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Sample records for hard-to-reach groups managing

  1. Online Facebook Focus Group Research of Hard-to-Reach Participants

    Directory of Open Access Journals (Sweden)

    Anastasia Aldelina Lijadi

    2015-12-01

    Full Text Available Conducting discovery-oriented qualitative research about the life experiences of hard-to-reach individuals posed several challenges for recruiting participants and collecting rich textual data. In a study pertaining the experiences of Third Culture Kids (TCKs, we explored the benefits of the social media, such as Facebook as a platform to collect data. TCKs are individuals who define their sense of belonging to the third culture trailing their parents moving across borders during their developmental years. Adult TCKs live in many different countries, and accessing and interviewing respondents could be a difficult and costly endeavor. In this article, the authors share their experience conducting online, asynchronous focus groups using a Facebook platform. We reflect upon the process of setting up a secret Facebook focus group for research purposes, recruiting participants, rapport building between facilitator and participants, monitoring and keeping track of participants’ responses, and the dynamics emerging within an online focus group. We also discuss the novelty, limitations, and benefits of the Facebook focus group as an emerging mode for collecting qualitative data from hard-to-reach participants.

  2. Promoting healthy diets and active lives to hard-to-reach groups: market research study.

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    White, S L; Maloney, S K

    1990-01-01

    Continued progress over the next decade in reducing premature morbidity and mortality from chronic disease will require that health communication efforts target a significant proportion of the American public that has not been influenced by the health promotion efforts of the 1980s. Focus groups conducted with members of the hard-to-reach American public showed that while being healthy seemed to be important to participants, and they were generally aware of what to do to stay healthy, they had a different operational definition of health than that used in health promotion programs. Participants seemed to believe that better health behaviors would build their resistance to acute illnesses, that is, keep them healthy, but that chronic diseases, such as cancer and diabetes, were due to fate and heredity and beyond their individual control. The focus group results show that participants had not made the link between chronic disease prevention and the importance of diet, exercise, and weight control. Although most of them seemed to express a genuine interest in "doing better," they were not able to supply more than superficial examples of how such changes might be made. Surprisingly, there were more similarities than differences in participants' attitudes and beliefs, with the similarities cutting across boundaries of race-ethnicity, age, and sex. Interest in changing behaviors was only slightly more pronounced among female rather than male, and older rather than younger, participants. However, there was not much evidence from the participants that they were actively seeking health information or trying to reconcile conflicting knowledge and beliefs.

  3. Community Engagement in a complex intervention to improve access to primary mental health care for hard-to-reach groups.

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    Lamb, Jonathan; Dowrick, Christopher; Burroughs, Heather; Beatty, Susan; Edwards, Suzanne; Bristow, Kate; Clarke, Pam; Hammond, Jonathan; Waheed, Waquas; Gabbay, Mark; Gask, Linda

    2015-12-01

    Despite the availability of effective evidence-based treatments for depression and anxiety, many 'harder-to-reach' social and patient groups experience difficulties accessing treatment. We developed a complex intervention, the AMP (Improving Access to Mental Health in Primary Care) programme, which combined community engagement (CE), tailored (individual and group) psychosocial interventions and primary care involvement. To develop and evaluate a model for community engagement component of the complex intervention. This paper focuses on the development of relationships between stakeholders, their engagement with the issue of access to mental health and with the programme through the CE model. Our evaluation draws on process data, qualitative interviews and focus groups, brought together through framework analysis to evaluate the issues and challenges encountered. A case study of the South Asian community project carried out in Longsight in Greater Manchester, United Kingdom. Complex problems require multiple local stakeholders to work in concert. Assets based approaches implicitly make demands on scarce time and resources. Community development approaches have many benefits, but perceptions of open-ended investment are a barrier. The time-limited nature of a CE intervention provides an impetus to 'do it now', allowing stakeholders to negotiate their investment over time and accommodating their wider commitments. Both tangible outcomes and recognition of process benefits were vital in maintaining involvement. CE interventions can play a key role in improving accessibility and acceptability by engaging patients, the public and practitioners in research and in the local service ecology. © 2014 John Wiley & Sons Ltd.

  4. Recruiting hard-to-reach United States population sub-groups via adaptations of snowball sampling strategy

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    Sadler, Georgia Robins; Lee, Hau-Chen; Seung-Hwan Lim, Rod; Fullerton, Judith

    2011-01-01

    Nurse researchers and educators often engage in outreach to narrowly defined populations. This article offers examples of how variations on the snowball sampling recruitment strategy can be applied in the creation of culturally appropriate, community-based information dissemination efforts related to recruitment to health education programs and research studies. Examples from the primary author’s program of research are provided to demonstrate how adaptations of snowball sampling can be effectively used in the recruitment of members of traditionally underserved or vulnerable populations. The adaptation of snowball sampling techniques, as described in this article, helped the authors to gain access to each of the more vulnerable population groups of interest. The use of culturally sensitive recruitment strategies is both appropriate and effective in enlisting the involvement of members of vulnerable populations. Adaptations of snowball sampling strategies should be considered when recruiting participants for education programs or subjects for research studies when recruitment of a population based sample is not essential. PMID:20727089

  5. Reaching the hard to reach.

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    Bhiwandi, P; Campbell, M; Potts, M

    1994-01-01

    The 1994 International Conference on Population and Development proposed increasing contraceptive couple protection from 550 million in 1995 to 880 million in 2015. The task for family planning (FP) programs is to provide access to services for, sometimes, inaccessible rural populations. FP need based on desire for no more children has ranged from under 20% in Senegal to almost 80% in Peru. Socioeconomic development was found not to be a prerequisite for fertility change. Gender inequalities in education and social autonomy must be changed. FP access is very important among women with a disadvantaged background or among women unsure about FP. Bangladesh is a good example of a country with increased contraceptive prevalence despite low income. The rule of thumb is that contraception increases of 15% contribute to a drop in family size of about one child. Program effectiveness is related to a variety of factors: contraceptive availability at many locations, acceptable price of contraception, delivery of the oral contraceptives without prescriptions, and other strategies. FP is a service not a medical treatment. A range of methods must be promoted and available from a range of facilities. Contraceptive use is dependent on the woman's stage in her lifecycle and is dependent on informed choice. Community-based distribution systems are effective, whereas free distribution by poorly-trained field workers is not always very effective because patient payment of all or part of the cost assures quality and freedom of choice. Effective programs for underprivileged groups involve aggressive, easy to manage programs that can be replicated rapidly. FP serves a useful function in depressing maternal mortality among the poor in Africa, who have no access to quality health services. Social marketing is an effective strategy for reaching remote areas. Political will and robust management are necessary commodities.

  6. Reaching the hard-to-reach: a systematic review of strategies for improving health and medical research with socially disadvantaged groups

    Science.gov (United States)

    2014-01-01

    Background This study aims to review the literature regarding the barriers to sampling, recruitment, participation, and retention of members of socioeconomically disadvantaged groups in health research and strategies for increasing the amount of health research conducted with socially disadvantaged groups. Methods A systematic review with narrative synthesis was conducted. Searches of electronic databases Medline, PsychInfo, EMBASE, Social Science Index via Web of Knowledge and CINHAL were conducted for English language articles published up to May 2013. Qualitative and quantitative studies as well as literature reviews were included. Articles were included if they reported attempts to increase disadvantaged group participation in research, or the barriers to research with disadvantaged groups. Groups of interest were those described as socially, culturally or financially disadvantaged compared to the majority of society. Eligible articles were categorised according to five phases of research: 1) sampling, 2) recruitment and gaining consent, 3) data collection and measurement, 4) intervention delivery and uptake, and 5) retention and attrition. Results In total, 116 papers from 115 studies met inclusion criteria and 31 previous literature reviews were included. A comprehensive summation of the major barriers to working with various disadvantaged groups is provided, along with proposed strategies for addressing each of the identified types of barriers. Most studies of strategies to address the barriers were of a descriptive nature and only nine studies reported the results of randomised trials. Conclusions To tackle the challenges of research with socially disadvantaged groups, and increase their representation in health and medical research, researchers and research institutions need to acknowledge extended timeframes, plan for higher resourcing costs and operate via community partnerships. PMID:24669751

  7. British Asian families and the use of child and adolescent mental health services: a qualitative study of a hard to reach group \\ud \\ud

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    Bradby, Hannah; Varyani, Maya; Oglethorpe, Rachel; Raine, Wendy; White, Ishbel; Helen, Minnis

    2007-01-01

    We explored attitudes to and experiences of Child and Adolescent Mental Health Services (CAMHS) among families of South Asian origin who are underrepresented as service-users in an area of a Scottish city with a high concentration of people of South Asian origin. Six community focus groups were conducted, followed by semi-structured interviews with families who had used CAMHS and with CAMHS professionals involved in those families’ cases. Lastly, parents of children who had problems usually r...

  8. British Asian families and the use of child and adolescent mental health services: a qualitative study of a hard to reach group.

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    Bradby, Hannah; Varyani, Maya; Oglethorpe, Rachel; Raine, Wendy; White, Ishbel; Helen, Minnis

    2007-12-01

    We explored attitudes to and experiences of Child and Adolescent Mental Health Services (CAMHS) among families of South Asian origin who are underrepresented as service-users in an area of a Scottish city with a high concentration of people of South Asian origin. Six community focus groups were conducted, followed by semi-structured interviews with families who had used CAMHS and with CAMHS professionals involved in those families' cases. Lastly, parents of children who had problems usually referred to CAMHS but who had not used the service were interviewed. Qualitative analysis of transcripts and notes was undertaken using thematic and logical methods. Participants consisted of 35 adults who identified themselves as Asian and had children; 7 parents and/or the young service users him-herself; 7 health care professionals involved in the young person's care plus 5 carers of 6 young people who had not been referred to CAMHS, despite having suitable problems. Focus groups identified the stigma of mental illness and the fear of gossip as strong disincentives to use CAMHS. Families who had been in contact with CAMHS sought to minimise the stigma they suffered by emphasising that mental illness was not madness and could be cured. Families whose children had complex emotional and behavioural problems said that discrimination by health, education and social care professionals exacerbated their child's difficulties. Families of children with severe and enduring mental illness described tolerating culturally inappropriate services. Fear of gossip about children's 'madness' constituted a major barrier to service use for Asian families in this city. Given the widespread nature of the concern over the stigma of children's mental illness, it should be considered in designing culturally competent services for children's mental health.

  9. Assessing the role of syringe dispensing machines and mobile van outlets in reaching hard-to-reach and high-risk groups of injecting drug users (IDUs: a review

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    Islam Md Mofizul

    2007-10-01

    Full Text Available Abstract Reaching hard-to-reach and high-risk injecting drug users (IDUs is one of the most important challenges for contemporary needle syringe programs (NSPs. The aim of this review is to examine, based upon the available international experience, the effectiveness of syringe vending machines and mobile van/bus based NSPs in making services more accessible to these hard-to-reach and high-risk groups of IDUs. A literature search revealed 40 papers/reports, of which 18 were on dispensing machines (including vending and exchange machines and 22 on mobile vans. The findings demonstrate that syringe dispensing machines and mobile vans are promising modalities of NSPs, which can make services more accessible to the target group and in particular to the harder-to-reach and higher-risk groups of IDUs. Their anonymous and confidential approaches make services attractive, accessible and acceptable to these groups. These two outlets were found to be complementary to each other and to other modes of NSPs. Services through dispensing machines and mobile vans in strategically important sites are crucial elements in continuing efforts in reducing the spread of HIV and other blood borne viruses among IDUs.

  10. Taking family planning services to hard-to-reach populations.

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    Donovan, P

    1996-01-01

    Interviews were conducted in 1995 among 100 US family planning program personnel who serve hard-to-reach populations, such as drug abusers, prisoners, the disabled, homeless persons, and non-English speaking minorities. Findings indicate that a range of services is available for hard-to-reach groups. Most family planning agencies focus on drug abusers because of the severity of HIV infections and the availability of funding. This article describes the activities of various agencies in Michigan, Pennsylvania, and Massachusetts that serve substance abuse centers with family planning services. One recommendation for a service provider is to present services in an environment where it is safe to talk about a person's needs. One other program offered personal greetings upon arrival and the continuity of having a familiar face to oversee all reproductive and health needs. Programs for prisoners ranged from basic sex education classes to comprehensive reproductive health care. Some prisons offered individual counseling. Some programs were presented in juvenile offender facilities. Outreach to the homeless involved services at homeless shelters, outreach workers who recruited women into traditional family planning clinics, and establishment of nontraditional sites for the homeless and other hard-to-reach persons. One provider's suggestion was to offer services where high-risk women already go for other services. Most services to the disabled target the developmentally disabled rather than the physically disabled. Experience has shown that many professionals working with the disabled do not recognize their clients' sexual needs. Other hard-to-reach groups include women in housing projects and shelters for battered women, welfare applicants, and sex workers. Key to service provision is creating trust, overcoming language and cultural differences, and subsidizing the cost of care.

  11. Auxiliary midwives in hard to reach rural areas of Myanmar: filling MCH gaps.

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    Wangmo, Sangay; Suphanchaimat, Rapeepong; Htun, Wai Mar Mar; Tun Aung, Tin; Khitdee, Chiraporn; Patcharanarumol, Walaiporn; Htoon, Pe Thet; Tangcharoensathien, Viroj

    2016-09-01

    Auxiliary Midwives (AMWs) are community health volunteers supporting the work of midwives, especially maternal and child health services in hard to-reach areas in Myanmar. This paper assessed the contributions of AMW to maternal and child health services, factors influencing their productivity and their willingness to serve the community. The study applied quantitative cross-sectional survey using census method. Total of 1,185 AMWs belonging to three batches: trained prior to 2000, between 2000 and 2011, and in 2012, from 21 townships of 17 states and regions in Myanmar participated in the study. Multiple logit regression was used to examine the impact of age, marital status, education, domicile, recruitment pattern and 'batch of training', on AMW's confidence level in providing care, and their intention to serve the community more than 5 years. All AMWs were able to provide essential maternal and child health services including antenatal care, normal delivery and post-natal care. They could identify and refer high-risk pregnancies to larger health facilities for proper management. On average, 9 deliveries, 11 antenatal and 9 postnatal cases were performed by an AMW during the six months prior to this study. AMWs had a comparative advantage for longer service in hard-to-reach villages where they lived, spoke the same dialect as the locals, understood the socio-cultural dimensions, and were well accepted by the community. Despite these contributions, 90 % of the respondents expressed receiving no adequate supervision, refresher training, replenishment of the AMW kits and transportation cost. AMWs in the elder age group are significantly more confident in taking care of the patients than those in the younger groups. Over 90 % of the respondents intended to stay more than five years in the community. The confidence in catering services appeared to have significant association with a longer period of stay in AMW jobs as evidenced by the odds ratio of 3.5, compared

  12. Auxiliary midwives in hard to reach rural areas of Myanmar: filling MCH gaps

    Directory of Open Access Journals (Sweden)

    Sangay Wangmo

    2016-09-01

    Full Text Available Abstract Background Auxiliary Midwives (AMWs are community health volunteers supporting the work of midwives, especially maternal and child health services in hard to-reach areas in Myanmar. This paper assessed the contributions of AMW to maternal and child health services, factors influencing their productivity and their willingness to serve the community. Method The study applied quantitative cross-sectional survey using census method. Total of 1,185 AMWs belonging to three batches: trained prior to 2000, between 2000 and 2011, and in 2012, from 21 townships of 17 states and regions in Myanmar participated in the study. Multiple logit regression was used to examine the impact of age, marital status, education, domicile, recruitment pattern and ‘batch of training’, on AMW’s confidence level in providing care, and their intention to serve the community more than 5 years. Results All AMWs were able to provide essential maternal and child health services including antenatal care, normal delivery and post-natal care. They could identify and refer high-risk pregnancies to larger health facilities for proper management. On average, 9 deliveries, 11 antenatal and 9 postnatal cases were performed by an AMW during the six months prior to this study. AMWs had a comparative advantage for longer service in hard-to-reach villages where they lived, spoke the same dialect as the locals, understood the socio-cultural dimensions, and were well accepted by the community. Despite these contributions, 90 % of the respondents expressed receiving no adequate supervision, refresher training, replenishment of the AMW kits and transportation cost. AMWs in the elder age group are significantly more confident in taking care of the patients than those in the younger groups. Over 90 % of the respondents intended to stay more than five years in the community. The confidence in catering services appeared to have significant association with a longer period of stay

  13. Dedicated outreach service for hard to reach patients with tuberculosis in London: observational study and economic evaluation.

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    Jit, Mark; Stagg, Helen R; Aldridge, Robert W; White, Peter J; Abubakar, Ibrahim

    2011-09-14

    To assess the cost effectiveness of the Find and Treat service for diagnosing and managing hard to reach individuals with active tuberculosis. Economic evaluation using a discrete, multiple age cohort, compartmental model of treated and untreated cases of active tuberculosis. London, United Kingdom. Population Hard to reach individuals with active pulmonary tuberculosis screened or managed by the Find and Treat service (48 mobile screening unit cases, 188 cases referred for case management support, and 180 cases referred for loss to follow-up), and 252 passively presenting controls from London's enhanced tuberculosis surveillance system. Incremental costs, quality adjusted life years (QALYs), and cost effectiveness ratios for the Find and Treat service. The model estimated that, on average, the Find and Treat service identifies 16 and manages 123 active cases of tuberculosis each year in hard to reach groups in London. The service has a net cost of £1.4 million/year and, under conservative assumptions, gains 220 QALYs. The incremental cost effectiveness ratio was £6400-£10,000/QALY gained (about €7300-€11,000 or $10,000-$16 000 in September 2011). The two Find and Treat components were also cost effective, even in unfavourable scenarios (mobile screening unit (for undiagnosed cases), £18,000-£26,000/QALY gained; case management support team, £4100-£6800/QALY gained). Both the screening and case management components of the Find and Treat service are likely to be cost effective in London. The cost effectiveness of the mobile screening unit in particular could be even greater than estimated, in view of the secondary effects of infection transmission and development of antibiotic resistance.

  14. Climate Resilience: Outreach and Engagement with Hard to Reach Communities

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    Baja, K.

    2017-12-01

    Baltimore faces a unique combination of shocks and stresses that cut across social, economic, and environmental sectors. Like many postindustrial cities, Baltimore has experienced a decline in its population - resulting in a lower tax base. These trends have had deleterious effects on the city's ability to attend to much needed infrastructure improvements and human services. Furthermore, Baltimore has an unfortunate history of deliberate racial segregation that is directly responsible for many of the economic and social challenges the City faces today. In addition to considerable social and economic issues, the city is already experiencing negative impacts from climate change. Baltimore is vulnerable to many natural hazards including heavy precipitation, sea level rise, storm surge, and extreme heat. Impacts from hazards and the capacity to adapt to them is not equal across all populations. Low-income residents and communities of color are most vulnerable and lack access to the resources to effectively plan, react and recover. They are also less likely to engage in government processes or input sessions, either due to distrust or ineffective outreach efforts by government employees and partners. This session is focused on sharing best practices and lessons learned from Baltimore's approach to community outreach and engagement as well as its focus on power shifting and relationship building with hard-to-reach communities. Reducing neighborhood vulnerability and strengthening the fabric that holds systems together requires a large number of diverse stakeholders coordinated around resiliency efforts. With the history of deliberate segregation and current disparities it remains critical to build trust, shift power from government to residents, and focus on relationship building. Baltimore City utilized this approach in planning, implementation and evaluation of resiliency work. This session will highlight two plan development processes, several projects, and innovative

  15. Sure start: voices of the 'hard-to-reach'.

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    Coe, C; Gibson, A; Spencer, N; Stuttaford, M

    2008-07-01

    This research aimed to look in depth at the factors affecting the ability of four Sure Start local programmes, based in a multicultural Midlands city, to engage with 'hard-to-reach' populations. A variety of research strategies and methods were employed. Geographical information systems, participatory research methods and interviews were used in order to understand the extent of the challenge, and hear first hand, why parents may not get involved with Sure Start. The mapping exercise involved collation and mapping of postcode data with respect to boundaries and potential and actual users of Sure Start services. This made possible the identification of any geographical patterning in the distribution of service users and non-users. Participatory research methods were used with parents, enabling them to conduct short interviews within their own communities and make sense of the data collected. Interviews were also conducted with 70 parents across the city, recruited through local schools. The results indicate that parental decisions regarding Sure Start are the product of a complex interaction between numerous factors which may act as either barriers or facilitators to service utilization. The results suggest that a multi-method approach to data collection is useful and appropriate in gaining access to those parents who are non-users of the Sure Start services and enabling their voices to be heard. These findings offer some explanations and insight into the apparent ambivalent attitudes of some families toward Sure Start services. Implications for future practice are discussed.

  16. Comparing two sampling methods to engage hard-to-reach communities in research priority setting.

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    Valerio, Melissa A; Rodriguez, Natalia; Winkler, Paula; Lopez, Jaime; Dennison, Meagen; Liang, Yuanyuan; Turner, Barbara J

    2016-10-28

    Effective community-partnered and patient-centered outcomes research needs to address community priorities. However, optimal sampling methods to engage stakeholders from hard-to-reach, vulnerable communities to generate research priorities have not been identified. In two similar rural, largely Hispanic communities, a community advisory board guided recruitment of stakeholders affected by chronic pain using a different method in each community: 1) snowball sampling, a chain- referral method or 2) purposive sampling to recruit diverse stakeholders. In both communities, three groups of stakeholders attended a series of three facilitated meetings to orient, brainstorm, and prioritize ideas (9 meetings/community). Using mixed methods analysis, we compared stakeholder recruitment and retention as well as priorities from both communities' stakeholders on mean ratings of their ideas based on importance and feasibility for implementation in their community. Of 65 eligible stakeholders in one community recruited by snowball sampling, 55 (85 %) consented, 52 (95 %) attended the first meeting, and 36 (65 %) attended all 3 meetings. In the second community, the purposive sampling method was supplemented by convenience sampling to increase recruitment. Of 69 stakeholders recruited by this combined strategy, 62 (90 %) consented, 36 (58 %) attended the first meeting, and 26 (42 %) attended all 3 meetings. Snowball sampling recruited more Hispanics and disabled persons (all P research, focusing on non-pharmacologic interventions for management of chronic pain. Ratings on importance and feasibility for community implementation differed only on the importance of massage services (P = 0.045) which was higher for the purposive/convenience sampling group and for city improvements/transportation services (P = 0.004) which was higher for the snowball sampling group. In each of the two similar hard-to-reach communities, a community advisory board partnered with researchers

  17. Comparing two sampling methods to engage hard-to-reach communities in research priority setting

    Directory of Open Access Journals (Sweden)

    Melissa A. Valerio

    2016-10-01

    Full Text Available Abstract Background Effective community-partnered and patient-centered outcomes research needs to address community priorities. However, optimal sampling methods to engage stakeholders from hard-to-reach, vulnerable communities to generate research priorities have not been identified. Methods In two similar rural, largely Hispanic communities, a community advisory board guided recruitment of stakeholders affected by chronic pain using a different method in each community: 1 snowball sampling, a chain- referral method or 2 purposive sampling to recruit diverse stakeholders. In both communities, three groups of stakeholders attended a series of three facilitated meetings to orient, brainstorm, and prioritize ideas (9 meetings/community. Using mixed methods analysis, we compared stakeholder recruitment and retention as well as priorities from both communities’ stakeholders on mean ratings of their ideas based on importance and feasibility for implementation in their community. Results Of 65 eligible stakeholders in one community recruited by snowball sampling, 55 (85 % consented, 52 (95 % attended the first meeting, and 36 (65 % attended all 3 meetings. In the second community, the purposive sampling method was supplemented by convenience sampling to increase recruitment. Of 69 stakeholders recruited by this combined strategy, 62 (90 % consented, 36 (58 % attended the first meeting, and 26 (42 % attended all 3 meetings. Snowball sampling recruited more Hispanics and disabled persons (all P < 0.05. Despite differing recruitment strategies, stakeholders from the two communities identified largely similar ideas for research, focusing on non-pharmacologic interventions for management of chronic pain. Ratings on importance and feasibility for community implementation differed only on the importance of massage services (P = 0.045 which was higher for the purposive/convenience sampling group and for city improvements

  18. Approaches to Recruiting 'Hard-To-Reach' Populations into Re-search: A Review of the Literature.

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    Shaghaghi, Abdolreza; Bhopal, Raj S; Sheikh, Aziz

    2011-01-01

    'Hard-to-reach' is a term used to describe those sub-groups of the population that may be difficult to reach or involve in research or public health programmes. Application of a single term to call these sub-sections of populations implies a homogeneity within distinct groups, which does not necessarily exist. Different sampling techniques were introduced so far to recruit hard-to-reach populations. In this article, we have reviewed a range of ap-proaches that have been used to widen participation in studies. We performed a Pubmed and Google search for relevant English language articles using the keywords and phrases: (hard-to-reach AND population* OR sampl*), (hidden AND population* OR sample*) and ("hard to reach" AND population* OR sample*) and a consul-tation of the retrieved articles' bibliographies to extract empirical evidence from publications that discussed or examined the use of sampling techniques to recruit hidden or hard-to-reach populations in health studies. Reviewing the literature has identified a range of techniques to recruit hard-to-reach populations, including snowball sampling, respondent-driven sampling (RDS), indigenous field worker sampling (IFWS), facility-based sampling (FBS), targeted sampling (TS), time-location (space) sampling (TLS), conventional cluster sampling (CCS) and capture re-capture sampling (CR). The degree of compliance with a study by a certain 'hard-to-reach' group de-pends on the characteristics of that group, recruitment technique used and the subject of inter-est. Irrespective of potential advantages or limitations of the recruitment techniques reviewed, their successful use depends mainly upon our knowledge about specific characteristics of the target populations. Thus in line with attempts to expand the current boundaries of our know-ledge about recruitment techniques in health studies and their applications in varying situa-tions, we should also focus on possibly all contributing factors which may have an impact on

  19. Reaching Hard-to-Reach Individuals: Nonselective Versus Targeted Outbreak Response Vaccination for Measles

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    Minetti, Andrea; Hurtado, Northan; Grais, Rebecca F.; Ferrari, Matthew

    2014-01-01

    Current mass vaccination campaigns in measles outbreak response are nonselective with respect to the immune status of individuals. However, the heterogeneity in immunity, due to previous vaccination coverage or infection, may lead to potential bias of such campaigns toward those with previous high access to vaccination and may result in a lower-than-expected effective impact. During the 2010 measles outbreak in Malawi, only 3 of the 8 districts where vaccination occurred achieved a measureable effective campaign impact (i.e., a reduction in measles cases in the targeted age groups greater than that observed in nonvaccinated districts). Simulation models suggest that selective campaigns targeting hard-to-reach individuals are of greater benefit, particularly in highly vaccinated populations, even for low target coverage and with late implementation. However, the choice between targeted and nonselective campaigns should be context specific, achieving a reasonable balance of feasibility, cost, and expected impact. In addition, it is critical to develop operational strategies to identify and target hard-to-reach individuals. PMID:24131555

  20. Hard-to-Reach? Using Health Access Status as a Way to More Effectively Target Segments of the Latino Audience

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    Wilkin, Holley A.; Ball-Rokeach, Sandra J.

    2011-01-01

    Health issues disproportionately affect Latinos, but variations within this ethnic group may mean that some Latinos are harder to reach with health messages than others. This paper introduces a methodology grounded in communication infrastructure theory to better target "hard-to-reach" audiences. A random digit dialing telephone survey…

  1. Access and Attitudes to HPV Vaccination amongst Hard-To-Reach Populations in Kenya.

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    Deborah Watson-Jones

    Full Text Available Sub-Saharan Africa bears the greatest burden of cervical cancer. Human papillomavirus (HPV vaccination programmes to prevent the disease will need to reach vulnerable girls who may not be able access health and screening services in the future. We conducted formative research on facilitators and barriers to HPV vaccination and potential acceptability of a future HPV vaccination programme amongst girls living in hard-to-reach populations in Kenya.Stakeholder interviews with Ministry of Health staff explored barriers to and support for the uptake of HPV vaccination. A situation assessment was conducted to assess community services in Maasai nomadic pastoralist communities in Kajiado County and in Korogocho informal settlement in Nairobi city, followed by focus group discussions (n=14 and semi-structured interviews (n=28 with health workers, parents, youth, and community and religious leaders. These covered marriage, knowledge of cervical cancer and HPV, factors that might inhibit or support HPV vaccine uptake and intention to accept HPV vaccine if a programme was in place.Reported challenges to an HPV vaccination programme included school absenteeism and drop-out, early age of sex and marriage, lack of parental support, population mobility and distance from services. Despite little prior knowledge of cervical cancer and HPV, communities were interested in receiving HPV vaccination. Adequate social mobilisation and school-based vaccination, supplemented by out-reach activities, were considered important facilitating factors to achieve high coverage. There was some support for a campaign approach to vaccine delivery.Given the high level of support for a vaccine against cervical cancer and the experience of reaching pastoralist and slum-dwellers for other immunizations, implementing an HPV vaccine programme should be feasible in such hard-to-reach communities. This may require additional delivery strategies in addition to the standard school

  2. Data Quality in the Application of Tailored Calendar Methods in Hard-to-Reach Populations

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    Navarra, M.Q.; Vaart, van der W.; Niehof, Anke

    2012-01-01

    Abstract A tailored calendar method was used to collect retrospective data from hard-to-reach populations: people with very low levels of income, education and literacy that live in complex societal situations and have low trust in authorities. Recognizing the serious threats to data quality in

  3. Maternal complications in a geographically challenging and hard to reach district of Bangladesh: a qualitative study.

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    Biswas, Animesh; Dalal, Koustuv; Abdullah, Abu Sayeed Md; Gifford, Mervyn; Halim, M A

    2016-01-01

    Background: Maternal complications contribute to maternal deaths in developing countries. Bangladesh still has a high prevalence of maternal mortality, which is often preventable. There are some geographically challenging and hard to reach rural districts in Bangladesh and it is difficult to get information about maternal complications in these areas. In this study, we examined the community lay knowledge of possible pregnancy complications. We also examined the common practices associated with complications and we discuss the challenges for the community. Methods: The study was conducted in Moulvibazar of north east Bangladesh, a geographically challenged, difficult to reach district. Qualitative methods were used to collect the information. Pregnant women, mothers who had recently delivered, their guardians and traditional birth attendants participated in focus group discussions. Additionally, in-depth interviews were conducted with the family members. Thematic analyses were performed. Results: The study revealed that there is a lack of knowledge of maternal complications. In the majority of cases, the mothers did not receive proper treatment for maternal complications.   There are significant challenges that these rural societies need to address: problems of ignorance, traditional myths and family restrictions on seeking better treatment. Moreover, traditional birth attendants and village doctors also have an important role in assuring appropriate, effective and timely treatment. Conclusions:  The rural community lacks adequate knowledge on maternal complications.  Reduction of the societal barriers including barriers within the family can improve overall practices. Moreover, dissemination of adequate information to the traditional birth attendant and village doctors may improve the overall situation, which would eventually help to reduce maternal deaths.

  4. Cultural democracy: the way forward for primary care of hard to reach New Zealanders.

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    Finau, Sitaleki A; Finau, Eseta

    2007-09-01

    The use of cultural democracy, the freedom to practice one's culture without fear, as a framework for primary care service provision is essential for improved health service in a multi cultural society like New Zealand. It is an effective approach to attaining health equity for all. Many successful health ventures are ethnic specific and have gone past cultural competency to the practice of cultural democracy. That is, the services are freely taking on the realities of clients without and malice from those of other ethnicities. In New Zealand the scientific health service to improve the health of a multi cultural society are available but there is a need to improve access and utilization by hard to reach New Zealanders. This paper discusses cultural democracy and provide example of how successful health ventures that had embraced cultural democracy were implemented. It suggests that cultural democracy will provide the intellectual impetus and robust philosophy for moving from equality to equity in health service access and utilization. This paper would provide a way forward to improved primary care utilization, efficiency, effectiveness and equitable access especially for the hard to reach populations. use the realities of Pacificans in New Zealand illustrate the use of cultural democracy, and thus equity to address the "inverse care law" of New Zealand. The desire is for primary care providers to take cognizance and use cultural democracy and equity as the basis for the design and practice of primary health care for the hard to reach New Zealanders.

  5. Facebook as an effective recruitment strategy for mental health research of hard to reach populations

    Directory of Open Access Journals (Sweden)

    Rony Kayrouz

    2016-05-01

    Full Text Available Recent reports indicate that Facebook (FB may facilitate recruitment of hard to reach participants into mental health research. The present study aimed to contribute to this emerging literature by exploring recruitment data from a recently completed trial of online treatment for symptoms of anxiety and depression that targeted Arab people. The present study compared traditional recruitment strategies such as media releases, emails, and print advertisements with Facebook strategies including boosting posts, promoting websites, events and FB public fan pages. The main outcomes of interest were the number of started applications and the time and cost per application associated with the FB and traditional recruitment strategies. A target sample of 350 was sought and a total of 81 participants applied to participate over the 42-week recruitment period. Overall, 86% of the resultant applications occurred via FB recruitment and a Poisson regression analysis indicated the FB strategies were more time-effective, recruiting participants 2.5 times faster than the traditional strategies. However, there were no differences in cost-effectiveness for FB ($US37 per participant and traditional strategies ($US40 per participant. The findings of the current study add to existing literature detailing the value of FB recruitment strategies, alongside more traditional strategies, as a way of recruiting hard-to-reach populations for research. However, more research is needed to explore alternative and optimal strategies for the successful recruitment of hard to reach populations via FB and other online social media platforms.

  6. Performance of a New Blunt-Tip Coaxial Needle for Percutaneous Biopsy and Drainage of "Hard-To-Reach" Targets.

    Science.gov (United States)

    Cazzato, Roberto Luigi; Garnon, Julien; Shaygi, Behnam; Caudrelier, Jean; Bauones, Salem; Tsoumakidou, Georgia; Koch, Guillaume; Gangi, Afshin

    2017-09-01

    To present a new blunt-tip coaxial needle (SoftGuard) applied to access "hard-to-reach" targets undergoing percutaneous image-guided biopsy or drainage. All consecutive patients presenting between August and December 2016 with "hard-to-reach" (blunt-tip needle is a safe and effective tool when applied as a coaxial working cannula for percutaneous biopsy or drainage of "hard-to-reach" targets.

  7. Applying attachment theory to effective practice with hard-to-reach youth: the AMBIT approach.

    Science.gov (United States)

    Bevington, Dickon; Fuggle, Peter; Fonagy, Peter

    2015-01-01

    Adolescent Mentalization-Based Integrative Treatment (AMBIT) is a developing approach to working with "hard-to-reach" youth burdened with multiple co-occurring morbidities. This article reviews the core features of AMBIT, exploring applications of attachment theory to understand what makes young people "hard to reach," and provide routes toward increased security in their attachment to a worker. Using the theory of the pedagogical stance and epistemic ("pertaining to knowledge") trust, we show how it is the therapeutic worker's accurate mentalizing of the adolescent that creates conditions for new learning, including the establishment of alternative (more secure) internal working models of helping relationships. This justifies an individual keyworker model focused on maintaining a mentalizing stance toward the adolescent, but simultaneously emphasizing the critical need for such keyworkers to remain well connected to their wider team, avoiding activation of their own attachment behaviors. We consider the role of AMBIT in developing a shared team culture (shared experiences, shared language, shared meanings), toward creating systemic contexts supportive of such relationships. We describe how team training may enhance the team's ability to serve as a secure base for keyworkers, and describe an innovative approach to treatment manualization, using a wiki format as one way of supporting this process.

  8. Online Communities: researching sociability and usability in hard to reach populations

    Directory of Open Access Journals (Sweden)

    Jenny Preece

    2004-05-01

    Full Text Available Thousands of social gatherings - online communities – occur via ICTs across the Internet. They use listservers, bulletin boards, instant messaging, blogs, social network and meeting facilitation systems and purpose-build platforms. Each community is the product of a complex set of interacting variables. Some of these variables come from usability of the software but social factors have a strong influence. Direct cause and effect relationships are often difficult to tease out and identifying criteria for successful online communities can be difficult. Furthermore several disciplines own this topic, each with its own theories, research methods, community of researchers and publication outlets. This is good for multidisciplinary research but it can be challenging. In this paper I discuss two research projects. Each focuses on community populations that are hard to reach. The first analyses why people do not actively participate in online discussions, i.e., lurk. The second is a new project to develop cross-cultural online book communities for children across the world who do not speak each other’s languages. I present the key findings from each project and suggest ways of working with these hard to reach populations.

  9. Community health worker in hard-to-reach rural areas of Myanmar: filling primary health care service gaps.

    Science.gov (United States)

    Sommanustweechai, Angkana; Putthasri, Weerasak; Nwe, Mya Lay; Aung, Saw Thetlya; Theint, Mya Min; Tangcharoensathien, Viroj; Wynn, San Shway

    2016-10-21

    Myanmar is classified as critical shortage of health workforce. In responses to limited number of trained health workforce in the hard-to-reach and remote areas, the MOH trained the Community Health Worker (CHW) as health volunteers serving these communities on a pro bono basis. This study aimed to assess the socio-economic profiles, contributions of CHW to primary health care services and their needs for supports to maintain their quality contributions in rural hard to reach areas in Myanmar. In 2013, cross-sectional census survey was conducted on all three groups of CHW classified by their training dates: (1) prior to 2000, (2) between 2000 and 2011, and (3) more recently trained in 2012, who are still working in 21 townships of 17 states and regions in Myanmar, using a self-administered questionnaire survey in the Burmese language. The total 715 CHWs from 21 townships had completely responded to the questionnaire. CHWs were trained to support the work of midwives in the sub-centres and health assistant and midwives in rural health centres (RHCs) such as community mobilization for immunization, advocates of safe water and sanitation, and general health education and health awareness for the citizens. CHWs were able to provide some of the services by themselves, such as treatment of simple illnesses, and they provided services to 62 patients in the last 6 months. Their contributions to primary health care services were well accepted by the communities as they are geographically and culturally accessible. However, supports from the RHC were inadequate in particular technical supervision, as well as replenishment of CHW kits and financial support for their work and transportation. In practice, 6 % of service provided by CHWs was funded by the community and 22 % by the patients. The CHW's confidence in providing health services was positively associated with their age, education, and more recent training. A majority of them intended to serve as a CHW for more than

  10. Comparison of Online Survey Recruitment Platforms for Hard-to-Reach Pregnant Smoking Populations: Feasibility Study.

    Science.gov (United States)

    Ibarra, Jose Luis; Agas, Jessica Marie; Lee, Melissa; Pan, Julia Lily; Buttenheim, Alison Meredith

    2018-04-16

    Recruiting hard-to-reach populations for health research is challenging. Web-based platforms offer one way to recruit specific samples for research purposes, but little is known about the feasibility of online recruitment and the representativeness and comparability of samples recruited through different Web-based platforms. The objectives of this study were to determine the feasibility of recruiting a hard-to-reach population (pregnant smokers) using 4 different Web-based platforms and to compare participants recruited through each platform. A screener and survey were distributed online through Qualtrics Panel, Soapbox Sample, Reddit, and Amazon Mechanical Turk (mTurk). Descriptive statistics were used to summarize results of each recruitment platform, including eligibility yield, quality yield, income, race, age, and gestational age. Of the 3847 participants screened for eligibility across all 4 Web-based platforms, 535 were eligible and 308 completed the survey. Amazon mTurk yielded the fewest completed responses (n=9), 100% (9/9) of which passed several quality metrics verifying pregnancy and smoking status. Qualtrics Panel yielded 14 completed responses, 86% (12/14) of which passed the quality screening. Soapbox Sample produced 107 completed surveys, 67% (72/107) of which were found to be quality responses. Advertising through Reddit produced the highest completion rate (n=178), but only 29.2% (52/178) of those surveys passed the quality metrics. We found significant differences in eligibility yield, quality yield, age, number of previous pregnancies, age of smoking initiation, current smokers, race, education, and income (Precruited pregnant smokers, results varied in quality, cost, and percentage of complete responses. Moving forward, investigators should pay careful attention to the percentage yield and cost of online recruitment platforms to maximize internal and external validity. ©Jose Luis Ibarra, Jessica Marie Agas, Melissa Lee, Julia Lily Pan, Alison

  11. Strategies to improve engagement of 'hard to reach' older people in research on health promotion: a systematic review.

    Science.gov (United States)

    Liljas, Ann E M; Walters, Kate; Jovicic, Ana; Iliffe, Steve; Manthorpe, Jill; Goodman, Claire; Kharicha, Kalpa

    2017-04-21

    This systematic review aimed to identify facilitators, barriers and strategies for engaging 'hard to reach' older people in research on health promotion; the oldest old (≥80 years), older people from black and minority ethnic groups (BME) and older people living in deprived areas. Eight databases were searched to identify eligible studies using quantitative, qualitative, and mixed research methods. Using elements of narrative synthesis, engagement strategies, and reported facilitators and barriers were identified, tabulated and analysed thematically for each of the three groups of older people. Twenty-three studies (3 with oldest-old, 16 with BME older people, 2 within deprived areas, 1 with both oldest-old and BME, 1 with both BME and deprived areas) were included. Methods included 10 quantitative studies (of which 1 was an RCT), 12 qualitative studies and one mixed-methods study. Facilitators for engaging the oldest old included gaining family support and having flexible sessions. Facilitators for BME groups included building trust through known professionals/community leaders, targeting personal interests, and addressing ethnic and cultural characteristics. Among older people in deprived areas, facilitators for engagement included encouragement by peers and providing refreshments. Across all groups, barriers for engagement were deteriorating health, having other priorities and lack of transport/inaccessibility. Feeling too tired and lacking support from family members were additional barriers for the oldest old. Similarly, feeling too tired and too old to participate in research on health promotion were reported by BME groups. Barriers for BME groups included lack of motivation and self-confidence, and cultural and language differences. Barriers identified in deprived areas included use of written recruitment materials. Strategies to successfully engage with the oldest old included home visits and professionals securing consent if needed. Strategies to engage

  12. Effectiveness of interventions for diagnosis and treatment of tuberculosis in hard-to-reach populations in countries of low and medium tuberculosis incidence: a systematic review.

    Science.gov (United States)

    Heuvelings, Charlotte C; de Vries, Sophia G; Greve, Patrick F; Visser, Benjamin J; Bélard, Sabine; Janssen, Saskia; Cremers, Anne L; Spijker, René; Shaw, Beth; Hill, Ruaraidh A; Zumla, Alimuddin; Sandgren, Andreas; van der Werf, Marieke J; Grobusch, Martin P

    2017-05-01

    Tuberculosis is over-represented in hard-to-reach (underserved) populations in high-income countries of low tuberculosis incidence. The mainstay of tuberculosis care is early detection of active tuberculosis (case finding), contact tracing, and treatment completion. We did a systematic review with a scoping component of relevant studies published between 1990 and 2015 to update and extend previous National Institute for Health and Care Excellence (NICE) reviews on the effectiveness of interventions for identifying and managing tuberculosis in hard-to-reach populations. The analyses showed that tuberculosis screening by (mobile) chest radiography improved screening coverage and tuberculosis identification, reduced diagnostic delay, and was cost-effective among several hard-to-reach populations. Sputum culture for pre-migration screening and active referral to a tuberculosis clinic improved identification. Furthermore, monetary incentives improved tuberculosis identification and management among drug users and homeless people. Enhanced case management, good cooperation between services, and directly observed therapy improved treatment outcome and compliance. Strong conclusions cannot be drawn because of the heterogeneity of evidence with regard to study population, methodology, and quality. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Prevention of postpartum haemorrhage by community-based auxiliary midwives in hard-to-reach areas of Myanmar: a qualitative inquiry into acceptability and feasibility of task shifting.

    Science.gov (United States)

    Than, Kyu Kyu; Mohamed, Yasmin; Oliver, Victoria; Myint, Theingi; La, Thazin; Beeson, James G; Luchters, Stanley

    2017-05-17

    In Myanmar, postpartum haemorrhage is the leading cause of maternal mortality and contributes to around 30% of all maternal deaths. The World Health Organization recommends training and supporting auxiliary midwives to administer oral misoprostol for prevention of postpartum haemorrhage in resource-limited settings. However, use of misoprostol by auxiliary midwives has not formally been approved in Myanmar. Our study aimed to explore community and provider perspectives on the roles of auxiliary midwives and community-level provision of oral misoprostol by auxiliary midwives. A qualitative inquiry was conducted in Ngape Township, Myanmar. A total of 15 focus group discussions with midwives, auxiliary midwives, community members and mothers with children under the age of three were conducted. Ten key informant interviews were performed with national, district and township level health planners and implementers of maternal and child health services. All audio recordings were transcribed verbatim in Myanmar language. Transcripts of focus group discussions were fully translated into English before coding, while key informants' data were coded in Myanmar language. Thematic analysis was done using ATLAS.ti software. Home births are common and auxiliary midwives were perceived as an essential care provider during childbirth in hard-to-reach areas. Main reasons provided were that auxiliary midwives are more accessible than midwives, live in the hard-to-reach areas, and are integrated in the community and well connected with midwives. Auxiliary midwives generally reported that their training involved instruction on active management of the third stage of labour, including use of misoprostol, but not all auxiliary midwives reported using misoprostol in practice. Supportive reasons for task-shifting administration of oral misoprostol to auxiliary midwives included discussions around the good relationship and trust between auxiliary midwives and midwives, whereby midwives felt

  14. Emerging role of HPV self-sampling in cervical cancer screening for hard-to-reach women: Focused literature review.

    Science.gov (United States)

    Madzima, Tina R; Vahabi, Mandana; Lofters, Aisha

    2017-08-01

    To provide a focused critical review of the literature on the acceptability, feasibility, and uptake of human papillomavirus (HPV) self-sampling among hard-to-reach women. A focused search to obtain relevant literature published in English between 1997 and 2015 was done using PubMed and EMBASE using search terms including HPV self-test or HPV self-sample or HPV kit in combination with acceptability or feasibility . Only studies that focused on never-screened or underscreened populations were included in this review. Human papillomavirus self-sampling was found to be highly acceptable and feasible among these hard-to-reach women across most studies. Mailing of self-sampling kits has been shown to increase participation among hard-to reach women. Some concerns remain regarding adherence to further follow-up among high-risk women with positive test results for HPV after screening. There is a strong body of evidence to support the usefulness of HPV self-sampling in increasing participation of hard-to-reach women in screening programs (level I evidence). Convenience, privacy, ease of use, and, likely, cost-effectiveness of HPV self-sampling are driving forces in its emerging role in cervical cancer screening among hard-to-reach women. Key barriers to participation could be addressed by overcoming disparities in HPV-related knowledge and perceptions about cervical cancer screening. Copyright© the College of Family Physicians of Canada.

  15. Reaching out to the hard to reach: using a science centre model to deliver public engagement with research.

    Science.gov (United States)

    Gagen, M.; Allton, C.; Bryan, W. A.; O'Leary, M.

    2017-12-01

    Science communication is at an all-time high but public faith in expertise is low. However, within this climate of suspicion, research scientists remain a publicly trusted expert group. While there is both academic and public appetite for Public Engagement with Research (PER), there are barriers to reaching a wide range of publics. Attempts to connect the public with research often end up targeting the `already engaged'; the hard-to-reach remain just that. Engaging scientific curiosity in a wider demographic is crucial to promote scientific curiosity, itself known to profoundly counter the politically motivated reasoning that threatens informed debate around contemporary environmental issues. This requires the creation of opportunities for the public to engage with research in places in which they feel they belong. We report here on an 8 month pilot of a science centre model for PER. Oriel Science (www.orielscience.co.uk) is a research-led science exhibition in Swansea city centre delivering Swansea University's PER and run by academics and student ambassadors. Oriel Science (Oriel is Gallery in Welsh) received 16,000 visitors in 8 months, 40% of whom had no previous interaction with the university or its research and >40% of whom came from socio-economically deprived areas. We report on the public engagement leadership we enabled, working with 18 research groups over 8 months and our achievements in giving a broad range of publics the most direct access to participate in contemporary science.

  16. Hard-to-reach? Using health access status as a way to more effectively target segments of the Latino audience.

    Science.gov (United States)

    Wilkin, Holley A; Ball-Rokeach, Sandra J

    2011-04-01

    Health issues disproportionately affect Latinos, but variations within this ethnic group may mean that some Latinos are harder to reach with health messages than others. This paper introduces a methodology grounded in communication infrastructure theory to better target 'hard-to-reach' audiences. A random digit dialing telephone survey of 739 Latinos living in two Los Angeles communities was conducted. The relationships between health access difficulties and connections to an integrated storytelling network as well as individual health communication source connections were explored. Findings suggest that Latinos who are connected to an integrated storytelling network report marginally greater ease finding healthcare, despite not being any more likely to have insurance or a regular place for healthcare. Latinos who have health access problems tended to rely more upon Spanish-language television for health information. In addition, those without healthcare access problems are more likely to indicate that they use health professionals, the Internet, mainstream TV and printed materials like health pamphlets for health information. The theoretical and methodological contributions of this work, its major findings, implications, limitations and policy guidelines are discussed.

  17. A Case Study of Engaging Hard-to-Reach Participants in the Research Process: Community Advisors on Research Design and Strategies (CARDS)®.

    Science.gov (United States)

    Kaiser, Betty L; Thomas, Gay R; Bowers, Barbara J

    2017-02-01

    Lack of diversity among study participants in clinical research limits progress in eliminating health disparities. The engagement of lay stakeholders, such as patient or community advisory boards (CABs), has the potential to increase recruitment and retention of underrepresented groups by providing a structure for gathering feedback on research plans and materials from this target population. However, many CABs intentionally recruit prominent stakeholders who are connected to or comfortable with research and academia and thus may not accurately represent the perspectives of underrepresented groups who have been labeled hard-to-reach, including racial minorities and low-income or low-literacy populations. We developed a partnership between the University of Wisconsin-Madison School of Nursing and two community centers to deliberately engage hard-to-reach people in two lay advisory groups, the Community Advisors on Research Design and Strategies (CARDS)®. Community center staff recruited the CARDS from center programs, including parenting and childcare programs, women's support groups, food pantries, and senior meal programs. The CARDS model differs from other CABs in its participants, processes, and outcomes. Since 2010, the CARDS have met monthly with nurses and other researchers, helping them understand how research processes and the language, tone, appearance, and organization of research materials can discourage people from enrolling in clinical studies. We have successfully used the CARDS model to bring hard-to-reach populations into the research process and have sustained their participation. The model represents a promising strategy for increasing the diversity of participants in clinical research. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  18. Using peer advocates to improve access to services among hard-to-reach populations with hepatitis C: a qualitative study of client and provider relationships.

    Science.gov (United States)

    MacLellan, Jennifer; Surey, Julian; Abubakar, Ibrahim; Stagg, Helen R; Mannell, Jenevieve

    2017-11-28

    Peer support programmes use individuals with specific experiences to improve engagement and outcomes among new clients. However, the skills and techniques used to achieve this engagement have not been mapped. This potentially restricts the development and replication of successful peer advocate models of care. This study explored how a group of peer advocates with experience of homelessness, alcohol and drug misuse made and sustained relationships with their client group. For the purposes of this project, the client group were located among a hepatitis C-positive cohort of people who have a history of injecting drug use and homelessness. Five self-selecting advocates gave a narrative interview lasting 40-90 min. These interviews were double transcribed using both thematic analysis and narrative analysis in order to triangulate the data and provide a robust set of findings about the unique skills of peer advocates in creating and sustaining relationships with clients from hard-to-reach populations. Peer advocates build rapport with clients through disclosing personal details about their lives. While this runs counter to assumptions about the need to maintain distance in client-patient relationships, the therapeutic benefits appear to outweigh the potential costs of this engagement. We conclude the therapeutic benefits of self-disclosure between peer advocates and their clients offer a moral grounding for self-disclosure as a means of building relationships with key hard-to-reach populations.

  19. It Could Be a Pearl to You: Exploring Recruitment and Retention of the Program to Encourage Active, Rewarding Lives (PEARLS) With Hard-to-Reach Populations.

    Science.gov (United States)

    Steinman, Lesley; Hammerback, Kristen; Snowden, Mark

    2015-08-01

    We partnered with 3 social service organizations to identify hard-to-reach populations, barriers to reach, and strategies for improving recruitment and retention for Program to Encourage Active, Rewarding Lives (PEARLS), a home-based depression-care management program for elders. We conducted semistructured interviews with staff and former PEARLS participants. All interviews were transcribed verbatim and thematically analyzed. Veterans, African Americans, Filipino men, other immigrants and English-language learners, old-older adults, rural communities, and people with limited education were identified as hard to reach. The themes of trust, cultural appropriateness, meet them where they are, and framing and reframing, cut across barriers to participation in PEARLS and approaches for overcoming these barriers. Research findings will be used to inform technical assistance activities with PEARLS providers, changes to PEARLS program and training materials, and future PEARLS research activities. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  20. Harnessing Social Networks along with Consumer-Driven Electronic Communication Technologies to Identify and Engage Members of 'Hard-to-Reach' Populations: A Methodological Case Report

    Directory of Open Access Journals (Sweden)

    Rock Melanie J

    2010-01-01

    Full Text Available Abstract Background Sampling in the absence of accurate or comprehensive information routinely poses logistical, ethical, and resource allocation challenges in social science, clinical, epidemiological, health service and population health research. These challenges are compounded if few members of a target population know each other or regularly interact. This paper reports on the sampling methods adopted in ethnographic case study research with a 'hard-to-reach' population. Methods To identify and engage a small yet diverse sample of people who met an unusual set of criteria (i.e., pet owners who had been treating cats or dogs for diabetes, four sampling strategies were used. First, copies of a recruitment letter were posted in pet-friendly places. Second, information about the study was diffused throughout the study period via word of mouth. Third, the lead investigator personally sent the recruitment letter via email to a pet owner, who then circulated the information to others, and so on. Fourth, veterinarians were enlisted to refer people who had diabetic pets. The second, third and fourth strategies rely on social networks and represent forms of chain referral sampling. Results Chain referral sampling via email proved to be the most efficient and effective, yielding a small yet diverse group of respondents within one month, and at negligible cost. Conclusions The widespread popularity of electronic communication technologies offers new methodological opportunities for researchers seeking to recruit from hard-to-reach populations.

  1. Harnessing social networks along with consumer-driven electronic communication technologies to identify and engage members of 'hard-to-reach' populations: a methodological case report.

    Science.gov (United States)

    Rock, Melanie J

    2010-01-20

    Sampling in the absence of accurate or comprehensive information routinely poses logistical, ethical, and resource allocation challenges in social science, clinical, epidemiological, health service and population health research. These challenges are compounded if few members of a target population know each other or regularly interact. This paper reports on the sampling methods adopted in ethnographic case study research with a 'hard-to-reach' population. To identify and engage a small yet diverse sample of people who met an unusual set of criteria (i.e., pet owners who had been treating cats or dogs for diabetes), four sampling strategies were used. First, copies of a recruitment letter were posted in pet-friendly places. Second, information about the study was diffused throughout the study period via word of mouth. Third, the lead investigator personally sent the recruitment letter via email to a pet owner, who then circulated the information to others, and so on. Fourth, veterinarians were enlisted to refer people who had diabetic pets. The second, third and fourth strategies rely on social networks and represent forms of chain referral sampling. Chain referral sampling via email proved to be the most efficient and effective, yielding a small yet diverse group of respondents within one month, and at negligible cost. The widespread popularity of electronic communication technologies offers new methodological opportunities for researchers seeking to recruit from hard-to-reach populations.

  2. Recruitment of hard-to-reach population subgroups via adaptations of the snowball sampling strategy.

    Science.gov (United States)

    Sadler, Georgia Robins; Lee, Hau-Chen; Lim, Rod Seung-Hwan; Fullerton, Judith

    2010-09-01

    Nurse researchers and educators often engage in outreach to narrowly defined populations. This article offers examples of how variations on the snowball sampling recruitment strategy can be applied in the creation of culturally appropriate, community-based information dissemination efforts related to recruitment to health education programs and research studies. Examples from the primary author's program of research are provided to demonstrate how adaptations of snowball sampling can be used effectively in the recruitment of members of traditionally underserved or vulnerable populations. The adaptation of snowball sampling techniques, as described in this article, helped the authors to gain access to each of the more-vulnerable population groups of interest. The use of culturally sensitive recruitment strategies is both appropriate and effective in enlisting the involvement of members of vulnerable populations. Adaptations of snowball sampling strategies should be considered when recruiting participants for education programs or for research studies when the recruitment of a population-based sample is not essential.

  3. Use of mobile phones for improving vaccination coverage among children living in rural hard-to-reach areas and urban streets of Bangladesh.

    Science.gov (United States)

    Uddin, Md Jasim; Shamsuzzaman, Md; Horng, Lily; Labrique, Alain; Vasudevan, Lavanya; Zeller, Kelsey; Chowdhury, Mridul; Larson, Charles P; Bishai, David; Alam, Nurul

    2016-01-04

    In Bangladesh, full vaccination rates among children living in rural hard-to-reach areas and urban streets are low. We conducted a quasi-experimental pre-post study of a 12-month mobile phone intervention to improve vaccination among 0-11 months old children in rural hard-to-reach and urban street dweller areas. Software named "mTika" was employed within the existing public health system to electronically register each child's birth and remind mothers about upcoming vaccination dates with text messages. Android smart phones with mTika were provided to all health assistants/vaccinators and supervisors in intervention areas, while mothers used plain cell phones already owned by themselves or their families. Pre and post-intervention vaccination coverage was surveyed in intervention and control areas. Among children over 298 days old, full vaccination coverage actually decreased in control areas--rural baseline 65.9% to endline 55.2% and urban baseline 44.5% to endline 33.9%--while increasing in intervention areas from rural baseline 58.9% to endline 76*8%, difference +18.8% (95% CI 5.7-31.9) and urban baseline 40.7% to endline 57.1%, difference +16.5% (95% CI 3.9-29.0). Difference-in-difference (DID) estimates were +29.5% for rural intervention versus control areas and +27.1% for urban areas for full vaccination in children over 298 days old, and logistic regression adjusting for maternal education, mobile phone ownership, and sex of child showed intervention effect odds ratio (OR) of 3.8 (95% CI 1.5-9.2) in rural areas and 3.0 (95% CI 1.4-6.4) in urban areas. Among all age groups, intervention effects on age-appropriate vaccination coverage were positive: DIDs +13.1-30.5% and ORs 2.5-4.6 (pmobile phone intervention can improve vaccination coverage in rural hard-to-reach and urban street dweller communities in Bangladesh. This small-scale successful demonstration should serve as an example to other low-income countries with high mobile phone usage. Copyright © 2015

  4. Birth preparedness and complication readiness (BPCR) among pregnant women in hard-to-reach areas in Bangladesh.

    Science.gov (United States)

    Moinuddin, Md; Christou, Aliki; Hoque, Dewan Md Emdadul; Tahsina, Tazeen; Salam, Shumona Sharmin; Billah, Sk Masum; Kuppens, Lianne; Matin, Md Ziaul; Arifeen, Shams El

    2017-01-01

    Birth preparedness and complication readiness aims to reduce delays in care seeking, promote skilled birth attendance, and facility deliveries. Little is known about birth preparedness practices among populations living in hard-to-reach areas in Bangladesh. To describe levels of birth preparedness and complication readiness among recently delivered women, identify determinants of being better prepared for birth, and assess the impact of greater birth preparedness on maternal and neonatal health practices. A cross-sectional survey with 2,897 recently delivered women was undertaken in 2012 as part of an evaluation trial done in five hard-to-reach districts in rural Bangladesh. Mothers were considered well prepared for birth if they adopted two or more of the four birth preparedness components. Descriptive statistics and multivariable logistic regression were used for analysis. Less than a quarter (24.5%) of women were considered well prepared for birth. Predictors of being well-prepared included: husband's education (OR = 1.3; CI: 1.1-1.7), district of residence, exposure to media in the form of reading a newspaper (OR = 2.2; CI: 1.2-3.9), receiving home visit by a health worker during pregnancy (OR = 1.5; CI: 1.2-1.8), and receiving at least 3 antenatal care visits from a qualified provider (OR = 1.4; CI: 1.0-1.9). Well-prepared women were more likely to deliver at a health facility (OR = 2.4; CI: 1.9-3.1), use a skilled birth attendant (OR = 2.4, CI: 1.9-3.1), practice clean cord care (OR = 1.3, CI: 1.0-1.5), receive post-natal care from a trained provider within two days of birth for themselves (OR = 2.6, CI: 2.0-3.2) or their newborn (OR = 2.6, CI: 2.1-3.3), and seek care for delivery complications (OR = 1.8, CI: 1.3-2.6). Greater emphasis on BPCR interventions tailored for hard to reach areas is needed to improve skilled birth attendance, care seeking for complications and essential newborn care and facilitate reductions in maternal and neonatal mortality in low

  5. Birth preparedness and complication readiness (BPCR among pregnant women in hard-to-reach areas in Bangladesh.

    Directory of Open Access Journals (Sweden)

    Md Moinuddin

    Full Text Available Birth preparedness and complication readiness aims to reduce delays in care seeking, promote skilled birth attendance, and facility deliveries. Little is known about birth preparedness practices among populations living in hard-to-reach areas in Bangladesh.To describe levels of birth preparedness and complication readiness among recently delivered women, identify determinants of being better prepared for birth, and assess the impact of greater birth preparedness on maternal and neonatal health practices.A cross-sectional survey with 2,897 recently delivered women was undertaken in 2012 as part of an evaluation trial done in five hard-to-reach districts in rural Bangladesh. Mothers were considered well prepared for birth if they adopted two or more of the four birth preparedness components. Descriptive statistics and multivariable logistic regression were used for analysis.Less than a quarter (24.5% of women were considered well prepared for birth. Predictors of being well-prepared included: husband's education (OR = 1.3; CI: 1.1-1.7, district of residence, exposure to media in the form of reading a newspaper (OR = 2.2; CI: 1.2-3.9, receiving home visit by a health worker during pregnancy (OR = 1.5; CI: 1.2-1.8, and receiving at least 3 antenatal care visits from a qualified provider (OR = 1.4; CI: 1.0-1.9. Well-prepared women were more likely to deliver at a health facility (OR = 2.4; CI: 1.9-3.1, use a skilled birth attendant (OR = 2.4, CI: 1.9-3.1, practice clean cord care (OR = 1.3, CI: 1.0-1.5, receive post-natal care from a trained provider within two days of birth for themselves (OR = 2.6, CI: 2.0-3.2 or their newborn (OR = 2.6, CI: 2.1-3.3, and seek care for delivery complications (OR = 1.8, CI: 1.3-2.6.Greater emphasis on BPCR interventions tailored for hard to reach areas is needed to improve skilled birth attendance, care seeking for complications and essential newborn care and facilitate reductions in maternal and neonatal mortality

  6. Using Social Media and Targeted Snowball Sampling to Survey a Hard-to-reach Population: A Case Study

    Directory of Open Access Journals (Sweden)

    Gary Dusek

    2015-08-01

    Full Text Available Response rates to the academic surveys used in quantitative research are decreasing and have been for several decades among both individuals and organizations. Given this trend, providing doctoral students an opportunity to complete their dissertations in a timely and cost effective manner may necessitate identifying more innovative and relevant ways to collect data while maintaining appropriate research standards and rigor. The case of a research study is presented which describes the data collection process used to survey a hard-to-reach population. It details the use of social media, in this case LinkedIn, to facilitate the distribution of the web-based survey. A roadmap to illustrate how this data collection process unfolded is presented, as well as several “lessons learned” during this journey. An explanation of the considerations that impacted the sampling design is provided. The goal of this case study is to provide researchers, including doctoral students, with realistic expectations and an awareness of the benefits and risks associated with the use of this method of data collection.

