quality of life, and spiritual well-being in outpatients undergoing bone marrow and/or stem cell transplantation (BMSCT).
. Cross-sectional, descriptive, exploratory.
. Outpatient bone marrow transplantation clinic at the Tom Baker Cancer Centre in Calgary, Alberta, Canada.
. 100 patients (21 pre-BMSCT and 79 post-BMSCT) accrued consecutively via non-probability sampling.
. Study participants completed the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation (FACT-BMT), the Post-Traumatic Growth Inventory (PTGI), the Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being (FACIT-Sp), and a demographic questionnaire. Data analysis included descriptive statistics, t tests, and correlational analyses.
. Demographic variables, FACT-BMT scores, PTGI scores, FACIT-Sp scores. 
. The majority of participants identified themselves as being at least somewhat spiritual. Significant differences were noted between those who identified as being not religious at all versus having at least some religiosity in several subscales of the PTGI, as well as on the FACIT-Sp. Similarly, significant differences were observed between participants who identified as being not spiritual at all versus having at least some spirituality for several subscales on the PTGI. Most participants indicated they would be at least somewhat likely to recommend spiritual care to a new patient. 
. Most patients in this study within a publicly funded healthcare system self-identified with spirituality, used spiritual resources, and would recommend that other patients undergoing BMSCT seek the support of a spiritual care professional or chaplain. Spirituality, along with practical and relational factors, had a positive impact on certain aspects of post-traumatic growth, quality of life, and spiritual and physical well-being.
. Oncology nurses are

  3. Current and Future Dynamics of the Red-Cockaded Woodpecker Population Inhabiting the Savannah River National Environmental Research Park: Managing For Population Growth

    International Nuclear Information System (INIS)

    Walters, J.R.; Taylor, T.B.; Daniels, S.J.; Crowder, L.B.; Pridd, J.A.

    2001-01-01

    Research aimed to study the dynamics of the SRS population of Red-Cockaded woodpecker and compare to those of other populations to identify factors limiting population growth; recruitment clusters were evaluated to determine what properties of individual cavity trees, surrounding habitat and the surrounding landscape might limit occupancy through natural dispersal. A spatial simulation model was used to project expected dispersal rates and population growth under current conditions and compare those estimates to observed dispersal and population growth. Red cockaded woodpecker populations at SRS are stable considering size. Research reveals that closer placement of recruitment clusters to active territories would produce higher growth rates while decreasing management intensity

  4. Microbial field pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, R.M.; McInerney, M.J.; Menzie, D.E.; Chisholm, J.L.

    1992-03-01

    The objective of this project is to perform a microbial enhanced oil recovery field pilot in the Southeast Vassar Vertz Sand Unit (SEVVSU) in Payne County, Oklahoma. Indigenous, anaerobic, nitrate reducing bacteria will be stimulated to selectively plug flow paths which have been referentially swept by a prior waterflood. This will force future flood water to invade bypassed regions of the reservoir and increase sweep efficiency. This report covers progress made during the second year, January 1, 1990 to December 31, 1990, of the Microbial Field Pilot Study project. Information on reservoir ecology, surface facilities design, operation of the unit, core experiments, modeling of microbial processes, and reservoir characterization and simulation are presented in the report. To better understand the ecology of the target reservoir, additional analyses of the fluids which support bacteriological growth and the microbiology of the reservoir were performed. The results of the produced and injected water analysis show increasing sulfide concentrations with respect to time. In March of 1990 Mesa Limited Partnership sold their interest in the SEVVSU to Sullivan and Company. In April, Sullivan and Company assumed operation of the field. The facilities for the field operation of the pilot were refined and implementation was begun. Core flood experiments conducted during the last year were used to help define possible mechanisms involved in microbial enhanced oil recovery. The experiments were performed at SEVVSU temperature using fluids and inoculum from the unit. The model described in last year's report was further validated using results from a core flood experiment. The model was able to simulate the results of one of the core flood experiments with good quality.

  5. Microbial field pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Knapp, R.M.; McInerney, M.J.; Menzie, D.E.; Chisholm, J.L.

