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. Urban growth management

    DEFF Research Database (Denmark)

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

    2011-01-01

    , 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...... 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...

  3. 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.

  4. 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.

  5. 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

  6. 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.

  7. 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

  8. 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)

  9. 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... supplemented by Bus Discretionary funds in support of the Transit Asset Management (TAM) Pilot Program, which was announced in the TAM Program Notice of Funding Availability on November 19, 2010. The TAM program...

  10. 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

  11. 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

  12. 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...

  13. 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.

  14. 75 FR 70966 - Transit Asset Management (TAM) Pilot Program

    Science.gov (United States)

    2010-11-19

    ... DEPARTMENT OF TRANSPORTATION Federal Transit Administration Transit Asset Management (TAM) Pilot... Management (TAM) systems and ``best practices'', which can be replicated to improve transportation asset... with asset management system suppliers; however the official proposer must be a public agency. The TAM...

  15. 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)

  16. 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

  17. 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.

  18. DIRAC pilot framework and the DIRAC Workload Management System

    Energy Technology Data Exchange (ETDEWEB)

    Casajus, Adrian; Graciani, Ricardo [Universitat de Barcelona (Spain); Paterson, Stuart [CERN (Switzerland); Tsaregorodtsev, Andrei, E-mail: adria@ecm.ub.e, E-mail: graciani@ecm.ub.e, E-mail: stuart.paterson@cern.c, E-mail: atsareg@in2p3.f [CPPM Marseille (France)

    2010-04-01

    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. Achievements and Problems of Reform of Investment Management System for Shanghai Pilot Free Trade Zone

    Institute of Scientific and Technical Information of China (English)

    Chengrong; PAN

    2014-01-01

    The establishment of Shanghai Pilot Free Trade Zone provides many possibilities for China’s economic construction. This paper made a comparative analysis on investment management system of Shanghai Pilot Free Trade Zone and traditional investment management system,discussed achievements and problems of reform of investment management system of Shanghai Pilot Free Trade Zone,and finally came up with pertinent policy recommendations.

  1. 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.

  2. MPI support in the DIRAC Pilot Job Workload Management System

    International Nuclear Information System (INIS)

    Tsaregorodtsev, A; Hamar, V

    2012-01-01

    Parallel job execution in the grid environment using MPI technology presents a number of challenges for the sites providing this support. Multiple flavors of the MPI libraries, shared working directories required by certain applications, special settings for the batch systems make the MPI support difficult for the site managers. On the other hand the workload management systems with Pilot Jobs became ubiquitous although the support for the MPI applications in the Pilot frameworks was not available. This support was recently added in the DIRAC Project in the context of the GISELA Latin American Grid Initiative. Special services for dynamic allocation of virtual computer pools on the grid sites were developed in order to deploy MPI rings corresponding to the requirements of the jobs in the central task queue of the DIRAC Workload Management System. Pilot Jobs using user space file system techniques install the required MPI software automatically. The same technique is used to emulate shared working directories for the parallel MPI processes. This makes it possible to execute MPI jobs even on the sites not supporting them officially. Reusing so constructed MPI rings for execution of a series of parallel jobs increases dramatically their efficiency and turnaround. In this contribution we describe the design and implementation of the DIRAC MPI Service as well as its support for various types of MPI libraries. Advantages of coupling the MPI support with the Pilot frameworks are outlined and examples of usage with real applications are presented.

  3. 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.

  4. National Conversion Pilot Project Waste Management Program

    International Nuclear Information System (INIS)

    Engelmann, G.G.; Simmons, M.S.

    1995-01-01

    The U.S. Department of Energy facilities are in the process of downsizing. Most plans for downsizing focus on the decontamination and decommissioning of excess production facilities. A different approach for downsizing is taken at Rocky Flats Environmental Technology Site (RFETS), which has four production buildings. These buildings were used for the production of weapons components from uranium and beryllium and contain unique and valuable equipment, such as rolling mills, furnaces, and high-capacity presses, which could be utilized for stage-III metal recycling. The mission of this National Conversion Pilot Project (NCPP) open-quotes is to explore and demonstrate, at the Rocky Flats Environmental Technology Site (RFETS), the feasibility of economic conversion at Department of Energy facilities.close quotes The NCPP has been divided into three stages: 1. Stage I-planning and feasibility determination 2. Stage II-facility cleanup for reuse and operational assessment 3. Stage III-metals recycling. The NCPP has recently been approved to begin stage II. The objective of the NCPP stage II is to prepare the four NCPP buildings for stage III, to remove unwanted equipment, and to decontaminate buildings and essential equipment to levels consistent with those that commercial industrial operations must meet pursuant to applicable Occupational Safety and Health Administration, U.S. Environmental Protection Agency, U.S. Nuclear Regulatory Commission, and state workplace regulations

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

    Science.gov (United States)

    2013-09-01

    attention among them in an intricate dance commonly referred to as multitasking or concurrent task management (Chou, Madhaven, & Funk, 1996; Hoover & Russ...if they were interested in participating. One hundred one pilots responded and were sent, via email , a copy of the NASA Informed Consent form and...comfortable multitasking and dividing their attention between things such as talking to ATC and mak- ing power adjustments during the descent. All seven of

  6. 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...

  7. 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.

  8. 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)

  9. 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).

  10. 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.

  11. Pain assessement and management in surgical cancer patients: pilot and evaluation of a continuing education program.

    NARCIS (Netherlands)

    Francke, A.L.; Huijer-Abu Saad, H.; Grypdonck, M.

    1995-01-01

    In a pilot study, a continuing education program on pain assessment and management was implemented and evaluated. Questionnaires were completed by the nurse participants at the beginning, the end, and 2 months after the end of the pilot program. After the pilot program, participants reported having

  12. Achievements and Problems of Reform of Investment Management System for Shanghai Pilot Free Trade Zone

    OpenAIRE

    PAN, Chengrong

    2014-01-01

    The establishment of Shanghai Pilot Free Trade Zone provides many possibilities for China’s economic construction. This paper made a comparative analysis on investment management system of Shanghai Pilot Free Trade Zone and traditional investment management system, discussed achievements and problems of reform of investment management system of Shanghai Pilot Free Trade Zone, and finally came up with pertinent policy recommendations.

  13. 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.

  14. Evaluation of a pilot hypertension management programme for Guatemalan adults.

    Science.gov (United States)

    Mendoza Montano, Carlos; Fort, Meredith; deRamirez, Miriam; Cruz, Judith; Ramirez-Zea, Manuel

    2016-06-01

    Corazón Sano y Feliz is a hypertension management intervention developed to address deficiencies in the management of hypertensive patients in Guatemala. From 2007 to 2009, Corazón Sano y Feliz was pilot-tested in the community of Mixco. Corazón Sano y Feliz comprises a clinical risk assessment and treatment component implemented primarily by nurses, and a health education component implemented by community health workers. To accomplish our secondary objective of determining Corazon Sano y Feliz's potential for change at the patient level, we implemented a one-group pretest-posttest study design to examine changes in clinical measures, knowledge and practices between baseline and the end of the 6-month intervention. Two nurses and one physician set up a hypertension clinic to manage patients according to risk level. Twenty-nine community health workers were trained in CVD risk reduction and health promotion and in turn led six educational sessions for patients. Comparing baseline and 6-month measures, the intervention achieved significant improvements in mean knowledge and behaviour (increase from 54.6 to 59.1 out of a possible 70 points) and significant reductions of mean systolic and diastolic blood pressure (27.2 and 7.7 mmHg), body mass index (from 26.5 to 26.2 kg/m(2)) and waist circumference (89.6-88.9 cm). In this pilot study we obtained preliminary evidence that this community-oriented hypertension management and health promotion intervention model was feasible and achieved significant reduction in risk factors. If scaled up, this intervention has the potential to substantially reduce CVD burden. © The Author 2015. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  15. 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

  16. The role of knowledge management in raising the efficiency of pilots ...

    African Journals Online (AJOL)

    The role of knowledge management in raising the efficiency of pilots' performance in the ... Journal of Fundamental and Applied Sciences ... the actual knowledge management implementation in the aviation industry as well as determining the ...

  17. 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.

  18. 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

  19. 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.

  20. 75 FR 75725 - Financial Management Service; Proposed Collection of Information: Tax Time Card Account Pilot...

    Science.gov (United States)

    2010-12-06

    ... Information: Tax Time Card Account Pilot, Screening, Focus Groups, and Study AGENCY: Financial Management... general public and other Federal agencies to take this opportunity to comment on a continuing information... Account Pilot Screening, Focus Groups, and Study.'' DATES: Written comments should be received on or...

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

    DEFF Research Database (Denmark)

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

    2015-01-01

    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-intention......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...... of the program. Originality/value The paper is the first systematic study of the importance of who enrolls in training programs for SME managers....

  2. Pilot interaction with cockpit automation - Operational experiences with the Flight Management System

    Science.gov (United States)

    Sarter, Nadine B.; Woods, David D.

    1992-01-01

    Results are presented of two studies on the potential effect of cockpit automation on the pilot's performance, which provide data on pilots' difficulties with understanding and operating one of the core systems of cockpit automation, the Flight Management System (FMS). The results of both studies indicate that, although pilots do become proficient in standard FMS operations through ground training and subsequent flight experience, they still have difficulties tracking the FMS status and behavior in certain flight contexts and show gaps in the understanding of the functional structure of the system. The results suggest that design-related factors such as opaque interfaces contribute to these difficulties, which can affect the pilot's situation awareness.

  3. Intrauterine growth restriction: screening, diagnosis, and management.

    Science.gov (United States)

    Lausman, Andrea; Kingdom, John

    2013-08-01

    Intrauterine growth restriction (IUGR) is an obstetrical complication, which by definition would screen in 10% of fetuses in the general population. The challenge is to identify the subset of pregnancies affected with pathological growth restriction in order to allow intervention that would decrease morbidity and mortality. The purpose of this guideline is to provide summary statements and recommendations and to establish a framework for screening, diagnosis, and management of pregnancies affected with IUGR. Affected pregnancies are compared with pregnancies in which the fetus is at an appropriate weight for its gestational age. History, physical examination, and laboratory investigations including biochemical markers and ultrasound characteristics of IUGR are reviewed, and a management strategy is suggested. Published literature in English was retrieved through searches of PubMed or MEDLINE, CINAHL, and The Cochrane Library in January 2013 using appropriate controlled vocabulary via MeSH terms (fetal growth restriction and small for gestational age) and key words (fetal growth, restriction, growth retardation, IUGR, low birth weight, small for gestational age). Results were restricted to systematic reviews, randomized control trials/controlled clinical trials, and observational studies. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. The quality of evidence in this document was rated using the criteria described in the Report of the Canadian Task Force on Preventive Health Care (Table). Implementation of the recommendations in this guideline should increase clinician recognition of IUGR and guide intervention where appropriate. Optimal long-term follow-up of neonates diagnosed as IUGR may improve their long-term health.

  4. The policy work of piloting: Mobilising and managing conflict and ambiguity in the English NHS.

    Science.gov (United States)

    Bailey, Simon; Checkland, Kath; Hodgson, Damian; McBride, Anne; Elvey, Rebecca; Parkin, Stephen; Rothwell, Katy; Pierides, Dean

    2017-04-01

    In spite of their widespread use in policy making in the UK and elsewhere, there is a relatively sparse literature specifically devoted to policy pilots. Recent research on policy piloting has focused on the role of pilots in making policy work in accordance with national agendas. Taking this as a point of departure, the present paper develops the notion of pilots doing policy work. It does this by situating piloting within established theories of policy formulation and implementation, and illustrating using an empirical case. Our case is drawn from a qualitative policy ethnography of a local government pilot programme aiming to extend access to healthcare services. Our case explores the collective entrepreneurship of regional policy makers together with local pilot volunteers. We argue that pilots work to mobilise and manage the ambiguity and conflict associated with particular policy goals, and in their structure and design, shape action towards particular outcomes. We conclude with a discussion of the generative but managed role which piloting affords to local implementers. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Step 1: Human System Integration (HSI) FY05 Pilot-Technology Interface Requirements for Contingency Management

    Science.gov (United States)

    2005-01-01

    This document involves definition of technology interface requirements for Contingency Management. This was performed through a review of Contingency Management-related, HSI requirements documents, standards, and recommended practices. Technology concepts in use by the Contingency Management Work Package were considered. Beginning with HSI high-level functional requirements for Contingency Management, and Contingency Management technology elements, HSI requirements for the interface to the pilot were identified. Results of the analysis describe (1) the information required by the pilot to have knowledge of system failures and associated contingency procedures, and (2) the control capability needed by the pilot to obtain system status and procedure information. Fundamentally, these requirements provide the candidate Contingency Management technology concepts with the necessary human-related elements to make them compatible with human capabilities and limitations. The results of the analysis describe how Contingency Management operations and functions should interface with the pilot to provide the necessary Contingency Management functionality to the UA-pilot system. Requirements and guidelines for Contingency Management are partitioned into four categories: (1) Health and Status and (2) Contingency Management. Each requirement is stated and is supported with a rationale and associated reference(s).

  6. Risk Assessment and Analysis of the M109 Family of Vehicles Fleet Management Pilot Program

    National Research Council Canada - National Science Library

    Hitz, Stephen

    1997-01-01

    ...) Fleet Management Pilot Program. The objective of this program is to reengineer the fleet's logistical support system by outsourcing those functions which make sense and that can be performed more efficiently by private industry...

  7. Connected Vehicle Pilot Deployment Program phase 1 : security management operating concept : New York City : final report.

    Science.gov (United States)

    2016-05-18

    This document describes the Security Management Operating Concept (SMOC) for the New York City Department of Transportation (NYCDOT) Connected Vehicle Pilot Deployment (CVPD) Project. This SMOC outlines the security mechanisms that will be used to pr...

  8. Form planning Control to growth management

    DEFF Research Database (Denmark)

    Enemark, Stig

    2016-01-01

    its so-called “comprehensive-integrated” tradition and both the steering and strategic roles of national-level planning have been largely superseded by a more “flexible” planning style fit to promote specific sectoral agendas. While the legacy of land-use planning is still embedded at the local level...... 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....

  9. Growth failure, somatomedin and growth hormone levels in juvenile diabetes mellitus--a pilot study.

    Science.gov (United States)

    Nash, H

    1979-06-01

    Growth hormone (hGH) responsiveness to exercise and somatomedin C (SmC) activity were measured in ten children with insulin-deficient diabetes mellitus. Four of the ten children showed a significant degree of growth retardation. Normal SmC activity was found in association with elevated hGH levels. The hypothesis that growth-retarded diabetics have a failure of Sm production despite high hGH levels (analogous to malnutrition and Laron dwarfism) was not substantiated by this study. Chronic deficiency of insulin, itself a somatomedin, may play a major role in diabetic growth failure.

  10. 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)

  11. 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.

  12. 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.

  13. 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.

  14. 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.

  15. How Newspaper Advertising Sales Managers Spend Their Time: A Pilot Study.

    Science.gov (United States)

    Hudson, Jerry C.; Saathoff, Roger C.

    A pilot study examined how newspaper advertising sales managers in five southwestern states spend their time during a typical work day. Of the 360 questionnaires mailed, 176 responses were received. The largest number of responses (93) came from retail sales managers of newspapers in markets with less than 50,000 population. The questionnaire…

  16. 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 contribution to the diffusion of the innovation and so to a policy transition in South African coastal zone management. Finally, we identify types of pilot project and the accompanying design choices that are most suitable for transition management....

  17. Managing ethical issues in sexual violence research using a pilot study

    Directory of Open Access Journals (Sweden)

    S.E. Duma

    2009-09-01

    Full Text Available Conducting research in the area of sexual violence has complex ethical and practical challenges for the researcher. Managing ethical issues in sexual violence is important and can be achieved through the use of pilot studies. The primary purpose of the pilot study was to identify and manage potential ethical and practical problems that could jeopardise the main study or violate the ethical and human rights of participants in the main study on women’s journey of recovery from sexual assault. The secondary purpose was to collect preliminary data in order to determine the human, financial and time resources needed for a planned study. The methods and processes used in conducting the pilot study in the study on women’s journey of recovery are discussed according to each of the objectives of the pilot study, methods used to achieve the objective, observations or findings made during the pilot study, and implications for the main study. This article aims to demonstrate how a pilot study was used to manage identified potential ethical and practical research issues during the recruitment of participants and data collection for the research that was conducted by the first author to investigate women’s journey of recovery from sexual assault trauma within the first week following sexual assault.

  18. Microbial growth associated with granular activated carbon in a pilot water treatment facility.

    Science.gov (United States)

    Wilcox, D P; Chang, E; Dickson, K L; Johansson, K R

    1983-01-01

    The microbial dynamics associated with granular activated carbon (GAC) in a pilot water treatment plant were investigated over a period of 16 months. Microbial populations were monitored in the influent and effluent waters and on the GAC particles by means of total plate counts and ATP assays. Microbial populations between the influent and effluent waters of the GAC columns generally increased, indicating microbial growth. The dominant genera of microorganisms isolated from interstitial waters and GAC particles were Achromobacter, Acinetobacter, Aeromonas, Alcaligenes, Bacillus, Chromobacterium, Corynebacterium, Micrococcus, Microcyclus, Paracoccus, and Pseudomonas. Coliform bacteria were found in small numbers in the effluents from some of the GAC columns in the later months of the study. Oxidation of influent waters with ozone and maintenance of aerobic conditions on the GAC columns failed to appreciably enhance the microbial growth on GAC. PMID:6625567

  19. 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.

  20. glideinWMS - A generic pilot-based Workload Management System

    International Nuclear Information System (INIS)

    Sfiligoi, Igor

    2007-01-01

    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

  1. 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

  2. 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.

  3. 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

  4. Pilot Preference, Compliance, and Performance With an Airborne Conflict Management Toolset

    Science.gov (United States)

    Doble, Nathan A.; Barhydt, Richard; Krishnamurthy, Karthik

    2005-01-01

    A human-in-the-loop experiment was conducted at the NASA Ames and Langley Research Centers, investigating the En Route Free Maneuvering component of a future air traffic management concept termed Distributed Air/Ground Traffic Management (DAG-TM). NASA Langley test subject pilots used the Autonomous Operations Planner (AOP) airborne toolset to detect and resolve traffic conflicts, interacting with subject pilots and air traffic controllers at NASA Ames. Experimental results are presented, focusing on conflict resolution maneuver choices, AOP resolution guidance acceptability, and performance metrics. Based on these results, suggestions are made to further improve the AOP interface and functionality.

  5. 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.

  6. 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.

  7. 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.

  8. 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.

  9. Mood Management Intervention for College Smokers with Elevated Depressive Symptoms: A Pilot Study

    Science.gov (United States)

    Schleicher, Holly E.; Harris, Kari Jo; Campbell, Duncan G.; Harrar, Solomon W.

    2012-01-01

    Objective: This pilot study examined smoking reduction and cessation among college smokers with elevated depressive symptomatology participating in a group-based behavioral counseling, mood management, and motivational enhancement combined intervention (CBT). Participants and Methods: Fifty-eight smokers (smoked 6 days in the past 30) were…

  10. Step 1: Human System Integration Pilot-Technology Interface Requirements for Weather Management

    Science.gov (United States)

    2005-01-01

    This document involves definition of technology interface requirements for Hazardous Weather Avoidance. Technology concepts in use by the Access 5 Weather Management Work Package were considered. Beginning with the Human System Integration (HIS) high-level functional requirement for Hazardous Weather Avoidance, and Hazardous Weather Avoidance technology elements, HSI requirements for the interface to the pilot were identified. Results of the analysis describe (1) the information required by the pilot to have knowledge of hazardous weather, and (2) the control capability needed by the pilot to obtain hazardous weather information. Fundamentally, these requirements provide the candidate Hazardous Weather Avoidance technology concepts with the necessary human-related elements to make them compatible with human capabilities and limitations. The results of the analysis describe how Hazardous Weather Avoidance operations and functions should interface with the pilot to provide the necessary Weather Management functionality to the UA-pilot system. Requirements and guidelines for Hazardous Weather Avoidance are partitioned into four categories: (1) Planning En Route (2) Encountering Hazardous Weather En Route, (3) Planning to Destination, and (4) Diversion Planning Alternate Airport. Each requirement is stated and is supported with a rationale and associated reference(s).

  11. 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.

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

    OpenAIRE

    Ferguson, J; Koivula, T; 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 ...

  13. 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.

  14. CMS Proposal for the Engineering Data Management System (EDMS) Pilot Project with Matrix & Report

    CERN Document Server

    Kuipers, Jos

    1997-01-01

    The CMS Working Group for Engineering and Integration ( WOGEI) has been involved in the Engineering Data Management System ( EDMS) Task Force. This Task Force has started in 1995 with definition and selection procedure for an EDMS. The aim is to find out whether an EDMS is useful for CERN and the LHC experiments and which product is most suited. The CMS-WOGEI has proposed and carried out a pilot project with Matrix, the EDMS selected by the EDMS task force. In this technical note the pilot project is described and the experience gained with this is summarised.

  15. Waste Isolation Pilot Plant Groundwater Protection Management Program Plan

    International Nuclear Information System (INIS)

    1993-01-01

    The DOE has mandated in DOE Order 5400.1 that its operations will be conducted in an environmentally safe manner. The Waste Isolation Pilot Plant (WIPP) will comply with DOE Order 5400.1 and will conduct its operations in a manner that ensures the safety of the environment and the public. This document outlines how the WIPP will protect and preserve groundwater within and surrounding the WIPP facility. Groundwater protection is just one aspect of the WIPP environmental protection effort. The WIPP groundwater surveillance program is designed to determine statistically if any changes are occurring in groundwater characteristics within and surrounding the WIPP facility. If a change is noted, the cause will be determined and appropriate corrective action initiated

  16. "Cold" X5 Hairlaser™ used to treat male androgenic alopecia and hair growth: an uncontrolled pilot study.

    Science.gov (United States)

    Blum, Kenneth; Han, David; Madigan, Margaret A; Lohmann, Raquel; Braverman, Eric R

    2014-02-24

    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. 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. 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 laser hair devices requires intensive further investigation. NCT02067260.

  17. “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 laser hair devices requires intensive further investigation. Trial registration NCT02067260 PMID:24559020

  18. 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.

  19. management and growth paradox of rural small-scale industrial

    African Journals Online (AJOL)

    User

    Keywords: Rural Small-Scale Industries, firm growth, management, proprietors, workforce ... veloping countries as a solution to the problem of scarcity .... In the analysis logistic regression sta- ..... of imported raw materials such as high cost and.

  20. 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.

  1. Pediatric Nurses’ Beliefs and Pain Management Practices: An Intervention Pilot

    OpenAIRE

    Vincent, Catherine Van Hulle; Wilkie, Diana J.; Wang, Edward

    2010-01-01

    We evaluated feasibility of the Internet-based Relieve Children's Pain (RCP) protocol to improve nurses’ management of children's pain. RCP is an interactive, content-focused, and Kolb's Experiential Learning Theory-based intervention. Using a one-group, pre/posttest design, we evaluated feasibility of RCP and pre/post difference in scores for nurses’ beliefs, and simulated and actual pain management practices. Twenty-four RNs completed an Internet-based Pain Beliefs and Practices Questionnai...

  2. 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.

  3. Enhancing resilience, empowerment, and conflict management among baccalaureate students: outcomes of a pilot study.

    Science.gov (United States)

    Pines, Eula W; Rauschhuber, Maureen L; Cook, Jennifer D; Norgan, Gary H; Canchola, Leticia; Richardson, Cynthia; Jones, Mary Elaine

    2014-01-01

    To manage interpersonal conflict, nursing students need evidence-based interventions to strengthen stress resiliency, psychological empowerment, and conflict management skills. A pilot 1-group, pre-post-design, 2-semester intervention used simulated experiences to enhance these skills with 60 undergraduate nursing students. Findings suggest that integration of conflict resolution skills throughout the curriculum, with repeated opportunities to practice using a variety of styles of conflict management in relation to situational factors, may be beneficial to prepare students for the challenges of today's healthcare environment.

  4. Learning from urban growth management in the Pacific Northwest

    DEFF Research Database (Denmark)

    Fertner, Christian

    2010-01-01

    The development of contemporary urban growth management in the Northwest United States began in the 1970s. The major tool is the implementation of urban containment boundaries, fostering growth within and limiting it outside the boundary. Additionally a set of policies reaching from densification...... Washington and Oregon as e.g. the municipalities in Denmark have strong control options in planning. However, especially the metropolitan co-operation and co-ordination instruments can certainly contribute to the discussion on urban growth management in Denmark and elsewhere....

  5. 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...

  6. Screening, diagnosis, and management of intrauterine growth restriction.

    Science.gov (United States)

    Lausman, Andrea; McCarthy, Fergus P; Walker, Melissa; Kingdom, John

    2012-01-01

    To provide comprehensive background knowledge relevant to the SOGC Maternal-Fetal Medicine Committee-approved guideline entitled "Intrauterine Growth Restriction: Screening, Diagnosis, and Management." Publications in English were retrieved through searches of PubMed or Medline, CINAHL, and the Cochrane Library in January 2011 using appropriate controlled vocabulary via MeSH terms (fetal growth restriction and small for gestational age) and any key words (fetal growth, restriction, growth retardation, intrauterine growth restriction [IUGR], low birth weight, small for gestational age). Results were restricted to systematic reviews, randomized controlled trials or controlled clinical trials, and high-quality prospective and retrospective observational studies. Grey (unpublished) literature was identified through searching the websites of health technology assessment and health technology assessment-related agencies, clinical practice guideline collections, clinical trial registries, and national and international medical specialty societies. Evidence obtained from at least one properly randomized controlled trial, Cochrane Reviews, and high quality cohort data have been combined to provide clinicians with evidence to optimize their practice for screening, diagnosis, and management of intrauterine growth restriction. Considerable advances have been made to improve clinicians' ability to screen, diagnose, and manage pregnancies with suspected IUGR more effectively, including several properly randomized controlled trials. Pregnancies with late-onset IUGR may be managed equally effectively by early delivery or delayed delivery (with increased surveillance) anticipating favourable outcomes. By contrast, many aspects of the management of early-onset IUGR require further clinical trials.

  7. 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

    , qualitative research and the preliminary analysis of a single, pilot case study of The Technical University of Denmark. Progress with the other complementary cases will be included in the presentation. The cases should be supplemented by more research on sustainable facilities management. Originality......, stakeholder interviews, focus groups, usability evaluations and practice-research workshops. The Technical University of Denmark (DTU) is the pilot case of an international collaboration, and more studies are planned to follow. Findings: The paper presents a framework for qualitative research on Sustainable...... Facilities Management (SFM), which can guide future research on Sustainability in FM and increase comparability between case studies. The research identifies the challenges and opportunities for integrating ecological, social and economical sustainability in university FM. The paper presents the analysis...

  8. 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...

  9. 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.

  10. Pediatric nurses' beliefs and pain management practices: an intervention pilot.

    Science.gov (United States)

    Van Hulle Vincent, Catherine; Wilkie, Diana J; Wang, Edward

    2011-10-01

    We evaluated feasibility of the Internet-based Relieve Children's Pain (RCP) protocol to improve nurses' management of children's pain. RCP is an interactive, content-focused, and Kolb's experiential learning theory-based intervention. Using a one-group, pretest-posttest design, we evaluated feasibility of RCP and pretest-posttest difference in scores for nurses' beliefs, and simulated and actual pain management practices. Twenty-four RNs completed an Internet-based Pain Beliefs and Practices Questionnaire (PBPQ, alpha=.83) before and after they completed the RCP and an Acceptability Scale afterward. Mean total PBPQ scores significantly improved from pretest to posttest as did simulated practice scores. After RCP in actual hospital practice, nurses administered significantly more ibuprofen and ketorolac and children's pain intensity significantly decreased. Findings showed strong evidence for the feasibility of RCP and study procedures and significant improvement in nurses' beliefs and pain management practices. The 2-hr RCP program is promising and warrants replication with an attention control group and a larger sample.

  11. 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.

  12. 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.

  13. 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

  14. Growth Dynamics of Araucaria after Management Interventions in Natural Forest

    Directory of Open Access Journals (Sweden)

    Régis Villanova Longhi

    2018-02-01

    Full Text Available ABSTRACT The objective of this study was to evaluate the effect of selective logging on the growth dynamics of Araucaria angustifolia in a natural forest of Rio Grande do Sul state, Brazil. Treatments were based on percentage reduction of the basal area per DBH class, namely, T0 (control = 0%; T1 (light selective logging = reduction of 20-30%; T2 (moderate selective logging = reduction of 40-50%. Data were obtained prior to the management interventions and four, eight and 13 years after selective logging. Changes between treatments were assessed using the following parameters: absolute density, absolute dominance, importance value index, and growth rates. Results show that population reduction and canopy opening provided greater recruitment and higher growth rates for araucaria in the management treatments (T1 and T2 compared with those of the control treatment (T0. These results reinforce that management practices are necessary for the continuous development of araucaria in this forest formation.