  7. Oral cholera vaccine coverage in hard-to-reach fishermen communities after two mass Campaigns, Malawi, 2016.

    Science.gov (United States)

    Sauvageot, Delphine; Saussier, Christel; Gobeze, Abebe; Chipeta, Sikhona; Mhango, Innocent; Kawalazira, Gift; Mengel, Martin A; Legros, Dominique; Cavailler, Philippe; M'bang'ombe, Maurice

    2017-09-12

    From December 2015 to August 2016, a large epidemic of cholera affected the fishermen of Lake Chilwa in Malawi. A first reactive Oral Cholera Vaccines (OCV) campaign was organized, in February, in a 2km radius of the lake followed by a preemptive one, conducted in November, in a 25km radius. We present the vaccine coverage reached in hard-to-reach population using simplified delivery strategies. We conducted two-stage random-sampling cross-sectional surveys among individuals living in a 2km and 25km radius of Lake Chilwa (islands and floating homes included). Individuals aged 12months and older from Machinga and Zomba districts were sampled: 43 clusters of 14 households were surveyed. Simplified strategies were used for those living in islands and floating homes: self- delivery and community-supervised delivery of the second dose. Vaccine coverage (VC) for at-least-two-doses was estimated taking into account sampling weights and design effects. A total of 1176 households were surveyed (2.7% of non-response). Among the 2833 individuals living in the 2km radius of Lake and the 2915 in the 25km radius: 457 (16.1%) and 239 (8.2%) lived in floating homes or on islands at some point in the year, respectively. For the overall population, VC was 75.6% and 54.2%, respectively. In the 2km radius, VC was 92.2% for those living on the lake at some point of the year: 271 (64.8%) used the simplified strategies. The main reasons for non-vaccination were absence during the campaign and vaccine shortage. Few adverse events occurring in the 24h following vaccination was reported. We reached a high two-dose coverage of the most at-risk population using simplified delivery strategies. Because of the high fishermen mobility, regular catch-up campaigns or another strategy specifically targeting fishermen need to be assessed for more efficient vaccines use. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Pandemics and vaccines: perceptions, reactions, and lessons learned from hard-to-reach Latinos and the H1N1 campaign.

    Science.gov (United States)

    Cassady, Diana; Castaneda, Xochitl; Ruelas, Magdalena Ruiz; Vostrejs, Meredith Miller; Andrews, Teresa; Osorio, Liliana

    2012-08-01

    This paper examines knowledge, risk perception, and attitudes around the H1N1 pandemic among Latino hard-to-reach (HTR) populations in the United States. Ten focus groups were conducted throughout California (N=90), representing Latino immigrants disproportionately affected by H1N1: farmworkers, indigenous Mexicans, pregnant women, and children. Overall, participants were aware of the H1N1 epidemic and common prevention practices. However, many expressed doubts that the H1N1 outbreak constituted an epidemic because the U.S. media reports of the epidemic in Mexico did not match reports from participants' families in Mexico and because of participants' absence of personal experience with the disease. Participants mistrusted the H1N1 vaccine due to its novelty, conspiracy theories, and inconsistent information. Study findings confirm that vaccination campaign strategies should reflect the diversity of meaning, experiences, and socio-economic realities among target populations. Key findings inform future emergency response activities targeting HTR Latino communities.

  9. Approaching the Hard-to-Reach in Organized Colorectal Cancer Screening: an Overview of Individual, Provider and System Level Coping Strategies

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    Jason Liwen Huang

    2017-06-01

    Full Text Available Background: Despite the proven effectiveness of colorectal cancer (CRC screening on reduction of CRC mortality, the uptake of CRC screening remains low. Participation rate is one of determinants for the success of organized population-based screening program. This review aims to identify those who are hard-to-reach, and summarize the strategies to increase their screening rate from individual, provider and system levels. Methods: A systematic search of electronic English databases was conducted on the factors and strategies of uptake in CRC screening for the hard-to-reach population up to May 2017. Discussion: The coverage rate and participation rate are two indexes to identify the hard-to-reach population in organized CRC screening program. However, the homeless, new immigrants, people with severe mental illness, the jail intimates, and people with characteristics including lower education levels and/or low socioeconomic status, living in rural/remote areas, without insurance, and racial minorities are usually recognized as hard-to-reach populations. For them, organized screening programs offer a better coverage, while novel invitation approaches for eligible individuals and multiple strategies from primary care physicians are still needed to enhance screening rates among subjects who are hard-to-reach. Suggestions implied the effectiveness of interventions at the system level, including linkages to general practice; use of decision making tools; enlisting supports from coalition; and the continuum from screening to diagnosis and treatment. Conclusion: Organized CRC screening offers a system access to approach the hard-to-reach populations. To increase their uptake, multiple and novel strategies from individual, provider and system levels should be applied. For policymakers, public healthcare providers and community stakeholders, it is a test to tailor their potential needs and increase their participation rates through continuous efforts to

  10. Effectiveness of interventions for diagnosis and treatment of tuberculosis in hard-to-reach populations in countries of low and medium tuberculosis incidence: a systematic review

    NARCIS (Netherlands)

    Heuvelings, Charlotte C.; de Vries, Sophia G.; Greve, Patrick F.; Visser, Benjamin J.; Bélard, Sabine; Janssen, Saskia; Cremers, Anne L.; Spijker, René; Shaw, Beth; Hill, Ruaraidh A.; Zumla, Alimuddin; Sandgren, Andreas; van der Werf, Marieke J.; Grobusch, Martin P.

    2017-01-01

    Tuberculosis is over-represented in hard-to-reach (underserved) populations in high-income countries of low tuberculosis incidence. The mainstay of tuberculosis care is early detection of active tuberculosis (case finding), contact tracing, and treatment completion. We did a systematic review with a

  11. Maternal complications in a geographically challenging and hard to reach district of Bangladesh: a qualitative study [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Animesh Biswas

    2016-09-01

    Full Text Available Background: Maternal complications contribute to maternal deaths in developing countries. Bangladesh still has a high prevalence of maternal mortality, which is often preventable. There are some geographically challenging and hard to reach rural districts in Bangladesh and it is difficult to get information about maternal complications in these areas. In this study, we examined the community lay knowledge of possible pregnancy complications. We also examined the common practices associated with complications and we discuss the challenges for the community. Methods: The study was conducted in Moulvibazar of north east Bangladesh, a geographically challenged, difficult to reach district. Qualitative methods were used to collect the information. Pregnant women, mothers who had recently delivered, their guardians and traditional birth attendants participated in focus group discussions. Additionally, in-depth interviews were conducted with the family members. Thematic analyses were performed. Results: The study revealed that there is a lack of knowledge of maternal complications. In the majority of cases, the mothers did not receive proper treatment for maternal complications.   There are significant challenges that these rural societies need to address: problems of ignorance, traditional myths and family restrictions on seeking better treatment. Moreover, traditional birth attendants and village doctors also have an important role in assuring appropriate, effective and timely treatment. Conclusions:  The rural community lacks adequate knowledge on maternal complications.  Reduction of the societal barriers including barriers within the family can improve overall practices. Moreover, dissemination of adequate information to the traditional birth attendant and village doctors may improve the overall situation, which would eventually help to reduce maternal deaths.

  12. Pilot of a diabetes primary prevention program in a hard-to-reach, low-income, immigrant Hispanic population.

    Science.gov (United States)

    Millard, Ann V; Graham, Margaret A; Wang, Xiaohui; Mier, Nelda; Sánchez, Esmeralda R; Flores, Isidore; Elizondo-Fournier, Marta

    2011-10-01

    An immigrant Hispanic population in the Texas-Mexico border region urgently requested assistance with diabetes. The project team implemented an exploratory pilot intervention to prevent type 2 diabetes in the general population through enhanced nutrition and physical activity. Social networks in low-income rural areas(colonias) participated in an adaptation of the Diabetes Empowerment Education Program. The program had a pre-post-test design with a comparison group. The intervention had a small but significant effect in lowering body mass index, the biological outcome variable. The process evaluation shows that the participants valued the pilot project and found it culturally and economically appropriate. This program was the first primary prevention program in diabetes to address a general population successfully. The study shows that low-income, rural Mexican American families will take ownership of a program that is participatory and tailored to their culture and economic situation.

  13. Graphic Novels: A New Stress Mitigation Tool for Military Training: Developing Content for Hard-to-Reach Audiences.

    Science.gov (United States)

    Hourani, Laurel; Lambert, Shari; Peeler, Russ; Lane, Becky; Borst, Carrie

    2017-05-01

    This article describes the development of two graphic novels as a new approach to mental health communication and coping strategies for the Navy and Marine Corps. The novels are intended to capture the attention of the younger target audience and provide vital teaching messages to better prepare personnel for deployment to combat zones. The novels were developed based on embedding the principles of combat and operational stress control (COSC) into realistic and relatable characters, stories, and images. Approaches used for development included (a) basing storylines on real-life service members and the situations they face in combat and their personal lives; (b) partnering with COSC experts to embed teaching points; (c) ensuring technical accuracy through research and target audience reviews of the storyboard and artwork; (d) developing characters that are representative of the target audience, with varied jobs, ages, backgrounds, and professional concerns; and (e) designing artwork in a manner sensitive to training objectives and the psychological effects on readers. Because technical accuracy, realism, and sensitivity were noted as essential components of an effective graphic novel tool, focus-group research and review of author drafts by the target audience and technical experts are strongly recommended.

  14. We are Not Hard-to-Reach: Community Competent Research to Address Racial Tobacco-Related Disparities

    Science.gov (United States)

    Dr. Webb Hooper is Associate Director for Cancer Disparities Research and Director of the Office of Cancer Disparities Research in the Case Comprehensive Cancer Center at Case Western Reserve University. She is also Professor of Oncology, Family Medicine & Community Health and Psychological Sciences. Dr. Webb Hooper is a licensed clinical health psychologist whose research interests are in chronic illness prevention and cancer risk behaviors, with an emphasis on minority health and racial/ethnic disparities. Much of her research focuses on tobacco use and weight management interventions, the development of culturally specific approaches, and understanding relationships between behavior change and race/ethnicity, cultural variables, modifiable risk factors, and the biological stress response. Dr. Webb Hooper has received international recognition for her contributions to nicotine and tobacco research, and is a leader in the field of cancer health disparities. Her research goal is to make a significant public health impact by reducing the prevalence of cancer and cancer health disparities in high-risk populations. Her long-term goal is to help eliminate disparities in chronic diseases. Dr. Webb Hooper’s research has been funded with over $9 million dollars by the National Cancer Institute (NCI), American Cancer Society (ACS), CVS Health Foundation, and the Florida Department of Health James and Esther King Biomedical Research Program.  In addition, Dr. Webb Hooper serves on committees for the NIH, several peer-reviewed journal editorial boards, is an Associate Editor of the Ethnicity & Disease Journal, and is Co-Chair of the Health Disparities Network of the Society for Research on Nicotine and Tobacco. WebEx When it's time, join the meeting. Meeting number (access code):  857 862 211 Meeting password:  Colloqu1@ Join by phone 1-650-479-3207 Call-in toll number (US/Canada) Can't join the meeting? IMPORTANT NOTICE:  Please note that this WebEx service allows

  15. A Bayesian evidence synthesis approach to estimate disease prevalence in hard-to-reach populations: hepatitis C in New York City

    Directory of Open Access Journals (Sweden)

    Sarah Tan

    2018-06-01

    Full Text Available Existing methods to estimate the prevalence of chronic hepatitis C (HCV in New York City (NYC are limited in scope and fail to assess hard-to-reach subpopulations with highest risk such as injecting drug users (IDUs. To address these limitations, we employ a Bayesian multi-parameter evidence synthesis model to systematically combine multiple sources of data, account for bias in certain data sources, and provide unbiased HCV prevalence estimates with associated uncertainty. Our approach improves on previous estimates by explicitly accounting for injecting drug use and including data from high-risk subpopulations such as the incarcerated, and is more inclusive, utilizing ten NYC data sources. In addition, we derive two new equations to allow age at first injecting drug use data for former and current IDUs to be incorporated into the Bayesian evidence synthesis, a first for this type of model. Our estimated overall HCV prevalence as of 2012 among NYC adults aged 20–59 years is 2.78% (95% CI 2.61–2.94%, which represents between 124,900 and 140,000 chronic HCV cases. These estimates suggest that HCV prevalence in NYC is higher than previously indicated from household surveys (2.2% and the surveillance system (2.37%, and that HCV transmission is increasing among young injecting adults in NYC. An ancillary benefit from our results is an estimate of current IDUs aged 20–59 in NYC: 0.58% or 27,600 individuals. Keywords: Bayesian evidence synthesis, Disease prevalence estimation, Hard-to-reach populations, Injecting drug use, hepatitis C in New York City

  16. Target population's requirements on a community-based intervention for stimulating physical activity in hard-to-reach physically disabled people: an interview study.

    Science.gov (United States)

    Krops, Leonie A; Folkertsma, Nienke; Hols, Doortje H J; Geertzen, Jan H B; Dijkstra, Pieter U; Dekker, Rienk

    2018-05-31

    To explore ideas of the target population about a community-based intervention to stimulate physical activity in hard-to-reach physically disabled people. Semi-structured interviews were performed with 21 physically disabled people, and analyzed using thematic analyses. Findings were interpreted using the integrated Physical Activity for People with a Disability and Intervention Mapping model. The intervention should aim to stimulate intrinsic motivation and raise awareness for the health effects of physical activity. It should provide diverse activities, increase visibility of these activities, and improve image of physical activity for physically disabled people. Participants suggested to provide individual coaching sessions, increase marketing, present role models, and assign buddies. Potential users should be approached personally through intermediate organizations, or via social media and word of mouth promotion. Participants suggested that users, government, sponsors, and health insurers should finance the intervention. Self-responsibility for being physically active was strongly emphasized by participants. An intervention to stimulate physical activity in hard-to-reach physically disabled people should be individualized, include personal support, and should include marketing to improve image of physical activity of physically disabled people. The intervention that fulfills these requirements should be developed and tested for effects in future research. Implications for rehabilitation An intervention to stimulate physical activity in physically disabled people should aim to raise awareness for the health effects of physical activity, stimulate intrinsic motivation, offer diverse activities, increase the visibility of the possible activities, and improve the image of physical activity for physically disabled people. An intervention should include both individual- and environmental-level intervention methods. Physically disabled people most emphasized

  17. International non-governmental organizations' provision of community-based tuberculosis care for hard-to-reach populations in Myanmar, 2013-2014.

    Science.gov (United States)

    Soe, Kyaw Thu; Saw, Saw; van Griensven, Johan; Zhou, Shuisen; Win, Le; Chinnakali, Palanivel; Shah, Safieh; Mon, Myo Myo; Aung, Si Thu

    2017-03-24

    National tuberculosis (TB) programs increasingly engage with international non-governmental organizations (INGOs), especially to provide TB care in complex settings where community involvement might be required. In Myanmar, however, there is limited data on how such INGO community-based programs are organized and how effective they are. In this study, we describe four INGO strategies for providing community-based TB care to hard-to-reach populations in Myanmar, and assess their contribution to TB case detection. We conducted a descriptive study using program data from four INGOs and the National TB Program (NTP) in 2013-2014. For each INGO, we extracted information on its approach and key activities, the number of presumptive TB cases referred and undergoing TB testing, and the number of patients diagnosed with TB and their treatment outcomes. The contribution of INGOs to TB diagnosis in their selected townships was calculated as the proportion of INGO-diagnosed new TB cases out of the total NTP-diagnosed new TB cases in the same townships. All four INGOs implemented community-based TB care in challenging contexts, targeting migrants, post-conflict areas, the urban poor, and other vulnerable populations. Two recruited community volunteers via existing community health volunteers or health structures, one via existing community leaderships, and one directly involved TB infected/affected individuals. Two INGOs compensated volunteers via performance-based financing, and two provided financial and in-kind initiatives. All relied on NTP laboratories for diagnosis and TB drugs, but provided direct observation treatment support and treatment follow-up. A total of 21 995 presumptive TB cases were referred for TB diagnosis, with 7 383 (34%) new TB cases diagnosed and almost all (98%) successfully treated. The four INGOs contributed to the detection of, on average, 36% (7 383/20 663) of the total new TB cases in their respective townships (range: 15-52%). Community-based TB

  18. Assessing Child Obesity and Physical Activity in a Hard-to-Reach Population in California’s Central Valley, 2012–2013

    Science.gov (United States)

    Camacho-Gomez, Rosa; Sadeghi, Banefsheh; Kaiser, Lucia; German, J. Bruce; de la Torre, Adela

    2015-01-01

    Introduction In California’s agricultural Central Valley, the rate of childhood obesity is higher than the national average. Adequate physical activity contributes to obesity prevention and its assessment is useful to evaluate the impact of interventions. Methods Niños Sanos, Familia Sana (Healthy Children, Healthy Family [NSFS]) uses community-based participatory research to implement an intervention program to reduce childhood obesity among people of Mexican origin in the Central Valley. Anthropometric measurements were conducted on more than 650 children enrolled in NSFS. Physical activity data from a subgroup of children aged 4 to 7 years (n = 134) were collected via a wearable accelerometer. Results Children were classified on the basis of age and sex-adjusted body mass index as healthy weight (57.7%); overweight (19.3%), or obese (23%). Logistic regression showed that moderate to vigorous physical activity (MVPA) was associated with a child’s likelihood of having a healthy BMI (odds ratio: 1.03; 95% CI, 1.01–1.05; P = .017). Conclusion NSFS’s community-based participatory approach resulted in successful use of a commercial electronic device to measure physical activity quantity and quality in this hard-to-reach population. Promotion of adequate daily MVPA is an appropriate and necessary component of NSFS’s childhood obesity prevention strategy. PMID:26203815

  19. Hard-to-reach populations of men who have sex with men and sex workers: a systematic review on sampling methods.

    Science.gov (United States)

    Barros, Ana B; Dias, Sonia F; Martins, Maria Rosario O

    2015-10-30

    In public health, hard-to-reach populations are often recruited by non-probabilistic sampling methods that produce biased results. In order to overcome this, several sampling methods have been improved and developed in the last years. The aim of this systematic review was to identify all current methods used to survey most-at-risk populations of men who have sex with men and sex workers. The review also aimed to assess if there were any relations between the study populations and the sampling methods used to recruit them. Lastly, we wanted to assess if the number of publications originated in middle and low human development (MLHD) countries had been increasing in the last years. A systematic review was conducted using electronic databases and a total of 268 published studies were included in the analysis. In this review, 11 recruitment methods were identified. Semi-probabilistic methods were used most commonly to survey men who have sex with men, and the use of the Internet was the method that gathered more respondents. We found that female sex workers were more frequently recruited through non-probabilistic methods than men who have sex with men (odds = 2.2; p review identified 11 methods used to sample men who have sex with men and female sex workers. There is an association between the type of sampling method and the population being studied. The number of studies based in middle and low human development countries has increased in the last 6 years of this study.

  20. Predictors of inconsistent condom use among a hard to reach population of young women with multiple sexual partners in peri-urban South Africa.

    Directory of Open Access Journals (Sweden)

    Yanga Z Zembe

    Full Text Available Evidence suggests that multiple concurrent sexual partnering may be a key driver of the high HIV prevalence among young women in South Africa. However, little is known about whether and to what extent women who have multiple sexual partners also engage in other high risk sexual behaviors such as inconsistent condom use. And yet, multiple concurrent sexual partnering is of little epidemiological relevance if all partners in these sexual networks use condoms consistently. This study assesses the prevalence of sexual risk behaviors and HIV, and predictors of inconsistent condom use among women aged 16-24 with multiple sexual partners in a peri-urban setting in South Africa.We used Respondent Driven Sampling, a sampling strategy for hard-to-reach populations to recruit 259 women aged 16-24 in a bio-behavioral cross-sectional survey in the Western Cape province. Estimates of population proportions and 95% confidence intervals (CIs were calculated using the Respondent-Driven Sampling Analysis Tool 5.6 (RDSAT. The primary outcome was inconsistent condom use in the past three months.Young women reported an average of 7 partners in the past 3 months and a high prevalence of sexual risk behaviors: concurrency (87%, transactional sex (91% and age mixing (59%. Having >5 sexual partners in the last 3 months doubled the risk of unprotected sex (OR 2.43, CI 1.39-4.25. HIV prevalence was 4% among 16-19 year olds, increasing threefold (12% at age 20-24.Multiple sexual partnering, where a high number of partners are acquired in a short space of time, is a fertile context for unprotected and risky sexual behavior. The young women featured in this survey present with a constellation of high-risk sexual behaviors that cluster to form a risk syndrome. Carefully tailored repeat bio-behavioral surveillance surveys are recommended for this sub-population.

  1. A Bayesian evidence synthesis approach to estimate disease prevalence in hard-to-reach populations: hepatitis C in New York City.

    Science.gov (United States)

    Tan, Sarah; Makela, Susanna; Heller, Daliah; Konty, Kevin; Balter, Sharon; Zheng, Tian; Stark, James H

    2018-06-01

    Existing methods to estimate the prevalence of chronic hepatitis C (HCV) in New York City (NYC) are limited in scope and fail to assess hard-to-reach subpopulations with highest risk such as injecting drug users (IDUs). To address these limitations, we employ a Bayesian multi-parameter evidence synthesis model to systematically combine multiple sources of data, account for bias in certain data sources, and provide unbiased HCV prevalence estimates with associated uncertainty. Our approach improves on previous estimates by explicitly accounting for injecting drug use and including data from high-risk subpopulations such as the incarcerated, and is more inclusive, utilizing ten NYC data sources. In addition, we derive two new equations to allow age at first injecting drug use data for former and current IDUs to be incorporated into the Bayesian evidence synthesis, a first for this type of model. Our estimated overall HCV prevalence as of 2012 among NYC adults aged 20-59 years is 2.78% (95% CI 2.61-2.94%), which represents between 124,900 and 140,000 chronic HCV cases. These estimates suggest that HCV prevalence in NYC is higher than previously indicated from household surveys (2.2%) and the surveillance system (2.37%), and that HCV transmission is increasing among young injecting adults in NYC. An ancillary benefit from our results is an estimate of current IDUs aged 20-59 in NYC: 0.58% or 27,600 individuals. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Development of an intervention to stimulate physical activity in hard-to-reach physically disabled people and design of a pilot implementation: an intervention mapping approach.

    Science.gov (United States)

    Krops, Leonie A; Dekker, Rienk; Geertzen, Jan H B; Dijkstra, Pieter U

    2018-03-16

    Physically disabled people are less physically active compared with healthy people. Existing physical activity (PA) interventions are limited in reach, since they are primarily rehabilitation or school based. The current study aims to develop a community-based intervention for stimulating PA in hard-to-reach physically disabled people. To systematically develop a PA-stimulating intervention, intervention mapping (six steps) was applied. PA level and health-related quality of life of patients after rehabilitation was determined using questionnaires (step 1). Qualitative research was performed to study professionals' and physically disabled people's ideas about intervention objectives, determinants and design (steps 2 and 3). Since experts expressed no need for a new intervention, the existing intervention 'Activity coach' was adapted to the specific target population. The adapted intervention 'Activity coach+' composes a network of intermediate organisations that refers participants to an activity coach, who coaches participants during 1 year. After a preintervention physical assessment by a physiotherapist, participants will be individually guided to existing organised or non-organised activities. An activity tracker will be used to monitor and stimulate PA in daily life (step 4). To support adoption and implementation, meetings between involved parties are organised (step 5). 'Activity coach+' is implemented in community in March 2017, and will be evaluated using a mixed-method analysis. Quantitative evaluation of intervention effects on PA, health and social participation takes place after 0, 2, 4, 6 and 12 months. The implementation process and experiences with the intervention will be determined using qualitative research (step 6). Insights from this study will be used for dissemination and further development of the intervention. The Medical Ethical Committee of the University Medical Center Groningen confirmed that formal ethical approval was not required

  3. Reflections on Ethical Dilemmas in Working with So-Called "Vulnerable" and "Hard-to-Reach" Groups: Experiences from the Foodways and Futures Project

    Science.gov (United States)

    Gombert, Karolina; Douglas, Flora; McArdle, Karen; Carlisle, Sandra

    2016-01-01

    This article reflects on ethical limitations and dilemmas encountered during fieldwork of the Foodways and Futures project (2013-2016). Foodways and Futures is a qualitative action research project aimed at exploring the food choices of former homeless young people (aged 16-25) in Aberdeenshire. In Scotland, where over 13,000 young people become…

  4. Still a hard-to-reach population? Using social media to recruit Latino gay couples for an HIV intervention adaptation study.

    Science.gov (United States)

    Martinez, Omar; Wu, Elwin; Shultz, Andrew Z; Capote, Jonathan; López Rios, Javier; Sandfort, Theo; Manusov, Justin; Ovejero, Hugo; Carballo-Dieguez, Alex; Chavez Baray, Silvia; Moya, Eva; López Matos, Jonathan; DelaCruz, Juan J; Remien, Robert H; Rhodes, Scott D

    2014-04-24

    -based organizations across New York City to promote the study and build in the social media components. Our findings highlight the importance of incorporating communication technologies into the recruitment and engagement of participants in HIV interventions. Particularly, the success of our social media recruitment strategy with Spanish-speaking Latino MSM shows that this population is not particularly "hard to reach", as it is often characterized within public health literature.

  5. Virucidal Activity of Fogged Chlorine Dioxide- and Hydrogen Peroxide-Based Disinfectants against Human Norovirus and Its Surrogate, Feline Calicivirus, on Hard-to-Reach Surfaces

    Directory of Open Access Journals (Sweden)

    Naim Montazeri

    2017-06-01

    Full Text Available Human norovirus (NoV is the leading cause of foodborne illnesses in the United States. Norovirus is shed in high numbers in the feces and vomitous of infected individuals. Contact surfaces contaminated with bodily fluids harboring infectious virus particles serve as vehicles for pathogen transmission. Environmental stability of NoV and its resistance to many conventional disinfectants necessitate effective inactivation strategies to control the spread of virus. We investigated the efficacy of two commercial disinfectants, hydrogen peroxide (7.5% and a chlorine dioxide (0.2%-surfactant-based product using a fogging delivery system against human NoV GI.6 and GII.4 Sydney strains as well as the cultivable surrogate, feline calicivirus (FCV dried on stainless steel coupons. Log10 reductions in human NoV and FCV were calculated utilizing RNase RT-qPCR and infectivity (plaque assay, respectively. An improved antiviral activity of hydrogen peroxide as a function of disinfectant formulation concentration in the atmosphere was observed against both GII.4 and FCV. At 12.4 ml/m3, hydrogen peroxide achieved a respective 2.5 ± 0.1 and 2.7 ± 0.3 log10 reduction in GI.6 and GII.4 NoV genome copies, and a 4.3 ± 0.1 log10 reduction in infectious FCV within 5 min. At the same disinfectant formulation concentration, chlorine dioxide-surfactant-based product resulted in a respective 1.7 ± 0.2, 0.6 ± 0.0, and 2.4 ± 0.2 log10 reduction in GI.6, GII.4, and FCV within 10 min; however, increasing the disinfectant formulation concentration to 15.9 ml/m3 negatively impacted its efficacy. Fogging uniformly delivered the disinfectants throughout the room, and effectively decontaminated viruses on hard-to-reach surfaces. Hydrogen peroxide delivered by fog showed promising virucidal activity against FCV by meeting the United States EPA 4-log10 reduction criteria for an anti-noroviral disinfectant; however, fogged chlorine dioxide-surfactant-based product did not achieve

  6. The challenge and impact of engaging hard-to-reach populations in regular physical activity and health behaviours: an examination of an English Premier League 'Football in the Community' men's health programme.

    Science.gov (United States)

    Curran, K; Drust, B; Murphy, R; Pringle, A; Richardson, D

    2016-06-01

    To investigate the challenges that men from hard-to-reach (HTR) populations encounter when attempting to commit to regular participation in physical activity and health behaviours, and to explore the psychological and social effects of participation in a twelve week football-led health improvement intervention. A twelve week football specific physical activity intervention targeting men from HTR populations was delivered by Everton Football Clubs' Football in the Community (FitC) scheme as part of a national programme of men's health delivered in/by English Premier League (EPL) football clubs. Men living in homeless shelters and/or recovering from substance misuse were recruited over a period of three months. The programme consisted of a two hour football session, twice weekly, alongside the dissemination of healthy living messages. Football sessions were conducted by a qualified FitC coach. This research was conducted during a twelve week period of immersed practitioner-research. Ethnographic and observational methodologies were adopted. Psychosocial issues were discussed with participants through informal client-researcher interactions and data were logged via field notes. Records of attendance were logged. Participants who failed to attend a session were contacted and their reason(s) for non-attendance were recorded. Data were analysed using deductive and inductive reasoning. Despite the apparent ambition of the participants to regularly participate in the FitC programme, adherence to the programme was poor. Economic, environmental and social barriers to engagement in the programme were apparent. Engagement in the programme resulted in positive psychosocial developments; the development of structure, social interaction and social capital. Community based football-led health improvement programmes endorsed by professional football clubs appear well positioned to connect with, and attract, men from HTR populations. The evidence suggests that such programmes can

  7. A Randomized Trial to Compare Alternative Educational Interventions to Increase Colorectal Cancer Screening in a Hard-to-Reach Urban Minority Population with Health Insurance.

    Science.gov (United States)

    Basch, Charles E; Zybert, Patricia; Wolf, Randi L; Basch, Corey H; Ullman, Ralph; Shmukler, Celia; King, Fionnuala; Neugut, Alfred I; Shea, Steven

    2015-10-01

    This randomized controlled trial assessed different educational approaches for increasing colorectal cancer screening uptake in a sample of primarily non-US born urban minority individuals, over aged 50, with health insurance, and out of compliance with screening guidelines. In one group, participants were mailed printed educational material (n = 180); in a second, participants' primary care physicians received academic detailing to improve screening referral and follow-up practices (n = 185); in a third, physicians received academic detailing and participants received tailored telephone education (n = 199). Overall, 21.5% of participants (n = 121) received appropriate screening within one year of randomization. There were no statistically significant pairwise differences between groups in screening rate. Among those 60 years of age or older, however, the detailing plus telephone education group had a higher screening rate than the print group (27.3 vs. 7.7%, p = .02). Different kinds of interventions will be required to increase colorectal cancer screening among the increasingly small population segment that remains unscreened. ClinicalTrials.gov Identifier: NCT02392143.

  8. Recruiting Hard-to-Reach Populations for Survey Research: Using Facebook and Instagram Advertisements and In-Person Intercept in LGBT Bars and Nightclubs to Recruit LGBT Young Adults.

    Science.gov (United States)

    Guillory, Jamie; Wiant, Kristine F; Farrelly, Matthew; Fiacco, Leah; Alam, Ishrat; Hoffman, Leah; Crankshaw, Erik; Delahanty, Janine; Alexander, Tesfa N

    2018-06-18

    Tobacco public education campaigns focus increasingly on hard-to-reach populations at higher risk for smoking, prompting campaign creators and evaluators to develop strategies to reach hard-to-reach populations in virtual and physical spaces where they spend time. The aim of this study was to describe two novel recruitment strategies (in-person intercept interviews in lesbian, gay, bisexual, and transgender [LGBT] social venues and targeted social media ads) and compares characteristics of participants recruited via these strategies for the US Food and Drug Administration's This Free Life campaign evaluation targeting LGBT young adults who smoke cigarettes occasionally. We recruited LGBT adults aged 18-24 years in the United States via Facebook and Instagram ads (N=1709, mean age 20.94, SD 1.94) or intercept in LGBT social venues (N=2348, mean age 21.98, SD 1.69) for the baseline evaluation survey. Covariates related to recruitment strategy were age; race or ethnicity; LGBT identity; education; pride event attendance; and alcohol, cigarette, and social media use. Lesbian or gay women (adjusted odds ratio, AOR 1.88, 95% CI 1.54-2.29, PInstagram at least once daily were less likely to be recruited via social media (AOR 0.73, 95% CI 0.62-0.86, P<.001). Social media recruitment was faster (incidence rate ratio, IRR=3.31, 95% CI 3.11-3.52, P<.001) and less expensive (2.2% of combined social media and intercept recruitment cost) but had greater data quality issues-a larger percentage of social media respondents were lost because of duplicate and low-quality responses (374/4446, 8.41%) compared with intercept respondents lost to interviewer misrepresentation (15/4446, 0.34%; P<.001). Social media combined with intercept provided access to important LGBT subpopulations (eg, gender and other sexual minorities) and a more diverse sample. Social media methods have more data quality issues but are faster and less expensive than intercept. Recruiting hard-to-reach populations

  9. The cross-border project between France and Italy MARS+. Sub-project - Innovative technologies for the mechanization of the areas hard to reach

    Directory of Open Access Journals (Sweden)

    G. Tirrò

    2013-09-01

    Full Text Available The care and protection of the mountain areas and their traditional crops were some of the reasons that led regional governments of Liguria and Tuscany to participate in the strategic project “Sea, Countryside and Land: potentiate the strategic unitarily” (MARS +. This project has also involved the participation of the four cross-border regions: Tuscany (leader, Sardinia, Liguria and Corsica. The aim was to promote the development of the innovations and entrepreneurship in the rural areas in order to increase competitiveness. In particular, the subproject SC has provided the transfer of innovations to facilitate the processes of mechanization in vineyards and olive orchards in contexts defined as “heroic”, areas of high landscape and environmental value in which the typical cultures has been always carried out, generally, on terraces or slopes. These conditions require a great effort by the farmers and result in high production costs. The transfer of the innovations has provided the organization of demonstration days in which the technological solutions for the management of the farming operations in vineyards and olive orchards were proposed and tested. During these events, the participative process was fundamentally reconfirmed, not only as a means to expand the knowledge of innovative products, but also as an opportunity for farmers, retailers, manufacturers, researchers, and local administrators to interact and facilitate the development of other technologies. The parameters that led to the innovative solutions included: the small size, user-friendliness, agility, and the ability of operating on systems not easily accessible. These products must also ensure the ergonomics and safety of workers performing all the growing operations. A thorough research of the available technologies and prototypes, still under development, affirms the presence of many innovations. These innovations not only allow the execution of all the field

  10. Reaching the hard-to-reach.

    Science.gov (United States)

    Valdes, C

    1992-01-01

    Guatemala's family planning (FP) programs are innovative but contraceptive use is only 23%. Total fertility is 5.3 children/woman, and the 9.5 million population will double in 23 years. The problem is poverty and illiteracy among rural residents removed from health services. 80% live in poverty and 80% are illiterate. Government effort is devoted to combating diseases such as diarrhea so there are few funds for implementing a comprehensive population policy. There is support within the national government but FP lacks priority status. APROFAM's goals are to use innovative marketing methods to inform the rural population who lack access to and knowledge about FP. Service delivery is constrained by the difficulty in reaching remote areas where 4 out of 10 indigenous Guatemalans live. Infant mortality can reach as high as 200/1000 live births. Population growth has slowed, and APROFAM plans to reach 16,000 more in the future. Promotions are conducted in several languages and aired on radio, television, and in the print media. It has been found that market research is the most effective strategy in reaching indigenous families. APROFAM has also been effective in upgrading service facilities through training, client surveys, and setting improved clinic standards. Breastfeeding, training, and voluntary sterilization programs contribute to the primary care effort. The example is given of Paulina Lebron from a very poor area who has learned how to space her children and thus improve the standard of living for her family. Eventually, she convinced herself and her family that sterilization was necessary, and now the couple enjoy the bliss of newlyweds without fear of pregnancy.

  11. Group key management

    Energy Technology Data Exchange (ETDEWEB)

    Dunigan, T.; Cao, C.

    1997-08-01

    This report describes an architecture and implementation for doing group key management over a data communications network. The architecture describes a protocol for establishing a shared encryption key among an authenticated and authorized collection of network entities. Group access requires one or more authorization certificates. The implementation includes a simple public key and certificate infrastructure. Multicast is used for some of the key management messages. An application programming interface multiplexes key management and user application messages. An implementation using the new IP security protocols is postulated. The architecture is compared with other group key management proposals, and the performance and the limitations of the implementation are described.

  12. Using Exploratory Focus Groups to Inform the Development of Targeted COPD Self-Management Education DVDs for Rural Patients

    Directory of Open Access Journals (Sweden)

    Michael Stellefson

    2010-01-01

    Full Text Available This exploratory study assessed the self-management learning needs, experiences, and perspectives of COPD patients treated at a Certified Federal Rural Health Clinic to inform the development of a COPD self-management DVD. A purposive, homogeneous sample of COPD patients participated in focus group interviews. Data from these interviews were referenced to edit a library of Rvision COPD self-management DVDs into a single condensed DVD containing only the most pertinent self-management topics. Patients reported a lack of knowledge and skill development related to purse lipped breathing, controlled coughing, and stress management; while medication management skills were found to be quite adequate. Engaging rural communities in formal qualitative inquiries to describe COPD specific needs for self-management may lead to future use of educational technologies aimed at improving quality of life for these rural, hard to reach populations.

  13. The Liabilities Management Group

    International Nuclear Information System (INIS)

    Whitehead, A.W.

    1998-01-01

    The Liabilities Management Group (LMG) was initiated by DTI. It is a cooperative forum which was set up in 1995. The current participants are DTI, UKAEA, NLM (for BNFL), MOD and Magnox Electric. The LMG was initiated to produce closer cooperation between public sector liability management organizations, achieve more cost-effective management of UK nuclear liabilities and enhance development of the UK nuclear decommissioning and waste management strategy. The objectives are to compare practices between liabilities management organizations discuss the scope for collaboration identify priority areas for possible collaboration agree action plans for exploring and undertaking such collaboration.Four task forces have been formed to look at specific areas (R and D, safety, contracts, and project management) and each reports separately to the LMG. The LMG has achieved its original aim of bringing together those with public sector liability management responsibilities. All participants feel that the LMG has been useful and that it should continue. Looking to the future, there is a continuing need for the LMG to facilitate removal of barriers to the achievement of best value for money. The LMG might also consider addressing the 'business process' elements that a liability management organization must be good at in order to define best practice in these. (author)

  14. Future of energy managers groups

    Energy Technology Data Exchange (ETDEWEB)

    Henshaw, T.

    1979-07-01

    The objectives of the Energy Managers Groups, formed to provide a regular opportunity for industry and commerce to exchange views and experiences on energy conservation matters are discussed. Group procedure, liaison and cooperation, government support, and options for the future are discussed. (MCW)

  15. The Lung Screen Uptake Trial (LSUT): protocol for a randomised controlled demonstration lung cancer screening pilot testing a targeted invitation strategy for high risk and 'hard-to-reach' patients.

    Science.gov (United States)

    Quaife, Samantha L; Ruparel, Mamta; Beeken, Rebecca J; McEwen, Andy; Isitt, John; Nolan, Gary; Sennett, Karen; Baldwin, David R; Duffy, Stephen W; Janes, Samuel M; Wardle, Jane

    2016-04-20

    Participation in low-dose CT (LDCT) lung cancer screening offered in the trial context has been poor, especially among smokers from socioeconomically deprived backgrounds; a group for whom the risk-benefit ratio is improved due to their high risk of lung cancer. Attracting high risk participants is essential to the success and equity of any future screening programme. This study will investigate whether the observed low and biased uptake of screening can be improved using a targeted invitation strategy. A randomised controlled trial design will be used to test whether targeted invitation materials are effective at improving engagement with an offer of lung cancer screening for high risk candidates. Two thousand patients aged 60-75 and recorded as a smoker within the last five years by their GP, will be identified from primary care records and individually randomised to receive either intervention invitation materials (which take a targeted, stepped and low burden approach to information provision prior to the appointment) or control invitation materials. The primary outcome is uptake of a nurse-led 'lung health check' hospital appointment, during which patients will be offered a spirometry test, an exhaled carbon monoxide (CO) reading, and an LDCT if eligible. Initial data on demographics (i.e. age, sex, ethnicity, deprivation score) and smoking status will be collected in primary care and analysed to explore differences between attenders and non-attenders with respect to invitation group. Those who attend the lung health check will have further data on smoking collected during their appointment (including pack-year history, nicotine dependence and confidence to quit). Secondary outcomes will include willingness to be screened, uptake of LDCT and measures of informed decision-making to ensure the latter is not compromised by either invitation strategy. If effective at improving informed uptake of screening and reducing bias in participation, this invitation

  16. Group Decisions in Value Management

    Directory of Open Access Journals (Sweden)

    Christiono Utomo

    2015-04-01

    Full Text Available This research deals with a technique to expedite group decision making during the selection of technical solutions for value management process. Selection of a solution from a set of alternatives is facilitated by evaluating using multicriteria decision making techniques. During the process, every possible solution is rated on criteria of function and cost. Function deals more with quality than with quantity, and cost can be calculated based on the theoretical time value of money. Decision-making techniques based on satisfying games are applied to determine the relative function and cost of solutions and hence their relative value. The functions were determined by function analysis system technique. Analytical hierarchy process was applied to decision making and life-cycle cost analysis were used to calculate cost. Cooperative decision making was shown to consist of identifying agreement options, analyzing, and forming coalitions. The objective was attained using the satisfying game model as a basis for two main preferences. The model will improve the value of decision regarding design. It further emphasizes the importance of performance evaluation in the design process and value analysis. The result of the implementation, when applied to the selection of a building wall system, demonstrates a process of selecting the most valuable technical solution as the best-fit option for all decision makers. This work is relevant to group decision making and negotiation, as it aims to provide a framework to support negotiation in design activity.

  17. Constructive Management of Conflict in Groups.

    Science.gov (United States)

    Mitchell, Rex C.; Mitchell, Rie R.

    1984-01-01

    Provides a concise overview of important conflict management concepts and strategies for those working in group settings. Presents a brief conceptual basis for understanding conflict and group memebers' behavior when in conflict, followed by specific recommendations for managing and making use of conflict in groups. (JAC)

  18. Zidan Management Group, Inc. Information Sheet

    Science.gov (United States)

    Zidan Management Group, Inc. (the Company) is located in Indianapolis, Indiana. The settlement involves renovation activities conducted at property constructed prior to 1978, located in Kalamazoo, Michigan.

  19. Report of the ERIC Management Review Group.

    Science.gov (United States)

    Carter, Launor F.; And Others

    The mission of the ERIC Management Review Group was to examine the practices and procedures used by Central ERIC Management in their guidance and management of the 19 ERIC clearinghouses. The major topics covered in this report are: recommendations; the role of the clearinghouses; the bibliographic and documentation function; the interpretation…

  20. Can Management Potential Be Revealed in Groups?

    Science.gov (United States)

    Chartrand, P. J.; Jackson, D.

    1971-01-01

    Videotaping small group problem solving sessions and applying Bales Social Interaction scale can give valuable insight into areas where people (particularly managers) can profitably spend time developing themselves. (Author/EB)

  1. Proses Knowledge Management di Semen Indonesia Group

    OpenAIRE

    Putri, Natalia Yan

    2017-01-01

    Penelitian ini dilakukan untuk mengetahui prosesknowledge management yang ada di Perusahaan Semen IndonesiaGroup, yakni PT Semen Gresik, PT Semen Padang, PT SemenTonasa. Proses knowledge management dapat dilakukan denganpenciptaan pengetahuan, berbagi pengetahuan dan penggunaankembali pengetahuan. Penelitian ini menggunakan metodekualitatif dengan wawancara. Validasi data menggunakan codingdan uji triangulasi sumber data dan teori.

  2. Critical success factors for managing purchasing groups

    NARCIS (Netherlands)

    Schotanus, Fredo; Telgen, Jan; de Boer, L.

    2010-01-01

    In this article, we identify critical success factors for managing small and intensive purchasing groups by comparing successful and unsuccessful purchasing groups in a large-scale survey. The analysis of our data set suggests the following success factors: no enforced participation, sufficient

  3. Total Quality Management (TQM): Group Dynamics Workshop

    Science.gov (United States)

    1990-05-15

    take for these changes to penetrate most OSD agencies. - The unique organizational culture, structure, and functioning of OSD (i.e., a gigantic size...Performing (group problem solving; Performing diagnosing and solving quality problems and sele2cting and implementing solutions). Total Quality Management...Stage, the quality improvement group diagnoses the quality problem/opportunity, gathers the right kind of quantitative data, and formulates, selects, and

  4. CHALLANGES OF MANAGING WORKFORCE : Posti Group Oyj

    OpenAIRE

    Dhaunya , Rajendra

    2015-01-01

    The aim of this thesis project was to analyze the challenges of managing workforce and its minimizing techniques according to current changing trends in delivery department of Posti Group Oyj. The project was taken forward in co-ordination with supervisors where the qualitative method of research “Interview” was used to analyze the outcomes of questionnaire. The interview was conducted with three different supervisors. Communication and cultural challenge were mostly focused by them. Only rel...

  5. 75 FR 34476 - Glen Canyon Dam Adaptive Management Work Group

    Science.gov (United States)

    2010-06-17

    ... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Glen Canyon Dam Adaptive Management Work Group... Management Work Group. The purpose of the Adaptive Management Work Group is to advise and to provide... of the Glen Canyon Dam Adaptive Management Work Group is in the public interest in connection with...

  6. Pain management in pediatric age group

    Directory of Open Access Journals (Sweden)

    R Namrata

    2009-01-01

    Full Text Available The management of pain in palliative care of children is somewhat different from that in adults.The use of opioids in pediatric palliative care presents some unique challenges. Confident and rational use of opioids, illustrated by WHO Guidelines is essential for adequate management of pain in children with life limiting conditions.

  7. Integrated sign management system : ADOT maintenance group

    Science.gov (United States)

    2003-12-01

    The Arizona Department of Transportation (ADOT) maintains and manages an inventory of roadway signs. Before the implementation of this project, sign technicians maintained inventory records on individual laptops to track their daily sign maintenance ...

  8. 77 FR 9265 - Glen Canyon Dam Adaptive Management Work Group

    Science.gov (United States)

    2012-02-16

    ... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Glen Canyon Dam Adaptive Management Work Group... Adaptive Management Work Group (AMWG) makes recommendations to the Secretary of the Interior concerning.... L. 102-575) of 1992. The AMP includes a Federal advisory committee, the AMWG, a technical work group...

  9. 78 FR 7810 - Glen Canyon Dam Adaptive Management Work Group

    Science.gov (United States)

    2013-02-04

    ... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Glen Canyon Dam Adaptive Management Work Group... Adaptive Management Work Group (AMWG) makes recommendations to the Secretary of the Interior concerning..., the AMWG, a technical work group (TWG), a Grand Canyon Monitoring and Research Center, and independent...

  10. 78 FR 21415 - Glen Canyon Dam Adaptive Management Work Group

    Science.gov (United States)

    2013-04-10

    ... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Glen Canyon Dam Adaptive Management Work Group... Adaptive Management Work Group (AMWG) makes recommendations to the Secretary of the Interior concerning... Federal advisory committee, the AMWG, a technical work group, a Grand Canyon Monitoring and Research...

  11. 77 FR 22801 - Glen Canyon Dam Adaptive Management Work Group

    Science.gov (United States)

    2012-04-17

    ... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Glen Canyon Dam Adaptive Management Work Group...). SUMMARY: The Glen Canyon Dam Adaptive Management Work Group (AMWG) makes recommendations to the Secretary..., the AMWG, a technical work group, a Grand Canyon Monitoring and Research Center, and independent...

  12. 77 FR 45370 - Trinity Adaptive Management Working Group

    Science.gov (United States)

    2012-07-31

    ...-FF08EACT00] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders... take place at the North Fork Grange Hall, Dutch Creek Road, Junction City, CA 96048. The group will...

  13. 76 FR 24516 - Glen Canyon Dam Adaptive Management Work Group

    Science.gov (United States)

    2011-05-02

    ... DEPARTMENT OF THE INTERIOR Bureau of Reclamation Glen Canyon Dam Adaptive Management Work Group... Adaptive Management Work Group (AMWG) makes recommendations to the Secretary of the Interior concerning..., the AMWG, a technical work group (TWG), a Grand Canyon Monitoring and Research Center, and independent...

  14. Medical group management: a marketing orientation.

    Science.gov (United States)

    Bopp, K D; Allcorn, S

    1986-09-01

    This article considers the pragmatic aspects of conducting a situation/marketing audit for group medical practices. This audit is a key component in the formulation of a competitive strategy and the development of a marketing program. Given are a series of questions that may be used by medical groups to guide assessment of the opportunities and threats present in the environment as well as the strengths and weaknesses of the organization in meeting the environmental challenges. Furthermore, the article provides a framework for thinking about strategy and the variables that should be considered and aligned to achieve effective implementation of strategy. Finally, the parameters are outlined for deciding on a marketing program: the mix of marketing tools (service design, distribution channels, pricing and promotion) that should be employed to offensively and/or defensively position the medical group in the competitive marketplace.

  15. Anxiety management groups in clinical practice.

    Science.gov (United States)

    Childs-Clarke, A; Whitfield, W; Cadbury, S; Sandu, S

    Anxiety symptoms are commonly reported both in patients and in the general population. There is also increasing concern being expressed over the widespread use of prescribed anxiolytics. This has encouraged the development of psychological interventions for both specific and generalised anxiety. In this paper, 29 patients, most of whom suffered from generalised or free-floating anxiety, were treated in small groups as part of a staff training programme. Their treatment was standardised, and consisted of progressive muscular relaxation, cognitive therapy and an educational input as to the nature of anxiety. Two measures, the Spielberger Trait Scale and an individualised problem rating scale were completed before and after the group and at three months follow-up. All but one of the results was statistically significant. The implications of these results are discussed.

  16. Increasing Contraceptive Access for Hard-to-Reach Populations With Vouchers and Social Franchising in Uganda.

    Science.gov (United States)

    Bellows, Benjamin; Mackay, Anna; Dingle, Antonia; Tuyiragize, Richard; Nnyombi, William; Dasgupta, Aisha

    2017-09-27

    From 2001 to 2011, modern contraceptive prevalence in Uganda increased from 18% to 26%. However, modern method use, in particular use of long-acting reversible contraceptives (LARCs) and permanent methods (PMs), remained low. In the 2011 Uganda Demographic and Health Survey, only 1 of 5 married women used a LARC or PM even though 34% indicated an unmet need for contraception. Between 2011 and 2014, a social franchise and family planning voucher program, supporting 400 private facilities to provide family planning counseling and broaden contraceptive choice by adding LARCs and PMs to the service mix, offered a voucher to enable poor women to access family planning services at franchised facilities. This study analyzes service trends and voucher client demographics and estimates the contribution of the program to increasing contraceptive prevalence in Uganda, using the Impact 2 model developed by Marie Stopes International. Between March 2011 and December 2014, 330,826 women received a family planning service using the voucher, of which 70% of voucher clients chose an implant and 25% chose an intrauterine device. The median age of voucher users was 28 years; 79% had no education or only a primary education; and 48% reported they were unemployed or a housewife. We estimated that by 2014, 280,000 of the approximately 8,600,000 women of reproductive age in Uganda were using a contraceptive method provided by the program and that 120,000 of the clients were "additional users" of contraception, contributing 1.4 percentage points to the national modern contraceptive prevalence rate. The combination of family planning vouchers and a franchise-based quality improvement initiative can leverage existing private health infrastructure to substantially expand family planning access and choice for disadvantaged populations and potentially improve contraceptive prevalence when scaled nationally. © Bellows et al.

  17. APPLICATION OF SENTINEL-1 RADAR DATA FOR MAPPING HARD-TO-REACH NORTHERN TERRITORIES

    Directory of Open Access Journals (Sweden)

    Е. А. Baldina

    2017-01-01

    Full Text Available The new European space satellites Sentinel-1A and 1B with C-band radars on board, launched in 2014 and 2016 respectively, provide regular radar data on the Earth’s surface with high temporal resolution. These new non-commercial data provides extensive opportunities for research of remote Arctic territories, poorly supplied with optical images due to cloud conditions. Difficulties in recognizing objects on radar images can be compensated for by the possibility of using multiple repeated surveys, which make it possible to identify areas of the terrain which are similar in character of changes. In the study, four Sentinel-1A images of the largest from the New Siberian islands – Kotelny – were used, which were acquired during the summer period from July 3 to August 20, 2015. After preprocessing aimed at improving the visual properties and coregistration of the multitemporal images, an automated clustering of the multitemporal image set was carried out. Clustering results were analyzed on comparison with additional sources of spatial information. Both specialized software for Sentinel-1 radar data processing - SNAP, and the GIS software complex ArcGIS were used. The latter provided the creation of the spatial data base for comparing the results of radar data processing and cartographic sources. The map of the territory zoning was obtained as clustering results which is based on the changes in the normalized radar cross section (sigma nought over the summer period, and the approximate correspondence of the areas to the main types of the relief and landscapes of the island was established.

  18. Increasing Contraceptive Access for Hard-to-Reach Populations With Vouchers and Social Franchising in Uganda

    Science.gov (United States)

    Bellows, Benjamin; Mackay, Anna; Dingle, Antonia; Tuyiragize, Richard; Nnyombi, William; Dasgupta, Aisha

    2017-01-01

    ABSTRACT From 2001 to 2011, modern contraceptive prevalence in Uganda increased from 18% to 26%. However, modern method use, in particular use of long-acting reversible contraceptives (LARCs) and permanent methods (PMs), remained low. In the 2011 Uganda Demographic and Health Survey, only 1 of 5 married women used a LARC or PM even though 34% indicated an unmet need for contraception. Between 2011 and 2014, a social franchise and family planning voucher program, supporting 400 private facilities to provide family planning counseling and broaden contraceptive choice by adding LARCs and PMs to the service mix, offered a voucher to enable poor women to access family planning services at franchised facilities. This study analyzes service trends and voucher client demographics and estimates the contribution of the program to increasing contraceptive prevalence in Uganda, using the Impact 2 model developed by Marie Stopes International. Between March 2011 and December 2014, 330,826 women received a family planning service using the voucher, of which 70% of voucher clients chose an implant and 25% chose an intrauterine device. The median age of voucher users was 28 years; 79% had no education or only a primary education; and 48% reported they were unemployed or a housewife. We estimated that by 2014, 280,000 of the approximately 8,600,000 women of reproductive age in Uganda were using a contraceptive method provided by the program and that 120,000 of the clients were “additional users” of contraception, contributing 1.4 percentage points to the national modern contraceptive prevalence rate. The combination of family planning vouchers and a franchise-based quality improvement initiative can leverage existing private health infrastructure to substantially expand family planning access and choice for disadvantaged populations and potentially improve contraceptive prevalence when scaled nationally. PMID:28963175

  19. Provision of Education to the "Hard to Reach" amidst Discontinuity in Nomadic Communities in Kenya

    Science.gov (United States)

    Ayiro, Laban P.; Sang, James K.

    2016-01-01

    This study explores why nomadic children in the counties of Turkana and West Pokot are left behind in the primary education process despite free primary education (FPE), and considers the variables that contribute to high dropout rates, low enrollment, poor attendance, and unsatisfactory academic achievement with a view of bringing out possible…

  20. 75 FR 17158 - Trinity Adaptive Management Working Group

    Science.gov (United States)

    2010-04-05

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R8-FHC-2010-N065; 81331-1334-8TWG-W4] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the...

  1. 75 FR 51284 - Trinity Adaptive Management Working Group

    Science.gov (United States)

    2010-08-19

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R8-FHC-2010-N168; 81331-1334-8TWG-W4] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the...

  2. 77 FR 10766 - Trinity Adaptive Management Working Group

    Science.gov (United States)

    2012-02-23

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R8-FHC-2012-N039; FXFR1334088TWG0W4-123-FF08EACT00] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders...

  3. 75 FR 70947 - Trinity Adaptive Management Working Group

    Science.gov (United States)

    2010-11-19

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R8-FHC-2010-N253; 81331-1334-8TWG-W4] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the...

  4. 76 FR 52345 - Trinity Adaptive Management Working Group

    Science.gov (United States)

    2011-08-22

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R8-FHC-2011-N168; 81331-1334-8TWG-W4] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the...

  5. 76 FR 70751 - Trinity Adaptive Management Working Group

    Science.gov (United States)

    2011-11-15

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R8-FHC-2011-N237; FXFR1334088TWG0W4] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the...

  6. 75 FR 27814 - Trinity Adaptive Management Working Group

    Science.gov (United States)

    2010-05-18

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R8-FHC-2010-N101; 81331-1334-8TWG-W4] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the...

  7. 76 FR 14044 - Trinity Adaptive Management Working Group

    Science.gov (United States)

    2011-03-15

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R8-FHC-2011-N044; 81331-1334-8TWG-W4] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the...

  8. 77 FR 74203 - Trinity Adaptive Management Working Group

    Science.gov (United States)

    2012-12-13

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R8-FHC-2012-N266; FXFR1334088TWG0W4-123-FF08EACT00] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders...

  9. 76 FR 34248 - Trinity Adaptive Management Working Group

    Science.gov (United States)

    2011-06-13

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R8-FHC-2011-N116; 81331-1334-8TWG-W4] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the...

  10. 76 FR 23621 - Trinity Adaptive Management Working Group

    Science.gov (United States)

    2011-04-27

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R8-FHC-2011-N083; 81331-1334-8TWG-W4] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the...

  11. 77 FR 30314 - Trinity Adaptive Management Working Group

    Science.gov (United States)

    2012-05-22

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R8-FHC-2012-N124: FXFR1334088TWG0W4-123-FF08EACT00] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders...

  12. 77 FR 50155 - Trinity Adaptive Management Working Group

    Science.gov (United States)

    2012-08-20

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R8-FHC-2012-N201;FXFR1334088TWG0W4-123-FF08EACT00] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders...

  13. 75 FR 10501 - Trinity Adaptive Management Working Group

    Science.gov (United States)

    2010-03-08

    ... DEPARTMENT OF THE INTERIOR Fish and Wildlife Service [FWS-R8-FHC-2010-N041; 81331-1334-8TWG-W4] Trinity Adaptive Management Working Group AGENCY: Fish and Wildlife Service, Interior. ACTION: Notice of meeting. SUMMARY: The Trinity Adaptive Management Working Group (TAMWG) affords stakeholders the...

  14. Diabetes quality management in care groups and outpatient clinics

    NARCIS (Netherlands)

    Campmans-Kuijpers, M.J.E.

    2015-01-01

    This research project relates to diabetes quality management in Dutch care groups (40-200 GP practices) and outpatient clinics. Improvement of quality management at an organisational level on top of the existing quality management in separate general practices is expected to be associated with

  15. Introduction of the UNIX International Performance Management Work Group

    Science.gov (United States)

    Newman, Henry

    1993-01-01

    In this paper we presented the planned direction of the UNIX International Performance Management Work Group. This group consists of concerned system developers and users who have organized to synthesize recommendations for standard UNIX performance management subsystem interfaces and architectures. The purpose of these recommendations is to provide a core set of performance management functions and these functions can be used to build tools by hardware system developers, vertical application software developers, and performance application software developers.

  16. Management systems, control and motivation methods used at enterprises groups

    OpenAIRE

    Leugaudaitė, Dalia

    2017-01-01

    MANAGEMENT SYSTEMS, CONTROL AND MOTIVATION METHODS USED AT ENTERPRISES GROUPS 69 pages, 3 tables, 25 pictures, 39 literature references. The aim of the Master's paper is to determine the implementation impact of the motivation and controlling methods to achieve efficiency in management systems. As a result of the scientific literature analysis, the advantages and disadvantages of the management systems were selected. These statements were used for the primary survey of the initial group of co...

  17. Managing parental groups: personal impact of a group leadership course for child healthcare nurses.

    OpenAIRE

    Lefevre, Åsa; Lundqvist, Pia; Drevenhorn, Eva; Hallström, Inger

    2017-01-01

    AIMS AND OBJECTIVES: To investigate the experience and personal impact of a group leadership course for child healthcare nurses.BACKGROUND: During their child's first year, all parents in Sweden are invited to participate in parental groups within the child health service; however, only 49% choose to participate. Despite extensive experience, child healthcare nurses find managing parental groups challenging and express a need for training in group dynamics and group leadership.DESIGN: The stu...

