WorldWideScience

Sample records for incident management techniques

  1. The Critical Incident Technique in Library and Information Management Research.

    Science.gov (United States)

    Fisher, Shelagh; Oulton, Tony

    1999-01-01

    Focuses on the application of the Critical Incident Technique (CIT) in three studies at the Department of Information and Communications, Manchester Metropolitan University, United Kingdom. Examines staff-development needs as a key element in change in higher education; decision-making practices in small- to medium-size libraries; and development…

  2. Using the Critical Incident Technique for Triangulation and Elaboration of Communication Management Competencies

    Science.gov (United States)

    Brunton, Margaret Ann; Jeffrey, Lynn Maud

    2010-01-01

    This paper presents the findings from research using the critical incident technique to identify the use of key competencies for communication management practitioners. Qualitative data was generated from 202 critical incidents reported by 710 respondents. We also present a brief summary of the quantitative data, which identified two superordinate…

  3. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chirag [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States); Vicini, Frank A., E-mail: fvicini@beaumont.edu [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, MI (United States)

    2011-11-15

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer-related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2-65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  4. Breast Cancer-Related Arm Lymphedema: Incidence Rates, Diagnostic Techniques, Optimal Management and Risk Reduction Strategies

    International Nuclear Information System (INIS)

    Shah, Chirag; Vicini, Frank A.

    2011-01-01

    As more women survive breast cancer, long-term toxicities affecting their quality of life, such as lymphedema (LE) of the arm, gain importance. Although numerous studies have attempted to determine incidence rates, identify optimal diagnostic tests, enumerate efficacious treatment strategies and outline risk reduction guidelines for breast cancer–related lymphedema (BCRL), few groups have consistently agreed on any of these issues. As a result, standardized recommendations are still lacking. This review will summarize the latest data addressing all of these concerns in order to provide patients and health care providers with optimal, contemporary recommendations. Published incidence rates for BCRL vary substantially with a range of 2–65% based on surgical technique, axillary sampling method, radiation therapy fields treated, and the use of chemotherapy. Newer clinical assessment tools can potentially identify BCRL in patients with subclinical disease with prospective data suggesting that early diagnosis and management with noninvasive therapy can lead to excellent outcomes. Multiple therapies exist with treatments defined by the severity of BCRL present. Currently, the standard of care for BCRL in patients with significant LE is complex decongestive physiotherapy (CDP). Contemporary data also suggest that a multidisciplinary approach to the management of BCRL should begin prior to definitive treatment for breast cancer employing patient-specific surgical, radiation therapy, and chemotherapy paradigms that limit risks. Further, prospective clinical assessments before and after treatment should be employed to diagnose subclinical disease. In those patients who require aggressive locoregional management, prophylactic therapies and the use of CDP can help reduce the long-term sequelae of BCRL.

  5. Incident Information Management Tool

    CERN Document Server

    Pejovic, Vladimir

    2015-01-01

    Flaws of\tcurrent incident information management at CMS and CERN\tare discussed. A new data\tmodel for future incident database is\tproposed and briefly described. Recently developed draft version of GIS-­‐based tool for incident tracking is presented.

  6. Traffic incident management resource management.

    Science.gov (United States)

    2009-01-01

    The necessity of a multi-disciplinary approach involving law enforcement, fire and rescue, transportation, towing and recovery, and others has been well-recognized and integrated into incident management operations. This same multidisciplinar...

  7. Bladder neck contracture-incidence and management following contemporary robot assisted radical prostatectomy technique

    Directory of Open Access Journals (Sweden)

    Jaspreet Singh Parihar

    2014-03-01

    Conclusions: BNC was identified in 1.6% of patients in our series following RARP. Intraoperative blood loss was a significant risk factor for BNC. In 20% of BNC patients a migrated foreign body was noted at vesicourethral anastomosis. Primary management of patients with BNC following RARP should be bladder neck incision and self CIC regimen.

  8. Incident Management: Process into Practice

    Science.gov (United States)

    Isaac, Gayle; Moore, Brian

    2011-01-01

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

  9. Improving freight crash incident management.

    Science.gov (United States)

    2015-06-01

    The objective of this study was to determine the most effective way to mitigate the effect of freight : crash incidents on Louisiana freeways. Candidate incident management strategies were reviewed from : practice in other states and from those publi...

  10. Information sharing for traffic incident management.

    Science.gov (United States)

    2009-01-01

    Traffic incident management focuses on developing procedures, implementing policies, and deploying technologies to more quickly identify incidents, improve response times, and more effectively and efficiently manage the incident scene. Because so man...

  11. The critical incident technique reappraised: using critical incidents to illuminate organizational practices and build theory

    OpenAIRE

    Bott, Gregory; Tourish, Dennis

    2016-01-01

    Purpose: The purpose of this paper is to offer a reconceptualization of the critical incident technique (CIT) and affirm its utility in management and organization studies.\\ud \\ud Design/methodology/approach: Utilizing a case study from a leadership context, the paper applies the CIT to explore various leadership behaviours in the context of nonprofit boards in Canada. Semi-structured critical incident interviews were used to collect behavioural data from 53 participants – board chairs, board...

  12. Incident Management in Academic Information System using ITIL Framework

    Science.gov (United States)

    Palilingan, V. R.; Batmetan, J. R.

    2018-02-01

    Incident management is very important in order to ensure the continuity of a system. Information systems require incident management to ensure information systems can provide maximum service according to the service provided. Many of the problems that arise in academic information systems come from incidents that are not properly handled. The objective of this study aims to find the appropriate way of incident management. The incident can be managed so it will not be a big problem. This research uses the ITIL framework to solve incident problems. The technique used in this study is a technique adopted and developed from the service operations section of the ITIL framework. The results of this research found that 84.5% of incidents appearing in academic information systems can be handled quickly and appropriately. 15.5% incidents can be escalated so as to not cause any new problems. The model of incident management applied to make academic information system can run quickly in providing academic service in a good and efficient. The incident management model implemented in this research is able to manage resources appropriately so as to quickly and easily manage incidents.

  13. Melanoma in Organ Transplant Recipients: Incidence, Outcomes and Management Considerations

    Directory of Open Access Journals (Sweden)

    Faisal R. Ali

    2012-01-01

    Full Text Available The incidence of melanoma continues to increase year on year. With better surgical techniques and medical management, greater numbers of organ transplants are being performed annually with much longer graft survival. The authors review our current understanding of the incidence of melanoma amongst organ transplant recipients, outcomes compared to the immunocompetent population, and management strategies in this burgeoning group.

  14. 49 CFR 1542.307 - Incident management.

    Science.gov (United States)

    2010-10-01

    ... 49 Transportation 9 2010-10-01 2010-10-01 false Incident management. 1542.307 Section 1542.307 Transportation Other Regulations Relating to Transportation (Continued) TRANSPORTATION SECURITY ADMINISTRATION... Incident management. (a) Each airport operator must establish procedures to evaluate bomb threats, threats...

  15. Management of science technique

    International Nuclear Information System (INIS)

    Bae, Byeong Han; Lee, Gap Du

    2002-08-01

    This book mentions change of environment and management of technique, business environment in information age technology and management such as classification of technology, innovation of technology and meaning of technology management, item innovation and technology about meaning of item development, innovation and item development, creation of item concept and item development, process of product innovation, product activity, product innovation product innovation and technology, development of product innovation, technology and marketing innovation, innovation of skill of marketing information system and globalization.

  16. Stargate: Energy Management Techniques

    OpenAIRE

    Vijay Raghunathan; Mani Srivastava; Trevor Pering; Roy Want

    2004-01-01

    This poster presents techniques for energy efficient operation of the Stargate wireless platform. In addition to conventional power management techniques such as dynamic voltage and scaling and processor shutdown, the Stargate features several mechanisms for energy efficient operation of the communication subsystem, such as support for hierarchical radios, Bluetooth based remote wakeup, mote based wakeup, etc. Finally, design optimizations including the use of power gating, and provision for ...

  17. Project Management Techniques

    OpenAIRE

    Mihalache Anita; Salagean Liana

    2010-01-01

    Project management is a technique that can aid in the planning, scheduling, and monitoring of complex projects characterized by numerous, non repetitive jobs called activities. Examples of projects that would use project management include: - developing a mass rapid – transit system for a metropolitan area; - organizing the relocation of a corporate headquarters; - planning the production of a concert, film, or play; - developing and marketing a new automobile; - constructing a high – rise of...