  15. Accounting for unobserved management in renewable energy and growth

    International Nuclear Information System (INIS)

    Menegaki, Angeliki N.

    2013-01-01

    The paper employs a management random parameters frontier stochastic frontier and a simple frontier stochastic model to benchmark European countries according to their management efficiency in growth and renewable energy development. The results come from an empirical application of a panel with 31 European countries over a 14 year old period using a translog type stochastic frontier production function. In particular the paper focuses on results from a management random coefficients model and compares results with the conventional stochastic frontier model with inputs such as renewable energy, fossil fuel energy, employment and capital. The results suggest that the interaction of renewable energy with management affects growth in Europe and that the technical efficiency estimated by the management model is by 6.05% higher than the one produced by the simple stochastic frontier model. - Highlights: • Application of management random coefficients frontier model in growth-renewable energy nexus. • Comparison with the simple frontier efficiency model. • Technical efficiency is higher by 6.05% in the management model

  16. The Palouse Basin Participatory Model Pilot Project: A Participatory Approach to Bi-state Groundwater Management

    Science.gov (United States)

    Beall, A.; Fiedler, F.; Boll, J.; Cosens, B.; Harris, C.

    2008-12-01

    In March 2008, The University of Idaho Waters of the West, the Palouse Basin Aquifer Committee and its Citizen Advisory Group undertook a pilot project to explore the use of participatory modeling to assist with water resource management decisions. The Palouse basin supplies Moscow, Idaho, Pullman, Washington, and surrounding communities with high quality groundwater. However, water levels in the major aquifer systems have been declining since records have been kept. Solutions are complicated by jurisdictional considerations and limited alternatives for supply. We hope that by using a participatory approach major conflicts will be avoided. Group system dynamics modeling has been used for various environmental concerns such as air quality, biological management, water quality and quantity. These models create a nexus of science, policy, and economic and social concerns, which enhances discussion of issues surrounding the use of natural resources. Models may be developed into educational and or decision support tools which can be used to assist with planning processes. The long-term goal of the Palouse basin project is to develop such a model. The pilot project participants include hydrologists, facility operators, policy makers and local citizens. The model they have developed integrates issues such as scientific uncertainty, groundwater volumes, and potential conservation measures and costs. Preliminary results indicate that participants are satisfied with the approach and are looking to use the model for education and to help direct potential research. We will present the results of the pilot project, including the developed model and insights from the process.

  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

    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

  19. 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

  20. 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; style="text-decoration: none; " href="javascript:void(0); " onClick="displayelement('author_20130014930'); toggleEditAbsImage('author_20130014930_show'); toggleEditAbsImage('author_20130014930_hide'); "> style="display:inline; width:12px; height:12px; " src="images/arrow-up.gif" width="12" height="12" border="0" alt="hide" id="author_20130014930_show"> style="width:12px; height:12px; display:none; " src="images/arrow-down.gif" width="12" height="12" border="0" alt="hide" id="author_20130014930_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

  1. 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

  2. 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.

  3. Amnioinfusion before 26 weeks' gestation for severe fetal growth restriction with oligohydramnios: preliminary pilot study.

    Science.gov (United States)

    Takahashi, Yuichiro; Iwagaki, Shigenori; Chiaki, Rika; Iwasa, Tomotake; Takenaka, Motoki; Kawabata, Ichiro; Itoh, Mitsuaki

    2014-03-01

    The prognosis for severe fetal growth restriction (FGR) with severe oligohydramnios before 26 weeks' gestation (WG) is currently poor; furthermore, its management is controversial. We report the innovative new management of FGR, such as therapeutic amnioinfusion and tocolysis. For FGR and severe oligohydramnios before 26 WG complicated with absent or reversed umbilical artery end-diastolic flow velocity and/or deceleration by ultrasonography, we performed transabdominal amnioinfusion with tocolysis. Cases with multiple anomalies were excluded. Survival rate and long-term prognosis were analyzed. Among 570 FGR cases, 18 were included in the study. Mean diagnosis and delivery were at 22.6 ± 2.0 and 28.7 ± 3.3 WG. Median birthweight was 625 g (-4.2 standard deviation). Final survival rate was 11/13 (85%). There were five fetal deaths. In seven cases, oligohydramnios improved. Growth was detected in 10/18 fetuses. Furthermore, 8/8 decelerations, 4/12 cases of reversed umbilical artery end-diastolic flow velocity, 7/14 cases of brain-sparing effect, and 6/13 venous Doppler abnormalities were improved. When we detected umbilical cord compression, 8/10 cases were rescued. Eleven infants were followed up for an average of 5 years; one case of cerebral palsy with normal development and 10 cases with intact motor functions without major neurological handicap were confirmed. In cases of extremely severe FGR before 26 WG with oligohydramnios and circulatory failure, amnioinfusion might be a promising, innovative tool. © 2013 The Authors. Journal of Obstetrics and Gynaecology Research © 2013 Japan Society of Obstetrics and Gynecology.

  4. Credit Unions and Capital Adequacy: Managing Growth and Risk

    Directory of Open Access Journals (Sweden)

    R. Raymond Sant PhD, CFA, CMA

    2013-07-01

    Full Text Available In this paper we argue that a financial institution needs to continuously monitor and assess its risk exposure in the context of capital requirements and available growth opportunities. Judicious management of the interaction between these three elements is crucial to the long term survival and growth of such an institution. We highlight different approaches to risk analysis, beyond stress testing, such as, Value at Risk and Monte Carlo simulation. We recommend that the board of directors establish a sub-committee of its directors to oversee risk management and capital control functions, and to monitor a credit union’s asset liability management activities on an ongoing basis. Efforts should also be made to increase the level of internal expertise regarding risk management and analysis with the full participation of the board, a function that should not be outsourced. In an increasingly regulated financial industry environment it is imperative that a financial institution seeks out growth opportunities while maintaining the balance between capital and risk exposure for long-term business continuity.

  5. 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.

  6. 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

  7. 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

  8. 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

  9. 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.

  10. 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.

  11. Development and pilot of an internationally standardized measure of cardiovascular risk management in European primary care

    Directory of Open Access Journals (Sweden)

    Szecsenyi Joachim

    2011-04-01

    Full Text Available Abstract Background Primary care can play an important role in providing cardiovascular risk management in patients with established Cardiovascular Diseases (CVD, patients with a known high risk of developing CVD, and potentially for individuals with a low risk of developing CVD, but who have unhealthy lifestyles. To describe and compare cardiovascular risk management, internationally valid quality indicators and standardized measures are needed. As part of a large project in 9 European countries (EPA-Cardio, we have developed and tested a set of standardized measures, linked to previously developed quality indicators. Methods A structured stepwise procedure was followed to develop measures. First, the research team allocated 106 validated quality indicators to one of the three target populations (established CVD, at high risk, at low risk and to different data-collection methods (data abstraction from the medical records, a patient survey, an interview with lead practice GP/a practice survey. Secondly, we selected a number of other validated measures to enrich the assessment. A pilot study was performed to test the feasibility. Finally, we revised the measures based on the findings. Results The EPA-Cardio measures consisted of abstraction forms from the medical-records data of established Coronary Heart Disease (CHD-patients - and high-risk groups, a patient questionnaire for each of the 3 groups, an interview questionnaire for the lead GP and a questionnaire for practice teams. The measures were feasible and accepted by general practices from different countries. Conclusions An internationally standardized measure of cardiovascular risk management, linked to validated quality indicators and tested for feasibility in general practice, is now available. Careful development and pilot testing of the measures are crucial in international studies of quality of healthcare.

  12. High-level-waste records management system: the NRC pilot project

    International Nuclear Information System (INIS)

    Bender, A.; Altomare, P.

    1987-01-01

    The US Nuclear Regulatory Commission (NRC) and the US Dept. of Energy (DOE) have agreed to develop a licensing support system (LSS) to address the records management requirements created by the Nuclear Waste Policy Act (NWPA). The NRC is planning to conduct a negotiated rule making the modify 10CFR2, including rules governing discovery, so that parties to the licensing process will use a single information management system as a source for all licensing-related documents. The successful demonstration of the pilot project has resulted in an operational on-line record management system for NRC-related HLW documents. Both incoming and outgoing documents are being scanned and stored on a mainframe system and on an optical disk. At this writing the optical disk portion of the system is being tested to evaluate its potential use as a future archival and distribution medium for licensing records. Experience gained from this project is being shared with other government agencies that are in the process of using similar technologies to come to grips with the complex records management problem endemic to our information-based society

  13. Outcomes of neurofeedback training in childhood obesity management: a pilot study.

    Science.gov (United States)

    Chirita-Emandi, Adela; Puiu, Maria

    2014-11-01

    This pilot study sought to evaluate the neurofeedback training outcomes in childhood obesity management. The study involved 34 overweight and obese children, age 6-18 years (12 patients in the intervention group, 22 in the control group). Complete assessment of children was done before the intervention and 3 and 6 months after the intervention; eating behavior and quality-of-life questionnaires were assessed at study start and 6 months after. All children received classic lifestyle recommendations for weight management, while the intervention group also had 20 neurofeedback sessions (infra-low-frequency training). The neurofeedback intervention was associated with less weight loss compared with classic weight management. The mean change in body-mass index standard deviation score at 3 months was -0.29 for the intervention group and -0.36 for the control group (p=0.337); after 6 months, the changes were -0.30 and -0.56, respectively (p=0.035). Quality of life improved similarly for both groups. Subjective outcomes reported by patients in the intervention were less snacking, improved satiety, enhanced attention capacity, ameliorated hyperactivity, and better sleep patterns. Larger studies, with training methods involving both the left and right cortices, should further clarify the role of neurofeedback training in obesity management.

  14. 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.

  15. 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...

  16. 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

  17. Illness Management & Recovery (IMR) in the Netherlands : A naturalistic pilot study to explore the feasibility of a randomized controlled trial

    NARCIS (Netherlands)

    Roosenschoon, B.J.; Van Weeghel, J.; Bogaards, M.; Deen, M.L.; Mulder, C.L.

    2016-01-01

    Background Illness Management & Recovery (IMR) is a curriculum-based program for people with severe and persistent mental illness. To date, four randomized controlled trials (RCTs) have been published on it. As these produced mixed results, we conducted a pilot study to test the feasibility of

  18. Illness Management & Recovery (IMR) in the Netherlands; a naturalistic pilot study to explore the feasibility of a randomized controlled trial

    NARCIS (Netherlands)

    B.J. Roosenschoon (Bert); J. van Weeghel (Jaap); Bogaards, M. (Moniek); M. Deen (Mathijs); C.L. Mulder (Niels)

    2016-01-01

    textabstractBackground: Illness Management & Recovery (IMR) is a curriculum-based program for people with severe and persistent mental illness. To date, four randomized controlled trials (RCTs) have been published on it. As these produced mixed results, we conducted a pilot study to test the

  19. 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…

  20. 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.

  1. 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

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

    Energy Technology Data Exchange (ETDEWEB)

    Triay, I R; Matthews, M L [U.S. Dept. of Energy Carlsbad Field Office, New Mexico (United States); Eriksson, L G [GRAM, Inc., Albuquerque, NM (United States)

    2001-07-01

    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)

  3. 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)

  4. Airborne Conflict Management within Confined Airspace in a Piloted Simulation of DAG-TM Autonomous Aircraft Operations

    Science.gov (United States)

    Barmore, Bryan; Johnson, Edward; Wing, David J.; Barhydt, Richard

    2003-01-01

    A human-in-the-loop experiment was performed at the NASA Langley Research Center to study the feasibility of Distributed Air/Ground Traffic Management (DAG-TM) autonomous aircraft operations in highly constrained airspace. The airspace was constrained by a pair of special use airspace (SUA) regions on either side of the pilot s planned route. The available airspace was further varied by changing the separation standard for lateral separation between 3 nm and 5 nm. The pilot had to maneuver through the corridor between the SUA s, avoid other traffic and meet flow management constraints. Traffic flow management (TFM) constraints were imposed as a required time of arrival and crossing altitude at an en route fix. This is a follow-up study to work presented at the 4th USA/Europe Air Traffic Management R&D Seminar in December 2001. Nearly all of the pilots were able to meet their TFM constraints while maintaining adequate separation from other traffic. In only 3 out of 59 runs were the pilots unable to meet their required time of arrival. Two loss of separation cases are studied and it is found that the pilots need conflict prevention information presented in a clearer manner. No degradation of performance or safety was seen between the wide and narrow corridors. Although this was not a thorough study of the consequences of reducing the en route lateral separation, nothing was found that would refute the feasibility of reducing the separation requirement from 5 nm to 3 nm. The creation of additional, second-generation conflicts is also investigated. Two resolution methods were offered to the pilots: strategic and tactical. The strategic method is a closed-loop alteration to the Flight Management System (FMS) active route that considers other traffic as well as TFM constraints. The tactical resolutions are short-term resolutions that leave avoiding other traffic conflicts and meeting the TFM constraints to the pilot. Those that made use of the strategic tools avoided

  5. 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.

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

    DEFF Research Database (Denmark)

    Andersen, O; Haugaard, S B; Flyvbjerg, A

    2004-01-01

    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......-I and fat distribution. Glucose metabolism was examined by oral glucose tolerance tests and hyperinsulinaemic euglycaemic clamps. RESULTS: Total IGF-I increased twofold (P

  7. 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...

  8. 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.

  9. 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.

  10. 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.

  11. Managing simple food allergy in community settings: A pilot study investigating a new model of care.

    Science.gov (United States)

    Danchin, Margaret; De Bono, Natalie; Allen, Katrina; Tang, Mimi; Hiscock, Harriet

    2016-03-01

    The prevalence of food allergy in Australia has increased, paralleled by an increase in waiting time to access tertiary paediatric allergy care. We aimed to test whether a new model of care, based on serum specific IgE testing, was feasible and acceptable to Australian families. A prospective pilot intervention study was conducted in community paediatric practices within 20-40 km of The Royal Children's Hospital, Melbourne. Children ≤7 years with likely food allergy referred to the Department of Allergy and Immunology at RCH were included; children with anaphylaxis, drug allergy or complex food allergy (>three food groups) were excluded. Community general paediatricians, recruited through the Australian Paediatric Research Network, were trained via webinars on the management of four common food allergy-related scenarios. Paediatrician and child and family parameters were assessed at baseline and 3 months, including safety. 34/45 (76%) eligible families and 10/12 (83%) paediatricians participated. Paediatricians managed 27/34 (80%) of children independently, with 7/34 (20%) requiring referral to an allergist for more complex food allergy. Paediatricians reported improved knowledge and competency in managing food allergy: (mean (standard deviation) scores pre = 35 (5.3) and post = 43.3 (3.9) training). The majority of children received appropriate management; there were no anaphylaxis episodes. There was no significant change in child quality of life or parent mental health. Management of simple food allergy by community paediatricians appears feasible and acceptable to paediatricians and families alike. Future research will evaluate this approach in an adequately powered and controlled trial. © 2015 The Authors. Journal of Paediatrics and Child Health © 2015 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  12. 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

  13. 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.

  14. 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

  15. Growth failure associated with early neglect: pilot comparison of neglected US children and international adoptees.

    Science.gov (United States)

    Miller, Bradley S; Spratt, Eve G; Himes, John H; Condon, Doreen; Summer, Andrea; Papa, Carrie E; Brady, Kathleen T

    2015-01-01

    The long-lasting impact of different neglectful environments on growth in children is not well studied. Three groups of children, 3-10 years old, were recruited (n=60): previously institutionalized international adoptees living in stable home environments for at least 2 years (IA; n=15), children with a history of neglect born in the USA (USN; n=17), and controls (n=28). Children underwent physical examination, anthropometry, and collection of serum for growth parameters. Mean height standard deviation scores (SDS) were different (pneglected children. IGF-1 adjusted for age and weight SDS were different (pneglect groups. The degree of growth failure in height and HC in IAs was more severe than neglected US children. These findings may reflect differences between the impact of chronic and intermittent deprivation on the growth hormone system.

  16. 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...

  17. Contingency management for tobacco smoking during opioid addiction treatment: a randomised pilot study.

    Science.gov (United States)

    Ainscough, Tom Stephen; Brose, Leonie S; Strang, John; McNeill, Ann

    2017-09-01

    Smoking rates among individuals in treatment for opioid addiction are close to five times that of the general public. Moreover, drug-addicted smokers have a premature mortality rate four times greater than drug-addicted non-smokers. The aim of this pilot study was to investigate whether contingency management (CM) can be successfully added to evidence-based stop smoking treatment in individuals undergoing treatment for opioid addiction and assess preliminary evidence for its impact. Forty tobacco smokers currently undergoing treatment for opioid addiction. Escalating with reset CM as an adjunct to standard smoking cessation treatment. Financial incentives will be administered over a 5-week period for either biochemically verified abstinence from smoking or attendance at the clinic. Participants will be randomised to conditions stratified on current levels of smoking (high or low). To assess whether a CM intervention can be successfully added to standard stop smoking services treatment, in patients undergoing outpatient treatment for opioid addiction. This will be measured as the number of people completing the 5 weeks of the intervention. Ethics approval for the study was granted on the 16 June 2016 by the London-city and east (reference 16/LO/0990) ethics committee. The pilot study was retrospectively registered on clincaltrials.gov in January 2017 (ID: NCT03015597). A SPIRIT checklist and figure are available for this protocol. It is planned that the results of this study will be published in an academic journal. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  18. 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.

  19. 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.

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

    Science.gov (United States)

    Cunningham, Jennifer M; Blake, Catherine; Power, Camillus K; O'Keeffe, Declan; Kelly, Valerie; Horan, Sheila; Spencer, Orla; Fullen, Brona M

    2011-01-10

    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. 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 measures. Sleep will be measured for seven days

  1. A Social Media Peer Group Intervention for Mothers to Prevent Obesity and Promote Healthy Growth from Infancy: Development and Pilot Trial.

    Science.gov (United States)

    Gruver, Rachel S; Bishop-Gilyard, Chanelle T; Lieberman, Alexandra; Gerdes, Marsha; Virudachalam, Senbagam; Suh, Andrew W; Kalra, Gurpreet K; Magge, Sheela N; Shults, Justine; Schreiner, Mark S; Power, Thomas J; Berkowitz, Robert I; Fiks, Alexander G

    2016-08-02

    of participants as well as the requirements of the local institutional review board (IRB), which included use of a "secret" group and frequent screening of participant posts. Clinicians, 97% (29/30) women and 87% (26/30) pediatricians, preferred no direct involvement in the intervention, but were supportive of their patients' participation. In our 8-week, single group pilot trial, all participants (mean BMI 35 kg/m(2), all Medicaid-insured, mean age 28, all Black) viewed every weekly video post, and interacted frequently, with a weekly average of 4.4 posts/comments from each participant. All participant posts were related to parenting topics. Participants initiated conversations about behaviors related to healthy infant growth including solid food introduction, feeding volume, and managing stress. All 8 pilot group participants reported that they found the group helpful and would recommend it to others. Our methodology was feasible and acceptable to low-income mothers of infants at high risk of obesity, and could be adapted to implement peer groups through social media for underserved populations in varied settings. ClinicalTrials.gov NCT01977105; https://clinicaltrials.gov/ct2/show/NCT01977105 (Archived by WebCite at http://www.webcitation.org/6iMFfOBat).

  2. 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.

  3. 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.

  4. 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.

  5. 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 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.

  6. The use of topical minoxidil to accelerate nail growth: a pilot study.

    Science.gov (United States)

    Aiempanakit, Kumpol; Geater, Alan; Limtong, Preeyachat; Nicoletti, Kathleen

    2017-07-01

    Linear nail growth rate is affected by various conditions, one of which is the level of blood flow. Our supposition was that topical minoxidil, which has vasodilatory properties, can increase the rate of nail growth. The aim of this study was to determine the impact of topical minoxidil on nail growth. A 5% topical minoxidil solution was applied twice daily to the fingernails of 32 participants. Two groups of 16 participants were randomly chosen. In one group, the applications were made to the right index and left ring fingernails, and, in the other, the left index and right ring fingernails. During each visit (weekly during the first month and every 2 weeks during the second month), the nail length of six fingernails (index, middle, and ring of both hands) was measured using a digital caliper. Beginning in the first week, the mean nail length of the treated nails was greater than that of nails in the untreated group with statistical significance. There were no systemic or cutaneous side effects. During the first month, the mean growth of the treated nails was 4.27 mm/month compared with 3.91 mm/month in the untreated nails (P = 0.003). These findings suggest that a 5% concentration of topical minoxidil can stimulate nail growth with increased growth beginning in the first week of application. The results may have important implications for the treatment of nail disorders; however, a comparable study involving participants with nail disorders is highly recommended. © 2017 The International Society of Dermatology.

  7. 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.

  8. 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

  9. 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.

  10. 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...

  11. Management of growth failure in the treatment of malignant disease

    International Nuclear Information System (INIS)

    Leiper, A.D.

    1990-01-01

    Growth failure due to endocrine dysfunction as a result of treatment for malignant disease is becoming increasingly common. It may occur after cranial or craniospinal irradiation given in the treatment of acute lymphoblastic leukemia and brain tumors, and is often coupled with early or precocious puberty. It also occurs after neck and gonadal radiation and is particularly severe after total body irradiation where multiple endocrine deficiencies frequently occur. Failure to appreciate its occurrence or failure to institute therapy early enough may lead to short stature in adult life. Accurate and regular monitoring of standing and sitting height, bone age, and endocrine data should be undertaken by the oncologist in close collaboration with an endocrinologist, to ensure appropriate management of the patient. 17 references

  12. A Pilot Study of Abnormal Growth in Autism Spectrum Disorders and Other Childhood Psychiatric Disorders

    Science.gov (United States)

    Rommelse, Nanda N. J.; Peters, Cindy T. R.; Oosterling, Iris J.; Visser, Janne C.; Bons, Danielle; van Steijn, Daphne J.; Draaisma, Jos; van der Gaag, Rutger-Jan; Buitelaar, Jan. K.

    2011-01-01

    The aims of the current study were to examine whether early growth abnormalities are (a) comparable in autism spectrum disorders (ASD) and other childhood psychiatric disorders, and (b) specific to the brain or generalized to the whole body. Head circumference, height, and weight were measured during the first 19 months of life in 129 children…

  13. Effects of intensive forest management practices on insect infestation levels and loblolly pine growth

    Science.gov (United States)

    John T. Nowak; C. Wayne Berisford

    2000-01-01

    Intensive forest management practices have been shown to increase tree growth and shorten rotation time. However, they may also lead to an increased need for insect pest management because of higher infestation levels and lower action thresholds. To investigate the relationship between intensive management practices arid insect infestation, maximum growth potential...

  14. 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......-I and fat distribution. Glucose metabolism was examined by oral glucose tolerance tests and hyperinsulinaemic euglycaemic clamps. RESULTS: Total IGF-I increased twofold (P ....01). Patients reported improvements of lipodystrophy, which was supported by a decreased waist-to-thigh ratio (P = 0.01), and waist-to-hip ratio (P = 0.06). Ratio of peripheral to trunk soft tissue mass increased (P = 0.01, measured by dual-energy X-ray absorptiometry scans) and a trend towards reduction...

  15. 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

  16. Performance-Based Contingency Management in Cognitive Remediation Training: A Pilot Study.

    Science.gov (United States)

    Kiluk, Brian D; Buck, Matthew B; Devore, Kathleen A; Babuscio, Theresa A; Nich, Charla; Carroll, Kathleen M

    2017-01-01

    Impairments in attention, working memory, and executive function are common among substance users and may adversely affect SUD treatment outcomes. The ability of cognitive remediation (CR) interventions to improve these deficits is hindered in part because levels of engagement in CR training may be inadequate to achieve benefit. This pilot study aimed to increase CR engagement and improve outcome by implementing contingency management (CM) procedures that reinforce performance improvements on CR tasks. Participants were forty individuals (50% male; 65% African American) in an outpatient substance use treatment facility with mild cognitive impairment who had ≥30-days of abstinence from alcohol and drugs. They were randomized to standard (CR-S; n=21) or CM-enhanced (CR-CM; n=19) cognitive remediation training. CR consisted of 1-hour sessions, three times per week for four weeks (12 sessions). A neuropsychological assessment battery was administered prior to and after the four-week intervention. Both groups had high rates of CR session attendance (mean CR-S=11.7, CR-CM=10.9 sessions). Performance on 8 of the 9 CR tasks significantly improved over time for both conditions, with the CR-CM condition demonstrating greater improvement on a CR Sequenced Recall task [F(1,37)=5.81, ptraining and suggest the potential value of more research in this area. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. 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

  18. Application of Radiation Degraded Chitosan as Plant Growth Promoter. A Pilot Scale Production and Field Trial Study of Radiation Processed Chitosan as Plant Growth Promoter for Rice Crops

    International Nuclear Information System (INIS)

    Dahlan, Khairul Zaman Hj Mohd; Hashim, Kamaruddin; Bahari, Kamarudin

    2010-01-01

    The application of radiation processed chitosan as plant growth promoter has been carried out in the 24 hectares of rice crops. For the field trial, a pilot scale production of oligochitosan was established using gamma irradiation for partial degradation of chitosan powder of DDA 90% and followed by gamma irradiation of aqueous solution of 3% irradiated chitosan powder in 2% lactic acids (3CL2). Radiation dose of 50 kGy was selected for initial degradation of chitosan powder and followed by 12 kGy irradiation of 3CL2. A viscosity average molecular weight of ~10,000 of oligochitosan was obtained and subsequently used in the field trial of MR219 type of rice seeds on 24 hectares of rice plots. The seedlings were carried out after the rice seeds were soaked 24hrs in water and 30 minutes in 200ppm oligochitosan. The rice plots that were sprayed with oligochitosan were found to have higher resistant towards blast diseases. Oligochitosan of 40ppm was found to be effective as fungicides and resulted in the increase of yield of rice seeds of about 5%. (author)

  19. Protecting Water Quality With Smart Growth Strategies and Natural Stormwater Management in Sussex County, Delaware

    Science.gov (United States)

    The report describes a technical assistance project that explored how smart growth and sustainable stormwater management approaches (known as green infrastructure) could be applied to Sussex County, DE.

  20. 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.

  1. 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

  2. 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.

  3. 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

  4. 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.

  5. 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.

  6. 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 ...

  7. Connected vehicle pilot deployment program phase I : security management operational concept, Tampa Hillsborough Expressway Authority (THEA).

    Science.gov (United States)

    2016-05-01

    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...

  8. Connected vehicle pilot deployment program phase 2, data management plan - Wyoming

    Science.gov (United States)

    2017-04-10

    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 ...

  9. 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...

  10. 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

  11. Financial Management and Economic Growth: The European Countries Experience

    Directory of Open Access Journals (Sweden)

    Nuno Carlos LEITÃO

    2012-12-01

    Full Text Available The purpose of this research is to investigate the impact of financial development on economic growth applied to European Countries. The initial GDP per capita is negatively correlated with growth of real GDP per capita. Our study shows that there is convergence within European Countries for the period 1990-2009. This paper confirms relevant theoretical hypothesis as international trade and saving encourage the economic growth. The inflation has a negative impact on economic growth as previous studies.

  12. 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.

  13. Shareholder/Stakeholder Value Management, Company Growth and

    OpenAIRE

    Ekholm, Bo-Göran; Wallin, Jan

    2003-01-01

    There has been considerable discussion in the literature about the relative merits of shareholder value management and stakeholder value management, but relatively little empirical research has been reported concerning the relationship between these types of management and financial performance. The present study puts forward a hypothesis that true shareholder value management also encompasses stakeholder value management. This combination of shareholder/stakeholder value management is hypoth...

  14. 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.

  15. 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.

  16. 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

  17. 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

  18. 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.