  18. Knowledge Management in the Neutronics Group of CAREM Project

    International Nuclear Information System (INIS)

    Torres, L.; Lopasso, E.

    2016-01-01

    Full text: An analysis of the Neutronics Group of CAREM25 project was performed in order to plan for the gradual implementation of knowledge management. The group structure, performed tasks and the way these tasks are linked together were studied. Staff functions within the group, profiles of each position and the training and education of human resources were also analyzed. (author

  19. Managing parental groups: personal impact of a group leadership course for child healthcare nurses.

    Science.gov (United States)

    Lefèvre, Åsa; Lundqvist, Pia; Drevenhorn, Eva; Hallström, Inger

    2017-02-01

    To investigate the experience and personal impact of a group leadership course for child healthcare nurses. During their child's first year, all parents in Sweden are invited to participate in parental groups within the child health service; however, only 49% choose to participate. Despite extensive experience, child healthcare nurses find managing parental groups challenging and express a need for training in group dynamics and group leadership. The study was designed as a controlled study with a pretest/post-test design where the participants form their own control group. A group leadership course was given to 56 child healthcare nurses and evaluated in a pre- and postintervention questionnaire, a course evaluation and an interview with the course leaders. The child healthcare nurses felt their group leadership skills were strengthened and the majority (96%) felt that the course had changed their way of leading parental groups. They felt that the group leader role had been clarified and that they had obtained several new tools to use in their groups. Clarifying the role of group leader and adding knowledge about group leadership and dynamics seems to have increased the self-confidence for child healthcare nurses in group leadership. Improved confidence in group management might motivate the child healthcare nurses to further develop parental groups to attract the parents who currently choose not to participate. © 2016 John Wiley & Sons Ltd.

  20. Group Policy Fundamentals, Security, and the Managed Desktop

    CERN Document Server

    Moskowitz, Jeremy

    2010-01-01

    The ultimate Group Policy guide-now updated for Windows 7 and Server 2008 R2!. IT and network administrators can streamline their Windows Server management tasks by using Group Policy tools to automate or implement rules, processes, or new security across the enterprise. In this comprehensive guide, Microsoft Group Policy MVP Jeremy Moskowitz thoroughly explores Group Policy across all Windows platforms, including the latest on Windows 7 and Server 2008 R2. If you're a Windows network administrator managing scores of users and computers, you need this essential reference on your desk.: Covers

  1. The Weight Management Dietetics Practice Group collecting outcomes mentoring program

    Science.gov (United States)

    The is a newsletter article for the Academy of Nutrition and Dietetics (AND), Weight Management Dietetics Practice Group (WM DPG). The article presents the ‘Collecting Outcomes Mentoring Program’ for 2017 that is managed by the Research Section of the WM DPG. Dietitians in the WM DGP are provided wi...

  2. Factors facilitating dementia case management : Results of online focus groups

    NARCIS (Netherlands)

    Dr. J. de Lange; E. Deusing; I.F.M. van Asch; J. Peeters; M. Zwaanswijk; A.M. Pot; A.L. Francke

    2016-01-01

    To obtain insight into facilitating factors for case management in dementia care, we conducted a qualitative study with 13 online focus groups (OFGs). Participants were professionals involved in dementia case management (N = 99). We used mind-maps and the method of constant comparison for analysis.

  3. Using Leadered Groups in Organizational Behavior and Management Survey Courses

    Science.gov (United States)

    Andre, Rae

    2011-01-01

    In organizational behavior and management survey courses, students are likely to maximize certain career-appropriate knowledge when their classroom groups are leadered rather than leaderless. Using leadered groups facilitates the learning of the professional and managerial skills associated with formal leadership while reducing some problematic…

  4. Group decision-making techniques for natural resource management applications

    Science.gov (United States)

    Coughlan, Beth A.K.; Armour, Carl L.

    1992-01-01

    This report is an introduction to decision analysis and problem-solving techniques for professionals in natural resource management. Although these managers are often called upon to make complex decisions, their training in the natural sciences seldom provides exposure to the decision-making tools developed in management science. Our purpose is to being to fill this gap. We present a general analysis of the pitfalls of group problem solving, and suggestions for improved interactions followed by the specific techniques. Selected techniques are illustrated. The material is easy to understand and apply without previous training or excessive study and is applicable to natural resource management issues.

  5. The role of enterprise asset management system in the PVO group`s business

    Energy Technology Data Exchange (ETDEWEB)

    Jaervinen, J. [RAMSE Consulting Oy, Helsinki (Finland)

    1998-12-31

    This presentation describes the role of the Enterprise Asset Management (EAM) and Enterprise Document Management (EDM) in the PVO Group`s business. The use of the functionality of the EAM (Immpower) and EDM (Documentum) is not limited only to the plant maintenance. All power plants and some other business functions and units will use the system in the future for financial management, activity based costing, purchasing, of materials, office supplies and fuel, invoice matching, project budgeting and costing, real estate management etc. The technical service concept of IT solution is also described in this presentation. The Information Management Strategy development as background to the project is also outlined together with the company information. The benefits of the common EAM system and related business process needs are also described. (orig.)

  6. The role of enterprise asset management system in the PVO group`s business

    Energy Technology Data Exchange (ETDEWEB)

    Jaervinen, J [RAMSE Consulting Oy, Helsinki (Finland)

    1999-12-31

    This presentation describes the role of the Enterprise Asset Management (EAM) and Enterprise Document Management (EDM) in the PVO Group`s business. The use of the functionality of the EAM (Immpower) and EDM (Documentum) is not limited only to the plant maintenance. All power plants and some other business functions and units will use the system in the future for financial management, activity based costing, purchasing, of materials, office supplies and fuel, invoice matching, project budgeting and costing, real estate management etc. The technical service concept of IT solution is also described in this presentation. The Information Management Strategy development as background to the project is also outlined together with the company information. The benefits of the common EAM system and related business process needs are also described. (orig.)

  7. Consolidation of medical groups into physician practice management organizations.

    Science.gov (United States)

    Robinson, J C

    1998-01-14

    Medical groups are growing and merging to improve efficiency and bargaining leverage in the competitive managed care environment. An increasing number are affiliating with physician practice management (PPM) firms that offer capital financing, expertise in utilization management, and global capitation contracts with health insurance entities. These physician organizations provide an alternative to affiliation with a hospital system and to individual physician contracting with health plans. To describe the growth, structure, and strategy of PPM organizations that coordinate medical groups in multiple markets and contract with health maintenance organizations (HMOs). Case studies, including interviews with administrative and clinical leaders, review of company documents, and analysis of documents from investment bankers, the Securities and Exchange Commission, and industry observers. Medical groups and independent practice associations (IPAs) in California and New Jersey affiliated with MedPartners, FPA Medical Management, and UniMed. Growth in number of primary care and specialty care physicians employed by and contracting with affiliated medical groups; growth in patient enrollment from commercial, Medicare, and Medicaid HMOs; growth in capitation and noncapitation revenues; structure and governance of affiliated management service organizations and professional corporations; and contracting strategies with HMOs. Between 1994 and 1996, medical groups and IPAs affiliated with 3 PPMs grew from 3787 to 25763 physicians; 65% of employed physicians provide primary care, while the majority of contracting physicians provide specialty care. Patient enrollment in HMOs grew from 285503 to 3028881. Annual capitation revenues grew from $190 million to $2.1 billion. Medical groups affiliated with PPMs are capitated for most professional, hospital, and ancillary clinical services and are increasingly delegated responsibility by HMOs for utilization management and quality

  8. THE MANAGEMENT SUBSIDIARIES: CORPORATE GOVERNANCE MECHANISMS IN GROUP OF COMPANIES

    Directory of Open Access Journals (Sweden)

    A. K. Tatulyan

    2016-01-01

    Full Text Available Many holdings in the process of converting its organizational structure to face several new problems, which reduce the overall efficiency of the management of its group of companies. Most often these problems are related to the control activities of subsidiaries. Due to the large number of organizations in the group of companies the Supervisory Board has no possibility to monitor all the activities of its sub-sidiaries, as a result of which most of these "daughters" more freedom and opportunity to conduct their activities without agreeing it with top management. Group of companies or integrated structures imply a close interaction between companies and coordination of their activities in the moment and end-to-end operational control. The main study is how the parent organization may be based on legitimate mechanisms to manage the activities of the subsidiary. The article is devoted to the interaction between subsidiaries and the parent organization in the group companies. It also discusses a variety of mecha-nisms through which the parent organization may influence the decisions made by subsidiaries. There is a very actual problem of management and control over the activities of subsidiaries and affiliates group companies that have a well developed organizational structure, a large number of subsidiaries and lead-ing the activities of several types. These mechanisms have already proven international practice and are promising in terms of adaptation to the management structure of the Russian groups of companies that will allow you to create the best conditions for conducting control activities of subsidiaries. The article describes some of the most common tools for the management of subsidiaries, for example is the direct involvement of senior management or even the owners of parent organization in the work of the Board of Directors of the subsidiary. The article discusses the contradictions that arise in the organization of the procedure of

  9. Evaluation of risk management and financial performance of BMW Group

    OpenAIRE

    Mysina, Amira

    2017-01-01

    Effective risk and financial management possess a great challenge for the multinational companies operating globally. Despite the increasing development of diverse hedging strategies against foreign exchange risk, global firms cannot fully foresee and measure the degree of the impact of foreign currency fluctuations. This paper aims to evaluate the exchange risk management and financial performance of the BMW Group from the year 2005 to 2016. Moreover, this paper is devoted to provide explana...

  10. The Nonactinide Isotope and Sealed Sources Management Group

    International Nuclear Information System (INIS)

    Low, J. L.; Polansky, G. F.; Parks, D. L.

    2002-01-01

    The Nonactinide Isotope and Sealed Sources Management Group (NISSMG) is sponsored by the Department of Energy (DOE) Office of Environmental Management and managed by Albuquerque Operations Office (DOE/AL) to serve as a complex-wide resource for the management of DOE-owned Nonactinide Isotope and Sealed Source (NISS) materials. NISS materials are defined as including: any isotope in sealed sources or standards; and isotopes, regardless of form, with atomic number less than 90. The NISSMG assists DOE sites with the storage, reuse, disposition, transportation, and processing of these materials. The NISSMG has focused its efforts to date at DOE closure sites due to the immediacy of their problems. Recently, these efforts were broadened to include closure facilities at non-closure sites. Eventually, the NISSMG plans to make its resources available to all DOE sites. This paper documents the lessons learned in managing NISS materials at DOE sites to date

  11. Group anxiety management: effectiveness, perceived helpfulness and follow-up.

    Science.gov (United States)

    Cadbury, S; Childs-Clark, A; Sandhu, S

    1990-05-01

    An evaluation was conducted on out-patient cognitive-behavioural anxiety management groups. Twenty-nine clients assessed before and after the group and at three-month follow-up showed significant improvement on self-report measures. A further follow-up on 21 clients, conducted by an independent assessor at an average of 11 months, showed greater improvement with time. Clients also rated how helpful they had found non-specific therapeutic factors, and specific anxiety management techniques. 'Universality' was the most helpful non-specific factor, and 'the explanation of anxiety' was the most helpful technique.

  12. Facebook Groups for the Management of Chronic Diseases.

    Science.gov (United States)

    Partridge, Stephanie R; Gallagher, Patrick; Freeman, Becky; Gallagher, Robyn

    2018-01-17

    The use of Facebook groups by health care researchers and professionals for chronic disease management, namely type 2 diabetes mellitus and coronary heart disease, is in its early stages and challenges are emerging. While Facebook groups offer great potential to deliver health support, research of Facebook groups for chronic disease management remains in its infancy, with robust evidence not yet available. Designing Facebook groups that are acceptable to users, health care researchers as well as health care professionals is a challenge, and there is a poor fit with traditional research and evaluation methods. Key recommendations for future research of Facebook groups for chronic disease management include: (1) iterative content development with input from the target patient population; (2) further understanding of the potential role of group "champions"; (3) ensuring the social media policies of health care institutions allow for real time online communication; and (4) utilizing comprehensive evaluation strategies, including the use of process evaluations. ©Stephanie R Partridge, Patrick Gallagher, Becky Freeman, Robyn Gallagher. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 17.01.2018.

  13. Conditioning Factors for Group Management in Blended Learning Scenarios

    NARCIS (Netherlands)

    Pérez-Sanagustín, Mar; Hernández-Leo, Davinia; Blat, Josep

    2009-01-01

    Pérez-Sanagustín, M., Hernández-Leo D., & Blat, J. (accepted). Conditioning Factors for Group Management in Blended Learning Scenarios. The 9th IEEE International Conference on Advanced Learning Technologies. July, 14-18, 2009, Riga, Latvia.

  14. Class Management and Homogeneous Grouping in Kindergarten Literacy Instruction

    Science.gov (United States)

    Hong, Guanglei; Pelletier, Janette; Hong, Yihua; Corter, Carl

    2010-01-01

    The purpose of this study is two-fold. Firstly the authors examine, given the amount of time allocated to literacy instruction, whether homogeneous grouping helps improve class manageability over the kindergarten year and whether individual students' externalizing problem behaviors will decrease in tandem. Secondly, they investigate whether the…

  15. Strategic Approach to Group Anger Management with Incarcerated Murderers.

    Science.gov (United States)

    Napolitano, Susan; Brown, Lillian G.

    1991-01-01

    Incarcerated male murderers manifested consistent changes in attitudes toward treatment efficacy and their culpability as function of participating in 12-week anger management groups. Four qualitatively different stages were evident during treatment as prisoners' resistive responses were actively encouraged: initial apathy, emerging interest in…

  16. Diagnosis-Related Groups (DRG and Hospital Business Performance Management

    Directory of Open Access Journals (Sweden)

    Szynkiewicz Piotr

    2014-12-01

    Full Text Available The goal of this article is to present the possibility of using Diagnosis- Related Groups (DRG in the hospital management process and to analyse the need for business performance management on the part of hospital management staff. The following research methods were used: literature analysis, case studies, and poll analysis. It is not possible to increase the effectiveness of operation of healthcare entities without increasing the importance of IT systems and using DRG more effectively in the management process. Training users in IT and the use of DRGs is important to achieving hospital effectiveness. The increased importance of analyses and planning in a hospital should be reflected in the organisational structure of service providers. Hospital controllers should have a similar role to those present in most companies in other industries.

  17. Group handoff management in low power microcell-femtocell network

    Directory of Open Access Journals (Sweden)

    Debashis De

    2017-02-01

    Full Text Available This paper presents an analytical model of group based hand-off management based on bird flocking behavior. In the proposed scheme, a number of mobile devices form a group if these devices move together for a long time duration. Although call delivery or call generation are performed individually, hand-off is performed in a group. Dynamic group formation, group division and group merging methods are proposed in this paper. From the simulation results it is demonstrated that approximately 75%, 65% and 90% reduction in power, cost and latency consumption can be obtained respectively using group hand-off management. Thus the proposed scheme is referred as green, economic and fast hand-off strategy. In this paper instead of a macrocell network, a microcell-femtocell network is considered as the transmission power of a microcell or a femtocell base station is much less than a macrocell base station. Simulation results present that the microcell-femtocell network achieves approximately 25–55% and 35–55% reduction in power transmission, and 50–65% and 15–45% reduction in path loss than only a macrocell network and macrocell-femtocell network respectively. Thus microcell-femtocell network is a power-efficient network.

  18. The management of social problems talk in a support group

    Directory of Open Access Journals (Sweden)

    Andrezza Gomes Peretti

    2013-01-01

    Full Text Available The comprehension of the health-disease process from a multifactorial perspective has allowed important transformations in the healthcare practices. In this article, we discuss the use of the support group as a resource for mental health care, analyzing how conversations about social issues are managed in this context. Based on contributions from the social constructionist movement, we analyzed the transcripts of the conversations developed in meetings of a support group offered to patients of a mental health outpatient clinic. The analysis of the process of meaning making indicates that the discourse of the social influence on mental health is not legitimized, due to a predominant individualistic discourse, which psychologizes care and is centered on the emotional analysis of the problems of the quotidian. We argue that this mode of management brings limits to the construction of the group as a device for promoting autonomy and encouraging the social transformation processes.

  19. THE FORMATION OF CONSCIENCE AND MANAGEMENT GROUPS IN ORGANIZATIONS

    Directory of Open Access Journals (Sweden)

    Neisa Maria, Martins da Cunha

    2010-01-01

    Full Text Available This paper presents theoretical proposals, as the Theory of Human Relations, especially the Theory of Group Dynamics and the Conscience Formation, which promote understanding and support for the conduct of the leaders in team management, aiming at a route suitable for questions, reflections, enabling new perceptions of self-consciousness, as Hegel says. It is worth highlighting that through these considerations, it becomes possible to conduct more realistic impacts triggered in the organizational culture, as from a better management of interpersonal relationships within teams, these teams have a training goal or not.

  20. Management of Assortment Inventory Groups in Selected Foundry

    Directory of Open Access Journals (Sweden)

    Szymszal J.

    2015-09-01

    Full Text Available As experience shows the practical, reliable assessment and optimisation of total costs of logistical processes implemented in supply chains of foundry plants is a quite complex and complicated process, because it requires to enclose all, without exception, performed actions, including them in various reference cross-sections, systematic activities and finally transforming them in a totally homogenous collection. Only solid analysis and assessment of assortment management in logistical supply systems in foundry plants of particular assortment groups allows to lower the supply costs significantly. In the article the analysis and assessment of the newest implemented optimising algorithms are presented in the process stock management of selected material groups used in a production process of a chosen foundry plant. A practical solution to solve a problem of rotary stock cost minimisation is given as well as of costs while creating a stock with the usage of economical volume and value of order.

  1. Scalable Multi-group Key Management for Advanced Metering Infrastructure

    OpenAIRE

    Benmalek , Mourad; Challal , Yacine; Bouabdallah , Abdelmadjid

    2015-01-01

    International audience; Advanced Metering Infrastructure (AMI) is composed of systems and networks to incorporate changes for modernizing the electricity grid, reduce peak loads, and meet energy efficiency targets. AMI is a privileged target for security attacks with potentially great damage against infrastructures and privacy. For this reason, Key Management has been identified as one of the most challenging topics in AMI development. In this paper, we propose a new Scalable multi-group key ...

  2. Managing Climate Risk. Integrating Adaptation into World Bank Group Operations

    International Nuclear Information System (INIS)

    Van Aalst, M.

    2006-08-01

    Climate change is already taking place, and further changes are inevitable. Developing countries, and particularly the poorest people in these countries, are most at risk. The impacts result not only from gradual changes in temperature and sea level but also, in particular, from increased climate variability and extremes, including more intense floods, droughts, and storms. These changes are already having major impacts on the economic performance of developing countries and on the lives and livelihoods of millions of poor people around the world. Climate change thus directly affects the World Bank Group's mission of eradicating poverty. It also puts at risk many projects in a wide range of sectors, including infrastructure, agriculture, human health, water resources, and environment. The risks include physical threats to the investments, potential underperformance, and the possibility that projects will indirectly contribute to rising vulnerability by, for example, triggering investment and settlement in high-risk areas. The way to address these concerns is not to separate climate change adaptation from other priorities but to integrate comprehensive climate risk management into development planning, programs, and projects. While there is a great need to heighten awareness of climate risk in Bank work, a large body of experience on climate risk management is already available, in analytical work, in country dialogues, and in a growing number of investment projects. This operational experience highlights the general ingredients for successful integration of climate risk management into the mainstream development agenda: getting the right sectoral departments and senior policy makers involved; incorporating risk management into economic planning; engaging a wide range of nongovernmental actors (businesses, nongovernmental organizations, communities, and so on); giving attention to regulatory issues; and choosing strategies that will pay off immediately under current

  3. Air Force Supply Management Analysis of Activity Groups Financial Reports, Prices, and Cash Management

    National Research Council Canada - National Science Library

    1998-01-01

    The Air Force supply management activity group provides about two million types of inventory items, including weapon system spare parts, fuels, and medical-dental supplies, to customers which consist...

  4. Diagnosis and Management of High Risk Group for Gastric Cancer

    Science.gov (United States)

    Yoon, Hyuk; Kim, Nayoung

    2015-01-01

    Gastric cancer is associated with high morbidity and mortality worldwide. To reduce the socioeconomic burden related to gastric cancer, it is very important to identify and manage high risk group for gastric cancer. In this review, we describe the general risk factors for gastric cancer and define high risk group for gastric cancer. We discuss strategies for the effective management of patients for the prevention and early detection of gastric cancer. Atrophic gastritis (AG) and intestinal metaplasia (IM) are the most significant risk factors for gastric cancer. Therefore, the accurate selection of individuals with AG and IM may be a key strategy for the prevention and/or early detection of gastric cancer. Although endoscopic evaluation using enhanced technologies such as narrow band imaging-magnification, the serum pepsinogen test, Helicobacter pylori serology, and trefoil factor 3 have been evaluated, a gold standard method to accurately select individuals with AG and IM has not emerged. In terms of managing patients at high risk of gastric cancer, it remains uncertain whether H. pylori eradication reverses and/or prevents the progression of AG and IM. Although endoscopic surveillance in high risk patients is expected to be beneficial, further prospective studies in large populations are needed to determine the optimal surveillance interval. PMID:25547086

  5. Group dynamics for the acquisition of competences in Project Management

    Science.gov (United States)

    Taguas, E. V.; Aguilar, M. C.; Castillo, C.; Polo, M. J.; Pérez, R.

    2012-04-01

    The Bologna Process promotes European citizens' employability from teaching fields in the University which implies the design of activities addressed to the development of skills for the labor market and engagement of employers. This work has been conceived for improving the formation of Engineering Project Management through group dynamics focused on: 1) the use of the creativity for solving problems; 2) promoting leadership capacities and social skills in multidisciplinary/multicultural work groups; 3) the ethical, social and environmental compromise; 4) the continuous learning. Different types of activities were designed: short activities of 15-30 minutes where fragments of books or songs are presented and discussed and long activities (2 h) where groups of students take different roles for solving common problems and situations within the Engineering Projects context. An electronic book with the content of the dynamics and the material for the students has been carried out. A sample of 20 students of Electronic Engineering degree which had participated at least in two dynamics, evaluated the utility for improving their formation in Engineering Project Management with a mark of 8.2 (scale 0-10, standard deviation equal to 0.9). On the other hand, the teachers observed how this type of work, promotes the interdisciplinary training and the acquisition of social skills, usually not-included in the objectives of the subjects.

  6. Management of group B streptococcal bacteriuria in pregnancy.

    Science.gov (United States)

    Allen, Victoria M; Yudin, Mark H

    2012-05-01

    To provide information regarding the management of group B streptococcal (GBS) bacteriuria to midwives, nurses, and physicians who are providing obstetrical care. The outcomes considered were neonatal GBS disease, preterm birth, pyelonephritis, chorioamnionitis, and recurrence of GBS colonization. Medline, PubMed, and the Cochrane database were searched for articles published in English to December 2010 on the topic of GBS bacteriuria in pregnancy. Bacteriuria is defined in this clinical practice guideline as the presence of bacteria in urine, regardless of the number of colony-forming units per mL (CFU/mL). Low colony counts refer to pregnancies in which it is appropriate to treat GBS bacteriuria to optimize maternal and perinatal outcomes, to reduce the occurrences of antibiotic anaphylaxis, and to prevent increases in antibiotic resistance to GBS and non-GBS pathogens. No cost-benefit analysis is provided. 1. Treatment of any bacteriuria with colony counts ≥ 100 000 CFU/mL in pregnancy is an accepted and recommended strategy and includes treatment with appropriate antibiotics. (II-2A) 2. Women with documented group B streptococcal bacteriuria (regardless of level of colony-forming units per mL) in the current pregnancy should be treated at the time of labour or rupture of membranes with appropriate intravenous antibiotics for the prevention of early-onset neonatal group B streptococcal disease. (II-2A) 3. Asymptomatic women with urinary group B streptococcal colony counts pregnancy should not be treated with antibiotics for the prevention of adverse maternal and perinatal outcomes such as pyelonephritis, chorioamnionitis, or preterm birth. (II-2E) 4. Women with documented group B streptococcal bacteriuria should not be re-screened by genital tract culture or urinary culture in the third trimester, as they are presumed to be group B streptococcal colonized. (II-2D).

  7. Barriers to Managing Fertility: Findings From the Understanding Fertility Management in Contemporary Australia Facebook Discussion Group.

    Science.gov (United States)

    Holton, Sara; Rowe, Heather; Kirkman, Maggie; Jordan, Lynne; McNamee, Kathleen; Bayly, Christine; McBain, John; Sinnott, Vikki; Fisher, Jane

    2016-02-15

    As part of research investigating the complexities of managing fertility in Australia, public opinions about how Australians manage their fertility were sought from women and men. To identify public opinion about sexual and reproductive health in Australia. To ensure access to a diverse group of people throughout Australia, an online group was advertised and convened on Facebook from October through December 2013. In a closed-group moderated discussion, participants responded to questions about how people in Australia attempt to manage three aspects of fertility: avoiding pregnancy, achieving pregnancy, and difficulties conceiving. Nonidentifiable demographic information was sought; no personal accounts of fertility management were requested. The discussion transcript was analyzed thematically. There were 61 female and 2 male Facebook users aged 18 to 50 years living in Australia participating in the study. Four main themes about fertility management were identified: access, geographical location, knowledge, and cost. Participants reported that young people and people from rural areas face barriers accessing contraception and fertility services. Limited knowledge about sex and reproduction and the cost of fertility services and contraception were also said to impede effective fertility management. Reasons for inequalities in effective fertility management that are amenable to change were identified. Facebook is an effective method for gaining insights into public opinion about sexual and reproductive health.

  8. Barriers to Managing Fertility: Findings From the Understanding Fertility Management in Contemporary Australia Facebook Discussion Group

    Science.gov (United States)

    Rowe, Heather

    2016-01-01

    Background As part of research investigating the complexities of managing fertility in Australia, public opinions about how Australians manage their fertility were sought from women and men. Objective To identify public opinion about sexual and reproductive health in Australia. Methods To ensure access to a diverse group of people throughout Australia, an online group was advertised and convened on Facebook from October through December 2013. In a closed-group moderated discussion, participants responded to questions about how people in Australia attempt to manage three aspects of fertility: avoiding pregnancy, achieving pregnancy, and difficulties conceiving. Nonidentifiable demographic information was sought; no personal accounts of fertility management were requested. The discussion transcript was analyzed thematically. Results There were 61 female and 2 male Facebook users aged 18 to 50 years living in Australia participating in the study. Four main themes about fertility management were identified: access, geographical location, knowledge, and cost. Participants reported that young people and people from rural areas face barriers accessing contraception and fertility services. Limited knowledge about sex and reproduction and the cost of fertility services and contraception were also said to impede effective fertility management. Conclusions Reasons for inequalities in effective fertility management that are amenable to change were identified. Facebook is an effective method for gaining insights into public opinion about sexual and reproductive health. PMID:26878865

  9. 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.

  10. Planning and managing future space facility projects. [management by objectives and group dynamics

    Science.gov (United States)

    Sieber, J. E.; Wilhelm, J. A.; Tanner, T. A.; Helmreich, R. L.; Burgenbauch, S. F.

    1979-01-01

    To learn how ground-based personnel of a space project plan and organize their work and how such planning and organizing relate to work outcomes, longitudinal study of the management and execution of the Space Lab Mission Development Test 3 (SMD 3) was performed at NASA Ames Research Center. A view of the problems likely to arise in organizations and some methods of coping with these problems are presented as well as the conclusions and recommendations that pertain strictly to SMD 3 management. Emphasis is placed on the broader context of future space facility projects and additional problems that may be anticipated. A model of management that may be used to facilitate problem solving and communication - management by objectives (MBO) is presented. Some problems of communication and emotion management that MBO does not address directly are considered. Models for promoting mature, constructive and satisfying emotional relationships among group members are discussed.

  11. Polio Endgame: Lessons Learned From the Immunization Systems Management Group.

    Science.gov (United States)

    Zipursky, Simona; Vandelaer, Jos; Brooks, Alan; Dietz, Vance; Kachra, Tasleem; Farrell, Margaret; Ottosen, Ann; Sever, John L; Zaffran, Michel J

    2017-07-01

    The Immunization Systems Management Group (IMG) was established to coordinate and oversee objective 2 of the Polio Eradication and Endgame Strategic Plan 2013-2018, namely, (1) introduction of ≥1 dose of inactivated poliovirus vaccine in all 126 countries using oral poliovirus vaccine (OPV) only as of 2012, (2) full withdrawal of OPV, starting with the withdrawal of its type 2 component, and (3) using polio assets to strengthen immunization systems in 10 priority countries. The IMG's inclusive, transparent, and partnership-focused approach proved an effective means of leveraging the comparative and complementary strengths of each IMG member agency. This article outlines 10 key factors behind the IMG's success, providing a potential set of guiding principles for the establishment and implementation of other interagency collaborations and initiatives beyond the polio sphere. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America.

  12. Short Essay on Managing Multicultural Students Groups within Diversity Context

    Directory of Open Access Journals (Sweden)

    Cătălin Ploae

    2016-01-01

    Full Text Available The present essay focuses on summarizing the key elements that should be considered wheneducators are in a position to manage and interact with a group of students from different culturesor social environments. In this respect, we consider that the challenge educators’ face inconnecting with students of diverse backgrounds is to develop a critical consciousness of the waysin which these larger discourses operate in their classrooms and to care enough to question them,to challenge them and to advocate for their students. To care for students who come fromhistorically marginalized populations educators need to remember that schooling can serve eithera liberating or marginalizing function. They can empower students to identify structures in societythat have contributed to marginalizing their perspective and seek to maintain inequitable structuresin society or even narrow communities.

  13. The management committee for post-accidental management - CODIRPA. Synthesis and report by each work group

    International Nuclear Information System (INIS)

    2012-01-01

    This huge document contains several parts and reports. The first part contains a report addressing zoning (proposition for the definition of zones just after the emergency phase). The other parts contain stage reports, seminar synthesis, presentations, and final reports made by the different work groups. The topics of these work groups are: Lifting emergency actions of protection of population and reducing the contact between the body and a radioactive source in built environment; Life in contaminated rural territories, agriculture and water; Assessment of radiological and dosimetric consequences; Health monitoring of populations; Compensation; Management of contaminated soils, products and wastes; Organization of public authorities and commitment of stakeholders; Communication; Hypotheses (choice of hypotheses for the assessment of radiological and dosimetric consequences); Interveners; Water (management of water resources); Regulation; Culture; Centre for population reception and information. A last report has been published by a commission on guidelines for preparation to the long-term management of contaminated territories after a nuclear accident

  14. The social educator as manager of self- managed communities towards a didactics of group work

    Directory of Open Access Journals (Sweden)

    Carlos G. Juliao Vargas

    2005-02-01

    Full Text Available This paper seeks to reflect upon the function of social educators as promoters of self-managing communities as well as to outline the didactic contribution which group work techniques provide for this task. Therefore, the competencies that a social educator should have been addressed from a trace concept of “community” and its relationship whit social education as a non formal process; principally insisting on its role as “leader” of the self-management community processes: how far Leadership should go and where it should stop. It can be concluded that the social educator is required to work among groups of human beings with the main purpose of arousing the collective processes of teaching and learning of knowledge, attitudes and strategies. These strategies lead communities to manage the environment in which they live in an autonomous way so that decent living conditions are guaranteed for everyone. 

  15. 76 FR 4365 - Renewal of the Trinity River Adaptive Management Working Group

    Science.gov (United States)

    2011-01-25

    ... Management Working Group AGENCY: Office of the Secretary, Interior. ACTION: Notice. SUMMARY: The Secretary of... Trinity River Adaptive Management Working Group (Working Group) for 2 years. The Working Group provides... stakeholders the opportunity to give policy, management, and technical input concerning Trinity River...

  16. 78 FR 5830 - Renewal of the Trinity River Adaptive Management Working Group

    Science.gov (United States)

    2013-01-28

    ... Management Working Group AGENCY: Office of the Secretary, Interior. ACTION: Notice. SUMMARY: The Secretary of... Trinity River Adaptive Management Working Group (Working Group) for 2 years. The Working Group provides... stakeholders the opportunity to give policy, management, and technical input concerning Trinity River...

  17. Promotion of health and physical activity improves the mental health of elderly immigrants: Results of a group randomised controlled trial among Turkish immigrants in the Netherlands aged 45 and over

    NARCIS (Netherlands)

    Reijneveld, S.A.; Westhoff, M.H.; Hopman-Rock, M.

    2003-01-01

    Objectives: Older immigrants from non-industrialised countries are a growing group, they have comparatively many health problems and are often hard to reach through health promotion and other preventive services. The aim of this study was to assess the effect of a short health education and physical

  18. Update on Activities of CEOS Disaster Management Support Group

    Science.gov (United States)

    Wood, H. M.; Lauritson, L.

    The Committee on Earth Observation Satellites (CEOS) Disaster Management Support Group (DMSG) has supported natural and technological disaster management on a worldwide basis by fostering improved utilization of existing and planned Earth Observation (EO) satellite data. The DMSG has focused on developing and refining recommendations for the application of satellite data to selected hazard areas--drought, earthquake, fire, flood, ice, landslide, oil spill, and volcanic hazards. Particular emphasis was placed on working closely with space agencies, international and regional organizations, and commercial organizations on the implementation of these recommendations. The DMSG is in its last year with its primary focus on documenting its work and migrating on going activities to other fora. With over 300 participants from more than 140 organizations, the DMSG has found strong support among CEOS space agencies and the Integrated Global Observing Strategy (IGOS), as well as an enthusiastic reception from numerous international, regional, and national emergency managers, and distinct interest from the commercial sector. In addition, the group has worked to give full support to the work of the United Nations Committee on the Peaceful Uses of Outer Space (COPUOS) in pursuit of decisions taken at UNISPACE III and the United Nations International Strategy on Disaster Reduction (ISDR). In conjunction with the IGOS, several of the DMSG hazards teams (earthquake, landslide, and solid Earth dimensions of volcanoes) are joining in the effort to develop an IGOS Geohazards theme team. Cooperation efforts with organizations such as IGOS, COPUOS, and ISDR will hopefully lead to the pick up of much of the on going DMSG activities. Since the inception of this ad hoc working group and its predecessor project, the DMSG has developed and refined recommendations for the application of satellite data by bringing together experts from eight hazard areas to identify user needs, as well as

  19. The Impact of Instructor's Group Management Strategies on Students' Attitudes to Group Work and Generic Skill Development

    Science.gov (United States)

    Natoli, Riccardo; Jackling, Beverley; Seelanatha, Lalith

    2014-01-01

    This paper examines the influence of two distinct group work management strategies on finance students' attitudes towards group work and their perceptions of generic skill development. Using quantitative and qualitative data, comparisons are made between students who experienced a supportive group work environment and students who experienced an…

  20. 76 FR 13666 - Pitney Bowes, Inc., Mailing Solutions Management, Global Engineering Group, Including On-Site...

    Science.gov (United States)

    2011-03-14

    ...., Mailing Solutions Management, Global Engineering Group, Including On-Site Leased Workers From Guidant... workers and former workers of Pitney Bowes, Inc., Mailing Solutions Management Division, Engineering... reviewed the certification to clarify the subject worker group's identity. Additional information revealed...

  1. CH2M Hill Hanford Group Inc (CHG) Information Resource Management (IRM) Strategic Plan

    Energy Technology Data Exchange (ETDEWEB)

    NELSON, R.L.

    2000-05-08

    The CH2M Hill Hanford Group, Inc., Information Resource Management Strategic Plan is the top-level planning document for applying information and information resource management to achieve the CHG mission for the management of the River Protection Project

  2. CH2M Hill Hanford Group Inc (CHG) Information Resource Management (IRM) Strategic Plan

    International Nuclear Information System (INIS)

    NELSON, R.L.

    2000-01-01

    The CH2M Hill Hanford Group, Inc., Information Resource Management Strategic Plan is the top-level planning document for applying information and information resource management to achieve the CHG mission for the management of the River Protection Project

  3. Permanent education and co-management: experience of a health managing group

    Directory of Open Access Journals (Sweden)

    Diogo Faria Corrêa da Costa

    2015-08-01

    Full Text Available This paper presents the experience lived by a group of workers of the Regional Center for Action on Health of the 4th. Regional Health State Department of Health of Rio Grande do Sul in Santa Maria. The paper presents an experience of reorganization of the work process in order to tackle the historical fragmentation of activities in the field of health management, and trigger a learning process for institutional support to carry thirty-two municipalities in the area of administrative scope of this coordinating body . To do so, it relies upon the co-management strategies and continuing health education as tools to trigger processes of change and inventing other ways of designing and conducting health work. With this experience, we can dislodge established places, inventing new forms of teamwork and interdisciplinary manner in order to strengthen this group of workers and their practices.

  4. 76 FR 46854 - Hewlett Packard Company, Imaging and Printing Group, World Wide Product Data Management...

    Science.gov (United States)

    2011-08-03

    ..., Imaging and Printing Group, World Wide Product Data Management Operations, Including On-Site Leased... Company, Imaging and Printing Group, World Wide Products Data Management Operations, Boise, Idaho and Fort... of Hewlett Packard Company, Imaging and Printing Group, World Wide Product Data Management Operations...

  5. 76 FR 66327 - Iron Mountain Information Management, Inc., Corporate Service Group, Information Technology (IT...

    Science.gov (United States)

    2011-10-26

    ... Management, Inc., Corporate Service Group, Information Technology (IT) Division, Including On-Site Leased... Information Management, Inc., Corporate Service Group, Information Technology (IT) Division, including on-site... location of Iron Mountain Information Management, Inc., Corporate Service Group, Information Technology (IT...

  6. Construction of Student Groups Using Belbin: Supporting Group Work in Environmental Management

    Science.gov (United States)

    Smith, Mark; Polglase, Giles; Parry, Carolyn

    2012-01-01

    Belbin team role self and observer perceptions were applied to a large cohort (145) of Geography, Earth and Environmental Sciences undergraduates in a module assessed through two separate group projects. Students self-selected groups for the first project; for the second, groups were more "balanced." Results show slight improvement in…

  7. Nursing leadership in a chronic pain management group approach.

    Science.gov (United States)

    Dysvik, Elin; Furnes, Bodil

    2012-03-01

    To explore and debate nursing leadership and challenges on organizational and group levels when conducting rehabilitation groups for people suffering from chronic pain. Group approaches based on cognitive behavioural therapy are generally described as effective. Leadership in group approaches offered to people suffering from chronic pain is a great challenge for nurses on an organizational as well as a group level. One overall leader and nine group leaders conducting 13 groups constituted the sample. Qualitative content analysis was used by identifying categories, subthemes and themes. The results from the content analysis revealed one main theme ('Complexity in nursing leadership') and three subthemes ('Challenges in leadership on organizational level', 'Challenges in leadership on teamwork level' and 'Challenges in leadership on group level'. The results show how important it is to have firm overall leadership and trained group leaders with a common purpose, interdependent roles and complementary skills, who are thus well prepared to prevent or deal with challenging group processes. The leaders of both levels, which are highly interrelated, should have a current theoretical understanding of pain theory, group leadership skills and a cognitive behavioural approach. © 2012 Blackwell Publishing Ltd.

  8. Personnel Identity Management and the Expeditionary Strike Group

    National Research Council Canada - National Science Library

    Neises, Glen E

    2007-01-01

    .... Chapter I defines IM and explains why IM is important for the Department of Defense (DoD). Chapter II provides an overview of DoD human resource management and Defense Manpower Data Center information systems...

  9. [From quality management to dynamic management through quality: Deployment within a radiotherapy group].

    Science.gov (United States)

    Guerrier, B; Halm, É; Craman, M; Dujols, J-P; Norkowski, J-L; Meynard, K

    2017-10-01

    In 2015, the quality group of the radiotherapy clinic Groupement de Radiothérapie et d'Oncologie des Pyrénées (GROP, Pau, France) decided to review the deployment of its quality approach in order to optimize it continuously. For this, two improvements were proposed: an involvement of process drivers and a material and financial investment in document management software. The implementation of these organizational and managerial provisions enabled us to better cover the requirements of the ISO 9001 standard, the international reference in quality management. Copyright © 2017 Société française de radiothérapie oncologique (SFRO). Published by Elsevier SAS. All rights reserved.

  10. 78 FR 61387 - Supermedia LLC, Publishing Operations Divison, Account Management Group, a Subsidiary of Dex...

    Science.gov (United States)

    2013-10-03

    ... LLC, Publishing Operations Divison, Account Management Group, a Subsidiary of Dex Media Inc..., Publishing Operations Divison, Listing Management Group, a Subsidiary of Dex Media Inc., Including On-Site... to workers and former workers of SuperMedia LLC, Publishing Operation Division, Account Management...

  11. [Job performance in work organizations: the effects of management by group goals and job interdependence].

    Science.gov (United States)

    Ikeda, Hiroshi; Furukawa, Hisataka

    2015-04-01

    cThis study examined the interactive effect of management by group goals and job interdependence on employee's activities in terms of task and contextual performance. A survey was conducted among 140 Japanese employees. Results indicated that management by group goals was related only to contextual performance. Job interdependence, however, had a direct effect on both task and contextual performance. Moreover, moderated regression analyses revealed that for work groups requiring higher interdependence among employees, management by group goals had a positive relation to contextual performance but not to task performance. When interdependence was not necessarily required, however, management by group goals had no relation to contextual performance and even negatively impacted task performance, respectively. These results show that management by group goals affects task and contextual performance, and that this effect is moderated by job interdependence. This provides a theoretical extension as well as a practical application to the setting and management of group goals.

  12. An integrative framework for managing project issues across stakeholder groups

    NARCIS (Netherlands)

    van Offenbeek, Marjolein A.G.; Vos, Janita F.J.

    2016-01-01

    The stakeholders and the issues associated with a project are different concepts but closely interconnected. Despite this, the project stakeholder management literature falls short in analyzing the linkages between the stakeholders and the issues they bring. This paper develops a multilayered

  13. Implications of Boy Scout group use of public lands for natural resource managers: a regional comparison

    Science.gov (United States)

    Gail A. Vander Stoep

    1992-01-01

    Resource managers can apply group-specific rather than generic communications and management strategies to different public land user groups. This study compares use patterns of one user group, Boy Scout troops, from two regions of the United States. It identifies their public land use patterns, activities, needs, and motivations. Results can be used by resource...

  14. Design of material management system of mining group based on Hadoop

    Science.gov (United States)

    Xia, Zhiyuan; Tan, Zhuoying; Qi, Kuan; Li, Wen

    2018-01-01

    Under the background of persistent slowdown in mining market at present, improving the management level in mining group has become the key link to improve the economic benefit of the mine. According to the practical material management in mining group, three core components of Hadoop are applied: distributed file system HDFS, distributed computing framework Map/Reduce and distributed database HBase. Material management system of mining group based on Hadoop is constructed with the three core components of Hadoop and SSH framework technology. This system was found to strengthen collaboration between mining group and affiliated companies, and then the problems such as inefficient management, server pressure, hardware equipment performance deficiencies that exist in traditional mining material-management system are solved, and then mining group materials management is optimized, the cost of mining management is saved, the enterprise profit is increased.

  15. Managing more than the mean: Using quantile regression to identify factors related to large elk groups

    Science.gov (United States)

    Brennan, Angela K.; Cross, Paul C.; Creely, Scott

    2015-01-01

    Summary Animal group size distributions are often right-skewed, whereby most groups are small, but most individuals occur in larger groups that may also disproportionately affect ecology and policy. In this case, examining covariates associated with upper quantiles of the group size distribution could facilitate better understanding and management of large animal groups.

  16. The Influence of Group Training in the Incredible Years Teacher Classroom Management Program on Preschool Teachers' Classroom Management Strategies

    Science.gov (United States)

    Carlson, John S.; Tiret, Holly B.; Bender, Stacy L.; Benson, Laurie

    2011-01-01

    This study examined changes in preschool teachers' perceptions of classroom management strategies following group training in the recently revised Incredible Years Teacher Classroom Management Program (C. Webster-Stratton, 2006). The authors used a pre/post follow-up design across 2 groups that each met for 8 sessions over an 8-10-week period for…

  17. Recommendations to establish a waste management group for emergency situations

    International Nuclear Information System (INIS)

    Tello, Cledola Cassia Oliveira de; Silva, Eliane Magalhaes Pereira da; Prado, Maria Augusta Silva do

    1997-01-01

    The establishment of a radiation waste group to work in the emergency situations is proposed, as well as the guidelines for its formation. The purpose is to avoid or minimise possible wastes arising from accidents/incidents, and therefore minimise the environmental, economical and social impacts originated from these situations to the present and future generations

  18. A Model for Behavioral Management and Relationship Training for Parents in Groups,

    Science.gov (United States)

    Behavior, Human relations, *Training, *Families(Human), Symposia, Models, Children, Psychotherapy, Problem solving, Management, Control, Learning, Skills, Decision making , Group dynamics, Military psychology, Military medicine

  19. Nurses' Educational Needs Assessment for Financial Management Education Using the Nominal Group Technique.

    Science.gov (United States)

    Noh, Wonjung; Lim, Ji Young

    2015-06-01

    The purpose of this study was to identify the financial management educational needs of nurses in order to development an educational program to strengthen their financial management competencies. Data were collected from two focus groups using the nominal group technique. The study consisted of three steps: a literature review, focus group discussion using the nominal group technique, and data synthesis. After analyzing the results, nine key components were selected: corporate management and accounting, introduction to financial management in hospitals, basic structure of accounting, basics of hospital accounting, basics of financial statements, understanding the accounts of financial statements, advanced analysis of financial statements, application of financial management, and capital financing of hospitals. The present findings can be used to develop a financial management education program to strengthen the financial management competencies of nurses. Copyright © 2015. Published by Elsevier B.V.

  20. Footwear Supply Network Management for Specific Target Groups

    OpenAIRE

    Franchini, Valentina

    2013-01-01

    This research is a part of CoReNet (Customer-ORiented and Eco-friendly NETworks for healthy fashionable goods), an European 7th Framework Program project, whose objective is to implement innovative methods and tools to fulfil needs and expectations of specific target groups – elderly, obese, disabled and diabetic people – by improving the supply network structure of the European Textile, Clothing and Footwear Industry (TCFI) to produce small series of functional and fashionable clothes and fo...

  1. Nurses' Educational Needs Assessment for Financial Management Education Using the Nominal Group Technique

    OpenAIRE

    Wonjung Noh, PhD, RN; Ji Young Lim, PhD, RN, MBA

    2015-01-01

    Purpose: The purpose of this study was to identify the financial management educational needs of nurses in order to development an educational program to strengthen their financial management competencies. Methods: Data were collected from two focus groups using the nominal group technique. The study consisted of three steps: a literature review, focus group discussion using the nominal group technique, and data synthesis. Results: After analyzing the results, nine key components were s...

  2. Implementing Self-Management within a Group Counseling Context: Effects on Academic Enabling Behaviors

    Science.gov (United States)

    Briesch DuBois, Jacquelyn M.; Briesch, Amy M.; Hoffman, Jessica A.; Struzziero, Joan; Toback, Robin

    2017-01-01

    Self-management interventions have been adapted to serve as targeted interventions to increase academic enabling behaviors in groups of students. However, a trade-off exists between adapting these interventions to feasibly fit group contexts and maintaining theoretical intervention components. This study examines the use of self-management within…

  3. 75 FR 66125 - Federal Land Managers' Air Quality Related Values Work Group (FLAG)

    Science.gov (United States)

    2010-10-27

    ... pollutants that could affect the health and status of resources in areas managed by the three agencies... Work Group (FLAG) AGENCY: National Park Service, Interior. ACTION: Notice of availability of final... Public Comments document. The Federal Land Managers' Air Quality Related Values Work Group (FLAG) was...

  4. 78 FR 46361 - Trinity Adaptive Management Working Group; Public Meeting, Teleconference and Web-Based Meeting

    Science.gov (United States)

    2013-07-31

    ... stakeholders the opportunity to give policy, management, and technical input concerning Trinity River...-FF08EACT00] Trinity Adaptive Management Working Group; Public Meeting, Teleconference and Web-Based Meeting... Trinity Management Council (TMC). DATES: Public meeting, Teleconference, and web-based meeting: TAMWG and...

  5. CH2M Hill Hanford Group Inc (CHG) Information Resource Management (IRM) Strategic Plan

    Energy Technology Data Exchange (ETDEWEB)

    NELSON, R.L.

    2000-06-06

    The CH2M HILL Hanford Group, Inc. (CHG), Information Resource Management Strategic Plan is the top-level planning document for applying information and information resource management to achieve the CHG mission for the management of the River Protection Project waste tank farm.

  6. CH2M Hill Hanford Group Inc (CHG) Information Resource Management (IRM) Strategic Plan

    International Nuclear Information System (INIS)

    NELSON, R.L.

    2000-01-01

    The CH2M HILL Hanford Group, Inc. (CHG), Information Resource Management Strategic Plan is the top-level planning document for applying information and information resource management to achieve the CHG mission for the management of the River Protection Project waste tank farm

  7. Relation Analysis of Knowledge Management, Research, and Innovation in University Research Groups

    Directory of Open Access Journals (Sweden)

    Heyder Paez-Logreira

    2016-12-01

    Full Text Available Knowledge is a competitive advantage for companies. Knowledge Management helps to keep this competitiveness. Universities face with challenges in research, innovation and international competitiveness. The purpose of this paper includes studying Knowledge Management Models, and Innovation Models apply to Research Groups of Universities, through an analysis of relation in inter-organizational level. Some researchers and leaders of research groups participated in a survey about knowledge management and innovation. Here we show the relationship between knowledge management, innovation and research, including processes and operations performed by universities around these. We organize the results in three dimensions: Knowledge Management perception, the relationship between Knowledge Management and Innovation, and Strategic Knowledge organization. Too, we identify a generality of good practices, challenges, and limitations on Research Groups for Knowledge Management.

  8. Proceedings of the 7. annual workshop of the CEATI Water Management Group : water management 2006 : collecting and managing hydrologic data

    International Nuclear Information System (INIS)

    2006-01-01

    This workshop by the Water Management Interest Group of CEATI focused on the development and methods and tools needed to optimize hydraulic processes while maintaining safe and environmentally-sound operations. In particular, it addressed issues regarding watershed management and water use planning, meteorological forecasting, operational modeling, data acquisition techniques, and impact assessment. Hydrologic data must be acquired and processed in order to effectively operate water control structures. It was noted that although data requirements may change from basin to basin, depending on seasonal forecasting, quality data is the foundation of all hydrological operational modelling and decision support software packages. As such, better acquisition methods and equipment are needed along with well designed networks and modern control applications. The first session of this workshop dealt with network data collection offered an opportunity to expand network design criteria standards and technologies that can offer support for cost effective maintenance to achieve acceptable levels of reliability and accuracy. The second session on quality control and data validation explored potential solutions for improved methods and techniques in quality control. The third session on data sharing and network coordination examined ways that companies and government agencies manage and share hydrologic data. The workshop featured 22 presentations, of which 3 have been catalogued separately for inclusion in this database. refs., tabs., figs

  9. Managing medical groups: 21st century challenges and the impact of physician leadership styles.

    Science.gov (United States)

    Martin, William E; Keogh, Timothy J

    2004-01-01

    Physician group managers and administrators charged with leading medical groups in the 21st century face a set of old and new challenges and opportunities. Leadership is assumed to make the difference between a successful and not-so-successful medical group. Yet, there is little research about how physician manager leadership styles contribute to the success of medical group practices. This article is a study of physician leadership styles using the DiSC, based upon a sample of 232 physician managers. Dominance (D) and conscientiousness (C) were the two dominant styles found in this study. Moreover, the two dominant combination leadership styles fall under the categories of the "creative" and the 'perfectionist." The article formulates practical recommendations for both physician managers and administrators for leading medical groups to respond more effectively to the challenges and opportunities facing medical groups in the 21st century.

  10. Site-Specific Waste Management Instruction - 100-DR-1 Group 2 Sites

    International Nuclear Information System (INIS)

    Jackson, R.W.

    1998-01-01

    This site-specific waste management instruction (SSWMI) provides guidance for the management of wastes that may be generated during the excavation and remediation of the 100-DR-1 Group 2 sites. The management of waste generated as a result of these activities will be as directed in this SSWMI. This SSWMI will be revised to incorporate guidance for management of wastes encountered that are not addressed in this SSWMI

  11. Conflict Management in Student Groups - a Teacher’s Perspective in Higher Education

    OpenAIRE

    Markus Borg; Joakim Kembro; Jesper Notander; Catarina Petersson; Lars Ohlsson

    2011-01-01

    Students working in groups is a commonly used method of instruction in higher education, popularized by the introduction of problem based learning. As a result, management of small groups of people has become an important skill for teachers. The objective of our study is to investigate why conflicts arise in student groups at the Faculty of Engineering at Lund University and how teachers manage them. We have conducted an exploratory interdepartmental interview study on teachers' views on this...

  12. Small, Task-Oriented Groups: Conflict, Conflict Management, Satisfaction, and Decision Quality.

    Science.gov (United States)

    Wall, Victor D., Jr.; And Others

    1987-01-01

    Examined relationship among amount of conflict experienced, the style of its management, individual satisfaction, and decision quality of small, task-oriented groups using 129 college student subjects in 24 groups. Data suggest a curvilinear relationship between the number of conflict episodes experienced by group members and the subsequent…

  13. Making time for learning-oriented leadership in multidisciplinary hospital management groups.

    Science.gov (United States)

    Singer, Sara J; Hayes, Jennifer E; Gray, Garry C; Kiang, Mathew V

    2015-01-01

    Although the clinical requirements of health care delivery imply the need for interdisciplinary management teams to work together to promote frontline learning, such interdisciplinary, learning-oriented leadership is atypical. We designed this study to identify behaviors enabling groups of diverse managers to perform as learning-oriented leadership teams on behalf of quality and safety. We randomly selected 12 of 24 intact groups of hospital managers from one hospital to participate in a Safety Leadership Team Training program. We collected primary data from March 2008 to February 2010 including pre- and post-staff surveys, multiple interviews, observations, and archival data from management groups. We examined the level and trend in frontline perceptions of managers' learning-oriented leadership following the intervention and ability of management groups to achieve objectives on targeted improvement projects. Among the 12 intervention groups, we identified higher- and lower-performing intervention groups and behaviors that enabled higher performers to work together more successfully. Management groups that achieved more of their performance goals and whose staff perceived more and greater improvement in their learning-oriented leadership after participation in Safety Leadership Team Training invested in structures that created learning capacity and conscientiously practiced prescribed learning-oriented management and problem-solving behaviors. They made the time to do these things because they envisioned the benefits of learning, valued the opportunity to learn, and maintained an environment of mutual respect and psychological safety within their group. Learning in management groups requires vision of what learning can accomplish; will to explore, practice, and build learning capacity; and mutual respect that sustains a learning environment.

  14. Effects of a group-based reproductive management extension programme on key management outcomes affecting reproductive performance.

    Science.gov (United States)

    Brownlie, Tom S; Morton, John M; Heuer, Cord; McDougall, Scott

    2015-02-01

    A group-based reproductive management extension programme has been designed to help managers of dairy herds improve herd reproductive performance. The aims of this study were, firstly, to assess effects of participation by key decision makers (KDMs) in a farmer action group programme in 2009 and 2010 on six key management outcomes (KMOs) that affect reproductive performance over 2 years (2009-2010 and 2010-2011), and secondly, to describe KDM intentions to change management behaviour(s) affecting each management outcome after participation in the programme. Seasonal calving dairy herds from four regions of New Zealand were enrolled in the study. Intentions to modify management behaviour were recorded using the formal written action plans developed during the extension programme. KMOs assessed were calving pattern of the herd, pre-calving heifer liveweight, pre-calving and premating body condition score (BCS), oestrus detection, anoestrus cow management and bull management. Participation was associated with improvements in heifer liveweight, more heifers calving in the first 6 weeks of the seasonal calving period, premating BCS and oestrus detection. No significant effects were observed on anoestrus cow management or bull management. KDMs with greater numbers of proposed actions had lower 6 week in-calf rates in the second study year than KDMs who proposed fewer actions. A more effective strategy to ensure more appropriate objectives is proposed. Strategies to help KDMs to implement proposed actions more successfully should be investigated to improve the programme further. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. 77 FR 63872 - Alternative Management Resources, Inc., Doepker Group, Inc., D.B.A. Time Staffing, Inc...

    Science.gov (United States)

    2012-10-17

    ... Resources, Inc., Doepker Group, Inc., D.B.A. Time Staffing, Inc., Personnel Management Group, Inc...., Doepker Group, Inc., D.B.A. Time Staffing, Inc., Personnel Management Group, Inc., Select Staffing, and... follows: ''All workers of Alternative Management Resources, Inc., Doepker Group, Inc., D.B.A. Time...

  16. Client perceptions of group education in the management of type 2 diabetes mellitus in South Australia.

    Science.gov (United States)

    Smith, Cynthia; McNaughton, Darlene A; Meyer, Samantha

    2016-01-01

    Type 2 diabetes mellitus (T2DM) is a progressive chronic disease that requires significant self-surveillance and adherence to the treatment protocols for successful management and future health. There is a growing body of evidence suggesting that diabetes education is beneficial for patient outcomes. However, there is some debate about how best to deliver diabetes education, whether individually or in groups. Although several studies have investigated the role of group education in improving the management of T2DM, few studies have examined this issue from the client's perspective. It is here that this study makes a contribution to understanding diabetes management. Drawing on systematic observation of group education sessions provided by diabetic resource nurses and in-depth interviews with clients, this paper describes the experiences, perspectives and significance of these sessions to clients. Our results suggest that group education sessions were seen as valuable to the clients for: the opportunity they provided to meet others living with diabetes; to improve motivation for managing the disease; and to enhance knowledge of diabetes, its management and long-term implications. In short, this study demonstrates that the clients value group education sessions for the social contact, increasing knowledge about the disease for self-management and support they provide; factors recognised as important to maintaining health. In addition, group education sessions appear to be a cost-effective method for diabetes self-management that funders need to consider.

  17. Thymic Carcinoma Management Patterns among International Thymic Malignancy Interest Group (ITMIG) Physicians with Consensus from the Thymic Carcinoma Working Group.

    Science.gov (United States)

    Shepherd, Annemarie; Riely, Gregory; Detterbeck, Frank; Simone, Charles B; Ahmad, Usman; Huang, James; Korst, Robert; Rajan, Arun; Rimner, Andreas

    2017-04-01

    Thymic carcinomas are rare epithelial malignancies with limited data to guide management. To identify areas of agreement and variability in current clinical practice, a 16-question electronic survey was given to members of the International Thymic Malignancy Interest Group (ITMIG). Areas of controversy were discussed with the Thymic Carcinoma Working Group and consensus was achieved, as described. A total of 100 ITMIG members responded. There was general agreement regarding the role for multimodality therapy with definitive surgical resection in physically fit patients with advanced but resectable disease. Areas of controversy included the need for histologic confirmation before surgery, the role of adjuvant therapy, the optimal first-line chemotherapy regimen, and the recommended treatment course for marginally resectable disease with invasion into the great vessels, pericardium, and lungs. The results of the questionnaire provide a description of the management of thymic carcinoma by 100 ITMIG members with a specific interest or expertise in thymic malignancies. Although there was agreement in some areas, clinical practice appears to vary significantly. There is a great need for collaborative research to identify optimal evaluation and treatment strategies. Given the need for multimodality therapy in many cases, a multidisciplinary discussion of the management of patients with thymic carcinoma is critical. Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

  18. Managing wildfire events: risk-based decision making among a group of federal fire managers

    Science.gov (United States)

    Robyn S. Wilson; Patricia L. Winter; Lynn A. Maguire; Timothy. Ascher

    2011-01-01

    Managing wildfire events to achieve multiple management objectives involves a high degree of decision complexity and uncertainty, increasing the likelihood that decisions will be informed by experience-based heuristics triggered by available cues at the time of the decision. The research reported here tests the prevalence of three risk-based biases among 206...

  19. A summary of the Nordic-group conference on safety management

    International Nuclear Information System (INIS)

    Salo, I.; Svenson, O.

    2005-04-01

    The report summarizes the Nordic-group conference on safety management, which took place in Lund, Sweden on October 28-29, 2004. The theme-group was originally created by researchers who had a common interest in cooperation, sharing their results, and discuss topics focusing on safety management and safety culture in nuclear power production, but also in other technologies involving risks. The research has, so far, basically been related to the areas of MTO, partly from a psychological perspective, but also from other perspectives. Today, the group consists primarily of members from Sweden, Finland and Norway. During the last three years the group has gathered twice a year. (au)

  20. Managing diversity : How leaders' multiculturalism and colorblindness affect work group functioning

    NARCIS (Netherlands)

    Meeussen, Loes; Otten, Sabine; Phalet, Karen

    Workforces are becoming increasingly diverse and leaders face the challenge of managing their groups to minimize costs and maximize benefits of diversity. This paper investigates how leaders' multiculturalism and colorblindness affect cultural minority and majority members' experiences of

  1. Task complexity and task, goal, and reward interdependence in group performance management : A prescriptive model

    NARCIS (Netherlands)

    van Vijfeijken, H.; Kleingeld, A.; van Tuijl, H.; Algera, J.A.; Thierry, Hk.

    2002-01-01

    A prescriptive model on how to design effective combinations of goal setting and contingent rewards for group performance management is presented. The model incorporates the constructs task complexity, task interdependence, goal interdependence, and reward interdependence and specifies optimal fit

  2. Innovation management based on proactive engagement of customers: A case study on LEGO Group. Part I: Innovation Management at Lego Group

    Science.gov (United States)

    Rusu, G.; Avasilcăi, S.