    1992-03-01

    The objective of this project is to perform a microbial enhanced oil recovery field pilot in the Southeast Vassar Vertz Sand Unit (SEVVSU) in Payne County, Oklahoma. Indigenous, anaerobic, nitrate reducing bacteria will be stimulated to selectively plug flow paths which have been referentially swept by a prior waterflood. This will force future flood water to invade bypassed regions of the reservoir and increase sweep efficiency. This report covers progress made during the second year, January 1, 1990 to December 31, 1990, of the Microbial Field Pilot Study project. Information on reservoir ecology, surface facilities design, operation of the unit, core experiments, modeling of microbial processes, and reservoir characterization and simulation are presented in the report. To better understand the ecology of the target reservoir, additional analyses of the fluids which support bacteriological growth and the microbiology of the reservoir were performed. The results of the produced and injected water analysis show increasing sulfide concentrations with respect to time. In March of 1990 Mesa Limited Partnership sold their interest in the SEVVSU to Sullivan and Company. In April, Sullivan and Company assumed operation of the field. The facilities for the field operation of the pilot were refined and implementation was begun. Core flood experiments conducted during the last year were used to help define possible mechanisms involved in microbial enhanced oil recovery. The experiments were performed at SEVVSU temperature using fluids and inoculum from the unit. The model described in last year`s report was further validated using results from a core flood experiment. The model was able to simulate the results of one of the core flood experiments with good quality.

  6. Proposal of aviation safety management process.

    OpenAIRE

    Felipe Alexandre Nascimento Santos

    2004-01-01

    With the expected growth in air transportation, one can experience an increase in the number of incidents and accidents, despite constant or even slightly declining accident and incident rates. Therefore, it is necessary to examine how to improve aviation safety even further. Several studies and statistical analyses show that most accidents result from human and organizational factors, encompassing pilot error, training deficiencies, management error, an ineffective organizational structure, ...

  7. Policy in management based on corruption growth of resources agropolitan in the Gorontalo Province

    Science.gov (United States)

    Wantu, S. M.; Moonti, U.; Wantu, A.

    2018-02-01

    Gorontalo was formed as a new province in Indonesia as a producer of national maize, but until now the agropolitan-based agricultural development condition is still inadequate and needs to be developed well. Thus, it is necessary to conduct a governance-related study on empowering farmers in order to increase their capacity in exploring the agricultural sector. This study aims to see the need for local government policies in managing human resources in the agricultural sector in this case the potential and contribution of farmers in creating new jobs in rural areas. This study uses a qualitative approach to the use of secondary data and primary data as a basis for tracing or researching local government management policies in empowering farmers to improve their welfare and also how this policy is expected to organize effective market mechanisms for farmers.

  8. Pilot Evaluation of the Feasibility and Acceptability of StressOFF Strategies: A Single-Session School-Based Stress Management Program for Adolescents

    Science.gov (United States)

    Shapiro, Amy J.; Heath, Nancy L.; Carsley, Dana

    2016-01-01

    The present study reports the pilot evaluation of the feasibility and acceptability of StressOFF Strategies, a "single-session" (45 min) adolescent-targeted, school-based psychoeducational program, which introduces cognitive behavioral techniques and mindfulness-based techniques. Five hundred and sixty-five Grade 9 students (57% female;…

  9. Efficacy of Social Media Adoption on Client Growth for Independent Management Consultants

    Science.gov (United States)

    2017-02-01

    Retrieved from VitalBook file. Armitage, C. J., & Conner, M. (2001). Efficacy of the Theory of Planned Behaviour : A meta-analytic review. British... organisational social media. 20th Americas Conference on Information Systems, AMCIS 2014, 1–10. Retrieved from http://www.scopus.com/inward/record.url?eid=2-s2.0... organisational social media. Twentieth Americas Conference on Information Systems, 1-10. Sultan, N. (2013). Knowledge management in the age of cloud computing

  10. Kalimantan energy resource management to support energy independence and industry growth

    International Nuclear Information System (INIS)