  18. Kentucky's highway incident management strategic plan.

    Science.gov (United States)

    2005-06-01

    Kentucky s Highway Incident Management Strategic Plan consists of a mission statement, 4 goals, 16 objectives, and 49 action strategies. The action strategies are arranged by priority and recommended time frame for implementation. When implemented...

  19. Integrating incident investigation into the management system

    International Nuclear Information System (INIS)

    Peterson, E.E.

    1992-01-01

    In the last 10 yr, the size and frequency of incidents affecting the communities and environment surrounding chemical processing facilities has increased. The chemical process industry, which has always concerned itself with the safety of its facilities, has responded by committing to stricter standards of operation and management. A critical element of these management practices is the use of a structured incident investigation program. Many facilities have implemented and disciplined themselves to perform good investigation of incidents. However, most of these facilities maintain incident investigation as part of their safety management programs. This allows the process to be disconnected from the management system that deals with the day-to-day business of the facility. The first step of integration is understanding the objectives and functions of the management system into which the integration is to occur. To begin, a common definition of management is needed. Management, for the purposes of this discussion, is defined as the system of activities used to control, coordinate, and improve the flow of work within a facility or organization. This definition refers to several concepts that need further development in order to understand how incident investigation can be integrated into a management system, including (a) flow of work, (b) control, and (c) improvement. Application can be made to the nuclear industry

  20. SU-C-BRD-05: Implementation of Incident Learning in the Safety and Quality Management of Radiotherapy: The Primary Experience in a New Established Program with Advanced Techniques

    Energy Technology Data Exchange (ETDEWEB)

    Yang, R; Wang, J [Peking University Third Hospital, Beijing, Beijing (China)

    2014-06-15

    Purpose: To explore the implementation and effectiveness of incident learning for the safety and quality of radiotherapy in a new established radiotherapy program with advanced technology. Methods: Reference to the consensus recommendations by American Association of Physicist in Medicine, an incident learning system was specifically designed for reporting, investigating, and learning of individual radiotherapy incidents in a new established radiotherapy program, with 4D CBCT, Ultrasound guided radiotherapy, VMAT, gated treatment delivered on two new installed linacs. The incidents occurring in external beam radiotherapy from February, 2012 to January, 2014 were reported. Results: A total of 33 reports were analyzed, including 28 near misses and 5 incidents. Among them, 5 originated in imaging for planning, 25 in planning, 1 in plan transfer, 1 in commissioning and 1 in treatment delivery. Among them, three near misses originated in the safety barrier of the radiotherapy process. In terms of error type, 1 incident was classified as wrong patient, 7 near misses/incidents as wrong site, 6 as wrong laterality, 5 as wrong dose, 7 as wrong prescription, and 7 as suboptimal plan quality. 5 incidents were all classified as grade 1/2 of dosimetric severity, 1 as grade 0, and the other 4 as grade 1 of medical severity. For the causes/contributory factors, negligence, policy not followed, inadequate training, failure to develop an effective plan, and communication contributed to 19, 15, 12, 5 and 3 near misses/incidents, respectively. The average incident rate per 100 patients treated was 0.4; this rate fell to 0.28% in the second year from 0.56% in the first year. The rate of near miss fell to 1.24% from 2.22%. Conclusion: Effective incident learning can reduce the occurrence of near miss/incidents, enhance the culture of safety. Incident learning is an effective proactive method for improving the quality and safety of radiotherapy.

  1. SU-C-BRD-05: Implementation of Incident Learning in the Safety and Quality Management of Radiotherapy: The Primary Experience in a New Established Program with Advanced Techniques

    International Nuclear Information System (INIS)

    Yang, R; Wang, J

    2014-01-01

    Purpose: To explore the implementation and effectiveness of incident learning for the safety and quality of radiotherapy in a new established radiotherapy program with advanced technology. Methods: Reference to the consensus recommendations by American Association of Physicist in Medicine, an incident learning system was specifically designed for reporting, investigating, and learning of individual radiotherapy incidents in a new established radiotherapy program, with 4D CBCT, Ultrasound guided radiotherapy, VMAT, gated treatment delivered on two new installed linacs. The incidents occurring in external beam radiotherapy from February, 2012 to January, 2014 were reported. Results: A total of 33 reports were analyzed, including 28 near misses and 5 incidents. Among them, 5 originated in imaging for planning, 25 in planning, 1 in plan transfer, 1 in commissioning and 1 in treatment delivery. Among them, three near misses originated in the safety barrier of the radiotherapy process. In terms of error type, 1 incident was classified as wrong patient, 7 near misses/incidents as wrong site, 6 as wrong laterality, 5 as wrong dose, 7 as wrong prescription, and 7 as suboptimal plan quality. 5 incidents were all classified as grade 1/2 of dosimetric severity, 1 as grade 0, and the other 4 as grade 1 of medical severity. For the causes/contributory factors, negligence, policy not followed, inadequate training, failure to develop an effective plan, and communication contributed to 19, 15, 12, 5 and 3 near misses/incidents, respectively. The average incident rate per 100 patients treated was 0.4; this rate fell to 0.28% in the second year from 0.56% in the first year. The rate of near miss fell to 1.24% from 2.22%. Conclusion: Effective incident learning can reduce the occurrence of near miss/incidents, enhance the culture of safety. Incident learning is an effective proactive method for improving the quality and safety of radiotherapy

  2. Incident Management Organization succession planning stakeholder feedback

    Science.gov (United States)

    Anne E. Black

    2013-01-01

    This report presents complete results of a 2011 stakeholder feedback effort conducted for the National Wildfire Coordination Group (NWCG) Executive Board concerning how best to organize and manage national wildland fire Incident Management Teams in the future to meet the needs of the public, agencies, fire service and Team members. Feedback was collected from 858...

  3. IT Security Vulnerability and Incident Response Management

    NARCIS (Netherlands)

    Hafkamp, W.H.M.; Paulus, S.; Pohlman, N.; Reimer, H.

    2006-01-01

    This paper summarises the results of a Dutch PhD research project on IT security vulnerability and incident response management, which is supervised by the University of Twente in the Netherlands and which is currently in its final stage. Vulnerabilities are ‘failures or weaknesses in computer

  4. Evaluating and improving incident management using historical incident data : case studies at Texas transportation management centers.

    Science.gov (United States)

    2009-08-01

    The companion guidebook (0-5485-P2) developed as part of this study provides the procedures and : methodologies for effective use of historical incident data at Texas Transportation Management Centers : (TMCs). This research report documents the resu...

  5. Managing Materials and Wastes for Homeland Security Incidents

    Science.gov (United States)

    To provide information on waste management planning and preparedness before a homeland security incident, including preparing for the large amounts of waste that would need to be managed when an incident occurs, such as a large-scale natural disaster.

  6. Asset management techniques

    Energy Technology Data Exchange (ETDEWEB)

    Schneider, Joachim; Gaul, Armin J. [RWE Energy AG, Assetmanagement, Dortmund (Germany); Neumann, Claus [RWE Transportnetz Strom GmbH, Dortmund (Germany); Hograefer, Juergen [SAG Energieversorgungsloesungen GmbH, Langen (Germany); Wellssow, Wolfram; Schwan, Michael [Siemens AG, Power Transmission and Distribution, Erlangen (Germany); Schnettler, Armin [RWTH-Aachen, Institut fuer Hochspannungstechnik, Aachen (Germany)

    2006-11-15

    Deregulation and an increasing competition in electricity markets urge energy suppliers to optimize the utilization of their equipment, focusing on technical and cost-effective aspects. As a respond to these requirements utilities introduce methods formerly used by investment managers or insurance companies. The article describes the usage of these methods, particularly with regard to asset management and risk management within electrical grids. The essential information needed to set up an appropriate asset management system and differences between asset management systems in transmission and distribution systems are discussed. The bulk of costs in electrical grids can be found in costs for maintenance and capital depreciation. A comprehensive approach for an asset management in transmission systems thus focuses on the 'life-cycle costs' of the individual equipment. The objective of the life management process is the optimal utilisation of the remaining life time regarding a given reliability of service and a constant distribution of costs for reinvestment and maintenance ensuring a suitable return. In distribution systems the high number of components would require an enormous effort for the consideration of single individuals. Therefore statistical approaches have been used successfully in practical applications. Newest insights gained by a German research project on asset management systems in distribution grids give an outlook to future developments. (author)

  7. Asset management techniques

    International Nuclear Information System (INIS)

    Schneider, Joachim; Gaul, Armin J.; Neumann, Claus; Hograefer, Juergen; Wellssow, Wolfram; Schwan, Michael; Schnettler, Armin

    2006-01-01

    Deregulation and an increasing competition in electricity markets urge energy suppliers to optimize the utilization of their equipment, focusing on technical and cost-effective aspects. As a respond to these requirements utilities introduce methods formerly used by investment managers or insurance companies. The article describes the usage of these methods, particularly with regard to asset management and risk management within electrical grids. The essential information needed to set up an appropriate asset management system and differences between asset management systems in transmission and distribution systems are discussed. The bulk of costs in electrical grids can be found in costs for maintenance and capital depreciation. A comprehensive approach for an asset management in transmission systems thus focuses on the 'life-cycle costs' of the individual equipment. The objective of the life management process is the optimal utilisation of the remaining life time regarding a given reliability of service and a constant distribution of costs for reinvestment and maintenance ensuring a suitable return. In distribution systems the high number of components would require an enormous effort for the consideration of single individuals. Therefore statistical approaches have been used successfully in practical applications. Newest insights gained by a German research project on asset management systems in distribution grids give an outlook to future developments. (author)

  8. Resources planning for radiological incidents management

    Science.gov (United States)

    Hamid, Amy Hamijah binti Ab.; Rozan, Mohd Zaidi Abd; Ibrahim, Roliana; Deris, Safaai; Yunus, Muhd. Noor Muhd.