    2015-11-01

    Customers' proactive engagement in the innovation process represents a business priority for companies which adopt the open innovation business model. In such a context, it is of outmost importance for companies to use the online environment and social media, in order to create an interactive and open dialogue with customers and other important external stakeholders, achieving to gather creative solutions and innovative ideas by involving them in the process of co-creating value. Thus, the current paper is based on a case study approach, which aims to highlight the open innovation business model of the LEGO Group, one of the most successful and active company in engaging customers in submitting ideas and creative solutions for developing new products and new technologies, through online platforms. The study then proceeds to analyze the innovation management at LEGO Group, emphasizing the most important elements regarding the management team, the success and failures, the evolution of the LEGO products focusing on the innovation efforts of the company, its mission, vision, and values, emphasizing the innovation terms which guide the actions and objectives of the LEGO Group. Also, the research based on the case study approach, outlines the most important policies and strategies of the company, the organizational structure consisting of flat structures which facilitate the orientation of the team management on the innovation process and the proactive involvement of consumers and other external stakeholders in product development, highlighting also the most important activities developed by the management team in exploring the new opportunities which may occur on the market, involving customers in sharing their ideas at festivals, participating to discussions of adult fans on web-based platforms and establishing partnerships with the external stakeholders in order to create value. Moreover, the paper is focused on identifying the company's concerns regarding the

  3. Assessment of Groups Influence on Management Style as Related to University Governance

    Science.gov (United States)

    Irtwange, S. V.; Orsaah, S.

    2010-01-01

    The study was undertaken with the objective of assessing groups influence on management style as related to University governance with University of Agriculture, Makurdi as a case study from academic staff perspective. The management style of the Vice Chancellor of the University of Agriculture, Makurdi between the period September 3, 1996 to…

  4. Saving Face: Managing Rapport in a Problem-Based Learning Group

    Science.gov (United States)

    Robinson, Leslie; Harris, Ann; Burton, Rob

    2015-01-01

    This qualitative study investigated the complex social aspects of communication required for students to participate effectively in Problem-Based Learning and explored how these dynamics are managed. The longitudinal study of a group of first-year undergraduates examined interactions using Rapport Management as a framework to analyse communication…

  5. Using a Virtual Learning Environment to Manage Group Projects: A Case Study

    Science.gov (United States)

    Cleary, Yvonne; Marcus-Quinn, Ann

    2008-01-01

    Virtual Learning Environments (VLEs) are increasingly used by Higher Education Institutions to manage and enhance teaching and learning, and research. Discussion, chat, scheduling, and other collaboration tools make VLEs especially useful systems for designing and managing complex group projects. In the spring semester of 2006, students at the…

  6. 77 FR 60138 - Trinity Adaptive Management Working Group; Public Teleconference/Web-Based Meeting

    Science.gov (United States)

    2012-10-02

    ... meeting. Background The TAMWG affords stakeholders the opportunity to give policy, management, and...-FF08EACT00] Trinity Adaptive Management Working Group; Public Teleconference/ Web-Based Meeting AGENCY: Fish..., announce a public teleconference/web-based meeting of [[Page 60139

  7. 78 FR 17226 - Trinity Adaptive Management Working Group; Public Meeting, Teleconference and Web-Based Meeting

    Science.gov (United States)

    2013-03-20

    ... stakeholders the opportunity to give policy, management, and technical input concerning Trinity River...-FF08EACT00] Trinity Adaptive Management Working Group; Public Meeting, Teleconference and Web-Based Meeting... Service, announce a public meeting, teleconference and web-based meeting of the Trinity Adaptive...

  8. 78 FR 49281 - Trinity Adaptive Management Working Group; Public Meeting, Teleconference and Web-Based Meeting

    Science.gov (United States)

    2013-08-13

    ... opportunity to give policy, management, and technical input concerning Trinity River (California) restoration...-FF08EACT00] Trinity Adaptive Management Working Group; Public Meeting, Teleconference and Web-Based Meeting... Service, announce a public meeting, teleconference, and web-based meeting of the Trinity Adaptive...

  9. Spoiled Group Identities and Backstage Work: A Theory of Stigma Management Rehearsals

    Science.gov (United States)

    O'Brien, John

    2011-01-01

    How do persons with a stigmatized identity learn potential responses to discrimination and harassment? Drawing on three and a half years of ethnographic data, this paper demonstrates how members of a group of Muslim American youth are socialized in locally dominant stigma management strategies through stigma management rehearsals. Stigma…

  10. Democratic Leadership by Managing Meetings for Effective Group Decision-Making.

    Science.gov (United States)

    Stephens, Mary; Forest, Robert

    Instrumental to successful democratic leadership is the use of committees to solve management problems. In democratic leadership, a leader encourages participation and uses a guidance approach to direct a group toward consensus. This document offers leaders guidelines in effective democratic management of meetings. The authors first discuss the…

  11. Research on Group Decision-Making Mechanism of Internet Emergency Management

    Science.gov (United States)

    Xie, Kefan; Chen, Gang; Qian, Wu; Shi, Zhao

    With the development of information technology, internet has become a popular term and internet emergency has an intensive influence on people's life. This article offers a short history of internet emergency management. It discusses the definition, characteristics, and factor of internet emergency management. A group decision-making mechanism of internet emergency is presented based on the discussion. The authors establish a so-called Rough Set Scenario Flow Graphs (RSSFG) of group decision-making mechanism of internet emergency management and make an empirical analysis based on the RSSFG approach. The experimental results confirm that this approach is effective in internet emergency decision-making.

  12. Group affiliation in self-management: support or threat to identity?

    Science.gov (United States)

    Bossy, Dagmara; Knutsen, Ingrid Ruud; Rogers, Anne; Foss, Christina

    2017-02-01

    Self-management is considered important in chronic illness, and contemporary health policy recommends participation in support groups for individuals with chronic conditions. Although withdrawal from or non-participation in support groups is an important problem, there is limited knowledge about individuals' own motivation for participation in or withdrawal from self-management support groups. To investigate how individuals with type 2 diabetes perceive participation in group-based self-management support. This is a qualitative focus group study using a semi-structured interview guide. Sixteen participants diagnosed with type 2 diabetes were included in the study. Individuals with and without group affiliations were mixed in three focus groups to trigger discussions. In the analysis, reoccurring themes of engagement and discussions between participants were focused within a theoretical frame of institutional logic. The focus groups are seen as social spaces where participants construct identity. Both participation and non-participation in group-based self-management support are associated with dealing with the stigma of having type 2 diabetes. Negotiations contribute to constructing an illness dignity as a response to the logic of moral responsibility for the disease. Contemporary policy contributes to societal understandings of individuals with type 2 diabetes as morally inadequate. Our study shows that group-based self-management support may counteract blame and contribute in negotiations of identity for individuals with type 2 diabetes. This mechanism makes participation in groups beneficial for some but stigma inducing for others. © 2016 The Authors. Health Expectations Published by John Wiley & Sons Ltd.

  13. We Scrum Every Day: Using Scrum Project Management Framework for Group Projects

    Science.gov (United States)

    Pope-Ruark, Rebecca

    2012-01-01

    Collaborative group projects have documented learning benefits, yet collaboration is challenging for students because the educational system values individual achievement. This article explores Scrum, an approach to framing, planning, and managing group projects used in Web-software development. Designed for multi-faceted projects, this approach…

  14. A Randomized Trial of Contingency Management Delivered in the Context of Group Counseling

    Science.gov (United States)

    Petry, Nancy M.; Weinstock, Jeremiah; Alessi, Sheila M.

    2011-01-01

    Objective: Contingency management (CM) is efficacious in reducing drug use. Typically, reinforcers are provided on an individual basis to patients for submitting drug-negative samples. However, most treatment is provided in a group context, and poor attendance is a substantial concern. This study evaluated whether adding CM to group-based…

  15. Improving Study Habits of Junior High School Students Through Self-Management versus Group Discussion

    Science.gov (United States)

    Harris, Mary B.; Trujillo, Amaryllis E.

    1975-01-01

    Both a self-management approach, teaching the principles of behavior modification and self-control (n=36), and a group-discussion technique, involving discussion of study habits and problems (n=41), led to improvements in grade point averages compared with a no-treatment control group (n=36) for low-achieving junior high school students. (Author)

  16. Primary Children's Management of Themselves and Others in Collaborative Group Work: "Sometimes It Takes Patience…"

    Science.gov (United States)

    Kershner, Ruth; Warwick, Paul; Mercer, Neil; Kleine Staarman, Judith

    2014-01-01

    We focus on children's approaches to managing group work in classrooms where collaborative learning principles are explicit. Small groups of 8-10 year olds worked on collaborative science activities using an interactive whiteboard. Insubsequent interviews, they spoke of learning to "be patient" and "wait", for multiple social…

  17. The Effects of Virtual Communities on Group Identity in Classroom Management

    Science.gov (United States)

    Ho, Tu-Kuang; Lin, Yu-Tzeng

    2016-01-01

    Group identity is a critical component in developing effective classroom management. While there have been numerous studies on group identity, they have primarily focused on its effects on the physical classroom entity. Advances in information technology, however, have enabled the creation of virtual communities, which have become a vital channel…

  18. Antecendents and consequences of group potency : a study of self-managing teams in customer services

    NARCIS (Netherlands)

    Jong, de A.; Ruyter, de J.C.; Wetzels, M.G.M.

    2005-01-01

    This paper proposes and tests a model of antecedents and consequences of group potency in self-managing teams in retail banking. Based on data collected from boundary-spanning service employees organized in 60 teams and their customers, our findings reveal a significant positive impact of group

  19. Use of Self-Management with the CW-FIT Group Contingency Program

    Science.gov (United States)

    Kamps, Debra; Conklin, Carl; Wills, Howard

    2015-01-01

    The purpose of the study was to determine the effects of self-management as a tier two enhancement to the group contingency intervention, Class-Wide Function-related Intervention Teams Program (CW-FIT). Two classrooms, first and fourth grade, and two students in each of the classrooms participated in the intervention. The group contingency…

  20. Globus Nexus: A Platform-as-a-Service Provider of Research Identity, Profile, and Group Management.

    Science.gov (United States)

    Chard, Kyle; Lidman, Mattias; McCollam, Brendan; Bryan, Josh; Ananthakrishnan, Rachana; Tuecke, Steven; Foster, Ian

    2016-03-01

    Globus Nexus is a professionally hosted Platform-as-a-Service that provides identity, profile and group management functionality for the research community. Many collaborative e-Science applications need to manage large numbers of user identities, profiles, and groups. However, developing and maintaining such capabilities is often challenging given the complexity of modern security protocols and requirements for scalable, robust, and highly available implementations. By outsourcing this functionality to Globus Nexus, developers can leverage best-practice implementations without incurring development and operations overhead. Users benefit from enhanced capabilities such as identity federation, flexible profile management, and user-oriented group management. In this paper we present Globus Nexus, describe its capabilities and architecture, summarize how several e-Science applications leverage these capabilities, and present results that characterize its scalability, reliability, and availability.

  1. Globus Nexus: A Platform-as-a-Service provider of research identity, profile, and group management

    Energy Technology Data Exchange (ETDEWEB)

    Chard, Kyle; Lidman, Mattias; McCollam, Brendan; Bryan, Josh; Ananthakrishnan, Rachana; Tuecke, Steven; Foster, Ian

    2016-03-01

    Globus Nexus is a professionally hosted Platform-as-a-Service that provides identity, profile and group management functionality for the research community. Many collaborative e-Science applications need to manage large numbers of user identities, profiles, and groups. However, developing and maintaining such capabilities is often challenging given the complexity of modern security protocols and requirements for scalable, robust, and highly available implementations. By outsourcing this functionality to Globus Nexus, developers can leverage best-practice implementations without incurring development and operations overhead. Users benefit from enhanced capabilities such as identity federation, flexible profile management, and user-oriented group management. In this paper we present Globus Nexus, describe its capabilities and architecture, summarize how several e-Science applications leverage these capabilities, and present results that characterize its scalability, reliability, and availability.

  2. PERANCANGAN PROTOTYPE APLIKASI KNOWLEDGE MANAGEMENT PADA DIVISI MANAGEMENT AUTOMATION INFORMATION UNTUK MENDUKUNG ORACLE FINANCIAL PADA ORANG TUA GROUP

    Directory of Open Access Journals (Sweden)

    Gema Gema

    2010-10-01

    Full Text Available The purpose of this project is to design a knowledge management application as a media to document knowledge and facility that supported a knowledge sharing culture in Oracle Financial subdivision in Orang Tua Group. The researcher uses 7 first steps method which defined by Tiwana in doing knowledge management application prototype. The knowledge management prototype application modules consist of Wiki page, document library, discussion board, blog, picture library, knowledge base, help desk, frequently asked questions, and surveys. In using knowledge in knowledge base, user will get knowledge through business process, how to use the application, or how to finish some cases. Knowledge management prototype application design as a whole could fulfill user’s needs in sharing knowledge, but still needs continuous improvement for maximal usage.Keywords: prototype design, knowledge management application, knowledge

  3. A taxonomy for disease management: a scientific statement from the American Heart Association Disease Management Taxonomy Writing Group.

    Science.gov (United States)

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

    2006-09-26

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

  4. Change in quality management in diabetes care groups and outpatient clinics after feedback and tailored support.

    Science.gov (United States)

    Campmans-Kuijpers, Marjo J; Baan, Caroline A; Lemmens, Lidwien C; Rutten, Guy E

    2015-02-01

    To assess the change in level of diabetes quality management in primary care groups and outpatient clinics after feedback and tailored support. This before-and-after study with a 1-year follow-up surveyed quality managers on six domains of quality management. Questionnaires measured organization of care, multidisciplinary teamwork, patient centeredness, performance results, quality improvement policy, and management strategies (score range 0-100%). Based on the scores, responders received feedback and a benchmark and were granted access to a toolbox of quality improvement instruments. If requested, additional support in improving quality management was available, consisting of an elucidating phone call or a visit from an experienced consultant. After 1 year, the level of quality management was measured again. Of the initially 60 participating care groups, 51 completed the study. The total quality management score improved from 59.8% (95% CI 57.0-62.6%) to 65.1% (62.8-67.5%; P quality management score (P = 0.001). Of the 44 participating outpatient clinics, 28 completed the study. Their total score changed from 65.7% (CI 60.3-71.1%) to 67.3% (CI 62.9-71.7%; P = 0.30). Only the results in the domain multidisciplinary teamwork improved (P = 0.001). Measuring quality management and providing feedback and a benchmark improves the level of quality management in care groups but not in outpatient clinics. The questionnaires might also be a useful asset for other diabetes care groups, such as Accountable Care Organizations. © 2015 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  5. Active case finding and treatment adherence in risk groups in the tuberculosis pre-elimination era.

    Science.gov (United States)

    Gupta, R K; Lipman, M; Story, A; Hayward, A; de Vries, G; van Hest, R; Erkens, C; Rangaka, M X; Abubakar, I

    2018-05-01

    Vulnerable populations, including homeless persons, high-risk drug and alcohol users, prison inmates and other marginalised populations, contribute a disproportionate burden of tuberculosis (TB) cases in low-incidence settings. Drivers of this disease burden include an increased risk of both TB transmission in congregate settings, and progression from infection to active disease. Late diagnosis and poor treatment completion further propagate the epidemic and fuel the acquisition of drug resistance. These groups are therefore a major priority for TB control programmes in low-incidence settings. Targeted strategies include active case finding (ACF) initiatives and interventions to improve treatment completion, both of which should be tailored to local populations. ACF usually deploys mobile X-ray unit screening, which allows sensitive, high-throughput screening with immediate availability of results. Such initiatives have been found to be effective and cost-effective, and associated with reductions in proxy measures of transmission in hard-to-reach groups. The addition of point-of-care molecular diagnostics and automated X-ray readers may further streamline the screening pathway. There is little evidence to support interventions to improve adherence among these risk groups. Such approaches include enhanced case management and directly observed treatment, while video-observed therapy (currently under evaluation) appears to be a promising tool for the future. Integrating outreach services to include both case detection and case-management interventions that share a resource infrastructure may allow cost-effectiveness to be maximised. Integrating screening and treatment for other diseases that are prevalent among targeted risk groups into TB outreach interventions may further improve cost-effectiveness. This article reviews the existing literature, and highlights priorities for further research.

  6. User and group storage management the CMS CERN T2 centre

    Science.gov (United States)

    Cerminara, G.; Franzoni, G.; Pfeiffer, A.

    2015-12-01

    A wide range of detector commissioning, calibration and data analysis tasks is carried out by CMS using dedicated storage resources available at the CMS CERN Tier-2 centre. Relying on the functionalities of the EOS disk-only storage technology, the optimal exploitation of the CMS user/group resources has required the introduction of policies for data access management, data protection, cleanup campaigns based on access pattern, and long term tape archival. The resource management has been organised around the definition of working groups and the delegation to an identified responsible of each group composition. In this paper we illustrate the user/group storage management, and the development and operational experience at the CMS CERN Tier-2 centre in the 2012-2015 period.

  7. User and group storage management the CMS CERN T2 centre

    CERN Document Server

    Cerminara, G; Pfeiffer, A

    2015-01-01

    A wide range of detector commissioning, calibration and data analysis tasks is carried out by CMS using dedicated storage resources available at the CMS CERN Tier-2 centre. Relying on the functionalities of the EOS disk-only storage technology, the optimal exploitation of the CMS user/group resources has required the introduction of policies for data access management, data protection, cleanup campaigns based on access pattern, and long term tape archival. The resource management has been organised around the definition of working groups and the delegation to an identified responsible of each group composition. In this paper we illustrate the user/group storage management, and the development and operational experience at the CMS CERN Tier-2 centre in the 2012-2015 period.

  8. Web-based management of research groups - using the right tools and an adequate integration strategy

    Energy Technology Data Exchange (ETDEWEB)

    Barroso, Antonio Carlos de Oliveira; Menezes, Mario Olimpio de, E-mail: barroso@ipen.b, E-mail: mario@ipen.b [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil). Grupo de Pesquisa em Gestao do Conhecimento Aplicada a Area Nuclear

    2011-07-01

    Nowadays broad interest in a couple of inter linked subject areas can make the configuration of a research group to be much diversified both in terms of its components and of the binding relationships that glues the group together. That is the case of the research group for knowledge management and its applications to nuclear technology - KMANT at IPEN, a living entity born 7 years ago and that has sustainably attracted new collaborators. This paper describes the strategic planning of the group, its charter and credo, the present components of the group and the diversified nature of their relations with the group and with IPEN. Then the technical competencies and currently research lines (or programs) are described as well as the research projects, and the management scheme of the group. In the sequence the web-based management and collaboration tools are described as well our experience with their use. KMANT have experiment with over 20 systems and software in this area, but we will focus on those aimed at: (a) web-based project management (RedMine, ClockinIT, Who does, PhProjekt and Dotproject); (b) teaching platform (Moodle); (c) mapping and knowledge representation tools (Cmap, Freemind and VUE); (d) Simulation tools (Matlab, Vensim and NetLogo); (e) social network analysis tools (ORA, MultiNet and UciNet); (f) statistical analysis and modeling tools (R and SmartPLS). Special emphasis is given to the coupling of the group permanent activities like graduate courses and regular seminars and how newcomers are selected and trained to be able to enroll the group. A global assessment of the role the management strategy and available tool set for the group performance is presented. (author)

  9. Web-based management of research groups - using the right tools and an adequate integration strategy

    International Nuclear Information System (INIS)

    Barroso, Antonio Carlos de Oliveira; Menezes, Mario Olimpio de

    2011-01-01

    Nowadays broad interest in a couple of inter linked subject areas can make the configuration of a research group to be much diversified both in terms of its components and of the binding relationships that glues the group together. That is the case of the research group for knowledge management and its applications to nuclear technology - KMANT at IPEN, a living entity born 7 years ago and that has sustainably attracted new collaborators. This paper describes the strategic planning of the group, its charter and credo, the present components of the group and the diversified nature of their relations with the group and with IPEN. Then the technical competencies and currently research lines (or programs) are described as well as the research projects, and the management scheme of the group. In the sequence the web-based management and collaboration tools are described as well our experience with their use. KMANT have experiment with over 20 systems and software in this area, but we will focus on those aimed at: (a) web-based project management (RedMine, ClockinIT, Who does, PhProjekt and Dotproject); (b) teaching platform (Moodle); (c) mapping and knowledge representation tools (Cmap, Freemind and VUE); (d) Simulation tools (Matlab, Vensim and NetLogo); (e) social network analysis tools (ORA, MultiNet and UciNet); (f) statistical analysis and modeling tools (R and SmartPLS). Special emphasis is given to the coupling of the group permanent activities like graduate courses and regular seminars and how newcomers are selected and trained to be able to enroll the group. A global assessment of the role the management strategy and available tool set for the group performance is presented. (author)

  10. Risk management of radiation therapy. Survey by north Japan radiation therapy oncology group

    International Nuclear Information System (INIS)

    Aoki, Masahiko; Abe, Yoshinao; Yamada, Shogo; Hareyama, Masato; Nakamura, Ryuji; Sugita, Tadashi; Miyano, Takashi

    2004-01-01

    A North Japan Radiation Oncology Group (NJRTOG) survey was carried out to disclose the risk management of radiation therapy. During April 2002, we sent questionnaires to radiation therapy facilities in northern Japan. There were 31 replies from 27 facilities. Many incidents and accidents were reported, including old cases. Although 60% of facilities had a risk management manual and/or risk manager, only 20% had risk management manuals for radiation therapy. Eighty five percent of radiation oncologists thought that incidents may be due to a lack of manpower. Ninety percent of radiation oncologists want to know the type of cases happened in other facilities. The risk management system is still insufficient for radiation therapy. We hope that our data will be a great help to develop risk management strategies for radiation therapy for all radiation oncologists in Japan. (author)

  11. Diabetes quality management in Dutch care groups and outpatient clinics: a cross-sectional study.

    Science.gov (United States)

    Campmans-Kuijpers, Marjo J E; Baan, Caroline A; Lemmens, Lidwien C; Rutten, Guy E H M

    2014-08-07

    In recent years, most Dutch general practitioners started working under the umbrella of diabetes care groups, responsible for the organisation and coordination of diabetes care. The quality management of these new organisations receives growing interest, although its association with quality of diabetes care is yet unclear. The best way to measure quality management is unknown and it has not yet been studied at the level of outpatient clinics or care groups. We aimed to assess quality management of type 2 diabetes care in care groups and outpatient clinics. Quality management was measured with online questionnaires, containing six domains (see below). They were divided into 28 subdomains, with 59 (care groups) and 57 (outpatient clinics) questions respectively. The mean score of the domains reflects the overall score (0-100%) of an organisation. Two quality managers of all Dutch care groups and outpatient clinics were invited to fill out the questionnaire.Sixty care groups (response rate 61.9%) showed a mean score of 59.6% (CI 57.1-62.1%). The average score in 52 outpatient clinics (response rate 50.0%) was 61.9% (CI 57.5-66.8%).Mean scores on the six domains for care groups and outpatient clinics respectively were: 'organisation of care' 71.9% (CI 68.8-74.9%), 76.8% (CI 72.8-80.7%); 'multidisciplinary teamwork' 67.1% (CI 62.4-71.9%), 71.5% (CI 65.3-77.8%); 'patient centeredness' 46.7% (CI 42.6-50.7%), 62.5% (CI 57.7-67.2%); 'performance management' 63.3% (CI 61.2-65.3%), 50.9% (CI 44.2-57.5%); 'quality improvement policy' 52.6% (CI 49.2-56.1%), 50.9% (CI 44.6-57.3%); and 'management strategies' 56.0% (CI 51.4-60.7%), 59.0% (CI 52.8-65.2%). On subdomains, care groups scored highest on 'care program' (83.3%) and 'measured outcomes' (98.3%) and lowest on 'patient safety' (15.1%) and 'patient involvement' (17.7%). Outpatient clinics scored high on the presence of a 'diabetic foot team' (81.6%) and the support in 'self-management' (81.0%) and low on 'patient

  12. Managing Uncertainties Associated With Radioactive Waste Disposal: Task Group 4 Of The IAEA PRISM Project

    International Nuclear Information System (INIS)

    Seitz, R.

    2011-01-01

    It is widely recognized that the results of safety assessment calculations provide an important contribution to the safety arguments for a disposal facility, but cannot in themselves adequately demonstrate the safety of the disposal system. The safety assessment and a broader range of arguments and activities need to be considered holistically to justify radioactive waste disposal at any particular site. Many programs are therefore moving towards the production of what has become known as a Safety Case, which includes all of the different activities that are conducted to demonstrate the safety of a disposal concept. Recognizing the growing interest in the concept of a Safety Case, the International Atomic Energy Agency (IAEA) is undertaking an intercomparison and harmonization project called PRISM (Practical Illustration and use of the Safety Case Concept in the Management of Near-surface Disposal). The PRISM project is organized into four Task Groups that address key aspects of the Safety Case concept: Task Group 1 - Understanding the Safety Case; Task Group 2 - Disposal facility design; Task Group 3 - Managing waste acceptance; and Task Group 4 - Managing uncertainty. This paper addresses the work of Task Group 4, which is investigating approaches for managing the uncertainties associated with near-surface disposal of radioactive waste and their consideration in the context of the Safety Case. Emphasis is placed on identifying a wide variety of approaches that can and have been used to manage different types of uncertainties, especially non-quantitative approaches that have not received as much attention in previous IAEA projects. This paper includes discussions of the current results of work on the task on managing uncertainty, including: the different circumstances being considered, the sources/types of uncertainties being addressed and some initial proposals for approaches that can be used to manage different types of uncertainties.

  13. Nominal Group Technique and its Applications in Managing Quality in Higher Education

    Directory of Open Access Journals (Sweden)

    Rafikul Islam

    2011-09-01

    Full Text Available Quality management is an important aspect in all kinds of businesses – manufacturing or service. Idea generation plays a pivotal role in managing quality in organizations. It is thenew and innovative ideas which can help corporations to survive in the turbulent business environment. Research in group dynamics has shown that more ideas are generated by individuals working alone but in a group environment than the individuals engaged in a formal group discussion. In Nominal Group Technique (NGT, individuals work alone but in a group setting. This paper shows how NGT can be applied to generate large number of ideas to solve quality related problems specifically in Malaysian higher education setting. The paper also discusses the details of NGT working procedure andexplores the areas of its further applications.

  14. The Effect of Management Style on Encouraging Creativity in a Work Group

    Directory of Open Access Journals (Sweden)

    Uroš Bižal

    2013-10-01

    Full Text Available Research Question (RQ: Whether and how the manager with his management style affects the creativity of employees in departmentproduction preparation?Purpose: The purpose is to examine the management style through the eyes of managers and employees. In addition, the purpose was todiscover the optimal management style to be used by the manager tomaintain maximum creative employees in a work group.Method: The method used was to review existing literature and quantitative analysis of a closed - type questionnaire. Data analysiswas performed by using the average value, dependent ANOVA test andPearson correlation coefficient.Results: The results of the study provided a deeper insight into themanagement of the studied work group. Managers and most of the workers assessed management style as a dense (unified, but other tendencies were also visible. Employees estimated that in the workplace creativity is promoted with dense (unified management style, and partly contributes to the goal achievement with an ambitious management style.Organization: The organization will analyse the results and, if necessary, introduce improvements to procedures to improve overallbusiness excellence.Society: Study was conducted in one of the fastest growing companiesin the Dolenjska - Posavje region in which they are aware of theresponsibilities and role model to other businesses in the region,which is reflected in the constant care for employees withappropriate conditions for work and education, decent wages andbonuses. This is all cared for by responsible and capable management.Originality: This is the first research study of this type in the company studied.Limitations/Future Research: This study was conducted only in the production preparation department, but such an analysis should be implemented within other departments.

  15. Understanding perceptions of stakeholder groups about Forestry Best Management Practices in Georgia.

    Science.gov (United States)

    Tumpach, Chantal; Dwivedi, Puneet; Izlar, Robert; Cook, Chase

    2018-05-01

    Forestry Best Management Practices (BMPs) are critical in ensuring sustainable forest management in the United States because of their effectiveness in protecting water quality, reducing soil erosion, maintaining riparian habitat, and sustaining site productivity. The success of forestry BMPs depends heavily on coordination among primary stakeholder groups. It is important to understand perceptions of such groups for a successful forest policy formulation. We used the SWOT-AHP (Strengths, Weaknesses, Opportunities, and Threats analysis with the Analytical Hierarchy Process) framework to assess perceptions of three stakeholder groups (loggers, landowners, agency foresters) about forestry BMPs in Georgia, the largest roundwood producing state in the United States. The agency and logger stakeholder groups gave the highest priority to improved reputation under the strength category, whereas the landowner stakeholder group perceived sustainable forestry as the highest priority under the same category. Lack of landowner education was the highest priority under the weakness category for landowner and agency stakeholder groups, whereas the logger stakeholder group selected lack of trained personnel as the highest priority under the same category. Agency and landowner stakeholder groups gave the highest priority to training and education while loggers indicated maintenance of forest-based environmental benefits as their highest priority under the opportunity category. Finally, landowners and agency stakeholder groups perceived more regulations and restrictions as most significant in the threat category whereas the logger stakeholder group was most concerned about the insufficient accounting of cost sharing under the same category. Overall, selected stakeholder groups recognize the importance of forestry BMPs and had positive perceptions about them. A collaborative approach based on continuous feedback can streamline expectations of stakeholder groups about forestry BMPs in

  16. EXPERIENCE OF BARRIERS TO HYPERTENSION MANAGEMENT IN MINANGKABAU ETHNIC GROUP IN PAYAKUMBUH INDONESIA: A PHENOMENOLOGICAL STUDY

    Directory of Open Access Journals (Sweden)

    Vera Kurnia

    2018-05-01

    Full Text Available Background: Understanding barriers to hypertension managements remains important to reduce the hypertension rate in community. Minangkabau is one of the ethnic groups in West Sumatra Indonesia that has a high proportion of people with hypertension although its management has been implemented. Objective: This study aims to explore the experiences of barriers to hypertension management in Minangkabau ethnic group in Payakumbuh, Indonesia. Methods: This was a phenomenological study with twelve respondents selected using purposive sampling. Data were collected using in-depth interview. Colaizzi’s content analysis method was used for data analysis. Results: Five themes were emerged from the data, namely: (i lack of self-motivation in the management of hypertension, (ii disobedience in the management of hypertension, (iii culture pattern of food intake, (iv lack of social support, and (v excessive stress and anxiety. Conclusions: The barriers to hypertension management in Minangkabau ethnic group are closely related to its culture both in lifestyle and in food intake of the family members and the community. Nurses are expected toalways give health education about hypertension and finding the way to control it.

  17. The challenge of employing and managing new graduate midwives in midwifery group practices in hospitals.

    Science.gov (United States)

    Cummins, Allison M; Denney-Wilson, E; Homer, C S E

    2016-07-01

    This study explores the views of midwifery managers and key stakeholders, regarding the facilitators and barriers to employing new graduate midwives in midwifery continuity of care models. Maternity services in Australia are shifting towards midwifery continuity of care models, where midwives work in small group practices, requiring a change to the management of staff. Public policy in Australia supports maternity services to be reconfigured in this way. Historically, experienced midwives work in these models, as demand grows; new graduates are employed to staff the models. A qualitative descriptive approach exploring the manager's experience of employing new graduate's in the models. Managers, clinical educators and hospital midwifery consultants (n = 15) were recruited by purposeful sampling. Drivers, enablers, facilitators and barriers to employing new graduates in the models were identified. Visionary leadership enabled the managers to employ new graduates in the models through initial and ongoing support. Managing the myths stemming from fear of employing new graduates to work in midwifery continuity of care models was challenging. Managers and other key stakeholders provide initial and ongoing support through orientation and providing a reduced workload. Visionary leadership can be seen as critical to supporting new graduates into midwifery continuity of care models. The challenges for management to overcome include managing the myths stemming from fear of employing new graduates to work in a flexible way around the needs of the women within an organisation culture. © 2016 John Wiley & Sons Ltd.

  18. The role of bridging organizations in environmental management: examining social networks in working groups

    Directory of Open Access Journals (Sweden)

    Adam A. Kowalski

    2015-06-01

    Full Text Available The linkage of diverse sets of actors and knowledge systems across management levels and institutional boundaries often poses one of the greatest challenges in adaptive management of natural resources. Bridging organizations can facilitate interactions among actors in management settings by lowering the transaction costs of collaboration. The Center for Ocean Solutions (COS is an example of a bridging organization that is focused on linking actors within the ocean sciences and governance arena through the use of working groups. This research examines how network connections between group members affect working group functionality and, more specifically, whether cohesive network structures allow groups to more effectively achieve their goals and objectives. A mixed-methods approach, incorporating both qualitative and quantitative data collection and analysis methods, is employed to understand the structural characteristics of COS working groups. The study finds that cohesive network structures are not associated with increased working group functionality. Strong, centralized leadership is a better predictor of working group success in achieving goals and objectives.

  19. The role of enterprise asset management system in the PVO group's business

    International Nuclear Information System (INIS)

    Jaervinen, J.

    1998-01-01

    This presentation describes the role of the Enterprise Asset Management (EAM) and Enterprise Document Management (EDM) in the PVO Group's business. The use of the functionality of the EAM (Immpower) and EDM (Documentum) is not limited only to the plant maintenance. All power plants and some other business functions and units will use the system in the future for financial management, activity based costing, purchasing, of materials, office supplies and fuel, invoice matching, project budgeting and costing, real estate management etc. The technical service concept of IT solution is also described in this presentation. The Information Management Strategy development as background to the project is also outlined together with the company information. The benefits of the common EAM system and related business process needs are also described. (orig.)

  20. Distributed Group-Based Mobility Management Scheme in Wireless Body Area Networks

    Directory of Open Access Journals (Sweden)

    Moneeb Gohar

    2017-01-01

    Full Text Available For group-based mobility management in 6LoWPAN-based wireless body area networks (WBAN, some schemes using the Proxy Mobile IPv6 (PMIP have been proposed. However, the existing PMIP-based mobility schemes tend to induce large registration delay and handover delay. To overcome such limitations, we propose a new distributed group-based mobility management scheme, in which the Local Mobility Anchor (LMA function is implemented by each Mobile Access Gateway (MAG and the handover operation is performed between two neighboring MAGs without the help of LMA. Besides, each MAG maintains the information of the group of mobile sensors and aggregates the Authentication-Authorization-Accounting (AAA query messages for a group of mobile sensors as a “single” message to decrease the control overhead. By numerical analysis, it is shown that the proposed scheme can reduce the registration and handover delays, compared to the existing PMIP-based mobility schemes.

  1. Factors affecting research productivity of production and operations management groups: An empirical study

    OpenAIRE

    George C. Hadjinicola; Andreas C. Soteriou

    2006-01-01

    This paper identifies factors that promote research productivity of production and operations management (POM) groups of researchers in US business schools. In this study, research productivity of a POM group is defined as the number of articles published per POM professor in a specific period of time. The paper also examines factors that affect research quality, as measured by the number of articles published per POM professor in journals, which have been recognized in the POM literature as ...

  2. A Dynamic Active Multicast Group Access Control Framework Based on Trust Management System

    Institute of Scientific and Technical Information of China (English)

    YANG Chang; CHEN Xiaolin; ZHANG Huanguo

    2006-01-01

    The current multicast model provides no access control mechanism. Any host can send data directly to a multicast address or join a multicast group to become a member, which brings safety problems to multicast. In this paper, we present a new active multicast group access control mechanism that is founded on trust management. This structure can solve the problem that exists in multicast members' access control and distributing authorization of traditional IP multicast.

  3. 412th Test Engineering Group Vision for Future Knowledge Management (KM)

    Science.gov (United States)

    2018-05-17

    Presentation 3. DATES COVERED (From - To) 17 May 2018 4. TITLE AND SUBTITLE 412th Test Engineering Group Vision for Future Knowledge Management (KM... Engineering Group 307 E. Popson Ave Edwards AFB, CA 93523 8. PERFORMING ORGANIZATION REPORT NUMBER 412TW-PA...centers for the TENG test customers to allow the data to be readily available within minutes of a flight, for the data to be organized so that the engineer

  4. A Nordic survey of management practices and owners' attitudes towards keeping horses in groups.

    Science.gov (United States)

    Hartmann, E; Bøe, K E; Christensen, J W; Hyyppä, S; Jansson, H; Jørgensen, G H M; Ladewig, J; Mejdell, C M; Norling, Y; Rundgren, M; Särkijärvi, S; Søndergaard, E; Keeling, L J

    2015-09-01

    Keeping horses in groups is widely recommended but limited information is available about how this is implemented in practice. The aim of this survey was to describe how horses are kept in the Nordic countries in relation to sex, age, breed, and equestrian discipline and to assess owners' attitudes toward keeping horses in groups. Horse owners in Denmark, Finland, Norway, and Sweden were approached using a web-based questionnaire, which was translated into 4 languages and distributed online via equestrian forums, organizations, and social media. The number of respondents was 3,229, taking care of 17,248 horses. Only 8% of horses were never kept in groups, 47% were permanently grouped for 24 h/d, and 45% were stabled singly but grouped during turnout. Yearlings were most often permanently kept in groups (75%), mares and geldings more commonly during parts of the day (50 and 51%, respectively), and stallions were often kept alone (38%). Icelandic horses were more likely to be permanently kept in groups (36%) than warmbloods (16%) and ponies (15%). Twice as many competition horses (51%) were never grouped compared with horses used for breeding (20%) or leisure purposes (15%). The majority of respondents (86%) strongly agreed that group housing benefits horse welfare and that it is important for horses to have the company of conspecifics (92%). Nevertheless, not all horses were kept in groups, showing that attitudes toward group housing may not necessarily reflect current management. The risk of injury was a concern of many respondents (45%), as was introducing unfamiliar horses into already established groups (40%) and challenges in relation to feeding in groups (44%). Safety of people (23%) and difficulties handling group-kept horses (19%) were regarded as less problematic. Results suggest that the majority of horses have the possibility to freely interact with other horses, either as fulltime members of a group during 24 h/d or during turnout. Future research should

  5. Social management of laboratory rhesus macaques housed in large groups using a network approach: A review.

    Science.gov (United States)

    McCowan, Brenda; Beisner, Brianne; Hannibal, Darcy

    2017-12-07

    Biomedical facilities across the nation and worldwide aim to develop cost-effective methods for the reproductive management of macaque breeding groups, typically by housing macaques in large, multi-male multi-female social groups that provide monkey subjects for research as well as appropriate socialization for their psychological well-being. One of the most difficult problems in managing socially housed macaques is their propensity for deleterious aggression. From a management perspective, deleterious aggression (as opposed to less intense aggression that serves to regulate social relationships) is undoubtedly the most problematic behavior observed in group-housed macaques, which can readily escalate to the degree that it causes social instability, increases serious physical trauma leading to group dissolution, and reduces psychological well-being. Thus for both welfare and other management reasons, aggression among rhesus macaques at primate centers and facilities needs to be addressed with a more proactive approach.Management strategies need to be instituted that maximize social housing while also reducing problematic social aggression due to instability using efficacious methods for detection and prevention in the most cost effective manner. Herein we review a new proactive approach using social network analysis to assess and predict deleterious aggression in macaque groups. We discovered three major pathways leading to instability, such as unusually high rates and severity of trauma and social relocations.These pathways are linked either directly or indirectly to network structure in rhesus macaque societies. We define these pathways according to the key intrinsic and extrinsic variables (e.g., demographic, genetic or social factors) that influence network and behavioral measures of stability (see Fig. 1). They are: (1) presence of natal males, (2) matrilineal genetic fragmentation, and (3) the power structure and conflict policing behavior supported by this

  6. Managing the market. Focusing on a select group of customers can keep an organization competitive.

    Science.gov (United States)

    MacStravic, R S

    1989-05-01

    The real challenge in healthcare marketing today is managing markets, focusing on selected groups of customers rather than on the organization or its services. Market management includes three distinct but related levels: Strategic market management assesses current and potential markets and chooses those the organization can serve best; segment management focuses on the needs and wants of subsets of chosen customers; and customer management reinforces long-term commitments to the organization. The patient care experience can be broken down into specific contacts with each staff member. The key to managing the experience is to identify and achieve standards of performance for each contact by examining what each event means to the patients and how patients judge each staff member, as well as the overall care experience. Regular feedback helps. An unavoidable risk in market management is that a given segment may decline in size, in need for services, or in cohesiveness as a segment. Yet those organizations which can identify the right segments and "manage" them effectively will have an advantage in a competitive market.

  7. Considering the intrinsic constraints for groups management of TAPPS & Jigsaw CLFPs

    NARCIS (Netherlands)

    Pérez-Sanagustín, Mar; Burgos, Javier; Hernández-Leo, Davinia; Blat, Josep

    2009-01-01

    Pérez-Sanagustín, M., Burgos, J., Hernández-Leo, D., & Blat, J. (2009). Considering the intrinsic constraints for groups management of TAPPS & Jigsaw CLFPs. Proceedings of International Conference on Intelligent Networking and Collaborative Systems (INCoS 2009). November, 4-6, 2009, Barcelona,

  8. The Correlation between Interpersonal Communication Skills of Inspection Groups and Their Conflict Management Strategies

    Science.gov (United States)

    Sabanci, Ali; Sahin, Ahmet; Özdemir, Izzet

    2018-01-01

    The purpose of this study was to explore the correlation between interpersonal communication skills and conflict management strategies in the case of inspection groups constituted by a number of inspectors based on the geographical and demographic dispersion of the school population in Turkey. This research was conducted as a survey. The…

  9. Leadership-Driven Anger Management Groups for Adolescents: Do They Really Work?

    Science.gov (United States)

    Burt, Isaac

    2018-01-01

    This study investigated a current trend in anger-management groups labeled as leadership development. The goal of the investigation was to determine if leadership is a critical factor in working with angry youth. A total of 52 middle school-aged adolescents from 2 schools served as participants. Of those, 18 participants received a strength-based,…

  10. L-040: EPR-First Responders: Forensic Evidence Management group. Action Guides

    International Nuclear Information System (INIS)

    2011-01-01

    This conference is about the forensic evidence managed by the radiological emergency group. The protection guides, the evidences, the fingerprints, the experience, the strategies, the contamination level, the monitoring, the photography and the interrogation are important aspects to be considered by the first responders.

  11. An Empirical Study of Hospitality Management Student Attitudes toward Group Projects: Instructional Factors and Team Problems

    Science.gov (United States)

    Choi, Youngsoo; Ro, Heejung

    2012-01-01

    The development of positive attitudes in team-based work is important in management education. This study investigates hospitality students' attitudes toward group projects by examining instructional factors and team problems. Specifically, we examine how the students' perceptions of project appropriateness, instructors' support, and evaluation…

  12. European Education Thesaurus: Meeting of the Thesaurus Management Group (Budapest, Hungry, November 6-8, 1996).

    Science.gov (United States)

    EURYDICE European Unit, Brussels (Belgium).

    This report offers the agenda for a meeting in Budapest in November 1996 of the Thesaurus Management Group of the Council of Europe. The report includes a list of participants, a report on previous meetings, information on availability of the 1991 version of the thesaurus and subsequent addenda, information on new versions to be created, and a…

  13. A Retention Assessment Process: Utilizing Total Quality Management Principles and Focus Groups

    Science.gov (United States)

    Codjoe, Henry M.; Helms, Marilyn M.

    2005-01-01

    Retaining students is a critical topic in higher education. Methodologies abound to gather attrition data as well as key variables important to retention. Using the theories of total quality management and focus groups, this case study gathers and reports data from current college students. Key results, suggestions for replication, and areas for…

  14. WS-007: EPR-First Responders: Practical applications of FEMG concepts (Group management of forensic evidence)

    International Nuclear Information System (INIS)

    2011-01-01

    The purpose of this working session is that the participants can apply their knowledge in a potential crime. They have to know the forensic management group actions as well as how to preservate the scene and victim evidences for the forensic studies and how to prevent cross-contamination

  15. Local land management in Benin with special reference to pastoral groups

    NARCIS (Netherlands)

    L.J. de Haan (Leo); T. Djedjebi

    2000-01-01

    textabstractA review of local land management experiences in West Africa reveals that the resolution of conflicts over the uses of resources between herders and farmers depends on factors like land and water rights, promotion of the interests of pastoral groups and the Intervention of

  16. A Case Study: An ACT Stress Management Group in a University Counseling Center

    Science.gov (United States)

    Daltry, Rachel M.

    2015-01-01

    The aim of this study was to examine the effectiveness of an acceptance and commitment therapy (ACT) stress management group in a college counseling center setting. This study explored (a) the effectiveness of ACT in increasing participants' ability to tolerate distress, which directly affects their ability to function in a stressful college…

  17. 77 FR 22622 - AP Henderson Group, BPO Management Services, Inc., Capital Mineral Investors, Inc...

    Science.gov (United States)

    2012-04-16

    ... SECURITIES AND EXCHANGE COMMISSION [File No. 500-1] AP Henderson Group, BPO Management Services, Inc., Capital Mineral Investors, Inc., CardioVascular BioTherapeutics, Inc., and 1st Centennial... that there is a lack of current and accurate information concerning the securities of 1st Centennial...

  18. Do stakeholder groups influence environmental management system development in the Dutch agri-food sector?

    NARCIS (Netherlands)

    Bremmers, H.J.; Omta, S.W.F.; Kemp, R.G.M.; Haverkamp, D.J.

    2007-01-01

    This paper presents the results of a survey that included 492 companies in the Dutch agri-food sector with respect to the influence of stakeholder groups on the companies' level of environmental management system (EMS) implementation. It is concluded that primary stakeholders (government, clients)

  19. Self-Management Group Exercise Extends Healthy Life Expectancy in Frail Community-Dwelling Older Adults.

    Science.gov (United States)

    Yamada, Minoru; Arai, Hidenori

    2017-05-15

    Preventing frailty and its adverse health outcomes is crucial in countries with a large elderly population, such as Japan. Since the long-term care insurance (LTCI) system was launched, the number of certified older adults with LTCI service requirement has continued to increase. This is a serious problem, because the LTCI service requirement certification is equivalent to disability. The aim of this study was to evaluate the effect of a self-management group intervention on new LTCI service requirement certifications in community-dwelling older adults in Japan. We analyzed the cohort data from a prospective study. In this study, we recruited community-dwelling adults aged 65 years and older who were independent in a city in Kyoto prefecture in 2012. The subjects in the participation group (n = 1620) attended 60-min group training sessions once or twice every two weeks from December 2012 to December 2016. The exercise sessions consisted of mild-intensity aerobic exercise, mild strength training, flexibility and balance exercises, and cool-down activities. These exercise classes were facilitated by well-trained volunteer staff. The outcome measure was the number of new LTCI requirement certifications during a four-year follow-up period. During the four-year follow-up period, 247 subjects (15.2%) in the participation group and 334 (20.6%) in the control group were newly certified for LTCI service requirements. The hazard ratio for new LTCI service requirements in the participation group compared with the control group was 0.73 (95% CI = 0.62-0.86) in the four-year follow-up period. These results indicate the usefulness of self-management group exercise to reduce the incidence of disability in older adults. Thus, increasing self-management group activities in each community should be encouraged.

  20. Electricity company managers' views of environmental issues: Implications for environmental groups and government

    International Nuclear Information System (INIS)

    Fischhoff, Maya E.

    2007-01-01

    The electricity industry's environmental impacts are a matter of acute interest to many outsiders, including government and environmental groups-and they have sought to affect those impacts through regulations, public pressure, and technical assistance. These approaches reflect outsiders' intuitive theories regarding the industry's goals, practices, and capabilities. The research reported here provides a systematic insiders' view on these processes, based on in-depth interviews with 70 middle managers in two electricity companies heavily reliant on coal. It finds managers sincerely committed to environmental action, but often frustrated by confusing regulatory requirements, perceived costs, and other challenges. It identifies ways of enabling middle managers to act on their commitment, with lessons relevant for outside groups and those within companies seeking to effect change

  1. Regional cooperation-activities of the working group on waste management

    International Nuclear Information System (INIS)

    Brooks, G.L.

    1987-01-01

    A Working Group on Waste Management was formally established by the Pacific Basin Nuclear Cooperation Committee at its meeting on November 19, 1986. Co-chairmen are Dr. Kunihiko Uematsu of Japan and the author, Gordon L. Brooks of Canada. Since the Working Group is newly formed, a consensus program has not yet been developed. In lieu of this, the author suggests a series of basic issues and possible areas of future collaboration which could serve as a starting point for the Working Group in developing an appropriate cooperative program. (author)

  2. Management of CML in the Pediatric Age Group: Imatinib Mesylate or SCT.

    Science.gov (United States)

    El-Alfy, Mohsen S; Al-Haddad, Alaa M; Hamed, Ahmed A

    2010-12-01

    Management of CML has changed markedly since the introduction of tyrosine kinase inhibitors (TKIs). However stem cell transplantation (SCT) remains a valid therapeutic modality especially in developing countries due to its relatively lower cost. We aim to compare between imatinib mesylate and SCT as regard outcome in CML in the pediatric age group. Forty-eight patients with newly diagnosed CML in the chronic phase, aged 3 to 18 years were enrolled in this prospective study. Patients without a matched donor (Group I; N=30) were assigned to receive imatinib mesylate at a dose of 340mg÷m2÷day, while patients with a fully matched related donor (Group II; N=18), were offered SCT. Response (hematologic, cytogenetic and molecular), side effects and survival were analyzed. Complete hematologic response was obtained in 97% of the patients in group I and 94% in group II. Major cytogenetic response (CyR) was obtained in 80% of patients in group I and 100% in group II. Complete CyR was 57% in group I and 64% in group II. Major molecular response (MMR) was 36% in group I and 50% in group II with no significant difference between both groups. Six years overall survival (OS) was 87% in the 1st group and 61% in the 2nd group (pSCT group (55% had GVHD and 78% had infection). Imatinib mesylate has a superior OS and EFS than SCT in children. It is generally safe and well tolerated. Imatinib mesylate should be the 1st line treatment of pediatric patients with CML in the chronic phase. CML- Imatinib- SCT- Pediatrics.

  3. 8 Different approaches needed to manage ED demand among different age-groups.

    Science.gov (United States)

    Rimmer, Melanie; Ablard, Suzanne; O'Keeffe, Colin; Mason, Suzanne

    2017-12-01

    A variety of interventions have been proposed to manage rising demand for Emergency and Urgent Care, described by an NHS England review as unsustainable in the long term. However it is unlikely that any suggested approach will be equally suitable for the diverse population of ED users.We aimed to understand the patterns of demand amongst different types of patients attending ED. We also sought to understand the intended and unintended effects of demand management initiatives. Our study combined insights from routine data, a survey of ED patients, and qualitative interviews with ED staff. This paper describes the results of our analysis of the interviews. We conducted semi-structured interviews with 25 ED and Urgent Care Centre staff across 7 hospital sites in Yorkshire and Humber between 25 April and 11 July 2016. The interview topic guide asked about 4 broad areas; job role, description of patients and their impact on demand, description of inappropriate attendance, and current/future initiatives to deal with rising demand. Interviews were transcribed verbatim and analysed using framework analysis. We analysed the results to identify groups of patients with different patterns of use of ED services. We also explored ED staff experiences of demand management initiatives, and their suggestions for future initiatives. Although we did not ask specifically about patients' age, our analysis revealed that ED staff categorised attenders as children and young people, working age people, and older people. These groups had different reasons for attendance, different routes to the ED, different rate of non-urgent attendance, and different issues driving demand. Staff also described variation in the time taken to treat patients of different ages, with the oldest and youngest patients described as requiring the most time.There was no consensus amongst staff about the effectiveness of initiatives for managing demand. A strikingly wide variety of initiatives were mentioned

  4. Conflict Management in Student Groups - a Teacher’s Perspective in Higher Education

    Directory of Open Access Journals (Sweden)

    Markus Borg

    2011-12-01

    Full Text Available Students working in groups is a commonly used method of instruction in higher education, popularized by the introduction of problem based learning. As a result, management of small groups of people has become an important skill for teachers. The objective of our study is to investigate why conflicts arise in student groups at the Faculty of Engineering at Lund University and how teachers manage them. We have conducted an exploratory interdepartmental interview study on teachers' views on this matter, interviewing ten university teachers with different levels of seniority. Our results show that conflicts frequently arise in group work, most commonly caused by different levels of ambition among students. We also found that teachers prefer to work proactively against conflicts and stress the student’s responsibility. Finally, we show that teachers at our faculty tend to avoid the more drastic conflict resolution strategies suggested by previous research. The outcome of our study could be used as input to future guidelines on conflict management in student groups.

  5. Managing a work-life balance: the experiences of midwives working in a group practice setting.

    Science.gov (United States)

    Fereday, Jennifer; Oster, Candice

    2010-06-01

    To explore how a group of midwives achieved a work-life balance working within a caseload model of care with flexible work hours and on-call work. in-depth interviews were conducted and the data were analysed using a data-driven thematic analysis technique. Children, Youth and Women's Health Service (CYWHS) (previously Women's and Children's Hospital), Adelaide, where a midwifery service known as Midwifery Group Practice (MGP) offers a caseload model of care to women within a midwife-managed unit. 17 midwives who were currently working, or had previously worked, in MGP. analysis of the midwives' individual experiences provided insight into how midwives managed the flexible hours and on-call work to achieve a sustainable work-life balance within a caseload model of care. it is important for midwives working in MGP to actively manage the flexibility of their role with time on call. Organisational, team and individual structure influenced how flexibility of hours was managed; however, a period of adjustment was required to achieve this balance. the study findings offer a description of effective, sustainable strategies to manage flexible hours and on-call work that may assist other midwives working in a similar role or considering this type of work setting. Copyright 2008 Elsevier Ltd. All rights reserved.

  6. Remote technology in spent fuel management. Proceedings of an advisory group meeting

    International Nuclear Information System (INIS)

    1999-01-01

    Spent fuel management has always been one of the important stages in the nuclear fuel cycle and it is still one of the most vital problems common to all countries with nuclear reactors. It begins with the discharge of spent fuel from a power or research reactor and ends with its ultimate disposition either by direct disposal or by reprocessing of the spent fuel. Continuous attention is being given by the IAEA to the collection, analysis and exchange of information on spent fuel management. Its role in this area is to provide a forum for exchanging information and development activities that are of common interest. Within its spent fuel management programme, the IAEA has monitored the progress, the benefits and the implementation of remote technologies such as remote tools, robotics, etc. An Advisory Group Meeting on Remote Technology in Spent Fuel Management was held in September 1997 in order to bring together specialists working in this field and to collect information on new technical and economic developments. The objective of the Advisory Group meeting was to review remote technologies in use for the complete range of spent fuel handling and spent fuel management covering wet and dry environments, to describe ongoing developments and to prepare a technical report. This document contains contributions presented at the Meeting. Each paper was indexed and provided with an abstract

  7. Spent fuel management: Current status and prospects 1997. Proceedings of a regular advisory group meeting

    International Nuclear Information System (INIS)

    1998-03-01

    Spent fuel management has always been one of the important stages in the nuclear fuel cycle and it is still most vital problems common to all countries with nuclear reactors. It begins with the discharge of spent fuel from a power or a research reactor and ends with its ultimate disposition. Two options exist - an open, once-through cycle with direct disposal of the spent fuel and a closed cycle with reprocessing of the spent fuel, recycling of reprocessed plutonium and uranium in new mixed oxide fuels and disposal of the radioactive waste. Continuous attention is being given by the IAEA to the collection, analysis and exchange of information on spent fuel management. Its role in this area is to provide a forum for exchanging information and to co-ordinate and to encourage closer co-operation among Member States in certain research and development activities that are of common interest. Spent fuel management is recognized as a high priority IAEA activity. The Regular Advisory Group on Spent Fuel Management was established in 1982. The objective of the Regular Advisory Group is to serve as a means of exchanging information on the current status and progress of national programmes on spent fuel management and to provide advice to the IAEA. The results of the last Regular Advisory Group meeting (9-12 September 1997) are reflected in this report. It gives an overview of the status of spent fuel management programmes in a number of countries, a description of the current status and prospects of activities in this field and recommendations of the participants

  8. Supporting self-management by Community Matrons through a group intervention; an action research study.

    Science.gov (United States)

    Barkham, Abigail M; Ersser, Steven J

    2017-07-01

    The aim of this study was to examine the feasibility and impact of a group intervention by Community Matrons to support those living with multiple long-terms conditions. Little evidence exists as to how the role of the Community Matron (CM) should be delivered to effectively enhance disease self-management and levels of self-efficacy for the service users. This qualitative participatory action research study explored the use of group work as a method of intervention by CMs. A purposive sample of 29 participants was recruited. Each patient group had 8-10 participants, led by a CM working in both the researcher and practitioner role, operating over 12-month period. Data were collected by participant observation, researcher reflexive account and interviews. Grounded theory method was used to systematically analyse the data. Three main data categories emerged: (i) comparison by patients that leads to re-motivation of the self; (ii) learning, leading to enhanced self-management techniques, through storytelling and understanding of each other's experiences; and (iii) ownership that resulted in the self-awareness, cognisance and insight into the role of the support group they were based in and how it benefited them. The core category of 'Taking back the self - understanding the whole,' conveyed the impact that this care delivery method had upon readjusting the balance of power between health professional and service users and its consequence in refreshing and improving their self-management and the patients' self-efficacy. It was concluded that CM intervention using a model of group learning can lead to more effective and efficient support, through improving self-efficacy and patients' related self-management ability. © 2017 John Wiley & Sons Ltd.

  9. Differences within the groups of physicians and managers in Dutch hospitals providing leads for intergroup cooperation : Running head: group differences in hospitals

    NARCIS (Netherlands)

    van Harten, Willem H.

    2010-01-01

    Background: Effective cooperation between physicians and managers is difficult to achieve but is an important factor in successfully implementing improvement initiatives in hospitals. Intergroup literature suggests that large differences between groups hinder effective cooperation. - Purposes:

  10. The use of Facebook for virtual asynchronous focus groups in qualitative research.

    Science.gov (United States)

    Biedermann, Narelle

    2018-02-01

    The Internet and the development of more user-engaging applications have opened a whole new world for researchers as a means of recruitment and data collection source. This paper describes the methodological approach of a research study that explored the experiences of Australian military spouses who packed up their family and home to accompany their spouse on an overseas posting. The study used Facebook as a recruitment tool and then as a data source through the conduct of an asynchronous virtual focus group. This paper outlines the advantages and disadvantages of this unique data source as a means of capturing the voices of a hard-to-reach population.

  11. "From resistance to challenge": child health service nurses experiences of how a course in group leadership affected their management of parental groups.

    Science.gov (United States)

    Lefèvre, Åsa; Lundqvist, Pia; Drevenhorn, Eva; Hallström, Inger

    2017-01-01

    All parents in Sweden are invited to child health service (CHS) parental groups, however only 49% of the families participate. The way the parental groups are managed has been shown to be of importance for how parents experience the support and CHS nurses describe feeling insecure when running the groups. Lack of facilitation, structure and leadership might jeopardise the potential benefit of such support groups. This study describes CHS nurses' experiences of how a course in group leadership affected the way they ran their parental groups. A course in group leadership given to 56 CHS nurses was evaluated in focus group interviews 5-8 months after the course. The nurses felt strengthened in their group leader role and changed their leadership methods. The management of parental groups was after the course perceived as an important work task and the nurses included time for planning, preparation and evaluation, which they felt improved their parental groups. Parental participation in the activities in the group had become a key issue and they used their new exercises and tools to increase this. They expressed feeling more confident and relaxed in their role as group leaders and felt that they could adapt their leadership to the needs of the parents. Specific training might strengthen the CHS nurses in their group leader role and give them new motivation to fulfil their work with parental groups.  Clinical Trials.gov ID: NCT02494128.

  12. The management of respiratory motion in radiation oncology report of AAPM Task Group 76

    International Nuclear Information System (INIS)

    Keall, Paul J.; Mageras, Gig S.; Balter, James M.

    2006-01-01

    This document is the report of a task group of the AAPM and has been prepared primarily to advise medical physicists involved in the external-beam radiation therapy of patients with thoracic, abdominal, and pelvic tumors affected by respiratory motion. This report describes the magnitude of respiratory motion, discusses radiotherapy specific problems caused by respiratory motion, explains techniques that explicitly manage respiratory motion during radiotherapy and gives recommendations in the application of these techniques for patient care, including quality assurance (QA) guidelines for these devices and their use with conformal and intensity modulated radiotherapy. The technologies covered by this report are motion-encompassing methods, respiratory gated techniques, breath-hold techniques, forced shallow-breathing methods, and respiration-synchronized techniques. The main outcome of this report is a clinical process guide for managing respiratory motion. Included in this guide is the recommendation that tumor motion should be measured (when possible) for each patient for whom respiratory motion is a concern. If target motion is greater than 5 mm, a method of respiratory motion management is available, and if the patient can tolerate the procedure, respiratory motion management technology is appropriate. Respiratory motion management is also appropriate when the procedure will increase normal tissue sparing. Respiratory motion management involves further resources, education and the development of and adherence to QA procedures

  13. Cancer pain management by radiotherapists: a survey of radiation therapy oncology group physicians

    International Nuclear Information System (INIS)

    Cleeland, Charles S.; Janjan, Nora A.; Scott, Charles B.; Seiferheld, Wendy F.; Curran, Walter J.