    Rizki Firmansyah Setya Budi; Wiku Lulus Widodo; Djati Hoesen Salimy

    2014-01-01

    There are a large number of energy resource in Kalimantan such as coal, oil, CBM, gas and nuclear. While the electricity consumption still low. That condition caused by the bad energy planning. The aim of the study are to know the number and the ability of energy resource to supply the energy demand that support the growth of Kalimantan industry. The methodology are collecting and processing data through calculation using MESSAGE Program. The result is energy resource in Kalimantan can support Kalimantan energy independence and industry growth in Kalimantan. The coal resource is 34,814 million ton consumption 835 million ton, gas resource is 31,814 BSCF consumption 3,281 BSCF, Oil resource is 920 MMSTB consumption 4406 MMSTB, CBM resource is 210 TCF consumption 2.1 TCF, U 3 O 8 resource is 12,409 ton consumption zero. Whereas for hydro and biomass, the resource are 256 and 138 MWyr, the maximum consumption 185 and 126 MWyr every year. Oil consumption will exceed the resource so need import from other island or replaced by others energy that have large resource such as gas, CBM, or coal. Potency to make cleaner environment can be done by used nuclear energy. (author)

  11. Growth responses of low-alpine dwarf-shrub heath species to nitrogen deposition and management

    International Nuclear Information System (INIS)

    Britton, Andrea J.; Fisher, Julia M.

    2008-01-01

    Nitrogen deposition is a continuing problem in European alpine regions. We hypothesised that, despite climatic limitations, low-alpine Calluna heathland would respond to nitrogen addition with increased shoot growth and flowering and that fire and grazing would modify responses. In a five-year study, 0-50 kg N ha -1 y -1 were added, combined with burning (+/-) and clipping (+/-). Calluna vulgaris responded with increased shoot extension, but effects on flowering were variable. Burning enhanced the positive effect of nitrogen addition and negative effects of clipping. Sub-dominant shrubs generally did not respond to nitrogen. C. vulgaris shoot extension was stimulated by nitrogen addition of 10 kg N ha -1 y -1 (above background) supporting suggestions that alpine heathlands are sensitive to low levels of nitrogen deposition. Increased C. vulgaris growth could negatively impact on important lichen components of this vegetation through increased shading and competition. Climatic factors constrain productivity in this community, but do not prevent rapid responses to nitrogen deposition by some species. - Low levels of N deposition increase productivity in alpine dwarf-shrub heath despite strong climatic constraints

  12. A stochastic population model to evaluate Moapa dace (Moapa coriacea) population growth under alternative management scenarios

    Science.gov (United States)

    Perry, Russell W.; Jones, Edward; Scoppettone, G. Gary

    2015-07-14

    The primary goal of this research project was to evaluate the response of Moapa dace (Moapa coriacea) to the potential effects of changes in the amount of available habitat due to human influences such as ground water pumping, barriers to movement, and extirpation of Moapa dace from the mainstem Muddy River. To understand how these factors affect Moapa dace populations and to provide a tool to guide recovery actions, we developed a stochastic model to simulate Moapa dace population dynamics. Specifically, we developed an individual based model (IBM) to incorporate the critical components that drive Moapa dace population dynamics. Our model is composed of several interlinked submodels that describe changes in Moapa dace habitat as translated into carrying capacity, the influence of carrying capacity on demographic rates of dace, and the consequent effect on equilibrium population sizes. The model is spatially explicit and represents the stream network as eight discrete stream segments. The model operates at a monthly time step to incorporate seasonally varying reproduction. Growth rates of individuals vary among stream segments, with growth rates increasing along a headwater to mainstem gradient. Movement and survival of individuals are driven by density-dependent relationships that are influenced by the carrying capacity of each stream segment.