    2017-01-01

    Disastrous radiation and nuclear meltdown require an intricate scale of emergency health and social care capacity planning framework. In Malaysia, multiple agencies are responsible for implementing radiological and nuclear safety and security. This research project focused on the Radiological Trauma Triage (RTT) System. This system applies patient's classification based on their injury and level of radiation sickness. This classification prioritizes on the diagnostic and treatment of the casualties which include resources estimation of the medical delivery system supply and demand. Also, this system consists of the leading rescue agency organization and disaster coordinator, as well as the technical support and radiological medical response teams. This research implemented and developed the resources planning simulator for radiological incidents management. The objective of the simulator is to assist the authorities in planning their resources while managing the radiological incidents within the Internal Treatment Area (ITA), Reception Area Treatment (RAT) and Hospital Care Treatment (HCT) phases. The majority (75%) of the stakeholders and experts, who had been interviewed, witnessed and accepted that the simulator would be effective to resolve various types of disaster and resources management issues.

  9. Evaluating internal public relations using the critical incident technique

    NARCIS (Netherlands)

    Koning, K.H.; de Jong, Menno D.T.; van Vuuren, Hubrecht A.

    2015-01-01

    Although the critical incident technique (CIT) is one of the current methods in communication audits, little is known about the way it works. The validity of the CIT in the context of internal public relations depends on 3 assumptions: that participants can describe discrete communication events,

  10. Entrepreneurial behavior : New perspectives gained through the critical incident technique

    NARCIS (Netherlands)

    Nandram, S.S.; Samsom, K.J.

    2007-01-01

    Responding to criticism of the trait approach in studying entrepreneurship, a process and context oriented methodology was applied using the Critical Incident Technique (CIT) in predicting success and failure. The actions of entrepreneurs were subsequently translated into (1) dynamic traits with a

  11. Computer incident response and forensics team management conducting a successful incident response

    CERN Document Server

    Johnson, Leighton

    2013-01-01

    Computer Incident Response and Forensics Team Management provides security professionals with a complete handbook of computer incident response from the perspective of forensics team management. This unique approach teaches readers the concepts and principles they need to conduct a successful incident response investigation, ensuring that proven policies and procedures are established and followed by all team members. Leighton R. Johnson III describes the processes within an incident response event and shows the crucial importance of skillful forensics team management, including when and where the transition to forensics investigation should occur during an incident response event. The book also provides discussions of key incident response components. Provides readers with a complete handbook on computer incident response from the perspective of forensics team management Identify the key steps to completing a successful computer incident response investigation Defines the qualities necessary to become a succ...

  12. Consequences attributed to kidney transplantation: critical incident technique

    OpenAIRE

    Santos,Bianca Pozza dos; Schwartz,Eda; Beuter,Margrid; Muniz,Rosani Manfrin; Echevarría-Guanilo,Maria Elena; Viegas,Aline da Costa

    2015-01-01

    This study aimed to describe the consequences experienced in the life of a person with kidney transplantation. This is a descriptive and qualitative approach, using the Critical Incident Technique, in which the interview content was analyzed, in an attempt to isolate the consequences of the kidney transplantation, showing positive and/or negative references. When confronted with what kidney transplantation provided to people's life, the independence from the hemodialysis machine, the existenc...

  13. The critical incident technique in dental research: A review

    Directory of Open Access Journals (Sweden)

    Binu Santha

    2016-01-01

    Full Text Available Research is a scientific quest to find answers to certain questions. It makes us think with curiosity and wonderment about how to make something better. Research contributes in a major way to the development and maintenance of health and health care systems. Qualitative research is concerned with qualitative phenomena and includes subjective assessment of attitudes, opinions, and behavior. It is especially important in the behavioral sciences where the aim is to discover the underlying motives of human behavior. The critical incident technique (CIT is a well-established qualitative research tool used in many areas of health sciences including nursing, medicine, dentistry, and their respective education systems. This technique is described as consisting of “a set of procedures for collecting direct observations of human behavior in such a way as to facilitate their potential usefulness in solving practical problems.” This review gives a gist of CIT and its application in different aspects of dental research.

  14. Sequelae of Endoscopic Inguinal Hernia Repair : Incidence, evaluation and management

    NARCIS (Netherlands)

    Burgmans, J.P.J.

    2015-01-01

    The endoscopic preperitoneal technique (TEP) is an appealing inguinal hernia repair technique, theoretically superior to other approaches. In practice some problems remain unsolved. Real incidences of chronic postoperative inguinal pain (CPIP) and other important sequelae of endoscopic hernia repair

  15. CRITICAL INCIDENTS AND CRITICAL INCIDENT STRESS MANAGEMENT (CISM – AN EMPLOYEE ASSISTANCE PROGRAMME (EAP PERSPECTIVE

    Directory of Open Access Journals (Sweden)

    Terblanche, Lourie

    2014-04-01

    Full Text Available Employees are increasingly becoming victims of critical incidents. From a systems theory point of view, it is necessary to acknowledge the impact of critical incidents not only on the personal life of the employee, but on the workplace itself. Employees respond differently to critical incidents, which makes it even more complicated when this reaches the point of requiring therapeutic intervention. The most common response to critical incidents may be the risk of developing post-traumatic stress disorder (PTSD and/or depression. This reality requires management – through the Employee Assistance Programme (EAP – to be able to effectively deal with such critical incidents.

  16. Development of Kentucky's highway incident management strategic plan.

    Science.gov (United States)

    2005-05-01

    ven though Kentucky has undertaken many initiatives to improve specific aspects of incident management, there has never been a plan that establishes an overall framework for a systematic, statewide, multi-agency effort to improve the management of hi...

  17. [Patient satisfaction in hospital: critical incident technique or standardised questionnaire?].

    Science.gov (United States)

    Eckhardt-Abdulla, R; Bock, M; Bauer, M

    2008-03-01

    Questionnaires are usually used for the measurement of patient satisfaction, however, it is increasingly being recognized that the critical incident technique (CIT) also provides valuable insight. Questionnaires of the "Hamburger questionnaire on hospital stay" were distributed to 650 consecutive patients before discharge. Additionally 103 interviews were conducted in which the patients were asked to describe positive and negative incidents during their hospital stay. The results of both methods were then compared. A total of 369 patients returned the questionnaire and 103 patients participated in the interviews. The duration of a single interview was between 5 and 45 min with a mean of 12.7 min+/-10.1 min standard deviation (SD). Cronbach's alpha of the questionnaire was 0.9. A total of 424 incidents were reported, 301 of them were negative compared to 123 positive events. The questionnaires and interviews yielded partly similar and partly different results at category and subcategory levels concerning the areas of weaknesses and strengths in quality performance. The CIT was more concrete but did not give results for all aspects of quality. The CIT, but not the questionnaire, was able to detect 40/56 (71%) of the positive and 33/75 (44%) of the negative reports regarding medical performance and 25/42 (60%) of the positive and 15/51 (29.4%) of the negative reports of the performance of the nurses were revealed by the CIT and not by the questionnaires. The CIT gives valuable insights into the patient's perspective of strengths and weaknesses in hospital care, which might be overlooked by the questionnaire alone. However, the CIT is probably not suited for routine use because it is very time-consuming.

  18. Sports Related Injuries: Incidence, Management and Prevention

    OpenAIRE

    Stanger, Michael A.