    2000-01-01

    Purpose: Radiation Therapy Oncology Group (RTOG) physicians were surveyed to determine their approach to and attitudes toward cancer pain management. Methods and Materials: Physicians completed a questionnaire assessing their estimates of the magnitude of pain as a specific problem for cancer patients, their perceptions of the adequacy of pain management, and their report of how they manage pain in their own practice setting. Results: Eighty-three percent believed the majority of cancer patients with pain were undermedicated. Forty percent reported that pain relief in their own practice setting was poor or fair. Assessing a case scenario, 23% would wait until the patient's prognosis was 6 months or less before starting maximal analgesia. Adjuvants and prophylactic side effect management were underutilized in the treatment plan. Barriers to pain management included poor pain assessment (77%), patient reluctance to report pain (60%), patient reluctance to take analgesics (72%), and staff reluctance to prescribe opioids (41%). Conclusions: Physicians' perceptions of barriers to cancer pain management remain quite stable over time, and physicians continue to report inadequate pain treatment education. Future educational efforts should target radiation oncologists as an important resource for the treatment of cancer pain

  14. Phase I Recommendations by the Air Quality Management Work Group to the Clean Air Act Advisory Committee

    Science.gov (United States)

    Recommendations to the Clean Air Act Advisory Committee by Air Quality Management Work Group addressing the recommendations made by the National Research Council to improve the U.S. air quality management system.

  15. Intergroup conflict management strategies as related to perceptions of dual identity and separate groups.

    Science.gov (United States)

    Bizman, Aharon; Yinon, Yoel

    2004-04-01

    The authors examined the relations between (a) the perceptions of dual identity and separate groups and (b) intergroup conflict management strategies, in two contexts: the conflict between the secular and religious sectors in Israel and the allocation of resources among organizational subunits. In both contexts, contention (i.e., forcing one's will on the other party) was associated with the perception of separate groups. Only in the organizational context, avoidance (i.e., doing nothing or discontinuing participation in the conflict) was associated with the perception of dual identity. Problem solving (i.e., finding a solution that is acceptable to both parties) was related to the perception of dual identity in the secular-religious context. In the organizational context, this relation appeared only under a low perception of separate groups. Yielding (i.e., satisfying the other party's needs at the expense of one's own) was related to the perception of dual identity in the organizational context. In the secular-religious context, this relation appeared only under a high perception of separate groups. The authors discussed the varying pattern of the associations between (a) the perceptions of dual identity and separate groups and (b) the conflict management strategies in the two contexts in terms of the Dual Concern Model and the perceived feasibility of the strategies.

  16. The American Oystercatcher (Haematopus palliatus) Working Group: 15 years of collaborative focal species research and management

    Science.gov (United States)

    Simons, Theodore R.

    2017-01-01

    The American Oystercatcher (Haematopus palliatus) Working Group formed spontaneously in 2001 as coastal waterbird biologists recognized the potential for American Oystercatchers to serve as focal species for collaborative research and management. Accomplishments over the past 15 years include the establishment of rangewide surveys, color-banding protocols, mark-resight studies, a revision of the Birds of North America species account, and new mechanisms for sharing ideas and data. Collaborations among State, Federal, and private sector scientists, natural resource managers, and dedicated volunteers have provided insights into the biology and conservation of American Oystercatchers in the United States and abroad that would not have been possible without the relationships formed through the Working Group. These accomplishments illustrate how broad collaborative approaches and the engagement of the public are key elements of effective shorebird conservation programs.

  17. Analysis of a support group for children of parents with mental illnesses: managing stressful situations.

    Science.gov (United States)

    Gladstone, Brenda M; McKeever, Patricia; Seeman, Mary; Boydell, Katherine M

    2014-09-01

    We report an ethnographic analysis of a psycho-education and peer-support program for school-aged children of parents with mental illnesses. We conducted a critical discourse analysis of the program manual and observed group interactions to understand whether children shared program goals predetermined by adults, and how, or if, the intervention was responsive to their needs. Children were expected to learn mental illness information because "knowledge is power," and to express difficult feelings about being a child of a mentally ill parent that was risky. Participants used humor to manage group expectations, revealing how they made sense of their parents' problems, as well as their own. Suggestions are made for determining good mental health literacy based on children's preferences for explaining circumstances in ways they find relevant, and for supporting children's competencies to manage relationships that are important to them. © The Author(s) 2014.

  18. Development of a national sport event risk management training program for college command groups.

    Science.gov (United States)

    Hall, Stacey A

    2013-01-01

    The US Department of Homeland Security identified college sport venues as terrorist targets due to the potential for mass casualties and catastrophic social and economic impact. Therefore, it is critical for college sport safety and security personnel to implement effective risk management practices. However, deficiencies have been identified in the level of preparedness of college sport event security personnel related to risk management training and effective emergency response capabilities. To address the industry need, the National Center for Spectator Sports Safety and Security designed, developed, and evaluated a national sport event risk management training program for National Collegiate Athletic Association command groups. The purpose of this article was to provide an overview of the design, development, and evaluation process.

  19. Group assessment of key indicators of sustainable waste management in developing countries.

    Science.gov (United States)

    Tot, Bojana; Vujić, Goran; Srđević, Zorica; Ubavin, Dejan; Russo, Mário Augusto Tavares

    2017-09-01

    Decision makers in developing countries are struggling to solve the present problems of solid waste management. Prioritisation and ranking of the most important indicators that influence the waste management system is very useful for any decision maker for the future planning and implementation of a sustainable waste management system. The aim of this study is to evaluate key indicators and their related sub-indicators in a group decision-making environment. In order to gain insight into the subject it was necessary to obtain the qualified opinions of decision makers from different countries who understand the situation in the sector of waste management in developing countries. An assessment is performed by 43 decision makers from both developed and developing countries, and the applied methodology is based on a combined use of the analytic hierarchy process, from the multi-criteria decision-making set of tools, and the preferential voting method known as Borda Count, which belongs to social choice theory. Pairwise comparison of indicators is performed with the analytic hierarchy process, and the ranking of indicators once obtained is assessed with Borda Count. Detailed analysis of the final results showed that the Institutional-Administrative indicator was the most important one, with the maximum weight as derived by both groups of decision makers. The results also showed that the combined use of the analytic hierarchy process and Borda Count contributes to the credibility and objectivity of the decision-making process, allowing its use in more complex waste management group decision-making problems to be recommended.

  20. Management of Type 2 diabetes in Ramadan: Low-ratio premix insulin working group practical advice

    OpenAIRE

    Mohamed Hassanein; Mohamed Belhadj; Khalifa Abdallah; Arpan D Bhattacharya; Awadhesh K Singh; Khaled Tayeb; Monira Al-Arouj; Awad Elghweiry; Hinde Iraqi; Mohamed Nazeer; Henda Jamoussi; Mouna Mnif; Abdulrazzaq Al-Madani; Hossam Al-Ali; Robert Ligthelm

    2014-01-01

    The challenge of insulin use during Ramadan could be minimized, if people with diabetes are metabolically stable and are provided with structured education for at least 2–3 months pre-Ramadan. Although, American diabetes association (ADA) recommendations 2010 and South Asian Consensus Guideline 2012 deal with management of diabetes in Ramadan and changes in insulin dosage, no specific guidance on widely prescribed low-ratio premix insulin is currently available. Hence, the working group for i...

  1. Internet Group Management Protocol for IPTV Services in Passive Optical Network

    Science.gov (United States)

    Lee, Eunjo; Park, Sungkwon

    We propose a new Internet group management protocol (IGMP) which can be used in passive optical network (PON) especially for IPTV services which dramatically reduces the channel change response time caused by traditional IGMP. In this paper, the newly proposed IGMP is introduced in detail and performance analysis is also included. Simulation results demonstrated the performance of the newly proposed IGMP, whereby, viewers can watch the shared IPTV channels without the channel change response time when channel request reaches a threshold.

  2. Detection of rare blood group, Bombay (Oh) phenotype patients and management by acute normovolemic hemodilution.

    Science.gov (United States)

    Shrivastava, Manisha; Navaid, Seema; Peethambarakshan, A; Agrawal, Kalpana; Khan, Athar

    2015-01-01

    Due to lack of correct blood grouping practices, the rare Bombay Oh phenotype may be missed, subjecting patients to the risk of severe hemolytic transfusion reaction. In the absence of blood donor registry, transfusion management of patients needing immediate surgery is a challenge. This study presents detection of rare Bombay Oh phenotype patients and their management by acute peri-operative acute normovolemic hemodilution (ANH) in a hospital from central India. Blood grouping of patients and blood donors with a standard tube method was carried out and samples identified as rare Bombay phenotype were confirmed by saliva inhibition test. Surgical management of cases needing transfusion was done by ANH, as per the British Committee for Standards in Hematology guidelines. The incidence of Bombay phenotype was 0.002% or 1 in 51,924 in the study. Amongst three cases (patients) identified as Bombay phenotype, one was Bombay Oh, Rh negative. Two cases were missed in the first instance and one case actually did not require transfusion. In the absence of a blood donor registry for Bombay phenotype, the cases needing transfusion were successfully managed with ANH in the operation theatre. A simple test like blood grouping should be done with serious intention with incorporation of both forward and reverse grouping, so that no patient receives wrong blood leading to fatal hemolysis due to transfusion. ANH is a cost-effective transfusion option for suitable patients. Appropriate clinical decision making, use of strategies to decrease peri-operative blood losses and cost-effective country based planning could be more widely applied to improve clinical transfusion practice.

  3. Detection of rare blood group, Bombay (Oh phenotype patients and management by acute normovolemic hemodilution

    Directory of Open Access Journals (Sweden)

    Manisha Shrivastava

    2015-01-01

    Full Text Available Background: Due to lack of correct blood grouping practices, the rare Bombay Oh phenotype may be missed, subjecting patients to the risk of severe hemolytic transfusion reaction. In the absence of blood donor registry, transfusion management of patients needing immediate surgery is a challenge. This study presents detection of rare Bombay Oh phenotype patients and their management by acute peri-operative acute normovolemic hemodilution (ANH in a hospital from central India. Materials and Methods: Blood grouping of patients and blood donors with a standard tube method was carried out and samples identified as rare Bombay phenotype were confirmed by saliva inhibition test. Surgical management of cases needing transfusion was done by ANH, as per the British Committee for Standards in Hematology guidelines. Results: The incidence of Bombay phenotype was 0.002% or 1 in 51,924 in the study. Amongst three cases (patients identified as Bombay phenotype, one was Bombay Oh, Rh negative. Two cases were missed in the first instance and one case actually did not require transfusion. In the absence of a blood donor registry for Bombay phenotype, the cases needing transfusion were successfully managed with ANH in the operation theatre. Conclusion: A simple test like blood grouping should be done with serious intention with incorporation of both forward and reverse grouping, so that no patient receives wrong blood leading to fatal hemolysis due to transfusion. ANH is a cost-effective transfusion option for suitable patients. Appropriate clinical decision making, use of strategies to decrease peri-operative blood losses and cost-effective country based planning could be more widely applied to improve clinical transfusion practice.

  4. Group management influences reproductive function of the male cheetah (Acinonyx jubatus).

    Science.gov (United States)

    Koester, Diana C; Freeman, Elizabeth W; Wildt, David E; Terrell, Kimberly A; Franklin, Ashley D; Meeks, Karen; Crosier, Adrienne E

    2017-03-01

    Although the free-ranging cheetah is generally socially solitary, as many as 60% of males live in same-sex (usually sibling) coalitions. Under ex situ conditions, the cheetah experiences low reproductive success with only ~18% of males having ever produced young. Most male cheetahs (85%) are managed in captivity in coalitions, but with no data on the influence of social grouping on reproductive parameters. We examined the influence of singleton versus coalition management on various male cheetah physiological traits, including ejaculate quality and gonadal and adrenal hormone metabolite concentrations. We also assessed behaviour within coalitions for evidence of social hierarchy through initiation of interactions with group mates and relatedness to physiological traits. Ejaculate quality (including total motile and structurally normal spermatozoa per ejaculate) and androgen concentration profiles were higher (Pcheetah, specifically related to the development of normal, motile spermatozoa and androgen production, is influenced by management with same-sex conspecifics. The findings have implications for ex situ conservation breeding programs by suggesting that reproductive quality can be enhanced through group maintenance of cheetah males.

  5. Climate Change and Water Working Group - User Needs to Manage Hydrclimatic Risk from Days to Decades

    Science.gov (United States)

    Raff, D. A.; Brekke, L. D.; Werner, K.; Wood, A.; White, K. D.

    2012-12-01

    The Federal Climate Change Water Working Group (CCAWWG) provides engineering and scientific collaborations in support of water management. CCAWWG objectives include building working relationships across federal science and water management agencies, provide a forum to share expertise and leverage resources, develop education and training forums, to work with water managers to understand scientific needs and to foster collaborative efforts across the Federal and non-Federal water management and science communities to address those needs. Identifying and addressing water management needs has been categorized across two major time scales: days to a decade and multi-decadal, respectively. These two time periods are termed "Short-Term" and "Long-Term" in terms of the types of water management decisions they support where Short-Term roughly correlates to water management operations and Long-Term roughly correlates to planning activities. This presentation will focus on portraying the identified water management user needs across these two time periods. User Needs for Long-Term planning were identified in the 2011 Reclamation and USACE "Addressing Climate Change in Long-Term Water Resources Planning and Management: User Needs for Improving Tools and Information." User needs for Long-Term planning are identified across eight major categories: Summarize Relevant Literature, Obtain Climate Change Information, Make Decisions About How to Use the Climate Change Information, Assess Natural Systems Response, Assess Socioeconomic and Institutional Response, Assess System Risks and Evaluate Alternatives, Assess and Characterize Uncertainties, and Communicating Results and Uncertainties to Decisionmakers. User Needs for Short-Term operations are focused on needs relative to available or desired monitoring and forecast products from the hydroclimatic community. These needs are presenting in the 2012 USACE, Reclamation, and NOAA - NWS "Short-Term Water Management Decisions: User

  6. Group participants' experiences of a patient-directed group-based education program for the management of type 2 diabetes mellitus.

    Science.gov (United States)

    Odgers-Jewell, Kate; Isenring, Elisabeth A; Thomas, Rae; Reidlinger, Dianne P

    2017-01-01

    The objective of this study was to explore the experiences of individuals who participated in a group-based education program, including their motivators in relation to their diabetes management, and the perceived impact of group interactions on participants' experiences and motivation for self-management. Understanding individuals diagnosed with diabetes experiences of group-based education for the management of type 2 diabetes mellitus may guide the development and facilitation of these programs. Semi-structured interviews were conducted with all individuals who participated in the intervention. Using thematic analysis underpinned by self-determination theory, we developed themes that explored participants' motivators in relation to diabetes management and the impact of group interactions on their experiences and motivation. The key themes included knowledge, experience, group interactions and motivation. Participants perceived that the group interactions facilitated further learning and increased motivation, achieved through normalization, peer identification or by talking with, and learning from the experience of others. The results support the use of patient-centred programs that prioritize group interactions over the didactic presentation of content, which may address relevant psychological needs of people diagnosed with type 2 diabetes mellitus, and improve their motivation and health behaviours. Future group-based education programs may benefit from the use of self-determination theory as a framework for intervention design to enhance participant motivation.

  7. If two heads are better than one, why do I have bruises on my forehead? Managing the group process.

    Science.gov (United States)

    Miner, F C

    1991-01-01

    Managers are using groups more frequently for solving complex organizational problems because of numerous organizational and environmental factors. Yet, many managers see group decision-making meetings as more of a problem than a solution. This article discusses situations where groups should and should not be used and recommends specific skills a leader can use to improve the effectiveness of group decision making. Emphasis is placed on managing the group process to achieve a satisfactory outcome. An exercise to test the validity of the suggestions is provided.

  8. Association between quality management and performance indicators in Dutch diabetes care groups: a cross-sectional study.

    Science.gov (United States)

    Campmans-Kuijpers, Marjo J E; Baan, Caroline A; Lemmens, Lidwien C; Klomp, Maarten L H; Romeijnders, Arnold C M; Rutten, Guy E H M

    2015-05-11

    To enhance the quality of diabetes care in the Netherlands, so-called care groups with three to 250 general practitioners emerged to organise and coordinate diabetes care. This introduced a new quality management level in addition to the quality management of separate general practices. We hypothesised that this new level of quality management might be associated with the aggregate performance indicators on the patient level. Therefore, we aimed to explore the association between quality management at the care group level and its aggregate performance indicators. A cross-sectional study. All Dutch care groups (n=97). 23 care groups provided aggregate register-based performance indicators of all their practices as well as data on quality management measured with a questionnaire filled out by 1 or 2 of their quality managers. The association between quality management, overall and in 6 domains ('organisation of care', 'multidisciplinary teamwork', 'patient centredness', 'performance management', 'quality improvement policy' and 'management strategies') on the one hand and 3 process indicators (the percentages of patients with at least 1 measurement of glycated haemoglobin, lipid profile and systolic blood pressure), and 3 intermediate outcome indicators (the percentages of patients with glycated haemoglobin below 53 mmol/mol (7%); low-density lipoprotein cholesterol below 2.5 mmol/L; and systolic blood pressure below 140 mm Hg) by weighted univariable linear regression. The domain 'management strategies' was significantly associated with the percentage of patients with a glycated haemoglobin quality management were not associated with aggregate process or outcome indicators. This first exploratory study on quality management showed weak or no associations between quality management of diabetes care groups and their performance. It remains uncertain whether this second layer on quality management adds to better quality of care. Published by the BMJ Publishing

  9. How Local Landholder Groups Collectively Manage Weeds in South-Eastern Australia

    Science.gov (United States)

    Graham, Sonia; Rogers, Sarah

    2017-09-01

    For two decades researchers and policy makers have been arguing that community-based collective action is needed to effectively control weeds. Yet there has been little social research into the ways that collective weed control emerges at local scales. The aim of this paper is to investigate the mechanisms through which three local landholder groups in south-eastern Australia collectively manage weeds and the measures they use to evaluate success. Semi-structured interviews were conducted with members of three Landcare groups—Jerrawa Creek/Upper Lachlan, MacLaughlin River and Towamba Valley—as well as government staff external to the groups. The results reveal that for all three groups collective weed control is about supporting individual weed control efforts as well as proactively engaging landholders with the worst infestations. The groups were seen to be successful because they focused on the common challenge that weeds pose to all landholders, thereby removing the shame associated with having weeds, and because they organised community events that were as much about building and maintaining social relationships as improving weed control. Groups were positive about what they had achieved as collectives of landholders, but also saw an important role for government in providing funding, engaging with landholders who were unwilling to engage directly with the group, and controlling weeds on public lands.

  10. Review of recent reports of INLA study group V: radioactive waste management

    International Nuclear Information System (INIS)

    Hubert, E.H.

    1995-01-01

    As an introduction to this 1993 report, Working Group V offers this brief review of its three previous reports made in 1987, 1989 and 1991. the principal topics addressed in these reports were: clear definitions of terms such as radioactive waste, storage and final disposal; respective technical and financial responsibilities of waste producers management agencies, public authorities; the various phases of waste management such as production, package, transport, storage, preclosure and post closure of disposal installations; financing of these phases; information and participation of the public in choice and licensing of storage and final disposal installations; The aim of these studies is ti explore the nature of appropriate actions in radioactive waste management necessary to ensure adequate protection of man and environment. Moreover, it is important to assure adequate protection for the full life of the waste, even though that time may reach hundreds or thousands of years or more. Although this raises both technical and juridical problems, the study group focused mainly the juridical ones. (author)

  11. Leadership and management influences on personal and professional development and group dynamics: a student's experience.

    Science.gov (United States)

    Ahmed, Fathima

    2018-03-07

    The ever-evolving nature of nursing requires professionals to keep their knowledge up to date and uphold the Nursing and Midwifery Council (NMC) Code by engaging themselves in ongoing personal and professional development (PPD). This article aims to highlight the importance of good leadership and management in healthcare and to explore the literature surrounding leadership and management, such as the current NHS healthcare leadership model ( NHS Leadership Academy 2013 ), the Leading Change, Adding Value Framework underpinned by the 10 commitments and 6Cs ( NHS England 2016 ) and the NMC Code ( NMC 2015a ) in relation to PPD. It examines how nurses can be supported in their PPD by their team leader and or managers using examples experienced in a clinical setting while caring for children and young people (CYP). Furthermore, the importance of team working and group processes in the context of leadership will be deliberated, using examples of formative group work to illustrate principles described in the literature. Finally, reflections will be discussed on how learning from this experience can influence future practice when caring for CYP. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  12. Managing Indigenous Minority Groups in the Tourism Industry: An Exploratory Case Study in Southern Laos

    Directory of Open Access Journals (Sweden)

    Kuwahara Hiroshi

    2014-01-01

    Full Text Available Tourism-based employment has been promoted for reducing poverty in the least developed countries (LDCs. However, for employing the poor sustainably, particularly, indigenous minority groups, management has to cope with the socioeconomic disadvantages in these environments. This study aims to explore the challenges and practical strategies for human resource management (HRM of indigenous minority groups in the tourism sectors of LDCs; specifically, those identified as “best practice” in southern Laos. Semi-structured interviews were conducted with the managing director of the project regarding training, compatibility with family life, benefits and incentives, and leadership and teamwork. A qualitative analysis was applied to the interview data and hypothetical HRM strategies were derived. Then, to examine the validity of these strategies within the project, semi-structured interviews were conducted with a half of the employees. The results suggest significance for the following HRM strategies: a social orientation toward tourism industry hygiene standards; a flexible leave system that allows employees to participate in family events and family-operated farming; and nonfinancial benefits such as food, clothing, and housing.

  13. Management response plan for the Chemical Safety Vulnerability Working Group report. Volume 2

    International Nuclear Information System (INIS)

    1994-09-01

    The Chemical Safety Vulnerability (CSV) Working Group was established to identify adverse conditions involving hazardous chemicals at DOE facilities that might result in fires or explosions, release of hazardous chemicals to the environment, or exposure of workers or the public to chemicals. A CSV Review was conducted in 146 facilities at 29 sites. Eight generic vulnerabilities were documented related to: abandoned chemicals and chemical residuals; past chemical spills and ground releases; characterization of legacy chemicals and wastes; disposition of legacy chemicals; storage facilities and conditions; condition of facilities and support systems; unanalyzed and unaddressed hazards; and inventory control and tracking. Weaknesses in five programmatic areas were also identified related to: management commitment and planning; chemical safety management programs; aging facilities that continue to operate; nonoperating facilities awaiting deactivation; and resource allocations. To address the facility-specific and site-specific vulnerabilities, responsible DOE and site-contractor line organizations have developed initial site response plans. These plans, presented as Volume 2 of this Management Response Plan, describe the actions needed to mitigate or eliminate the facility- and site-specific vulnerabilities identified by the CSV Working Group field verification teams. Initial site response plans are described for: Brookhaven National Lab., Hanford Site, Idaho National Engineering Lab., Lawrence Livermore National Lab., Los Alamos National Lab., Oak Ridge Reservation, Rocky Flats Plant, Sandia National Laboratories, and Savannah River Site

  14. The Managing Epilepsy Well Network:: Advancing Epilepsy Self-Management.

    Science.gov (United States)

    Sajatovic, Martha; Jobst, Barbara C; Shegog, Ross; Bamps, Yvan A; Begley, Charles E; Fraser, Robert T; Johnson, Erica K; Pandey, Dilip K; Quarells, Rakale C; Scal, Peter; Spruill, Tanya M; Thompson, Nancy J; Kobau, Rosemarie

    2017-03-01

    Epilepsy, a complex spectrum of disorders, affects about 2.9 million people in the U.S. Similar to other chronic disorders, people with epilepsy face challenges related to management of the disorder, its treatment, co-occurring depression, disability, social disadvantages, and stigma. Two national conferences on public health and epilepsy (1997, 2003) and a 2012 IOM report on the public health dimensions of epilepsy highlighted important knowledge gaps and emphasized the need for evidence-based, scalable epilepsy self-management programs. The Centers for Disease Control and Prevention translated recommendations on self-management research and dissemination into an applied research program through the Prevention Research Centers Managing Epilepsy Well (MEW) Network. MEW Network objectives are to advance epilepsy self-management research by developing effective interventions that can be broadly disseminated for use in people's homes, healthcare providers' offices, or in community settings. The aim of this report is to provide an update on the MEW Network research pipeline, which spans efficacy, effectiveness, and dissemination. Many of the interventions use e-health strategies to eliminate barriers to care (e.g., lack of transportation, functional limitations, and stigma). Strengths of this mature research network are the culture of collaboration, community-based partnerships, e-health methods, and its portfolio of prevention activities, which range from efficacy studies engaging hard-to-reach groups, to initiatives focused on provider training and knowledge translation. The MEW Network works with organizations across the country to expand its capacity, help leverage funding and other resources, and enhance the development, dissemination, and sustainability of MEW Network programs and tools. Guided by national initiatives targeting chronic disease or epilepsy burden since 2007, the MEW Network has been responsible for more than 43 scientific journal articles, two

  15. The non-self-propelled hydropower vessel for electrical energy providing of Arctic and Far East hard-to-reach areas

    Directory of Open Access Journals (Sweden)

    Borisova L. F.

    2015-12-01

    Full Text Available The floating tidal unceasing action power plant design based on the non-self-propelled vessel has been proposed. To produce electric energy the renewable energy of wind and tidal waves has been used

  16. Comparison of sampling methods for hard-to-reach francophone populations: yield and adequacy of advertisement and respondent-driven sampling.

    Science.gov (United States)

    Ngwakongnwi, Emmanuel; King-Shier, Kathryn M; Hemmelgarn, Brenda R; Musto, Richard; Quan, Hude

    2014-01-01

    Francophones who live outside the primarily French-speaking province of Quebec, Canada, risk being excluded from research by lack of a sampling frame. We examined the adequacy of random sampling, advertising, and respondent-driven sampling for recruitment of francophones for survey research. We recruited francophones residing in the city of Calgary, Alberta, through advertising and respondentdriven sampling. These 2 samples were then compared with a random subsample of Calgary francophones derived from the 2006 Canadian Community Health Survey (CCHS). We assessed the effectiveness of advertising and respondent-driven sampling in relation to the CCHS sample by comparing demographic characteristics and selected items from the CCHS (specifically self-reported general health status, perceived weight, and having a family doctor). We recruited 120 francophones through advertising and 145 through respondent-driven sampling; the random sample from the CCHS consisted of 259 records. The samples derived from advertising and respondentdriven sampling differed from the CCHS in terms of age (mean ages 41.0, 37.6, and 42.5 years, respectively), sex (proportion of males 26.1%, 40.6%, and 56.6%, respectively), education (college or higher 86.7% , 77.9% , and 59.1%, respectively), place of birth (immigrants accounting for 45.8%, 55.2%, and 3.7%, respectively), and not having a regular medical doctor (16.7%, 34.5%, and 16.6%, respectively). Differences were not tested statistically because of limitations on the analysis of CCHS data imposed by Statistics Canada. The samples generated exclusively through advertising and respondent-driven sampling were not representative of the gold standard sample from the CCHS. Use of such biased samples for research studies could generate misleading results.

  17. Impact of a social franchise intervention program on the adoption of long and short acting family planning methods in hard to reach communities in Myanmar.

    Science.gov (United States)

    Aung, Tin; Thet, May Me; Sudhinaraset, May; Diamond-Smith, Nadia

    2018-03-12

    Myanmar has experienced slowly rising levels of contraceptive use in recent years. Between 2014 and 2016, Population Services International (PSI)/Myanmar implemented a multi-pronged intervention to increase contraceptive use by leveraging its social marketing clinics and providers, and providing additional community outreach. The aim of this study is to explore trends over time in contraceptive uptake and assess whether exposure to the PSI program was associated with women adopting a method. Baseline and end line data were collected using a repeated cross-sectional survey of married women of reproductive age in 2014 and 2016. We find that use of the implant and intrauterine device (IUD) has increased among contraceptive users over time, although there was no significant association for short-term methods. There was also an increase in all types of method use between time periods compared to non-users of contraception. Women who reported seeing a PSI contraception pamphlet had increased odds of having adopted an IUD or implant in the study period. This suggests that interventions that address both supply and demand side barriers to contraception can have an impact on contraceptive uptake, especially more effective long acting methods.

  18. Small farmers and agricultural extension : surviving on a small farm in the Netherlands and possibilities for agricultural extension to reach a hard-to-reach category

    NARCIS (Netherlands)

    Somers, B.M.

    1991-01-01

    This dissertation reports the results of the research project "Employment in Agriculture and Extension". Primary aims of the project were: a) to identify categories of farmers who are homogeneous in their survival strategies and b) to indicate ways agricultural extension could help farmers

  19. Compliance with birth dose of Hepatitis B vaccine in high endemic and hard to reach areas in the Colombian amazon: results from a vaccination survey.

    Science.gov (United States)

    Choconta-Piraquive, Luz Angela; De la Hoz-Restrepo, Fernando; Sarmiento-Limas, Carlos Arturo

    2016-07-21

    Hepatitis B vaccination was introduced into the Expanded Program of Immunization in Colombia in 1992, in response to WHO recommendations on hepatitis B immunization. Colombia is a low endemic country for Hepatitis B virus infection (HBV) but it has several high endemic areas like the Amazon basin where more than 70 % of adults had been infected. A cross- sectional study was carried out in three rural areas of the Colombian Amazon to evaluate compliance with the recommended schedule for hepatitis B vaccine in Colombian children (one monovalent dose given in the first 24 h after birth + 3 doses of a pentavalent containing Hepatitis B. (DPT + Hib + Hep B). A household survey was conducted in order to collect vaccination data from children aged from 6 months to studied, 79 % received a monovalent dose of hepatitis B vaccine, but only 30.7 % were vaccinated in the first 24 h after birth. This proportion did not increase by age or subsequent birth cohorts. Coverage with three doses of a DTP-Hib-HepB vaccine was 98 %, but most children did not receive them according to the recommended schedule. Being born in a health facility was the strongest predictor of receiving a timely birth dose. This study suggests that more focused strategies on improving compliance with hepatitis B birth dose should be implemented in rural areas of the Amazon, if elimination of perinatal transmission of HBV is to be achieved. Increasing the proportion of newborns delivered at health facilities should be one of the priorities to reach that goal.

  20. Still a Hard-to-Reach Population? Using Social Media to Recruit Latino Gay Couples for an HIV Intervention Adaptation Study

    Science.gov (United States)

    Wu, Elwin; Shultz, Andrew Z; Capote, Jonathan; López Rios, Javier; Sandfort, Theo; Manusov, Justin; Ovejero, Hugo; Carballo-Dieguez, Alex; Chavez Baray, Silvia; Moya, Eva; López Matos, Jonathan; DelaCruz, Juan J; Remien, Robert H; Rhodes, Scott D

    2014-01-01

    Background Online social networking use has increased rapidly among African American and Latino men who have sex with men (MSM), making it important to understand how these technologies can be used to reach, retain, and maintain individuals in care and promote health wellness. In particular, the Internet is increasingly recognized as a platform for health communication and education. However, little is known about how primarily Spanish-speaking populations use and engage with each other through social media platforms. Objective We aimed to recruit eligible couples for a study to adapt “Connect ‘n Unite” (an HIV prevention intervention initially created for black gay couples) for Spanish-speaking Latino gay couples living in New York City. Methods In order to successfully design and implement an effective social media recruitment campaign to reach Spanish-speaking Latino gay couples for our ongoing “Latinos en Pareja” study, our community stakeholders and research team used McGuire’s communication/persuasion matrix. The matrix guided our research, specifically each marketing “channel”, targeted “message”, and target population or “receiver”. We developed a social media recruitment protocol and trained our research staff and stakeholders to conduct social media recruitment. Results As a result, in just 1 month, we recruited all of our subjects (N=14 couples, that is, N=28 participants) and reached more than 35,658 participants through different channels. One of the major successes of our social media recruitment campaign was to build a strong stakeholder base that became involved early on in all aspects of the research process—from pilot study writing and development to recruitment and retention. In addition, the variety of “messages” used across different social media platforms (including Facebook, the “Latinos en Pareja” study website, Craigslist, and various smartphone applications such as Grindr, SCRUFF, and Jack’d) helped recruit Latino gay couples. We also relied on a wide range of community-based organizations across New York City to promote the study and build in the social media components. Conclusions Our findings highlight the importance of incorporating communication technologies into the recruitment and engagement of participants in HIV interventions. Particularly, the success of our social media recruitment strategy with Spanish-speaking Latino MSM shows that this population is not particularly “hard to reach”, as it is often characterized within public health literature. PMID:24763130

  1. Treating childhood pneumonia in hard-to-reach areas: a model-based comparison of mobile clinics and community-based care.

    Science.gov (United States)

    Pitt, Catherine; Roberts, Bayard; Checchi, Francesco

    2012-01-10

    Where hard-to-access populations (such as those living in insecure areas) lack access to basic health services, relief agencies, donors, and ministries of health face a dilemma in selecting the most effective intervention strategy. This paper uses a decision mathematical model to estimate the relative effectiveness of two alternative strategies, mobile clinics and fixed community-based health services, for antibiotic treatment of childhood pneumonia, the world's leading cause of child mortality. A "Markov cycle tree" cohort model was developed in Excel with Visual Basic to compare the number of deaths from pneumonia in children aged 1 to 59 months expected under three scenarios: 1) No curative services available, 2) Curative services provided by a highly-skilled but intermittent mobile clinic, and 3) Curative services provided by a low-skilled community health post. Parameter values were informed by literature and expert interviews. Probabilistic sensitivity analyses were conducted for several plausible scenarios. We estimated median pneumonia-specific under-5 mortality rates of 0.51 (95% credible interval: 0.49 to 0.541) deaths per 10,000 child-days without treatment, 0.45 (95% CI: 0.43 to 0.48) with weekly mobile clinics, and 0.31 (95% CI: 0.29 to 0.32) with CHWs in fixed health posts. Sensitivity analyses found the fixed strategy superior, except when mobile clinics visited communities daily, where rates of care-seeking were substantially higher at mobile clinics than fixed posts, or where several variables simultaneously differed substantially from our baseline assumptions. Current evidence does not support the hypothesis that mobile clinics are more effective than CHWs. A CHW strategy therefore warrants consideration in high-mortality, hard-to-access areas. Uncertainty remains, and parameter values may vary across contexts, but the model allows preliminary findings to be updated as new or context-specific evidence becomes available. Decision analytic modelling can guide needed field-based research efforts in hard-to-access areas and offer evidence-based insights for decision-makers.

  2. Project Engage: Snowball Sampling and Direct Recruitment to Identify and Link Hard-to-Reach HIV-Infected Persons Who Are Out of Care.

    Science.gov (United States)

    Wohl, Amy Rock; Ludwig-Barron, Natasha; Dierst-Davies, Rhodri; Kulkarni, Sonali; Bendetson, Jesse; Jordan, Wilbert; Bolan, Robert; Smith, Terry; Cunningham, William; Pérez, Mario J

    2017-06-01

    Innovative strategies are needed to identify and link hard-to-find persons living with HIV (PLWH) who are out of care (OOC). Project Engage, a health department-based project in Los Angeles County, used a mixed-methods approach to locate and provide linkage for PLWH who have limited contact with HIV medical and nonmedical services. Incentivized social network recruitment (SNR) and direct recruitment (DR) was used to identify eligible OOC alters for a linkage intervention that included HIV clinic selection, appointment and transportation support, reminder calls/texts, and clinic navigation. Between 2012 and 2015, 112 alters were identified using SNR (n = 74) and DR (n = 38). Most alters were male (80%), African American (38%), and gay (60%). Sizable percentages were homeless (78%), had engaged in sex work (32%) in the previous 6 months, had injected drugs (47%), were incarcerated in the previous 12 months (50%), and had only received HIV care during the previous 5 years while incarcerated (24%). SNR alters were more likely than DR alters to be African American, uninsured, unemployed, homeless, sex workers, injection drug users, recently incarcerated, and have unmet service needs. Alters linked to care within 3 (69%), 4-6 (5%), and 7-12 months (8%), and 72% were retained at 6-12 months. The percent virally suppressed increased (27% vs. 41%) and the median viral load decreased (P = 0.003) between linkage and follow-up at 6-12 months. The alternative approaches presented were effective at locating marginalized HIV-positive persons who are OOC for linkage and retention. The SNR approach was most successful at identifying alters with serious social challenges and gaps in needed medical/ancillary services.

  3. Definition of a COPD self-management intervention: International Expert Group consensus.

    Science.gov (United States)

    Effing, Tanja W; Vercoulen, Jan H; Bourbeau, Jean; Trappenburg, Jaap; Lenferink, Anke; Cafarella, Paul; Coultas, David; Meek, Paula; van der Valk, Paul; Bischoff, Erik W M A; Bucknall, Christine; Dewan, Naresh A; Early, Frances; Fan, Vincent; Frith, Peter; Janssen, Daisy J A; Mitchell, Katy; Morgan, Mike; Nici, Linda; Patel, Irem; Walters, Haydn; Rice, Kathryn L; Singh, Sally; Zuwallack, Richard; Benzo, Roberto; Goldstein, Roger; Partridge, Martyn R; van der Palen, Job

    2016-07-01

    There is an urgent need for consensus on what defines a chronic obstructive pulmonary disease (COPD) self-management intervention. We aimed to obtain consensus regarding the conceptual definition of a COPD self-management intervention by engaging an international panel of COPD self-management experts using Delphi technique features and an additional group meeting.In each consensus round the experts were asked to provide feedback on the proposed definition and to score their level of agreement (1=totally disagree; 5=totally agree). The information provided was used to modify the definition for the next consensus round. Thematic analysis was used for free text responses and descriptive statistics were used for agreement scores.In total, 28 experts participated. The consensus round response rate varied randomly over the five rounds (ranging from 48% (n=13) to 85% (n=23)), and mean definition agreement scores increased from 3.8 (round 1) to 4.8 (round 5) with an increasing percentage of experts allocating the highest score of 5 (round 1: 14% (n=3); round 5: 83% (n=19)).In this study we reached consensus regarding a conceptual definition of what should be a COPD self-management intervention, clarifying the requisites for such an intervention. Operationalisation of this conceptual definition in the near future will be an essential next step. The content of this work is not subject to copyright. Design and branding are copyright ©ERS 2016.

  4. Management of relapsed multiple myeloma: recommendations of the International Myeloma Working Group.

    Science.gov (United States)

    Laubach, J; Garderet, L; Mahindra, A; Gahrton, G; Caers, J; Sezer, O; Voorhees, P; Leleu, X; Johnsen, H E; Streetly, M; Jurczyszyn, A; Ludwig, H; Mellqvist, U-H; Chng, W-J; Pilarski, L; Einsele, H; Hou, J; Turesson, I; Zamagni, E; Chim, C S; Mazumder, A; Westin, J; Lu, J; Reiman, T; Kristinsson, S; Joshua, D; Roussel, M; O'Gorman, P; Terpos, E; McCarthy, P; Dimopoulos, M; Moreau, P; Orlowski, R Z; Miguel, J S; Anderson, K C; Palumbo, A; Kumar, S; Rajkumar, V; Durie, B; Richardson, P G

    2016-05-01

    The prognosis for patients multiple myeloma (MM) has improved substantially over the past decade with the development of new, more effective chemotherapeutic agents and regimens that possess a high level of anti-tumor activity. In spite of this important progress, however, nearly all MM patients ultimately relapse, even those who experience a complete response to initial therapy. Management of relapsed MM thus represents a vital aspect of the overall care for patients with MM and a critical area of ongoing scientific and clinical research. This comprehensive manuscript from the International Myeloma Working Group provides detailed recommendations on management of relapsed disease, with sections dedicated to diagnostic evaluation, determinants of therapy, and general approach to patients with specific disease characteristics. In addition, the manuscript provides a summary of evidence from clinical trials that have significantly impacted the field, including those evaluating conventional dose therapies, as well as both autologous and allogeneic stem cell transplantation. Specific recommendations are offered for management of first and second relapse, relapsed and refractory disease, and both autologous and allogeneic transplant. Finally, perspective is provided regarding new agents and promising directions in management of relapsed MM.

  5. Nominal group technique: a brainstorming tool for identifying areas to improve pain management in hospitalized patients.

    Science.gov (United States)

    Peña, Adolfo; Estrada, Carlos A; Soniat, Debbie; Taylor, Benjamin; Burton, Michael

    2012-01-01

    Pain management in hospitalized patients remains a priority area for improvement; effective strategies for consensus development are needed to prioritize interventions. To identify challenges, barriers, and perspectives of healthcare providers in managing pain among hospitalized patients. Qualitative and quantitative group consensus using a brainstorming technique for quality improvement-the nominal group technique (NGT). One medical, 1 medical-surgical, and 1 surgical hospital unit at a large academic medical center. Nurses, resident physicians, patient care technicians, and unit clerks. Responses and ranking to the NGT question: "What causes uncontrolled pain in your unit?" Twenty-seven health workers generated a total of 94 ideas. The ideas perceived contributing to a suboptimal pain control were grouped as system factors (timeliness, n = 18 ideas; communication, n = 11; pain assessment, n = 8), human factors (knowledge and experience, n = 16; provider bias, n = 8; patient factors, n = 19), and interface of system and human factors (standardization, n = 14). Knowledge, timeliness, provider bias, and patient factors were the top ranked themes. Knowledge and timeliness are considered main priorities to improve pain control. NGT is an efficient tool for identifying general and context-specific priority areas for quality improvement; teams of healthcare providers should consider using NGT to address their own challenges and barriers. Copyright © 2011 Society of Hospital Medicine.

  6. Diagnosing and managing anorexia nervosa in UK primary care: a focus group study.

    Science.gov (United States)

    Hunt, D; Churchill, R

    2013-08-01

    Anorexia is a leading cause of adolescent hospital admission and death from psychiatric disorder. Despite the potential role of general practitioners in diagnosis, appropriate referral and coordinating treatment, few existing studies provide fine-grained accounts of GPs' beliefs about anorexia. To identify GPs' understandings and experiences of diagnosing and managing patients with anorexia in primary care. Case-based focus groups with co-working general practitioners in the East Midlands region of England were used to explore attitudes towards issues common to patients with eating disorders. Group discussions were transcribed and analysed using corpus linguistic and discourse analytic approaches. Participants' discussion focused on related issues of making hesitant diagnoses, the utility of the body mass index, making referrals and overcoming patient resistance. Therapeutic relationships with patients with anorexia are considered highly complex, with participants using diagnostic tests as rhetorical strategies to help manage communicative obstacles. Overcoming patient repudiation and securing referrals are particular challenges with this patient group. Successfully negotiating these problems appears to require advanced communication skills.

  7. Impacts of Teacher-Child Managed Whole-Group Language and Literacy Instruction on the Depth of Preschoolers' Social Interaction

    Science.gov (United States)

    Lin, Tzu-Jung; Justice, Laura M.; Emery, Alyssa A.; Mashburn, Andrew J.; Pentimonti, Jill M.

    2017-01-01

    Research Findings: This study examined the potential impacts of ongoing participation (twice weekly for 30 weeks) in teacher-child managed whole-group language and literacy instruction on prekindergarten children's social interaction with classmates. Teacher-child managed whole-group instruction that provides children with opportunities to engage…

  8. Limited results of group self-management education for rheumatoid arthritis patients and their partners: explanations from the patient perspective

    NARCIS (Netherlands)

    Bode, C.; Taal, E.; Emons, P.A.A.; Galetzka, M.; Rasker, J.J.; Laar, M.A.F.J. van de

    2008-01-01

    This study aimed to identify the reasons for limited results of group self-management for RA patients and their partners from the patient perspective. Semi-structured interviews with ten male and ten female patients who had participated in group self-management with or without their partner were

  9. Limited results of group self-management education for rheumatoid arthritis patients and their partners: Explanations from the patient perspective.

    NARCIS (Netherlands)

    Bode, Christina; Taal, Erik; Emons, P.A.A.; Galetzka, Mirjam; Rasker, Johannes J.; van de Laar, Mart A F J

    2008-01-01

    This study aimed to identify the reasons for limited results of group self-management for RA patients and their partners from the patient perspective. Semi-structured interviews with ten male and ten female patients who had participated in group self-management with or without their partner were

  10. Lesson Learned from Leading an Anger Management Group Using the "Seeing Red" Curriculum within an Elementary School

    Science.gov (United States)

    Sportsman, Emily L.; Carlson, John S.; Guthrie, Kelly M.

    2010-01-01

    Four fourth-grade boys participated in an anger management group using "Seeing Red: An Anger Management and Peacemaking Curriculum for Kids" facilitated by a school psychology intern and her supervisor (J. Simmonds, 2003). The group met for 30 min weekly for a total of 14 sessions. Lessons consisted of practicing skills and strategies related to…

  11. The Fritz Roethlisberger Memorial Award Goes to "Using Leadered Groups in Organizational Behavior and Management Survey Courses"

    Science.gov (United States)

    Amoroso, Lisa M.; Loyd, Denise Lewin; Hoobler, Jenny M.

    2012-01-01

    The Fritz J. Roethlisberger Memorial Award for the best article in the 2011 "Journal of Management Education" goes to Rae Andre for her article, Using Leadered Groups in Organizational Behavior and Management Survey Courses ("Journal of Management Education," Volume 35, Number 5, pp. 596-619). In keeping with Roethlisberger's legacy, this year's…

  12. User group attitudes toward forest management treatments on the Shawnee National Forest: application of a photo-evaluation technique

    Science.gov (United States)

    Jonathan M. Cohen; Jean C. Mangun; Mae A. Davenport; Andrew D. Carver

    2008-01-01

    Diverse public opinions, competing management goals, and polarized interest groups combine with problems of scale to create a complex management arena for managers in the Central Hardwood Forest region. A mixed-methods approach that incorporated quantitative analysis of data from a photo evaluation-attitude scale survey instrument was used to assess attitudes toward...

  13. Fundamentals and Catalytic Innovation: The Statistical and Data Management Center of the Antibacterial Resistance Leadership Group.

    Science.gov (United States)

    Huvane, Jacqueline; Komarow, Lauren; Hill, Carol; Tran, Thuy Tien T; Pereira, Carol; Rosenkranz, Susan L; Finnemeyer, Matt; Earley, Michelle; Jiang, Hongyu Jeanne; Wang, Rui; Lok, Judith; Evans, Scott R

    2017-03-15

    The Statistical and Data Management Center (SDMC) provides the Antibacterial Resistance Leadership Group (ARLG) with statistical and data management expertise to advance the ARLG research agenda. The SDMC is active at all stages of a study, including design; data collection and monitoring; data analyses and archival; and publication of study results. The SDMC enhances the scientific integrity of ARLG studies through the development and implementation of innovative and practical statistical methodologies and by educating research colleagues regarding the application of clinical trial fundamentals. This article summarizes the challenges and roles, as well as the innovative contributions in the design, monitoring, and analyses of clinical trials and diagnostic studies, of the ARLG SDMC. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  14. Group psychotherapy for persons with traumatic brain injury: management of frustration and substance abuse.

    Science.gov (United States)

    Delmonico, R L; Hanley-Peterson, P; Englander, J

    1998-12-01

    Residual emotional and behavioral difficulties in individuals who have sustained a traumatic brain injury (TBI) have been well documented in the literature. The issues are complex, interdependent, and often include substance abuse, depression, anxiety, chronic suicidal or homicidal ideation, poor impulse control, and significant degrees of frustration and anger. Often, preexisting psychological conditions and poor coping strategies are exacerbated by the trauma. Emotional and behavioral difficulties can interfere with the neurorehabilitation process at all levels. In acute rehabilitation, these issues have traditionally been addressed on an individual basis. However, in postacute settings, an interpersonal group format can be effectively implemented. The majority of individuals with TBI have minimal funding for long-term cognitive and behavioral remediation; often the only avenue available is support groups. This article will describe group psychotherapy models used with individuals with acute or postacute TBI within a comprehensive rehabilitation center. Interdisciplinary treatment of frustration and substance abuse and a continuum of care will be emphasized. Education, social support, skills development, interpersonal process, and cognitive-behavioral approaches will also be discussed. The psychotherapy groups focus on treatment of substance abuse and frustration management through education, social support, and development of interpersonal skills. Practical considerations of running such groups are presented.

  15. Applying voting theory in natural resource management: a case of multiple-criteria group decision support.

    Science.gov (United States)

    Laukkanen, Sanna; Kangas, Annika; Kangas, Jyrki

    2002-02-01

    Voting theory has a lot in common with utility theory, and especially with group decision-making. An expected-utility-maximising strategy exists in voting situations, as well as in decision-making situations. Therefore, it is natural to utilise the achievements of voting theory also in group decision-making. Most voting systems are based on a single criterion or holistic preference information on decision alternatives. However, a voting scheme called multicriteria approval is specially developed for decision-making situations with multiple criteria. This study considers the voting theory from the group decision support point of view and compares it with some other methods applied to similar purposes in natural resource management. A case study is presented, where the approval voting approach is introduced to natural resources planning and tested in a forestry group decision-making process. Applying multicriteria approval method was found to be a potential approach for handling some challenges typical for forestry group decision support. These challenges include (i) utilising ordinal information in the evaluation of decision alternatives, (ii) being readily understandable for and treating equally all the stakeholders in possession of different levels of knowledge on the subject considered, (iii) fast and cheap acquisition of preference information from several stakeholders, and (iv) dealing with multiple criteria.

  16. Profitability recent open stock funds in Brazil: analysis of the performance of a management Funds Group active in relation to management fees charged for resource managers

    Directory of Open Access Journals (Sweden)

    Sergio Ricardo Mendes Vasconcelos

    2016-10-01

    Full Text Available This paper aimed to evaluate the performance of a specific group of active management equity investments funds relating it to the management fees charged by managers in order to answer the following research problem: open equity funds with active management, that charge higher management fees, are those that provide the best returns for the investor? The objective was to test the hypothesis under which it is evident that the funds that charged the highest rates are those with the best performances evaluated according to the average yield of the last five years. To achieve this objective, a study of descriptive nature was carried out with a quantitative approach having as object of study the profitability of Brazilian Equity Fund ranked by the Brazilian Association of Financial and Capital Markets (Anbima as IBX Active Equity Funds in the period 2010 to 2014. The analyzed returns were calculated from the Information ratio index, which measures the risk-adjusted return of the asset class. The study found no correlation between the performance of the funds and charged management fees.

  17. Empowerment in nurse leader groups in middle management: a quantitative comparative investigation.

    Science.gov (United States)

    Spencer, Caroline; McLaren, Susan

    2017-01-01

    The aim was to investigate structural empowerment in nurse leaders in middle management positions. Objectives were to determine levels of empowerment of nurse leaders and to compare levels of empowerment between nurse leader groups. Access to formal and informal power, opportunity, resources, information and support are determinants of structural empowerment. Empowerment of nurse leaders in middle management positions is vital given their roles in enabling nursing teams to deliver high-quality care, benefitting both patient and workforce outcomes. Quantitative component of a mixed methods study using survey principles. The Conditions of Work Effectiveness Questionnaire II was distributed to the total population (n = 517) of nurse leaders in an NHS Foundation Trust in England. Nurse leader groups comprised unit leaders (sisters, matrons) and senior staff nurses. Quantitative data entered on spss v 17/18, were analysed using descriptive and inferential statistics. Overall, the unit response rate was 44·1% (n = 228). Levels of total and global empowerment were moderate and moderate to high respectively. Groups did not differ significantly on these parameters or on five elements of total empowerment, but significantly higher scores were found for unit leaders' access to information. Significantly higher scores were found for senior staff nurses on selected aspects of informal power and access to resources, but scores were significantly lower than unit leaders for components of support. A moderately empowered population of nurse leaders differed in relation to access to information, aspects of support, resources and informal power, reflecting differences in roles, spheres of responsibility, hierarchical position and the constraints on empowerment imposed on unit leaders by financial and resource pressures. Empowerment of nurse leaders in middle management is vital in enabling nursing teams to deliver high-quality care. Roles, spheres of responsibility, hierarchical

  18. Group-Oriented Services: A Shift towards Consumer-Managed Relationships in the Telecom Industry

    Science.gov (United States)

    Vrdoljak, Luka; Bojic, Iva; Podobnik, Vedran; Jezic, Gordan; Kusek, Mario

    Today, telecom operators face a threefold challenge: a social challenge dealing with the evolution of the consumer lifestyle, a technological challenge dealing with ever changing ICT trends and a business challenge dealing with the need for innovative business models. This paper introduces an idea of group-oriented services, a special type of personalized telecom services, as a possible solution for all three of these challenges. A proof-of-concept service, called Agent-Based Mobile Content Brokerage, is presented and elaborated with the aim to demonstrate a shift towards consumer-managed relationships, a novel provisioning paradigm within the telecom industry.

  19. Marginalised social groups in contemporary weee management within social enterprises investments: A study in Greece

    International Nuclear Information System (INIS)

    Papaoikonomou, K.; Kipouros, S.; Kungolos, A.; Somakos, L.; Aravossis, K.; Antonopoulos, I.; Karagiannidis, A.

    2009-01-01

    This paper deals with the creation of appropriate conditions aimed at developing social services for reuse and recycling of waste electrical and electronic equipment (WEEE), by the inclusion of handicapped and Roma people in the workforce. Application areas for the project are the Hellenic (Greek) regions of Thessaly and North Aegean, where these groups suffer from professional and social exclusion. The efforts to reduce unemployment in the two aforementioned groups, together with the efforts to implement related Greek and European legislation for sustainable WEEE management, are examined here. Furthermore, networking and cooperation at local, regional and central levels between small enterprises, entrepreneurships and local authorities are examined, so that these social enterprises and their corresponding investments may support the development of the Greek alternative WEEE recycling system

  20. Status report on the land processes aircraft science management operations working group

    Science.gov (United States)

    Lawless, James G.; Mann, Lisa J.

    1991-01-01

    Since its inception three years ago, the Land Processes Aircraft Science Management Operations Working Group (MOWG) provided recommendations on the optimal use of the Agency's aircraft in support of the Land Processes Science Program. Recommendations covered topics such as aircraft and sensor usage, development of long-range plans, Multisensor Airborne Campaigns (MAC), program balance, aircraft sensor databases, new technology and sensor development, and increased University scientist participation in the program. Impacts of these recommendations improved the efficiency of various procedures including the flight request process, tracking of flight hours, and aircraft usage. The group also created a bibliography focused on publications produced by Land Processes scientists from the use of the aircraft program, surveyed NASA funded PI's on their participation in the aircraft program, and developed a planning template for multi-sensor airborne campaigns. Benefits from these activities are summarized.

  1. EDF - Annual results 2015. Consolidated financial statements at 31 December 2015. 2015 Management report - Group results

    International Nuclear Information System (INIS)

    Levy, Jean-Bernard

    2016-01-01

    As the world's biggest electricity generator, the EDF Group covers every sector of expertise, from generation to trading and transmission grids. EDF builds on the expertise of its people, its R and D and engineering skills, its experience as a leading industry operator and the attentive support of its customers to deliver competitive solutions that successfully reconcile economic growth with climate protection. This document presents the 2015 annual results, management report and Consolidated financial statements of the Group at 31 December 2015, as well as the 2015 activity report: Group results: Key figures; economic environment; significant events of 2015; subsequent events; analysis of the business and the consolidated income statements for 2014 and 2015; net indebtedness, cash flows and investments; management and control of market risks; transactions with related parties; scope of consolidation; principal risks and uncertainties; financial outlook. consolidated financial statements: group accounting standards; comparability; significant events and transactions; regulatory events in France; changes in the scope of consolidation; segment reporting; sales; fuel and energy purchases; other external expenses; personnel expenses; taxes other than income taxes; other operating income and expenses; impairment/reversals; other income and expenses; financial result; income taxes; basic earnings per share and diluted earnings per share; operating assets and liabilities, equity; goodwill; other intangible assets; property, plant and equipment operated under French public electricity distribution concessions; property, plant and equipment operated under concessions for other activities; property, plant and equipment used in generation and other tangible assets owned by the group; investments in associates and joint ventures; inventories; trade receivables; other receivables; equity; provisions; provisions related to nuclear generation - back-end of the nuclear cycle

  2. Factors affecting research productivity of production and operations management groups: An empirical study

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available This paper identifies factors that promote research productivity of production and operations management (POM groups of researchers in US business schools. In this study, research productivity of a POM group is defined as the number of articles published per POM professor in a specific period of time. The paper also examines factors that affect research quality, as measured by the number of articles published per POM professor in journals, which have been recognized in the POM literature as an elite set. The results show that three factors increase both the research productivity and the quality of the articles published by professors of a POM group. These factors are (a the presence of a POM research center, (b funding received from external sources for research purposes, and (c better library facilities. Doctoral students do assist in improving research quality and productivity, but they are not the driving force. These results have important implications for establishing policy guidelines for business schools. For example, real-world problems are funded by external sources and have a higher probability of publication. Furthermore, schools could place more emphasis on external funding, as most engineering schools do, since groups receiving external funding are more productive in terms of research.

  3. A resilient, robust and active managing of a nuclear crisis is essential for the EDF group

    International Nuclear Information System (INIS)

    Delamare, V.

    2016-01-01

    As a producer, a transmission and a dispatcher company of electricity, the EDF group has to face technological and industrial risks. The EDF group has set up a robust organisation for managing nuclear crisis. As soon as an incident appears in a nuclear power plant the PUI is triggered, this emergency plan allows the mobilization of humane and equipment means necessary to bring back the plant to a safe state. Between 60 and 80 people on duty have to join back their post in less than one hour. The crisis is also managed at a national scale by the activation of 4 crisis cells situated in Paris: the operational cell that will bring extra humane and equipment means to the damaged facility if necessary, the communication cell dedicated to the information of the media, the strategic cell that will supervise the consequences of the incident in terms of technological, legal, financial or societal impacts and the anticipation cell that will be able to analyse the response to the crisis in a critical way making suggestions for the future. (A.C.)

  4. Classroom management of situated group learning: A research study of two teaching strategies

    Science.gov (United States)

    Smeh, Kathy; Fawns, Rod

    2000-06-01

    Although peer-based work is encouraged by theories in developmental psychology and although classroom interventions suggest it is effective, there are grounds for recognising that young pupils find collaborative learning hard to sustain. Discontinuities in collaborative skill during development have been suggested as one interpretation. Theory and research have neglected situational continuities that the teacher may provide in management of formal and informal collaborations. This experimental study, with the collaboration of the science faculty in one urban secondary college, investigated the effect of two role attribution strategies on communication in peer groups of different gender composition in three parallel Year 8 science classes. The group were set a problem that required them to design an experiment to compare the thermal insulating properties of two different materials. This presents the data collected and key findings, and reviews the findings from previous parallel studies that have employed the same research design in different school settings. The results confirm the effectiveness of social role attribution strategies in teacher management of communication in peer-based work.

  5. [Autoimmune pancreatitis. Evidence based management guidelines of the Hungarian Pancreatic Study Group].

    Science.gov (United States)

    Dubravcsik, Zsolt; Farkas, Gyula; Hegyi, Péter; Hritz, István; Kelemen, Dezső; Lásztity, Natália; Morvay, Zita; Oláh, Attila; Pap, Ákos; Párniczky, Andrea; Sahin-Tóth, Miklós; Szentkereszti, Zsolt; Szmola, Richárd; Takács, Tamás; Tiszlavicz, László; Szücs, Ákos; Czakó, László

    2015-02-22

    Autoimmune pancreatitis is a rare disease which can even mimic pancreatic tumor, however, unlike the latter, it requires not surgical but conservative management. Correct diagnosis and differential diagnosis of autoimmune pancreatitis and treatment of these patients requires up-to-date and evidence based management guidelines. The Hungarian Pancreatic Study Group proposed to prepare an evidence based guideline based on the available international guidelines and evidences. The preparatory and consultation task force appointed by the Hungarian Pancreatic Study Group translated and complemented and/or modified the international guidelines if it was necessary. 29 relevant clinical questions in 4 topics were defined (Basics; Diagnosis; Differential diagnostics; Therapy). Evidence was classified according to the UpToDate(®) grading system. The draft of the guidelines was presented and discussed at the consensus meeting on September 12, 2014. All clinial questions were accepted with almost total (more than 95%) agreement. The present guideline is the first evidence based autoimmune pancreatitis guideline in Hungary. The guideline may provide very important and helpful data for tuition of autoimmune pancreatitis, for everyday practice and for establishing proper finance. Therefore, the authors believe that these guidelines will widely become a basic reference in Hungary.

  6. The environmental management problem of Pohorje, Slovenia: A new group approach within ANP - SWOT framework.

    Science.gov (United States)

    Grošelj, Petra; Zadnik Stirn, Lidija

    2015-09-15

    Environmental management problems can be dealt with by combining participatory methods, which make it possible to include various stakeholders in a decision-making process, and multi-criteria methods, which offer a formal model for structuring and solving a problem. This paper proposes a three-phase decision making approach based on the analytic network process and SWOT (strengths, weaknesses, opportunities and threats) analysis. The approach enables inclusion of various stakeholders or groups of stakeholders in particular stages of decision making. The structure of the proposed approach is composed of a network consisting of an objective cluster, a cluster of strategic goals, a cluster of SWOT factors and a cluster of alternatives. The application of the suggested approach is applied to a management problem of Pohorje, a mountainous area in Slovenia. Stakeholders from sectors that are important for Pohorje (forestry, agriculture, tourism and nature protection agencies) who can offer a wide range of expert knowledge were included in the decision-making process. The results identify the alternative of "sustainable development" as the most appropriate for development of Pohorje. The application in the paper offers an example of employing the new approach to an environmental management problem. This can also be applied to decision-making problems in various other fields. Copyright © 2015 Elsevier Ltd. All rights reserved.

  7. Establishment of review groups on US Department of Energy Environmental Restoration and Waste Management Program

    International Nuclear Information System (INIS)

    Eyman, L.D.