  19. 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

  20. 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

  1. The low level laser therapy in the management of neurological burning mouth syndrome. A pilot study

    Science.gov (United States)

    Romeo, Umberto; Del Vecchio, Alessandro; Capocci, Mauro; Maggiore, Claudia; Ripari, Maurizio

    2010-01-01

    sides of the tongue on the path of taste fibers. A NRS (numerical rating scale) evaluation of maximum and minimum pain was registered before and after the treatment. In each case to the total value of NRS rates registered before the treatment was deducted the total NRS rate registered after the treatment. The difference was estimated effective if over two points. The Kruskall-Wallis test revealed the significance of the study (p<0.0001) and the Dunn’s Multiple Comparison test, applied to compare NRS rates before and after the treatment, showed that there is not a statistically relevant difference between min NRS ratings before and after treatment, while there are statistically significant differences between max NRS ratings (p<0.05). Results All the patients agreed the treatment confirming the general good compliance related to laser treatments. No side effects were registered and all the patients completed the therapy without interruption. Seventeen patients (68%) had relevant benefits from the treatment with valid reduction of NRS ratings. In 8 cases the differences of NRS rates were not relevant being under the limit of reliability established in study design. In no case there was a worsening of the symptoms. Conclusions: According to the results of this pilot study it is reasonable to suppose that LLLT may play an important role in the management of nBMS cases, more investigations are needed to clarify, by a greater number of cases and a placebo control group, the real effectiveness of this innovative LLLT application. PMID:22238700

  2. 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.

  3. 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.

  4. Situ leaching uranium mining conditions of the pilot phase of the safety management

    International Nuclear Information System (INIS)

    Liu Wenyuan

    2014-01-01

    With China's large, very large sandstone type uranium deposits have been discovered in the Ordos Basin, Inner Mongolia and its surrounding for uranium mining in the region has been carried out. Sandstone-type uranium mining, mainly used in China is 'to dip' and the technology is relatively mature. Situ leaching mining process, the deposit conditions Test conditions pilot phase, however, limited by cost control and field conditions, equipment shabby, out in the conditions of the pilot phase of security issues in the larger securityrisks. This will be Ordos ongoing test conditions situ leaching uranium mines, for example, raised situ leaching uranium mining conditions of the pilot phase a few safety measures recommended. (author)

  5. 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.

  6. Pilot study of an Internet patient-physician communication tool for heart failure disease management.

    Science.gov (United States)

    Wu, Robert C; Delgado, Diego; Costigan, Jeannine; Ross, Heather; MacIver, Jane

    2006-01-01

    Internet disease management has the promise of improving care in patients with heart failure but evidence supporting its use is limited. We have designed a Heart Failure Internet Communication Tool (HFICT), allowing patients to enter messages for clinicians, as well as their daily symptoms, weight, blood pressure and heart rate. Clinicians review the information on the same day and provide feedback. This pilot study evaluated the feasibility and patients' acceptability of using the Internet to communicate with patients with symptomatic heart failure. Patients with symptomatic heart failure were instructed how to use the Internet communication tool. The primary outcome measure was the proportion of patients who used the system regularly by entering information on average at least once per week for at least 3 months. Secondary outcomes measures included safety and maintainability of the tool. We also conducted a content analysis of a subset of the patient and clinician messages entered into the comments field. Between 3 May 1999 and 1 November 2002, 62 patients (mean age 48.7 years) were enrolled. At 3 months 58 patients were alive and without a heart transplant. Of those, 26 patients (45%; 95% Confidence Interval, 0.33-0.58) continued using the system at 3 months. In 97% of all entries by participants weight was included; 68% of entries included blood pressure; and 71% of entries included heart rate. In 3,386 entries out of all 5,098 patient entries (66%), comments were entered. Functions that were not used included the tracking of diuretics, medications and treatment goals. The tool appeared to be safe and maintainable. Workload estimates for clinicians for entering a response to each patient's entry ranged from less than a minute to 5 minutes or longer for a detailed response. Patients sent 3,386 comments to the Heart Function Clinic. Based on the content analysis of 100 patient entries, the following major categories of communication were identified: patient

  7. 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

  8. 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.

  9. Development, content validity, and piloting of an instrument designed to measure managers' attitude toward workplace breastfeeding support.

    Science.gov (United States)

    Chow, Tan; Wolfe, Edward W; Olson, Beth H

    2012-07-01

    Manager attitude is influential in female employees' perceptions of workplace breastfeeding support. Currently, no instrument is available to assess manager attitude toward supporting women who wish to combine breastfeeding with work. We developed and piloted an instrument to measure manager attitudes toward workplace breastfeeding support entitled the "Managers' Attitude Toward Breastfeeding Support Questionnaire," an instrument that measures four constructs using 60 items that are rated agree/disagree on a 4-point Likert rating scale. We established the content validity of the Managers' Attitude Toward Breastfeeding Support Questionnaire measures through expert content review (n=22), expert assessment of item fit (n=11), and cognitive interviews (n=8). Data were collected from a purposive sample of 185 front-line managers who had experience supervising female employees, and responses were scaled using the Multidimensional Random Coefficients Multinomial Logit Model. Dimensionality analyses supported the proposed four-construct model. Reliability ranged from 0.75 to 0.86, and correlations between the constructs were moderately strong (0.47 to 0.71). Four items in two constructs exhibited model-to-data misfit and/or a low score-measure correlation. One item was revised and the other three items were retained in the Managers' Attitude Toward Breastfeeding Support Questionnaire. Findings of this study suggest that the Managers' Attitude Toward Breastfeeding Support Questionnaire measures are reliable and valid indicators of manager attitude toward workplace breastfeeding support, and future research should be conducted to establish external validity. The Managers' Attitude Toward Breastfeeding Support Questionnaire could be used to collect data in a standardized manner within and across companies to measure and compare manager attitudes toward supporting breastfeeding. Organizations can subsequently develop targeted strategies to improve support for breastfeeding

  10. 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.

  11. 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...... 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...

  12. 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...

  13. 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.

  14. 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...

  15. The unified approach of management and critical incident stress management: helping flight attendants and pilots in the aftermath of September 11.

    Science.gov (United States)

    McIntosh, Tania

    2006-01-01

    Experience suggests that effective and appropriate responses of an organization's management after a traumatic incident can help mitigate the reactions of primary, secondary, and tertiary victims. This commentary addresses the managerial response of Southwest Airlines to the trauma induced by September 11. It highlights the effectiveness of the unity between the company, the unions, and the Critical Incident Response Team, as well as the types of interventions that were highly regarded by flight attendants and pilots who received such services. This commentary also defines the phenomenon known as fear of flight.

  16. Nurse case-manager vs multifaceted intervention to improve quality of osteoporosis care after wrist fracture: randomized controlled pilot study.

    Science.gov (United States)

    Majumdar, S R; Johnson, J A; Bellerose, D; McAlister, F A; Russell, A S; Hanley, D A; Garg, S; Lier, D A; Maksymowych, W P; Morrish, D W; Rowe, B H

    2011-01-01

    Few outpatients with fractures are treated for osteoporosis in the years following fracture. In a randomized pilot study, we found a nurse case-manager could double rates of osteoporosis testing and treatment compared with a proven efficacious quality improvement strategy directed at patients and physicians (57% vs 28% rates of appropriate care). Few patients with fractures are treated for osteoporosis. An intervention directed at wrist fracture patients (education) and physicians (guidelines, reminders) tripled osteoporosis treatment rates compared to controls (22% vs 7% within 6 months of fracture). More effective strategies are needed. We undertook a pilot study that compared a nurse case-manager to the multifaceted intervention using a randomized trial design. The case-manager counseled patients, arranged bone mineral density (BMD) tests, and prescribed treatments. We included controls from our first trial who remained untreated for osteoporosis 1-year post-fracture. Primary outcome was bisphosphonate treatment and secondary outcomes were BMD testing, appropriate care (BMD test-treatment if bone mass low), and costs. Forty six patients untreated 1-year after wrist fracture were randomized to case-manager (n = 21) or multifaceted intervention (n = 25). Median age was 60 years and 68% were female. Six months post-randomization, 9 (43%) case-managed patients were treated with bisphosphonates compared with 3 (12%) multifaceted intervention patients (relative risk [RR] 3.6, 95% confidence intervals [CI] 1.1-11.5, p = 0.019). Case-managed patients were more likely than multifaceted intervention patients to undergo BMD tests (81% vs 52%, RR 1.6, 95%CI 1.1-2.4, p = 0.042) and receive appropriate care (57% vs 28%, RR 2.0, 95%CI 1.0-4.2, p = 0.048). Case-management cost was $44 (CDN) per patient vs $12 for the multifaceted intervention. A nurse case-manager substantially increased rates of appropriate testing and treatment for osteoporosis in

  17. The impact of risk management on internal and sustainable growth rate: Evidence from Tehran Stock Exchange

    Directory of Open Access Journals (Sweden)

    Hamid Reza Vakili Fard

    2014-09-01

    Full Text Available Measuring the relative risk of firms has been an open discussion among researchers. There are many studies on learning how leverage may influence on growth of the firms. This article reviews the relationship between risk management, internal and sustainable growth of accepted companies in Tehran stock exchange. The survey considers three types of risks including operating, financial and compound and investigates their relationships with internal growth rate as well as sustainable growth rate. Using some regression techniques, the study has determined negative and meaningful relationships between different types of leverage on side and internal as well as sustainable growth on the other side.

  18. 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.

  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. Optimizing patient management and adherence for children receiving growth hormone

    DEFF Research Database (Denmark)

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

    2017-01-01

    © 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....... 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...

  1. Pilot studies of management of ageing of nuclear power plant instrumentation and control components

    International Nuclear Information System (INIS)

    Burnay, S.G.; Simola, K.; Kossilov, A.; Pachner, J.

    1993-01-01

    This paper describes pilot studies which have been implemented to study the aging behavior of safety related component parts of nuclear power plants. In 1989 the IAEA initiated work on pilot studies related to the aging of such components. Four components were identified for study. They are the primary nozzle of a reactor vessel; a motor operated isolating valve; the concrete containment building; and instrumentation and control cables within the containment facility. The study was begun with phase 1 efforts directed toward understanding the aging process, and methods for monitoring and minimizing the effects of aging. Phase 2 efforts are directed toward aging studies, documentation of the ideas put forward, and research to answer questions identified in phase 1. This paper describes progress made on two of these components, namely the motor operated isolation valves, and in-containment I ampersand C cables

  2. 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

  3. 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.

  4. Web-Based Intervention for Nutritional Management in Cystic Fibrosis: Development, Usability, and Pilot Trial.

    Science.gov (United States)

    Stark, Lori J; Opipari-Arrigan, Lisa; Filigno, Stephanie S; Simon, Stacey L; Leonard, Amanda; Mogayzel, Peter J; Rausch, Joseph; Zion, Cynthia; Powers, Scott W

    2016-06-01

    Usability and pilot testing of a web intervention (BeInCharge.org [BIC]) of behavior plus nutrition intervention for children with cystic fibrosis (CF) ages 4-9 years. Think Aloud methodology was used with five mothers to assess usability and refine the intervention. A pilot trial was then conducted with 10 mothers of children with CF ages 4-9 years randomized to the web-based BIC or a Standard Care Control (STC). Change in weight gain for each group was compared in a pre-to-post design. Mothers rated the usability and clarity of BIC highly. The pilot trial showed children of mothers who received BIC had a significant change in weight pre-to-post-treatment (0.67 kg, p = .04). Change for the STC was not significant (0.41 kg, p = .10). A web-based behavior plus nutrition intervention appears promising in increasing weight gain in children with CF. © The Author 2015. Published by Oxford University Press on behalf of the Society of Pediatric Psychology. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  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. 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.

  7. The Effect of Silvicultural Management on Regeneration, Growth ...

    African Journals Online (AJOL)

    improved management, including protection from interference, culm yield of ... silvicultural measure helped boosting up of bamboo productivity (Midmore 2009). .... experiment was replicated three times, making the total number of plots ( ...

  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. 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.

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

    Directory of Open Access Journals (Sweden)

    Mwafongo Winfred

    2010-10-01

    Full Text Available Abstract 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

  11. 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

  12. Communicating old-growth forest management on the Allegheny National Forest

    Science.gov (United States)

    Brad Nelson; Chris Nowak; Dave deCalesta; Steve Wingate

    1997-01-01

    Successful communication of old-growth management, including the role of silviculture, is achieved by integrating as a working whole the topics addressed in this workshop. We have used research, technology transfer and adaptive management to achieve this integration on the Allegheny National Forest. Program success depends on scientists and practitioners working...

  13. Impact of a fatigue management in work programme on meeting work demands of individuals with rheumatic diseases: A pilot study.

    Science.gov (United States)

    McCormack, Róisín C; O'Shea, Finbar; Doran, Michele; Connolly, Deirdre

    2018-03-25

    Work disability and job loss are serious consequences of rheumatic diseases (RDs), and fatigue is a symptom of RDs commonly reported to have an impact on work performance. A FAtigue ManagEment in Work (FAME-W) programme was developed to facilitate the self-management of fatigue in work. The present pilot study explored if FAME-W could facilitate individuals with RDs to manage fatigue in work and improve their ability to meet work demands. Twenty-seven individuals with a variety of rheumatic diagnoses completed a 4-week, 2-h occupational therapy-led self-management programme. Each week focused on fatigue-related topics, including fatigue and activity management, pain management and joint protection, mental well-being, effective communication with employers and work colleagues, and employment legislation. Individual workplace ergonomic assessments were also offered. Study measures (work function, fatigue, pain, mood and self-efficacy) were completed prior to starting FAME-W, immediately post-intervention and 12 weeks post-intervention. Participants (56% male) had a mean age of 43 years. No significant improvements were observed immediately post-programme. However, at the 12-week follow-up, significant improvements were reported in meeting work demands (scheduling [p = 0.046], output [p = 0.002], physical [p = 0.003], mental [p = 0.016]), fatigue [p = 0.001], pain [p = 0.01], anxiety [p = 0.001], depression [p physical: p = 0.005; symptoms: p = 0.010; affect: p = 0.010; social: p = 0.001). Significant improvements were reported in participants' ability to meet various demands of their work 3 months post-FAME-W. These findings suggest that FAME-W has the potential to assist individuals with RDs to meet the demands of their work, although further research is required to test the effectiveness of this intervention. Copyright © 2018 John Wiley & Sons, Ltd.

  14. Simulation modeling on the growth of firm's safety management capability

    Institute of Scientific and Technical Information of China (English)

    LIU Tie-zhong; LI Zhi-xiang

    2008-01-01

    Aiming to the deficiency of safety management measure, established simulation model about firm's safety management capability(FSMC) based on organizational learning theory. The system dynamics(SD) method was used, in which level and rate system, variable equation and system structure flow diagram was concluded. Simulation model was verified from two aspects: first, model's sensitivity to variable was tested from the gross of safety investment and the proportion of safety investment; second, variables dependency was checked up from the correlative variable of FSMC and organizational learning. The feasibility of simulation model is verified though these processes.

  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. 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 ...

  18. 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

    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....... 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...

  19. The Alert Program for Self-Management of Behaviour in Second Level Schools: Results of Phase 1 of a Pilot Study

    Science.gov (United States)

    Mac Cobb, Siobhan; Fitzgerald, Brian; Lanigan-O'Keeffe, Carolyn

    2014-01-01

    This article reports on Phase 1 of a pilot programme on self-management of behaviour with challenging class groups of students as part of the evidence-informed practice of the National Behaviour Support Service. The Alert Program is a structured active learning programme using an engine analogy. The person's engine runs on high, low or just right…

  20. 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…

  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. 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

  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. Development of a Pilot Data Management Infrastructure for Biomedical Researchers at University of Manchester – Approach, Findings, Challenges and Outlook of the MaDAM Project

    Directory of Open Access Journals (Sweden)

    Meik Poschen

    2012-12-01

    Full Text Available Management and curation of digital data has been becoming ever more important in a higher education and research environment characterised by large and complex data, demand for more interdisciplinary and collaborative work, extended funder requirements and use of e-infrastructures to facilitate new research methods and paradigms. This paper presents the approach, technical infrastructure, findings, challenges and outlook (including future development within the successor project, MiSS of the ‘MaDAM: Pilot data management infrastructure for biomedical researchers at University of Manchester’ project funded under the infrastructure strand of the JISC Managing Research Data (JISCMRD programme. MaDAM developed a pilot research data management solution at the University of Manchester based on biomedical researchers’ requirements, which includes technical and governance components with the flexibility to meet future needs across multiple research groups and disciplines.

  5. 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

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

    International Nuclear Information System (INIS)

    Froehlich, G.K.; Williamson, C.M.; Ogden, H.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 GB, was accomplished in 5 months by two individuals, with full traceability and reproducibility

  7. 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.

  8. 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.

  9. Water resources management in a homogenizing world: Averting the Growth and Underinvestment trajectory

    Science.gov (United States)

    Mirchi, Ali; Watkins, David W.; Huckins, Casey J.; Madani, Kaveh; Hjorth, Peder

    2014-09-01

    Biotic homogenization, a de facto symptom of a global biodiversity crisis, underscores the urgency of reforming water resources management to focus on the health and viability of ecosystems. Global population and economic growth, coupled with inadequate investment in maintenance of ecological systems, threaten to degrade environmental integrity and ecosystem services that support the global socioeconomic system, indicative of a system governed by the Growth and Underinvestment (G&U) archetype. Water resources management is linked to biotic homogenization and degradation of system integrity through alteration of water systems, ecosystem dynamics, and composition of the biota. Consistent with the G&U archetype, water resources planning primarily treats ecological considerations as exogenous constraints rather than integral, dynamic, and responsive parts of the system. It is essential that the ecological considerations be made objectives of water resources development plans to facilitate the analysis of feedbacks and potential trade-offs between socioeconomic gains and ecological losses. We call for expediting a shift to ecosystem-based management of water resources, which requires a better understanding of the dynamics and links between water resources management actions, ecological side-effects, and associated long-term ramifications for sustainability. To address existing knowledge gaps, models that include dynamics and estimated thresholds for regime shifts or ecosystem degradation need to be developed. Policy levers for implementation of ecosystem-based water resources management include shifting away from growth-oriented supply management, better demand management, increased public awareness, and institutional reform that promotes adaptive and transdisciplinary management approaches.

  10. 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.

  11. A pilot study of a weight management program with food provision in schizophrenia.

    Science.gov (United States)

    Jean-Baptiste, Michel; Tek, Cenk; Liskov, Ellen; Chakunta, Umesh Rao; Nicholls, Sarah; Hassan, Akm Q; Brownell, Kelly D; Wexler, Bruce E

    2007-11-01

    Obesity is a serious medical problem that disproportionately affects people with severe mental illness. Behavioral strategies aimed at lifestyle modification have proven effective for weight loss in general population but have not been studied adequately among persons with schizophrenia. We have conducted a randomized controlled pilot trial of an established weight loss program, modified for this specific population, and supplemented with a novel food replacement program, as well as practical, community based teaching of shopping and preparing healthy food. The program not only arrested weight gain, and produced meaningful weight loss, but also weight loss continued 6 months after the intervention is completed. Cognitive impairment had no bearing to the extent a participant benefited from the program. As a conclusion, well designed simple behavioral programs can produce lasting weight loss for patients with schizophrenia and comorbid obesity, improve metabolic indices, and possibly decrease significant medical risks associated with obesity.

  12. What can a pilot congestive heart failure disease management program tell us about likely return on investment?: A case study from a program offered to federal employees.

    Science.gov (United States)

    vanVonno, Catherine J; Ozminkowski, Ronald J; Smith, Mark W; Thomas, Eileen G; Kelley, Doniece; Goetzel, Ron; Berg, Gregory D; Jain, Susheel K; Walker, David R

    2005-12-01

    In 1999, the Blue Cross and Blue Shield Federal Employee Program (FEP) implemented a pilot disease management program to manage congestive heart failure (CHF) among members. The purpose of this project was to estimate the financial return on investment in the pilot CHF program, prior to a full program rollout. A cohort of 457 participants from the state of Maryland was matched to a cohort of 803 nonparticipants from a neighboring state where the CHF program was not offered. Each cohort was followed for 12 months before the program began and 12 months afterward. The outcome measures of primary interest were the differences over time in medical care expenditures paid by FEP and by all payers. Independent variables included indicators of program participation, type of heart disease, comorbidity measures, and demographics. From the perspective of the funding organization (FEP), the estimated return on investment for the pilot CHF disease management program was a savings of $1.08 in medical expenditure for every dollar spent on the program. Adding savings to other payers as well, the return on investment was a savings of $1.15 in medical expenditures per dollar spent on the program. The amount of savings depended upon CHF risk levels. The value of a pilot initiative and evaluation is that lessons for larger-scale efforts can be learned prior to full-scale rollout.

  13. 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

  14. Growth

    Science.gov (United States)

    John R. Jones; George A. Schier

    1985-01-01

    This chapter considers aspen growth as a process, and discusses some characteristics of the growth and development of trees and stands. For the most part, factors affecting growth are discussed elsewhere, particularly in the GENETICS AND VARIATION chapter and in chapters in PART 11. ECOLOGY. Aspen growth as it relates to wood production is examined in the WOOD RESOURCE...

  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. 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

  17. Aerosol fluxes and particle growth above managed grassland

    Directory of Open Access Journals (Sweden)

    E. Nemitz

    2009-08-01

    Full Text Available Particle deposition velocities (11–3000 nm diameter measured above grassland by eddy covariance during the EU GRAMINAE experiment in June 2000 averaged 0.24 and 0.03 mm s−1 to long (0.75 m and short (0.07 m grass, respectively. After fertilisation with 108 kg N ha−1 as calcium ammonium nitrate, sustained apparent upward fluxes of particles were observed. Analysis of concentrations and fluxes of potential precursor gases, including NH3, HNO3, HCl and selected VOCs, shows that condensation of HNO3 and NH3 on the surface of existing particles is responsible for this effect. A novel approach is developed to derive particle growth rates at the field scale, from a combination of measurements of vertical fluxes and particle size-distributions. For the first 9 days after fertilization, growth rates of 11 nm particles of 7.04 nm hr−1 and 1.68 nm hr−1 were derived for day and night-time conditions, respectively. This implies total NH4NO3 production rates of 1.11 and 0.44 μg m−3 h−1, respectively. The effect translates into a small error in measured ammonia fluxes (0.06% day, 0.56% night and a large error in NH4+ and NO3 aerosol fluxes of 3.6% and 10%, respectively. By converting rapidly exchanged NH3 and HNO3 into slowly depositing NH4NO3, the reaction modifies the total N budget, though this effect is small (<1% for the 10 days following fertilization, as NH3 emission dominates the net flux. It is estimated that 3.8% of the fertilizer N was volatilised as NH3, of which 0.05% re-condensed to form NH4NO3 particles within the lowest 2 m of the surface layer. This surface induced process would at least scale up to a global NH4NO3 formation of ca. 0.21 kt N yr

  18. Linkage to care among adults being investigated for tuberculosis in South Africa: pilot study of a case manager intervention.

    Science.gov (United States)

    Maraba, Noriah; Chihota, Violet; McCarthy, Kerrigan; Churchyard, Gavin J; Grant, Alison D

    2018-05-24

    We piloted an intervention to determine if support from a case manager would assist adults being investigated for tuberculosis (TB) to link into TB and HIV care. Pilot interventional cohort study. Patients identified by primary healthcare clinic staff in South Africa as needing TB investigations were enrolled. Participants were supported for 3 months by case managers who facilitated the care pathway by promoting HIV testing, getting laboratory results, calling patients to return for results and facilitating treatment initiation. Linkage to TB care was defined as starting TB treatment within 28 days in those with a positive test result; linkage to HIV care, for HIV-positive people, was defined as having blood taken for CD4 count and, for those eligible, starting antiretroviral therapy within 3 months. Intervention implementation was measured by number of attempts to contact participants. Among 562 participants (307 (54.6%) female, median age: 36 years (IQR 29-44)), most 477 (84.8%) had previously tested for HIV; of these, 328/475 (69.1%) self-reported being HIV-positive. Overall, 189/562 (33.6%) participants needed linkage to care (132 HIV care linkage only; 35 TB treatment linkage only; 22 both). Of 555 attempts to contact these 189 participants, 407 were to facilitate HIV care linkage, 78 for TB treatment linkage and 70 for both. At the end of 3-month follow-up, 40 participants had not linked to care (29 of the 132 (22.0%) participants needing linkage to HIV care only, 4 of the 35 (11.4%) needing to start on TB treatment only and 7 of the 22 (31.8%) needing both). Many people testing for TB need linkage to care. Despite case manager support, non-linkage into HIV care remained higher than desirable, suggesting a need to modify this intervention before implementation. Innovative strategies to enable linkage to care are needed. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial

  19. 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.

  20. Impact of a medication therapy management intervention targeting medications associated with falling: Results of a pilot study.

    Science.gov (United States)

    Mott, David A; Martin, Beth; Breslow, Robert; Michaels, Barb; Kirchner, Jeff; Mahoney, Jane; Margolis, Amanda

    2016-01-01

    The use of fall risk-increasing drugs (FRIDs) by older adults is one factor associated with falling, and FRID use is common among older adults. A targeted medication therapy management intervention focused on FRID use that included prescription and over-the-counter (OTC) medications, along with follow-up telephone calls was designed. The purpose of this pilot study was to examine preliminary effects of a medication therapy management (MTM) intervention focused on FRIDs provided by a community pharmacist to older adults. Randomized, controlled trial. One community pharmacy. Eighty older adults who completed a fall prevention workshop. The main outcome measures were the rate of discontinuing FRIDs, the proportion of older adults falling, and the number of falls. A secondary outcome was the acceptance rate of medication recommendations by patients and prescribers. Thirty-eight older adults received the targeted MTM intervention. Of the 31 older adults using a FRID, a larger proportion in the intervention group had FRID use modified relative to controls (77% and 28%, respectively; P FRID use among older adults was effective in modifying FRID use. This result supports the preliminary conclusion that community pharmacists can play an important role in modifying FRID use among older adults. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  1. Results of a randomized controlled pilot trial of intravascular renal denervation for management of treatment-resistant hypertension.

    Science.gov (United States)

    Jacobs, Lotte; Persu, Alexandre; Huang, Qi-Fang; Lengelé, Jean-Philippe; Thijs, Lutgarde; Hammer, Frank; Yang, Wen-Yi; Zhang, Zhen-Yu; Renkin, Jean; Sinnaeve, Peter; Wei, Fang-Fei; Pasquet, Agnès; Fadl Elmula, Fadl Elmula M; Carlier, Marc; Elvan, Arif; Wunder, Cora; Kjeldsen, Sverre E; Toennes, Stefan W; Janssens, Stefan; Verhamme, Peter; Staessen, Jan A

    2017-12-01

    Previous trials of catheter-based renal-artery denervation (RDN) as treatment modality in resistant hypertension (rHT) generated unconvincing results. In the Investigator-Steered Project on Intravascular Denervation for Management of Treatment-Resistant Hypertension (INSPiRED; NCT01505010), we optimized selection and management of rHT patients. With ethical clearance to randomize 18 patients, three Belgian hypertension centers screened 29 rHT patients on treatment with ≥3 drugs, of whom 17 after optimization of treatment (age efficacy endpoint, and 2.5 mL/min/1.73 m 2 (+1.5 vs. -1.1 mL/min/1.73 m 2 ; P = .86) for eGFR, the primary safety endpoint. At 6 month, ECG voltages and the number of prescribed drugs (P ≤ .036) were lower in RDN patients, but quality of life and adherence, captured by questionnaire and urine analysis were similar in both groups. Changes in BP and adherence were unrelated. No major complications occurred. The INSPiRED pilot suggests that RDN with the EnligHTN ™ system is effective and safe and generated insights useful for the design of future RDN trials.

  2. 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.

  3. 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.

  4. 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.

  5. Yoga as a Therapeutic Intervention in the Management of Dysfunctional Uterine Bleeding: A Controlled Pilot Study

    Directory of Open Access Journals (Sweden)

    Snehal Pankaj Nalgirkar

    2018-01-01

    Full Text Available Background: Dysfunctional uterine bleeding (DUB is one of the most common gynecological disorders encountered in women during the reproductive age. Yoga therapy has shown promising benefits in several gynecological disorders. Methods: Thirty women between the ages of 20 and 40 years with primary DUB were randomly assigned to a yoga (n = 15 and a waitlist control group (n = 15. Participants in the yoga group received a 3-month yoga module and were assessed for hemoglobin values, endometrial thickness (ET, pictorial blood loss assessment chart (PBAC, State-Trait Anxiety Inventory, perceived stress scale, and Pittsburgh Sleep Quality Index (PSQI before and after a 3-month follow-up period. Results: At the end of 3 months of intervention, the yoga group, unlike the control group, reported a significant reduction in the anxiety scores (P < 0.05 and perceived stress (P < 0.05. The PSQI scores indicated a reduction in sleep disturbances (P < 0.001 and the need for sleep medications (P < 0.01 and higher global scores (P < 0.001. However, there were no changes in PBAC and ET in both the groups. Conclusion: The results indicate that yoga therapy positively impacts the outcome of DUB by reducing the perceived stress and state anxiety and improving the quality of sleep. This warrants larger clinical trials to validate the findings of this pilot study.