    1982-01-01

    The incidence of injury related to various sports is reviewed according to sport, area of injury, number of participants and hours per week spent at the sport. Organized sports accounted for fewer injuries than unsupervised recreational activities like tree climbing, skateboarding and running. The knee is the most commonly injured site. Sensitivity to patients' commitment to their sport is necessary: sometimes instead of rest, they can substitute a less hazardous form of exercise. Principles ...

  19. Safer travel, improved economic productivity : incident management systems

    Science.gov (United States)

    1999-01-01

    This brochure gives an overview of how incident management technologies can be used to reduce incident-related congestion and increase road safety. It focuses on the need for interagency cooperation and the benefits that can be derived from the coope...

  20. Simulating traffic for incident management and ITS investment decisions

    Science.gov (United States)

    1998-08-01

    UTPS-type models were designed to adequately support planning activities typical of the 1960s and 1970s. However, these packages were not designed to model intelligent transportation systems (ITS) and support incident management planning. To ov...

  1. Defining Incident Management Processes for CSIRTs: A Work in Progress

    National Research Council Canada - National Science Library

    Alberts, Chris; Dorofee, Audrey; Killcrece, Georgia; Ruefle, Robin; Zajicek, Mark

    2004-01-01

    .... Workflow diagrams and descriptions are provided for each of these processes. One advantage of the model is that it enables examination of incident management processes that cross organizational boundaries, both internally and externally...

  2. Congenital clinical malaria: Incidence, management and outcome ...

    African Journals Online (AJOL)

    Objective: With paucity of documentation of congenital clinical malaria in the world literature, we therefore aimed to review its rates, presentation, management and out come of this problem in neonates at the Usmanu Danfodiyo University Teaching Hospital, Sokoto. Methodology: This prospective study was carried out in ...

  3. Asset management techniques for transformers

    International Nuclear Information System (INIS)

    Abu-Elanien, Ahmed E.B.; Salama, M.M.A.

    2010-01-01

    In a deregulated/reformed environment, the electric utilities are under constant pressure for reducing operating costs, enhancing the reliability of transmission and distribution equipments, and improving quality of power and services to the customer. Moreover, the risk involved in running the system without proper attention to assets integrity in service is quite high. Additionally, the probability of losing any equipment vital to the transmission and distribution system, such as power and distribution transformers, is increasing especially with the aging of power system's assets. Today the focus of operating the power system is changed and efforts are being directed to explore new approaches/techniques of monitoring, diagnosis, condition evaluation, maintenance, life assessment, and possibility of extending the life of existing assets. In this paper, a comprehensive illustration of the transformer asset management activities is presented. The importance of each activity together with the latest researches done in the area is highlighted. (author)

  4. An isodose shift technique for obliquely incident electron beams

    International Nuclear Information System (INIS)

    Ulin, K.; Sternick, E.S.

    1989-01-01

    It is well known that when an electron beam is incident obliquely on the surface of a phantom, the depth dose curve measured normal to the surface is shifted toward the surface. Based on geometrical arguments alone, the depth of the nth isodose line for an electron beam incident at an angle θ should be equal to the product of cos θ and the depth of the nth isodose line at normal incidence. This method, however, ignores the effects of scatter and can lead to significant errors in isodose placement for beams at large angles of incidence. A semi-empirical functional relationship and a table of isodose shift factors have been developed with which one may easily calculate the depth of any isodose line for beams at incident angles of 0 degree to 60 degree. The isodose shift factors are tabulated in terms of beam energy (6--22 MeV) and isodose line (10%--90%) and are shown to be relatively independent of beam size and incident angle for angles <60 degree. Extensive measurements have been made on a Varian Clinac 2500 linear accelerator with a parallel-plate chamber and polystyrene phantom. The dependence of the chamber response on beam angulation has been checked, and the scaling factor of the polystyrene phantom has been determined to be equal to 1.00

  5. Management Styles and Techniques: Time.

    Science.gov (United States)

    Matthews, Priscilla J.

    1987-01-01

    Discusses strategies to improve individuals' use of time and personal satisfaction through time management. The 126-item bibliography includes citations for time management in general and special sections for career development, family and parenting, women, and home management. (CLB)

  6. The management of radiation treatment error through incident learning

    International Nuclear Information System (INIS)

    Clark, Brenda G.; Brown, Robert J.; Ploquin, Jodi L.; Kind, Anneke L.; Grimard, Laval

    2010-01-01

    Purpose: To assess efficacy of an incident learning system in the management of error in radiation treatment. Materials and methods: We report an incident learning system implementation customized for radiation therapy where any 'unwanted or unexpected change from normal system behaviour that causes or has the potential to cause an adverse effect to persons or equipment' is reported, investigated and learned from. This system thus captures near-miss (potential) and actual events. Incidents are categorized according to severity, type and origin. Results: Our analysis spans a period of 3 years with an average accrual of 11.6 incidents per week. We found a significant reduction in actual incidents of 28% and 47% in the second and third year when compared to the first year (p < 0.001), which we attribute to the many interventions prompted by the analysis of incidents reported. We also saw a similar significant reduction in incidents generated at the treatment unit correlating with the introduction of direct treatment parameter transfer and electronic imaging (p < 0.001). Conclusions: Implementation of an incident learning system has helped us to establish a just environment where all staff members report deviations from normal system behaviour and thus generate evidence to initiate safety improvements.

  7. Incidence and management of chyle leakage after esophagectomy

    NARCIS (Netherlands)

    Lagarde, Sjoerd M.; Omloo, Jikke M. T.; de Jong, Koen; Busch, Olivier R. C.; Obertop, Hugo; van Lanschot, J. Jan B.

    2005-01-01

    BACKGROUND: Postoperative chyle leakage is a rare but well-recognized complication after esophageal surgery. The aim of this study was to identify its incidence and potentially predisposing factors and to assess the consequences and management. METHODS: A consecutive series of 536 patients who

  8. Determinants of Peritoneal Dialysis Technique Failure in Incident US Patients

    OpenAIRE

    Shen, Jenny I.; Mitani, Aya A.; Saxena, Anjali B.; Goldstein, Benjamin A.; Winkelmayer, Wolfgang C.

    2013-01-01

    ♦ Objectives: Switching from peritoneal dialysis (PD) to hemodialysis (HD) is undesirable, because of complications from temporary vascular access, disruption of daily routine, and higher costs. Little is known about the role that social factors play in technique failure.

  9. Techniques for Improving Cash Management.

    Science.gov (United States)

    Lykins, Ronald G.

    1973-01-01

    This article deals with several techniques for regulating cash inflow and outflow and investing surplus cash for short periods of time. The techniques are: (1) consolidating checking accounts, (2) determining surplus cash by examining bank balances in conjunction with the cash book, (3) selecting a minimum bank balance, (4) investing a greater…

  10. Safety Incident Management Team Report for NIMLT Case 50796

    LENUS (Irish Health Repository)

    2017-01-17

    This is a report on the management of a patient safety incident involving BowelScreen and symptomatic colonoscopy services at Wexford General Hospital (WGH). The patient safety incident relates to the work of a Consultant Endoscopist (referred to as Clinician Y) employed by WGH who undertook screening colonoscopies on behalf of the BowelScreen Programme since the commencement of the screening programme in WGH in March 2013. Clinician Y also performed non-screening colonoscopies for the diagnosis of symptomatic patients as part of routine surgical service provision at WGH.\\r\

  11. Incidence of vascular complications during lateral lumbar interbody fusion: an examination of the mini-open access technique.

    Science.gov (United States)

    Kueper, Janina; Fantini, Gary A; Walker, Brendon R; Aichmair, Alexander; Hughes, Alexander P

    2015-04-01

    This article examines the incidence and management of vascular injury during Lateral Lumbar Interbody Fusion (LLIF). The details of the mini-open access technique are presented. A total of 900 patients who underwent a LLIF at an average 1.94 levels (range: 1-5 levels) by one of six fellowship trained surgeons on 1,754 levels from 2006 to 2013 were identified. The incidence of intraoperative vascular injury was retrospectively determined from the Operative Records. The management of vascular injury was evaluated. The mini-open access adapted by our institution for LLIF is described. The incidence of major vascular complication in our series was 1/900. The incidence of minor vascular injury was 4/900. The overall incidence of vascular injury was calculated to be 0.056 % per case and 0.029 % per level. All minor vascular injuries were identified to be segmental vessel lacerations, which were readily ligated under direct visualization without further extension of the incision with no clinical sequelae. The laceration of the abdominal aorta, the major vascular complication of this series, was emergently repaired through an exploratory laparotomy. None of the patients suffered long-term sequelae from their intraoperative vascular injuries. The mini-open lateral access technique for LLIF provides for minimal risk of vascular injury to the lumbar spine. In the rare event of minor vascular injury, the mini-open access approach allows for immediate visualization, confirmation and repair of the vessel with no long-term sequelae.