  13. Predicting the effects of environment and management on cotton fibre growth and quality: a functional–structural plant modelling approach

    Science.gov (United States)

    Wang, Xuejiao; Zhang, Lizhen; Evers, Jochem B.; Mao, Lili; Wei, Shoujun; Pan, Xuebiao; Zhao, Xinhua; van der Werf, Wopke; Li, Zhaohu

    2014-01-01

    In general, the quality of fruits depends on local conditions experienced by the fruit during its development. In cotton, fruit quality, and more specifically the quality of the fibre in the fruit, depends on interactions between fruit position in the plant architecture, temperature and agronomic practices, such as sowing time, mulching with plastic film and topping of the plant's main stem and branches. To quantify this response of cotton fibre quality to environment and management, we developed a simulation model of cotton growth and development, CottonXL. Simulation of cotton fibre quality (strength, length and micronaire) was implemented at the level of each individual fruit, in relation to thermal time (represented by physiological age of the fruit) and prevailing temperature during development of each fruit. Field experiments were conducted in China in 2007 to determine model parameters, and independent data on cotton fibre quality in three cotton producing regions in China were used for model validation. Simulated values for fibre quality closely corresponded to experimental data. Scenario studies simulating a range of management practices predicted that delaying topping times can significantly decrease fibre quality, while sowing date and film mulching had no significant effect. We conclude that CottonXL may be used to explore options for optimizing cotton fibre quality by matching cotton management to the environment, taking into account responses at the level of individual fruits. The model may be used at plant, crop and regional levels to address climate and land-use change scenarios. PMID:25011385

  14. The effect of extremely diluted agitated gibberellic acid (10e-30) on wheat stalk growth--a two researcher pilot study.

    Science.gov (United States)

    Pfleger, Andrea; Hofäcker, Jürgen; Scherer-Pongratz, Waltraud; Lothaller, Harald; Reich, Christian; Endler, Peter Christian

    2011-06-01

    Use of a wheat growth bio assay after 7 days in research on homeopathic dilutions of gibberellic acid. Grains of winter wheat (Triticum aestivum, Capo variety) were observed under the influence of extremely diluted gibberellic acid (10(-30)) prepared by stepwise dilution and agitation according to a protocol derived from homeopathy (30×). Analogously prepared water was used for control. In a two centre study, 3 experiments with a total of 4880 grains were performed. Data were found to be rather homogeneous within the control group as well as within the verum group in general. Germination rates were around 95%, with no significant difference between verum and control group (p>0.05). Mean stalk lengths (mm) were 40.63±20.96 for the verum and 44.33±21.11 for the control group (mean±S.D.) at grain level (N=2440 per group) and ±5.33 and ±5.89, respectively at dish level (122 cohorts of 20 grains per treatment group). In other words, verum stalk length (91.65%) was 8.35% smaller than control stalk length (100%). This difference is statistically highly significant (p<0.001) and was found by both researchers involved independently. These results suggest that there was an influence of gibberellic acid 30× on wheat seedling development, i.e. the wheat growth bio assay can be a useful tool for further experiments on homeopathic dilutions of gibberellic acid. Copyright © 2011 Elsevier Ltd. All rights reserved.

  15. Conflict Resolution Automation and Pilot Situation Awareness

    Science.gov (United States)

    Dao, Arik-Quang V.; Brandt, Summer L.; Bacon, Paige; Kraut, Josh; Nguyen, Jimmy; Minakata, Katsumi; Raza, Hamzah; Rozovski, David; Johnson, Walter W.

    2010-01-01

    This study compared pilot situation awareness across three traffic management concepts. The Concepts varied in terms of the allocation of traffic avoidance responsibility between the pilot on the flight deck, the air traffic controllers, and a conflict resolution automation system. In Concept 1, the flight deck was equipped with conflict resolution tools that enable them to fully handle the responsibility of weather avoidance and maintaining separation between ownship and surrounding traffic. In Concept 2, pilots were not responsible for traffic separation, but were provided tools for weather and traffic avoidance. In Concept 3, flight deck tools allowed pilots to deviate for weather, but conflict detection tools were disabled. In this concept pilots were dependent on ground based automation for conflict detection and resolution. Situation awareness of the pilots was measured using online probes. Results showed that individual situation awareness was highest in Concept 1, where the pilots were most engaged, and lowest in Concept 3, where automation was heavily used. These findings suggest that for conflict resolution tasks, situation awareness is improved when pilots remain in the decision-making loop.