  6. Optimizing continuous cover management of boreal forest when timber prices and tree growth are stochastic

    Directory of Open Access Journals (Sweden)

    Timo Pukkala

    2015-03-01

    Full Text Available Background Decisions on forest management are made under risk and uncertainty because the stand development cannot be predicted exactly and future timber prices are unknown. Deterministic calculations may lead to biased advice on optimal forest management. The study optimized continuous cover management of boreal forest in a situation where tree growth, regeneration, and timber prices include uncertainty. Methods Both anticipatory and adaptive optimization approaches were used. The adaptive approach optimized the reservation price function instead of fixed cutting years. The future prices of different timber assortments were described by cross-correlated auto-regressive models. The high variation around ingrowth model was simulated using a model that describes the cross- and autocorrelations of the regeneration results of different species and years. Tree growth was predicted with individual tree models, the predictions of which were adjusted on the basis of a climate-induced growth trend, which was stochastic. Residuals of the deterministic diameter growth model were also simulated. They consisted of random tree factors and cross- and autocorrelated temporal terms. Results Of the analyzed factors, timber price caused most uncertainty in the calculation of the net present value of a certain management schedule. Ingrowth and climate trend were less significant sources of risk and uncertainty than tree growth. Stochastic anticipatory optimization led to more diverse post-cutting stand structures than obtained in deterministic optimization. Cutting interval was shorter when risk and uncertainty were included in the analyses. Conclusions Adaptive optimization and management led to 6%–14% higher net present values than obtained in management that was based on anticipatory optimization. Increasing risk aversion of the forest landowner led to earlier cuttings in a mature stand. The effect of risk attitude on optimization results was small.

  7. Pain management for older persons living in nursing homes: a pilot study.

    Science.gov (United States)

    Tse, Mimi M Y; Ho, Suki S K

    2013-06-01

    Because the prevalence of chronic pain among the elderly in nursing homes is high and decreases their quality of life, effective nonpharmacologic pain management should be promoted. The purpose of this quasiexperimental pretest and posttest control design was to enhance pain management in nursing homes via an integrated pain management program (IPMP) for staff and residents. Nursing staff and residents from the experimental nursing home were invited to join the 8-week IPMP, whereas staff and residents from the control nursing home did not receive the IPMP. Baseline data were collected from nursing staff and residents in both groups before and after the IPMP. The IPMP consisted of eight lectures on pain assessment, drug knowledge,and nondrug strategies for the nursing staff, and 8 weeks of activities, including gardening therapy and physiotherapy exercise, for the residents. There were 48 and 42 older people in the experimental and control groups, respectively. No significant differences were found in their educational level, sleep quality, bowel habits, past and present health conditions, pain conditions and psychologic well-being parameters (p > .05) at baseline. After the IPMP, the experimental nursing staff showed a significant improvement in their knowledge of and attitudes to pain management (p pain scores and used more nondrug strategies for pain relief compared with the control group (p nursing staff, as well as reducing pain conditions and enhancing psychologic well-being for older persons in nursing homes. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  8. Electric utility load management: rational use of energy program pilot study

    Energy Technology Data Exchange (ETDEWEB)

    1977-08-01

    In recognition of the role that load management can play in ensuring that the growing demand for electricity is met in a cost- and energy-efficient manner, in mid-1974, the NATO Committee on the Challenges of Modern Society sponsored all three meetings to provide a forum for representatives of U.S. and European utilities to exchange views and experiences on the various aspects of load management. It was the consensus of representatives at the meetings that three overall approaches offer significant opportunities for achieving improved load management: development of marginal-cost rate structures; power pooling and energy storage by utilities; and efforts by consumers. Industrial consumers can assist electric utilities in their efforts to level system loads through three important methods: interruptible power and deferred load control; peak self-generation; and shifts in operating schedules. Residential/commercial consumers also have an important role to play by managing both their electric heating load (through the interruption of direct-resistance heating and the storage of heat) and their air conditioning load. In response to the interest expressed by the participants in the CCMS conferences, the U.S. and several European governments, national electric utility industry organizations, state public utility commissions, and many individual utilities have undertaken R and D projects to investigate and test various aspects of these three approaches to load management. This report describes the projects that were presented by the utility representatives.

  9. 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.

  10. 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.

  11. 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

  12. Management of Chronic Lateral Epicondylitis With Manual Therapy and Local Cryostimulation: A Pilot Study.

    Science.gov (United States)

    Richer, Nadia; Marchand, Andrée-Anne; Descarreaux, Martin

    2017-12-01

    The purpose of this pilot study was to evaluate the feasibility and efficacy of adding cryostimulation to manual therapy in patients with chronic lateral epicondylitis. The control group (n = 19) was treated with manual therapy consisting of soft-tissue therapy and radial head mobilizations. The experimental group (n = 18) received cryostimulation in addition to manual therapy care similar to that for the control group. Both protocols consisted of 8 treatments over a 4-week period. Outcome measures included pain intensity (visual analog scale), pain-free grip strength (handheld dynamometer), and functional index (Patient-Rated Tennis Elbow Evaluation questionnaire). Assessments were performed at baseline, postintervention, and 3-month follow-up. Adherence and dropout rates were also considered. Both groups exhibited significant improvements in pain intensity and functional index at postintervention assessments, which were maintained at follow-up. All participants attended the prescribed number of treatments, but 27% were lost at follow-up. Minor adverse events were reported after cryostimulation in 4 cases. This study indicated that it is feasible to complete a clinical trial evaluating the efficacy of adding cryostimulation to manual therapy in patients with chronic lateral epicondylitis. On the basis of these preliminary data, the combination of cryostimulation and manual therapy care did not provide any additional benefits in both the short term and the long term. Manual myofascial point treatment and mobilization techniques yielded positive outcomes in chronic lateral epicondylitis. Further studies should focus on the sole therapeutic effect of cryostimulation in both patients with acute and those with chronic conditions.

  13. Personalised telehealth intervention for chronic disease management: A pilot randomised controlled trial.

    Science.gov (United States)

    Bohingamu Mudiyanselage, Shalika; Stevens, Jo; Watts, Jennifer J; Toscano, Julian; Kotowicz, Mark A; Steinfort, Christopher L; Bell, Jennifer; Byrnes, Janette; Bruce, Stephanie; Carter, Sarah; Hunter, Claire; Barrand, Chris; Hayles, Robyn

    2018-01-01

    Introduction The aim of this study was to assess the impact of home-based telehealth monitoring on health outcomes, quality of life and costs over 12 months for patients with diabetes and/or chronic obstructive pulmonary disease (COPD) who were identified as being at high risk of readmission to hospital. Methods This pilot study was a randomised controlled trial combined with an economic analysis to examine the outcomes of standard care versus home-based telehealth for people with diabetes and/or COPD who were at risk of hospital readmission within one year. The primary outcomes were (i) hospital admission and length of stay (LOS); and (ii) health-related quality of life (HRQOL); and the secondary outcomes were (i) health-related clinical outcomes; (ii) anxiety and depression scores; and (iii) health literacy. The costs of the intervention and hospitalisations were included. Results A total of 86 and 85 participants were randomised to the intervention and control groups respectively. The difference between groups in hospital LOS was -3.89 (95% confidence interval (CI): -9.40, 1.62) days, and for HRQOL, 0.09 (95% CI: 0.05, 0.14) in favour of the telehealth monitoring group. There was a saving of AUD$6553 (95% CI: -12145, -961) in the cost of hospitalisation over 12 months, which offset the increased cost of tele-monitoring. The intervention group showed an improvement in anxiety, depression and health literacy at 12 months, and in the diabetes group, a reduction in microalbuminuria. Discussion The telehealth monitoring intervention improved patient's health outcomes and quality of life at no additional cost.

  14. Reduction in Fall Rate in Dementia Managed Care Through Video Incident Review: Pilot Study.

    Science.gov (United States)

    Bayen, Eleonore; Jacquemot, Julien; Netscher, George; Agrawal, Pulkit; Tabb Noyce, Lynn; Bayen, Alexandre

    2017-10-17

    Falls of individuals with dementia are frequent, dangerous, and costly. Early detection and access to the history of a fall is crucial for efficient care and secondary prevention in cognitively impaired individuals. However, most falls remain unwitnessed events. Furthermore, understanding why and how a fall occurred is a challenge. Video capture and secure transmission of real-world falls thus stands as a promising assistive tool. The objective of this study was to analyze how continuous video monitoring and review of falls of individuals with dementia can support better quality of care. A pilot observational study (July-September 2016) was carried out in a Californian memory care facility. Falls were video-captured (24×7), thanks to 43 wall-mounted cameras (deployed in all common areas and in 10 out of 40 private bedrooms of consenting residents and families). Video review was provided to facility staff, thanks to a customized mobile device app. The outcome measures were the count of residents' falls happening in the video-covered areas, the acceptability of video recording, the analysis of video review, and video replay possibilities for care practice. Over 3 months, 16 falls were video-captured. A drop in fall rate was observed in the last month of the study. Acceptability was good. Video review enabled screening for the severity of falls and fall-related injuries. Video replay enabled identifying cognitive-behavioral deficiencies and environmental circumstances contributing to the fall. This allowed for secondary prevention in high-risk multi-faller individuals and for updated facility care policies regarding a safer living environment for all residents. Video monitoring offers high potential to support conventional care in memory care facilities. ©Eleonore Bayen, Julien Jacquemot, George Netscher, Pulkit Agrawal, Lynn Tabb Noyce, Alexandre Bayen. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 17.10.2017.

  15. A pilot study of the eccentric decline squat in the management of painful chronic patellar tendinopathy.

    Science.gov (United States)

    Purdam, C R; Jonsson, P; Alfredson, H; Lorentzon, R; Cook, J L; Khan, K M

    2004-08-01

    This non-randomised pilot study investigated the effect of eccentric quadriceps training on 17 patients (22 tendons) with painful chronic patellar tendinopathy. Two different eccentric exercise regimens were used by subjects with a long duration of pain with activity (more than six months). (a) Nine consecutive patients (10 tendons; eight men, one woman; mean age 22 years) performed eccentric exercise with the ankle joint in a standard (foot flat) position. (b) Eight patients (12 tendons; five men, three women; mean age 28 years) performed eccentric training standing on a 25 degrees decline board, designed to increase load on the knee extensor mechanism. The eccentric training was performed twice daily, with three sets of 15 repetitions, for 12 weeks. Primary outcome measures were (a) 100 mm visual analogue scale (VAS), where the subject recorded the amount of pain during activity, and (b) return to previous activity. Follow up was at 12 weeks, with a further limited follow up at 15 months. Good clinical results were obtained in the group who trained on the decline board, with six patients (nine tendons) returning to sport and showing a significantly reduced amount of pain over the 12 week period. Mean VAS scores fell from 74.2 to 28.5 (p = 0.004). At 15 months, four patients (five tendons) reported satisfactory results (mean VAS 26.2). In the standard squat group the results were poor, with only one athlete returning to previous activity. Mean VAS scores in this group were 79.0 at baseline and 72.3 at 12 weeks (p = 0.144). In a small group of patients with patellar tendinopathy, eccentric squats on a decline board produced encouraging results in terms of pain reduction and return to function in the short term. Eccentric exercise using standard single leg squats in a similar sized group appeared to be a less effective form of rehabilitation in reducing pain and returning subjects to previous levels of activity.

  16. 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...

  17. 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

  18. Yield and growth components of potato and wheat under organic nitrogen management

    NARCIS (Netherlands)

    Delden, van A.

    2001-01-01

    In order to optimize N management in organic farming systems, knowledge of crop growth processes in relation to N limitation is necessary. The present paper examines the response of potato (Solanum tuberosum L.) and wheat (Triticum aestivum L.) to N with respect to intercepted photosynthetically

  19. Critical control points for the management of microbial growth in HVAC systems

    NARCIS (Netherlands)

    Gommers, S; Franchimon, F.; Bronswijk, van J.E.M.H.; Strøm-Tejsen, P; Olesen, BW; Wargocki, P; Zukowska, D; Toftum, J

    2008-01-01

    Office buildings with HVAC systems consistently report Sick Building Symptoms that are derived from microbial growth. We used the HACCP methodology to find the main critical control points (CCPs) for microbial management of HVAC systems in temperate climates. Desk research revealed relative humidity

  20. Growth and yield considerations and implications for alternative density management objectives and approaches

    Science.gov (United States)

    David. Marshall

    2013-01-01

    Density management through thinning is the most important tool foresters have to aff ect stand development and stand structure of existing stands. Reducing stand density by thinning increases the growing space and resource availability (e.g., light, water, and nutrients) for the remaining trees. Th is can result in increased average tree growth. More available site...

  1. 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

  2. Pilot Test and Evaluation of a System of Computer-Managed Instruction.

    Science.gov (United States)

    Spuck, Dennis W.; Bozeman, William C.

    1978-01-01

    The Wisconsin System for Instructional Management (WIS SIM) was evaluated on three dimensions (functioning, utilization, and effects) and the information gathered was classified into three types--actual, perceptual, and judgmental. The test demonstrates that a system supportive of an individualized system of education can be designed, developed,…

  3. 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

  4. 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

  5. Participatory farm management adaptations to reduce environmental impact on commercial pilot dairy farms in the Netherlands

    NARCIS (Netherlands)

    Oenema, J.; Keulen, van H.; Schils, R.L.M.; Aarts, H.F.M.

    2011-01-01

    Regulations in the Netherlands with respect to nutrient use force dairy farmers to improve nutrient management at the whole-farm level. On experimental farm ‘De Marke’, a coherent set of simple measures at farm level has been implemented, which has resulted in a drastic reduction in input of

  6. 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

    forests is discussed. We suggest dead wood input to be the driving variable leading to the observed differences in the nematode community between managed and natural forests of Zealand, Denmark. The marked site differences found in this study emphasizes the need to carefully choose reference areas where...

  7. 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.

  8. 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.

  9. A placenta clinic approach to the diagnosis and management of fetal growth restriction.

    Science.gov (United States)

    Kingdom, John C; Audette, Melanie C; Hobson, Sebastian R; Windrim, Rory C; Morgen, Eric

    2018-02-01

    Effective detection and management of fetal growth restriction is relevant to all obstetric care providers. Models of best practice to care for these patients and their families continue to evolve. Since much of the disease burden in fetal growth restriction originates in the placenta, the concept of a multidisciplinary placenta clinic program, managed primarily within a maternal-fetal medicine division, has gained popularity. In this context, fetal growth restriction is merely one of many placenta-related disorders that can benefit from an interdisciplinary approach, incorporating expertise from specialist perinatal ultrasound and magnetic resonance imaging, reproductive genetics, neonatal pediatrics, internal medicine subspecialties, perinatal pathology, and nursing. The accurate diagnosis and prognosis for women with fetal growth restriction is established by comprehensive clinical review and detailed sonographic evaluation of the fetus, combined with uterine artery Doppler and morphologic assessment of the placenta. Diagnostic accuracy for placenta-mediated fetal growth restriction may be enhanced by quantification of maternal serum biomarkers including placenta growth factor alone or combined with soluble fms-like tyrosine kinase-1. Uterine artery Doppler is typically abnormal in most instances of early-onset fetal growth restriction and is associated with coexistent preeclampsia and underlying maternal vascular malperfusion pathology of the placenta. By contrast, rare but potentially more serious underlying placental diagnoses, such as massive perivillous fibrinoid deposition, chronic histiocytic intervillositis, or fetal thrombotic vasculopathy, may be associated with normal uterine artery Doppler waveforms. Despite minor variations in placental size, shape, and cord insertion, placental function remains, largely normal in the general population. Consequently, morphologic assessment of the placenta is not currently incorporated into current screening

  10. 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

  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. Impact of patients' judgment skills on asthma self-management: a pilot study.

    Science.gov (United States)

    Londoño, Ana Maria Moreno; Schulz, Peter J

    2014-12-02

    The majority of current health literacy tools assess functional skills including reading, writing, and numeracy. Although these tools have been able to underline the impact of such skills on individuals' health behaviour, there is a need for comprehensive measures to examine more advanced skills. The individual's ability to use health-related information considering his/her own health context, and judging positive and negative consequences of their decisions has been conceptualized as judgment skills. The present study used a newly developed judgment skills tool to explore asthma self-management practices. Eighty asthma patients were recruited from medical offices during the year 2013. The questionnaire was self-administered and contained health literacy questions, the judgment skill tool, the Asthma Control Test, and several self-management questions. Sixty-nine percent of participants had adequate health literacy, while 24% and 5% had marginal and inadequate levels, respectively. The high-judgment group referred more to their doctor when experiencing asthma problems t(76)=-2.18, Pskills tool can help identify asthma patients' health information use and reveal how this use may affect some self-management practices. Significance for public healthPatients' health literacy has a great impact on their health behaviours and their health outcomes. Therefore, it has become more and more common to measure health literacy within the healthcare setting to determine the most effective approach to target patients. The measurement of asthma judgment skills contribute to a deeper understanding of patients' asthma self-management in crucial topics for asthma control, and have the advantage of assessing the specific abilities needed for this particular condition, which in turn benefits the translation of the findings from the use of this tool into strategies that directly tackle the needs of asthma patients.

  13. 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.

  14. 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 youth soccer 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.

  15. 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.

  16. 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.

  17. 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.

  18. Effect of a stress management program on subjects with neck pain: A pilot randomized controlled trial.

    Science.gov (United States)

    Metikaridis, T Damianos; Hadjipavlou, Alexander; Artemiadis, Artemios; Chrousos, George; Darviri, Christina

    2016-05-20

    Studies have shown that stress is implicated in the cause of neck pain (NP). The purpose of this study is to examine the effect of a simple, zero cost stress management program on patients suffering from NP. This study is a parallel-type randomized clinical study. People suffering from chronic non-specific NP were chosen randomly to participate in an eight week duration program of stress management (N= 28) (including diaphragmatic breathing, progressive muscle relaxation) or in a no intervention control condition (N= 25). Self-report measures were used for the evaluation of various variables at the beginning and at the end of the eight-week monitoring period. Descriptive and inferential statistic methods were used for the statistical analysis. At the end of the monitoring period, the intervention group showed a statistically significant reduction of stress and anxiety (p= 0.03, p= 0.01), report of stress related symptoms (p= 0.003), percentage of disability due to NP (p= 0.000) and NP intensity (p= 0.002). At the same time, daily routine satisfaction levels were elevated (p= 0.019). No statistically significant difference was observed in cortisol measurements. Stress management has positive effects on NP patients.

  19. 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.

  20. 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.

  1. 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

  2. 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...

  3. 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.

  4. 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

  5. Pharmacist-led management of chronic pain in primary care: costs and benefits in a pilot randomised controlled trial.

    Science.gov (United States)

    Neilson, Aileen R; Bruhn, Hanne; Bond, Christine M; Elliott, Alison M; Smith, Blair H; Hannaford, Philip C; Holland, Richard; Lee, Amanda J; Watson, Margaret; Wright, David; McNamee, Paul

    2015-04-01

    To explore differences in mean costs (from a UK National Health Service perspective) and effects of pharmacist-led management of chronic pain in primary care evaluated in a pilot randomised controlled trial (RCT), and to estimate optimal sample size for a definitive RCT. Regression analysis of costs and effects, using intention-to-treat and expected value of sample information analysis (EVSI). Six general practices: Grampian (3); East Anglia (3). 125 patients with complete resource use and short form-six-dimension questionnaire (SF-6D) data at baseline, 3 months and 6 months. Patients were randomised to either pharmacist medication review with face-to-face pharmacist prescribing or pharmacist medication review with feedback to general practitioner or treatment as usual (TAU). Differences in mean total costs and effects measured as quality-adjusted life years (QALYs) at 6 months and EVSI for sample size calculation. Unadjusted total mean costs per patient were £452 for prescribing (SD: £466), £570 for review (SD: £527) and £668 for TAU (SD: £1333). After controlling for baseline costs, the adjusted mean cost differences per patient relative to TAU were £77 for prescribing (95% CI -82 to 237) and £54 for review (95% CI -103 to 212). Unadjusted mean QALYs were 0.3213 for prescribing (SD: 0.0659), 0.3161 for review (SD: 0.0684) and 0.3079 for TAU (SD: 0.0606). Relative to TAU, the adjusted mean differences were 0.0069 for prescribing (95% CI -0.0091 to 0.0229) and 0.0097 for review (95% CI -0.0054 to 0.0248). The EVSI suggested the optimal future trial size was between 460 and 690, and between 540 and 780 patients per arm using a threshold of £30,000 and £20,000 per QALY gained, respectively. Compared with TAU, pharmacist-led interventions for chronic pain appear more costly and provide similar QALYs. However, these estimates are imprecise due to the small size of the pilot trial. The EVSI indicates that a larger trial is necessary to obtain more

  6. 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.

  7. Patient engagement with a mobile web-based telemonitoring system for heart failure self-management: a pilot study.

    Science.gov (United States)

    Zan, Shiyi; Agboola, Stephen; Moore, Stephanie A; Parks, Kimberly A; Kvedar, Joseph C; Jethwani, Kamal

    2015-04-01

    Intensive remote monitoring programs for congestive heart failure have been successful in reducing costly readmissions, but may not be appropriate for all patients. There is an opportunity to leverage the increasing accessibility of mobile technologies and consumer-facing digital devices to empower patients in monitoring their own health outside of the hospital setting. The iGetBetter system, a secure Web- and telephone-based heart failure remote monitoring program, which leverages mobile technology and portable digital devices, offers a creative solution at lower cost. The objective of this pilot study was to evaluate the feasibility of using the iGetBetter system for disease self-management in patients with heart failure. This was a single-arm prospective study in which 21 ambulatory, adult heart failure patients used the intervention for heart failure self-management over a 90-day study period. Patients were instructed to take their weight, blood pressure, and heart rate measurements each morning using a WS-30 bluetooth weight scale, a self-inflating blood pressure cuff (Withings LLC, Issy les Moulineaux, France), and an iPad Mini tablet computer (Apple Inc, Cupertino, CA, USA) equipped with cellular Internet connectivity to view their measurements on the Internet. Outcomes assessed included usability and satisfaction, engagement with the intervention, hospital resource utilization, and heart failure-related quality of life. Descriptive statistics were used to summarize data, and matched controls identified from the electronic medical record were used as comparison for evaluating hospitalizations. There were 20 participants (mean age 53 years) that completed the study. Almost all participants (19/20, 95%) reported feeling more connected to their health care team and more confident in performing care plan activities, and 18/20 (90%) felt better prepared to start discussions about their health with their doctor. Although heart failure-related quality of life

  8. 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

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

    International Nuclear Information System (INIS)

    Lee, Jung-Woon; Lee, Yong-Hee; Jang, Tong-Il; Kim, Dae-Ho

    2007-01-01

    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

  10. 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

  11. 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

  12. Telestroke ambulances in prehospital stroke management: concept and pilot feasibility study.

    Science.gov (United States)

    Liman, Thomas G; Winter, Benjamin; Waldschmidt, Carolin; Zerbe, Norman; Hufnagl, Peter; Audebert, Heinrich J; Endres, Matthias

    2012-08-01

    Pre- and intrahospital time delays are major concerns in acute stroke care. Telemedicine-equipped ambulances may improve time management and identify patients with stroke eligible for thrombolysis by an early prehospital stroke diagnosis. The aims of this study were (1) to develop a telestroke ambulance prototype; (2) to test the reliability of stroke severity assessment; and (3) to evaluate its feasibility in the prehospital emergency setting. Mobil, real-time audio-video streaming telemedicine devices were implemented into advanced life support ambulances. Feasibility of telestroke ambulances and reliability of the National Institutes of Health Stroke Scale assessment were tested using current wireless cellular communication technology (third generation) in a prehospital stroke scenario. Two stroke actors were trained in simulation of differing right and left middle cerebral artery stroke syndromes. National Institutes of Health Stroke Scale assessment was performed by a hospital-based stroke physician by telemedicine, by an emergency physician guided by telemedicine, and "a posteriori" on the basis of video documentation. In 18 of 30 scenarios, National Institutes of Health Stroke Scale assessment could not be performed due to absence or loss of audio-video signal. In the remaining 12 completed scenarios, interrater agreement of National Institutes of Health Stroke Scale examination between ambulance and hospital and ambulance and "a posteriori" video evaluation was moderate to good with weighted κ values of 0.69 (95% CI, 0.51-0.87) and 0.79 (95% CI, 0.59-0.98), respectively. Prehospital telestroke examination was not at an acceptable level for clinical use, at least on the basis of the used technology. Further technical development is needed before telestroke is applicable for prehospital stroke management during patient transport.

  13. Public perceptions, knowledge and awareness of cholesterol management in Singapore: a prospective pilot study.

    Science.gov (United States)

    Aung, Than Htike; Go, Yun Yun; Low, Lip Ping; Chua, Terrance

    2013-01-01

    Hyperlipidaemia is a major risk factor for coronary artery disease (CAD). Its effective treatment has been shown to reduce the incidence of cardiovascular events, both in secondary and primary prevention. An essential component of risk factor management at the community level is public awareness and knowledge of treatment benefits. However, this data is limited in Singapore. A cross-sectional survey questionnaire of public perception and knowledge on cholesterol treatment among adult Singaporeans aged 30-69 years was commissioned by the Singapore Heart Foundation and conducted by a professional market survey company. Regional quota sampling was performed to ensure that the sample was representative of the Singapore population. This was followed by random sampling of households and respondents. Of the 365 respondents, 40.9% were male, 70.3% were Chinese, 18.8% Malay and 10.9% Indian. The mean age was 47.5 years. Although 81.9% of respondents had medical check-ups involving blood tests, only 11.0% knew their actual cholesterol levels. A third of the respondents saw herbal medicine as healthier and safer than Western medication. More than 80% of respondents believed that diet and exercise were equally effective at lowering cholesterol as medication. About half of the respondents associated long-term use of statins with damage to the liver and kidney, while a third associated chronic statin use with the development of cancer. There are gaps in the level of public awareness and understanding of cholesterol treatment in Singapore. Common misconceptions should be addressed, as they could potentially impair effective management or treatment compliance.

  14. 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

  15. 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.

  16. 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.

  17. A community health worker intervention to improve management of hypertension among Filipino Americans in New York and New Jersey: a pilot study.

    Science.gov (United States)

    Ursua, Rhodora A; Aguilar, David E; Wyatt, Laura C; Katigbak, Carina; Islam, Nadia S; Tandon, S Darius; Nur, Potri Ranka Manis Queano; Van Devanter, Nancy; Rey, Mariano J; Trinh-Shevrin, Chau

    2014-01-01

    The purpose of the pilot study was to assess the feasibility and efficacy of a 4-month community health worker (CHW) intervention to improve hypertension management among Filipino immigrants in New York and New Jersey. Single-arm CHW pilot intervention using a pre-post design delivered by 5 CHWs. New York City, NY and Jersey City, NJ. Of 88 Filipino individuals recruited for the study, 39 received the full pilot intervention, 18 received a partial intervention, and 31 dropped out; 13 Filipino participants, 10 CHW Trainers, and 3 Filipino CHWs were interviewed for qualitative analysis. Individuals participated in 4 workshops related to hypertension management and cardiovascular disease (CVD) risk factors and received monthly in-person visits, and twice monthly phone calls individually from a CHW. Primary outcomes included blood pressure (BP) reduction and control, appointment keeping, and medication adherence; secondary outcomes included weight, body mass index (BMI), self-efficacy related to diet, exercise, and medication taking, CVD knowledge, and nutrition (salt/ sodium and cholesterol/fat). A mixed method analysis was used to assess the intervention, utilizing quantitative and qualitative methods. By the end of the intervention, significant changes were exhibited for systolic and diastolic BP, weight, and BMI (PFilipino Americans.