  12. The Development of a Differential Deposition Technique for Figure Correction in Grazing Incidence Optics

    Data.gov (United States)

    National Aeronautics and Space Administration — We propose the development of a physical-vapor-deposition coating technique to correct residual figure errors in grazing-incidence optics. The process involves...

  13. Effective Classroom Management Techniques for Secondary Schools

    African Journals Online (AJOL)

    Effective Classroom Management Techniques for Secondary Schools. ... engagement of students in activities, use of innovative instructional strategies by teachers, ... and teachers in their perception regarding the effects of teachers classroom ...

  14. Medical management of three workers following a radiation exposure incident

    International Nuclear Information System (INIS)

    House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L.

    1992-01-01

    The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms

  15. Medical management of three workers following a radiation exposure incident

    Energy Technology Data Exchange (ETDEWEB)

    House, R.A.; Sax, S.E.; Rumack, E.R.; Holness, D.L. (Department of Occupational and Environmental Health, St. Michael' s Hospital, Toronto, Ontario (Canada))

    1992-01-01

    The medical management of three individuals involved in an exposure incident to whole-body radiation at a nuclear generating plant of a Canadian electrical utility is described. The exposure incident resulted in the two highest whole-body radiation doses ever received in a single event by workers in a Canadian nuclear power plant. The individual whole-body doses (127.4 mSv, 92.0 mSv, 22.4 mSv) were below the threshold for acute radiation sickness but the exposures still presented medical management problems related to assessment and counseling. Serial blood counting and lymphocyte cytogenetic analysis to corroborate the physical dosimetry were performed. All three employees experienced somatic symptoms due to stress and one employee developed post-traumatic stress disorder. This incident indicates that there is a need in such radiation exposure accidents for early and continued counseling of exposed employees to minimize the risk of development of stress-related symptoms.

  16. Persistent perineal sinus. Incidence, pathogenesis, risk factors, and management

    International Nuclear Information System (INIS)

    Lohsiriwat, V.

    2009-01-01

    This review discusses the incidence, pathogenesis, risk factors, diagnosis, and therapeutic options for persistent perineal sinus (PPS), defined as a perineal wound that remains unhealed more than 6 months after surgery. The incidence of PPS after surgery for inflammatory bowel disease (IBD) ranges from 3% to 70% and after abdominoperineal resection (APR) for Low rectal cancer, it can be up to 30%. These unhealed wounds are frequently related to perioperative pelvic or perineal sepsis. Crohn's disease (CD) and neoadjuvant radiation therapy are also important risk factors. The management of PPS is based on an understanding of pathogenesis and clinical grounds. The advantages and disadvantages of the current therapeutic approaches, including the topical administration of various drugs, vacuum-assisted closure, and perineal reconstruction with a muscle flap or a myocutaneous flap are also discussed. (author)

  17. Explaining implementation behaviour of the National Incident Management System (NIMS).

    Science.gov (United States)

    Jensen, Jessica; Youngs, George

    2015-04-01

    This paper explains the perceived implementation behaviour of counties in the United States with respect to the National Incident Management System (NIMS). The system represents a massive and historic policy mandate designed to restructure, standardise and thereby unify the efforts of a wide variety of emergency management entities. Specifically, this study examined variables identified in the NIMS and policy literature that might influence the behavioural intentions and actual behaviour of counties. It found that three key factors limit or promote how counties intend to implement NIMS and how they actually implement the system: policy characteristics related to NIMS, implementer views and a measure of local capacity. One additional variable-inter-organisational characteristics-was found to influence only actual behaviour. This study's findings suggest that the purpose underlying NIMS may not be fulfilled and confirm what disaster research has long suggested: the potential for standardisation in emergency management is limited. © 2015 The Author(s). Disasters © Overseas Development Institute, 2015.

  18. PREDICTIVE MODELS FOR SUPPORT OF INCIDENT MANAGEMENT PROCESS IN IT SERVICE MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Martin SARNOVSKY

    2018-03-01

    Full Text Available ABSTRACT The work presented in this paper is focused on creating of predictive models that help in the process of incident resolution and implementation of IT infrastructure changes to increase the overall support of IT management. Our main objective was to build the predictive models using machine learning algorithms and CRISP-DM methodology. We used the incident and related changes database obtained from the IT environment of the Rabobank Group company, which contained information about the processing of the incidents during the incident management process. We decided to investigate the dependencies between the incident observation on particular infrastructure component and the actual source of the incident as well as the dependency between the incidents and related changes in the infrastructure. We used Random Forests and Gradient Boosting Machine classifiers in the process of identification of incident source as well as in the prediction of possible impact of the observed incident. Both types of models were tested on testing set and evaluated using defined metrics.

  19. [Second victim : Critical incident stress management in clinical medicine].

    Science.gov (United States)

    Schiechtl, B; Hunger, M S; Schwappach, D L; Schmidt, C E; Padosch, S A

    2013-09-01

    Critical incidents in clinical medicine can have far-reaching consequences on patient health. In cases of severe medical errors they can seriously harm the patient or even lead to death. The involvement in such an event can result in a stress reaction, a so-called acute posttraumatic stress disorder in the healthcare provider, the so-called second victim of an adverse event. Psychological distress may not only have a long lasting impact on quality of life of the physician or caregiver involved but it may also affect the ability to provide safe patient care in the aftermath of adverse events. A literature review was performed to obtain information on care giver responses to medical errors and to determine possible supportive strategies to mitigate negative consequences of an adverse event on the second victim. An internet search and a search in Medline/Pubmed for scientific studies were conducted using the key words "second victim, "medical error", "critical incident stress management" (CISM) and "critical incident stress reporting system" (CIRS). Sources from academic medical societies and public institutions which offer crisis management programs where analyzed. The data were sorted by main categories and relevance for hospitals. Analysis was carried out using descriptive measures. In disaster medicine and aviation navigation services the implementation of a CISM program is an efficient intervention to help staff to recover after a traumatic event and to return to normal functioning and behavior. Several other concepts for a clinical crisis management plan were identified. The integration of CISM and CISM-related programs in a clinical setting may provide efficient support in an acute crisis and may help the caregiver to deal effectively with future error events and employee safety.

  20. Management of response to the polonium-210 incident in London

    International Nuclear Information System (INIS)

    Croft, John; Bailey, Michael; Tattersall, Phil; Morrey, Mary; McColl, Neil; Prosser, Lesley; Maguire, Helen; Fraser, Graham; Gross, Roger

    2008-01-01

    On the 23 November 2006, Alexander Litvinenko died in London allegedly from poisoning by 210 Po, an alpha particle emitter. The spread of radioactive contamination, arising from the poisoning and the events leading up to it, involved many locations in London. The potential for intakes of 210 Po arising from the contamination posed a public health risk and generated significant public concern. The scale of the event required a multi-agency response, including top level UK Government emergency response management arrangements. The Health Protection Agency (HPA) had a leading role in co-ordinating and managing the public health response. This paper reviews the management of the incident response and the issues involved. The fatal poisoning of Mr Litvinenko with 210 Po, and the associated public health hazard from the spread of contamination to many locations across London, was an unprecedented event. Fortunately, no one else is known to have suffered any acute effects. Results from the programme of individual monitoring showed that whilst more than 100 people had measurable intakes of 210 Po, only 17 had assessed doses in excess of 6 mSv. The highest dose of about 100 mSv gives rise to an increased risk of fatal cancer of about 0.5%, compared with the natural incidence of about 25%. The incident required a co-ordinated and sustained multi-agency emergency response. The Health Protection Agency, as the lead on public health matters played a significant role in this. Whilst inevitably some lessons have been identified, the response is considered to have been very effective and to have benefited from the wide spectrum of experience and expertise developed through normal work, together with the effort put into emergency preparedness and the various emergency response. (author)

  1. Formal analysis of empirical traces in incident management

    International Nuclear Information System (INIS)

    Hoogendoorn, Mark; Jonker, Catholijn M.; Maanen, Peter-Paul van; Sharpanskykh, Alexei

    2008-01-01

    Within the field of incident management split second decisions have to be made, usually on the basis of incomplete and partially incorrect information. As a result of these conditions, errors occur in such decision processes. In order to avoid repetition of such errors, historic cases, disaster plans, and training logs need to be thoroughly analysed. This paper presents a formal approach for such an analysis that pays special attention to spatial and temporal aspects, to information exchange, and to organisational structure. The formal nature of the approach enables automation of analysis, which is illustrated by case studies of two disasters

  2. Program for accident and incident management support, AIMS

    International Nuclear Information System (INIS)

    Putra, M.A.