  16. Saúde e gestão na aviação: a experiência de pilotos e controladores de tráfego aéreo Health and management in aviation: the experience of air flight pilots and air trafic controllers

    Directory of Open Access Journals (Sweden)

    Alice Itani

    2009-08-01

    Full Text Available A aviação comercial é um ramo de atividade que apresenta um alto crescimento nas últimas duas décadas. Esse crescimento tem um impacto sobre a saúde do trabalhador do transporte aéreo, regulada por normas da aviação civil, sob responsabilidade do Estado. As políticas de gestão da saúde podem ser analisadas por meio do estudo realizado com pilotos e controladores de tráfego aéreo no período entre 1992 e 2004. Partiu-se da hipótese que a saúde é um atributo principal de qualificação, mas as práticas de gestão da saúde são contraditórias às exigências para o exercício das funções.The civil aviation has presented a high growth in the past three decades which has an actual effect on the aviation worker's health. the health of the aviation worker is ruled by civil aviation laws under the responsibility of the State. The health policies can be analysed by the data from pilots and air traffic controllers study undertaken during the period of 1992 and 2004. the hypothesis is that health is an important attribute of the qualification among pilots and air traffic controllers but the health management policies are contradictory when compared to the job demands.

  17. EMS pilots: selecting the very best.

    Science.gov (United States)

    Coffey, M; Cauthorne-Lindstrom, C

    1990-10-01

    This article has reviewed factors that should be taken into account when screening prospective pilots for EMS flight programs. While all may not apply directly to all programs, assessing the elements relevant to a particular program will enhance the quality of the selection process. Additionally, the orientation process can be shortened considerably when pilots who already have the necessary skills and experience are hired. This can prove more cost-effective, by shortening the time it takes for a pilot to meet the program's requirements. Safety is also impacted positively, as pilots with experience and skills in all elements are less likely to make potentially life-threatening mistakes through lack of knowledge. If pilots truly are the most critical factor in maintaining the safety of flight operations, it makes sense to choose the very best available. Hospital program managers should determine who is responsible for pilot selection, and take steps to ensure that the most qualified pilots are being recruited. Consideration of the factors mentioned here in the selection process will give managers a better shot at choosing the very best.

  18. The growth-defense pivot: Crisis management in plants mediated by LRR-RK surface receptors

    Science.gov (United States)

    Belkhadir, Youssef; Yang, Li; Hetzel, Jonathan; Dangl, Jeffery L.; Chory, Joanne

    2014-01-01

    Plants must adapt to their environment and require mechanisms for sensing their surroundings and responding appropriately. An expanded family of greater than 200 leucine-rich repeat receptor kinases (LRR-RKs) transduces fluctuating and often contradictory signals from the environment into changes in nuclear gene expression. Two LRR-RKs, BRASSINOSTEROID INSENSITIVE 1 (BRI1), a steroid receptor, and FLAGELLIN-SENSITIVE 2 (FLS2), an innate immune receptor that recognizes bacterial flagellin, act cooperatively to partition necessary growth-defense tradeoffs. BRI1 and FLS2 share common signaling components and slightly different activation mechanisms. BRI1 and FLS2 are paradigms for understanding signaling mechanisms of LRR-containing receptors in plants. PMID:25089011

  19. Management of textile wastewater for improving growth and yield of field mustard (Brassica campestris L.).

    Science.gov (United States)