  18. 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

  19. Developing tools for the safety specification in risk management plans: lessons learned from a pilot project.

    Science.gov (United States)

    Cooper, Andrew J P; Lettis, Sally; Chapman, Charlotte L; Evans, Stephen J W; Waller, Patrick C; Shakir, Saad; Payvandi, Nassrin; Murray, Alison B

    2008-05-01

    Following the adoption of the ICH E2E guideline, risk management plans (RMP) defining the cumulative safety experience and identifying limitations in safety information are now required for marketing authorisation applications (MAA). A collaborative research project was conducted to gain experience with tools for presenting and evaluating data in the safety specification. This paper presents those tools found to be useful and the lessons learned from their use. Archive data from a successful MAA were utilised. Methods were assessed for demonstrating the extent of clinical safety experience, evaluating the sensitivity of the clinical trial data to detect treatment differences and identifying safety signals from adverse event and laboratory data to define the extent of safety knowledge with the drug. The extent of clinical safety experience was demonstrated by plots of patient exposure over time. Adverse event data were presented using dot plots, which display the percentages of patients with the events of interest, the odds ratio, and 95% confidence interval. Power and confidence interval plots were utilised for evaluating the sensitivity of the clinical database to detect treatment differences. Box and whisker plots were used to display laboratory data. This project enabled us to identify new evidence-based methods for presenting and evaluating clinical safety data. These methods represent an advance in the way safety data from clinical trials can be analysed and presented. This project emphasises the importance of early and comprehensive planning of the safety package, including evaluation of the use of epidemiology data.

  20. 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.

  1. [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

  2. 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 Peripheral neuropathy, reflexology, chemotherapy, EORTC QLQ-CIPN-20, BPI. Copyright © 2017 Elsevier Ltd. All rights reserved.

  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. 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.

  5. 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

  6. 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

  7. The Effectiveness of Web-Based Asthma Self-Management System, My Asthma Portal (MAP): A Pilot Randomized Controlled Trial.

    Science.gov (United States)

    Ahmed, Sara; Ernst, Pierre; Bartlett, Susan J; Valois, Marie-France; Zaihra, Tasneem; Paré, Guy; Grad, Roland; Eilayyan, Owis; Perreault, Robert; Tamblyn, Robyn

    2016-12-01

    Whether Web-based technologies can improve disease self-management is uncertain. My Asthma Portal (MAP) is a Web-based self-management support system that couples evidence-based behavioral change components (self-monitoring of symptoms, physical activity, and medication adherence) with real-time monitoring, feedback, and support from a nurse case manager. The aim of this study was to compare the impact of access to a Web-based asthma self-management patient portal linked to a case-management system (MAP) over 6 months compared with usual care on asthma control and quality of life. A multicenter, parallel, 2-arm, pilot, randomized controlled trial was conducted with 100 adults with confirmed diagnosis of asthma from 2 specialty clinics. Asthma control was measured using an algorithm based on overuse of fast-acting bronchodilators and emergency department visits, and asthma-related quality of life was assessed using the Mini-Asthma Quality of Life Questionnaire (MAQLQ). Secondary mediating outcomes included asthma symptoms, depressive symptoms, self-efficacy, and beliefs about medication. Process evaluations were also included. A total of 49 individuals were randomized to MAP and 51 to usual care. Compared with usual care, participants in the intervention group reported significantly higher asthma quality of life (mean change 0.61, 95% CI 0.03 to 1.19), and the change in asthma quality of life for the intervention group between baseline and 3 months (mean change 0.66, 95% CI 0.35 to 0.98) was not seen in the control group. No significant differences in asthma quality of life were found between the intervention and control groups at 6 (mean change 0.46, 95% CI -0.12 to 1.05) and 9 months (mean change 0.39, 95% CI -0.2 to 0.98). For poor control status, there was no significant effect of group, time, or group by time. For all self-reported measures, the intervention group had a significantly higher proportion of individuals, demonstrating a minimal clinically

  8. Evaluation of growth performance of abergele goats under traditional management systems in Sekota District, Ethiopia.

    Science.gov (United States)

    Deribe, Belay; Taye, Mengistie

    2013-07-15

    The study was conducted at Abergele in the semi arid parts of Sekota district to evaluate growth performance of Abergele goats managed under traditional management systems. Data on growth and growth rates were collected from 724 kids for two years. The least squares mean birth, three months, six months and yearling weight of kids obtained were 1.91 +/- 0.04, 6.84 +/- 0.19, 9.13 +/- 0.31 and 16.42 +/- 1.20 kg, respectively. Parity of doe and birth type of kid significantly affected birth weight and three months weight while sex of kid and season of birth of kid affected birth, three months, six months and yearling weight consistently. Kids from first parity does were lighter at birth, three months and six months of age than kids from higher parity does. Twin born kids were lower in weight at birth and three months of ages than their single born counterparts. Female kids and kids born during the dry season had lower weight at all ages considered. The least squares mean pre-weaning and post-weaning growth rates obtained were 53.4 +/- 2.30 and 29.3 +/- 4.32 g day(-1), respectively. Parity of doe, type of birth and season birth of kid affected pre-weaning growth rate. Kids from first parity does, twin born kids and kids born during the dry season had lower growth rate. The significant effect of fixed factors needs to be considered in an effort to improve productivity of goats in the study areas.

  9. 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...

  10. 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

  11. Educating children and families about growth hormone deficiency and its management: part 2.

    Science.gov (United States)

    Collin, Jacqueline; Whitehead, Amanda; Walker, Jenny

    2016-03-01

    Growth hormone deficiency (GHD) is a long-term condition, therefore creating ongoing partnerships with families is a fundamental part of the role of a paediatric endocrine nurse specialist (PENS). Teaching children, young people and their families about GHD and exploring what it means to them and how they can manage their ongoing treatment is central to building positive relationships. Educating children about the management of their growth hormone treatment (GHT) is an ongoing process and professionals must respond to the changing needs for that information children may have as they grow and develop. Long-term relationships with families are strengthened by recognising and respecting the developing expertise of families as they gain confidence and competence to manage GHT. This article is the second of two parts. Part one was published in the February issue of Nursing Children and Young People and covered an overview of growth hormone, causes and clinical presentation of GHD, development and availability of GHT and the role of the PENS in building partnerships with parents. The focus of this article is the education role of the PENS and the importance of providing information that is appropriate to the child or young person's developmental age.

  12. Telehealth for diabetes self-management education and support in an underserved, free clinic population: A pilot study.

    Science.gov (United States)

    Threatt, Tiffaney B; Ward, Eileen D

    Primary study objectives were to (1) describe mean change in A1c from baseline of a free clinic population enrolled in telehealth diabetes self-management education and support (DSME/S) services and (2) to compare change in A1C and other clinical outcomes measures with free clinic patients enrolled in a traditional face-to-face DSME/S program. An exploratory study design and comparative evaluation of telehealth DSME/S services in a free clinic population was used. Baseline clinical measures were collected upon referral. Diabetes educators met with patients individually over 2-3 months. Clinical outcomes measures were collected within 6 months of program completion. Data from the telehealth group was assessed individually and compared to a free clinic traditional DSME/S program population. Twelve patients completed a telehealth free clinic DSME/S pilot program with a mean ± SD change in A1C from baseline of -1.03 ± 1.53% (P = 0.050). Mean ± SD change in A1C from baseline in the free clinic population participating in traditional face-to-face DSME/S services was -1.42 ± 1.80% (P = 0.001). No significant differences in secondary outcomes measures, including body mass index and blood pressure, were revealed among the study populations. Expanding access to care in populations faced with challenges of socioeconomics, limited education, and lower health literacy is a step toward reducing health disparities and positively affecting care. Mean A1C can be improved with telehealth DSME/S services in an underserved, free clinic population. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  13. Pilot trial of diabetes self-management education in the hospital setting.

    Science.gov (United States)

    Korytkowski, Mary T; Koerbel, Glory L; Kotagal, Lindsey; Donihi, Amy; DiNardo, Monica M

    2014-10-01

    Diabetes self-management education (DSME) is recommended for all patients with diabetes. Current estimates indicate that patients receive DSME, increasing risk for hospitalization which occurs more frequently with diabetes. Hospitalization presents opportunities to provide DSME, potentially decreasing readmissions. To address this, we investigated the feasibility of providing DSME to inpatients with diabetes. Patients hospitalized on four medicine units were randomized to receive DSME (Education Group) (n=9) prescribed by a certified diabetes educator and delivered by a registered nurse, or Usual Care (n=12). Participants completed Diabetes Knowledge Tests (DKT), Medical Outcomes Short Form (SF-36), Diabetes Treatment Satisfaction Questionnaire (DTSQ), and the DTSQ-inpatient (DTSQ-IP). Bedside capillary blood glucoses (CBG) on day of admission, randomization and discharge were compared. There were no group differences in demographics, diabetes treatment, admission CBG (186±93 mg/dL vs. 219±84 mg/dL, p=0.40), DKT scores (Education vs. Usual Care 48±25 vs. 68±19, p=0.09), SF-36, and DTSQ scores (28±6 vs. 25±7, p=0.41). Patients receiving education reported more satisfaction with inpatient treatment (83±13 vs. 65±19, p=0.03), less hyperglycemia prior to (2.7±4.5 vs. 4.5±1.4, p=0.03) and during hospitalization (3.9±1.9 vs. 5.5±1.2, p=0.04); and had lower mean discharge CBG (159±38 mg/dL vs. 211±67 mg/dL, p=0.02). Inpatient diabetes education has potential to improve treatment satisfaction, and reduce CBG. Copyright © 2013. Published by Elsevier Ltd.

  14. Do managed alcohol programs change patterns of alcohol consumption and reduce related harm? A pilot study.

    Science.gov (United States)

    Vallance, Kate; Stockwell, Tim; Pauly, Bernie; Chow, Clifton; Gray, Erin; Krysowaty, Bonnie; Perkin, Kathleen; Zhao, Jinhui

    2016-05-09

    Managed alcohol programs (MAPs) are a harm reduction strategy for people with severe alcohol dependence and unstable housing. MAPs provide controlled access to alcohol usually alongside accommodation, meals, and other supports. Patterns of alcohol consumption and related harms among MAP participants and controls from a homeless shelter in Thunder Bay, Ontario, were investigated in 2013. Structured interviews were conducted with 18 MAP and 20 control participants assessed as alcohol dependent with most using non-beverage alcohol (NBA). Qualitative interviews were conducted with seven participants and four MAP staff concerning perceptions and experiences of the program. Program alcohol consumption records were obtained for MAP participants, and records of police contacts and use of health services were obtained for participants and controls. Some participants' liver function test (LFT) results were available for before and after MAP entry. Compared with periods off the MAP, MAP participants had 41 % fewer police contacts, 33 % fewer police contacts leading to custody time (x (2) = 43.84, P detox admissions (t = -1.68, P = 0.06), and 32 % fewer hospital admissions (t = -2.08, P = 0.03). MAP and control participants shared similar characteristics, indicating the groups were broadly comparable. There were reductions in nearly all available LFT scores after MAP entry. Compared with controls, MAP participants had 43 % fewer police contacts, significantly fewer police contacts (-38 %) that resulted in custody time (x (2) = 66.10, P detox admissions (t = -2.19, P = 0.02), and 47 % fewer emergency room presentations. NBA use was significantly less frequent for MAP participants versus controls (t = -2.34, P detox episodes, and police contacts leading to custody, reduced NBA consumption, and decreases in some alcohol-related harms. These encouraging trends are being investigated in a larger national study.

  15. Contingency management for alcohol use reduction: a pilot study using a transdermal alcohol sensor.

    Science.gov (United States)

    Barnett, Nancy P; Tidey, Jennifer; Murphy, James G; Swift, Robert; Colby, Suzanne M

    2011-11-01

    Contingency management (CM) has not been thoroughly evaluated as a treatment for alcohol abuse or dependence, in part because verification of alcohol use reduction requires frequent in-person breath tests. Transdermal alcohol sensors detect alcohol regularly throughout the day, providing remote monitoring and allowing for rapid reinforcement of reductions in use. The purpose of this study was to evaluate the efficacy of CM for reduction in alcohol use, using a transdermal alcohol sensor to provide a continuous measure of alcohol use. Participants were 13 heavy drinking adults who wore the Secure Continuous Remote Alcohol Monitoring (SCRAM) bracelet for three weeks and provided reports of alcohol and drug use using daily web-based surveys. In Week 1, participants were asked to drink as usual; in Weeks 2 and 3, they were reinforced on an escalating schedule with values ranging from $5 to $17 per day on days when alcohol use was not reported or detected by the SCRAM. Self-reports of percent days abstinent and drinks per week, and transdermal measures of average and peak transdermal alcohol concentration and area under the curve declined significantly in Weeks 2-3. A nonsignificant but large effect size for reduction in days of tobacco use also was found. An adjustment to the SCRAM criteria for detecting alcohol use provided an accurate but less conservative method for use with non-mandated clients. Results support the efficacy of CM for alcohol use reductions and the feasibility of using transdermal monitoring of alcohol use for clinical purposes. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  16. Contingency Management for Alcohol Use Reduction: A Pilot Study using a Transdermal Alcohol Sensor*

    Science.gov (United States)

    Barnett, Nancy P.; Tidey, Jennifer; Murphy, James G.; Swift, Robert; Colby, Suzanne M.

    2011-01-01

    Background Contingency management (CM) has not been thoroughly evaluated as a treatment for alcohol abuse or dependence, in part because verification of alcohol use reduction requires frequent in-person breath tests. Transdermal alcohol sensors detect alcohol regularly throughout the day, providing remote monitoring and allowing for rapid reinforcement of reductions in use. Methods The purpose of this study was to evaluate the efficacy of CM for reduction in alcohol use, using a transdermal alcohol sensor to provide a continuous measure of alcohol use. Participants were 13 heavy drinking adults who wore the Secure Continuous Remote Alcohol Monitoring (SCRAM) bracelet for three weeks and provided reports of alcohol and drug use using daily web-based surveys. In Week 1, participants were asked to drink as usual; in Weeks 2 and 3, they were reinforced on an escalating schedule with values ranging from $5-$17 per day on days when alcohol use was not reported or detected by the SCRAM. Results Self-reports of percent days abstinent and drinks per week, and transdermal measures of average and peak transdermal alcohol concentration and area under the curve declined significantly in Weeks 2-3. A nonsignificant but large effect size for reduction in days of tobacco use also was found. An adjustment to the SCRAM criteria for detecting alcohol use provided an accurate but less conservative method for use with non-mandated clients. Conclusion Results support the efficacy of CM for alcohol use reductions and the feasibility of using transdermal monitoring of alcohol use for clinical purposes. PMID:21665385

  17. A pilot study to assess the pharmacy impact of implementing a chemotherapy-induced nausea or vomiting collaborative disease therapy management in the outpatient oncology clinics.

    Science.gov (United States)

    Jackson, Kasey; Letton, Cathy; Maldonado, Andy; Bodiford, Andrew; Sion, Amy; Hartwell, Rebekah; Graham, Anastasia; Bondarenka, Carolyn; Uber, Lynn

    2018-01-01

    Background Collaborative drug therapy management is a formal partnership between a pharmacist and physician to allow the pharmacist to manage a patient's drug therapy. Literature supports collaborative disease therapy management can improve patient outcomes, improve medication adherence, enhance medication safety, and positively influence healthcare expenditures. Chemotherapy induced nausea or vomiting is considered one of the most distressing and feared adverse events among patients receiving chemotherapy. Chemotherapy induced nausea or vomiting can impact a patient's quality of life and may affect compliance with the treatment plan. Purpose The objective of this pilot study was to determine the pharmacy impact of implementing a chemotherapy induced nausea or vomiting collaborative disease therapy management protocol in the outpatient oncology clinics at a National Cancer Institute (NCI)-designated cancer center associated with an academic medical center. The primary endpoint was to determine the number and type of chemotherapy induced nausea or vomiting clinical interventions made by the oncology pharmacists. Secondary endpoints included comparing patient's Multinational Association for Supportive Care in Cancer scores and revenue of pharmacists' services. Methods The credentialed oncology pharmacists were consulted by an oncologist to manage chemotherapy induced nausea or vomiting. Patients were included in the chemotherapy induced nausea or vomiting collaborative disease therapy management if they were seen in an outpatient oncology clinic from October 2016 to January 2017 and had a referral from a qualified provider to help manage chemotherapy induced nausea or vomiting. Patients admitted to the hospital at the time of consult were excluded from the study. The pharmacists interviewed patients and provided recommendations. The pharmacists followed up with the patient via a telephone call or during the next scheduled clinic visit to assess their symptoms

  18. Growth hormone as concomitant treatment in severe fibromyalgia associated with low IGF-1 serum levels. A pilot study

    Directory of Open Access Journals (Sweden)

    Güell Maria

    2007-11-01

    Full Text Available Abstract Background There is evidence of functional growth hormone (GH deficiency, expressed by means of low insulin-like growth factor 1 (IGF-1 serum levels, in a subset of fibromyalgia patients. The efficacy of GH versus placebo has been previously suggested in this population. We investigated the efficacy and safety of low dose GH as an adjunct to standard therapy in the treatment of severe, prolonged and well-treated fibromyalgia patients with low IGF-1 levels. Methods Twenty-four patients were enrolled in a randomized, open-label, best available care-controlled study. Patients were randomly assigned to receive either 0.0125 mg/kg/d of GH subcutaneously (titrated depending on IGF-1 added to standard therapy or standard therapy alone during one year. The number of tender points, the Fibromyalgia Impact Questionnaire (FIQ and the EuroQol 5D (EQ-5D, including a Quality of Life visual analogic scale (EQ-VAS were assessed at different time-points. Results At the end of the study, the GH group showed a 60% reduction in the mean number of tender points (pairs compared to the control group (p vs. 8.25 ± 0.9. Similar improvements were observed in FIQ score (p Conclusion The present findings indicate the advantage of adding a daily GH dose to the standard therapy in a subset of severe fibromyalgia patients with low IGF-1 serum levels. Trial Registration NCT00497562 (ClinicalTrials.gov.

  19. A pilot videoconference group stress management program in cancer survivors: lessons learned.

    Science.gov (United States)

    Zhou, Eric S; Partridge, Ann H; Blackmon, Jaime E; Morgan, Evan; Recklitis, Christopher J

    2016-01-01

    Cancer is a challenging experience and there is evidence that psychosocial interventions are effective at improving adjustment following treatment. At our cancer center, 14 cancer survivors (breast, prostate and blood cancers) completed a four-session cognitive-behavioral stress program. The first session was delivered at the survivor's local cancer center, where they were provided with a loaner tablet. The three subsequent sessions were delivered through group-based videoconference on the tablet. Session content was supplemented with a tailored ebook, designed specifically for this program. Participants provided feedback about the program as well as a standardized measure of perceived stress. Despite evidence that psychosocial programs are effective, there are significant barriers to dissemination, particularly for those residing in rural areas who do not live near academic medical centers where such programming is more readily available. Our experiences delivering a group-based videoconference program in cancer survivors are described, including positives and challenges associated with its design and implementation. Study participants enrolled from across four different US states, and the majority reported at least a 30-minute commute to their cancer center. This travel burden played a meaningful role in their desire to participate in our videoconference-based program. Although participants reported that session content was well suited to addressing stress management concerns, and session facilitators were able to effectively teach program techniques (eg progressive muscle relaxation, cognitive-reframing) and that the program was helpful overall, only modest improvements in perceived stress were seen. Participants noted challenges of the delivery including feeling disconnected from others, difficulty focusing, technical problems, and a desire for a longer program. Thus, although the novel delivery of a group-based, psychosocial program using tablet

  20. 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.

    2016-01-01

    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). 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. Results: 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 < 0.001) and completeness of removal (61 % vs 37 %, P < 0.001). In the prospective study 23 PM-colonoscopies where compared to 28 CR-colonoscopies. VAS-scores were significantly higher in the endoscopist-operated PM group. Time to report was 01:27 ± 01:43 minutes (median + interquartile range) in the entire group (PM as CR), reflecting potential time benefit per colonoscopy. Conclusions: 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

  1. 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

  2. A pilot study on production of G0 potato seed minitubers derived from growth-promoted by gamma-rays in vitro materials

    International Nuclear Information System (INIS)

    Nguyen Tien Thinh; Tran Thanh Han; Hoang Hung Tien; Le Viet Thanh; Nguyen Dinh Nhan

    2007-01-01

    A procedure for production of potato G 0 minitubers from in vitro materials like test-tube plantlets (CON), artificial seeds (HNT) and microtubers (CSB), which had been treated with 100 Rad of gamma-rays, was successfully established. The procedure started with producing low cost in vitro materials by growing them in semi-aseptic/non-aseptic culture conditions; treating them next with low doses of gamma-rays; then hydroponically cultivating the materials upon the following regime: culture density of 12x12 cm, nutritive hydroponical solution of CT1, and feeding frequency of T3 (3 times/week). Nearly 50,000 G 0 minitubers were produced by such a hydroponical way, and 30,000 of them were subsequently grown in field by local farmers. Observations of the above pilot production of the G 0 minitubers and of their field growing showed that the CSB was the most suitable in vitro starting stuff for forming G 0 minitubers, and that the growth-promotion effects of gamma-rays were not carried over to the field-growing stage of the G 0 minitubers. (author)

  3. 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.

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

    Directory of Open Access Journals (Sweden)

    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.

  5. A rapid assessment of a community health worker pilot programme to improve the management of hypertension and diabetes in Emfuleni sub-district of Gauteng Province, South Africa.

    Science.gov (United States)

    Ndou, Tshipfuralo; van Zyl, Greer; Hlahane, Salamina; Goudge, Jane

    2013-01-24

    Non-communicable diseases (NCD) and infectious chronic illnesses are recognised as significant contributing factors to the burden of disease globally, specifically in South Africa, yet clinical management is often poor. The involvement of community health workers (CHWs) in TB and HIV care in South Africa, and other low- and middle-income settings, suggests that they could make an important contribution in the management of NCDs. Using a rapid assessment, this study examines the outcomes of a pilot CHW programme to improve the management of hypertension and diabetes in Gauteng province, South Africa. A record review compared outcomes of patients receiving home visits (n56) with a control group (n168) attending the clinic, matched, as far as possible, on age, gender, and condition. Focus group discussions and semi-structured interviews with CHWs, patients, district, clinic, and NGO staff were used to obtain descriptions of the functioning of the programme and patient experiences. Despite the greater age and co-morbidity among those in the pilot programme, the findings suggest that control of hypertension was improved by CHW home visits in comparison to usual clinic care. However, too few doctor visits, insufficient monitoring of patient outcomes by clinic staff, and a poor procurement process for supplies required by the CHWs hampered the programme's activities. The role of CHWs in the management of hypertension should be given greater consideration, with larger studies being conducted to provide more robust evidence. Adequate training, supervision, and operational support will be required to ensure success of any CHW programme.

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

    Directory of Open Access Journals (Sweden)

    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.

  7. Pilot Implementations

    DEFF Research Database (Denmark)

    Manikas, Maria Ie

    by conducting a literature review. The concept of pilot implementation, although commonly used in practice, is rather disregarded in research. In the literature, pilot implementations are mainly treated as secondary to the learning outcomes and are presented as merely a means to acquire knowledge about a given...... objective. The prevalent understanding is that pilot implementations are an ISD technique that extends prototyping from the lab and into test during real use. Another perception is that pilot implementations are a project multiple of co-existing enactments of the pilot implementation. From this perspective......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...

  8. 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

  9. Management of ocular trauma in emergency (MOTE trial: A pilot randomized double-blinded trial comparing topical amethocaine with saline in the outpatient management of corneal trauma

    Directory of Open Access Journals (Sweden)

    Ting Joseph

    2009-01-01

    Full Text Available Background: It is unclear whether local anesthetic eye drops can be safely used for the topical anesthesia of patients with minor corneal injury who are discharged from the emergency department (ED. Objectives: To assess whether topical 0.4% amethocaine self-administered to a maximum recommended frequency of once every hour for 36-48 h is safe in the management of uncomplicated corneal injury in patients discharged from the ED. Patients and Methods: A pilot randomized double-blinded trial comparing topical 0.4% amethocaine with topical normal saline. Results: Forty-seven subjects were recruited, with 22 randomized to receive amethocaine and 25 to receive placebo (normal saline . Baseline characteristics, including corneal injury type, were similar in both groups. There were no significant functional or clinical adverse sequelae in the majority of enrolled patients who could be contacted at 2 weeks (17/22 for amethocaine and 21/25 for placebo. Follow-up for the primary study outcome was suboptimal, with only 7/22 from the amethocaine group and 9/25 from the saline group presenting for 36-48 h review; there was a statistically nonsignificant trend for persistence of the corneal defect in the amethocaine group as compared with the saline group (2/7 and 1/9, respectively. Conclusion: Compared with saline drops, amethocaine eye drops are not definitely safe but they are effective for topical analgesia in minor corneal injury. Until further definitive studies, topical nonsteroidal agents or long-lasting artificial tears may be preferred for the topical analgesia of minor corneal injury. Return for corneal re-evaluation will necessarily remain suboptimal in an otherwise self-limiting condition, leading to a bias even if study recruitment is good.

  10. Implementation of Pilot Protection System for Large Scale Distribution System like The Future Renewable Electric Energy Distribution Management Project

    Science.gov (United States)

    Iigaya, Kiyohito

    A robust, fast and accurate protection system based on pilot protection concept was developed previously and a few alterations in that algorithm were made to make it faster and more reliable and then was applied to smart distribution grids to verify the results for it. The new 10 sample window method was adapted into the pilot protection program and its performance for the test bed system operation was tabulated. Following that the system comparison between the hardware results for the same algorithm and the simulation results were compared. The development of the dual slope percentage differential method, its comparison with the 10 sample average window pilot protection system and the effects of CT saturation on the pilot protection system are also shown in this thesis. The implementation of the 10 sample average window pilot protection system is done to multiple distribution grids like Green Hub v4.3, IEEE 34, LSSS loop and modified LSSS loop. Case studies of these multi-terminal model are presented, and the results are also shown in this thesis. The result obtained shows that the new algorithm for the previously proposed protection system successfully identifies fault on the test bed and the results for both hardware and software simulations match and the response time is approximately less than quarter of a cycle which is fast as compared to the present commercial protection system and satisfies the FREEDM system requirement.

  11. 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.

  12. 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.

  13. 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..

  14. 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.

  15. 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

  16. Continuous Positive Airway Pressure for Motion Management in Stereotactic Body Radiation Therapy to the Lung: A Controlled Pilot Study

    Energy Technology Data Exchange (ETDEWEB)

    Goldstein, Jeffrey D. [Department of Radiation Oncology, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv (Israel); Lawrence, Yaacov R. [Department of Radiation Oncology, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv (Israel); Sackler School of Medicine, Tel Aviv University, Tel Aviv (Israel); Appel, Sarit; Landau, Efrat; Ben-David, Merav A.; Rabin, Tatiana; Benayun, Maoz; Dubinski, Sergey; Weizman, Noam; Alezra, Dror; Gnessin, Hila; Goldstein, Adam M.; Baidun, Khader [Department of Radiation Oncology, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv (Israel); Segel, Michael J.; Peled, Nir [Department of Pulmonary Medicine, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv (Israel); Sackler School of Medicine, Tel Aviv University, Tel Aviv (Israel); Symon, Zvi, E-mail: symonz@sheba.health.gov.il [Department of Radiation Oncology, Chaim Sheba Medical Center, Tel Hashomer, Tel Aviv (Israel); Sackler School of Medicine, Tel Aviv University, Tel Aviv (Israel)

    2015-10-01

    Objective: To determine the effect of continuous positive airway pressure (CPAP) on tumor motion, lung volume, and dose to critical organs in patients receiving stereotactic body radiation therapy (SBRT) for lung tumors. Methods and Materials: After institutional review board approval in December 2013, patients with primary or secondary lung tumors referred for SBRT underwent 4-dimensional computed tomographic simulation twice: with free breathing and with CPAP. Tumor excursion was calculated by subtracting the vector of the greatest dimension of the gross tumor volume (GTV) from the internal target volume (ITV). Volumetric and dosimetric determinations were compared with the Wilcoxon signed-rank test. CPAP was used during treatment if judged beneficial. Results: CPAP was tolerated well in 10 of the 11 patients enrolled. Ten patients with 18 lesions were evaluated. The use of CPAP decreased tumor excursion by 0.5 ± 0.8 cm, 0.4 ± 0.7 cm, and 0.6 ± 0.8 cm in the superior–inferior, right–left, and anterior–posterior planes, respectively (P≤.02). Relative to free breathing, the mean ITV reduction was 27% (95% confidence interval [CI] 16%-39%, P<.001). CPAP significantly augmented lung volume, with a mean absolute increase of 915 ± 432 cm{sup 3} and a relative increase of 32% (95% CI 21%-42%, P=.003), contributing to a 22% relative reduction (95% CI 13%-32%, P=.001) in mean lung dose. The use of CPAP was also associated with a relative reduction in mean heart dose by 29% (95% CI 23%-36%, P=.001). Conclusion: In this pilot study, CPAP significantly reduced lung tumor motion compared with free breathing. The smaller ITV, the planning target volume (PTV), and the increase in total lung volume associated with CPAP contributed to a reduction in lung and heart dose. CPAP was well tolerated, reproducible, and simple to implement in the treatment room and should be evaluated further as a novel strategy for motion management in radiation therapy.