    1993-12-01

    A prototype of an advisory computer program is presented which could be used in monitoring and analyzing an ongoing incident in a nuclear power plant. The advisory computer program, called the Accident and Incident Management Support (AIMS), focuses on processing a set of data that is to be transmitted from a nuclear power plant to a national or regional emergency center during an incident. The AIMS program will assess the reactor conditions by processing the measured plant parameters. The applied model of the power plant contains a level of complexity that is comparable with the simplified plant model that the power plant operator uses. A standardized decay heat function and a steam water property library is used in the integral balance equations for mass and energy. A simulation of the station blackout accident of the Borssele plant is used to test the program. The program predicts successively: (1) the time of dryout of the steam generators, (2) the time of saturation of the primary system, and (3) the onset of core uncovery. The coolant system with the actual water levels will be displayed on the screen. (orig./HP)

  3. Towards Incidence Management in 5G Based on Situational Awareness

    Directory of Open Access Journals (Sweden)

    Lorena Isabel Barona López

    2017-01-01

    Full Text Available The fifth generation mobile network, or 5G, moves towards bringing solutions to deploying faster networks, with hundreds of thousands of simultaneous connections and massive data transfer. For this purpose, several emerging technologies are implemented, resulting in virtualization and self-organization of most of their components, which raises important challenges related to safety. In order to contribute to their resolution, this paper proposes a novel architecture for incident management on 5G. The approach combines the conventional risk management schemes with the Endsley Situational Awareness model, thus improving effectiveness in different aspects, among them the ability to adapt to complex and dynamical monitoring environments, and countermeasure tracking or the role of context when decision-making. The proposal takes into account all layers for information processing in 5G mobile networks, ranging from infrastructure to the actuators responsible for deploying corrective measures.

  4. Mantram repetition for stress management in veterans and employees: a critical incident study.

    Science.gov (United States)

    Bormann, Jill E; Oman, Doug; Kemppainen, Jeanne K; Becker, Sheryl; Gershwin, Madeline; Kelly, Ann

    2006-03-01

    This paper reports a study assessing the usefulness of a mantram repetition programme. Complementary/alternative therapies are becoming commonplace, but more research is needed to assess their benefits. A 5-week programme teaching a 'mind-body-spiritual' technique of silently repeating a mantram - a word or phrase with spiritual meaning - to manage stress was developed. A mantram was chosen by individuals, who were taught to repeat it silently throughout the day or night to interrupt unwanted thoughts and elicit the relaxation response. Participants who attended a 5-week course were invited to participate in the study. Of those who consented, a randomly selected subset (n = 66) was contacted approximately 3 months after the course for a telephone interview using the critical incident interviewing technique. Participants were asked whether the intervention was helpful or not, and if helpful, to identify situations where it was applied. Interviews were transcribed and incidents were identified and categorized to create a taxonomy of uses. The data were collected in 2001-2002. Participants included 30 veterans, mostly males (97%), and 36 hospital employees, mostly females (86%). Mean age was 56 years (sd = 12.94). Fifty-five participants (83.3%) practiced the technique and reported 147 incidents where the programme was helpful. Outcomes were organized into a taxonomy of incidents using four major categories that included managing: (a) emotions other than stress (51%); (b) stress (23.8%); (c) insomnia (12.9%); and (d) unwanted thoughts (12.3%). A group of raters reviewed the categories for inter-rater reliability. The majority of participants from two distinct samples reported that the mantram programme was helpful in a variety of situations. The critical incident interviewing method was found to be practical, efficient, and thorough in collecting and analyzing data. Such qualitative methods contribute to understanding the benefits of mind-body complementary therapies.

  5. Incidence and Management of Bleeding Complications Following Percutaneous Radiologic Gastrostomy

    International Nuclear Information System (INIS)

    Seo, Nieun; Shin, Ji Hoon; Ko, Gi Young; Yoon, Hyun Ki; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu Bo

    2012-01-01

    Upper gastrointestinal (GI) bleeding is a serious complication that sometimes occurs after percutaneous radiologic gastrostomy (PRG). We evaluated the incidence of bleeding complications after a PRG and its management including transcatheter arterial embolization (TAE). We retrospectively reviewed 574 patients who underwent PRG in our institution between 2000 and 2010. Eight patients (1.4%) had symptoms or signs of upper GI bleeding after PRG. The initial presentation was hematemesis (n = 3), melena (n = 2), hematochezia (n = 2) and bloody drainage through the gastrostomy tube (n = 1). The time interval between PRG placement and detection of bleeding ranged from immediately after to 3 days later (mean: 28 hours). The mean decrease in hemoglobin concentration was 3.69 g/dL (range, 0.9 to 6.8 g/dL). In three patients, bleeding was controlled by transfusion (n = 2) or compression of the gastrostomy site (n = 1). The remaining five patients underwent an angiography because bleeding could not be controlled by transfusion only. In one patient, the bleeding focus was not evident on angiography or endoscopy, and wedge resection including the tube insertion site was performed for hemostasis. The other four patients underwent prophylactic (n = 1) or therapeutic (n = 3) TAEs. In three patients, successful hemostasis was achieved by TAE, whereas the remaining one patient underwent exploration due to persistent bleeding despite TAE. We observed an incidence of upper GI bleeding complicating the PRG of 1.4%. TAE following conservative management appears to be safe and effective for hemostasis.

  6. Incidence and Management of Bleeding Complications Following Percutaneous Radiologic Gastrostomy

    Energy Technology Data Exchange (ETDEWEB)

    Seo, Nieun; Shin, Ji Hoon; Ko, Gi Young; Yoon, Hyun Ki; Gwon, Dong Il; Kim, Jin Hyoung; Sung, Kyu Bo [Asan Medical Center, Ulsan University College of Medicine, Seoul (Korea, Republic of)

    2012-03-15

    Upper gastrointestinal (GI) bleeding is a serious complication that sometimes occurs after percutaneous radiologic gastrostomy (PRG). We evaluated the incidence of bleeding complications after a PRG and its management including transcatheter arterial embolization (TAE). We retrospectively reviewed 574 patients who underwent PRG in our institution between 2000 and 2010. Eight patients (1.4%) had symptoms or signs of upper GI bleeding after PRG. The initial presentation was hematemesis (n = 3), melena (n = 2), hematochezia (n = 2) and bloody drainage through the gastrostomy tube (n = 1). The time interval between PRG placement and detection of bleeding ranged from immediately after to 3 days later (mean: 28 hours). The mean decrease in hemoglobin concentration was 3.69 g/dL (range, 0.9 to 6.8 g/dL). In three patients, bleeding was controlled by transfusion (n = 2) or compression of the gastrostomy site (n = 1). The remaining five patients underwent an angiography because bleeding could not be controlled by transfusion only. In one patient, the bleeding focus was not evident on angiography or endoscopy, and wedge resection including the tube insertion site was performed for hemostasis. The other four patients underwent prophylactic (n = 1) or therapeutic (n = 3) TAEs. In three patients, successful hemostasis was achieved by TAE, whereas the remaining one patient underwent exploration due to persistent bleeding despite TAE. We observed an incidence of upper GI bleeding complicating the PRG of 1.4%. TAE following conservative management appears to be safe and effective for hemostasis.