    Yaseen, Muhammad; Aziz, Muhammad Zahir; Komal, Aqleema; Naveed, Muhammad

    2017-09-02

    Disposal of industrial wastewater is a current issue of urbanization. However, this problem can be sorted out by using wastewater as an alternate source of irrigation after the addition of some amendment. In this way, the problem of disposal of wastewater not only will be resolved but also scarcity of irrigation water can be kept off in the future. The current research study was performed to evaluate the influence of different concentrations of wastewater along with canal water for enhancing growth and yield of field mustard. Plants were irrigated with different mixtures of canal water and wastewater (75:25, 50:50, 25:75, and 00:100) in addition to canal water as control. The results revealed that application of 50:50% waste and canal water improved plant height, the number of pods plant -1 , pod length, root length, root dry weight, shoot dry weight, 100 grain weight, grain and biomass yield plant -1 , and nitrogen, phosphorus, and potassium concentration in grain and straw up to 16%, 15%, 17%, 29%, 15%, 56%, 25%, 41%, 35%, 20%, 52%, 45%, 20%, 44%, and 42%, respectively, over positive control treatment. While, nutrient uptakes and agronomic efficiency of fertilizers also improved by the application of 50:50% canal and wastewater compared to positive control treatment. Furthermore, the concentration of heavy metals, predominantly Cr, Cu, Cd, and Pb, was reduced in grains by application of 50% canal water and 50% wastewater. The outcomes suggest that wastewater utilization along with canal water mixing might be an effective approach for enhancing growth and yield of field mustard.

  20. Effect of management practices on mycorrhizal infection, growth and dry matter partitioning in field-grown bean

    Directory of Open Access Journals (Sweden)

    Antonio Alberto Rocha Oliveira

    1999-07-01

    Full Text Available The experiment was carried out on unsterilized field soil with low phosphorus availability with the objective of examining the effect of cultural practices on mycorrhizal colonization and growth of common bean. The treatments were: three pre-crops (maize, wheat and fallow followed by three soil management practices ("ploughing", mulching and bare fallow without "ploughing" during the winter months. After the cultural practices, Phaseolus vulgaris cv. Canadian Wonder was grown in this soil. Fallowing and soil disturbance reduced natural soil infectivity. Mycorrhizal infection of the bean roots occurred more rapidly in the recently cropped soil than in the fallow soil. Prior cropping with a strongly mycorrhizal plant (maize increased infectivity even further.

  1. Pilot study of dietary phosphorus restriction and phosphorus binders to target fibroblast growth factor 23 in patients with chronic kidney disease.

    Science.gov (United States)

    Isakova, Tamara; Gutiérrez, Orlando M; Smith, Kelsey; Epstein, Michael; Keating, Leigh K; Jüppner, Harald; Wolf, Myles

    2011-02-01

    High levels of fibroblast growth factor 23 (FGF23) are associated with mortality and progression of chronic kidney disease (CKD). Reducing dietary phosphorus intake lowers FGF23 secretion in healthly individuals, but there is little data on its effects in patients with pre-dialysis CKD. Using a 2×2 factorial design, we randomly assigned 16 normophosphataemic CKD stage 3-4 patients to receive a 2-week treatment with either lanthanum carbonate 1000 mg three times daily or placebo, and to ingest a tightly controlled diet containing 750 or 1500 mg of dietary phosphorus daily. We analysed serial measurements of FGF23, parathyroid hormone, serum phosphate and calcium, and 24-h urinary phosphate and calcium excretion using repeated-measures analyses. Compared with the 1500-mg phosphorus diet, patients assigned to the 750-mg diet had greater reduction in 24-h urinary phosphate excretion (66% vs. 29%; Pphosphorus loading. Although dietary phosphorus restriction and lanthanum lowered urinary phosphate excretion consistent with a rapid decrease in phosphorus absorption, inducing a reduction in FGF23 levels in CKD patients may require interventions with a longer duration than in healthy volunteers.

  2. Reduced appearance of under-eye bags with twice-daily application of epidermal growth factor (EGF) serum: a pilot study.