  17. Continuous Positive Airway Pressure for Motion Management in Stereotactic Body Radiation Therapy to the Lung: A Controlled Pilot Study

    International Nuclear Information System (INIS)

    Goldstein, Jeffrey D.; Lawrence, Yaacov R.; Appel, Sarit; Landau, Efrat; Ben-David, Merav A.; Rabin, Tatiana; Benayun, Maoz; Dubinski, Sergey; Weizman, Noam; Alezra, Dror; Gnessin, Hila; Goldstein, Adam M.; Baidun, Khader; Segel, Michael J.; Peled, Nir; Symon, Zvi

    2015-01-01

    Objective: To determine the effect of continuous positive airway pressure (CPAP) on tumor motion, lung volume, and dose to critical organs in patients receiving stereotactic body radiation therapy (SBRT) for lung tumors. Methods and Materials: After institutional review board approval in December 2013, patients with primary or secondary lung tumors referred for SBRT underwent 4-dimensional computed tomographic simulation twice: with free breathing and with CPAP. Tumor excursion was calculated by subtracting the vector of the greatest dimension of the gross tumor volume (GTV) from the internal target volume (ITV). Volumetric and dosimetric determinations were compared with the Wilcoxon signed-rank test. CPAP was used during treatment if judged beneficial. Results: CPAP was tolerated well in 10 of the 11 patients enrolled. Ten patients with 18 lesions were evaluated. The use of CPAP decreased tumor excursion by 0.5 ± 0.8 cm, 0.4 ± 0.7 cm, and 0.6 ± 0.8 cm in the superior–inferior, right–left, and anterior–posterior planes, respectively (P≤.02). Relative to free breathing, the mean ITV reduction was 27% (95% confidence interval [CI] 16%-39%, P<.001). CPAP significantly augmented lung volume, with a mean absolute increase of 915 ± 432 cm 3 and a relative increase of 32% (95% CI 21%-42%, P=.003), contributing to a 22% relative reduction (95% CI 13%-32%, P=.001) in mean lung dose. The use of CPAP was also associated with a relative reduction in mean heart dose by 29% (95% CI 23%-36%, P=.001). Conclusion: In this pilot study, CPAP significantly reduced lung tumor motion compared with free breathing. The smaller ITV, the planning target volume (PTV), and the increase in total lung volume associated with CPAP contributed to a reduction in lung and heart dose. CPAP was well tolerated, reproducible, and simple to implement in the treatment room and should be evaluated further as a novel strategy for motion management in radiation therapy

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

    Directory of Open Access Journals (Sweden)

    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.

  19. Plasma intact fibroblast growth factor 23 levels in women with bulimia nervosa: A cross-sectional pilot study

    Directory of Open Access Journals (Sweden)

    Yoshiuchi Kazuhiro

    2011-06-01

    Full Text Available Abstract Fibroblast growth factor (FGF 23, a circulating 26-kDa peptide produced by osteogenic cells, is a novel phosphaturic factor. In our previous study, binge-eating/purging type anorexia nervosa (AN-BP patients had elevated plasma intact FGF23 (iFGF23 levels, while restricting type (AN-R patients had plasma iFGF23 levels similar to healthy controls. Although bulimia nervosa (BN patients as well as some patients with AN-BP regularly engage in binge eating, there have been no studies regarding plasma iFGF23 levels in BN patients. Therefore, this study was performed to determine plasma iFGF23 concentrations in BN patients and healthy controls. The study population consisted of 13 female BN patients and 11 healthy female controls. Blood samples were collected from all subjects after overnight fasting. Plasma iFGF23 was measured using an ELISA kit in a cross-sectional manner. The two-tailed Mann-Whitney U-test was used to assess differences between BN patients and healthy controls. In addition, BN patients were divided into two groups based on questionnaire-reported binge eating frequency immediately prior to participation in this study: high frequency of binge eating (once a week or more; HF group; n = 8 and low frequency of binge eating (less than once a week; LF group; n = 5. Two-tailed Mann-Whitney U-test with Bonferroni's correction was performed after the Kruskal-Wallis test to assess differences between HF group, LF group, and healthy controls. Median (quartiles plasma iFGF23 levels were greater in BN patients (35.5 [14.8-65.0] pg/ml than in controls (3.8 [not detected-5.3] pg/ml; p = 0.002. In addition, median (quartiles plasma iFGF23 levels were greater in the HF group (62.3 [44.4-73.4] pg/ml than in controls (p

  20. 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...

  1. 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...

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

    DEFF Research Database (Denmark)

    Distel, Andreas Philipp

    conceptualization is lacking and it remains unclear under what conditions resource cognition leads to superior firm performance. Drawing on the Penrosian view and the dynamic managerial capabilities perspective, this study further develops resource cognition in terms of top managers’ cognitions about the firm......’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. Disentangling the effects of climate, species, and management on growth and mortality of southeast Asian mangroves

    Science.gov (United States)

    Baker, Patrick; Bunyavejchewin, Sarayudh; Robinson, Andrew

    2013-04-01

    Mangrove forests are one of the most biologically important ecosystems of the littoral tropics. They provide a wide range of ecosystem services including tsunami protection, food production, and waste processing. They are also rapidly disappearing due to increasing rates of clearance for development and aquaculture. It remains unclear how mangroves will respond to changing climatic conditions. Here we discuss the results of a long-term study that explored the interacting effects of climate, species, and management practices on annual variability of growth and mortality of mangroves in peninsular Thailand. The 15-year study period included the extreme 1997-98 ENSO event that led to widespread drought-induced mortality and forest fires across the region, but which appeared to have little impact on the mangroves. Our results provide an important, and much-needed, framework for conservation and forest management planning in these mangrove forests given future concerns and uncertainty about climate change in the tropics.

  4. Scale-up of Escherichia coli growth and recombinant protein expression conditions from microwell to laboratory and pilot scale based on matched k(L)a.

    Science.gov (United States)

    Islam, R S; Tisi, D; Levy, M S; Lye, G J

    2008-04-01

    Fermentation optimization experiments are ideally performed at small scale to reduce time, cost and resource requirements. Currently microwell plates (MWPs) are under investigation for this purpose as the format is ideally suited to automated high-throughput experimentation. In order to translate an optimized small-scale fermentation process to laboratory and pilot scale stirred-tank reactors (STRs) it is necessary to characterize key engineering parameters at both scales given the differences in geometry and the mechanisms of aeration and agitation. In this study oxygen mass transfer coefficients are determined in three MWP formats and in 7.5 L and 75 L STRs. k(L)a values were determined in cell-free media using the dynamic gassing-out technique over a range of agitation conditions. Previously optimized culture conditions at the MWP scale were then scaled up to the larger STR scales on the basis of matched k(L)a values. The accurate reproduction of MWP (3 mL) E. coli BL21 (DE3) culture kinetics at the two larger scales was shown in terms of cell growth, protein expression, and substrate utilization for k(L)a values that provided effective mixing and gas-liquid distribution at each scale. This work suggests that k(L)a provides a useful initial scale-up criterion for MWP culture conditions which enabled a 15,000-fold scale translation in this particular case. This work complements our earlier studies on the application of DoE techniques to MWP fermentation optimization and in so doing provides a generic framework for the generation of large quantities of soluble protein in a rapid and cost-effective manner.

  5. 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…

  6. A Pilot Study Exploring After-School Care Providers' Response to the Incredible Years Classroom Management Program

    Science.gov (United States)

    Hicks-Hoste, Taylor B.; Carlson, John S.; Tiret, Holly B.

    2015-01-01

    The need for and importance of bringing evidence-based interventions into school settings has been firmly established. Adapting and adjusting intervention programs to meet the unique needs of a school district requires personnel to use a data-based approach to implementation. This pilot study is the first to report on after-school care providers'…

  7. 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

  8. 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...

  9. Effects of tree size and spatial distribution on growth of ponderosa pine forests under alternative management scenarios

    Science.gov (United States)

    C.W. Woodall; C.E. Fiedler; R.E. McRoberts

    2009-01-01

    Forest ecosystems may be actively managed toward heterogeneous stand structures to provide both economic (e.g., wood production and carbon credits) and environmental benefits (e.g., invasive pest resistance). In order to facilitate wider adoption of possibly more sustainable forest stand structures, defining growth expectations among alternative management scenarios is...

  10. 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...

  11. 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.

  12. Learning together, working together: an evaluation of experiences of a pilot programme for partnership between unions and management in the health service.

    Science.gov (United States)

    Young, Pat; Moule, Pam; Evans, David; Simmons, Sue; Crack, Meg; Mayo, Gillian

    2012-07-01

    This article describes an innovative initiative to support partnership working between trade unions and management in three National Health Service Trusts, by means of shared participation in a series of learning and development days. Although there is existing evidence, within the literature on partnership, of the benefits of partnership working for employees and employers, there is little discussion of processes by which effective partnership is developed. More specifically, there is no current academic literature on the role of education in enabling improved partnership working between trade unions and managers. The findings of the evaluation suggest that the pilot provided a successful learning experience as well as a number of pointers for improving future developments of this nature. The recommendations include embedding of partnership work within existing staff development processes. Copyright © 2011 Elsevier Ltd. All rights reserved.

  13. 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 (<;149/90 mmHg) was 40.0% in control group, and 72.3% in POST group at 6 month follow-up. At the same time Home BP control (<;135/85 mmHg average of 6 days) in POST group was 87.5%. this pilot study suggests that 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

  14. Understanding Pain and Pain Management in Elderly Nursing Home Patients Applying an Interprofessional Learning Activity in Health Care Students: A Norwegian Pilot Study.

    Science.gov (United States)

    Damsgård, Elin; Solgård, Hege; Johannessen, Karin; Wennevold, Katrine; Kvarstein, Gunnvald; Pettersen, Gunn; Garcia, Beate

    2018-05-17

    Pain is common among elderly patients in nursing homes. However, pain assessment and treatment are inadequate. Interprofessional treatment is recommended, and consequently interprofessional education in pain management is necessary. This pilot project aimed to describe how two interprofessional groups of students approached pain management in two nursing home patients. We formed two teams comprising one student from the nursing, physical therapy, pharmacy, and medical educations. Each team spent one day examining a patient with chronic pain at a nursing home and they developed pain management plans. We collected data through video recordings during teamwork before and after examining the patients and field notes during the patient examination. We analysed the video-recordings applying the seven-step model including 1) viewing the video data, 2) describing the video data, 3) identifying critical events, 4) transcribing, 5) coding, 6) constructing storyline and 7) composing a narrative. Field notes supplied the transcripts. Both teams succeeded in making a pain management plan for their patient. The common examination of the patient was crucial for the students' approaches to pain management and changed their pre-assumptions about the patients' pain. By sharing knowledge and reflecting together, the students reached a common consensus on suggestions for management of the patients' problems. Interprofessional collaboration fostered enthusiasm and a more holistic pain management approach. However,students' lack of knowledge limited their understanding of pain. Knowledge of pain management in nursing home patients and the practice of interprofessional cooperation should be included in pain curricula for health care professionals. Copyright © 2018 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  15. 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.

  16. 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

  17. A pilot test of the GoWoman weight management intervention for women with mobility impairments in the online virtual world of Second Life®.

    Science.gov (United States)

    Nosek, Margaret A; Robinson-Whelen, Susan; Ledoux, Tracey A; Hughes, Rosemary B; O'Connor, Daniel P; Lee, Rebecca E; Goe, Rebecca; Silveira, Stephanie L; Markley, Rachel; Nosek, Thomas M

    2018-06-11

    Pilot test GoWoman, a small-group weight management intervention for mobility impaired women that was a disability- and gender-responsive adaptation of the Diabetes Prevention Program delivered in the online virtual world of Second Life ® . Objectives were to (1) examine pre-/post-intervention differences in weight, waist circumference, diet, physical activity, self-efficacy for diet and physical activity, nutrition knowledge and social support for weight management, (2) determine intervention feasibility (fidelity, attrition, engagement, acceptability). Single-group modified interrupted time series quasi-experimental design whereby participants served as their own controls. Thirteen women attended ≥8 of 16 GoWoman weekly sessions and lost an average of 5.97 pounds (2.71 kg) (3.31%) body weight (Cohen's d = 0.74) and 1.44 inches (3.66 cm) (3.58%) waist circumference (Cohen's d = 0.83). There were significant improvements in physical activity, diet and self-efficacy for diet and physical activity. All benchmarks for feasibility were met. Ratings of intervention content, group interactions and support and virtual world experiences were highly positive. Findings suggest that a disability- and gender-responsive weight management intervention with peer group support delivered in an online virtual world is feasible, meaningful and may assist with weight management for mobility impaired women. Implications for Rehabilitation This study addresses a gap in the general and rehabilitation research literature by addressing the disproportionately high rates of obesity among women with mobility impairments, who are generally excluded from tests of weight management interventions if they have limited ability to engage in vigorous physical activity. The GoWoman program is an adaptation of the Diabetes Prevention Program Lifestyle Change curriculum that is tailored to meet the unique weight management needs of women with mobility impairments, and was created to

  18. A Pilot Randomized Controlled Trial of a Guided Self-Help Intervention to Manage Chronic Orofacial Pain.

    Science.gov (United States)

    Goldthorpe, Joanna; Lovell, Karina; Peters, Sarah; McGowan, Linda; Nemeth, Imola; Roberts, Christopher; Aggarwal, Vishal R

    2017-01-01

    To conduct a pilot trial to test the feasibility of a guided self-help intervention for chronic orofacial pain. A pilot randomized controlled trial was conducted to compare the intervention with usual treatment. A total of 37 patients with chronic orofacial pain were randomized into either the intervention group (n = 19) or the usual treatment (control) group (n = 18). Validated outcome measures were used to measure the potential effectiveness of the intervention over a number of domains: physical and mental functioning (Short Form 36 [SF-36]); anxiety and depression (Hospital Anxiety and Depression Scale [HADS]); pain intensity and interference with life (Brief Pain Inventory [BPI]); disability (Manchester Orofacial Pain Disability Scale [MOPDS]); and illness behavior (Revised Illness Perceptions Questionnaire [IPQr]). Bootstrap confidence intervals were computed for the treatment effect (ES) posttreatment and at 3 months follow-up and adjusted for baseline values of the outcome measure by using analysis of covariance. At posttreatment and the 3-month follow-up, 11 participants in the intervention group and 7 in the control group failed to complete outcome measures. The intervention was acceptable and could be feasibly delivered face to face or over the telephone. Although the pilot trial was not powered to draw conclusions about the effectiveness, it showed significant (P orofacial pain. It showed potential effectiveness on outcome domains related to functioning and illness perception. Further research is needed to understand the cost effectiveness of the intervention for chronic orofacial pain.

  19. 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.

  20. The Impact of a Cognitive Behavioral Pain Management Program on Sleep in Patients with Chronic Pain: Results of a Pilot Study.

    Science.gov (United States)

    Blake, Catherine; Cunningham, Jennifer; Power, Camillus K; Horan, Sheila; Spencer, Orla; Fullen, Brona M

    2016-02-01

    To determine the impact of a cognitive behavioral pain management program on sleep in patients with chronic pain. Prospective nonrandomized controlled pilot study with evaluations at baseline and 12 weeks. Out-patient multidisciplinary cognitive behavioral pain management program in a university teaching hospital. Patients with chronic pain who fulfilled the criteria for participation in a cognitive behavioral pain management program. Patients assigned to the intervention group (n = 24) completed a 4 week cognitive behavioral pain management program, and were compared with a waiting list control group (n = 22). Assessments for both groups occurred at baseline and two months post cognitive behavioral pain management program. Outcome measures included self-report (Pittsburgh Sleep Quality Index) and objective (actigraphy) sleep measures, pain and quality of life measures. Both groups were comparable at baseline, and all had sleep disturbance. The Pittsburgh Sleep Quality Index correlated with only two of the seven objective sleep measures (fragmentation index r = 0.34, P = 0.02, and sleep efficiency percentage r = -0.31, P = 0.04). There was a large treatment effect for cognitive behavioral pain management program group in mean number of wake bouts (d = 0.76), where a significant group*time interaction was also found (P = 0.016), showing that the CBT-PMP group improved significantly more than controls in this sleep variable. Patients attending a cognitive behavioral pain management program have high prevalence of sleep disturbance, and actigraphy technology was well tolerated by the patients. Preliminary analysis of the impact of a cognitive behavioral pain management program on sleep is promising, and warrants further investigation.

  1. 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.

  2. Pilot implementation

    DEFF Research Database (Denmark)

    Hertzum, Morten; Bansler, Jørgen P.; Havn, Erling C.

    2012-01-01

    A recurrent problem in information-systems development (ISD) is that many design shortcomings are not detected during development, but first after the system has been delivered and implemented in its intended environment. Pilot implementations appear to promise a way to extend prototyping from...... the laboratory to the field, thereby allowing users to experience a system design under realistic conditions and developers to get feedback from realistic use while the design is still malleable. We characterize pilot implementation, contrast it with prototyping, propose a iveelement model of pilot...... implementation and provide three empirical illustrations of our model. We conclude that pilot implementation has much merit as an ISD technique when system performance is contingent on context. But we also warn developers that, despite their seductive conceptual simplicity, pilot implementations can be difficult...

  3. 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

  4. 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.

  5. 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. PMID:22163543

  6. THE GROWTH RATE OF PUBLIC DEBT IN ROMANIA - DETERMINANT OF A REAL STRATEGY MANAGEMENT

    Directory of Open Access Journals (Sweden)

    DOBROT;ăGABRIELA

    2017-12-01

    Full Text Available Contracting public debt is an omnipresent process in Member emerging. Low development of production capacities compared to consumption and investment, the existence of a reduced volume of savings internally, major imbalances in external plan or fluctuations in major capital are just some elements that determine the the orientation towards borrowings, and in particular to external funding. The growth rate in recent years emphasized, representing an issue of major importance for authorities, especially considering the sustainability of government debt. This may be evidenced at least by analysis of the level registered, of cost of financing and repayment period. In the paper is performed a descriptive statistical analysis on the evolution of growth in public debt and its structure by types of currencies, being presented and the factors affecting the maintenance of public debt to a sustainable level. The conclusion of the analysis carried out highlights a rapidly growing of the public debt in Romania after 2008, which requires the application of a clear strategy for its management so as to avoid the generated risks by high levels and inadequate structure.

  7. 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.

  8. Conceptualization and Pilot Testing of a Core Competency-Based Training Workshop in Suicide Risk Assessment and Management: Notes From the Field.

    Science.gov (United States)

    Cramer, Robert J; Bryson, Claire N; Eichorst, Morgam K; Keyes, Lee N; Ridge, Brittany E

    2017-03-01

    As professional psychology training programs and continuing education have moved toward competency based approaches, it has become equally important to develop uniform, evidence-based approaches for suicide risk assessment and management. The present article presents a workshop curriculum based on established core competencies in suicide risk assessment and management. Drawing on theories suicide risk formation, the workshop features an integration of didactic, process, and experiential components. We present pilot data from 2 small group workshops (n = 17): 1 from a clinical psychology doctoral program and 1 from a university counseling center. Workshop participation yielded increases in (a) the ability to recognize appropriate clinician responses to suicidal client statements, (b) self-perceptions of general capacity to interface with suicidal patients and mastery of the 10 core competencies, (c) factual knowledge concerning suicide risk assessment and management, and (d) the self-rated ability to assess and manage a suicidal patient. We discuss statistical and generalizability limitations as well as implications for future modification, implementation, and provision of this training method. © 2016 Wiley Periodicals, Inc.

  9. Plant Growth Regulators as Potential Tools in Aquatic Plant Management: Efficacy and Persistence in Small-Scale Tests

    Science.gov (United States)

    1994-01-01

    gratefully acknowledge the support of the Waterways Experi- ment Station and Drs. Howard Westerdahl and Kurt Getsinger as this research was being conducted...E. Westerdahl , eds., Plant Growth Regulator Society of America, San Antonio, TX, 127-45. Anderson, L. W. J., and Dechoretz, N. (1988). "Bensulfuron...Vegetation Management. J. E. Kaufman and H. E. Westerdahl , eds., Plant Growth Regulator Society of America, San Antonio, TX, 155-86. Herbicide Handbook

  10. Flow Management to Control Excessive Growth of Macrophytes - An Assessment Based on Habitat Suitability Modeling.

    Science.gov (United States)

    Ochs, Konstantin; Rivaes, Rui P; Ferreira, Teresa; Egger, Gregory

    2018-01-01

    Mediterranean rivers in intensive agricultural watersheds usually display outgrowths of macrophytes - notably alien species - due to a combination of high concentrations of nutrients in the water runoff and low flows resulting from water abstraction for irrigation. Standard mechanical and chemical control is used to mitigate the problems associated with excessive growth of plant biomass: mainly less drainage capacity and higher flood risk. However, such control measures are cost and labor-intensive and do not present long-term efficiency. Although the high sensitivity of aquatic vegetation to instream hydraulic conditions is well known, management approaches based on flow management remain relatively unexplored. The aim of our study was therefore to apply physical habitat simulation techniques promoted by the Instream Flow Incremental Method (IFIM) to aquatic macrophytes - the first time it has been applied in this context - in order to model shifts in habitat suitability under different flow scenarios in the Sorraia river in central Portugal. We used this approach to test whether the risk of invasion and channel encroachment by nuisance species can be controlled by setting minimum annual flows. We used 960 randomly distributed survey points to analyze the habitat suitability for the most important aquatic species (including the invasive Brazilian milfoil Myriophyllum aquaticum , Sparganium erectum , and Potamogeton crispus ) in regard to the physical parameters 'flow velocity,' 'water depth,' and 'substrate size'. We chose the lowest discharge period of the year in order to assess the hydraulic conditions while disturbances were at a low-point, thus allowing aquatic vegetation establishment and subsistence. We then used the two-dimensional hydraulic River2D software to model the potential habitat availability for different flow conditions based on the site-specific habitat suitability index for each physical parameter and species. Our results show that the growth

  11. Flow Management to Control Excessive Growth of Macrophytes – An Assessment Based on Habitat Suitability Modeling

    Science.gov (United States)

    Ochs, Konstantin; Rivaes, Rui P.; Ferreira, Teresa; Egger, Gregory

    2018-01-01

    Mediterranean rivers in intensive agricultural watersheds usually display outgrowths of macrophytes – notably alien species – due to a combination of high concentrations of nutrients in the water runoff and low flows resulting from water abstraction for irrigation. Standard mechanical and chemical control is used to mitigate the problems associated with excessive growth of plant biomass: mainly less drainage capacity and higher flood risk. However, such control measures are cost and labor-intensive and do not present long-term efficiency. Although the high sensitivity of aquatic vegetation to instream hydraulic conditions is well known, management approaches based on flow management remain relatively unexplored. The aim of our study was therefore to apply physical habitat simulation techniques promoted by the Instream Flow Incremental Method (IFIM) to aquatic macrophytes – the first time it has been applied in this context – in order to model shifts in habitat suitability under different flow scenarios in the Sorraia river in central Portugal. We used this approach to test whether the risk of invasion and channel encroachment by nuisance species can be controlled by setting minimum annual flows. We used 960 randomly distributed survey points to analyze the habitat suitability for the most important aquatic species (including the invasive Brazilian milfoil Myriophyllum aquaticum, Sparganium erectum, and Potamogeton crispus) in regard to the physical parameters ‘flow velocity,’ ‘water depth,’ and ‘substrate size’. We chose the lowest discharge period of the year in order to assess the hydraulic conditions while disturbances were at a low-point, thus allowing aquatic vegetation establishment and subsistence. We then used the two-dimensional hydraulic River2D software to model the potential habitat availability for different flow conditions based on the site-specific habitat suitability index for each physical parameter and species. Our results show

  12. 14 CFR 91.1089 - Qualifications: Check pilots (aircraft) and check pilots (simulator).

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Qualifications: Check pilots (aircraft) and check pilots (simulator). 91.1089 Section 91.1089 Aeronautics and Space FEDERAL AVIATION ADMINISTRATION... RULES Fractional Ownership Operations Program Management § 91.1089 Qualifications: Check pilots...

  13. Reducing Air Force Fighter Pilot Shortages

    Science.gov (United States)

    2015-12-31

    units). Pilot positions can be divided into two categories: absorbing and nonabsorbing. Absorbing positions are in operational units to which...Continued Attention to Aircrew Management Dynamics The primary source of stress in fighter- pilot management has been reductions in aircraft inventories...Fighter Pilot Shortages C O R P O R A T I O N Limited Print and Electronic Distribution Rights This document and trademark(s) contained herein are

  14. 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.

  15. 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

  16. 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.

  17. 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...

  18. A new method for evaluating forest thinning: growth dominance in managed Pinus resinosa stands

    Science.gov (United States)

    John B. Bradford; Anthony W. D' Amato; Brian J. Palik; Shawn. Fraver

    2010-01-01

    Growth dominance is a relatively new, simple, quantitative metric of within-stand individual tree growth patterns, and is defined as positive when larger trees in the stand display proportionally greater growth than smaller trees, and negative when smaller trees display proportionally greater growth than larger trees. We examined long-term silvicultural experiments in...

  19. The Power of Public Investment Management : Transforming Resources into Assets for Growth

    OpenAIRE

    Rajaram, Anand; Minh Le, Tuan; Kaiser, Kai; Kim, Jay-Hyung; Frank, Jonas

    2014-01-01

    This publication consists of seven chapters: building a system for public investment management; a unified framework for public investment management; country experiences of public investment management; approaches to better project appraisal; public investment management under uncertainty; procurement and public investment management; and public investment management for public-private pa...

  20. Conservative management or gamma knife radiosurgery for vestibular schwannoma: tumor growth, symptoms, and quality of life.

    Science.gov (United States)

    Breivik, Cathrine Nansdal; Nilsen, Roy Miodini; Myrseth, Erling; Pedersen, Paal Henning; Varughese, Jobin K; Chaudhry, Aqeel Asghar; Lund-Johansen, Morten

    2013-07-01

    There are few reports about the course of vestibular schwannoma (VS) patients following gamma knife radiosurgery (GKRS) compared with the course following conservative management (CM). In this study, we present prospectively collected data of 237 patients with unilateral VS extending outside the internal acoustic canal who received either GKRS (113) or CM (124). The aim was to measure the effect of GKRS compared with the natural course on tumor growth rate and hearing loss. Secondary end points were postinclusion additional treatment, quality of life (QoL), and symptom development. The patients underwent magnetic resonance imaging scans, clinical examination, and QoL assessment by SF-36 questionnaire. Statistics were performed by using Spearman correlation coefficient, Kaplan-Meier plot, Poisson regression model, mixed linear regression models, and mixed logistic regression models. Mean follow-up time was 55.0 months (26.1 standard deviation, range 10-132). Thirteen patients were lost to follow-up. Serviceable hearing was lost in 54 of 71 (76%) (CM) and 34 of 53 (64%) (GKRS) patients during the study period (not significant, log-rank test). There was a significant reduction in tumor volume over time in the GKRS group. The need for treatment following initial GKRS or CM differed at highly significant levels (log-rank test, P < .001). Symptom and QoL development did not differ significantly between the groups. In VS patients, GKRS reduces the tumor growth rate and thereby the incidence rate of new treatment about tenfold. Hearing is lost at similar rates in both groups. Symptoms and QoL seem not to be significantly affected by GKRS.

  1. 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.

  2. 14 CFR 91.1055 - Pilot operating limitations and pairing requirement.

    Science.gov (United States)

    2010-01-01

    ... 14 Aeronautics and Space 2 2010-01-01 2010-01-01 false Pilot operating limitations and pairing... Ownership Operations Program Management § 91.1055 Pilot operating limitations and pairing requirement. (a... aircraft being flown, and the pilot in command is not an appropriately qualified check pilot, the pilot in...

  3. 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

  4. A pilot mixed-methods evaluation of MS INFoRm: a self-directed fatigue management resource for individuals with multiple sclerosis.