  7. Patients' experiences and actions when describing pain after surgery--a critical incident technique analysis.

    Science.gov (United States)

    Eriksson, Kerstin; Wikström, Lotta; Fridlund, Bengt; Årestedt, Kristofer; Broström, Anders

    2016-04-01

    Postoperative pain assessment remains a significant problem in clinical care despite patients wanting to describe their pain and be treated as unique individuals. Deeper knowledge about variations in patients' experiences and actions could help healthcare professionals to improve pain management and could increase patients' participation in pain assessments. The aim of this study was, through an examination of critical incidents, to describe patients' experiences and actions when needing to describe pain after surgery. An explorative design involving the critical incident technique was used. Patients from one university and three county hospitals in both urban and rural areas were included. To ensure variation of patients a strategic sampling was made according to age, gender, education and surgery. A total of 25 patients who had undergone orthopaedic or general surgery was asked to participate in an interview, of whom three declined. Pain experiences were described according to two main areas: "Patients' resources when in need of pain assessment" and "Ward resources for performing pain assessments". Patients were affected by their expectations and tolerance for pain. Ability to describe pain could be limited by a fear of coming into conflict with healthcare professionals or being perceived as whining. Furthermore, attitudes from healthcare professionals and their lack of adherence to procedures affected patients' ability to describe pain. Two main areas regarding actions emerged: "Patients used active strategies when needing to describe pain" and "Patients used passive strategies when needing to describe pain". Patients informed healthcare professionals about their pain and asked questions in order to make decisions about their pain situation. Selfcare was performed by distraction and avoiding pain or treating pain by themselves, while others were passive and endured pain or refrained from contact with healthcare professionals due to healthcare professionals

  8. Development of a highway incident management operational and training guide for incident responders in Illinois.

    Science.gov (United States)

    2011-08-01

    Each year highway traffic incidents, such as crashes, place responders on and beside roadways with : dangerous high-speed traffic. The unexpected conditions of an incident scene have the potential to surprise : unsuspecting or inattentive drivers, po...

  9. Critical incidents and critical incident stress management (CISM) - an employee assistance programme (EAP) perspective

    OpenAIRE

    Terblanche, Lourie; van Wyk, André

    2014-01-01

    Employees are increasingly becoming victims of critical incidents. From a systems theory point of view, it is necessary to acknowledge the impact of critical incidents not only on the personal life of the employee, but on the workplace itself. Employees respond differently to critical incidents, which makes it even more complicated when this reaches the point of requiring therapeutic intervention. The most common response to critical incidents may be the risk of developing post-traumatic s...

  10. Major Incident Hospital: Development of a Permanent Facility for Management of Incident Casualties.

    Science.gov (United States)

    Marres, Geertruid; Bemelman, Michael; van der Eijk, John; Leenen, Luke

    2009-06-01

    . Collaboration with the NVIC and infrastructural adjustments enable us to not only care for patients with physical trauma, but also to provide centralized care of patients under quarantine conditions for, say, MRSA, SARS, smallpox, chemical or biological hazards. Triage plays an important role in medical disaster management and is therefore key to organization and infrastructure. Caps facilitate role distribution and recognizibility. The PBR resulted in more accurate registration and real-time availability of patient and group information. Infrastructure and a plan is not enough; training, research and evaluation are necessary to continuously work on disaster preparedness. The MIH in Utrecht (Netherlands) is a globally unique facility that can provide immediate emergency care for multiple casualties under exceptional circumstances. Resulting from the cooperation between a large academic medical institution, a trauma center, a military hospital and the NVIC, the MIH offers not only a good and complete infrastructure but also the expertise required to provide large-scale emergency care during disasters and major incidents.

  11. Emergency and crisis management: critical incident stress management for first responders and business organisations.

    Science.gov (United States)

    Guenthner, Daniel H

    2012-01-01

    A literature review was performed on critical incident stress after September 11th, 2001 (9/11), and Hurricanes Katrina and Rita, which focused on the need to implement a holistic critical incident stress management programme for first responders and business organisations. Critical incident stress management is required to handle acute stress and other distress in the face of natural or man-made disasters, including terrorist attacks. A holistic approach to community resilience through a well-planned and implemented critical incident stress management programme has been shown in the literature to promote self-help and self-efficacy of individuals and organisations. The interventions and programme elements defined clearly show how a number of different intervention and prevention strategies will promote business and community resilience and also self-efficacy in a culturally-diverse community and organisation. Implementing a critical incident stress management programme within a responding business organisation is critical because of the fact that first responders are the most susceptible every day to exposure to critical incidents that will affect their mental health; and business employees will suffer some of the same maladies as first responders in the event of a disaster or crisis. Utilising the framework provided, a holistic critical incident stress management programme can be implemented to help reduce the effects of burnout, absenteeism, acute stress, post-traumatic stress, substance use and traumatic stress, and to work to promote community resilience and toughen individuals against the effects of stress. Taking care of the needs of the employees of a business organisation, and of those of first responders, is clearly required.

  12. 76 FR 61371 - All-Hazard Position Task Books for Type 3 Incident Management Teams

    Science.gov (United States)

    2011-10-04

    ...-Hazard Position Task Books for Type 3 Incident Management Teams AGENCY: Federal Emergency Management... Books for Type 3 Incident Management Teams were developed to assist personnel achieve qualifications in... Management Teams were developed to assist personnel achieve qualifications in the All-Hazard ICS positions...

  13. Modified Koyanagi Technique in Management of Proximal ...

    African Journals Online (AJOL)

    xp

    Modified Koyanagi Technique in Management of Proximal Hypospadias. Adham Elsaied, Basem Saied, and Mohammed El- ... All operations were performed by the authors,using fine instruments and under 3.5X loupe ... the other needed an operation to close the fistula six months later. The case with meatal recession had ...

  14. Principal Experiences with Crisis Management Professional Development, Collaboration, and Implementation of the National Incident Management System Phases of Emergency Management

    Science.gov (United States)

    Naradko, Anthony M.

    2017-01-01

    The purpose of this qualitative single-subject case study was to identify the elements critical to crisis management professional development for school principals; the factors influencing the implementation of the National Incident Management System Phases of Emergency Management (2010) for principals; and the necessary elements for fostering…

  15. Keyboarding Instruction at NABTE Institutions: Are We Teaching Techniques to Reduce CTD Incidence?

    Science.gov (United States)

    Blaszczynski, Carol; Joyce, Marguerite Shane

    1996-01-01

    Responses from 157 of 193 business teachers who teach keyboarding indicated that 78.7% were aware of cumulative trauma disorder and 22% had experienced it. Only 13% of classrooms were equipped with wrist rests. About 53% teach techniques to reduce incidence, but 20% did not know whether they taught preventive measures. (SK)

  16. Development of the decision make supporting system on incident management

    International Nuclear Information System (INIS)

    Kasamatsu, Mizuki; Hanada, Satoshi; Noda, Eisuke

    2017-01-01

    Decision Make Supporting System is designed to support appropriate decision made by top management in the nuclear severe conditions. With crisis response in nuclear power plant (NPP), information entanglement between sites and control centers during intense situations interfere with prompt and accurate decision making. This research started with that kind of background. In order to solve the issue of the information entanglement, Mitsubishi Heavy Industries, Inc. (MHI) carried out the development of the Decision Make Supporting System and the system applies the technology combining the human factors engineering (HFE) and information and communication technology (ICT). During the crisis response, various commands, reactions and communications in a human system need to be managed. Therefore, the combined HFE method including detailed task analysis, user experience (UX), graphic user interface (GUI) and related human-system interface (HSI) design method is applied to the design of the system. These design results systematize the functions that prevent interference with decision-making in the headquarters for incident management. This new solution as a system enhances the safety improvement of the NPP and contributes to develop the skills and abilities of the resources in the NPP. The system has three key features for supporting emergency situations: 'understanding the situation', 'planning the next action', and 'managing resources'. The system helps commanders and responders to grasp the whole situation and allows them to share information in real time to get a whole picture, and the system accumulates the data of the past events in the chronological order to understand correctly how they happened and plan the next action by using a knowledge database that MHI has been developed. If the unexpected event happens which are not in the incident scenario, the system provides support to formulate alternative strategies and measures. With this

  17. A prospective study to select and evaluate anesthesiology residents: phase I, the critical incident technique.

    Science.gov (United States)

    Altmaier, E M; From, R P; Pearson, K S; Gorbatenko-Roth, K G; Ugolini, K A

    1997-12-01

    To develop categories of behavior that define an applicant's aptitude for anesthesia, and to attempt to determine the relative importance of these behaviors to successful residency performance. Prospective open study. Anesthesia residencies at three midwest university teaching hospitals. Using a structured interview format known as the critical incident technique, faculty anesthesiologists were asked to describe examples of effective and ineffective behaviors observed among anesthesia residents during the twelve months prior to the interview. Interviews initially held with 34 anesthesiologists generated 172 incidents. These incidents formed the basis for a categorization analysis performed by two anesthesiologists. Six categories were developed: preparedness, interpersonal skills, response to teaching, data monitoring, technical skills, and emergency situations. Validation of these categories was confirmed with three subsequent interviews, in which 92 anesthesiologists generated 475 incidents. Most incidents were found to conform to the previously defined categories using a reallocation index with a range of 0.70 to 0.80. The category "technical skills" fell below the defined range. Over 60 percent of the incidents involved noncognitive personal attributes: preparedness, interpersonal skills, and response to teaching. Effective behavior in six categories identifies an applicant's aptitude for anesthesia. Selection of residents may be enhanced by routinely assessing noncognitive characteristics.