    1992-12-01

    A primary purpose of this grant was the establishment of expert research review groups to help facilitate expanded and improved communications and information among states, public, federal agencies, contractors, and DOE, relative to national environmental and waste management issues/problems. The general objectives of this grant were: Research on the further participation avenues of industry and academia and provide appropriate research documentation concerning the implementation of multi-party agreements; Analysis of the impediments that delay the accomplishment of agreements between states and the federal government for environmental compliance, as well as an assessment of the public need for research because of the above agreements; Analysis of the impact of environmental actions on states, industry, academia, public and other federal agencies; Provide research to help facilitate an interactive system that provides the various involved parties the capability and capacity to strengthen their commitment to national environmental and waste management goals and objectives; and Furthering research of public education in the environmental arena and research of needed national education resources in scientific and technical areas related to environmental restoration and waste management

  8. General practitioners' perspectives on management of early-stage chronic kidney disease: a focus group study.

    Science.gov (United States)

    van Dipten, Carola; van Berkel, Saskia; de Grauw, Wim J C; Scherpbier-de Haan, Nynke D; Brongers, Bouke; van Spaendonck, Karel; Wetzels, Jack F M; Assendelft, Willem J J; Dees, Marianne K

    2018-06-06

    Guideline adherence in chronic kidney disease management is low, despite guideline implementation initiatives. Knowing general practitioners' (GPs') perspectives of management of early-stage chronic kidney disease (CKD) and the applicability of the national interdisciplinary guideline could support strategies to improve quality of care. Qualitative focus group study with 27 GPs in the Netherlands. Three analysts open-coded and comparatively analysed the data. Mind-mapping sessions were performed after data-saturation. Five themes emerged: defining CKD, knowledge and awareness, patient-physician interaction, organisation of CKD care and value of the guideline. A key finding was the abstractness of the CKD concept. The GPs expressed various perspectives about defining CKD and interpreting estimated glomerular filtration rates. Views about clinical relevance influenced the decision-making, although factual knowledge seems lacking. Striving to inform well enough without creating anxiety and to explain suitably for the intellectual ability of the patient caused tension in the patient-physician interaction. Integration with cardiovascular disease-management programmes was mentioned as a way of implementing CKD care in the future. The guideline was perceived as a rough guide rather than a leading document. CKD is perceived as an abstract rather than a clinical concept. Abstractness plays a role in all formulated themes. Management of CKD patients in primary care is complex and is influenced by physician-bound considerations related to individual knowledge and perception of the importance of CKD. Strategies are needed to improve GPs' understanding of the concept of CKD by education, a holistic approach to guidelines, and integration of CKD care into cardiovascular programmes. Not applicable.

  9. Modeling and performance analysis of movement-based group location management using RFID sensing in public transportation systems.

    Science.gov (United States)

    Chung, Yun Won

    2012-11-22

    Location management, which consists of location registration and paging, is essential to provide mobile communication services to mobile stations (MSs). Since MSs riding on a public transportation system (TS) generates significant location registration signaling loads simultaneously when a TS with riding MSs moves between location areas (LAs), group location management was proposed. Under the group location management, an MS performs group registration when it gets on a TS and performs group deregistration when it gets off a TS. Then, only a TS updates its current location when it changes LA, on behalf of all riding MSs. In this paper, movement-based group location management using radio frequency identification (RFID) is proposed, where the MS's getting on and getting off behaviors are detected using RFID and only location update of a TS is carried out if the number of crossed cells from the last updated cell exceeds a predefined movement threshold, on behalf of all riding MSs. Then, we develop an analytical model for the performance analysis of the movement-based group location management and analyze the effects of various parameters on the performance. The results show that the movement-based group location management has reduced signaling cost compared with movement-based individual location management, and optimal performance can be achieved by choosing appropriate movement threshold values.

  10. Performance Analysis of Hierarchical Group Key Management Integrated with Adaptive Intrusion Detection in Mobile ad hoc Networks

    Science.gov (United States)

    2016-04-05

    applications in wireless networks such as military battlefields, emergency response, mobile commerce , online gaming, and collaborative work are based on the...www.elsevier.com/locate/peva Performance analysis of hierarchical group key management integrated with adaptive intrusion detection in mobile ad hoc...Accepted 19 September 2010 Available online 26 September 2010 Keywords: Mobile ad hoc networks Intrusion detection Group communication systems Group

  11. A Comparative Study of Effectiveness of Peer Assessment of Individuals' Contributions to Group Projects in Undergraduate Construction Management Core Units

    Science.gov (United States)

    Jin, Xiao-Hua

    2012-01-01

    In recent years, various forms of group work have been introduced in university courses across various subject domains, including construction management courses. Although the use of group work in higher education has sound pedagogical reasons and advantages, group work has its own drawbacks. Therefore, the acceptance by students and the success…

  12. Data Management Plan and Functional System Design for the Information Management System of the Clinch River Remedial Investigation and Waste Area Grouping 6

    Energy Technology Data Exchange (ETDEWEB)

    Ball, T.; Brandt, C.; Calfee, J.; Garland, M.; Holladay, S.; Nickle, B.; Schmoyer, D.; Serbin, C.; Ward, M. [Oak Ridge National Lab., TN (United States)

    1994-03-01

    The Data Management Plan and Functional System Design supports the Clinch River Remedial Investigation (CRRI) and Waste Area Grouping (WAG) 6 Environmental Monitoring Program. The objective of the Data Management Plan and Functional System Design is to provide organization, integrity, security, traceability, and consistency of the data generated during the CRRI and WAG 6 projects. Proper organization will ensure that the data are consistent with the procedures and requirements of the projects. The Information Management Groups (IMGs) for these two programs face similar challenges and share many common objectives. By teaming together, the IMGs have expedited the development and implementation of a common information management strategy that benefits each program.

  13. Managing the conflict between individual needs and group interests--ethical leadership in health care organizations.

    Science.gov (United States)

    Shale, Suzanne

    2008-03-01

    This paper derives from a grounded theory study of how Medical Directors working within the UK National Health Service manage the moral quandaries that they encounter as leaders of health care organizations. The reason health care organizations exist is to provide better care for individuals through providing shared resources for groups of people. This creates a paradox at the heart of health care organization, because serving the interests of groups sometimes runs counter to serving the needs of individuals. The paradox presents ethical dilemmas at every level of the organization, from the boardroom to the bedside. Medical Directors experience these organizational ethical dilemmas most acutely by virtue of their position in the organization. As doctors, their professional ethic obliges them to put the interests of individual patients first. As executive directors, their role is to help secure the delivery of services that meet the needs of the whole patient population. What should they do when the interests of groups of patients, and of individual patients, appear to conflict? The first task of an ethical healthcare organization is to secure the trust of patients, and two examples of medical ethical leadership are discussed against this background. These examples suggest that conflict between individual and population needs is integral to health care organization, so dilemmas addressed at one level of the organization inevitably re-emerge in altered form at other levels. Finally, analysis of the ethical activity that Medical Directors have described affords insight into the interpersonal components of ethical skill and knowledge.

  14. Management of Type 2 diabetes in Ramadan: Low-ratio premix insulin working group practical advice

    Science.gov (United States)

    Hassanein, Mohamed; Belhadj, Mohamed; Abdallah, Khalifa; Bhattacharya, Arpan D.; Singh, Awadhesh K.; Tayeb, Khaled; Al-Arouj, Monira; Elghweiry, Awad; Iraqi, Hinde; Nazeer, Mohamed; Jamoussi, Henda; Mnif, Mouna; Al-Madani, Abdulrazzaq; Al-Ali, Hossam; Ligthelm, Robert

    2014-01-01

    The challenge of insulin use during Ramadan could be minimized, if people with diabetes are metabolically stable and are provided with structured education for at least 2–3 months pre-Ramadan. Although, American diabetes association (ADA) recommendations 2010 and South Asian Consensus Guideline 2012 deal with management of diabetes in Ramadan and changes in insulin dosage, no specific guidance on widely prescribed low-ratio premix insulin is currently available. Hence, the working group for insulin therapy in Ramadan, after collective analysis, evaluation, and opinion from clinical practice, have formulated a practical advice to empower physicians with pre-Ramadan preparation, dose adjustment, and treatment algorithm for self-titration of low-ratio premix insulin. PMID:25364673

  15. Management of Type 2 diabetes in Ramadan: Low-ratio premix insulin working group practical advice

    Directory of Open Access Journals (Sweden)

    Mohamed Hassanein

    2014-01-01

    Full Text Available The challenge of insulin use during Ramadan could be minimized, if people with diabetes are metabolically stable and are provided with structured education for at least 2-3 months pre-Ramadan. Although, American diabetes association (ADA recommendations 2010 and South Asian Consensus Guideline 2012 deal with management of diabetes in Ramadan and changes in insulin dosage, no specific guidance on widely prescribed low-ratio premix insulin is currently available. Hence, the working group for insulin therapy in Ramadan, after collective analysis, evaluation, and opinion from clinical practice, have formulated a practical advice to empower physicians with pre-Ramadan preparation, dose adjustment, and treatment algorithm for self-titration of low-ratio premix insulin.

  16. Environmental management in hard coal mine group in the Upper Silesian Coal Basin, Poland

    International Nuclear Information System (INIS)

    Pozzi, M.; Weglarczyk, J.

    2000-01-01

    Mining activity and the other branches of heavy industry existing in the USCB for over 2 centuries have made large unfavourable changes of environment. Prevention of its further degradation needs the solution for the following main problems: utilisation of high saline mine drainage water (a problem unique in the world scale), treatment of solid wastes, land reclamation (mainly treatment of areas of ground subsiding). Market economy introduced 10 years ago and the necessity that all fields of life conform to the requirements of the European Union force the process of deep restructurisation of mining industry. One of the conditions for success of restructuring is the solution of ecological problems. The possibility of environmental management system implementation according to the ISO 14000 standard in the coal mine group condition was discussed. The chances and presumed results of these activities were presented in this paper. 6 refs

  17. Large Scale Management of Physicists Personal Analysis Data Without Employing User and Group Quotas

    International Nuclear Information System (INIS)

    Norman, A.; Diesbug, M.; Gheith, M.; Illingworth, R.; Lyon, A.; Mengel, M.

    2015-01-01

    The ability of modern HEP experiments to acquire and process unprecedented amounts of data and simulation have lead to an explosion in the volume of information that individual scientists deal with on a daily basis. Explosion has resulted in a need for individuals to generate and keep large personal analysis data sets which represent the skimmed portions of official data collections, pertaining to their specific analysis. While a significant reduction in size compared to the original data, these personal analysis and simulation sets can be many terabytes or 10s of TB in size and consist of 10s of thousands of files. When this personal data is aggregated across the many physicists in a single analysis group or experiment it can represent data volumes on par or exceeding the official production samples which require special data handling techniques to deal with effectively.In this paper we explore the changes to the Fermilab computing infrastructure and computing models which have been developed to allow experimenters to effectively manage their personal analysis data and other data that falls outside of the typically centrally managed production chains. In particular we describe the models and tools that are being used to provide the modern neutrino experiments like NOvA with storage resources that are sufficient to meet their analysis needs, without imposing specific quotas on users or groups of users. We discuss the storage mechanisms and the caching algorithms that are being used as well as the toolkits are have been developed to allow the users to easily operate with terascale+ datasets. (paper)

  18. Management response plan for the Chemical Safety Vulnerability Working Group report. Volume 1

    International Nuclear Information System (INIS)

    1994-09-01

    The Chemical Safety Vulnerability (CSV) Working Group was established to identify adverse conditions involving hazardous chemicals at DOE facilities that might result in fires or explosions, release of hazardous chemicals to the environment, or exposure of workers or the public to chemicals. A CSV Review was conducted in 146 facilities at 29 sites. Eight generic vulnerabilities were documented related to: abandoned chemicals and chemical residuals; past chemical spills and ground releases; characterization of legacy chemicals and wastes; disposition of legacy chemicals; storage facilities and conditions; condition of facilities and support systems; unanalyzed and unaddressed hazards; and inventory control and tracking. Weaknesses in five programmatic areas were also identified related to: management commitment and planning; chemical safety management programs; aging facilities that continue to operate; nonoperating facilities awaiting deactivation; and resource allocations. Volume 1 contains a discussion of the chemical safety improvements planned or already underway at DOE sites to correct facility or site-specific vulnerabilities. The main part of the report is a discussion of each of the programmatic deficiencies; a description of the tasks to be accomplished; the specific actions to be taken; and the organizational responsibilities for implementation

  19. Social interaction in management group meetings: a case study of Finnish hospital.

    Science.gov (United States)

    Laapotti, Tomi; Mikkola, Leena

    2016-06-20

    Purpose - The purpose of this paper is to understand the role of management group meetings (MGMs) in hospital organization by examining the social interaction in these meetings. Design/methodology/approach - This case study approaches social interaction from a structuration point of view. Social network analysis and qualitative content analysis are applied. Findings - The findings show that MGMs are mainly forums for information sharing. Meetings are not held for problem solving or decision making, and operational coordinating is limited. Meeting interaction is very much focused on the chair, and most of the discussion takes place between the chair and one other member, not between members. The organizational structures are maintained and reproduced in the meeting interaction, and they appear to limit discussion. Meetings appear to fulfil their goals as a part of the organization's information structure and to some extent as an instrument for management. The significance of the relational side of MGMs was recognized. Research limitations/implications - The results of this study provide a basis for future research on hospital MGMs with wider datasets and other methodologies. Especially the relational role of MGMs needs more attention. Practical implications - The goals of MGMs should be reviewed and MG members should be made aware of meeting interaction structures. Originality/value - The paper provides new knowledge about interaction networks in hospital MGMs, and describes the complexity of the importance of MGMs for hospitals.

  20. Mechanism, Assessment and Management of Pain in Chronic Pancreatitis: Recommendations of a Multidisciplinary Study Group

    Science.gov (United States)

    Anderson, Michelle A; Akshintala, Venkata; Albers, Kathryn M; Amann, Stephen T.; Belfer, Inna; Brand, Randall; Chari, Suresh; Cote, Greg; Davis, Brian M.; Frulloni, Luca; Gelrud, Andres; Guda, Nalini; Humar, Abhinav; Liddle, Rodger A.; Slivka, Adam; Gupta, Rachelle Stopczynski; Szigethy, Eva; Talluri, Jyothsna; Wassef, Wahid; Wilcox, C Mel; Windsor, John; Yadav, Dhiraj; Whitcomb, David C.

    2015-01-01

    Description Pain in patients with chronic pancreatitis (CP) remains the primary clinical complaint and source of poor quality of life. However, clear guidance on evaluation and treatment is lacking. Methods Pancreatic Pain working groups reviewed information on pain mechanisms, clinical pain assessment and pain treatment in CP. Levels of evidence were assigned using the Oxford system, and consensus was based on GRADE. A consensus meeting was held during PancreasFest 2012 with substantial post-meeting discussion, debate, and manuscript refinement. Results Twelve discussion questions and proposed guidance statements were presented. Conference participates concluded: Disease Mechanism: Pain etiology is multifactorial, but data are lacking to effectively link symptoms with pathologic feature and molecular subtypes. Assessment of Pain: Pain should be assessed at each clinical visit, but evidence to support an optimal approach to assessing pain character, frequency and severity is lacking. Management: There was general agreement on the roles for endoscopic and surgical therapies, but less agreement on optimal patient selection for medical, psychological, endoscopic, surgical and other therapies. Conclusions Progress is occurring in pain biology and treatment options, but pain in patients with CP remains a major problem that is inadequately understood, measured and managed. The growing body of information needs to be translated into more effective clinical care. PMID:26620965

  1. Implications of Antibiotic Resistance in the Management of Helicobacter pylori Infection: Canadian Helicobacter Study Group

    Directory of Open Access Journals (Sweden)

    RH Hunt

    2000-01-01

    Full Text Available Eradication of Helicobacter pylori from the gastric and duodenal mucosa is an important clinical goal in the treatment of infected patients with peptic ulcer disease and other H pylori-associated conditions. Although several oral drug combination regimens are associated with eradication rates of approximately 85% in controlled trials, the success rate in patients infected with a resistant strain of H pylori is closer to 75%. Resistance to metronidazole and clarithromycin, which are common components of combination treatment regimens, is of greatest concern. Reported rates of H pylori resistance to various antibiotics vary considerably. In Canada, the data documenting H pylori susceptibility are limited but suggest that resistance to these antibiotics varies geographically and within specific treatment groups. Although susceptibility testing is not a prerequisite for initial treatment of individual patients infected with H pylori, formal efforts to identify and monitor both the causes and prevalence of antibiotic resistance across Canada are a much needed step in the ongoing management of this important infection. Recommended treatment regimens may be useful, even for treating apparently resistant H pylori strains. However, it is important to understand the mechanisms of the development of resistant strains to manage patients with treatment failure better.

  2. Effect of Group Parent Management Traning on Behavioral Disorders of Children with Attention Deficit-Hyoeractivity Disorder

    Directory of Open Access Journals (Sweden)

    Parsa Houshvar

    2009-10-01

    Conclusion: Group parent management training is significantly effective in decreasing behavioral disorders and anxiety status of children with attention deficit hyperactivity disorder and this psychosocial intervention could be used as an effective complementary method beside medication and occupational therapy programs.

  3. Activities of the IAEA International Working Group on Life Management of Nuclear Power Plants (IWG-LMNPP)

    International Nuclear Information System (INIS)

    Ianko, L.

    1994-01-01

    Activities of the IAEA international working group on life management of nuclear power plants are outlined with emphasis on objectives, scope of activities, methods of work, organizational matters, financing

  4. The experience of facilitators and participants of long term condition self-management group programmes: A qualitative synthesis.

    Science.gov (United States)

    Hughes, Stephen; Lewis, Sophie; Willis, Karen; Rogers, Anne; Wyke, Sally; Smith, Lorraine

    2017-12-01

    Our aim was to systematically review the qualitative literature about the experiences of both facilitators and participants in a range of group-based programmes to support the self-management of long-term conditions. We searched 7 databases using the terms 'self-management', 'group' and 'qualitative'. Full text articles meeting the inclusion criteria were retrieved for review. A thematic synthesis approach was used to analyse the studies. 2126 articles were identified and 24 were included for review. Group participants valued being with similar others and perceived peer support benefits. Facilitators (HCP and lay) had limited group specific training, were uncertain of purpose and prioritised education and medical conformity over supportive group processes and the promotion of self-management agency and engagement. Overall, studies prioritised positive descriptions. Group programmes' medical self-management focus may reduce their ability to contribute to patient-valued outcomes. Further research is needed to explore this disconnect. This review supports broadening the scope of group-based programmes to foreground shared learning, social support and development of agency. It is of relevance to developers and facilitators of group self-management programmes and their ability to address the burden of long-term conditions. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Management and schedule challenges for fossil projects in the 1990's. Working Group Three: Challenges and action items

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    The discussions of the working group resulted in identification of the following management challenges: New generation capacity - before 1995, after 1995; Shortages of critical resources - engineers and crafts, manufacturing capacity; Competitive restrictions; Management philosophy - not the owners' problem; delay commitment; custom plants; proven technology; build and own myself. The paper also lists action items under 3 categories: actions to increase resources and decrease needs; fostering competitive incentives; and changing management philosophy

  6. Wastewater Facilities Operation and Management. Instructor Guide. Working for Clean Water: An Information Program for Advisory Groups.

    Science.gov (United States)

    Long, David A.

    Local communities must be willing to spend funds to assure the proper operation and management of wastewater treatment facilities. Designed for citizen advisory groups, the one-hour learning session described in this instructor's manual covers problem areas, federal requirements, and responsibilities for wastewater plant operations and management.…

  7. BASHAN: A few-group three-dimensional diffusion code with burnup and fuel management features

    International Nuclear Information System (INIS)

    Pearce, D.F.

    1970-12-01

    The diffusion equation for a two or three-dimensional, two-group or multi-group downscatter problem is solved by conventional finite difference techniques. An x-y-z geometry is assumed with an 'in-channel' mesh point representation. Options are available which allow representation of a soluble poison dispersed throughout the reactor, and also absorber rods in specified channels. The power distribution and multiplication factor k eff are calculated and a point rating map is used to advance the irradiation at each mesh point by a specified time-step so that burnup is followed. Fuel changes may be made so that radial shuffling and axial shuffling fuel management schemes can be studies. The code has been written in FORTRAN S2 for an IBM 7030 (STRETCH) computer which, with a fast store of 80,000 locations, allows problems of up to 15,000 mesh points to be dealt with. Conversion to FORTRAN IV for IBM 360 has now been completed. (author)

  8. Use of social networking sites: Facebook group as a learning management system

    Directory of Open Access Journals (Sweden)

    Md. Abul Kalam Siddike

    2015-06-01

    Full Text Available Social networking sites (SNSs are becoming popular day by day in academia as well as in business organizations around the world. Facebook as the largest and fastest networking sites, is one of the important SNSs that can play an important role in different academic disciplines. The aim of this study is to investigate the use of SNSs by the undergraduate students of International Islamic University of Malaysia (IIUM. The specific objectives are: (i to explore the frequency of using SNSs by the undergraduates; (ii to identify the purpose of using SNSs; (iii to examine the perceptions of undergraduates for using SNSs as an academic tool; and (iv finally, to propose Facebook group as a learning management system (LMS of IIUM. A structured survey questionnaire was distributed among 500 undergraduate students of IIUM and 351 responses were received. The results report that Facebook and Google+ are preferred SNSs. Sharing information with friends, getting connected with people for different level, making new friends, and passing time are the main reasons for using SNSs. This study also proposes a six-step procedure for using Facebook group as a LMS.

  9. The Jari Project Managed By The Orsa Group: Corporate Social Responsibility Applied To The Amazon Context

    Directory of Open Access Journals (Sweden)

    Anna Greissing

    2012-07-01

    Full Text Available The development of the Jari region, in the Northeastern part of Brazil’s Amazon region, since the middle of the 20th century, ha been intrinsically linked to the evolution of the Jari project, a huge private agro-industrial enterprise aiming at the large-scale production of cellulose. Harshly criticized during the 1970s and 1980s for its ecological impact and waste of human resources, but also due to the lack of economic viability, the project was eventually taken over by a new firm (the Orsa group after coming close to bankruptcy in 1997. Under Orsa’s management, centered on the concept of corporate social and environmental responsibility (CSR, the Jari project of the XXI century resurrects as an innovative, lucrative and certified firm, pioneer in the application of CSR policies in the Amazon context. This article discusses the manifold strategies developed by the Orsa group and its conveniences and shortcomings for both the firm and the local populations of the Jari region today.

  10. Using interviews and focus groups with resource managers to explore risk perceptions and responses to climate scenarios

    Science.gov (United States)

    Clifford, K. R.; Travis, W.; Rangwala, I.; Rondeau, R.; Young, L.

    2016-12-01

    Resource managers in the western U.S. are increasingly tasked to incorporate climate change into management decisions and long-term planning, but this task is complicated by multiple challenges, among them the need to bridge between the differing perspectives and prerogatives of scientists and resource managers. As part of a larger, iterative, interdisciplinary, multi-landscape research project that built on a prior climate vulnerability research, we conducted more than 50 semi-structured interviews and four focus groups with resource managers in the Gunnison Basin in western Colorado. The interviews addressed the managers' risk perceptions and knowledge about the resources and landscapes, while the focus groups asked resource managers to reflect on their own resource decision-making in light of three narrative future climate scenarios created by scientists on the research team. While time-intensive, the interviews and focus groups produced important insights into the managers' understanding of both the resources in question and the future climate scenarios. We found that the managers' mental models of their systems, and their conceptions of landscape changes and future threats, were diverse and sometimes in conflict with those held by the research team. The managers' responses to the climate scenarios reflected divergent and nuanced perceptions of risk, adaptation and uncertainty, heavily shaped by personal experience—which could be a constraint under rapidly changing future conditions. Our deployment of social science methodologies facilitated the co-production of climate adaptation strategies and a bridge between and among scientists and managers. The participants found the focus groups helpful since they (1) provided space to focus on decision-making under climate change, rather than fixate on details of the science, and (2) facilitated interaction with colleagues from other agencies. Climate scientists used participant feedback to inform future scenario

  11. An approach to improve management visibility within the procurement and financial group at Goldstone

    Science.gov (United States)

    Maiocco, F. R.; Rozek, J. B.

    1976-01-01

    Improvements in the operational efficiency of the data management systems at the Goldstone Deep Space Communications Complex (GDSCC) are discussed. This addresses the existing procurement and financial management data system at GDSCC, identifies management requirements for better visibility, describes a proposed computerized data management system, summarizes results to data, and identifies plans for future development.

  12. Patellar Instability Management: A Survey of the International Patellofemoral Study Group.

    Science.gov (United States)

    Liu, Joseph N; Steinhaus, Michael E; Kalbian, Irene L; Post, William R; Green, Daniel W; Strickland, Sabrina M; Shubin Stein, Beth E

    2017-10-01

    Although patellofemoral instability is among the most prevalent knee disorders, the management of patients with this condition is complex and remains variable, given the lack of long-term, high-level clinical outcome studies to compare various operative and nonoperative modalities. To discover a consensus within treatment controversies in patellofemoral instability among experienced knee surgeons with a specific interest in the patellofemoral joint. Expert opinion; Level of evidence, 5. A 3-step modified Delphi technique was used to establish a consensus. A 34-question, case-based online survey regarding patellofemoral instability was distributed to all active members of the International Patellofemoral Study Group. Consensus statements were generated if at least 66% of the respondents agreed and then redistributed to the same panel. Modifications to the consensus statements were made based on the iterative feedback process until no discordance was encountered in the third stage. Eight consensus statements were achieved. Nonoperative management is the current standard of care for a first-time dislocation in the absence of an osteochondral fragment or loose body requiring excision (100% agreement). In patients with a first-time dislocation with an operative osteochondral fracture requiring excision or repair, patellar instability should be addressed concurrently (89% agreement). Recurrent instability should be treated surgically, with most surgeons favoring medial reconstruction (77%-86% agreement). While there is general agreement that bony procedures should be performed to correct underlying bony deformities, there is no consensus regarding the most appropriate type of procedure performed. Lateral release should not be performed in isolation for the treatment of patellar instability (89% agreement). Despite the consensus generated in this study, our current understanding remains limited by a lack of high-level evidence as well as the numerous complex variables

  13. Safety climate in the US federal wildland fire management community: influences of organizational, environmental, group, and individual characteristics

    Science.gov (United States)

    Anne E. Black; Brooke Baldauf McBride

    2013-01-01

    This study examined the effects of organisational, environmental, group and individual characteristics on five components of safety climate (High Reliability Organising Practices, Leadership, Group Culture, Learning Orientation and Mission Clarity) in the US federal wildland fire management community. Of particular interest were differences between perceptions based on...

  14. Safety climate in the federal fire management community: Influences of organizational, environmental, group, and individual characteristics (Abstract)

    Science.gov (United States)

    Brooke Baldauf McBride; Anne E. Black

    2012-01-01

    This study examined the effects of organizational, environmental, group and individual characteristics on five components of safety climate in the US federal fire management community (HRO Practices, Leadership, Group Culture, Learning Orientation and Mission Clarity). Multiple analyses of variance revealed that all types of characteristics had a significant effect on...

  15. 40 CFR 63.138 - Process wastewater provisions-performance standards for treatment processes managing Group 1...

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Process wastewater provisions-performance standards for treatment processes managing Group 1 wastewater streams and/or residuals removed from Group 1 wastewater streams. 63.138 Section 63.138 Protection of Environment ENVIRONMENTAL...

  16. 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

  17. Does whom you work with matter? Effects of referent group gender and age composition on managers' compensation.

    Science.gov (United States)

    Ostroff, Cheri; Atwater, Leanne E

    2003-08-01

    Much research has examined gender and age effects on compensation, concluding that a wage gap exists favoring men and negative stereotypes against older workers persist. Although the effect of an employee's gender or age has been widely studied, little work has examined the impact of the demographic characteristics of a focal employee's immediate referent groups (e.g., subordinates, peers, or supervisors) on pay. The effect of the gender and age composition of a focal manager's subordinates, peers, and supervisor on the manager's compensation levels was investigated in a sample of 2,178 managers across a wide range of organizations and functional areas. After controlling for a number of human capital variables, results indicated that not only does a wage gap favoring men exist, but also managerial pay is lower when managers' referent groups are largely female, when subordinates are outside the prime age group, and when peers and supervisors are younger.

  18. Operable Unit 3-13, Group 3, Other Surface Soils Remediation Sets 4-6 (Phase II) Waste Management Plan

    International Nuclear Information System (INIS)

    G. L. Schwendiman

    2006-01-01

    This Waste Management Plan describes waste management and waste minimization activities for Group 3, Other Surface Soils Remediation Sets 4-6 (Phase II) at the Idaho Nuclear Technology and Engineering Center located within the Idaho National Laboratory. The waste management activities described in this plan support the selected response action presented in the Final Record of Decision for Idaho Nuclear Technology and Engineering Center, Operable Unit 3-13. This plan identifies the waste streams that will be generated during implementation of the remedial action and presents plans for waste minimization, waste management strategies, and waste disposition

  19. Differential effects of professional leaders on health care teams in chronic disease management groups.

    Science.gov (United States)

    Wholey, Douglas R; Disch, Joanne; White, Katie M; Powell, Adam; Rector, Thomas S; Sahay, Anju; Heidenreich, Paul A

    2014-01-01

    Leadership by health care professionals is likely to vary because of differences in the social contexts within which they are situated, socialization processes and societal expectations, education and training, and the way their professions define and operationalize key concepts such as teamwork, collaboration, and partnership. This research examines the effect of the nurse and physician leaders on interdependence and encounter preparedness in chronic disease management practice groups. The aim of this study was to examine the effect of complementary leadership by nurses and physicians involved in jointly producing a health care service on care team functioning. The design is a retrospective observational study based on survey data. The unit of analysis is heart failure care groups in U.S. Veterans Health Administration medical centers. Survey and administrative data were collected in 2009 from 68 Veterans Health Administration medical centers. Key variables include nurse and physician leadership, interdependence, psychological safety, coordination, and encounter preparedness. Reliability and validity of survey measures were assessed with exploratory factor analysis and Cronbach alphas. Multivariate analyses tested hypotheses. Professional leadership by nurses and physicians is related to encounter preparedness by different paths. Nurse leadership is associated with greater team interdependence, and interdependence is positively associated with respect. Physician leadership is positively associated with greater psychological safety, respect, and shared goals but is not associated with interdependence. Respect is associated with involvement in learning activities, and shared goals are associated with coordination. Coordination and involvement in learning activities are positively associated with encounter preparedness. By focusing on increasing interdependence and a constructive climate, nurse and physician leaders have the opportunity to increase care coordination

  20. Characteristics of personal health information management groups: findings from an online survey using Amazon's mTurk.

    Science.gov (United States)

    Kim, Sujin; Huber, Jeffrey T

    2017-10-01

    The study characterized three groups with different levels of familiarity with personal health information management (PHIM) in terms of their demographics, health knowledge, technological competency, and information sources and barriers. In addition, the authors examined differences among PHIM groups in subjective self-ratings and objective test scores for health literacy. A total of 202 survey participants were recruited using Amazon's Mechanical Turk (mTurk) service, a crowdsourcing Internet service. Using K-means clustering, three groups with differing levels of familiarity with PHIM were formed: Advanced, Intermediate, and Basic. The Advanced group was the youngest, and the Basic group contained the highest proportion of males, whereas the Intermediate group was the oldest and contained the fewest males. The Advanced group was significantly more likely to engage in provider- or hospital-initiated PHIM activities such as emailing with providers, viewing test results online, and receiving summaries of hospital visits via email or websites than the other groups. The Basic group had significantly lower information management skills and Internet use than the other groups. Advanced and Basic groups reported significant differences in several information barriers. While the Advanced group self-reported the highest general literacy, they scored lowest on an objective health literacy test. For effective personal health records management, it is critical to understand individual differences in PHIM using a comprehensive measure designed to assess personal health records-specific activities. Because they are trained to perform an array of information management activities, medical librarians or patient educators are well positioned to promote the effective use of personal health records by health consumers.

  1. Defining and improving quality management in Dutch diabetes care groups and outpatient clinics: design of the study

    Science.gov (United States)

    2013-01-01

    Background Worldwide, the organisation of diabetes care is changing. As a result general practices and diabetes teams in hospitals are becoming part of new organisations in which multidisciplinary care programs are implemented. In the Netherlands, 97 diabetes care groups and 104 outpatient clinics are working with a diabetes care program. Both types of organisations aim to improve the quality of diabetes care. Therefore, it is essential to understand the comprehensive elements needed for optimal quality management at organisational level. This study aims to assess the current level of diabetes quality management in both care groups and outpatient clinics and its improvement after providing feedback on their quality management system and tailored support. Methods/design This study is a before-after study with a one-year follow-up comparing the levels of quality management before and after an intervention to improve diabetes quality management. To assess the status of quality management, online questionnaires were developed based on current literature. They consist of six domains: organisation of care, multidisciplinary teamwork, patient centeredness, performance management, quality improvement policy and management strategies. Based on the questionnaires, respondents will receive feedback on their score in a radar diagram and an elucidating table. They will also be granted access to an online toolbox with instruments that proved to be effective in quality of care improvement and with practical examples. If requested, personal support in implementing these tools will be available. After one year quality management will be measured again using the same questionnaire. Discussion This study will reveal a nationwide picture of quality management in diabetes care groups and outpatient clinics in the Netherlands and evaluate the effect of offering tailored support. The operationalisation of quality management on organisational level may be of interest for other countries

  2. Diagnosis, prevention, and management of statin adverse effects and intolerance: Canadian Working Group Consensus update.

    Science.gov (United States)

    Mancini, G B John; Tashakkor, A Yashar; Baker, Steven; Bergeron, Jean; Fitchett, David; Frohlich, Jiri; Genest, Jacques; Gupta, Milan; Hegele, Robert A; Ng, Dominic S; Pearson, Glen J; Pope, Janet

    2013-12-01

    The Proceedings of a Canadian Working Group Consensus Conference, first published in 2011, provided a summary of statin-associated adverse effects and intolerance and management suggestions. In this update, new clinical studies identified since then that provide further insight into effects on muscle, cognition, cataracts, diabetes, kidney disease, and cancer are discussed. Of these, the arenas of greatest controversy pertain to purported effects on cognition and the emergence of diabetes during long-term therapy. Regarding cognition, the available evidence is not strongly supportive of a major adverse effect of statins. In contrast, the linkage between statin therapy and incident diabetes is more firm. However, this risk is more strongly associated with traditional risk factors for new-onset diabetes than with statin itself and any possible negative effect of new-onset diabetes during statin treatment is far outweighed by the cardiovascular risk reduction benefits. Additional studies are also discussed, which support the principle that systematic statin rechallenge, and lower or intermittent statin dosing strategies are the main methods for dealing with suspected statin intolerance at this time. Copyright © 2013 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.

  3. MANAGEMENT OF CLINICALLY CURED TONSILLOPHARYNGITIS IN PATIENTS WITH GROUP A STREPTOCOCCUS ISOLATED FROM A PHARYNGEAL SWAB

    Directory of Open Access Journals (Sweden)

    Radica Živković-Zarić

    2015-12-01

    Full Text Available The group A streptococcus (GAS tonsillopharyngitis is a very common disease in children’s age. Inappropriate use of antibiotics is frequently encountered, both for treatment purposes and for eradication of the causative agents. The aim of our study was to discover reasons and causes for inappropriate use of antibiotics in children. We have used the triangulation approach to the problem which was studied by the analysis of interviews, observation of patient-cases and by the review of medical records. We discovered that prescribers had very different attitudes towards curing GAS tonsillopharyngitis as well as towards curing GAS carriage. The physicians were under the pressure to prescribe antibiotics and the parents were prone to administer antibiotics to children by themselves. Such behavior could be partially explained by the lack of funds for laboratory analyses. Moreover, the patients were still allowed to buy antibiotics without prescriptions. General culture of using antibiotics should be increased to a higher level among both health workers and parents in order to change some irrational behavior when managing patients who have been cured from streptococcal tonsillopharyngitis.

  4. Communication in natural resource management: agreement between and disagreement within stakeholder groups

    NARCIS (Netherlands)

    de Nooy, W.

    2013-01-01

    Communication among stakeholders is commonly held to improve agreement on facts and management goals. Results from statistical network analyses of six natural resource management systems indicate that the effects of communication depend on context. If communication affects stakeholder knowledge and

  5. Waste management plan for the remedial investigation of Waste Area Grouping 2 at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    Baron, L.A.

    1994-10-01

    This Project Waste Management Plan defines the criteria and methods to be used for managing waste generated during activities associated with Waste Area Grouping 2 at Oak Ridge National Laboratory. The waste management strategy is based on the generation and management of waste on a systematic basis using the most appropriate combination of waste reduction, segregation, treatment, storage, and disposal practices while protecting the environment and human health, maintaining as low as reasonably achievable limits. This plan contains provisions for safely and effectively managing soils and sediments, sampling water, decontamination fluids, and disposable personal protective equipment consistent with the US Environmental Protection Agency guidance. This plan will be used in conjunction with the ORNL ER Program Waste Management Plan

  6. [Isolated primary nocturnal enuresis: international evidence based management. Consensus recommendations by French expert group].

    Science.gov (United States)

    Aubert, D; Berard, E; Blanc, J-P; Lenoir, G; Liard, F; Lottmann, H

    2010-05-01

    The causes and treatment of isolated primary nocturnal enuresis (PNE) are the subject of ongoing controversy. We are proposing consensus practical recommendations, based on a formalised analysis of the literature and validated by a large panel of experts. A task force of six experts based its work on the guide for literature analysis and recommendations and recommendation grading of the French Haute Autorité de Santé (formalized consensus process methodological guidelines) to evaluate the level of scientific proof (grade of 1 to 4) and the strength of the recommendations (grade A, B, C) of the publications on PNE. As a result of this, 223 articles from 2003 on were identified, of which only 127 (57 %) have an evaluable level of proof. This evaluation was then reviewed by a 19-member rating group. Several recommendations, poorly defined by the literature, had to be proposed by a professional agreement resulting from a consultation between the members of the task force and those of the rating group. For its final validation, the document was submitted to a reading group of 21 members working in a wide range of specialist areas and practices but all involved in PNE. The definition of PNE is very specific: intermittent incontinence during sleep, from the age of 5, with no continuous period of continence longer than 6 months, with no other associated symptom, particularly during the day. Its diagnosis is clinical by the exclusion of all other urinary pathologies. Two factors must be identified during the consultation: nocturnal polyuria promoted by excessive fluid intake, inverse secretion of vasopressin, snoring and sleep apnoea. It is sensitive to desmopressin; small bladder capacity evaluated according to a voiding diary and the ICCS formula. It may be associated with diurnal hyperactivity of the detrusor (30 %). It is resistant to desmopressin. Problems associated with PNE are: abnormal arousal threshold, attention deficit hyperactivity disorder (ADHD) (10 %), low

  7. Meeting the expectations of chronic tinnitus patients: comparison of a structured group therapy program for tinnitus management with a problem-solving group.

    Science.gov (United States)

    Wise, K; Rief, W; Goebel, G

    1998-06-01

    Two different group treatments were evaluated in 144 in-patients suffering from impairment due to chronic tinnitus. A tinnitus management therapy (TMT) was developed using principles of cognitive-behavioral therapy and compared with problem solving group therapy. Self-ratings were used to evaluate the help patients found in dealing with life problems and tinnitus as well as the degree to which they felt they were being properly treated and taken seriously. Patients showed significantly more satisfaction with the TMT group and evaluated the help they found in coping with tinnitus and life problems significantly higher. Thus, in the light of unsatisfactory medical solutions and the poor acceptance of some psychological treatments for tinnitus, TMT appears to be an acceptable and helpful treatment program.

  8. Definition of a COPD self-management intervention: International Expert Group consensus

    NARCIS (Netherlands)

    Effing, T.W.; Vercoulen, Jan H.; Bourbeau, Jean; Trappenburg, Jaap C.A.; Lenferink, Anke; Cafarella, Paul; Coultas, David; Meek, Paula; van der Valk, Paul; Bischoff, Erik W.M.A.; Bucknall, Christine E.; Dewan, Naresh A.; Early, Frances; Fan, Vincent; Frith, Peter; Janssen, Daisy J.A.; Mitchell, Katy; Morgan, Mike; Nici, Linda; Patel, Irem; Walters, Haydn; Rice, Kathryn L.; Singh, Sally J.; ZuWallack, Richard; Benzo, Roberto; Goldstein, Roger S.; Partridge, Martyn R.; van der Palen, Jacobus Adrianus Maria

    2016-01-01

    There is an urgent need for consensus on what defines a chronic obstructive pulmonary disease (COPD) self-management intervention. We aimed to obtain consensus regarding the conceptual definition of a COPD self-management intervention by engaging an international panel of COPD self-management

  9. Self-management: challenges for allied healthcare professionals in stroke rehabilitation--a focus group study

    NARCIS (Netherlands)

    Satink, T.J.; Cup, E.H.; Swart, B.J.M. de; Sanden, M.W. van der

    2015-01-01

    PURPOSE: Self-management has become an important concept in stroke rehabilitation. This study explored allied healthcare professionals' (AHPs) perceptions and beliefs regarding the self-management of stroke survivors and their knowledge and skills regarding stroke self-management interventions.

  10. The Comparison of the Effects of a Didactic Stress Management Program and Group Counselling on the Coping Strategies of School Counsellors

    Science.gov (United States)

    Coban, Aysel Esen; Hamamci, Zeynep

    2009-01-01

    The aim of this study was to compare the effects of a didactic stress management program, group counselling, and a control group on school counsellors' stress coping strategies. Thirty-four school counsellors were randomly assigned to either a didactic stress management group, group counselling, or a control group. The didactic stress management…

  11. Financial risk relationships and adoption of management strategies in physician groups for self-administered injectable drugs.

    Science.gov (United States)

    Agnew, Jonathan D; Stebbins, Marilyn R; Hickman, David E; Lipton, Helene Levins

    2003-01-01

    To consider the extent, nature, and range of risk arrangements between physician groups and health maintenance organizations (HMOs) for self-administered injectable (SAI) drugs; to examine types and frequencies of SAI drug-use management strategies adopted by physician groups; and to explore the relationship between locus and level of financial risk for SAIs and physician group strategy adoption. We used a multiple case-study design to select physician groups and their health maintenance organization (HMO) contractual partners in 4 markets in the United States (Northwest, Northeast, Midwest, Southwest). Physician groups in these markets were chosen based on size (e50 physicians) and experience with drug risk (e1 year). Physician groups were asked to identify their 3 major HMO contractual partners in each market. Telephone interviews were conducted from January 2000 to June 2001, with the resulting purposive sample of 37 individuals representing 20 physician groups. We found that the level and locus of SAI financial risk were related to the adoption of management strategies. Physician groups with higher financial risk for SAIs adopted more strategies than lower-risk groups. Groups with SAI financial risk in the medical services capitation (MSC) adopted 9.2 strategies per group. In contrast, groups with SAI financial risk in the pharmacy-risk budget (PRB) averaged 1.5 strategies per group. Groups with SAI financial risk in both the MSC and PRB fell in-between, averaging 4.5 strategies per group. The most frequently adopted strategy was designing evidenced-based therapeutic guidelines, i.e., protocols based on evidence from the peer-reviewed literature used to guide physicians in the treatment of typically chronic conditions (9 groups, 45% of sample). The second most common strategy involved adapting the existing utilization management system to process SAIs (7 groups, 35%) and the establishment of office procedures for internal authorization (5 groups, 25%). The

  12. The South African Society of Psychiatrists/Psychiatry Management Group management guidelines for adult attention-deficit/hyperactivity disorder

    Directory of Open Access Journals (Sweden)

    Renata Schoeman

    2017-04-01

    of Stellenbosch Business School with a thesis entitled ‘A funding model proposal for private health insurance for adult attention-deficit/hyperactivity disorder in the South African context’. This is first South African study exploring the situation with regard to the prevalence and treatment of adult ADHD. Dr Schoeman was tasked by the SIG with the drafting of guidelines. Dr Liebenberg provided valuable input. The guidelines were then circulated to the SIG members, as well as the Chair of the Public Sector SIG, for written feedback and evidence- based suggestions which were then incorporated into the guidelines. The final guidelines were circulated for written approval by the SIG members, followed by formal approval at a SIG meeting held on 14 August 2016, after which it was submitted to the South African Society of Psychiatrists (SASOP and Psychiatry Management Group (PsychMG boards for recommendation and ratification.

  13. Researching of green finance management to promote sustainable development in group

    International Nuclear Information System (INIS)

    Ning Jing

    2014-01-01

    The scientific development of society is the basic idea of a national development in the new period, but also on the management of the enterprise, and the new requirement sproposed by financial management. Financial management should meet the development needs of the times, pay attention to the theory and practice of innovation. In the background of the national sustainable development and environmental protection, setting up the green concept of financial management, the construction of green financial management system, will promote the enterprise development comprehensively, coordinatly, sustainably, and strive to build the core competitiveness of the future to adapt to social development of enterprise. (author)

  14. Factors affecting collective action for forest fire management: a comparative study of community forest user groups in central Siwalik, Nepal.

    Science.gov (United States)

    Sapkota, Lok Mani; Shrestha, Rajendra Prasad; Jourdain, Damien; Shivakoti, Ganesh P

    2015-01-01

    The attributes of social ecological systems affect the management of commons. Strengthening and enhancing social capital and the enforcement of rules and sanctions aid in the collective action of communities in forest fire management. Using a set of variables drawn from previous studies on the management of commons, we conducted a study across 20 community forest user groups in Central Siwalik, Nepal, by dividing the groups into two categories based on the type and level of their forest fire management response. Our study shows that the collective action in forest fire management is consistent with the collective actions in other community development activities. However, the effectiveness of collective action is primarily dependent on the complex interaction of various variables. We found that strong social capital, strong enforcement of rules and sanctions, and users' participation in crafting the rules were the major variables that strengthen collective action in forest fire management. Conversely, users' dependency on a daily wage and a lack of transparency were the variables that weaken collective action. In fire-prone forests such as the Siwalik, our results indicate that strengthening social capital and forming and enforcing forest fire management rules are important variables that encourage people to engage in collective action in fire management.

  15. Managing diversity in organisations: practitioner and academic perspectives: report from a gender in management special interest group research event

    OpenAIRE

    Beauregard, T. Alexandra

    2008-01-01

    Purpose - This report aims to provide a brief summary of the presentations made by researchers and practitioners at the Gender in Management Special Interest Group’s research event, Managing Diversity in Organisations: Practitioner and Academic Perspectives.\\ud \\ud Design/methodology/approach - The research seminar was chaired by Dr. Adelina Broadbridge (University of Stirling) and Dr. Gillian Maxwell (Glasgow Caledonian University), and featured five presentations related to diversity in org...

  16. Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Group).

    Science.gov (United States)

    Kim, Jae Kyoung; Jeong, Ina; Lee, Ji Yeon; Kim, Jung Hyun; Han, Ah Yeon; Kim, So Yeon; Joh, Joon Sung

    2018-03-07

    The "Tuberculosis Relief Belt Supporting Project (Tuberculosis Patient Management Project for Poverty Groups)" is a national program for socioeconomically vulnerable tuberculosis (TB) patients. We sought to evaluate the clinical and socioeconomic characteristics of poverty-stricken TB patients, and determined the need for relief. We examined in-patients with TB, who were supported by this project at the National Medical Center from 2014 to 2015. We retrospectively investigated the patients' socioeconomic status, clinical characteristics, and project expenditures. Fifty-eight patients were enrolled. Among 55 patients with known income status, 24 (43.6%) had no income. Most patients (80%) lived alone. A total of 48 patients (82.8%) had more than one underlying disease. More than half of the enrolled patients (30 patients, 51.7%) had smear-positive TB. Cavitary disease was found in 38 patients (65.5%). Among the 38 patients with known resistance status, 19 (50%) had drug-resistant TB. In terms of disease severity, 96.6% of the cases had moderate-to-severe disease. A total of 14 patients (26.4%) died during treatment. Nursing expenses were supported for 12 patients (20.7%), with patient transportation costs reimbursed for 35 patients (60%). In terms of treatment expenses for 31 people (53.4%), 93.5% of them were supported by uninsured benefits. Underlying disease, infectivity, drug resistance, severity, and death occurred frequently in socioeconomically vulnerable patients with TB. Many uninsured treatment costs were not supported by the current government TB programs, and the "Tuberculosis Relief Belt Supporting Project" compensated for these limitations. Copyright©2018. The Korean Academy of Tuberculosis and Respiratory Diseases.

  17. Group Selection and Learning for a Lab-Based Construction Management Course

    Science.gov (United States)

    Solanki, Pranshoo; Kothari, Nidhi

    2014-01-01

    In construction industries' projects, working in groups is a normal practice. Group work in a classroom is defined as students working collaboratively in a group so that everyone can participate on a collective task. The results from literature review indicate that group work is more effective method of learning as compared to individual work.…

  18. Conflict Management in "Ad Hoc" Problem-Solving Groups: A Preliminary Investigation.

    Science.gov (United States)

    Wallace, Les; Baxter, Leslie

    Full study of small group communication must include consideration of task and socio-emotional dimensions, especially in relation to group problem solving. Thirty small groups were tested for their reactions in various "ad hoc" conflict resolution situations. Instructions to the groups were (1) no problem-solving instructions (control),…

  19. Effects of resource-building group intervention on career management and mental health in work organizations: randomized controlled field trial.

    Science.gov (United States)

    Vuori, Jukka; Toppinen-Tanner, Salla; Mutanen, Pertti

    2012-03-01

    A resource-building group intervention was developed to enhance career management, mental health, and job retention in work organizations. The in-company training program provided employees with better preparedness to manage their own careers. The program activities were universally implemented using an organization-level, 2-trainer model with trainers from the human resources management and occupational health services. The study was a within-organizations, randomly assigned field experimental study; it investigated the impacts of the intervention on immediate career management preparedness and later mental health and intentions to retire early. A total of 718 eligible individuals returned a questionnaire in 17 organizations and became voluntary participants. The respondents were randomly assigned to either an intervention (N = 369) or a comparison group (N = 349). Those in the intervention group were invited to group intervention workshops, whereas those in the comparison group received printed information about career and health-related issues. The 7-month follow-up results showed that the program significantly decreased depressive symptoms and intentions to retire early and increased mental resources among the group participants compared to the others. The mediation analyses demonstrated that the increase in career management preparedness as a proximal impact of the intervention mediated the longer term mental health effects. Those who benefited most from the intervention as regards their mental health were employees with elevated levels of depression or exhaustion and younger employees, implying additional benefits of a more targeted use of the intervention. The results demonstrated the benefits of the enhancement of individual-level career management and resilience resources as career and health promotion practice in work organizations.

  20. Use of e-Learning for Stress management – Multi-group moderation analysis

    Directory of Open Access Journals (Sweden)

    Aamir Sarwar

    2016-12-01

    Full Text Available The goal of this study is to find out the moderating role of type of industry and different levels of management with respect to eLearning perception, eLearning advantages and use of eLearning for Stress Management. Study tried to find out relationship between perceptions of eLearning, eLearning Advantages, perception of using eLearning for corporate training and more specifically for stress management. A cross sectional survey is conducted through structured questionnaire to collect the data from 686 managers working at different levels including 331 from manufacturing sector and 355 from services sector. Results of the study show positive relationship between perception of eLearning and eLearning for stress management and this relationship is significantly stronger for services industry. Positive relationship between eLearning advantages and eLearning for stress management and this relationship is significantly stronger for manufacturing industry. Study also revealed that positive relationship between eLearning perception and eLearning for stress management and this relationship is not significantly stronger for senior management than for middle management.

  1. 78 FR 69124 - Trinity Adaptive Management Working Group; Public Meeting and Teleconference

    Science.gov (United States)

    2013-11-18

    ... give policy, management, and technical input concerning Trinity River (California) restoration efforts... Recommendation, Bylaw discussion, 2014 Flow Alternatives, Status of Klamath fall flow release, Mining issues...

  2. Focus groups for developing a peer mentoring program to improve self-management in pediatric inflammatory bowel disease.

    Science.gov (United States)

    Mackner, Laura M; Ruff, Jessica M; Vannatta, Kathryn

    2014-10-01

    Inflammatory bowel disease (IBD) presents challenges for self-management in many areas. A peer mentoring program may offer advantages over other forms of self-management interventions because youth may be more receptive to learning self-management skills from a peer than from a parent or professional. The purpose of the present study was to identify themes from focus groups to inform development of a peer mentoring program for improving self-management in pediatric IBD. Focus groups were conducted for youth ages 12 to 17, stratified by age (3 groups; n = 14), young adults ages 18 to 20 (1 group; n = 5), and parents of the youth (3 groups; n = 17). Broad questions covered program goals, general program characteristics, mentor/mentee characteristics, and family involvement, and transcriptions were analyzed via directed content analysis, with the a priori codes specified as the broad questions above. Participants identified the primary goals of a program as support, role model, information/education, and fun. They described a program that would include a year-long, 1-on-1 mentor relationship with a peer who has had IBD for at least a year, educational group activities, fun activities that are not focused on IBD, expectations for in-person contact 1 to 2 times per month, and mentor-to-mentor and parent support. Many of the suggestions from the focus groups correspond with research findings associated with successful mentoring programs. Using participants' suggestions and empirically based best practices for mentoring may result in an effective peer mentoring program for improving self-management in youth with IBD.

  3. Let's face it: patient and parent perspectives on incorporating a Facebook group into a multidisciplinary weight management program.

    Science.gov (United States)

    Woolford, Susan J; Esperanza Menchaca, Alicia D M; Sami, Areej; Blake, Natalie

    2013-08-01

    Social media may have the potential to enhance weight management efforts. However, the acceptability of incorporating this entity into pediatrics is unknown. The objective of this project was to explore patients' and parents' perspectives about developing a Facebook group as a component of a pediatric weight management program. Semistructured interviews were performed between September, 2011, and February, 2012, with patients and parents in a multidisciplinary weight management program. Interviews explored participants' perceptions of potential benefits, concerns, and preferences related to a program-specific Facebook group. Transcripts were reviewed and themes identified. The study concluded when thematic saturation was achieved. Participants (n=32) were largely enthusiastic about the idea of a program-specific Facebook group for adolescents. Most preferred a secret group, where only participants would know of the group's existence or group members' identity. No parents expressed concern about security or privacy related to a program-specific Facebook group; one parent expressed concern about undesirable advertisements. Participants endorsed a variety of ideas for inclusion on the page, including weight loss tips, live chats with providers, quizzes, and an incentive system where participants could gain points for making healthy choices. Many parents requested a separate parent-focused page, an idea that was supported by the adolescents. This study suggests that participants perceive potential benefits from incorporating social media interventions into pediatric weight management efforts. Privacy and security issues do not appear to be major parental concerns. Future work should explore the impact of program-specific social media interventions on outcomes for patients in weight management programs.

  4. Integrated Social and Quality of Service Trust Management of Mobile Groups in Ad Hoc Networks

    Science.gov (United States)

    2013-01-01

    high resiliency to malicious attacks and misbehaving nodes. Keywords—trust management; mobile ad hoc networks; QoS trust; social trust; trust...paper we address an importance issue of trust management protocol design for MANETs: trust bias minimization despite misbehaving nodes performing

  5. Effectiveness of a group-based self-management program for people with chronic fatigue syndrome: a randomized controlled trial.

    Science.gov (United States)

    Pinxsterhuis, Irma; Sandvik, Leiv; Strand, Elin Bolle; Bautz-Holter, Erik; Sveen, Unni

    2017-01-01

    To evaluate the effectiveness of a group-based self-management program for people with chronic fatigue syndrome. A randomized controlled trial. Four mid-sized towns in southern Norway and two suburbs of Oslo. A total of 137 adults with chronic fatigue syndrome. A self-management program including eight biweekly meetings of 2.5 hours duration. The control group received usual care. Primary outcome measure: Medical Outcomes Study-Short Form-36 physical functioning subscale. Fatigue severity scale, self-efficacy scale, physical and mental component summary of the Short Form-36, and the illness cognition questionnaire (acceptance subscale). Assessments were performed at baseline, and at six-month and one-year follow-ups. At the six-month follow-up, a significant difference between the two groups was found concerning fatigue severity ( p = 0.039) in favor of the control group, and concerning self-efficacy in favor of the intervention group ( p = 0.039). These significant differences were not sustained at the one-year follow-up. No significant differences were found between the groups concerning physical functioning, acceptance, and health status at any of the measure points. The drop-out rate was 13.9% and the median number of sessions attended was seven (out of eight). The evaluated self-management program did not have any sustained effect, as compared with receiving usual care.

  6. Small Group Conflict: A Look at Equity, Satisfaction, and Styles of Conflict Management.

    Science.gov (United States)

    Wall, Victor D., Jr.; Nolan, Linda L.

    1987-01-01

    Study of 71 task-oriented groups revealed that perceived inequity was negatively related to amount of expressed satisfaction with the group and positively related to amount of perceived conflict within the group. Inequity was associated more strongly with conflict centered around people than with conflict centered around task; least associated…

  7. US ethnic group differences in self-management in the 2nd diabetes attitudes, wishes and needs (DAWN2) study.

    Science.gov (United States)

    Peyrot, Mark; Egede, Leonard E; Funnell, Martha M; Hsu, William C; Ruggiero, Laurie; Siminerio, Linda M; Stuckey, Heather L

    2018-03-08

    Understanding the relationship between ethnicity and self-management is important due to disparities in healthcare access, utilization, and outcomes among adults with type 2 diabetes from different ethnic groups in the US. Self-reports of self-management and interest in improving self-management from US people with diabetes (PWD) in the 2nd Diabetes Attitudes, Wishes and Needs (DAWN2) study, a multinational, multi-stakeholder survey, were analyzed, including 447 non-Hispanic White, 241 African American, 194 Hispanic American, and 173 Chinese American PWD (>18 years). Overall, self-management behavior was highest for medication taking and lowest for physical activity. Non-Hispanic Whites had lowest physical activity and highest adherence to insulin therapy. Chinese Americans had lowest foot care and highest healthy eating. Overall, interest was highest for improving healthy eating and physical activity. Chinese Americans and Hispanic Americans were more interested than non-Hispanic Whites in improving most self-management behaviors. Chinese Americans were more interested than African Americans in improving most self-management behaviors. Healthcare providers telling PWD that their A1c needs improvement was associated with lower self-rated glucose control, which was associated with higher PWD interest in improving self-management behaviors. Diabetes care providers should use patient-centered approaches and consider ethnicity in tailoring self-management support. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  8. Self-management by family caregivers to manage changes in the behavior and mood of their relative with dementia: an online focus group study.

    Science.gov (United States)

    Huis In Het Veld, Judith; Verkaik, Renate; van Meijel, Berno; Verkade, Paul-Jeroen; Werkman, Wendy; Hertogh, Cees; Francke, Anneke

    2016-05-03

    Self-management is important for family caregivers of people with dementia, especially when they face changes in their relative's behavior and mood, such as depression, apathy, anxiety, agitation and aggression. The aim of this study is to give insight into why these changes in behavior and mood are stressful for family caregivers, what self-management strategies family caregivers use when managing these changes and the stress they experience. A qualitative study was conducted using four online focus groups with 32 family caregivers of people with dementia living in the Netherlands. Transcripts of the focus group discussions were analyzed using principles of thematic analysis. Managing changes in the behavior and mood of their relative with dementia is stressful for family caregivers because of constantly having to switch, continuously having to keep the person with dementia occupied and distracted, the fact that others see a different side to the relative, and the fact that caregivers know what to do, but are often not able to put this into practice. Caregivers use calming down and stimulation as self-management strategies for influencing the changes in the behavior and mood of their relative. Furthermore, caregivers describe three self-management strategies that let them manage their own stress and keep up the care for their loved ones: looking for distractions, getting rest, and discussing their feelings and experiences. Behavior and mood changes of a person with dementia are stressful for family caregivers. They use several self-management strategies to positively affect the mood and behavior changes, and also to manage their own stress.

  9. Patient self-management and pharmacist-led patient self-management in Hong Kong: A focus group study from different healthcare professionals' perspectives

    Directory of Open Access Journals (Sweden)

    Wong Eliza LY

    2011-05-01

    Full Text Available Abstract Background Patient self-management is a key approach to manage non-communicable diseases. A pharmacist-led approach in patient self-management means collaborative care between pharmacists and patients. However, the development of both patient self-management and role of pharmacists is limited in Hong Kong. The objectives of this study are to understand the perspectives of physicians, pharmacists, traditional Chinese medicine (TCM practitioners, and dispensers on self-management of patients with chronic conditions, in addition to exploring the possibilities of developing pharmacist-led patient self-management in Hong Kong. Methods Participants were invited through the University as well as professional networks. Fifty-one participants comprised of physicians, pharmacists, TCM practitioners and dispensers participated in homogenous focus group discussions. Perspectives in patient self-management and pharmacist-led patient self-management were discussed. The discussions were audio recorded, transcribed and analysed accordingly. Results The majority of the participants were in support of patients with stable chronic diseases engaging in self-management. Medication compliance, monitoring of disease parameters and complications, lifestyle modification and identifying situations to seek help from health professionals were generally agreed to be covered in patient self-management. All pharmacists believed that they had extended roles in addition to drug management but the other three professionals believed that pharmacists were drug experts only and could only play an assisting role. Physicians, TCM practitioners, and dispensers were concerned that pharmacist-led patient self-management could be hindered, due to unfamiliarity with the pharmacy profession, the perception of insufficient training in disease management, and lack of trust of patients. Conclusions An effective chronic disease management model should involve patients in stable

  10. Use of e-Learning for Stress management – Multi-group moderation analysis

    OpenAIRE

    Aamir Sarwar; Chitapa Ketavan; Nadeem Shafique Butt

    2016-01-01

    The goal of this study is to find out the moderating role of type of industry and different levels of management with respect to eLearning perception, eLearning advantages and use of eLearning for Stress Management. Study tried to find out relationship between perceptions of eLearning, eLearning Advantages, perception of using eLearning for corporate training and more specifically for stress management. A cross sectional survey is conducted through structured questionnaire to collect the data...