    Science.gov (United States)

    Akbar, Nadine; Turpin, Karen; Petrin, Julie; Smyth, Penny; Finlayson, Marcia

    2018-06-01

    Fatigue management interventions for individuals with multiple sclerosis (MS) often feature structured programmes requiring repeated, in-person attendance that is not possible for all individuals. We sought to determine whether MS INFoRm, a self-directed fatigue management resource for individuals with MS, was worth further, more rigorous evaluation. Our indicators of worthiness were actual use of the resource by participants over 3 months, reductions in fatigue impact and increases in self-efficacy, and participant reports of changes in fatigue management knowledge and behaviours. This was a single-group, mixed-methods, before-after pilot study in individuals with MS reporting mild to moderate fatigue. Thirty-five participants were provided with MS INFoRm by a USB flash drive to use at home for 3 months, on their own volition. Twenty-three participants completed all standardized questionnaires, semi-structured interviews and study process measures. Participants reported actively using MS INFoRm over the 3-month study period (median total time spent using MS INFoRm=315 min) as well as significantly lower overall fatigue impact (Modified Fatigue Impact Scale: t=2.6, P=0.01), increased knowledge of MS fatigue (z=-2.8, P=0.01) and greater confidence in managing MS fatigue (z=-3.3, P=0.001). Individuals with significant reductions in fatigue impact also reported behavioural changes including tracking fatigue, better communication with others, greater awareness, improved quality of life and being more proactive. This study provides evidence that further rigorous evaluation of MS INFoRm, a self-directed resource for managing fatigue, is worth pursuing.

  5. 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 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.

  6. Muscle energy technique compared to eccentric loading exercise in the management of achilles tendinitis: A pilot randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Hariharasudhan Ravichandran

    2017-01-01

    Full Text Available Background: Achilles tendinitis is a common overuse injury among both elite and recreational athletes involved in activities such as repetitive jumping and running. Aim: The aim of this single-blinded randomized study was to compare the efficacy of muscle energy technique (MET and eccentric loading exercise (ELE interventions on improving functional ability and pain reduction among athletes with Achilles tendinitis. Methods: A single-blinded, pilot, randomized study was conducted in the Department of Physical Therapy, Global Hospitals and Health City, India, with 6-week follow-up. A total of 30 patients with Achilles tendinitis were randomly allocated to receive either MET (n = 15 or ELE (n = 15 treatment. Treatment effects were evaluated by pre- and post-treatment assessment of visual analog scale (VAS and Victorian Institute of Sports Assessment-Achilles (VISA-A questionnaire. Measures were performed by single-blinded evaluators at baseline and at 2, 4, and after 6 weeks of treatment. Results: Both groups showed a significant difference in VAS after 6 weeks' ELE group showed a significant improvement during treatment at 2 and 4 weeks in comparison with MET group. The VISA-A scale score significantly improved in both groups. Yet, comparison of VISA scores between groups showed marginally significant difference (P = 0.012. Conclusion: This pilot randomized controlled trial (RCT showed the efficacy of ELE in reducing pain and improving functional ability among patients with Achilles tendinitis. The findings of this study provide the rationale for undertaking a large-scale RCT. A large sized trial is needed to establish evidence for clinical practice of ELE in Achilles tendinitis cases.

  7. 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...

  8. 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

  9. 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.

  10. A pilot application of regional scale risk assessment to the forestry management of the upper Grand Ronde watershed, Oregon

    Science.gov (United States)

    Suzanne M. Anderson; Wayne G. Landis

    2012-01-01

    An issue in forestry management has been the integration of a variety of different information into a threat analysis or risk assessment. In this instance, regional scale risk assessment was applied to the Upper Grande Ronde watershed in eastern Oregon to examine the potential of risk assessment for use in the management of broad landscapes. The site was a focus of...

  11. 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.

  12. 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

  13. Business Growth : A study of the Impact of Transformational Leadership, Innovation and Competence Management

    OpenAIRE

    Jegede, Ifeoluwa Olaitan; Haskan, Tarkan

    2011-01-01

    For every firm, company or business organisation, growth and progress is the major focus. In fact for every facet of living organism, growth is an essential factor which if not in place, stagnation is inevitable. Growth in this sense could be in terms of the market performance, sales, number of employees to mention a few. There have been researches carried out on different factors which could enhance or have positive influence on business growth, one of them is Innovation. Leadership of an or...

  14. 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.

  15. Shareholder/Stakeholder Value Management, Company Growth and Financial Performance: An Exploratory Study

    OpenAIRE

    Ekholm, Bo-Göran; Wallin, Jan

    2003-01-01

    There has been considerable discussion in the literature about the relative merits of shareholder value management and stakeholder value management, but relatively little empirical research has been reported concerning the relationship between these types of management and financial performance. The present study puts forward a hypothesis that true shareholder value management also encompasses stakeholder value management. This combination of shareholder/stakeholder value management is hypoth...

  16. 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.

  17. 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.

  18. 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.

  19. A community living management program for people with disabilities who have moved out of nursing homes: a pilot study.

    Science.gov (United States)

    Lee, Danbi; Hammel, Joy; Wilson, Tom

    2015-06-23

    This study describes implementation and evaluation of the Stepping Stones program, a community living management program designed to assist people with disabilities to gain community living skills after moving out of nursing homes. Thirteen people with diverse disabilities participated in the 10-week Stepping Stones program. The participants attended two sessions a day every week, over a 5-week period. Interviewer-administered surveys were used at baseline and 1 week post-intervention to evaluate the impact of the program. Focus group interviews were conducted at 1 week post-intervention. Analyses of quantitative data demonstrated improved self-efficacy in community living management skills, with medium-to-high effect sizes. Participants reported improved sense of empowerment and confidence in finding resources and managing community living. They also reported high satisfaction with the program. Preliminary findings suggest that the Stepping Stones program is beneficial to the target group. The study indicates that application of social learning and self-efficacy theories is effective to empower and enable people with disabilities to manage their lives in the community. The Stepping Stones program may be provided as a risk management intervention after individuals' transition into the community. Implications for Rehabilitation Long-term institutionalization negatively influences people with disabilities' self-esteem, autonomy and ability to independently live in the community. Successful community living requires complex management involving the coordination of personal, social, resource and environmental factors. This study shows that programming on choice and control and community living skill development improved participants' confidence in managing community living.

  20. 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.

  1. 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 ...

  2. 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.

  3. Regeneration Responses to Management for Old-Growth Characteristics in Northern Hardwood-Conifer Forests

    Directory of Open Access Journals (Sweden)

    Aviva J. Gottesman

    2017-02-01

    Full Text Available Successful tree regeneration is essential for sustainable forest management, yet it can be limited by the interaction of harvesting effects and multiple ecological drivers. In northern hardwood forests, for example, there is uncertainty whether low-intensity selection harvesting techniques will result in adequate and desirable regeneration. Our research is part of a long-term study that tests the hypothesis that a silvicultural approach called “structural complexity enhancement” (SCE can accelerate the development of late-successional forest structure and functions. Our objective is to understand the regeneration dynamics following three uneven-aged forestry treatments with high levels of retention: single-tree selection, group selection, and SCE. Regeneration density and diversity can be limited by differing treatment effects on or interactions among light availability, competitive environment, substrate, and herbivory. To explore these relationships, manipulations and controls were replicated across 2 ha treatment units at two Vermont sites. Forest inventory data were collected pre-harvest and periodically over 13 years post-harvest. We used mixed effects models with repeated measures to evaluate the effect of treatment on seedling and sapling density and diversity (Shannon–Weiner H’. The treatments were all successful in recruiting a sapling class with significantly greater sapling densities compared to the controls. However, undesirable and prolific beech (Fagus americana sprouting dominates some patches in the understory of all the treatments, creating a high degree of spatial variability in the competitive environment for regeneration. Multivariate analyses suggest that while treatment had a dominant effect, other factors were influential in driving regeneration responses. These results indicate variants of uneven-aged systems that retain or enhance elements of stand structural complexity—including old-growth characteristics

  4. Role of two insect growth regulators in integrated pest management of citrus scales.

    Science.gov (United States)

    Grafton-Cardwell, E E; Lee, J E; Stewart, J R; Olsen, K D

    2006-06-01

    Portions of two commercial citrus orchards were treated for two consecutive years with buprofezin or three consecutive years with pyriproxyfen in a replicated plot design to determine the long-term impact of these insect growth regulators (IGRs) on the San Joaquin Valley California integrated pest management program. Pyriproxyfen reduced the target pest, California red scale, Aonidiella aurantii Maskell, to nondetectable levels on leaf samples approximately 4 mo after treatment. Pyriproxyfen treatments reduced the California red scale parasitoid Aphytis melinus DeBach to a greater extent than the parasitoid Comperiella bifasciata Howard collected on sticky cards. Treatments of lemons Citrus limon (L.) Burm. f. infested with scale parasitized by A. melinus showed only 33% direct mortality of the parasitoid, suggesting the population reduction observed on sticky cards was due to low host density. Three years of pyriproxyfen treatments did not maintain citricola scale, Coccus pseudomagnoliarum (Kuwana), below the treatment threshold and cottony cushion scale, Icerya purchasi Maskell, was slowly but incompletely controlled. Buprofezin reduced California red scale to very low but detectable levels approximately 5 mo after treatment. Buprofezin treatments resulted in similar levels of reduction of the two parasitoids A. melinus and C. bifasciata collected on sticky cards. Treatments of lemons infested with scale parasitized by A. melinus showed only 7% mortality of the parasitoids, suggesting the population reduction observed on sticky cards was due to low host density. Citricola scale was not present in this orchard, and cottony cushion scale was slowly and incompletely controlled by buprofezin. These field plots demonstrated that IGRs can act as organophosphate insecticide replacements for California red scale control; however, their narrower spectrum of activity and disruption of coccinellid beetles can allow other scale species to attain primary pest status.

  5. 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

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

    Science.gov (United States)

    O'Brien, C; Cambouropoulos, P

    2000-01-01

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

  7. 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.

  8. A Controlled Pilot Trial of PainTracker Self-Manager, a Web-Based Platform Combined With Patient Coaching, to Support Patients' Self-Management of Chronic Pain.

    Science.gov (United States)

    Sullivan, Mark; Langford, Dale J; Davies, Pamela Stitzlein; Tran, Christine; Vilardaga, Roger; Cheung, Gifford; Yoo, Daisy; McReynolds, Justin; Lober, William B; Tauben, David; Vowles, Kevin E

    2018-03-29

    The objective of this study was to develop and pilot test a chronic pain empowerment and self-management platform, derived from acceptance and commitment therapy, in a pain specialty setting. A controlled, sequential, nonrandomized study design was used to accommodate intervention development and to test the efficacy of the PainTracker Self-Manager (PTSM) intervention (Web-based educational modules and outcome tracking combined with tailored patient coaching sessions and provider guidance). Generalized estimating equations evaluated changes over time (baseline, 3 months, 6 months) in pain self-efficacy (primary outcome), chronic pain acceptance (activity engagement and pain willingness), perceived efficacy in patient-provider interactions, pain intensity and interference, and overall satisfaction with pain treatment (secondary outcomes) between intervention (n = 48) and usual care control groups (n = 51). The full study sample (N = 99) showed greater improvements over time (significant Group × Time interactions) in pain self-efficacy and satisfaction with pain treatment. Among study completers (n = 82), greater improvement in activity engagement as well as pain intensity and interference were also observed. These preliminary findings support the efficacy of the PTSM intervention in a pain specialty setting. Further research is needed to refine and expand the PTSM intervention and to test it in a randomized trial in primary care settings. We developed a Web-based patient empowerment platform that combined acceptance and commitment therapy-based educational modules and tailored coaching sessions with longitudinal tracking of treatments and patient-reported outcomes, named PTSM. Pilot controlled trial results provide preliminary support for its efficacy in improving pain self-efficacy, activity engagement, pain intensity and interference, and satisfaction with pain treatment. Copyright © 2018 The American Pain Society. Published by Elsevier Inc. All

  9. Bootstrapping as a Resource Dependence Management Strategy and its Association with Startup Growth

    OpenAIRE

    T. VANACKER; S. MANIGART; M. MEULEMAN; L. SELS

    2011-01-01

    This paper studies the association between bootstrapping and startup growth. Bootstrapping reduces a startup’s dependence on financial investors, but may create new dependencies. Drawing upon resource dependence theory, we hypothesize that when bootstrapping does not create new strong dependencies it will benefit startup growth, especially when dependence from financial investors is high. However, when bootstrapping creates new strong dependencies it will constrain growth, especially when dep...

  10. 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.

  11. Information management

    Science.gov (United States)

    Ricks, Wendell; Corker, Kevin

    1990-01-01

    Primary Flight Display (PFD) information management and cockpit display of information management research is presented in viewgraph form. The information management problem in the cockpit, information management burdens, the key characteristics of an information manager, the interface management system handling the flow of information and the dialogs between the system and the pilot, and overall system architecture are covered.

  12. Baseline knowledge on vehicle safety and head restraints among Fleet Managers in British Columbia Canada: a pilot study.

    Science.gov (United States)

    Desapriya, Ediriweera; Hewapathirane, D Sesath; Peiris, Dinithi; Romilly, Doug; White, Marc

    2011-09-01

    Whiplash is the most common injury type arising from motor vehicle collisions, often leading to long-term suffering and disability. Prevention of such injuries is possible through the use of appropriate, correctly positioned, vehicular head restraints. To survey the awareness and knowledge level of vehicle fleet managers in the province of British Columbia, Canada, on the topics of vehicle safety, whiplash injury, and prevention; and to better understand whether these factors influence vehicle purchase/lease decisions. A survey was administered to municipal vehicle fleet managers at a professional meeting (n = 27). Although many respondents understood the effectiveness of vehicle head restraints in the prevention of whiplash injury, the majority rarely adjusted their own headrests. Fleet managers lacked knowledge about the seriousness of whiplash injuries, their associated costs for Canada's healthcare system, and appropriate head restraint positions to mitigate such injuries. The majority of respondents indicated that fleet vehicle purchase/lease decisions within their organization did not factor whiplash prevention as an explicit safety priority. There is relatively little awareness and enforcement of whiplash prevention strategies among municipal vehicle fleet managers.

  13. 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…

  14. 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.

  15. The Impact of Supervision on Internal Medicine Residents' Attitudes and Management of Depression in Primary Care: A Pilot Study

    Science.gov (United States)

    Milone, Jennifer M.; Gottumukkala, Aruna; Ward, Christopher P.; York, Kaki M.

    2013-01-01

    Objective: The authors examined the effect of supervision on internal medicine residents' attitudes toward and management of depression. Method: Internal medicine residents completed a survey during preclinical conferences. The survey included a published, validated questionnaire, the Depression Attitude Questionnaire, and items developed by the…

  16. 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 (Pmanagement behaviors (Pmanagement 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.

  17. 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.

  18. 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.

  19. 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...

  20. Effects of a Peer-Led Pain Management Program for Nursing Home Residents with Chronic Pain: A Pilot Study.

    Science.gov (United States)

    Tse, Mimi Mun Yee; Yeung, Suey Shuk Yu; Lee, Paul Hong; Ng, Shamay Sheung Mei

    2016-09-01

    OBJECTIVES : To examine the feasibility of a peer-led pain management program among nursing home residents. DESIGN : A quasi-experimental design. SETTING : Two nursing homes. SUBJECTS : Fifty nursing home residents. METHODS : The experimental group (n = 32) was given a 12-week group-based peer-led pain management program. There were two 1-hour sessions per week. Education in pain and demonstrations of nonpharmacological pain management strategies were provided. The research team and 12 trained peers led the sessions. The control group (n = 18) received one 1-hour session of pain management program each week over 12 weeks from the research team only. Outcome measures for the participants were collected at baseline (P1) and at week 12 (P2). Data from peer volunteers were collected prior to training (V1) and at week 12 (V2). T-tests were used to compare the differences in outcome measures collected at two time points. RESULTS : There was a significant reduction in pain intensity from 5.8 ± 2.6 (P1) to 3.4 ± 2.5 (P2) for the experimental group (p = 0.003) and from 6.3 ± 3.0 (P1) to 3.1 ± 2.4 (P2) for the control group (p = 0.001). Activities of daily living significantly improved for both the experimental group (p = 0.008) and the control group (p = 0.014). There was an enhancement in happiness level for the experimental group (p pain management knowledge (2.9 ± 2.6 to 8.1 ± 1.2, p pain management program was feasible and has potential in relieving chronic pain and enhancing the physical and psychological health of nursing home residents. © 2016 American Academy of Pain Medicine. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  1. 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

  2. Patient-centered professional practice models for managing low back pain in older adults: a pilot randomized controlled trial.

    Science.gov (United States)

    Goertz, Christine M; Salsbury, Stacie A; Long, Cynthia R; Vining, Robert D; Andresen, Andrew A; Hondras, Maria A; Lyons, Kevin J; Killinger, Lisa Z; Wolinsky, Fredric D; Wallace, Robert B

    2017-10-13

    Low back pain is a debilitating condition for older adults, who may seek healthcare from multiple providers. Few studies have evaluated impacts of different healthcare delivery models on back pain outcomes in this population. The purpose of this study was to compare clinical outcomes of older adults receiving back pain treatment under 3 professional practice models that included primary medical care with or without chiropractic care. We conducted a pilot randomized controlled trial with 131 community-dwelling, ambulatory older adults with subacute or chronic low back pain. Participants were randomly allocated to 12 weeks of individualized primary medical care (Medical Care), concurrent medical and chiropractic care (Dual Care), or medical and chiropractic care with enhanced interprofessional collaboration (Shared Care). Primary outcomes were low back pain intensity rated on the numerical rating scale and back-related disability measured with the Roland-Morris Disability Questionnaire. Secondary outcomes included clinical measures, adverse events, and patient satisfaction. Statistical analyses included mixed-effects regression models and general estimating equations. At 12 weeks, participants in all three treatment groups reported improvements in mean average low back pain intensity [Shared Care: 1.8; 95% confidence interval (CI) 1.0 to 2.6; Dual Care: 3.0; 95% CI 2.3 to 3.8; Medical Care: 2.3; 95% CI 1.5 to 3.2)] and back-related disability (Shared Care: 2.8; 95% CI 1.6 to 4.0; Dual Care: 2.5; 95% CI 1.3 to 3.7; Medical Care: 1.5; 95% CI 0.2 to 2.8). No statistically significant differences were noted between the three groups on the primary measures. Participants in both models that included chiropractic reported significantly better perceived low back pain improvement, overall health and quality of life, and greater satisfaction with healthcare services than patients who received medical care alone. Professional practice models that included primary care and

  3. 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

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

    Science.gov (United States)

    2010-01-01

    analysis methodology called constant comparative analysis ( Lincoln and Guba, 1985; Denzin and Lincoln , 2000). First, two RAND researchers independently...and Yvonna S. Lincoln , “Introduction: The Discipline and Practice of Qualitative Research,” in Norman K. Denzin and Yvonna S. Lincoln , eds...Management Services,” undated web page. As of June 3, 2010: http://www.coastandards.org/standards.php?navView=private§ion_id=114 Denzin , Norman K

  5. 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.

  6. Managing challenging behaviour in preschool children post-traumatic brain injury with online clinician support: protocol for a pilot study

    OpenAIRE

    Taylor, Kaitlyn; Catroppa, Cathy; Godfrey, Celia; McKinlay, Audrey; Ponsford, Jennie; Matthews, Jan; Anderson, Vicki

    2017-01-01

    Background Traumatic brain injury (TBI) in children is associated with a range of poor long-term outcomes, including behavioural disturbances. Parents can experience high levels of stress and injury-related burden, and evidence suggests that distressed parents are less likely to adopt positive parenting styles to manage their child?s behaviour. The ?Signposts for Building Better Behaviour? program is a parenting programme that was originally developed to assist parents of children with an int...

  7. 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...

  8. Green roofs as contributors for water management schemes within urban areas – a pilot study in Porto

    OpenAIRE

    Monteiro, C. M.; Calheiros, C. S. C.; Pimentel-Rodrigues, C.; Palha, P.; Silva-Afonso, A.; Castro, P. M. L.

    2016-01-01

    Water scarcity is an issue of worldwide concern and a holistic approach to water management is needed to overcome the potential threats that climate change brings to water availability and security in many parts of the globe. Societal and economic challenges need to be addressed when implementing technological solutions to environmental problems. The fact that green areas in the cities have been reduced and replaced by impervious buildings and paved streets has caused a number of problems, su...

  9. 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.

  10. A pilot study investigating the feasibility of symptom assessment manager (SAM), a Web-based real-time tool for monitoring challenging behaviors.

    Science.gov (United States)

    Loi, Samantha M; Wanasinghage, Sangeeth; Goh, Anita; Lautenschlager, Nicola T; Darby, David G; Velakoulis, Dennis

    2018-04-01

    Improving and minimizing challenging behaviors seen in psychiatric conditions, including behavioral and psychological symptoms of dementia are important in the care of people with these conditions. Yet there is a lack of systematic evaluation of these as a part of routine clinical care. The Neuropsychiatric Inventory is a validated and reliable tool for rating the severity and disruptiveness of challenging behaviors. We report on the evaluation of a Web-based symptom assessment manager (SAM), designed to address the limitation of previous tools using some of the Neuropsychiatric Inventory functions, to monitor behaviors by staff caring for people with dementia and other psychiatric conditions in inpatient and residential care settings. The SAM was piloted in an 8-bed inpatient neuropsychiatry unit over 5 months. Eleven nurses and 4 clinicians were trained in usage of SAM. Primary outcomes were usage of SAM and perceived usability, utility, and acceptance of SAM. Secondary outcomes were the frequencies of documented behavior. Usage data were analyzed using chi-square and logistic regression analyses. The SAM was used for all admitted patients regardless of diagnosis, with a usage rate of 64% for nurses regularly employed in the unit. Staff provided positive feedback regarding the utility of SAM. The SAM appeared to offer individualized behavior assessment by providing a quick, structured, and standardized platform for assessing behavior in a real-world setting. Further research would involve trialing SAM with more staff in alternative settings such as in home or residential care settings. Copyright © 2017 John Wiley & Sons, Ltd.

  11. 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 employees, and additional observational data collected. 424 of 649 (65%) employees approached consented, of whom 350 provided WEMWBS at baseline and 284 at follow-up; 41 managers out of 49 were recruited from the three intervention clusters and 21 adhered to the intervention. WEMWBS scores fell from 50.4-49.0 in the control (n=59) and 51.0-49.9 in the intervention (n=225), giving an intervention effect of 0.5 (95% CI -3.2 to 4.2). 120/225 intervention employees had a manager who was adherent to the intervention. HR data on 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

  12. Functional Management Competence and Growth of Young Technology-Based Firms

    DEFF Research Database (Denmark)

    Salomo, Søren; Brinckmann, Jan; Talke, Katrin

    2008-01-01

    . While technology management competence is positively driving development speed, the marketing management competence impact on speed is mediated by competitive advantage of the new products developed by young technology-based firms. Financial management competence has no significant link to firm...

  13. 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

  14. 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.

  15. Growing pains: How risk perception and risk communication research can help to manage the challenges of global population growth.

    Science.gov (United States)

    Dawson, Ian G J; Johnson, Johnnie E V

    2014-08-01

    In 2011, the global human population reached 7 billion and medium variant projections indicate that it will exceed 9 billion before 2045. Theoretical and empirical perspectives suggest that this growth could lead to an increase in the likelihood of adverse events (e.g., food shortages, climate change, etc.) and/or the severity of adverse events (e.g., famines, natural disasters, etc.). Several scholars have posited that the size to which the global population grows and the extent to which this growth increases the likelihood of adverse outcomes will largely be shaped by individuals' decisions (in households, organizations, governments, etc.). In light of the strong relationship between perceived risk and decision behaviors, it is surprising that there remains a dearth of empirical research that specifically examines the perceived risks of population growth and how these perceptions might influence related decisions. In an attempt to motivate this important strand of research, this article examines the major risks that may be exacerbated by global population growth and draws upon empirical work concerning the perception and communication of risk to identify potential directions for future research. The article also considers how individuals might perceive both the risks and benefits of population growth and be helped to better understand and address the related issues. The answers to these questions could help humanity better manage the emerging consequences of its continuing success in increasing infant survival and adult longevity. © 2014 Society for Risk Analysis.

  16. 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.

  17. 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.

  18. Knowledge, attitude, and practice (KAP) of 'teaching laboratory' technicians towards laboratory safety and waste management: a pilot interventional study.

    Science.gov (United States)

    El-Gilany, A-H; El-Shaer, S; Khashaba, E; El-Dakroory, S A; Omar, N

    2017-06-01

    A quasi-experimental study was performed on 20 technicians working in the Faculty of Medicine, Mansoura University, Egypt. The knowledge, attitude, and practice (KAP) of laboratory technicians was measured before and two months after enrolling them in an intervention programme about laboratory best practice procedures. The programme addressed laboratory safety and medical waste management. The assessment was performed using a validated Arabic self-administered questionnaire. Pre- and post-intervention scores were compared using non-parametric tests. There are significant increases in the scores of KAP after implementation of the training programme. Copyright © 2017 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  19. Veterinary Business Management Association presents program to aid future growth and stability of veterinary profession

    OpenAIRE

    Douglas, Jeffrey S.

    2008-01-01

    Spiraling veterinary student debt and the lack of a sustainable and profitable business model for many private practices in the modern business environment threaten the future growth and stability of the veterinary profession.

  20. Pilot study

    International Nuclear Information System (INIS)

    Hofmeester, G.H.; Swart, A.; Dijk, E. van

    1984-01-01

    In May 1980 it was decided to organize an intercomparison of personal dosimeters for photon radiations. The Commission of the European Communities initiated the intercomparison by starting a pilot study in which three laboratories NPL (United Kingdom), PTB (Germany) and RIV (The Netherlands) were asked to irradiate a series of personal dosemeters from institutes, GSF (Muenchen), CEA (Fontenay-aux-Roses), CNEN (Bologna) and CEGB (Berkeley). The latter institutes are secondary standard laboratories and have a radiation protection service as well. A new aspect of this pilot study is the fact that the irradiations also take place in front of a phantom. Irradiations took place in July and August 1980. The results of 4 institutes show that the personal dosemeters are quite capable of measuring the backscattered photon components

  1. Managing challenging behaviour in preschool children post-traumatic brain injury with online clinician support: protocol for a pilot study.

    Science.gov (United States)

    Taylor, Kaitlyn; Catroppa, Cathy; Godfrey, Celia; McKinlay, Audrey; Ponsford, Jennie; Matthews, Jan; Anderson, Vicki

    2017-01-01

    Traumatic brain injury (TBI) in children is associated with a range of poor long-term outcomes, including behavioural disturbances. Parents can experience high levels of stress and injury-related burden, and evidence suggests that distressed parents are less likely to adopt positive parenting styles to manage their child's behaviour. The 'Signposts for Building Better Behaviour' program is a parenting programme that was originally developed to assist parents of children with an intellectual disability in managing their child's behaviour. More recently, it has been adapted to include a TBI module, to assist parents in managing post-TBI behaviour. However, geographical and financial barriers remain, preventing many parents from accessing the programme in the standard face-to-face modality. This project aims to investigate the feasibility and acceptability of the programme when delivered with clinician support via videoconferencing. The sample for this feasibility study will be recruited from the Royal Children's Hospital, Melbourne, and the Victorian Paediatric Rehabilitation Service. Participants will be the parents of a child who sustained a TBI between the ages of 2.0 and 6.11, within the previous 2 years. The parents of 15 children will complete the programme, with clinician support via videoconferencing, while the parents of a further 15 children will form a treatment as usual wait-list control group. Parents complete questionnaires assessing their child's behaviour, as well as assessing their own mental health, sense of parenting competency, disciplinary style, and family functioning. These will be completed upon enrolment in the study regarding their child's pre-injury behaviour and then again pre-intervention, immediately post-intervention, and 4 months post-intervention. Parents who complete the intervention will also complete questionnaires assessing their satisfaction with the programme and its delivery. Information will be collected on the feasibility

  2. 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...... 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...... 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...

  3. 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.

  4. 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.