    Science.gov (United States)

    Seidel, Rachel; Moy, Ronald L

    2015-04-01

    Under-eye bags are a common manifestation of age and a frequent complaint among patients who no longer feel youthful. Non-invasive topical agents are largely ineffective at reducing their appearance. We studied the ability of a topical serum containing epidermal growth factor (EGF) to minimize the appearance of under-eye bags. A single-center clinical trial was performed on eighteen volunteer male and female patients with under-eye bags. Subjects applied EGF serum to the infraorbital area twice daily for 12 weeks. At each visit, subjects were evaluated using clinical photography and written self-assessment. A grade on the Merz Infraorbital Hollowness Scale was also given and two independent, blind investigators assigned an Investigator's Global Assessment (IGA) score. At the trial's end, patients shared their final evaluation and perception of results with a questionnaire. Sixteen subjects completed the trial. The final average Merz grade was 1.63 (SEM = .273), statistically significantly lower than the mean baseline average of 2.06 (SEM = .232) (P = .0019). A reduction in average IGA score was also significant (Pbags as milder at the end of the trial compared to the first visit. Seven subjects reported greater satisfaction with their overall facial appearance. Of the subjects who had used other topical treatments in the past, two reported the serum to be "significantly better" and four said it was "better" in treating their under-eye bags. Our results offer evidence that topical EGF can reduce the appearance of under-eye bags.

  3. Pilot chargeback system program plan

    International Nuclear Information System (INIS)

    Smith, P.

    1997-03-01

    This planning document outlines the steps necessary to develop, test, evaluate, and potentially implement a pilot chargeback system at the Idaho National Engineering and Environmental Laboratory for the treatment, storage, and disposal of current waste. This pilot program will demonstrate one system that can be used to charge onsite generators for the treatment and disposal of low-level radioactive waste. In FY 1997, mock billings will begin by July 15, 1997. Assuming approvals are received to do so, FY 1998 activities will include modifying the associated automated systems, testing and evaluating system performance, and estimating the amount generators will spend for waste storage, treatment, and disposal in FY 1999. If the program is fully implemented in FY 1999, generators will pay actual, automated bills for waste management services from funds transferred to their budgets from Environmental Management

  4. Sustainability and shared smart and mutual--green growth (SSaM-GG) in Korean medical waste management.

    Science.gov (United States)

    Koo, Ja-Kong; Jeong, Seung-Ik

    2015-05-01

    Since medical insurance was introduced in the Republic of Korea, there have been several increases concerning medical waste. In order to solve these problems, we have applied life cycle assessment and life cycle cost. But these methods cannot be a perfect decision-making tool because they can only evaluate environmental and economic burdens. Thus, as one of many practical methods the shared smart and mutual - green growth considers economic growth, environmental protection, social justice, science technology and art, and mutual voluntarism when applied to medical waste management in the Republic of Korea. Four systems were considered: incineration, incineration with heat recovery, steam sterilisation, and microwave disinfection. This research study aimed to assess pollutant emissions from treatment, transport, and disposal. Global warming potential, photochemical oxidant creation potential, acidifications potential, and human toxicity are considered to be environmental impacts. Total investment cost, transport cost, operation, and maintenance cost for the medical waste are considered in the economy evaluations though life cycle cost. The social development, science technology and art, and mutual voluntarism are analysed through the Delphi-method conducted by expert groups related to medical waste. The result is that incineration with heat recovery is the best solution. However, when heat recovery is impossible, incineration without heat recovery becomes the next best choice. That is why 95% of medical waste is currently treated by both incineration and incineration with heat recovery within the Republic of Korea. © The Author(s) 2015.

  5. A pilot study of regenerative therapy using controlled release of recombinant human fibroblast growth factor for patients with pre-collapse osteonecrosis of the femoral head.

    Science.gov (United States)

    Kuroda, Yutaka; Asada, Ryuta; So, Kazutaka; Yonezawa, Atsushi; Nankaku, Manabu; Mukai, Kumi; Ito-Ihara, Toshiko; Tada, Harue; Yamamoto, Michio; Murayama, Toshinori; Morita, Satoshi; Tabata, Yasuhiko; Yokode, Masayuki; Shimizu, Akira; Matsuda, Shuichi; Akiyama, Haruhiko

    2016-08-01

    We evaluated the safety and clinical outcomes of a single local administration of gelatin hydrogel impregnated with recombinant human fibroblast growth factor (rhFGF)-2 for the treatment of the precollapse stage of osteonecrosis of the femoral head (ONFH). Patients with ONFH (precollapse stage ≤2) received a singl