  11. Objectives and tasks for sub-group B: Plutonium management and recycle

    International Nuclear Information System (INIS)

    1978-01-01

    The paper restates the prime objectives of Working Group 4 and explains that in order to accomplish their objectives two sub-groups (A and B) have been established. The Co-Chairmen suggested that sub group B take as their terms of reference those tasks remitted to them by Working Group 4 as a whole. The paper identifies and comments on 11 tasks into which the work of the sub-group is divided. The paper also includes a number of annexes giving the guidelines for data input to each task

  12. Virtual Versus In-Person Focus Groups: Comparison of Costs, Recruitment, and Participant Logistics.

    Science.gov (United States)

    Rupert, Douglas J; Poehlman, Jon A; Hayes, Jennifer J; Ray, Sarah E; Moultrie, Rebecca R

    2017-03-22

    Virtual focus groups-such as online chat and video groups-are increasingly promoted as qualitative research tools. Theoretically, virtual groups offer several advantages, including lower cost, faster recruitment, greater geographic diversity, enrollment of hard-to-reach populations, and reduced participant burden. However, no study has compared virtual and in-person focus groups on these metrics. To rigorously compare virtual and in-person focus groups on cost, recruitment, and participant logistics. We examined 3 focus group modes and instituted experimental controls to ensure a fair comparison. We conducted 6 1-hour focus groups in August 2014 using in-person (n=2), live chat (n=2), and video (n=2) modes with individuals who had type 2 diabetes (n=48 enrolled, n=39 completed). In planning groups, we solicited bids from 6 virtual platform vendors and 4 recruitment firms. We then selected 1 platform or facility per mode and a single recruitment firm across all modes. To minimize bias, the recruitment firm employed different recruiters by mode who were blinded to recruitment efforts for other modes. We tracked enrollment during a 2-week period. A single moderator conducted all groups using the same guide, which addressed the use of technology to communicate with health care providers. We conducted the groups at the same times of day on Monday to Wednesday during a single week. At the end of each group, participants completed a short survey. Virtual focus groups offered minimal cost savings compared with in-person groups (US $2000 per chat group vs US $2576 per in-person group vs US $2,750 per video group). Although virtual groups did not incur travel costs, they often had higher management fees and miscellaneous expenses (eg, participant webcams). Recruitment timing did not differ by mode, but show rates were higher for in-person groups (94% [15/16] in-person vs 81% [13/16] video vs 69% [11/16] chat). Virtual group participants were more geographically diverse (but

  13. Exploring the Development of Competence in Lean Management through Action Learning Groups: A Study of the Introduction of Lean to a Facilities Management Function

    Science.gov (United States)

    Wyton, Paul; Payne, Robin

    2014-01-01

    The introduction of a Lean approach to management requires the development of understanding and capability. This in turn requires a structured training intervention and other supporting activities. This paper explores, through a case study, the way in which action learning groups (ALGs) supported the development of Lean capabilities in the…

  14. Commentary on "Lessons Learned from Leading an Anger Management Group Using the "Seeing Red" Curriculum in an Elementary School"

    Science.gov (United States)

    Hoover, Sally

    2010-01-01

    This commentary responds to "Lessons Learned From Leading an Anger Management Group Using the "Seeing Red" Curriculum in an Elementary School," E. L. Sportsman, J. S. Carlson, and K. M. Guthrie's (2010/this issue) account of an anger control intervention's implementation and effectiveness in an elementary school setting. The accompanying article…

  15. Best management practices plan for environmental monitoring in Waste Area Grouping 6 at Oak Ridge National Laboratory, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1994-02-01

    This Best Management Practices (BMP) Plan has been developed as part of the environmental monitoring program at Waste Area Grouping (WAG) 6. The BMP Plan describes the requirements for personnel training, spill prevention and control, environmental compliance, and sediment/erosion control as they relate to environmental monitoring activities and installation of Monitoring Station 4 at WAG 6

  16. The impact of conservation management on the community composition of multiple organism groups in eutrophic interconnected man-made ponds

    NARCIS (Netherlands)

    Lemmens, P.; Mergeay, J.; Van Wichelen, J.; De Meester, Luc; Declerck, S.A.J.

    2015-01-01

    Ponds throughout the world are subjected to a variety of management measures for purposes of biodiversity conservation. Current conservation efforts typically comprise a combination of multiple measures that directly and indirectly impact a wide range of organism groups. Knowledge of the relative

  17. A Group Contingency plus Self-Management Intervention Targeting At-Risk Secondary Students' Class-Work and Active Engagement

    Science.gov (United States)

    Trevino-Maack, Sylvia I.; Kamps, Debra; Wills, Howard

    2015-01-01

    The purpose of the present study is to show that an independent group contingency (GC) combined with self-management strategies and randomized-reinforcer components can increase the amount of written work and active classroom responding in high school students. Three remedial reading classes and a total of 15 students participated in this study.…

  18. The Impact of Social Intelligence and Impression Management on Perceived Leadership Potential and Group Cohesiveness

    National Research Council Canada - National Science Library

    Tumley, William

    2001-01-01

    .... Specifically, this report details the results to two research projects. In the first project, two studies are conducted to examine how impression management tactics are used in combination with one another...

  19. Comparison of three distinct management strategies for pig slurry applied to three groups of farms

    International Nuclear Information System (INIS)

    Dauden, A.; Teresa, M.; Siegler, C.; Bescos, B.; Burton, C.

    2009-01-01

    Poor management of pig slurry can lead to the contamination of the soil, water and air, which is mostly of the result of sur-plus nutrients. Such environmental impact from pig farming are common in areas with intensive livestock farming. The projects primary objectives is to demonstrate at farm scale the application of the three main manure management technologies deployed within structured local schemes to minimize the environmental impact. (Author)

  20. A sustainable urban logistics dashboard from the perspective of a group of logistics managers

    OpenAIRE

    Morana , Joëlle; Gonzalez-Feliu , Jesus

    2014-01-01

    Urban logistics has now become a priority issue in both supply chain management and urban planning. However, the different stakeholders involved develop different approaches whose aims and objectives do not always coincide and sometimes present conflicting standpoints. The aim of this paper is to complete existing literature by proposing a sustainable dashboard for evaluating the sustainable performance of urban delivery systems, from the perspective of operational logistics managers, one of ...

  1. Small groups, large profits: Calculating interest rates in community-managed microfinance

    DEFF Research Database (Denmark)

    Rasmussen, Ole Dahl

    2012-01-01

    Savings groups are a widely used strategy for women’s economic resilience – over 80% of members worldwide are women, and in the case described here, 72.5%. In these savings groups it is common to see the interest rate on savings reported as "20-30% annually". Using panel data from 204 groups...... in Malawi, I show that the right figure is likely to be at least twice this figure. For these groups, the annual return is 62%. The difference comes from sector-wide application of a non-standard interest rate calculations and unrealistic assumptions about the savings profile in the groups. As a result......, it is impossible to compare returns in savings groups with returns elsewhere. Moreover, the interest on savings is incomparable to the interest rate on loans. I argue for the use of a standardized comparable metric and suggest easy ways to implement it. Developments of new tools and standard along these lines...

  2. Are You Still with Us? Managing Mobile Phone Use and Group Interaction in PBL

    OpenAIRE

    Hendry, Gillian; Wiggins, Sally; Anderson, Tony

    2016-01-01

    As mobile phone technology becomes more advanced, so too does its presence in everyday life. Research has shown, for instance, that students are using their mobile phones in classroom settings, a practice that holds both potential advantages and disadvantages. In group work, these interactions may have consequences for group dynamics in that orienting to a mobile phone can display a shift in an individual’s attention to the group. The current essay details a research project conducted on prob...

  3. Are you still with us? : Managing group togetherness and mobile phone use in PBL tutorials

    OpenAIRE

    Hendry, Gillian; Wiggins, Sally; Anderson, Tony

    2016-01-01

    As mobile phone technology becomes more advanced, so too does its presence in everyday life. Research has shown, for instance, that students are using their mobile phones in classroom settings, a practice that holds both potential advantages and disadvantages. In group work, these interactions may have consequences for group dynamics in that orienting to a mobile phone can display a shift in an individual’s attention to the group. The current essay details a research project conducted on prob...

  4. Management of basic education for ethnic groups in highland and border regions of Thailand

    Directory of Open Access Journals (Sweden)

    Phathombut Keawsomnuk

    2017-05-01

    The research findings revealed that the actors for advocacy policy in basic education for ethnic groups consist of: 1 the primary education service area, 2 community, 3 NGOs, 4 scholars, and 5 schools. This study indicated that the provision of basic education policy for ethnic groups must consist of knowledge from communities such as ethnic life styles integrated in the curriculum, and a special education mechanism and process for Thai ethnic groups, including facilitation of ethnic group participation in the abovementioned actors by various means.

  5. Medical Managment of the Acute Radiation Syndrome: Recommendations of the Strategic National Stockpile Radiation Working Group

    National Research Council Canada - National Science Library

    Waselenka, Jamie K; MacVittie, Thomas J; Blakely, William F; Pesik, Nicki; Wiley, Albert L; Dickerson, William E; Tsu, Horace; Confer, Dennis L; Coleman, Norman; Seed, Thomas

    2004-01-01

    .... This consensus document was developed by the Strategic National Stockpile Radiation Working Group to provide a framework for physicians in internal medicine and the medical subspecialties to evaluate...

  6. A center for self-management of chronic illnesses in diverse groups.

    Science.gov (United States)

    Inouye, Jillian; Boland, Mary G; Nigg, Claudio R; Sullivan, Kathleen; Leake, Anne; Mark, Debra; Albright, Cheryl L

    2011-01-01

    Prevention and successful treatment of chronic disease require a scientific understanding of the impacts and interactions of ethnicity, culture, and illness on self-management interventions. This article presents one approach to developing effective methods to address the needs of ethnic minorities living with chronic illnesses. Described is the University of Hawaii Center for Ohana Self-Management of Chronic Illnesses (COSMCI) located in the School of Nursing & Dental Hygiene and funded by the National Institute of Nursing Research (Award Number P20NR010671). The interdisciplinary center focuses on family and community self-management interventions in ethnically diverse populations with chronic illnesses. Areas discussed are: 1) the operational structure for creating an environment conducive to interdisciplinary ohana self-management chronic illness research in ethnically diverse populations; and 2) the development of sustainable interdisciplinary, biobehavioral research capacity. The COSMCI uses a social cognitive theory framework to guide the application of established self-management interventions to Asian and Pacific Island populations (API) through three conceptually linked research projects on HIV infection, type 2 diabetes, and chronic obstructive pulmonary disease. COSMI addresses the feasibility of sharing of lessons learned among the approaches taken. The interdisciplinary nature of COSMCI increases the potential success of the intervention efforts. Hawaii Medical Journal Copyright 2010.

  7. Multipoint Multimedia Conferencing System with Group Awareness Support and Remote Management

    Science.gov (United States)

    Osawa, Noritaka; Asai, Kikuo

    2008-01-01

    A multipoint, multimedia conferencing system called FocusShare is described that uses IPv6/IPv4 multicasting for real-time collaboration, enabling video, audio, and group awareness information to be shared. Multiple telepointers provide group awareness information and make it easy to share attention and intention. In addition to pointing with the…

  8. The Emergence of Cross-Border Insurance Groups within Europe with Centralised Risk Management

    NARCIS (Netherlands)

    Schoenmaker, D.; Oosterloo, S.; Winkels, O.

    2008-01-01

    This paper analyses the degree of internationalisation of insurance business. Using a novel data set of 25 large EU insurance groups, we find that the insurance industry has a strong international orientation. About 55 percent of the business of these large insurance groups is conducted abroad. The

  9. Are You Still with Us? Managing Mobile Phone Use and Group Interaction in PBL

    Science.gov (United States)

    Hendry, Gillian; Wiggins, Sally; Anderson, Tony

    2016-01-01

    As mobile phone technology becomes more advanced, so too does its presence in everyday life. Research has shown, for instance, that students are using their mobile phones in classroom settings, a practice that holds both potential advantages and disadvantages. In group work, these interactions may have consequences for group dynamics in that…

  10. Self-management Experiences of Older Korean Women With Urinary Incontinence: A Descriptive Qualitative Study Using Focus Groups.

    Science.gov (United States)

    Park, Sunah; Yeoum, SoonGyo; Kim, Yoonjung; Kwon, Hye Jin

    The purpose of this study was to explore the self-management experiences of Korean women with urinary incontinence (UI). Descriptive, qualitative study using focus groups. Twenty-two community-dwelling women, 65 years and older, participated in 3 focus-group interviews. Participants were recruited from 2 elderly halls and 1 senior welfare center in South Korea. Three focus group interviews comprising 6 to 8 individuals were conducted in a quiet venue at the elderly hall or senior welfare center. Two investigators performed the interviews; one acted as moderator and one as notetaker; interviews began with scripted open-ended questions. All interviews were electronically recorded and transcribed verbatim. Using an inductive thematic approach, data were first analyzed by the first and second authors; and all 4 authors contributed to coding and agreed on final themes. Korean women perceived UI as a loss of dignity, an odor problem, an uncontrollable disease, and a life impairment. Thematic analysis revealed 4 themes regarding the self-management experience of UI: preserving self-respect in the sociocultural environment, deodorizing the smell, keeping the secret of uncontrollability, and adjusting to an impaired life. Women in this study used various daily-living strategies to manage UI, but they mainly implemented strategies to keep UI a secret, including restrictions in activities of daily living. Educational approaches are needed to inform women with UI about more effective management skills.

  11. A Nordic survey of management practices and owners’ attitudes towards keeping horses in groups

    DEFF Research Database (Denmark)

    Hartmann, E.; Bøe, K.E.; Christensen, Janne Winther

    2015-01-01

    Keeping horses in groups is widely recommended but limited information is vailable about how this is implemented in practice. The aim of this survey was to describe how horses are kept in the Nordic countries in relation to sex, age, breed, and equestrian discipline and to assess owners’ attitudes...... widespread, such as it is the case for most farm animals, future research could focus on solving some of the reoccurring problems perceived with keeping horses in groups. The dissemination of evidence-based information on all aspects around keeping horses in groups can ultimately stimulate further positive...

  12. Bibliographic Management Software: A Focus Group Study of the Preferences and Practices of Undergraduate Students

    Science.gov (United States)

    Salem, Jamie; Fehrmann, Paul

    2013-01-01

    With the growing population of undergraduate students on our campus and an increased focus on their success, librarians at a large midwestern university were interested in the citation management styles of this university cohort. Our university library spends considerable resources each year to maintain and promote access to the robust…

  13. Using Simulation to Support Novice Teachers' Classroom Management Skills: Comparing Traditional and Alternative Certification Groups

    Science.gov (United States)

    Pankowski, Jennifer; Walker, Joan T.

    2016-01-01

    Drawing from research on situated cognition and the development of expertise and simulations in professional education, we designed two simulation tasks that provided novice teachers with repeated opportunities to deliberately practice managing a classroom under no-fault conditions. The simulations immersed novices in two perennial classroom…

  14. Flexible Grouping as a Means for Classroom Management in a Heterogeneous Classroom

    Science.gov (United States)

    Rytivaara, Anna

    2011-01-01

    This article concerns issues of classroom management in heterogeneous classrooms. Although research in the field of learning styles has yielded mixed results, there is a call for information about how they could be used to individualize instruction, especially in primary schools. This article is part of an ethnographic study aiming to examine…

  15. Surgical Management of Crohn Disease in Children - Guidelines from the Paediatric IBD Porto Group of ESPGHAN

    DEFF Research Database (Denmark)

    Amil Dias, Jorge; Kolacek, Sanja; Turner, Dan

    2017-01-01

    for surgery in CD there was a need for a comprehensive review of existing evidence on the role of elective surgery and options in pediatric patients affected with CD. We present an expert opinion and critical review of the literature to provide evidence-based guidance to manage these patients. Indications...

  16. Academic Performance Differences among Ethnic Groups: Do the Daily Use and Management of Time Offer Explanations?

    Science.gov (United States)

    Meeuwisse, Marieke; Born, Marise Ph.; Severiens, Sabine E.

    2013-01-01

    This explorative study describes time use and time management behaviour of ethnic minority and ethnic majority students as possible explanations for the poorer study results of ethnic minority students compared to those of majority students. We used a diary approach in a small sample to examine students' daily time use in both a lecture week…

  17. Functional groups show distinct differences in nitrogen cycling during early stand development: implications for forest management

    Science.gov (United States)

    Doug P. Aubrey; David R. Coyle; Mark D. Coleman

    2012-01-01

    Background and aims Nutrient acquisition of forest stands is controlled by soil resource availability and belowground production, but tree species are rarely compared in this regard. Here, we examine ecological and management implications of nitrogen (N) dynamics during early forest stand development in productive commercial tree species with narrow (Populus...

  18. The influence of team members’ personal characteristics on the effectiveness of group management and social stability of organization

    Directory of Open Access Journals (Sweden)

    A B Chernykh

    2015-12-01

    Full Text Available The authors consider issues of organizational management in terms of improving its economic efficiency and interpret personnel risks as potential losses or threats to the economic activities of enterprise. The article focuses on a special group of risks associated with individual characteristics and interpersonal interaction, i. e. social activities of team members within the group. As a rule, organizations use methods of socio-psychological diagnostics at the first step of candidates’ selection to create such an organizational structure that takes into account professional and personal characteristics and competencies of candidates as well as their predisposition to a certain type of activities. The authors consider the problem of candidates’ acceptance or rejection of a certain type of corporate culture prevailing in the enterprise, and at the same time team’s acceptance or rejection of candidates with certain cultural preferences. The second application for social-psychological research techniques, important for management practices, is keeping up the team active state and increasing its effectiveness through its human potential realization. The article presents the results of the study of groups with low social status focusing on their members’ individual characteristics. The authors propose methods to work with team members and groups as a whole that can stabilize social systems and develop techniques for managing personnel risks.

  19. Behavioral and biological effects of autonomous versus scheduled mission management in simulated space-dwelling groups

    Science.gov (United States)

    Roma, Peter G.; Hursh, Steven R.; Hienz, Robert D.; Emurian, Henry H.; Gasior, Eric D.; Brinson, Zabecca S.; Brady, Joseph V.

    2011-05-01

    Logistical constraints during long-duration space expeditions will limit the ability of Earth-based mission control personnel to manage their astronaut crews and will thus increase the prevalence of autonomous operations. Despite this inevitability, little research exists regarding crew performance and psychosocial adaptation under such autonomous conditions. To this end, a newly-initiated study on crew management systems was conducted to assess crew performance effectiveness under rigid schedule-based management of crew activities by Mission Control versus more flexible, autonomous management of activities by the crews themselves. Nine volunteers formed three long-term crews and were extensively trained in a simulated planetary geological exploration task over the course of several months. Each crew then embarked on two separate 3-4 h missions in a counterbalanced sequence: Scheduled, in which the crews were directed by Mission Control according to a strict topographic and temporal region-searching sequence, and Autonomous, in which the well-trained crews received equivalent baseline support from Mission Control but were free to explore the planetary surface as they saw fit. Under the autonomous missions, performance in all three crews improved (more high-valued geologic samples were retrieved), subjective self-reports of negative emotional states decreased, unstructured debriefing logs contained fewer references to negative emotions and greater use of socially-referent language, and salivary cortisol output across the missions was attenuated. The present study provides evidence that crew autonomy may improve performance and help sustain if not enhance psychosocial adaptation and biobehavioral health. These controlled experimental data contribute to an emerging empirical database on crew autonomy which the international astronautics community may build upon for future research and ultimately draw upon when designing and managing missions.

  20. FLIGHT EXPERT RISK ASSESSMENT OF AIRCRAFT GROUP AT THEIR PROXIMITY USING A PROGRAM-MANAGER

    Directory of Open Access Journals (Sweden)

    D. A. Mikhaylin

    2017-01-01

    Full Text Available The paper presents an approach to solving the problem of aircraft flight safety. External threats in the form of aircraft-offenders are considered. The algorithm of collision danger coefficients with aircraft-offenders is presented, оn the basis of which the side-program manager of flight safety monitoring is formed.Two danger coefficients in the horizontal and vertical planes are introduced. Based on various flight situations four possible decisions are offered: absence of any aircraft activity, flight level change, deviation in the horizontal plane and both in vertical and horizontal planes. For each case the formulas of double evaluation are received. They take into account different parameters of aircraft relative motion. Based on these estimates it is possible to build a final expert evaluation for the considered flight situations. It is implemented in the onboard program-manager. The structure of the program is presented. At the program-manager output the expected minimized risk evaluation and the selected alternative of the avoidance of aircraft from the meeting point are formed. The paper presents a detailed description of the procedures to test the performance of the program-manager algorithms. The initial conditions for different flight situations are provided. The simulation results of the algorithm are given. The danger coefficients comparison when performing maneuvers to prevent dangerous approach and in their absence is illustrated. It is shown that the maneuver implementation recommended by program-manager algorithms decreases the resulting danger coefficient. Particular attention was paid to aircraft landing, especially if the landing area had several conflicting aircraft.

  1. A description of the "event manager" role in resuscitations: A qualitative study of interviews and focus groups of resuscitation participants.

    Science.gov (United States)

    Taylor, Katherine L; Parshuram, Christopher S; Ferri, Susan; Mema, Briseida

    2017-06-01

    Communication during resuscitation is essential for the provision of coordinated, effective care. Previously, we observed 44% of resuscitation communication originated from participants other than the physician team leader; 65% of which was directed to the team, exclusive of the team leader. We called this outer-loop communication. This institutional review board-approved qualitative study used grounded theory analysis of focus groups and interviews to describe and define outer-loop communication and the role of "event manager" as an additional "leader." Participants were health care staff involved in the medical management of resuscitations in a quaternary pediatric academic hospital. The following 3 domains were identified: the existence and rationale of outer-loop communication; the functions fulfilled by outer-loop communication; and the leadership and learning of event manager skills. The role was recognized by all team members and evolved organically as resuscitation complexity increased. A "good" manager has similar qualities to a "good team leader" with strong nontechnical skills. Event managers were not formally identified and no specific training had occurred. "Outer-loop" communication supports resuscitation activities. An event manager gives direction to the team, coordinates activities, and supports the team leader. We describe a new role in resuscitation in light of structural organizational theory and cognitive load with a view to incorporating this structure into resuscitation training. Copyright © 2017 Elsevier Inc. All rights reserved.

  2. Management of metastatic retroperitoneal sarcoma: a consensus approach from the Trans-Atlantic Retroperitoneal Sarcoma Working Group (TARPSWG).

    Science.gov (United States)

    2018-04-01

    Retroperitoneal sarcoma (RPS) is a rare disease accounting for 0.1%-0.2% of all malignancies. Management of RPS is complex and requires multidisciplinary, tailored treatment strategies at all stages, but especially in the context of metastatic or multifocal recurrent disease. Due to the rarity and heterogeneity of this family of diseases, the literature to guide management is limited. The Trans-Atlantic Retroperitoneal Sarcoma Working Group (TARPSWG) is an international collaboration of sarcoma experts from all disciplines convened in an effort to overcome these limitations. The TARPSWG has compiled the available evidence surrounding metastatic and multifocally recurrent RPS along with expert opinion in an iterative process to generate a consensus document regarding the complex management of this disease. The objective of this document is to guide sarcoma specialists from all disciplines in the diagnosis and treatment of multifocal recurrent or metastatic RPS. All aspects of patient assessment, diagnostic processes, local and systemic treatments, and palliation are reviewed in this document, and consensus recommendations provided accordingly. Recommendations were guided by available evidence, in conjunction with expert opinion where evidence was lacking. This consensus document combines the available literature regarding the management of multifocally recurrent or metastastic RPS with the practical expertise of high-volume sarcoma centers from multiple countries. It is designed as a tool for decision making in the complex multidisciplinary management of this condition and is expected to standardize management across centers, thereby ensuring that patients receive the highest quality care.

  3. A Framework to Evaluate Ecological and Social Outcomes of Collaborative Management: Lessons from Implementation with a Northern Arizona Collaborative Group

    Science.gov (United States)

    Muñoz-Erickson, Tischa A.; Aguilar-González, Bernardo; Loeser, Matthew R. R.; Sisk, Thomas D.

    2010-01-01

    As collaborative groups gain popularity as an alternative means for addressing conflict over management of public lands, the need for methods to evaluate their effectiveness in achieving ecological and social goals increases. However, frameworks that examine both effectiveness of the collaborative process and its outcomes are poorly developed or altogether lacking. This paper presents and evaluates the utility of the holistic ecosystem health indicator (HEHI), a framework that integrates multiple ecological and socioeconomic criteria to evaluate management effectiveness of collaborative processes. Through the development and application of the HEHI to a collaborative in northern Arizona, the Diablo Trust, we present the opportunities and challenges in using this framework to evaluate the ecological and social outcomes of collaborative adaptive management. Baseline results from the first application of the HEHI are presented as an illustration of its potential as a co-adaptive management tool. We discuss lessons learned from the process of selecting indicators and potential issues to their long-term implementation. Finally, we provide recommendations for applying this framework to monitoring and adaptive management in the context of collaborative management.

  4. Epidemiology and management of head injury in paediatric age group in North-Eastern Nigeria

    Directory of Open Access Journals (Sweden)

    J Y Chinda

    2013-01-01

    Full Text Available Background: Paediatric head injury (HI is the single most common cause of death and permanent disability in children world over, and this is increasingly becoming worrisome in our society because of increased risks and proneness to road traffic accidents on our highways and streets. The study set to determine causes and management of HI among children in our society. Patients and Methods: A retrospective review of all children aged 0-15 years with traumatic head injury (THIs who were managed at the University of Maiduguri Teaching Hospital between July, 2006 and August, 2008. Results: A total of 45 children with THIs presented to the casualty unit of the hospital; 30 (66.7% were boys and 15 (33.3% were girls. Three (6.7% children were less than 1 year of age, 21 (46.7% were between 1 years and 6 years while 16 (35.6% and 5 (11.0% were aged 7-11 years and 12-15 years respectively. Thirty six (80.0% of the children were pedestrians, 6 (13.4% fell from a height, while 2 (4.4% and 1 (2.2% were as a result of home accident and assault, respectively. Twenty one patients (46.7% had mild HI, while 53.3% had moderate to severe category. Forty one (91.1% of children were managed as in-patients, mostly (95.1% by conservative non-operative management, while 4 (8.9% were treated on the out-patient basis. The mortality rate was 17.8%. Conclusion: H1 among children is of a great concern, because of its incremental magnitude, due to increasing child labour and interstate religious discipleship among children, with attendant high mortality and permanent disabilities. Necessary laws and legislations should be formulated and implemented with organized campaigns and public enlightenment to prevent and mitigate this menace.

  5. Australian Paediatric Rheumatology Group standards of care for the management of juvenile idiopathic arthritis.

    Science.gov (United States)

    Munro, Jane; Murray, Kevin; Boros, Christina; Chaitow, Jeffrey; Allen, Roger C; Akikusa, Jonathan; Adib, Navid; Piper, Susan E; Singh-Grewal, Davinder

    2014-09-01

    This standards document outlines accepted standards of management for children, adolescents and young adults with juvenile idiopathic arthritis (JIA) in Australia. This document acknowledges that the chronic inflammatory arthritis conditions (JIA) in childhood are different diseases from inflammatory arthritis in adults and that specific expertise is required in the care of children with arthritis. © 2014 The Authors. Journal of Paediatrics and Child Health © 2014 Paediatrics and Child Health Division (Royal Australasian College of Physicians).

  6. An online app platform enhances collaborative medical student group learning and classroom management.

    Science.gov (United States)

    Peacock, Justin G; Grande, Joseph P

    2016-01-01

    The authors presented their results in effectively using a free and widely-accessible online app platform to manage and teach a first-year pathology course at Mayo Medical School. The authors utilized the Google "Blogger", "Forms", "Flubaroo", "Sheets", "Docs", and "Slides" apps to effectively build a collaborative classroom teaching and management system. Students were surveyed on the use of the app platform in the classroom, and 44 (94%) students responded. Thirty-two (73%) of the students reported that "Blogger" was an effective place for online discussion of pathology topics and questions. 43 (98%) of the students reported that the "Forms/Flubaroo" grade-reporting system was helpful. 40 (91%) of the students used the remote, collaborative features of "Slides" to create team-based learning presentations, and 39 (89%) of the students found those collaborative features helpful. "Docs" helped teaching assistants to collaboratively create study guides or grading rubrics. Overall, 41 (93%) of the students found that the app platform was helpful in establishing a collaborative, online classroom environment. The online app platform allowed faculty to build an efficient and effective classroom teaching and management system. The ease of accessibility and opportunity for collaboration allowed for collaborative learning, grading, and teaching.

  7. Ethics in practice: managed care and the changing health care environment: medicine as a profession managed care ethics working group statement.

    Science.gov (United States)

    Povar, Gail J; Blumen, Helen; Daniel, John; Daub, Suzanne; Evans, Lois; Holm, Richard P; Levkovich, Natalie; McCarter, Alice O; Sabin, James; Snyder, Lois; Sulmasy, Daniel; Vaughan, Peter; Wellikson, Laurence D; Campbell, Amy

    2004-07-20

    Cost pressures and changes in the health care environment pose ethical challenges and hard choices for patients, physicians, policymakers, and society. In 2000 and 2001, the American College of Physicians, with the Harvard Pilgrim Health Care Ethics Program, convened a working group of stakeholders--patients, physicians, and managed care representatives, along with medical ethicists--to develop a statement of ethics for managed care. The group explored the impact of a changing health care environment on patient-physician relationships and how to best apply the principles of professionalism in this environment. The statement that emerged offers guidance on preserving the patient-clinician relationship, patient rights and responsibilities, confidentiality and privacy, resource allocation and stewardship, the obligation of health plans to foster an ethical environment for the delivery of care, and the clinician's responsibility to individual patients, the community, and the public health, among other issues.

  8. Unequal representation of women and men in energy company boards and management groups. Are there implications for mitigation?

    Energy Technology Data Exchange (ETDEWEB)

    Carlsson-Kanyama, A. [Swedish Defence Research Institute, Stockholm (Sweden); Ripa Julia, Isabel [Consultoria Ambiental, Logrono (Spain); Roehr, Ulrike [LIFE e.V, Berlin (Germany)

    2010-08-15

    This survey shows that female representation in boards and management groups of large energy companies in Germany, Spain and Sweden is far from being gender-equal. Of the 464 companies surveyed, 295 (64%) had no women at all in boards or management groups and only 5% could be considered gender-equal by having 40% or more women in such positions. Interviews with energy companies confirmed current trends that gender equality efforts within decision-making in business are weak or non-existent. The findings are discussed against the background of differences in risk perceptions among women and men, evidence of women's impact on boards and companies' performance and the substantial risks related to unabated climate change. Research is suggested for exploring potential impacts on energy companies' performance with more women in the boards when it comes to mitigation activities. (author)

  9. Unequal representation of women and men in energy company boards and management groups: Are there implications for mitigation?

    Energy Technology Data Exchange (ETDEWEB)

    Carlsson-Kanyama, A., E-mail: carlsson@foi.s [Swedish Defence Research Institute, Stockholm (Sweden); Ripa Julia, Isabel [Consultoria Ambiental, Logrono (Spain); Roehr, Ulrike [LIFE e.V, Berlin (Germany)

    2010-08-15

    This survey shows that female representation in boards and management groups of large energy companies in Germany, Spain and Sweden is far from being gender-equal. Of the 464 companies surveyed, 295 (64%) had no women at all in boards or management groups and only 5% could be considered gender-equal by having 40% or more women in such positions. Interviews with energy companies confirmed current trends that gender equality efforts within decision-making in business are weak or non-existent. The findings are discussed against the background of differences in risk perceptions among women and men, evidence of women's impact on boards and companies' performance and the substantial risks related to unabated climate change. Research is suggested for exploring potential impacts on energy companies' performance with more women in the boards when it comes to mitigation activities.

  10. Unequal representation of women and men in energy company boards and management groups: Are there implications for mitigation?

    International Nuclear Information System (INIS)

    Carlsson-Kanyama, A.; Ripa Julia, Isabel; Roehr, Ulrike

    2010-01-01

    This survey shows that female representation in boards and management groups of large energy companies in Germany, Spain and Sweden is far from being gender-equal. Of the 464 companies surveyed, 295 (64%) had no women at all in boards or management groups and only 5% could be considered gender-equal by having 40% or more women in such positions. Interviews with energy companies confirmed current trends that gender equality efforts within decision-making in business are weak or non-existent. The findings are discussed against the background of differences in risk perceptions among women and men, evidence of women's impact on boards and companies' performance and the substantial risks related to unabated climate change. Research is suggested for exploring potential impacts on energy companies' performance with more women in the boards when it comes to mitigation activities.

  11. A Tutorial on Interfacing the Object Management Group (OMG) Data Distribution Service (DDS) with LabView

    Science.gov (United States)

    Smith, Kevin

    2011-01-01

    This tutorial will explain the concepts and steps for interfacing a National Instruments LabView virtual instrument (VI) running on a Windows platform with another computer via the Object Management Group (OMG) Data Distribution Service (DDS) as implemented by the Twin Oaks Computing CoreDX. This paper is for educational purposes only and therefore, the referenced source code will be simplistic and void of all error checking. Implementation will be accomplished using the C programming language.

  12. Making and maintaining lifestyle changes after participating in group based type 2 diabetes self-management educations: a qualitative study.

    Directory of Open Access Journals (Sweden)

    Marit B Rise

    Full Text Available BACKGROUND: Disease management is crucial in type 2 diabetes. Diabetes self-management education aims to provide the knowledge necessary to make and maintain lifestyle changes. However, few studies have investigated the processes after such courses. The aim of this study was to investigate how participants make and maintain lifestyle changes after participating in group-based type 2 diabetes self-management education. METHODS: Data was collected through qualitative semi-structured interviews with 23 patients who attended educational group programs in Central Norway. The participants were asked how they had used the advice given and what they had changed after the course. RESULTS: Knowledge was essential for making lifestyle changes following education. Three factors affected whether lifestyle changes were implemented: obtaining new knowledge, taking responsibility, and receiving confirmation of an already healthy lifestyle. Four factors motivated individuals to maintain changes: support from others, experiencing an effect, fear of complications, and the formation of new habits. CONCLUSION: Knowledge was used to make and maintain changes in diet, medication and physical activity. Knowledge also acted as confirmation of an already adequate lifestyle. Knowledge led to no changes if diabetes appeared "not that scary" or if changes appeared too time consuming. Those involved in diabetes education need to be aware of the challenges in convincing asymptomatic patients about the benefits of adherence to self-management behaviour.

  13. 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.

  14. Fostering Undergraduate Research Experiences in Management Information Systems through the "Research Group" Framework

    Science.gov (United States)

    Bartkus, Ken; Mills, Robert; Olsen, David

    2010-01-01

    The purpose of this paper is to propose an innovative approach to engaged learning. Founded on the principles of a scholarly think-tank and administered along the lines of a consulting organization, the proposed "Research Group" framework is designed to facilitate effective and efficient undergraduate research experiences in Management…

  15. Management factors affecting aggression in dynamic group housing systems with electronic sow feeding - a field trial

    DEFF Research Database (Denmark)

    Sørensen, L S; Bertelsen, D; Jensen, K H

    1999-01-01

    A series of 24-h video studies on four commercial Danish pig herds investigated the behaviour of pregnant sows kept in dynamic groups (72 to 200 sows) with electronic sow feeding (ESF). The herds mainly differed with respect to provision of a layer of unchopped straw as bedding material, the freq...

  16. External Supply of Skill Groups: A Case of Industrial Management in Taiwan.

    Science.gov (United States)

    Kao, Chiang; Chen, Liang-Hsuan; Wang, Tai-Yue; Lee, Hong-Tau

    1997-01-01

    Quantitative and qualitative analysis was conducted of the supply of skill groups and the output of junior colleges, colleges, and graduate schools in Taiwan. Discrepancies were identified between labor need of industry and numbers of graduates as well as between training expected by industry and supplied by schools. (SK)

  17. Group exercise and self-management for older adults with osteoarthritis: a feasibility study.

    Science.gov (United States)

    Patel, Shilpa; Heine, Peter J; Ellard, David R; Underwood, Martin

    2016-05-01

    Osteoarthritis (OA) is a common condition expected to be the fourth leading cause of disability by the year 2020. Treatment with non-steroidal anti-inflammatory drugs is problematic in older adults (>75 years) where the presence of comorbidities is more prevalent. Exercise has been recommended irrespective of age and comorbidity. The purpose of this project was to develop a combined exercise and self-management intervention to help older adults with OA to manage their comorbidities. Literature reviews were conducted to inform the development of an intervention followed by a pilot study to assess feasibility and test outcome measures. Participant interviews and session observation were used to evaluate the pilot study. Evidence from the literature reviews suggested that a combined intervention consisting of behavioural change/self-management education and exercise was the most appropriate. Each component was developed and then tested as a combined package in a pilot study which comprised 12 sessions delivered over six weeks. Four males and six females aged between 75 and 92 years took part. The average attendance was 89%. Most participants reported some benefit and satisfaction with the programme along with changes in physical ability. The majority of participants continued with some form of exercise at three months. The intervention was well received and has encouraged 80% of participants to continue exercising after the programme. The small but positive changes seen in comorbidities, benefit of the intervention, satisfaction and general health are promising. Randomised controlled trial evidence of effectiveness and cost effectiveness is needed before such interventions can be recommended.

  18. Family reactions and their management in a parents group with beta-thalassaemia.

    Science.gov (United States)

    Tsiantis, J; Xypolita-Tsantili, D; Papadakou-Lagoyianni, S

    1982-11-01

    The parents of children with beta-thalassaemia displayed various patterns of emotion (guilt, death anxiety, denial of feelings) and their behaviour towards the child was inappropriate (overprotective, conspiracy of silence); this could affect his psychosocial development and lead to tension within the family. Some parents were overdemanding and even hostile to hospital staff, thus making the management of cases difficult. The therapeutic team has tried to concentrate on these problems in order to clarify them and give support to the families. This has facilitated communication within the family as well as between the family and hospital staff, and had diminished the problems.

  19. CH2M Hill Hanford Group, Inc., Standards and Requirements Identification Document (SRID) Requirements Management System and Requirements Specification

    International Nuclear Information System (INIS)

    JOHNSON, A.L.

    2000-01-01

    The current Tank Farm Contractor (TFC) for the U. S. Department of Energy, Office of River Protection (ORP), River Protection Project (RPP), CH2M Hill Hanford Group, Inc. (CHG), will use a computer based requirements management system. The system will serve as a tool to assist in identifying, capturing, and maintaining the Standards/Requirements Identification Document (S/RID) requirements and links to implementing procedures and other documents. By managing requirements as one integrated set, CHG will be able to carry out its mission more efficiently and effectively. CHG has chosen the Dynamic Object Oriented Requirements System (DOORS(trademark)) as the preferred computer based requirements management system. Accordingly, the S/RID program will use DOORS(trademark). DOORS(trademark) will replace the Environmental Requirements Management Interface (ERMI) system as the tool for S/RID data management. The DOORS(trademark) S/RID test project currently resides on the DOORSTM test server. The S/RID project will be migrated to the DOORS(trademark) production server. After the migration the S/RID project will be considered a production project and will no longer reside on the test server

  20. Spent fuel management: Current status and prospects 1995. Proceedings of a regular advisory group meeting

    International Nuclear Information System (INIS)

    1996-08-01

    Spent fuel management has always been one of the important stages in the nuclear fuel cycle and it is still one of the most vital problems common to all countries with nuclear reactors. It begins with the discharge of spent fuel from a power or a research reactor and ends with its ultimate disposition, either by direct disposal or by reprocessing of the spent fuel. Two options exist - an open, once-through cycle with direct disposal of the spent fuel and a closed cycle with reprocessing of the spent fuel and recycling of plutonium and uranium in new mixed oxide fuels. The selection of a spent fuel strategy is a complex procedure in which many factors have to be weighed, including political, economic and safeguards issues as well as protection of the environment. This report gives an overview of the status of spent fuel management programmes in a number of countries, a description of the current status and prospects of activities in this field and recommendations of the participants. Refs, figs, tabs

  1. Group versus individual stress management intervention in breast cancer patients for fatigue and emotional reactivity: a randomised intervention study.

    Science.gov (United States)

    Rissanen, Ritva; Arving, Cecilia; Ahlgren, Johan; Nordin, Karin

    2014-09-01

    Fatigue and emotional reactivity are common among women suffering from breast cancer and might detrimentally affect these women's quality of life. This study evaluates if the stress management delivered either in a group or individual setting would improve fatigue and emotional reactivity among women with a newly diagnosed breast cancer. Participants (n = 304) who reported elevated levels of distress at three-month post-inclusion were randomised between stress management in a group (GSM) (n = 77) or individual (ISM) (n = 78) setting. Participation was declined by 149 women. Participants completed the Multidimensional Fatigue Inventory (MFI-20) and the Everyday Life Stress Scale (ELSS) at the time of inclusion, 3- and 12-month post-inclusion. Analyses were made according to intention to treat and per-protocol principles. Mann-Whitney tests were used to examine differences between the two intervention groups. No significant differences were detected between the GSM and ISM groups on fatigue or emotional reactivity. In addition, there were no changes over time for these outcomes. There were no differences between the two intervention arms with reference to fatigue or emotional reactivity; however, a clinically interesting finding was the low number of women who were interested in participating in a psychosocial intervention. This finding may have clinical implications when psychosocial support is offered to women with a newly diagnosed breast cancer and also in the planning of future studies.

  2. Medical Management of the Acute Radiation Syndrome: Recommendations of the Strategic National Stockpile Radiation Working Group

    Science.gov (United States)

    2004-06-15

    STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY ...Assistance Medicine http://usuhs.mil U.S. Army www.nbc-med.org U.S. Department of Homeland Security Working Group on Radiological Dispersal Device...22. 97. Abbott B, Ippoliti C, Bruton J, Neumann J, Whaley R, Champlin R. Antiemetic efficacy of granisetron plus dexamethasone in bone marrow

  3. Medical Managment of the Acute Radiation Syndrome: Recommendations of the Strategic National Stockpile Radiation Working Group

    Science.gov (United States)

    2004-06-15

    AVAILABILITY STATEMENT Approved for public release; distribution unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT 15. SUBJECT TERMS 16. SECURITY ...Humanitarian Assistance Medicine http://usuhs.mil U.S. Army www.nbc-med.org U.S. Department of Homeland Security Working Group on Radiological Dispersal...2002:11-22. 97. Abbott B, Ippoliti C, Bruton J, Neumann J, Whaley R, Champlin R. Antiemetic efficacy of granisetron plus dexamethasone in bone marrow

  4. Management of career development of civil servants of the senior age group

    Directory of Open Access Journals (Sweden)

    Shvanova I. S.

    2016-07-01

    Full Text Available modern studies of the population structure in the Russian Federation show that the improvement of living conditions and the development of medicine causes the rapid growth of the share of people, who are older than working age. Nowadays, the number of such people in our country is about 21%. This trend leads to the fact that society sees the retirement age as the same socially significant period of life like all life until retirement. In this context, it is important to build an effective system of career management for older workers, taking into account their age and psychological characteristics, as well as the creation of conditions for the productive use of their experience and unique resources. These measures can be a catalyst for modernization and increase the number of qualified and experienced personnel in government.

  5. Dynamic Group Management Scheme for Sustainable and Secure Information Sensing in IoT

    Directory of Open Access Journals (Sweden)

    Hyungjoo Kim

    2016-10-01

    Full Text Available The services provided to users in the environment associated with the Internet of Things (hereinafter referred to as IoT begin with the information collected from sensors. It is imperative to transmit high-quality sensor data for providing better services. It is also required to collect data only from those authenticated sensors. Moreover, it is imperative to collect high-quality data on a sustainable and continuous basis in order to provide services anytime and anywhere in the IoT environment. Therefore, high-quality, authenticated sensor networks should be constructed. The most prominent routing protocol to enhance the energy consumption efficiency for the sustainable data collection in a sensor network is the LEACH routing protocol. The LEACH routing protocol transmits sensor data by measuring the energy of sensors and allocating sensor groups dynamically. However, these sensor networks have vulnerabilities such as key leakage, eavesdropping, replay attack and relay attack, given the nature of wireless network communication. A large number of security techniques have been studied in order to solve these vulnerabilities. Nonetheless, these studies still cannot support the dynamic sensor group allocation of the LEACH routing protocol. Furthermore, they are not suitable for the sensor nodes whose hardware computing ability and energy resources are limited. Therefore, this paper proposed a group sensor communication protocol that utilizes only the four fundamental arithmetic operations and logical operation for the sensor node authentication and secure data transmission. Through the security analysis, this paper verified that the proposed scheme was secure to the vulnerabilities resulting from the nature of wireless network communication. Moreover, this paper verified through the performance analysis that the proposed scheme could be utilized efficiently.

  6. Diagnosis and management of group A streptococcal pharyngitis and associated complications [digest].

    Science.gov (United States)

    Vazquez, Michelle N; Sanders, Jennifere E; Wilson, Bryan

    2017-12-21

    Although group A Streptococcus (GAS) pharyngitis is the most common cause of bacterial pharyngitis in children and adolescents, many viral and bacterial infections mimic the symptoms of GAS pharyngitis. Emergency clinicians must recognize the symptomatology of GAS pharyngitis and use appropriate means of diagnosis and treatment to promote good antibiotic stewardship. This issue reviews the signs and symptoms of GAS pharyngitis, as well as associated complications, and provides recommendations for appropriate treatment that focuses on reducing the severity and duration of symptoms, reducing the incidence of nonsuppurative complications, and reducing transmission. [Points & Pearls is a digest of Pediatric Emergency Medicine Practice].

  7. The BCG (Boston Consulting Group) matrix for management of periodic publications

    OpenAIRE

    Serrano Gallardo, Mª del Pilar; Arroyo Gordo, Mª Pilar; Giménez Maroto, Ana Mª

    2005-01-01

    El marketing documental se ha de encargar de satisfacer las necesidades informativas de los usuarios de forma rentable para ellos y para el centro; para ello se ha de partir de un conjunto de herramientas técnicas que se conocen como el Marketing - Mix, y que abarcan el Producto, el Precio, la Distribución y la Comunicación. Dentro de las herramientas destinadas al producto se encuentra la matriz BCG (Boston Consulting Group), que está orientada a gestión, sobre la base de la situación del pr...

  8. Mission Operations and Information Management Area Spacecraft Monitoring and Control Working Group

    Science.gov (United States)

    Lokerson, Donald C. (Editor)

    2005-01-01

    Working group goals for this year are: Goal 1. Due to many review comments the green books will be updated and available for re-review by CCSDS. Submission of green books to CCSDS for approval. Goal 2.Initial set of 4 new drafts of the red books as following: SM&C protocol: update with received comments. SM&C common services: update with received comments and expand the service specification. SM&C core services: update with received comments and expand the service the information model. SM&C time services: (target objective): produce initial draft following template of core services.

  9. Information basis for developing comprehensive waste management system-US-Japan joint nuclear energy action plan waste management working group phase I report.

    Energy Technology Data Exchange (ETDEWEB)

    Nutt, M.; Nuclear Engineering Division

    2010-05-25

    The activity of Phase I of the Waste Management Working Group under the United States - Japan Joint Nuclear Energy Action Plan started in 2007. The US-Japan JNEAP is a bilateral collaborative framework to support the global implementation of safe, secure, and sustainable, nuclear fuel cycles (referred to in this document as fuel cycles). The Waste Management Working Group was established by strong interest of both parties, which arise from the recognition that development and optimization of waste management and disposal system(s) are central issues of the present and future nuclear fuel cycles. This report summarizes the activity of the Waste Management Working Group that focused on consolidation of the existing technical basis between the U.S. and Japan and the joint development of a plan for future collaborative activities. Firstly, the political/regulatory frameworks related to nuclear fuel cycles in both countries were reviewed. The various advanced fuel cycle scenarios that have been considered in both countries were then surveyed and summarized. The working group established the working reference scenario for the future cooperative activity that corresponds to a fuel cycle scenario being considered both in Japan and the U.S. This working scenario involves transitioning from a once-through fuel cycle utilizing light water reactors to a one-pass uranium-plutonium fuel recycle in light water reactors to a combination of light water reactors and fast reactors with plutonium, uranium, and minor actinide recycle, ultimately concluding with multiple recycle passes primarily using fast reactors. Considering the scenario, current and future expected waste streams, treatment and inventory were discussed, and the relevant information was summarized. Second, the waste management/disposal system optimization was discussed. Repository system concepts were reviewed, repository design concepts for the various classifications of nuclear waste were summarized, and the factors

  10. Information basis for developing comprehensive waste management system. US-Japan joint nuclear energy action plan waste management working group phase I report (Joint research)

    International Nuclear Information System (INIS)

    Yui, Mikazu; Ishikawa, Hirohisa; Umeki, Hiroyuki; Hioki, Kazumasa; Naito, Morimasa; Makino, Hitoshi; Oda, Chie; Tachi, Yukio; Mitsui, Seiichiro; Shibata, Masahiro; Watanabe, Atsuo; Yoshino, Kyoji; Seo, Toshihiro; Miyamoto, Yoichi; Nutt, Mark; Peters, Mark; Bresee, James; Lesica, Sue; Schwab, Patrick; Gomberg, Steve; Jones, Jay; Halsey, Bill; Marra, John; Vienna, John; Gombert, Drik; McMahon, Kevin; James, Scott; Caporuscio, Florie

    2010-05-01

    The activity of Phase I of the Waste Management Working Group under the United States - Japan Joint Nuclear Energy Action Plan started in 2007. The US-Japan JNEAP is a bilateral collaborative framework to support the global implementation of safe, secure, and sustainable, nuclear fuel cycles (referred to in this document as fuel cycles). The Waste Management Working Group was established by strong interest of both parties, which arise from the recognition that development and optimization of waste management and disposal system(s) are central issues of the present and future nuclear fuel cycles. This report summarizes the activity of the Waste Management Working Group that focused on consolidation of the existing technical basis between the U.S. and Japan and the joint development of a plan for future collaborative activities. Firstly, the political/regulatory frameworks related to nuclear fuel cycles in both countries were reviewed. The various advanced fuel cycle scenarios that have been considered in both countries were then surveyed and summarized. The working group established the working reference scenario for the future cooperative activity that corresponds to a fuel cycle scenario being considered both in Japan and the U.S. This working scenario involves transitioning from a once-through fuel cycle utilizing light water reactors to a one-pass uranium-plutonium fuel recycle in light water reactors to a combination of light water reactors and fast reactors with plutonium, uranium, and minor actinide recycle, ultimately concluding with multiple recycle passes primarily using fast reactors. Considering the scenario, current and future expected waste streams, treatment and inventory were discussed, and the relevant information was summarized. Second, the waste management/disposal system optimization was discussed. Repository system concepts were reviewed, repository design concepts for the various classifications of nuclear waste were summarized, and the factors

  11. [Beliefs and knowledge of a group of doctors about the nutritional management of the child with acute diarrhea].

    Science.gov (United States)

    Corral-Terrazas, Martha; Martínez, Homero; Flores-Huerta, Samuel; Duque-L, Ma Ximena; Turnbull, Bernardo; Levario-Carrillo, Margarita

    2002-01-01

    To identify the beliefs and knowledge of a group of rural physicians on the dietary management of children under five years of age, with acute diarrhea. Physicians' dietary management was compared with that recommended by the World Health Organization. A cognitive anthropology study was carried out from July to December 1998, on ten physicians that care for the infant population ascribed to Hospital Rural IMSS-Solidaridad of San Juanito Bocoyna, Chihuahua, Mexico. Data were collected through focus groups, case vignettes, free listing, pile sorting, and a semi-structured questionnaire, and then cross-referred. The physicians recognized the negative impact of diarrhea on the nutritional state of the child, but not all of them evaluated this state. Prevailing interventions were antibiotic therapy, fluid management, and feeding recommendations. Among the latter, the most consistent were breastfeeding, delayed feeding, and gradual feeding. The obtained information is in conflict with WHO's recommendations, specially with that of sustained feeding. The English version of this paper is available at: http://www.insp.mx/salud/index.html.

  12. Intensive care management of severe hypernatraemia in the context of group A streptococcal septicaemia.

    Science.gov (United States)

    Davies, Bethan; Jesty, Robert; Uddin, Shahana; Metaxa, Victoria

    2018-04-26

    This case describes a 54-year-old woman with exudative eczema, who was admitted to the intensive care unit with a serum sodium concentration of 191 mmol/L, secondary to profound dehydration in the context of group A streptococcal septicaemia. Successful rehydration and electrolyte normalisation was achieved with continuous venovenous haemodiafiltration (CVVHDF), the replacement fluid of which was infused with hypertonic saline to limit the rate of sodium reduction. This case report comments on three areas of interest. First, hypernatraemia of this level is unusual. Second, the infusion of hypertonic saline into the replacement fluid of the CVVHDF filter is not common practice but successfully ensured a controlled reduction in serum sodium concentration while aggressively replacing a 9 L water deficit. Third, the notable physiological reserve demonstrated by the patient: despite an extraordinary serum sodium concentration in the context of overwhelming streptococcal septicaemia, she has made a full cognitive recovery. © BMJ Publishing Group Ltd (unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  13. Management of chronic kidney disease–mineral and bone disorder: Korean working group recommendations

    Directory of Open Access Journals (Sweden)

    Eunah Hwang

    2015-03-01

    Full Text Available For Korean dialysis patients, chronic kidney disease–mineral bone disorder is a serious burden because of cardiovascular calcification and mortality. However, recent epidemiologic data have demonstrated that many patients undergoing maintenance hemodialysis are out of the target ranges of serum calcium, phosphorus, and intact parathyroid hormone. Thus, we felt the necessity for the development of practical recommendations to treat abnormal serum phosphorus, calcium, and iPTH in dialysis patients. In this paper, we briefly comment on the measurement of serum calcium, phosphorus, iPTH, dialysate calcium concentration, dietary phosphorus restriction, use of phosphate binders, and medical and surgical options to correct secondary hyperparathyroidism. In particular, for the optimal management of secondary hyperparathyroidism, we suggest a simplified medication adjustment according to certain ranges of serum phosphorus and calcium. Large-scale, well-designed clinical studies are required to support our strategies to control chronic kidney disease–mineral bone disorder in this country. Based on such data, our practice guidelines could be established and better long-term outcomes should be anticipated in our dialysis patients.

  14. Emergency preparedness: medical management of nuclear accidents involving large groups of victims

    International Nuclear Information System (INIS)

    Parmentier, N.; Nenot, J.C.

    1988-01-01

    The treatment of overexposed individuals implies hospitalisation in a specialized unit applying hematological intense care. If the accident results in a small number of casualties, the medical management does not raise major problems in most of the countries, where specialized units exist, as roughly 7% of the beds are available at any time. But an accident which would involved tens or hundreds of people raises much more problems for hospitalization. Such problems are also completely different and will involve steps in the medical handling, mainly triage, (combined injuries), determination of whole body dose levels, transient hospitalization. In this case, preplanning is necessary, adapted to the system of medical care in case of a catastrophic event in the given Country, with the main basic principles : emergency concerns essentially the classical injuries (burns and trauma) - and contamination problems in some cases - treatment of radiation syndrome is not an emergency during the first days but some essential actions have to be taken such as early blood sampling for biological dosimetry and for HLa typing

  15. Organizational and Personal Dimension’s of the Conflicts. Strategies for Managing Group Conflicts

    Directory of Open Access Journals (Sweden)

    Simona Mina

    2012-05-01

    Full Text Available The area of conflictology finds itself between the border of interest and challenge. Whatever thecommunication skills we might master, interacting is a difficult exercise; the ongoing interacting willdetermine the ongoing situations of conflict and crisis, as well. Conflict is a reality, a natural consequence ofinteracting; here is an approach that we propose in this volume. The misunderstandings are intermediarysteps to conflict, generated by the different reception of the message, other than the intentions of the emittingfactor. However, we are too vain to admit when we are wrong, as an emitting factor, when we cannot makeourselves understood and our messages are received differently than their main intentions, for which theywere initiated (nobody understands me, we are on different communication channels: this is the way wethink and behave in misunderstood situations. However, communication above all, is perception. That iswhy, misunderstandings are solved straightforward by using the communication techniques (we reformulatethe initial message, making sure we made ourselves understood. This scientific endeavor’s objective is tooffer just such an approach in solving interpersonal conflict. Managing conflicts is difficult to handle due tothe dynamics of conflicts also.

  16. European Climate Change Programme. Working Group II. Impacts and Adaptation. Water Management. Sectoral Report

    International Nuclear Information System (INIS)

    2007-03-01

    Adaptation is a new policy area for the European climate change policy. The Impacts and Adaptation Workgroup has been set up as part of European Climate Change Programme (ECCP II). The main objective of the workgroup is to explore options to improve Europe's resilience to Climate Change Impacts, to encourage the integration of climate change adaptation into other policy areas at the European, national and regional level and to define the role of EU-wide policies complementing action by Member States. The aim of this initial programme of work is to identify good practice in the development of adaptation policy and foster learning from different sectoral experiences and explore a possible EU role in adaptation policies. The Commission has led a series of 10 sectoral meetings looking at adaptation issues for different sectors. One of these meetings looked at the impacts on the water cycle and water resources management and prediction of extreme events in particular. This report summarises the state of play in the Water Resources sector in relation to adaptation to climate change on the basis of the information gathered at the stakeholder meeting on 11 April, 2006

  17. Application fields for the new Object Management Group (OMG) Standards Case Management Model and Notation (CMMN) and Decision Management Notation (DMN) in the perioperative field.

    Science.gov (United States)

    Wiemuth, M; Junger, D; Leitritz, M A; Neumann, J; Neumuth, T; Burgert, O

    2017-08-01

    Medical processes can be modeled using different methods and notations. Currently used modeling systems like Business Process Model and Notation (BPMN) are not capable of describing the highly flexible and variable medical processes in sufficient detail. We combined two modeling systems, Business Process Management (BPM) and Adaptive Case Management (ACM), to be able to model non-deterministic medical processes. We used the new Standards Case Management Model and Notation (CMMN) and Decision Management Notation (DMN). First, we explain how CMMN, DMN and BPMN could be used to model non-deterministic medical processes. We applied this methodology to model 79 cataract operations provided by University Hospital Leipzig, Germany, and four cataract operations provided by University Eye Hospital Tuebingen, Germany. Our model consists of 85 tasks and about 20 decisions in BPMN. We were able to expand the system with more complex situations that might appear during an intervention. An effective modeling of the cataract intervention is possible using the combination of BPM and ACM. The combination gives the possibility to depict complex processes with complex decisions. This combination allows a significant advantage for modeling perioperative processes.

  18. Patient-perceived value of Medication Therapy Management (MTM services: a series of focus groups

    Directory of Open Access Journals (Sweden)

    Heidi Schultz

    2012-01-01

    Full Text Available Objective: To determine the patient-perceived value of MTM services and non-financial barriers preventing patients with insurance coverage from receiving MTM services. Design: Focus groups. Setting: Fairview Pharmacy Services, Minneapolis, MN. Participants: Three focus groups, each with five to nine participants, consisting of different participant populations: (i patients who paid out-of-pocket to receive MTM services; (ii insurance beneficiaries, under which MTM is a covered benefit and participants may have received incentives for receiving MTM services; (iii patients with an insurance plan which covers MTM services who were recruited to receive MTM services but declined. Intervention: MTM services. Main Outcome Measure: Patient-perceived value of MTM services and non-financial barriers. Results: Seven themes were identified relating to the patient-perceived value of MTM services: collaboration of the health care team, MTM pharmacist as a supporter/advocate/confidant, MTM pharmacist as a resource for questions and education, accessibility to the MTM pharmacist, financial incentives for participation in MTM services, MTM pharmacy as a specialty field, and the MTM pharmacist as a coordinator. Three themes were identified regarding patient-perceived non-financial barriers to receiving MTM services, including: availability of the MTM pharmacist, patient/physician lack of knowledge of MTM services, patient's belief that MTM services are not needed. Conclusion: MTM is a service which patients identify as valuable. Patients are able to identify non-financial barriers that may prevent some patients from receiving MTM services. This study provides preliminary evidence of both the value and barriers perceived by patients.   Type: Original Research

  19. Patient-perceived value of Medication Therapy Management (MTM services: a series of focus groups

    Directory of Open Access Journals (Sweden)

    Amanda Brummel, PharmD

    2012-01-01

    Full Text Available Objective: To determine the patient-perceived value of MTM services and non-financial barriers preventing patients with insurance coverage from receiving MTM services. Design: Focus groups. Setting: Fairview Pharmacy Services, Minneapolis, MN.Participants: Three focus groups, each with five to nine participants, consisting of different participant populations: (i patients who paid out-of-pocket to receive MTM services; (ii insurance beneficiaries, under which MTM is a covered benefit and participants may have received incentives for receiving MTM services; (iii patients with an insurance plan which covers MTM services who were recruited to receive MTM services but declined. Intervention: MTM services. Main Outcome Measure: Patient-perceived value of MTM services and non-financial barriers. Results: Seven themes were identified relating to the patient-perceived value of MTM services: collaboration of the health care team, MTM pharmacist as a supporter/advocate/confidant, MTM pharmacist as a resource for questions and education, accessibility to the MTM pharmacist, financial incentives for participation in MTM services, MTM pharmacy as a specialty field, and the MTM pharmacist as a coordinator. Three themes were identified regarding patient-perceived non-financial barriers to receiving MTM services, including: availability of the MTM pharmacist, patient/physician lack of knowledge of MTM services, patient’s belief that MTM services are not needed. Conclusion: MTM is a service which patients identify as valuable. Patients are able to identify non-financial barriers that may prevent some patients from receiving MTM services. This study provides preliminary evidence of both the value and barriers perceived by patients.