  5. 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

  6. Surveying some strategies of cultural management on species growth indices and yield in the field of soybean

    Directory of Open Access Journals (Sweden)

    habibeh soltani

    2018-01-01

    Full Text Available Introduction soybean (Glycine max L. plays an important role in three major markets of grains, oil and meal. damage of weeds in soybean generally 13 to 60 and sometimes more than %80 have been reported Farming methods through proper management, sowing date and by use of optimum density could be a strategy for the development of ecological competitiveness of crops and inhibit weed growth are the comparison the growth indices to design interference models of weed and crop and estimate crop yield loss in competition with weed is essential and allow to plant breeding researcher to choice the more competitive varieties of crop in competition with weed. Materials and Methods With the aim of influencing sowing date and plant density on the growth indices and evaluation the competitive ability of soybean cultivar Williams with weeds, an experiment was conducted in 2013, at Agricultural Research Station, Ferdowsi University of Mashhad, as split-split based on a randomized complete block design with three replications. Main plot included three sowing dates levels (17 April, 12 May, 6 June and sub - plots included four crop density (30, 40, 50 and 60 plant . m-2 and sub - sub plots included weed management of two level (weed infested and weedy control. First sampling was started at 35 days after planting and was every 14 days until the end of growth period. Leaf area index, dry matter, crop growth rate and the growth rate were calculated Results and Discussion The results showed that 11 species weed belonging to 9 families observed and identified. In the early stages of growth, leaf area index and dry matter increased slowly, but in the seven to eight leaf stage of plant growth (Log phase, leaf area index and dry matter increased rapidly, and a little upon entry to the plant Physiological maturity period (Early seedling peeks, and again began to decline at the end of seedling. The sowing date 12 May in contrast to early sowing date (17 April and delayed

  7. 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.

  8. Investigation of Peri-Implant Bone Healing Using Autologous Plasma Rich in Growth Factors in the Canine Mandible After 12 Weeks: A Pilot Study

    Science.gov (United States)

    Birang, Reza; Tavakoli, Mohammad; Shahabouei, Mohammad; Torabi, Alireza; Dargahi, Ali; Soolari, Ahmad

    2011-01-01

    Introduction: Faster reconstruction of patients’ masticatory systems is the aim of modern dentistry. A number of studies have indicated that application of growth factors to the surface of a dental implant leads to accelerated and enhanced osseointegration. The objective of the present study was to investigate the effect of plasma rich in growth factors on peri-implant bone healing. Materials and Methods: For the purpose of this study, two healthy, mixed-breed canines were selected, and the premolars were extracted from both sides of the mandible. Three months after premolar removal, 12 implants, each 5 mm in diameter and 10 mm in length, were placed in osteotomy sites on both sides of the mandible. Prior to placement, plasma rich in growth factors was applied to the surfaces of six implants, while the other six were used without plasma rich in growth factors. The implants were removed after 12 weeks along with the bone surrounding the sites using a trephine bur. One mesiodistal section containing the surrounding bone from each implant block, 50 µm in diameter, was prepared for histologic and histomorphometric investigation with an optical microscope. Results: The sites with implants treated with plasma rich in growth factors showed more bone-to-implant contact compared to control sites. Also, higher values for bone trabecular thickness and bone maturity were recorded for the PRGF-treated sites than for the control sites. Conclusion: Application of plasma rich in growth factors to the surface of an implant may enhance the bone healing process as well as bone-to-implant contact, thereby helping to achieve faster osseointegration. PMID:22145011

  9. 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.

  10. The Manager of Academic Outreach: A Role of Consequence to University Survival and Growth

    Science.gov (United States)

    Miller, Lawrence R.

    1977-01-01

    University managers of academic outreach need outstanding skills in communication, persuasion, and negotiation to win and maintain active faculty/administrator support for outreach activities. Failure to generate such support will make it impossible for outreach managers to deliver on the promise of the outreach concept. (Editor/LBH)

  11. 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...

  12. Cognitive Symptom Management and Rehabilitation Therapy (CogSMART) for veterans with traumatic brain injury: pilot randomized controlled trial.

    Science.gov (United States)

    Twamley, Elizabeth W; Jak, Amy J; Delis, Dean C; Bondi, Mark W; Lohr, James B

    2014-01-01

    Traumatic brain injury (TBI) can result in cognitive impairments and persistent postconcussive symptoms that limit functional recovery, including return to work. We evaluated a 12 wk compensatory cognitive training intervention (Cognitive Symptom Management and Rehabilitation Therapy [CogSMART]) in the context of supported employment for Veterans with mild to moderate TBI. Participants were randomly assigned to receive 12 wk of supported employment plus CogSMART or enhanced supported employment that controlled for therapist attention (control). CogSMART sessions were delivered by the employment specialist and included psychoeducation regarding TBI; strategies to improve sleep, fatigue, headaches, and tension; and compensatory cognitive strategies in the domains of prospective memory, attention, learning and memory, and executive functioning. Compared with controls, those assigned to supported employment plus CogSMART demonstrated significant reductions in postconcussive symptoms (Cohen d = 0.97) and improvements in prospective memory functioning (Cohen d = 0.72). Effect sizes favoring CogSMART for posttraumatic stress disorder symptom severity, depressive symptom severity, and attainment of competitive work within 14 wk were in the small to medium range (Cohen d = 0.35-0.49). Those who received CogSMART rated the intervention highly. Results suggest that adding CogSMART to supported employment may improve postconcussive symptoms and prospective memory. These effects, as well as smaller effects on psychiatric symptoms and ability to return to work, warrant replication in a larger trial.

  13. 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.

  14. Stress Management and Resiliency Training (SMART) program among Department of Radiology faculty: a pilot randomized clinical trial.

    Science.gov (United States)

    Sood, Amit; Sharma, Varun; Schroeder, Darrell R; Gorman, Brian

    2014-01-01

    To test the efficacy of a Stress Management and Resiliency Training (SMART) program for decreasing stress and anxiety and improving resilience and quality of life among Department of Radiology physicians. The study was approved by the institutional review board. A total of 26 Department of Radiology physicians were randomized in a single-blind trial to either the SMART program or a wait-list control arm for 12 weeks. The program involved a single 90-min group session in the SMART training with two follow-up phone calls. Primary outcomes measured at baseline and week 12 included the Perceived Stress Scale, Linear Analog Self-Assessment Scale, Mindful Attention Awareness Scale, and Connor-Davidson Resilience Scale. A total of 22 physicians completed the study. A statistically significant improvement in perceived stress, anxiety, quality of life, and mindfulness at 12 weeks was observed in the study arm compared to the wait-list control arm; resilience also improved in the active arm, but the changes were not statistically significant when compared to the control arm. A single session to decrease stress among radiologists using the SMART program is feasible. Furthermore, the intervention afforded statistically significant and clinically meaningful improvement in anxiety, stress, quality of life, and mindful attention. Further studies including larger sample size and longer follow-up are warranted. Copyright © 2014. Published by Elsevier Inc.

  15. Management of reticular oral lichen planus patients with burning mouth syndrome-like oral symptoms: a pilot study.

    Science.gov (United States)

    Adamo, Daniela; Mignogna, Michele Davide; Pecoraro, Giuseppe; Aria, Massimo; Fortuna, Giulio

    2018-01-31

    We sought to determine the efficacy of psychotropic drug in the management of BMS-like oral symptoms in patients with reticular oral lichen planus (R-OLP) refractory to conventional therapies, and its impact on anxious and depressive symptoms. We enrolled 28 cases of symptomatic R-OLP. The Numeric Rating Scale (NRS), the Total Pain Rating Index (T-PRI), the Hamilton rating scales for Depression (HAM-D) and Anxiety (HAM-A) were performed at baseline (time 0), after 2 months of topical clonazepam (time 1) and after 6 months of benzodiazepine and antidepressant drugs (time 2). R-OLP patients showed a statistically significant improvement in the NRS and T-PRI scores from time 0 [median: 9.0 (IQR: 7.2-10.0) and 10.5 (IQR: 7.0-13.0), respectively] to time 2 [(median: 2.0 (IQR: 2.0-3.0) (p oral symptoms in R-OLP patients refractory to conventional immunosuppressive therapy, although in a long-term period.

  16. 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.

  17. 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...

  18. 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

  19. Crisis Resources for Emergency Workers (CREW II): results of a pilot study and simulation-based crisis resource management course for emergency medicine residents.

    Science.gov (United States)

    Hicks, Christopher M; Kiss, Alex; Bandiera, Glen W; Denny, Christopher J

    2012-11-01

    Emergency department resuscitation requires the coordinated efforts of an interdisciplinary team. Aviation-based crisis resource management (CRM) training can improve safety and performance during complex events. We describe the development, piloting, and multilevel evaluation of "Crisis Resources for Emergency Workers" (CREW), a simulation-based CRM curriculum for emergency medicine (EM) residents. Curriculum development was informed by an a priori needs assessment survey. We constructed a 1-day course using simulated resuscitation scenarios paired with focused debriefing sessions. Attitudinal shifts regarding team behaviours were assessed using the Human Factors Attitude Survey (HFAS). A subset of 10 residents participated in standardized pre- and postcourse simulated resuscitation scenarios to quantify the effect of CREW training on our primary outcome of CRM performance. Pre/post scenarios were videotaped and scored by two blinded reviewers using a validated behavioural rating scale, the Ottawa CRM Global Rating Scale (GRS). Postcourse survey responses were highly favourable, with the majority of participants reporting that CREW training can reduce errors and improve patient safety. There was a nonsignificant trend toward improved team-based attitudes as assessed by the HFAS (p  =  0.210). Postcourse performance demonstrated a similar trend toward improved scores in all categories on the Ottawa GRS (p  =  0.16). EM residents find simulation-based CRM instruction to be useful, effective, and highly relevant to their practice. Trends toward improved performance and attitudes may have arisen because our study was underpowered to detect a difference. Future efforts should focus on interdisciplinary training and recruiting a larger sample size.

  20. 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 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 of University Radiologists. Published by Elsevier Inc. All rights reserved.

  1. Residential Consumer-Centric Demand-Side Management Based on Energy Disaggregation-Piloting Constrained Swarm Intelligence: Towards Edge Computing

    Science.gov (United States)

    Hu, Yu-Chen

    2018-01-01

    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

  2. Residential Consumer-Centric Demand-Side Management Based on Energy Disaggregation-Piloting Constrained Swarm Intelligence: Towards Edge Computing

    Directory of Open Access Journals (Sweden)

    Yu-Hsiu Lin

    2018-04-01

    Full Text Available 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

  3. 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

  4. 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.

  5. Process Experimental Pilot Plant

    International Nuclear Information System (INIS)

    Henze, H.

    1986-01-01

    The Process Experimental Pilot Plant (PREPP) at the Idaho National Engineering Laboratory (INEL) was built to convert transuranic contaminated solid waste into a form acceptable for disposal at the Waste Isolation Pilot Plant (WIPP), located near Carlsbad, New Mexico. There are about 2.0 million cubic ft of transuranic waste stored at the Transuranic Storage Area of the INEL's Radioactive Waste Management Complex (RWMC). The Stored Waste Examination Pilot Plant (SWEPP) located at the RWMC will examine this stored transuranic waste to determine if the waste is acceptable for direct shipment to and storage at WIPP, or if it requires shipment to PREPP for processing before shipment to WIPP. The PREPP process shreds the waste, incinerates the shredded waste, and cements (grouts) the shredded incinerated waste in new 55-gal drums. Unshreddable items are repackaged and returned to SWEPP. The process off-gas is cleaned prior to its discharge to the atmosphere, and complies with the effluent standards of the State of Idaho, EPA, and DOE. Waste liquid generated is used in the grouting operation

  6. 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.

  7. Forest restoration at Redwood National Park: exploring prescribed fire alternatives to second-growth management: a case study

    Science.gov (United States)

    Engber, Eamon; Teraoka, Jason; van Mantgem, Phillip J.

    2017-01-01

    Almost half of Redwood National Park is comprised of second-growth forests characterized by high stand density, deficient redwood composition, and low understory biodiversity. Typical structure of young redwood stands impedes the recovery of old-growth conditions, such as dominance of redwood (Sequoia sempervirens (D. Don) Endl.), distinct canopy layers and diverse understory vegetation. Young forests are commonly comprised of dense, even-aged Douglas-fir (Pseudotsuga menziesii (Mirb.) Franco) and redwood stump sprouts, with simple canopy structure and little understory development. Moreover, many of these young stands are believed to be vulnerable to disturbance in the form of drought, disease and fire. Silvicultural practices are increasingly being employed by conservation agencies to restore degraded forests throughout the coast redwood range; however, prescribed fire treatments are less common and potentially under-utilized as a restoration tool. We present an early synthesis from three separate management-scale prescribed fire projects at Redwood National Park spanning 1to 7 years post-treatment. Low intensity prescribed fire had minimal effect on overstory structure, with some mortality observed in trees smaller than 30 cm diameter. Moderate to high intensity fire may be required to reduce densities of larger Douglas-fir, the primary competitor of redwood in the Park’s second growth forests. Fine woody surface fuels fully recovered by 7 years post-burn, while recruitment of larger surface fuels was quite variable. Managers of coastal redwood ecosystems will benefit by having a variety of tools at their disposal for forest restoration and management.

  8. A Web-based self-management exercise and diet intervention for breast cancer survivors: pilot randomized controlled trial.

    Science.gov (United States)

    Lee, Myung Kyung; Yun, Young Ho; Park, Hyeoun-Ae; Lee, Eun Sook; Jung, Kyung Hae; Noh, Dong-Young

    2014-12-01

    Regular exercise and dietary practices have been shown to affect the health-related quality of life (HRQOL) and survival of breast cancer patients. The current study aimed to investigate whether the WSEDI was a feasible and primarily effective method for promoting exercise and dietary behaviours for breast cancer patients. A 12-week randomized, controlled trial. Oncology outpatient treatment clinics at 3 university hospitals and 1 National Cancer Center in South Korea. Fifty-nine breast cancer patients who had received curative surgery and completed primary cancer treatment within 12 months prior to the study and who had been diagnosed with stage 0-III cancers within 2 years prior to the study were recruited. Participants were randomly assigned to either the intervention group, which used a Web-based self-management exercise and diet intervention program incorporating transtheoretical model (TTM)-based strategies (n=29), or to the control group, which used a 50-page educational booklet on exercise and diet (n=28). The intervention efficacy was measured at the baseline and 12 weeks via a Web-based survey that addressed the promotion of exercise and consumption of 5 servings of fruits and vegetables (F&V) per day, dietary quality, HRQOL, anxiety, depression, fatigue, motivational readiness, and self-efficacy. The proportion of subjects who performed at least moderate-intensity aerobic exercise for at least 150 min per week; ate 5 servings of F&V per day; and had overall improvements in dietary quality, physical functioning and appetite loss (HRQOL), fatigue, and motivational readiness was greater in the intervention group than in the control group. The self-efficacy with respect to exercise and F&V consumption was greater in the intervention group than in the control group. A Web-based program that targets changes in exercise and dietary behaviours might be effective for breast cancer survivors if the TTM theory has been used to inform the program strategy, although

  9. Managing knee osteoarthritis with yoga or aerobic/strengthening exercise programs in older adults: a pilot randomized controlled trial.

    Science.gov (United States)

    Cheung, Corjena; Wyman, Jean F; Bronas, Ulf; McCarthy, Teresa; Rudser, Kyle; Mathiason, Michelle A

    2017-03-01

    Although exercise is often recommended for managing osteoarthritis (OA), limited evidence-based exercise options are available for older adults with OA. This study compared the effects of Hatha yoga (HY) and aerobic/strengthening exercises (ASE) on knee OA. Randomized controlled trial with three arms design was used: HY, ASE, and education control. Both HY and ASE groups involved 8 weekly 45-min group classes with 2-4 days/week home practice sessions. Control group received OA education brochures and weekly phone calls from study staff. Standardized instruments were used to measure OA symptoms, physical function, mood, spiritual health, fear of falling, and quality of life at baseline, 4 and 8 weeks. HY/ASE adherences were assessed weekly using class attendance records and home practice video recordings. Primary analysis of the difference in the change from baseline was based on intent-to-treat and adjusted for baseline values. Eight-three adults with symptomatic knee OA completed the study (84% female; mean age 71.6 ± 8.0 years; mean BMI 29.0 ± 7.0 kg/m 2 ). Retention rate was 82%. Compared to the ASE group at 8 weeks, participants in the HY group had a significant improvement from baseline in perception of OA symptoms (-9.6 [95% CI -15.3, -4]; p = .001), anxiety (-1.4 [95% CI -2.7, -0]; p = .04), and fear of falling (-4.6 [-7.5, -1.7]; p = .002). There were no differences in class/home practice adherence between HY and ASE. Three non-serious adverse events were reported from the ASE group. Both HY and ASE improved symptoms and function but HY may have superior benefits for older adults with knee OA. Trial registration The full trial protocol is available at clinicaltrials.gov (NCT02525341).

  10. 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.

  11. The effect of plasma rich in growth factors combined with follicular unit extraction surgery for the treatment of hair loss: A pilot study.

    Science.gov (United States)

    Navarro, Roge M; Pino, Ander; Martinez-Andres, Asunción; Molina, Consuelo; Martinez, Ana María; Martinez, Nahikari; Orive, Gorka; Anitua, Eduardo

    2017-10-26

    Hair transplant surgery using follicular unit extraction technique (FUE) is a common surgical procedure for the treatment of severe hair loss. Blood-derived autologous growth factors have also proved to promote hair regeneration in patients with different types of alopecia. The aim of this study was to evaluate the safety and clinical efficacy of plasma rich in growth factors (PRGF) technology as an adjuvant therapy for FUE surgery in hair loss affected patients. The biologic potential of PRGF was firstly in vitro evaluated over follicular germinal matrix and dermal papilla cells. Afterward, fifteen patients were subjected to routine FUE procedure while 15 patients underwent FUE+PRGF therapy. PRGF group included intradermal injections of growth factors and follicular transfer unit (FTU) preservation in an autologous fibrin clot. Postsurgical patient satisfaction and clinical improvement were evaluated, and PRGF or saline-preserved hair grafts were histomorphometrically analyzed. Follicular cell proliferation and migration was induced after autologous growth factors treatment. PRGF-preserved FTUs presented higher bioactivity signals and improved integrity of perifollicular structures and extracellular matrix proteins such as collagen and elastic fibers. PRGF not only reduced the postsurgical crust healing and hair fixation period, but also decreased the inflammatory pain and itching sensation. This preliminary data demonstrate that PRGF is able to minimize the postsurgical follicle loss and potentiate the performance of grafted hairs. The fibrin clot not only acts as a protective barrier against environmental factors, but also provides a biologically active scaffold that induces resident cell proliferation and maintains an optimal integrity of the grafted hair. © 2017 Wiley Periodicals, Inc.

  12. 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_2O_2 solution. The effects of radiation dose, dose rate, ratio of CTS:H_2O and H_2O_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_2O_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)

  13. Treatment of carcinoma in situ of the urinary bladder with an alpha-emitter immunoconjugate targeting the epidermal growth factor receptor: a pilot study.

    Science.gov (United States)

    Autenrieth, Michael E; Seidl, Christof; Bruchertseifer, Frank; Horn, Thomas; Kurtz, Florian; Feuerecker, Benedikt; D'Alessandria, Calogero; Pfob, Christian; Nekolla, Stephan; Apostolidis, Christos; Mirzadeh, Saed; Gschwend, Jürgen E; Schwaiger, Markus; Scheidhauer, Klemens; Morgenstern, Alfred

    2018-07-01

    Patients with carcinoma in situ (CIS) of the bladder refractory to bacillus Calmette-Guérin (BCG) treatment are usually treated with cystectomy. Therefore, new treatment options with preservation of the urinary bladder are needed. The objective of the study was to investigate the feasibility, safety and efficacy of a novel targeted alpha-emitter immunotherapy for CIS after BCG treatment failure. A pilot study was conducted in 12 patients (age range 64-86 years, ten men, two women) with biopsy-proven CIS of the bladder refractory to BCG treatment. The patients were treated intravesically with a single instillation (one patient was treated twice) of the alpha-emitter 213 Bi coupled to an anti-EGFR antibody (366-821 MBq). The primary aims of the study were to determine the feasibility of treatment with the 213 Bi-immunoconjugate and evaluation of adverse effects. Therapeutic efficacy was monitored by histological mapping of the urinary bladder 8 weeks after treatment and at different time points thereafter. The study proved that intravesical instillation of the 213 Bi-immunoconjugate targeting EGFR is feasible. No adverse effects were observed and all blood and urine parameters determined remained in their normal ranges. Therapeutic efficacy was considered satisfactory, in that three of the 12 patients showed no signs of CIS 44, 30 and 3 months after treatment. Intravesical instillation of 213 Bi-anti-EGFR monoclonal antibody was well tolerated and showed therapeutic efficacy. Repeated instillation and/or instillation of higher activities of the 213 Bi-immunoconjugate might lead to better therapeutic outcomes. A phase I clinical trial is planned.

  14. 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.

  15. 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

  16. 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.

  17. 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.

  18. Results of a survey to determine demographic and business management factors associated with size and growth rate of rural mixed-animal veterinary practices.

    Science.gov (United States)

    Brusk, Amy M; White, Brad J; Goehl, Dan R; Dhuyvetter, Kevin C

    2010-12-15

    To determine potential associations between demographic and business management factors and practice size and growth rate in rural mixed-animal veterinary practices. Cross-sectional survey. 54 mixed-animal practitioners. A cross-sectional survey (96 questions) was electronically disseminated. Responses were collected, and outcomes (number of veterinarians [NV], growth in number of veterinarians [NVG], gross practice income [GPI], growth in gross practice income [GPIG], gross practice income per veterinarian [GPIV], and growth in gross practice income per veterinarian [GPIVG]) were calculated. Bivariate analyses were performed and multivariable models created to determine associations between survey responses and outcomes of interest. Survey respondents were from mixed-animal practices, and most (46/54 [85.2%]) practiced in small communities (business manager. Typically, practices had positive mean growth in NVG (4.4%), GPIG (8.5%), and GPIVG (8.1%), but growth rate was highly variable among practices. Factors associated with growth rate included main species interest, frequency for adjusting prices, use of a marketing plan, service fee structure, and sending a client newsletter. Mixed-animal practices had a large range in size and growth rate. Economic indices were impacted by common business management practices.

  19. A growth state transition model as driver for business process management in small medium enterprises

    CSIR Research Space (South Africa)

    Jacobs, D

    2017-04-01

    Full Text Available and Rogério Patrício Chagas do Nascimento 417 Risk Management Maturity Evaluation Artifact to Enhance Enterprise IT Quality Misael Sousa de Araujo, Edgard Costa Oliveira, Simone Borges Simão Monteiro and Tharcísio Marcos Ferreira de Queiroz Mendonça 425 FACIN...

  20. MANAGEMENT OF CAREER GROWTH OF TALENTED EMPLOYEES IN THE STRATEGIC DEVELOPMENT OF THE ENTERPRISE

    Directory of Open Access Journals (Sweden)

    Tatiana Valerevna Bolshunova

    2018-02-01

    Full Text Available Purpose. Modern business is constantly seeking new resources to optimize and improve their own processes. In this context, particular attention is paid to staff, but rather opportunities for its development. Man becomes the most important condition for the victory in the competition. Given the conditions of economic globalization, companies are becoming increasingly difficult to compete in technology and finance – these resources are becoming more and more accessible, and as a consequence of the same. The main opportunity to gain a competitive advantage becomes a staff, his skills and his attitude to work. In this case, the concept of talent management is to constantly identify talented personnel and their application is best for the company. Methodology. The basis of the research is the comparative and phenomenological methods and such methods of sociological research as expert survey, in-depth interviews, questionnaires, analyze of documents. Results. The author proposes to maintain a high level of innovativeness of the organization due to the activation of talented employees. The proposed organizational practices of career development are aimed at retaining talents of the organization. With some correction, the research results сan be used to develop a strategy of talent management in enterprises with a similar profile of activity. Practical implications. The results of the study can be applied in the sphere of sociology of management and human resources management.

  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. Prospects for managing African elephant population growth by immunocontraception: a review

    NARCIS (Netherlands)

    Perdok, A.A.; Boer, de W.F.; Stout, T.A.E.

    2007-01-01

    Immunocontraception has been proposed as a tool for managing African elephant populations threatening to. 'outgrow' a wildlife reserve. To date, however, the only immunocontraceptive technique tested on elephant cows is porcine zona pellucida (pZP) vaccination, in which solubilized pZP is injected

  3. Adapting irrigation management to water scarcity: constraints of plant growth, hydraulics and carbon assimilation.

    Science.gov (United States)

    Water shortages are responsible for the greatest crop losses around the world and are expected to worsen. In arid areas where agriculture is dependent on irrigation, various forms of deficit irrigation management have been suggested to optimize crop yields for available soil water. The relationshi...

  4. 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…

  5. 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

  6. Current and Future Dynamics of the Red-Cockaded Woodpecker Population Inhabiting the Savannah River National Environmental Research Park: Managing For Population Growth

    Energy Technology Data Exchange (ETDEWEB)

    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.

  7. Evidence-based national guidelines for the management of suspected fetal growth restriction: comparison, consensus, and controversy.

    Science.gov (United States)

    McCowan, Lesley M; Figueras, Francesc; Anderson, Ngaire H

    2018-02-01

    Small for gestational age is usually defined as an infant with a birthweight restriction refers to a fetus that has failed to reach its biological growth potential because of placental dysfunction. Small-for-gestational-age babies make up 28-45% of nonanomalous stillbirths, and have a higher chance of neurodevelopmental delay, childhood and adult obesity, and metabolic disease. The majority of small-for-gestational-age babies are not recognized before birth. Improved identification, accompanied by surveillance and timely delivery, is associated with reduction in small-for-gestational-age stillbirths. Internationally and regionally, detection of small for gestational age and management of fetal growth problems vary considerably. The aim of this review is to: summarize areas of consensus and controversy between recently published national guidelines on small for gestational age or fetal growth restriction; highlight any recent evidence that should be incorporated into existing guidelines; and identify future research priorities in this field. A search of MEDLINE, Google, and the International Guideline Library identified 6 national guidelines on management of pregnancies complicated by fetal growth restriction/small for gestational age published from 2010 onwards. There is general consensus between guidelines (at least 4 of 6 guidelines in agreement) in early pregnancy risk selection, and use of low-dose aspirin for women with major risk factors for placental insufficiency. All highlight the importance of smoking cessation to prevent small for gestational age. While there is consensus in recommending fundal height measurement in the third trimester, 3 specify the use of a customized growth chart, while 2 recommend McDonald rule. Routine third-trimester scanning is not recommended for small-for-gestational-age screening, while women with major risk factors should have serial scanning in the third trimester. Umbilical artery Doppler studies in suspected small

  8. Coping Skills Practice and Symptom Change: A Secondary Analysis of a Pilot Telephone Symptom Management Intervention for Lung Cancer Patients and Their Family Caregivers.

    Science.gov (United States)

    Winger, Joseph G; Rand, Kevin L; Hanna, Nasser; Jalal, Shadia I; Einhorn, Lawrence H; Birdas, Thomas J; Ceppa, DuyKhanh P; Kesler, Kenneth A; Champion, Victoria L; Mosher, Catherine E

    2018-05-01

    Little research has explored coping skills practice in relation to symptom outcomes in psychosocial interventions for cancer patients and their family caregivers. To examine associations of coping skills practice to symptom change in a telephone symptom management (TSM) intervention delivered concurrently to lung cancer patients and their caregivers. This study was a secondary analysis of a randomized pilot trial. Data were examined from patient-caregiver dyads (n = 51 dyads) that were randomized to the TSM intervention. Guided by social cognitive theory, TSM involved four weekly sessions where dyads were taught coping skills including a mindfulness exercise, guided imagery, pursed lips breathing, cognitive restructuring, problem solving, emotion-focused coping, and assertive communication. Symptoms were assessed, including patients' and caregivers' psychological distress and patients' pain interference, fatigue interference, and distress related to breathlessness. Multiple regression analyses examined associations of coping skills practice during the intervention to symptoms at six weeks after the intervention. For patients, greater practice of assertive communication was associated with less pain interference (β = -0.45, P = 0.02) and psychological distress (β = -0.36, P = 0.047); for caregivers, greater practice of guided imagery was associated with less psychological distress (β = -0.30, P = 0.01). Unexpectedly, for patients, greater practice of a mindfulness exercise was associated with higher pain (β = 0.47, P = 0.07) and fatigue interference (β = 0.49, P = 0.04); greater practice of problem solving was associated with higher distress related to breathlessness (β = 0.56, P = 0.01) and psychological distress (β = 0.36, P = 0.08). Findings suggest that the effectiveness of TSM may have been reduced by competing effects of certain coping skills. Future interventions should consider focusing on assertive communication

  9. Evaluation of the efficacy of an appeasing pheromone diffuser product vs placebo for management of feline aggression in multi-cat households: a pilot study.

    Science.gov (United Stat