  20. Student use of a Learning Management System for group projects: A case study investigating interaction, collaboration, and knowledge construction

    Science.gov (United States)

    Lonn, Steven D.

    Web-based Learning Management Systems (LMS) allow instructors and students to share instructional materials, make class announcements, submit and return course assignments, and communicate with each other online. Previous LMS-related research has focused on how these systems deliver and manage instructional content with little concern for how students' constructivist learning can be encouraged and facilitated. This study investigated how students use LMS to interact, collaborate, and construct knowledge within the context of a group project but without mediation by the instructor. The setting for this case study was students' use in one upper-level biology course of the local LMS within the context of a course-related group project, a mock National Institutes of Health grant proposal. Twenty-one groups (82 students) voluntarily elected to use the LMS, representing two-thirds of all students in the course. Students' peer-to-peer messages within the LMS, event logs, online surveys, focus group interviews, and instructor interviews were used in order to answer the study's overarching research question. The results indicate that students successfully used the LMS to interact and, to a significant extent, collaborate, but there was very little evidence of knowledge construction using the LMS technology. It is possible that the ease and availability of face-to-face meetings as well as problems and limitations with the technology were factors that influenced whether students' online basic interaction could be further distinguished as collaboration or knowledge construction. Despite these limitations, students found several tools and functions of the LMS useful for their online peer interaction and completion of their course project. Additionally, LMS designers and implementers are urged to consider previous literature on computer-supported collaborative learning environments in order to better facilitate independent group projects within these systems. Further research is

  1. LEADERSHIP IN OPTIMIZING MANAGEMENT OF HUMAN RESOURCES FOR GROUP SUSTAINABILITY (Case of Farmer Groups of Gisik Pranaji Bugel Village Panjatan Kulon Progo Regency

    Directory of Open Access Journals (Sweden)

    Sri Kuning Retno Dewandini

    2016-07-01

    Full Text Available Leadership is one important aspect in the sucess of the group. The leader of a group have a role as determinat sucess of the group. Nothing a leader, a group will only run without direction and purpose. But the sucess of a group is not only determined by a leader, but also it determined by his followers as well as a supportive environment. Gisik Pranaji farmer groups in the Bugel village of Panjatan Kulon Progo Regency able to survive due to the role of farmer group. To sustain these group need the support of the parties involved in it, including all the members of farmers and the environment.

  2. Management of Overweight during Childhood: A Focus Group Study on Health Professionals’ Experiences in General Practice,”

    DEFF Research Database (Denmark)

    Larsen, Lone Marie; Ledderer, Loni; Jarbol, Dorte E

    2015-01-01

    Background. Because of the increasing prevalence of overweight and obesity in childhood in the Western world, focus on the management in general practice has also increased. Objective. To explore the experiences of general practitioners (GPs) and practice nurses participating in a randomised...... controlled trial (RCT) comparing two management programmes in general practice for children who are overweight or obese. Methods. Three focus groups with GPs and nurses participating in the RCT. Transcribed data were analysed using systematic text condensation followed by thematic analysis. Results. Health...... to addressing overweight in children. However, increasing awareness of obesity in childhood and its consequences in society was considered helpful to reach an understanding of the articulations concerning how best to address the issue. Conclusions. Health professionals in general practice recognised...

  3. Peer-based control in self-managing teams: linking rational and normative influence with individual and group performance.

    Science.gov (United States)

    Stewart, Greg L; Courtright, Stephen H; Barrick, Murray R

    2012-03-01

    The authors use a multilevel framework to introduce peer-based control as a motivational state that emerges in self-managing teams. The authors specifically describe how peer-based rational control, which is defined as team members perceiving the distribution of economic rewards as dependent on input from teammates, extends and interacts with the more commonly studied normative control force of group cohesion to explain both individual and collective performance in teams. On the basis of data from 587 factory workers in 45 self-managing teams at 3 organizations, peer-based rational control corresponded with higher performance for both individuals and collective teams. Results further demonstrated that the rational and normative mechanism of peer-based control interacted to explain performance at both the individual and team levels. Increased peer-based rational control corresponded with higher individual and collective performance in teams with low cohesion, but the positive effects on performance were attenuated in cohesive teams.

  4. Water supply management using an extended group fuzzy decision-making method: a case study in north-eastern Iran

    Science.gov (United States)

    Minatour, Yasser; Bonakdari, Hossein; Zarghami, Mahdi; Bakhshi, Maryam Ali

    2015-09-01

    The purpose of this study was to develop a group fuzzy multi-criteria decision-making method to be applied in rating problems associated with water resources management. Thus, here Chen's group fuzzy TOPSIS method extended by a difference technique to handle uncertainties of applying a group decision making. Then, the extended group fuzzy TOPSIS method combined with a consistency check. In the presented method, initially linguistic judgments are being surveyed via a consistency checking process, and afterward these judgments are being used in the extended Chen's fuzzy TOPSIS method. Here, each expert's opinion is turned to accurate mathematical numbers and, then, to apply uncertainties, the opinions of group are turned to fuzzy numbers using three mathematical operators. The proposed method is applied to select the optimal strategy for the rural water supply of Nohoor village in north-eastern Iran, as a case study and illustrated example. Sensitivity analyses test over results and comparing results with project reality showed that proposed method offered good results for water resources projects.

  5. The Management of Synchronous Bilateral Wilms Tumor: A Report from the National Wilms Tumor Study Group

    Science.gov (United States)

    Hamilton, Thomas E.; Ritchey, Michael L.; Haase, Gerald M.; Argani, Pedram; Peterson, Susan M.; Anderson, James R.; Green, Daniel M.; Shamberger, Robert C.

    2013-01-01

    Objective To provide guidelines for future trials, we reviewed the outcomes of children with synchronous bilateral Wilms tumors (BWT) treated on National Wilms Tumor Study-4 (NWTS-4). Methods NWTS-4 enrolled 3,335 patients (pts) including 188 pts with BWT (5.6%). Treatment and outcome data were collected. Results Among 188 BWT pts registered with NWTS-4, 195 kidneys in 123 patients had initial open biopsy, 44 kidneys in 31 pts had needle biopsies. Although pre-resection chemotherapy was recommended, 87 kidneys in 83 pts were managed with primary resection: Complete nephrectomy 48 in 48 pts, 31 partial/wedge nephrectomies in 27 pts, enucleations 8 in 8 pts. No initial surgery was performed in 45 kidneys in 43 pts, 5 kidneys in 3 pts not coded. Anaplasia was diagnosed after completion of the initial course of chemotherapy in 14 pts (initial surgical procedure: 9 open biopsies, 4 needle biopsies, 1 partial nephrectomy). The average number of days from the start of chemotherapy to diagnosis of anaplasia was 390 (range 44–1,925 days). Relapse or progression of disease occurred in 54 children. End stage renal failure occurred in 23 children, 6 of whom had bilateral nephrectomies. The 8 year event free survival (EFS) for BWT with favorable histology was 74%, and overall survival (OS) was 89%; while the EFS for BWT with unfavorable histology was 40%, OS was 45%. Conclusion The current analysis of patients with BWT treated on NWTS-4 shows that preservation of renal parenchyma is possible in many pts following initial preoperative chemotherapy. The incidence of end-stage renal disease remains significantly higher in children with BWT. Future studies are warranted to address the need for earlier biopsy in non-responsive tumors and earlier definitive surgery to recognize unfavorable histology in these high risk patients. PMID:21394016

  6. Investigating temporary acyclicity in a captive group of Asian elephants (Elephas maximus): Relationship between management, adrenal activity and social factors.

    Science.gov (United States)

    Edwards, Katie L; Trotter, Jessica; Jones, Martin; Brown, Janine L; Steinmetz, Hanspeter W; Walker, Susan L

    2016-01-01

    Routine faecal steroid monitoring has been used to aid the management of five captive Asian elephant (Elephas maximus) females at Chester Zoo, UK, since 2007. Progestagen analysis initially revealed synchronised oestrous cycles among all females. However, a 14- to 20-week period of temporary acyclicity subsequently occurred in three females, following several management changes (increased training, foot-care and intermittent matriarch removal for health reasons) and the initiation of pregnancy in another female. The aim of this study was to retrospectively investigate whether these management changes were related to increased adrenal activity and disruption of ovarian activity, or whether social factors may have been involved in the temporary cessation of cyclicity. Faecal samples collected every other day were analysed to investigate whether glucocorticoid metabolites were related to reproductive status (pregnant, cycling, acyclic) or management (training, foot-care, matriarch presence). Routine training and foot-care were not associated with adrenal activity; however, intensive foot-care to treat an abscess in one female was associated with increased glucocorticoid concentration. Matriarch presence influenced adrenal activity in three females, being lower when the matriarch was separated from the group at night compared to being always present. However, in the females that exhibited temporary acyclicity, there was no consistent relationship between glucocorticoids and cyclicity state. Although the results of this study do not fully explain this occurrence, the highly synchronised nature of oestrous cycles within this group, and the concurrent acyclicity in three females, raises the question of whether social factors could have been involved in the temporary disruption of ovarian activity. Copyright © 2015 Elsevier Inc. All rights reserved.

  7. A glucocorticoid education group meeting: an effective strategy for improving self-management to prevent adrenal crisis.

    Science.gov (United States)

    Repping-Wuts, Han J W J; Stikkelbroeck, Nike M M L; Noordzij, Alida; Kerstens, Mies; Hermus, Ad R M M

    2013-07-01

    To assess self-management in patients receiving glucocorticoid replacement therapy for primary or secondary adrenal failure before and 6 months after a glucocorticoid education group meeting. All patients with primary or secondary adrenal insufficiency, treated at the Department of Medicine, Division of Endocrinology, were invited by their endocrinologist to participate in a 3-h glucocorticoid education group meeting, consisting of a lecture about the disease and glucocorticoid doses adjustments in case of stress, followed by an instruction on how to inject hydrocortisone i.m. Finally, all participants could practise the i.m. injection and discuss their experience with (imminent) adrenal crises with other patients and the health care providers. Two weeks before the meeting and 6 months after the meeting, patients were asked to fill out a questionnaire about how they would act in six different conditions (e.g. febrile illness or vomiting). Of the 405 patients who were invited, 246 patients (61%) participated. At baseline the response by the participants on the questionnaire was 100% (n=246) and at follow-up 74% (n=183). At follow-up, significantly more participants (P≤0.005) gave the correct answers to how to act in different situations (e.g. self-administration of a glucocorticoid injection and phone contact in case of vomiting/diarrhoea without fever). Moreover, the use of self-management tools, such as having a 'medicine passport (travel document with information about disease and medication) (P=0.007) or SOS medallion (P=0.0007)', increased. A glucocorticoid education group meeting for patients with adrenal failure seems helpful to improve self-management and proper use of stress-related glucocorticoid dose adjustment.

  8. Trial of a "credit card" asthma self-management plan in a high-risk group of patients with asthma.

    Science.gov (United States)

    D'Souza, W; Burgess, C; Ayson, M; Crane, J; Pearce, N; Beasley, R

    1996-05-01

    The "credit card" asthma self-management plan provides the adult asthmatic patient with simple guidelines for the self-management of asthma, which are based on the self-assessment of peak expiratory flow rate recordings and symptoms. The study was a trial of the clinical efficacy of the credit card plan in a high-risk group of asthmatic patients. In this "before-and-after" trial, patients discharged from the emergency department of Wellington Hospital, after treatment for severe asthma were invited to attend a series of hospital outpatient clinics at which the credit card plan was introduced. Questionnaires were used to compare markers of asthma morbidity, requirement for emergency medical care, and medication use during the 6-month period before and after intervention with the credit card plan. Of the 30 patients with asthma who attended the first outpatient clinic, 26 (17 women and 9 men) completed the program. In these 26 participants, there was a reduction in both morbidity and requirement for acute medical services: specifically, the proportion waking with asthma more than once a week decreased from 65% to 23% (p = 0.005) and the proportion visiting the emergency department for treatment of severe asthma decreased from 58% to 15% (p = 0.004). The patients attending the clinics commented favorably on the plan, in particular on its usefulness as an educational tool for monitoring and treating their asthma. Although the interpretation of this study is limited by the lack of a randomized control group, the findings are consistent with other evidence that the credit card asthma self-management plan can be an effective and acceptable system for improving asthma care in a high-risk group of adult patients with asthma.

  9. A Cloud Computing Approach to Personal Risk Management: The Open Hazards Group

    Science.gov (United States)

    Graves, W. R.; Holliday, J. R.; Rundle, J. B.

    2010-12-01

    According to the California Earthquake Authority, only about 12% of current California residences are covered by any form of earthquake insurance, down from about 30% in 1996 following the 1994, M6.7 Northridge earthquake. Part of the reason for this decreasing rate of insurance uptake is the high deductible, either 10% or 15% of the value of the structure, and the relatively high cost of the premiums, as much as thousands of dollars per year. The earthquake insurance industry is composed of the CEA, a public-private partnership; modeling companies that produce damage and loss models similar to the FEMA HAZUS model; and financial companies such as the insurance, reinsurance, and investment banking companies in New York, London, the Cayman Islands, Zurich, Dubai, Singapore, and elsewhere. In setting earthquake insurance rates, financial companies rely on models like HAZUS, that calculate on risk and exposure. In California, the process begins with an official earthquake forecast by the Working Group on California Earthquake Probabilities. Modeling companies use these 30 year earthquake probabilities as inputs to their attenuation and damage models to estimate the possible damage factors from scenario earthquakes. Economic loss is then estimated from processes such as structural failure, lost economic activity, demand surge, and fire following the earthquake. Once the potential losses are known, rates can be set so that a target ruin probability of less than 1% or so can be assured. Open Hazards Group was founded with the idea that the global public might be interested in a personal estimate of earthquake risk, computed using data supplied by the public, with models running in a cloud computing environment. These models process data from the ANSS catalog, updated at least daily, to produce rupture forecasts that are backtested with standard Reliability/Attributes and Receiver Operating Characteristic tests, among others. Models for attenuation and structural damage

  10. Multicomponent interdisciplinary group intervention for self-management of fibromyalgia: a mixed-methods randomized controlled trial.

    Directory of Open Access Journals (Sweden)

    Patricia Bourgault

    Full Text Available This study evaluated the efficacy of the PASSAGE Program, a structured multicomponent interdisciplinary group intervention for the self-management of FMS.A mixed-methods randomized controlled trial (intervention (INT vs. waitlist (WL was conducted with patients suffering from FMS. Data were collected at baseline (T0, at the end of the intervention (T1, and 3 months later (T2. The primary outcome was change in pain intensity (0-10. Secondary outcomes were fibromyalgia severity, pain interference, sleep quality, pain coping strategies, depression, health-related quality of life, patient global impression of change (PGIC, and perceived pain relief. Qualitative group interviews with a subset of patients were also conducted. Complete data from T0 to T2 were available for 43 patients.The intervention had a statistically significant impact on the three PGIC measures. At the end of the PASSAGE Program, the percentages of patients who perceived overall improvement in their pain levels, functioning and quality of life were significantly higher in the INT Group (73%, 55%, 77% respectively than in the WL Group (8%, 12%, 20%. The same differences were observed 3 months post-intervention (Intervention group: 62%, 43%, 38% vs Waitlist Group: 13%, 13%, 9%. The proportion of patients who reported ≥ 50% pain relief was also significantly higher in the INT Group at the end of the intervention (36% vs 12% and 3 months post-intervention (33% vs 4%. Results of the qualitative analysis were in line with the quantitative findings regarding the efficacy of the intervention. The improvement, however, was not reflected in the primary outcome and other secondary outcome measures.The PASSAGE Program was effective in helping FMS patients gain a sense of control over their symptoms. We suggest including PGIC in future clinical trials on FMS as they appear to capture important aspects of the patients' experience.International Standard Randomized Controlled Trial Number

  11. Implementing Kanban for agile process management within the ALMA Software Operations Group

    Science.gov (United States)

    Reveco, Johnny; Mora, Matias; Shen, Tzu-Chiang; Soto, Ruben; Sepulveda, Jorge; Ibsen, Jorge

    2014-07-01

    After the inauguration of the Atacama Large Millimeter/submillimeter Array (ALMA), the Software Operations Group in Chile has refocused its objectives to: (1) providing software support to tasks related to System Integration, Scientific Commissioning and Verification, as well as Early Science observations; (2) testing the remaining software features, still under development by the Integrated Computing Team across the world; and (3) designing and developing processes to optimize and increase the level of automation of operational tasks. Due to their different stakeholders, each of these tasks presents a wide diversity of importances, lifespans and complexities. Aiming to provide the proper priority and traceability for every task without stressing our engineers, we introduced the Kanban methodology in our processes in order to balance the demand on the team against the throughput of the delivered work. The aim of this paper is to share experiences gained during the implementation of Kanban in our processes, describing the difficulties we have found, solutions and adaptations that led us to our current but still evolving implementation, which has greatly improved our throughput, prioritization and problem traceability.

  12. The management of change in BNFL's UK group with particular reference to the restructuring of the health and safety functions

    International Nuclear Information System (INIS)

    Brandwood, A.R.

    1996-01-01

    BNFL's UK group business involves reprocessing of uranium metal (Magnox) fuel, storage and dismantling of advanced gas rector (ceramic UO 2 ) fuel, waste treatment and storage, decommissioning and electricity generation. These activities are carried out at three sites in the North West corner of England and Southern Scotland: Sellafield - all activities, Chapelcross -electricity generation, Drigg - waste storage. Achieving fundamental change in a well established nuclear business which is highly regulated is possible and can bring large benefits. The keys to success are leadership and commitment from all senior managers, involvement of all stakeholders and communication. It is essential to involve the regulator as a stakeholder. (author)

  13. Service guidelines based on Resource Utilization Groups Version III for Home Care provide decision-making support for case managers.

    Science.gov (United States)

    Collister, Barbara; Stein, Glenda; Katz, Deborah; DeBruyn, Joan; Andrusiw, Linda; Cloutier, Sheila

    2012-01-01

    Increasing costs and budget reductions combined with increasing demand from our growing, aging population support the need to ensure that the scarce resources allocated to home care clients match client needs. This article details how Integrated Home Care for the Calgary Zone of Alberta Health Services considered ethical and economic principles and used data from the Resident Assessment Instrument for Home Care (RAI-HC) and case mix indices from the Resource Utilization Groups Version III for Home Care (RUG-III/HC) to formulate service guidelines. These explicit service guidelines formalize and support individual resource allocation decisions made by case managers and provide a consistent and transparent method of allocating limited resources.

  14. The Use of Nominal Group Technique to Determine Additional Support Needs for a Group of Victorian TAFE Managers and Senior Educators

    Science.gov (United States)

    Bailey, Anthony

    2013-01-01

    The nominal group technique (NGT) is a structured process to gather information from a group. The technique was first described in 1975 and has since become a widely-used standard to facilitate working groups. The NGT is effective for generating large numbers of creative new ideas and for group priority setting. This paper describes the process of…

  15. Hypertension management research priorities from patients, caregivers, and healthcare providers: A report from the Hypertension Canada Priority Setting Partnership Group.

    Science.gov (United States)

    Khan, Nadia; Bacon, Simon L; Khan, Samia; Perlmutter, Sara; Gerlinsky, Carline; Dermer, Mark; Johnson, Lonni; Alves, Finderson; McLean, Donna; Laupacis, Andreas; Pui, Mandy; Berg, Angelique; Flowitt, Felicia

    2017-11-01

    Patient- and stakeholder-oriented research is vital to improving the relevance of research. The authors aimed to identify the 10 most important research priorities of patients, caregivers, and healthcare providers (family physicians, nurses, nurse practitioners, pharmacists, and dietitians) for hypertension management. Using the James Lind Alliance approach, a national web-based survey asked patients, caregivers, and care providers to submit their unanswered questions on hypertension management. Questions already answered from randomized controlled trial evidence were removed. A priority setting process of patient, caregiver, and healthcare providers then ranked the final top 10 research priorities in an in-person meeting. There were 386 respondents who submitted 598 questions after exclusions. Of the respondents, 78% were patients or caregivers, 29% lived in rural areas, 78% were aged 50 to 80 years, and 75% were women. The 598 questions were distilled to 42 unique questions and from this list, the top 10 research questions prioritized included determining the combinations of healthy lifestyle modifications to reduce the need for antihypertensive medications, stress management interventions, evaluating treatment strategies based on out-of-office blood pressure compared with conventional (office) blood pressure, education tools and technologies to improve patient motivation and health behavior change, management strategies for ethnic groups, evaluating natural and alternative treatments, and the optimal role of different healthcare providers and caregivers in supporting patients with hypertension. These priorities can be used to guide clinicians, researchers, and funding bodies on areas that are a high priority for hypertension management research for patients, caregivers, and healthcare providers. This also highlights priority areas for improved knowledge translation and delivering patient-centered care. ©2017 Wiley Periodicals, Inc.

  16. 'You give us rangoli, we give you talk': using an art-based activity to elicit data from a seldom heard group.

    Science.gov (United States)

    Redwood, Sabi; Gale, Nicola K; Greenfield, Sheila

    2012-01-30

    The exclusion from health research of groups most affected by poor health is an issue not only of poor science, but also of ethics and social justice. Even if exclusion is inadvertent and unplanned, policy makers will be uninformed by the data and experiences of these groups. The effect on the allocation of resources is likely to be an exacerbation of health inequalities. We subject to critical analysis the notion that certain groups, by virtue of sharing a particular identity, are inaccessible to researchers - a phenomenon often problematically referred to as 'hard to reach'. We use the term 'seldom heard' to move the emphasis from a perceived innate characteristic of these groups to a consideration of the methods we choose as researchers. Drawing on a study exploring the intersections of faith, culture, health and food, we describe a process of recruitment, data collection and analysis in which we sought to overcome barriers to participation. As we were interested in the voices of South Asian women, many of whom are largely invisible in public life, we adopted an approach to data collection which was culturally in tune with the women's lives and values. A collaborative activity mirroring food preparation provided a focus for talk and created an environment conducive to data collection. We discuss the importance of what we term 'shoe leather research' which involves visiting the local area, meeting potential gatekeepers, and attending public events in order to develop our profile as researchers in the community. We examine issues of ethics, data quality, management and analysis which were raised by our choice of method. In order to work towards a more theoretical understanding of how material, social and cultural factors are connected and influence each other in ways that have effects on health, researchers must attend to the quality of the data they collect to generate finely grained and contextually relevant findings. This in turn will inform the design of

  17. 'You give us rangoli, we give you talk': using an art-based activity to elicit data from a seldom heard group

    Directory of Open Access Journals (Sweden)

    Redwood Sabi

    2012-01-01

    Full Text Available Abstract Background The exclusion from health research of groups most affected by poor health is an issue not only of poor science, but also of ethics and social justice. Even if exclusion is inadvertent and unplanned, policy makers will be uninformed by the data and experiences of these groups. The effect on the allocation of resources is likely to be an exacerbation of health inequalities. Discussion We subject to critical analysis the notion that certain groups, by virtue of sharing a particular identity, are inaccessible to researchers - a phenomenon often problematically referred to as 'hard to reach'. We use the term 'seldom heard' to move the emphasis from a perceived innate characteristic of these groups to a consideration of the methods we choose as researchers. Drawing on a study exploring the intersections of faith, culture, health and food, we describe a process of recruitment, data collection and analysis in which we sought to overcome barriers to participation. As we were interested in the voices of South Asian women, many of whom are largely invisible in public life, we adopted an approach to data collection which was culturally in tune with the women's lives and values. A collaborative activity mirroring food preparation provided a focus for talk and created an environment conducive to data collection. We discuss the importance of what we term 'shoe leather research' which involves visiting the local area, meeting potential gatekeepers, and attending public events in order to develop our profile as researchers in the community. We examine issues of ethics, data quality, management and analysis which were raised by our choice of method. Summary In order to work towards a more theoretical understanding of how material, social and cultural factors are connected and influence each other in ways that have effects on health, researchers must attend to the quality of the data they collect to generate finely grained and contextually

  18. Contemporary Management of Achalasia by Pediatric Surgeons: A Survey of the International Pediatric Endosurgical Group.

    Science.gov (United States)

    Gould, Joanna L; Rentea, Rebecca M; St Peter, Shawn D

    2016-07-01

    Achalasia is a rare neurodegenerative disorder of the esophagus. Surgical repair consists of esophagomyotomy, often in conjunction with an antireflux procedure. We sought to determine practice patterns in surgical treatment of pediatric achalasia. Data regarding preferences were collected as part of a comprehensive online-based survey sent to members of the International Pediatric Endosurgery Group (IPEG) completed by 191 surgeons of which 141 performed esophagomyotomies for achalasia. Procedures performed per surgeon were 1-2 (n = 21, 15%); 3-5 (n = 49, 34%); 6-10 (n = 39, 28%); 11-20 (n = 21, 15%); >20 (n = 11, 8%). Most approached the operation laparoscopically (n = 127, 90%). Workup before esophageal myotomy consisted of a diagnostic esophagram (n = 133, 94%) or manometry (n = 102, 73%). Only 60% of surgeons (n = 84) required an EGD. No preference observed in division location of the phrenoesophageal ligament for mobilization of the esophagus. There was a predominant preference for hook cautery (n = 82, 58%) over harmonic shears (n = 30, 21%), heated sealing device LigaSure™ (n = 18, 13%), and other devices (n = 11, 8%) for muscle division. Intraoperatively, 57% (n = 80) had endoscopy and 50% (n = 71) had postoperative esophagram before initiation of enteral feeding. For antireflux procedure, Thal/Dor approach was performed most frequently (n = 111, 79%) followed by the Toupet (n = 18, 13%) and Nissen (n = 4, 3%) and none (n = 7, 5%). Diet restrictions were provided in 76% (n = 107) of postoperative patients. Given the infrequency of achalasia in children, there are a range of treatment plans among pediatric surgeons. We have identified current practices as a first step in developing more standard treatment pathways.

  19. The patient’s voice: an exploratory study of the impact of a group self-management support program

    Directory of Open Access Journals (Sweden)

    Johnston Sharon

    2012-06-01

    Full Text Available Abstract Background Given the potential value of self-management support programs for people with chronic diseases, it is vital to understand how they influence participants’ health attitudes and behaviours. The Stanford Chronic Disease Self-Management Program (CDSMP, the most well-known and widely studied such program, is funded in many provinces and jurisdictions throughout Canada. However, there is little published evidence on its impact in the Canadian health-care system. We studied participants’ reactions and perceived impacts of attending the Stanford program in one Ontario health region so we could assess its value to the health region. The study asked: What are participants’ reactions and perceived impacts of attending the Stanford CDSMP? Methods This mixed methods exploratory study held four focus groups approximately one year after participants attended a Stanford program workshop. At the beginning of each session, participants filled out a survey on the type and frequency of community and health resources used for their self-management. During the sessions, a moderator guided the discussion, asking about such things as long-term impact of the program on their lives and barriers to self-management of their chronic conditions. Results Participants perceived diverse effects of the workshop: from having a profound impact on one area to affecting all aspects of their lives. A change in physical activity patterns was the most prominent behaviour change, noted by over half the participants. Other recurrent effects included an improved sense of social connection and better coping skills. Barriers to self-management were experienced by almost all participants with several dominant themes emerging including problems with the health system and patient-physician interaction. Participants reported a wide variety of resources used in their self-management, and in some cases, an increase in use was noted for some resources. Conclusions Self-management

  20. An improved one-and-a-half group BWR core simulator for a new-generation core management system

    International Nuclear Information System (INIS)

    Iwamoto, Tatsuya; Yamamoto, Munenari

    2000-01-01

    An improved one-and-a-half group core simulator method for a next-generation BWR core management system is presented. In the improved method, intranodal spectral index (thermal to fast flux ratio) is expanded with analytic solutions to the diffusion equation, and the nodal power density and the interface net current are calculated, taking the intranodal flux shape into consideration. A unique method was developed for assembly heterogeneity correction. Thus eliminating the insufficiencies of the conventional one-and-a-half group method, we can have accurate power distributions as well as local peaking factors for cores having large spectral mismatch between fuel assemblies. The historical effects of spectral mismatch are also considered in both nodal power and local peaking calculations. Although reflectors are not solved explicitly, there is essentially no need for core dependent adjustable parameters, since boundary conditions are derived in the same manner as in the interior nodes. Calculation time for nodal solutions is comparable to that for the conventional method, and is less than 1/10 of a few-group nodal simulator. Verifications of the present method were made by comparing the results with those obtained by heterogeneous fine-mesh multi-group core depletion calculations, and the accuracy was shown to be fairly good. (author)

  1. Guidelines for the management of Helicobacter pylori infection in Italy: The III Working Group Consensus Report 2015.

    Science.gov (United States)

    Zagari, Rocco Maurizio; Romano, Marco; Ojetti, Veronica; Stockbrugger, Reinhold; Gullini, Sergio; Annibale, Bruno; Farinati, Fabio; Ierardi, Enzo; Maconi, Giovanni; Rugge, Massimo; Calabrese, Carlo; Di Mario, Francesco; Luzza, Francesco; Pretolani, Stefano; Savio, Antonella; Gasbarrini, Giovanni; Caselli, Michele

    2015-11-01

    Knowledge on the role of Helicobacter pylori (HP) infection is continually evolving, and treatment is becoming more challenging due to increasing bacterial resistance. Since the management of HP infection is changing, an update of the national Italian guidelines delivered in 2007 was needed. In the III Working Group Consensus Report 2015, a panel of 17 experts from several Italian regions reviewed current evidence on different topics relating to HP infection. Four working groups examined the following topics: (1) "open questions" on HP diagnosis and treatment (focusing on dyspepsia, gastro-oesophageal reflux disease, non-steroidal anti-inflammatory drugs or aspirin use and extra-gastric diseases); (2) non-invasive and invasive diagnostic tests; (3) treatment of HP infection; (4) role of HP in the prevention of gastric cancer. Statements and recommendations were discussed and a consensus reached in a final plenary session held in February 2015 in Bologna. Recommendations are based on the best current evidence to help physicians manage HP infection in Italy. The guidelines have been endorsed by the Italian Society of Gastroenterology and the Italian Society of Digestive Endoscopy. Copyright © 2015 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevier Ltd. All rights reserved.

  2. Deliberations of working group 5: are waste management institutions set up for achieving confidence over the long term?

    International Nuclear Information System (INIS)

    Eng, T.

    2000-01-01

    Working Group 5 started with a presentation providing an overview of recent research on the issue of public acceptance of waste management. It identified a trustworthy and credible organisation as one that could be also described as: Open, innovative, flexible, responsive, and fair. This presentation was followed by a discussion about 'Which re structural requirements for the effective performance of waste management institutions?'; The WG continued then with a round around the table during which it was possible to compile the views of all participants on the question 'What would characterise a organisation that would earn the trust from the stakeholders (a high reliability organisation)?'. In answering this question, each participant was also asked to consider whether there are differences to be noted according to whether the organisation is an implementing one, authority, municipality or a NGO. Most answers concentrated on the implementer's role. It was concluded, however, that many of the items listed below are valid for the other actors and, especially, the authorities. When compiling the list there was a need to structure the answers into 3 groups, which are discussed in this paper: - Organisational aspects. - Mission(s). - Behaviour. (author)

  3. Management and storage of spent nuclear fuel at research and test reactors. Proceedings of an advisory group meeting

    International Nuclear Information System (INIS)

    1996-08-01

    Irradiated fuel from research and test reactors has been stored at various facilities for several decades. As these facilities age and approach or exceed their original design lifetimes, there is mounting concern about closure of the fuel cycle and about the integrity of ageing fuels from the materials point of view as well as some concern about the loss of self-protection of the fuels as their activity decays. It is clear that an international effort is necessary to give these problems sufficient exposure and to ensure that work continues on appropriate solutions. The future of nuclear research, with its many benefits to mankind, is in jeopardy in some countries, especially countries without nuclear power programmes, because effective solutions for extended interim storage and final disposition of spent research reactor fuels are not yet available. An advisory Group meeting was convened in Vienna to consider a Database on the Management and Storage of Spent Nuclear Fuel from Research and Test Reactors. Sixteen experts from sixteen different countries participated in the Advisory Group meeting and presented country reports, which together represent an overview of the technologies used in spent fuel management and storage at research and test reactors world-wide. The sixteen country reports together with the database summary are presented in this publication. Refs, figs, tabs

  4. A focus group study of patient's perspective and experiences of type 2 diabetes and its management in Jordan.

    Science.gov (United States)

    Jarab, Anan S; Mukattash, Tareq L; Al-Azayzih, Ahmad; Khdour, Maher

    2018-03-01

    Diabetes is increasingly becoming a major health problem in Jordan and glycemic goals are often not achieved. To explore the patients' perspectives regarding type 2 diabetes and its management in order to "fine-tune" future pharmaceutical care intervention programs. Focus groups method was used to explore views from individuals with type 2 diabetes attending outpatient diabetes clinic at the Royal Medical Services Hospital. All interviews were recorded, transcribed and analyzed using a thematic analysis approach. A total of 6 focus groups, with 6 participants in each one, were conducted. Participants in the present study demonstrated a great information needs about diabetes and the prescribed treatment. Medication regimen characteristics including rout of administration, number of prescribed medications and dosage frequency in addition to perceived side effects represented the major barriers to medication adherence. In addition to demonstrating negative beliefs about the illness and the prescribed medications, participants showed negative attitudes and low self-efficacy to adhere to necessary self-care activities including diet, physical activity and self-monitoring of blood glucose. Future pharmaceutical care interventions designed to improve patients' adherence and health outcomes in patients with type 2 diabetes should consider improving patients' understanding of type 2 diabetes and its management, simplifying dosage regimen, improving patient's beliefs and attitudes toward type 2 diabetes, prescribed medications and different self-care activities in addition to improving patient's self efficacy to perform different treatment recommendations.

  5. An ongoing six-year innovative osteoporosis disease management program: challenges and success in an IPA physician group environment.

    Science.gov (United States)

    Woo, Ann; Hittell, Jodi; Beardsley, Carrie; Noh, Charles; Stoukides, Cheryl A; Kaul, Alan F

    2004-01-01

    The goal of this ongoing comprehensive osteoporosis disease management initiative is to provide the adult primary care physicians' (PCPs) offices with a program enabling them to systematically identify and manage their population for osteoporosis. For over six years, Hill Physicians Medical Group (Hill Physicians) has implemented multiple strategies to develop a best practice for identifying and treating members who were candidates for osteoporosis therapy. Numerous tools were used to support this disease management effort, including: evidence-based clinical practice guidelines, patient education sessions, the Simple Calculated Osteoporosis Risk Estimation (SCORE) questionnaire tool, member specific reports for PCPs, targeted member mailings, office-based Peripheral Instantaneous X-ray Imaging (PIXI) test and counseling, dual x-ray absorptiometry (DEXA) scan guidelines, and web-based Electronic Simple Calculated Osteoporosis Risk Estimation (eSCORE) questionnaire tools. Hill Physicians tabulated results for patients who completed 2649 SCORE tests, screened 978 patients with PIXI tests, and identified 338 osteopenic and 124 osteoporotic patients. The preliminary results of this unique six-year ongoing educational initiative are slow but promising. New physician offices express interest in participating and those offices that have participated in the program continue to screen for osteoporosis. Hill Physicians' message is consistent and is communicated to the physicians repeatedly in different ways in accordance with the principles of educational outreach. Physicians who have conducted the program have positive feedback from their patients and office staff and have begun to communicate their experience to their peers.

  6. Developing a decision-making model based on an interdisciplinary oncological care group for the management of colorectal cancer.

    Science.gov (United States)

    Genovesi, Domenico; Mazzilli, Lorenzo; Trignani, Marianna; DI Tommaso, Monica; Nuzzo, Antonio; Biondi, Edoardo; Tinari, Nicola; Martino, Maria Teresa; Innocenti, Paolo; DI Sebastiano, Pierluigi; Mazzola, Lorenzo; Lanci, Carmine; Neri, Matteo; Laterza, Francesco; Marino, Maria; Ferrini, Giovanni; Spadaccini, Antonio; Filippone, Antonella; DI Giandomenico, Enzo; Marulli, Antonio; Palombo, Giuseppe; Sparvieri, Antonio; Marchetti, Antonio; Pizzicannella, Giuseppe; Petrini, Flavia; DI Felice, Maria; Ottaviani, Floriana; Monteodorisio, Antonio; DI Nicola, Marta; Cefaro, Giampiero Ausili

    2014-05-01

    To report our experience on implementation and preliminary results of a decision-making model based on the recommendations of an Interdisciplinary Oncological Care Group developed for the management of colorectal cancer. The multidisciplinary team identified a reference guideline using appraisal of guidelines for research and evaluation (AGREE) tool based on a sequential assessment of the guideline quality. Thereafter, internal guidelines with diagnostic and therapeutic management for early, locally advanced and metastatic colonic and rectal cancer were drafted; organizational aspects, responsibility matrices, protocol actions for each area of specialty involved and indicators for performing audits were also defined. The National Institute for Health and Care Excellence (NICE) UK guideline was the reference for drafting the internal guideline document; from February to November 2013, 125 patients with colorectal cancer were discussed by and taken under the care of the Interdisciplinary Oncological Care Group. The first audit performed in December 2013 revealed optimal adherence to the internal guideline, mainly in terms of uniformity and accuracy of perioperative staging, coordination and timing of multi-modal therapies. To date, all patients under observation are within the diagnostic and therapeutic course, no patient came out from the multidisciplinary "path" and only in 14% of cases have the first recommendations proposed been changed. The selected indicators appear effective and reliable, while at the moment, it is not yet possible to assess the impact of the multidisciplinary team on clinical outcome. Although having a short observation period, our model seems capable of determining optimal uniformity of diagnostic and therapeutic management, to a high degree of patient satisfaction. A longer observation period is necessary in order to confirm these observations and for assessing the impact on clinical outcome.

  7. Image guidance doses delivered during radiotherapy: Quantification, management, and reduction: Report of the AAPM Therapy Physics Committee Task Group 180.

    Science.gov (United States)

    Ding, George X; Alaei, Parham; Curran, Bruce; Flynn, Ryan; Gossman, Michael; Mackie, T Rock; Miften, Moyed; Morin, Richard; Xu, X George; Zhu, Timothy C

    2018-05-01

    With radiotherapy having entered the era of image guidance, or image-guided radiation therapy (IGRT), imaging procedures are routinely performed for patient positioning and target localization. The imaging dose delivered may result in excessive dose to sensitive organs and potentially increase the chance of secondary cancers and, therefore, needs to be managed. This task group was charged with: a) providing an overview on imaging dose, including megavoltage electronic portal imaging (MV EPI), kilovoltage digital radiography (kV DR), Tomotherapy MV-CT, megavoltage cone-beam CT (MV-CBCT) and kilovoltage cone-beam CT (kV-CBCT), and b) providing general guidelines for commissioning dose calculation methods and managing imaging dose to patients. We briefly review the dose to radiotherapy (RT) patients resulting from different image guidance procedures and list typical organ doses resulting from MV and kV image acquisition procedures. We provide recommendations for managing the imaging dose, including different methods for its calculation, and techniques for reducing it. The recommended threshold beyond which imaging dose should be considered in the treatment planning process is 5% of the therapeutic target dose. Although the imaging dose resulting from current kV acquisition procedures is generally below this threshold, the ALARA principle should always be applied in practice. Medical physicists should make radiation oncologists aware of the imaging doses delivered to patients under their care. Balancing ALARA with the requirement for effective target localization requires that imaging dose be managed based on the consideration of weighing risks and benefits to the patient. © 2018 American Association of Physicists in Medicine.

  8. Manage at work: a randomized, controlled trial of a self-management group intervention to overcome workplace challenges associated with chronic physical health conditions.

    Science.gov (United States)

    Shaw, William S; Besen, Elyssa; Pransky, Glenn; Boot, Cécile R L; Nicholas, Michael K; McLellan, Robert K; Tveito, Torill H

    2014-05-28

    The percentage of older and chronically ill workers is increasing rapidly in the US and in many other countries, but few interventions are available to help employees overcome the workplace challenges of chronic pain and other physical health conditions. While most workers are eligible for job accommodation and disability compensation benefits, other workplace strategies might improve individual-level coping and problem solving to prevent work disability. In this study, we hypothesize that an employer-sponsored group intervention program employing self-management principles may improve worker engagement and reduce functional limitation associated with chronic disorders. In a randomized controlled trial (RCT), workers participating in an employer-sponsored self-management group intervention will be compared with a no-treatment (wait list) control condition. Volunteer employees (n = 300) will be recruited from five participating employers and randomly assigned to intervention or control. Participants in the intervention arm will attend facilitated group workshop sessions at work (10 hours total) to explore methods for improving comfort, adjusting work habits, communicating needs effectively, applying systematic problem solving, and dealing with negative thoughts and emotions about work. Work engagement and work limitation are the principal outcomes. Secondary outcomes include fatigue, job satisfaction, self-efficacy, turnover intention, sickness absence, and health care utilization. Measurements will be taken at baseline, 6-, and 12-month follow-up. A process evaluation will be performed alongside the randomized trial. This study will be most relevant for organizations and occupational settings where some degree of job flexibility, leeway, and decision-making autonomy can be afforded to affected workers. The study design will provide initial assessment of a novel workplace approach and to understand factors affecting its feasibility and effectiveness

  9. The report of Task Group 100 of the AAPM: Application of risk analysis methods to radiation therapy quality management

    Energy Technology Data Exchange (ETDEWEB)

    Huq, M. Saiful, E-mail: HUQS@UPMC.EDU [Department of Radiation Oncology, University of Pittsburgh Cancer Institute and UPMC CancerCenter, Pittsburgh, Pennsylvania 15232 (United States); Fraass, Benedick A. [Department of Radiation Oncology, Cedars-Sinai Medical Center, Los Angeles, California 90048 (United States); Dunscombe, Peter B. [Department of Oncology, University of Calgary, Calgary T2N 1N4 (Canada); Gibbons, John P. [Ochsner Health System, New Orleans, Louisiana 70121 (United States); Ibbott, Geoffrey S. [Department of Radiation Physics, UT MD Anderson Cancer Center, Houston, Texas 77030 (United States); Mundt, Arno J. [Department of Radiation Medicine and Applied Sciences, University of California San Diego, San Diego, California 92093-0843 (United States); Mutic, Sasa [Department of Radiation Oncology, Washington University School of Medicine, St. Louis, Missouri 63110 (United States); Palta, Jatinder R. [Department of Radiation Oncology, Virginia Commonwealth University, P.O. Box 980058, Richmond, Virginia 23298 (United States); Rath, Frank [Department of Engineering Professional Development, University of Wisconsin, Madison, Wisconsin 53706 (United States); Thomadsen, Bruce R. [Department of Medical Physics, University of Wisconsin, Madison, Wisconsin 53705-2275 (United States); Williamson, Jeffrey F. [Department of Radiation Oncology, Virginia Commonwealth University, Richmond, Virginia 23298-0058 (United States); Yorke, Ellen D. [Department of Medical Physics, Memorial Sloan-Kettering Center, New York, New York 10065 (United States)

    2016-07-15

    The increasing complexity of modern radiation therapy planning and delivery challenges traditional prescriptive quality management (QM) methods, such as many of those included in guidelines published by organizations such as the AAPM, ASTRO, ACR, ESTRO, and IAEA. These prescriptive guidelines have traditionally focused on monitoring all aspects of the functional performance of radiotherapy (RT) equipment by comparing parameters against tolerances set at strict but achievable values. Many errors that occur in radiation oncology are not due to failures in devices and software; rather they are failures in workflow and process. A systematic understanding of the likelihood and clinical impact of possible failures throughout a course of radiotherapy is needed to direct limit QM resources efficiently to produce maximum safety and quality of patient care. Task Group 100 of the AAPM has taken a broad view of these issues and has developed a framework for designing QM activities, based on estimates of the probability of identified failures and their clinical outcome through the RT planning and delivery process. The Task Group has chosen a specific radiotherapy process required for “intensity modulated radiation therapy (IMRT)” as a case study. The goal of this work is to apply modern risk-based analysis techniques to this complex RT process in order to demonstrate to the RT community that such techniques may help identify more effective and efficient ways to enhance the safety and quality of our treatment processes. The task group generated by consensus an example quality management program strategy for the IMRT process performed at the institution of one of the authors. This report describes the methodology and nomenclature developed, presents the process maps, FMEAs, fault trees, and QM programs developed, and makes suggestions on how this information could be used in the clinic. The development and implementation of risk-assessment techniques will make radiation

  10. The report of Task Group 100 of the AAPM: Application of risk analysis methods to radiation therapy quality management

    International Nuclear Information System (INIS)

    Huq, M. Saiful; Fraass, Benedick A.; Dunscombe, Peter B.; Gibbons, John P.; Ibbott, Geoffrey S.; Mundt, Arno J.; Mutic, Sasa; Palta, Jatinder R.; Rath, Frank; Thomadsen, Bruce R.; Williamson, Jeffrey F.; Yorke, Ellen D.

    2016-01-01

    The increasing complexity of modern radiation therapy planning and delivery challenges traditional prescriptive quality management (QM) methods, such as many of those included in guidelines published by organizations such as the AAPM, ASTRO, ACR, ESTRO, and IAEA. These prescriptive guidelines have traditionally focused on monitoring all aspects of the functional performance of radiotherapy (RT) equipment by comparing parameters against tolerances set at strict but achievable values. Many errors that occur in radiation oncology are not due to failures in devices and software; rather they are failures in workflow and process. A systematic understanding of the likelihood and clinical impact of possible failures throughout a course of radiotherapy is needed to direct limit QM resources efficiently to produce maximum safety and quality of patient care. Task Group 100 of the AAPM has taken a broad view of these issues and has developed a framework for designing QM activities, based on estimates of the probability of identified failures and their clinical outcome through the RT planning and delivery process. The Task Group has chosen a specific radiotherapy process required for “intensity modulated radiation therapy (IMRT)” as a case study. The goal of this work is to apply modern risk-based analysis techniques to this complex RT process in order to demonstrate to the RT community that such techniques may help identify more effective and efficient ways to enhance the safety and quality of our treatment processes. The task group generated by consensus an example quality management program strategy for the IMRT process performed at the institution of one of the authors. This report describes the methodology and nomenclature developed, presents the process maps, FMEAs, fault trees, and QM programs developed, and makes suggestions on how this information could be used in the clinic. The development and implementation of risk-assessment techniques will make radiation

  11. The report of Task Group 100 of the AAPM: Application of risk analysis methods to radiation therapy quality management

    Science.gov (United States)

    Huq, M. Saiful; Fraass, Benedick A.; Dunscombe, Peter B.; Gibbons, John P.; Mundt, Arno J.; Mutic, Sasa; Palta, Jatinder R.; Rath, Frank; Thomadsen, Bruce R.; Williamson, Jeffrey F.; Yorke, Ellen D.

    2016-01-01

    The increasing complexity of modern radiation therapy planning and delivery challenges traditional prescriptive quality management (QM) methods, such as many of those included in guidelines published by organizations such as the AAPM, ASTRO, ACR, ESTRO, and IAEA. These prescriptive guidelines have traditionally focused on monitoring all aspects of the functional performance of radiotherapy (RT) equipment by comparing parameters against tolerances set at strict but achievable values. Many errors that occur in radiation oncology are not due to failures in devices and software; rather they are failures in workflow and process. A systematic understanding of the likelihood and clinical impact of possible failures throughout a course of radiotherapy is needed to direct limit QM resources efficiently to produce maximum safety and quality of patient care. Task Group 100 of the AAPM has taken a broad view of these issues and has developed a framework for designing QM activities, based on estimates of the probability of identified failures and their clinical outcome through the RT planning and delivery process. The Task Group has chosen a specific radiotherapy process required for “intensity modulated radiation therapy (IMRT)” as a case study. The goal of this work is to apply modern risk-based analysis techniques to this complex RT process in order to demonstrate to the RT community that such techniques may help identify more effective and efficient ways to enhance the safety and quality of our treatment processes. The task group generated by consensus an example quality management program strategy for the IMRT process performed at the institution of one of the authors. This report describes the methodology and nomenclature developed, presents the process maps, FMEAs, fault trees, and QM programs developed, and makes suggestions on how this information could be used in the clinic. The development and implementation of risk-assessment techniques will make radiation

  12. Clinical utility of the Prostate Health Index (phi) for biopsy decision management in a large group urology practice setting.

    Science.gov (United States)

    White, Jay; Shenoy, B Vittal; Tutrone, Ronald F; Karsh, Lawrence I; Saltzstein, Daniel R; Harmon, William J; Broyles, Dennis L; Roddy, Tamra E; Lofaro, Lori R; Paoli, Carly J; Denham, Dwight; Reynolds, Mark A

    2018-04-01

    Deciding when to biopsy a man with non-suspicious DRE findings and tPSA in the 4-10 ng/ml range can be challenging, because two-thirds of such biopsies are typically found to be benign. The Prostate Health Index (phi) exhibits significantly improved diagnostic accuracy for prostate cancer detection when compared to tPSA and %fPSA, however only one published study to date has investigated its impact on biopsy decisions in clinical practice. An IRB approved observational study was conducted at four large urology group practices using a physician reported two-part questionnaire. Physician recommendations were recorded before and after receiving the phi test result. A historical control group was queried from each site's electronic medical records for eligible men who were seen by the same participating urologists prior to the implementation of the phi test in their practice. 506 men receiving a phi test were prospectively enrolled and 683 men were identified for the historical control group (without phi). Biopsy and pathological findings were also recorded for both groups. Men receiving a phi test showed a significant reduction in biopsy procedures performed when compared to the historical control group (36.4% vs. 60.3%, respectively, P phi score impacted the physician's patient management plan in 73% of cases, including biopsy deferrals when the phi score was low, and decisions to perform biopsies when the phi score indicated an intermediate or high probability of prostate cancer (phi ≥36). phi testing significantly impacted the physician's biopsy decision for men with tPSA in the 4-10 ng/ml range and non-suspicious DRE findings. Appropriate utilization of phi resulted in a significant reduction in biopsy procedures performed compared to historical patients seen by the same participating urologists who would have met enrollment eligibility but did not receive a phi test.

  13. A Practical Application Combining Wireless Sensor Networks and Internet of Things: Safety Management System for Tower Crane Groups

    Directory of Open Access Journals (Sweden)

    Dexing Zhong

    2014-07-01

    Full Text Available The so-called Internet of Things (IoT has attracted increasing attention in the field of computer and information science. In this paper, a specific application of IoT, named Safety Management System for Tower Crane Groups (SMS-TC, is proposed for use in the construction industry field. The operating status of each tower crane was detected by a set of customized sensors, including horizontal and vertical position sensors for the trolley, angle sensors for the jib and load, tilt and wind speed sensors for the tower body. The sensor data is collected and processed by the Tower Crane Safety Terminal Equipment (TC-STE installed in the driver’s operating room. Wireless communication between each TC-STE and the Local Monitoring Terminal (LMT at the ground worksite were fulfilled through a Zigbee wireless network. LMT can share the status information of the whole group with each TC-STE, while the LMT records the real-time data and reports it to the Remote Supervision Platform (RSP through General Packet Radio Service (GPRS. Based on the global status data of the whole group, an anti-collision algorithm was executed in each TC-STE to ensure the safety of each tower crane during construction. Remote supervision can be fulfilled using our client software installed on a personal computer (PC or smartphone. SMS-TC could be considered as a promising practical application that combines a Wireless Sensor Network with the Internet of Things.

  14. A Practical Application Combining Wireless Sensor Networks and Internet of Things: Safety Management System for Tower Crane Groups

    Science.gov (United States)

    Zhong, Dexing; Lv, Hongqiang; Han, Jiuqiang; Wei, Quanrui

    2014-01-01

    The so-called Internet of Things (IoT) has attracted increasing attention in the field of computer and information science. In this paper, a specific application of IoT, named Safety Management System for Tower Crane Groups (SMS-TC), is proposed for use in the construction industry field. The operating status of each tower crane was detected by a set of customized sensors, including horizontal and vertical position sensors for the trolley, angle sensors for the jib and load, tilt and wind speed sensors for the tower body. The sensor data is collected and processed by the Tower Crane Safety Terminal Equipment (TC-STE) installed in the driver's operating room. Wireless communication between each TC-STE and the Local Monitoring Terminal (LMT) at the ground worksite were fulfilled through a Zigbee wireless network. LMT can share the status information of the whole group with each TC-STE, while the LMT records the real-time data and reports it to the Remote Supervision Platform (RSP) through General Packet Radio Service (GPRS). Based on the global status data of the whole group, an anti-collision algorithm was executed in each TC-STE to ensure the safety of each tower crane during construction. Remote supervision can be fulfilled using our client software installed on a personal computer (PC) or smartphone. SMS-TC could be considered as a promising practical application that combines a Wireless Sensor Network with the Internet of Things. PMID:25196106

  15. A group-based approach to stabilisation and symptom management in a phased treatment model for refugees and asylum seekers

    Directory of Open Access Journals (Sweden)

    Mary E. A. Robertson

    2013-12-01

    Full Text Available Background: Traumatised asylum seekers and refugees may present with significant and complex mental health problems as a result of prolonged, extreme, and multiple traumatic events. This is further complicated by ongoing complex social circumstances. Concepts: In our work at the Traumatic Stress Clinic (TSC, the understanding afforded by the concept of complex posttraumatic stress disorder (PTSD together with the related notion of a phased treatment model, provides a useful framework for organising our work with this population. Clinical Applications: An explication of complex PTSD as it applies to our client group is presented, followed by a description of our phased treatment model and an outline of the core principles, which guide our clinical approach. Our symptom management and stabilisation groups have been developed and refined over time and draw on techniques from a variety of cognitive behavioural therapies. These are described in some detail with illustrative clinical case vignettes. Conclusion: This paper concludes with some reflections on the challenges inherent to working with this complex client group.

  16. A practical application combining wireless sensor networks and Internet of Things: Safety Management System for Tower Crane Groups.

    Science.gov (United States)

    Zhong, Dexing; Lv, Hongqiang; Han, Jiuqiang; Wei, Quanrui

    2014-07-30

    The so-called Internet of Things (IoT) has attracted increasing attention in the field of computer and information science. In this paper, a specific application of IoT, named Safety Management System for Tower Crane Groups (SMS-TC), is proposed for use in the construction industry field. The operating status of each tower crane was detected by a set of customized sensors, including horizontal and vertical position sensors for the trolley, angle sensors for the jib and load, tilt and wind speed sensors for the tower body. The sensor data is collected and processed by the Tower Crane Safety Terminal Equipment (TC-STE) installed in the driver's operating room. Wireless communication between each TC-STE and the Local Monitoring Terminal (LMT) at the ground worksite were fulfilled through a Zigbee wireless network. LMT can share the status information of the whole group with each TC-STE, while the LMT records the real-time data and reports it to the Remote Supervision Platform (RSP) through General Packet Radio Service (GPRS). Based on the global status data of the whole group, an anti-collision algorithm was executed in each TC-STE to ensure the safety of each tower crane during construction. Remote supervision can be fulfilled using our client software installed on a personal computer (PC) or smartphone. SMS-TC could be considered as a promising practical application that combines a Wireless Sensor Network with the Internet of Things.

  17. An Analysis of a System of Rural Regional Environmental Management Led by ‘a Group of University Students’

    Science.gov (United States)

    Nakajima, Masahiro; Nakamura, Masato; Hiroshige, Yutaka

    This paper aims to analyze the formative processes and the current state of a collaboration between ‘outsiders’ and local residents in a System of Rural Regional Environmental management from the view point of human networks. The system seeks to solve the problem of abandoned farmlands led by a group of university students (outsiders). We chronologically classified a total of eighty-nine activities addressing the issue of abandoned farmlands by utilizing three concepts: ‘calculated devices’ (e.g. the making of relations between a group of university students and local residents and strengthening these relations), ‘assistance/participation’, and ‘voluntary interaction/desire’. Based on this analysis, we: 1) developed an understanding of the formative processes as well as the current state of the collaboration between a group of university students and twenty seven local residents from an individual perspective; 2) identified ten key individuals who played a significant role in the activities examined and revealed their characteristics and motivations; 3) suggest that an existing NPO and informal relations between the local residents played a major role in the formation of collaborative networks; 4) argue that the perceived characteristics of the students (e.g. ‘youthful’, ‘inexperienced’) and the Mori-Mori club (e.g. unstable) contributed to the maintenance and expansion of the collaboration between ‘outsiders’ and local residents.

  18. How are clinical commissioning groups managing conflicts of interest under primary care co-commissioning in England? A qualitative analysis.

    Science.gov (United States)

    Moran, Valerie; Allen, Pauline; McDermott, Imelda; Checkland, Kath; Warwick-Giles, Lynsey; Gore, Oz; Bramwell, Donna; Coleman, Anna

    2017-11-08

    From April 2015, NHS England (NHSE) started to devolve responsibility for commissioning primary care services to clinical commissioning groups (CCGs). The aim of this paper is to explore how CCGs are managing potential conflicts of interest associated with groups of GPs commissioning themselves or their practices to provide services. We carried out two telephone surveys using a sample of CCGs. We also used a qualitative case study approach and collected data using interviews and meeting observations in four sites (CCGs). We conducted 57 telephone interviews and 42 face-to-face interviews with general practitioners (GPs) and CCG staff involved in primary care co-commissioning and observed 74 meetings of CCG committees responsible for primary care co-commissioning. Conflicts of interest were seen as an inevitable consequence of CCGs commissioning primary care. Particular problems arose with obtaining unbiased clinical input for new incentive schemes and providing support to GP provider federations. Participants in meetings concerning primary care co-commissioning declared conflicts of interest at the outset of meetings. Different approaches were pursued regarding GPs involvement in subsequent discussions and decisions with inconsistency in the exclusion of GPs from meetings. CCG senior management felt confident that the new governance structures and policies dealt adequately with conflicts of interest, but we found these arrangements face limitations. While the revised NHSE statutory guidance on managing conflicts of interest (2016) was seen as an improvement on the original (2014), there still remained some confusion over various terms and concepts contained therein. Devolving responsibility for primary care co-commissioning to CCGs created a structural conflict of interest. The NHSE statutory guidance should be refined and clarified so that CCGs can properly manage conflicts of interest. Non-clinician members of committees involved in commissioning primary care

  19. Management of operational safety in nuclear power plants. INSAG-13. A report by the International Nuclear Safety Advisory Group

    International Nuclear Information System (INIS)

    1999-01-01

    The International Atomic Energy Agency's activities relating to nuclear safety are based upon a number of premises. First and foremost, each Member State bears full responsibility for the safety of its nuclear facilities. States can be advised, but they cannot be relieved of this responsibility. Secondly, much can be gained by exchanging experience; lessons learned can prevent accidents. Finally, the image of nuclear safety is international; a serious accident anywhere affects the public's view of nuclear power everywhere. With the intention of strengthening its contribution to ensuring the safety of nuclear power plants, the IAEA established the International Nuclear Safety Advisory Group (INSAG), whose duties include serving as a forum for the exchange of information on nuclear safety issues of international significance and formulating, where possible, commonly shared safety principles. Engineering issues have received close attention from the nuclear community over many years. However, it is only in the last decade or so that organizational and cultural issues have been identified as vital to achieving safe operation. INSAG's publication No. 4 has been widely recognized as a milestone in advancing thinking about safety culture in the nuclear community and more widely. The present report deals with the framework for safety management that is necessary in organizations in order to promote safety culture. It deals with the general principles underlying the management of operational safety in a systematic way and provides guidance on good practices. It also draws on the results of audits and reviews to highlight how shortfalls in safety management have led to incidents at nuclear power plants. In addition, several specific issues are raised which are particularly topical in view of organizational changes that are taking place in the nuclear industry in various countries. Advice is given on how safety can be managed during organizational change, how safety

  20. Development of Quality Management System Under ISO 9001:2015 and Joint Inspection Group (JIG for Aviation Fuelling Service

    Directory of Open Access Journals (Sweden)

    Ruamchat Kanon

    2017-09-01

    Full Text Available The Joint Inspection Group (JIG standard for aviation fuel quality management assists in the operational process and maintenance of aviation fuel from its point of origin and through distribution systems to airports. Currently, problems arise as the JIG standard and quality management in aviation fuel are isolated and have independent procedures. Merging the JIG standards with ISO 9001:2015 can override original JIG’s philosophy by connecting all quality assessment, and management parties involved, throughout the supply chain. This integration can harmonize auditing tasks, focusing on risk/opportunity, and continue quality improvement focus. This paper proposes a development of quality management system (QMS under ISO 9001:2015 for aviation fuelling service in a systematic way. The content and critical success factors of ISO 9001:2015 and JIG standards were studied. The beneficial synergies, similarities, and logical linkages between both standards are identified. This QMS was developed in the largest petroleum company in Thailand and 60 selected experts were surveyed, with a response rate of 88.3%, for their agreement on integrated criteria. Two external quality auditors, who have ISO 9001 and JIG expertise, were interviewed to modify our initial proposed QMS. The final QMS was implemented in the into-plane fuelling services as the first phase of this implementation. Results of framework implementation are discussed in a case study. There are mutual benefits resulting from the integration of JIG and ISO 9001:2015 standards. This QMS provides a unified process for quality management practices, and enhances the effectiveness of risk evaluation as well as the opportunity for continued quality improvement. It facilitates the identification of ISO 9001:2015 requirements and establishes relationships between the roles of JIG standard and the clauses of ISO 9001:2015. The first experience from five airports as the pilot study of proposed QMS