  18. STUDY OF INCIDENCE & MANAGEMENT OF PARA PHARYNGEAL TUMORS

    Directory of Open Access Journals (Sweden)

    Aruna Kumari

    2015-11-01

    Full Text Available INTRODUCTION: Parapharyngeal tumors are rare, comprising approximately 0.5% of all head and neck tumours. Most of them are benign. These tumors present with difficulties in diagnosis - complementary MRI and CT scanning are necessary for diagnosis, and Fine Needle Aspiration Cytology (FNAC is very specific in the histological diagnosis of these tumours. Open biopsy is not advisable due to bleeding, breaching of the capsule and seeding of the tumor. These tumors presents a challenge to the surgeon due to its anatomical complexities. This study deals with the incidence and management of various parapharyngeal tumors. OBJECTIVE OF THE STUDY: This study deals with the incidence of various tumors in the parapharyngeal space in different age and sex groups, role of sophisticated diagnostic modalities like CT, MRI, MR Angio. Colour Doppler along with FNAC and various surgical approaches to this space. This study also deals with intra-operative and post operative complications. In this series, a total of 25 cases has been studied retrospectively in a time period of 2 years from 2012 to 2014, presenting in our ENT and Head and Neck Dept., Gandhi hospital. RESULTS: According to this study, there is male preponderance (52% and highest incidence is seen in 3rd and 5th decade (24% each. Most common presenting symptoms are difficulty in swallowing (36% and swelling either intraoral or in the neck (28%. Least common symptoms being cranial nerve palsy (4%, difficulty in breathing/noisy breathing (4%, nasal regurgitation (4% and hard of hearing (8%. FNAC was done in 21 cases, in which 13 were correlating with the biopsy report. CT scan was required in all cases. MR Angiography was done in 4 cases and colour Doppler in 2 cases. Surgery is the mainstay of the treatment. Most common tumor in PPS is neurogenic (schwannoma/neurofibroma.i.e 44%. Next commonly occurring tumor in our study is of salivary origin-pleomorphic adenoma (24%, paragangliomas (12%. Other less

  19. Empowerment methods and techniques for sport managers

    Directory of Open Access Journals (Sweden)

    THANOS KRIEMADIS

    2006-01-01

    Full Text Available We live in a globalize economic, social and technological environment where organizations can be successful only if they have required resources (material resources, facilities and equipment, and human resources. The managers and the organizations should empower and enable employees to accomplish their work in meaningful ways. Empowerment has been described as a means to enable employees to make decisions and as a personal phenomenon where individuals take responsibility for their own actions. The aim of the present study was to present effective methods and techniques of employee empowerment which constitute for the organization a source of competitive advantage. The paper will present and explain empowerment methods and techniques such as: (a organizational culture, (b vision statements, (c organizational values, (d teamwork, (e the role of manager - leadership, (f devolving responsibility accountability, (g information sharing, (h continuous training, (i appraisal rewards, (j goal setting, and (k performance appraisal process.

  20. Acceptability and perceived utility of drone technology among emergency medical service responders and incident commanders for mass casualty incident management.

    Science.gov (United States)

    Hart, Alexander; Chai, Peter R; Griswold, Matthew K; Lai, Jeffrey T; Boyer, Edward W; Broach, John

    2017-01-01

    This study seeks to understand the acceptability and perceived utility of unmanned aerial vehicle (UAV) technology to Mass Casualty Incidents (MCI) scene management. Qualitative questionnaires regarding the ease of operation, perceived usefulness, and training time to operate UAVs were administered to Emergency Medical Technicians (n = 15). A Single Urban New England Academic Tertiary Care Medical Center. Front-line emergency medical service (EMS) providers and senior EMS personnel in Incident Commander roles. Data from this pilot study indicate that EMS responders are accepting to deploying and operating UAV technology in a disaster scenario. Additionally, they perceived UAV technology as easy to adopt yet impactful in improving MCI scene management.

  1. Factors influencing patient compliance with therapeutic regimens in chronic heart failure: A critical incident technique analysis.

    Science.gov (United States)

    Strömberg, A; Broström, A; Dahlström, U; Fridlund, B

    1999-01-01

    The aim of this study was to identify factors influencing compliance with prescribed treatment in patients with chronic heart failure. A qualitative design with a critical incident technique was used. Incidents were collected through interviews with 25 patients with heart failure strategically selected from a primary health care clinic, a medical ward, and a specialist clinic. Two hundred sixty critical incidents were identified in the interviews and 2 main areas emerged in the analysis: inward factors and outward factors. The inward factors described how compliance was influenced by the personality of the patient, the disease, and the treatment. The outward factors described how compliance was influenced by social activities, social relationships, and health care professionals. By identifying the inward and outward factors influencing patients with chronic heart failure, health care professionals can assess whether intervention is needed to increase compliance.

  2. Military Personnel: DOD Has Processes for Operating and Managing Its Sexual Assault Incident Database

    Science.gov (United States)

    2017-01-01

    MILITARY PERSONNEL DOD Has Processes for Operating and Managing Its Sexual Assault Incident Database Report to...to DSAID’s system speed and ease of use; interfaces with MCIO databases ; utility as a case management tool; and users’ ability to query data and... Managing Its Sexual Assault Incident Database What GAO Found As of October 2013, the Department of Defense’s (DOD) Defense Sexual Assault Incident

  3. SWOT ANALYSIS-MANAGEMENT TECHNIQUES TO STREAMLINE PUBLIC BUSINESS MANAGEMENT

    OpenAIRE

    Rodica IVORSCHI

    2012-01-01

    SWOT analysis is the most important management techniques for understanding the strategic position of an organization. Objective SWOT analysis is to recommend strategies to ensure the best alignment between internal and external environment, and choosing the right strategy can be benefi cial organization in order to adapt their strengths to opportunities, minimize risks and eliminate weaknesses.

  4. SWOT ANALYSIS-MANAGEMENT TECHNIQUES TO STREAMLINE PUBLIC BUSINESS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Rodica IVORSCHI

    2012-06-01

    Full Text Available SWOT analysis is the most important management techniques for understanding the strategic position of an organization.Objective SWOT analysis is to recommend strategies to ensure the best alignment between internal and external environment, and choosing the right strategy can be beneficial organization in order to adapt their strengths to opportunities, minimize risks and eliminate weaknesses.

  5. Prostate Cancer in Transgender Women: Incidence, Etiopathogenesis, and Management Challenges.

    Science.gov (United States)

    Deebel, Nicholas A; Morin, Jacqueline P; Autorino, Riccardo; Vince, Randy; Grob, Baruch; Hampton, Lance J

    2017-12-01

    To critically analyze the available evidence regarding the incidence, etiopathogenesis, and management of prostate cancer (CaP) in transgender women. In addition, this article aims to present a recent case report of a transgender woman with a unique presentation at the author's institution. An electronic nonsystematic literature search was performed to identify pertinent studies. PubMed search engine was queried by using the following search terms: "prostate cancer," "male to female transsexual," "transgender patient," "androgen + prostate cancer," "estrogen therapy + prostate cancer," and "health care barrier." In addition, a clinical case managed at our institution was reviewed and critically discussed. Including our case, there have been only 10 documented cases of CaP in transgender women. Additionally, an emerging body of literature has questioned the role of androgens in the development of CaP and suggested that estrogen therapy may not be as protective as initially thought. Therefore, the current evidence suggests that the transgender woman should be screened for CaP the same as a nontransgender men. Barriers to care in the transgender female population include accessing resources, medical knowledge deficits, ethics of transition-related medical care, diagnosing vs pathologizing transgender patients, financial restrictions of the patient, and health system determinants. Although rare, CaP in transgender women has been documented. Both the mechanism and the impact of receiving a bilateral orchiectomy on disease development are unclear. Future study is needed to examine these factors, and to further shape the treatment and screening regimen for these patients. Published by Elsevier Inc.

  6. The Use of Management Control Systems and Operations Management Techniques

    Directory of Open Access Journals (Sweden)

    Edelcio Koitiro Nisiyama

    2016-01-01

    Full Text Available It is well known that both management control systems (MCSs and operations management (OM are related to firm performance; however, an integrated st udy that involves MCS and OM within the context of firm performance is still lacking. This research aimed to examine the relationships among the use of MCSs and OM techniques and firm performance in the Brazilian auto parts industry. Simons’ levers of cont rol framework was used to characterise the uses of MCSs, and OM techniques, such as total quality management (TQM and continuous improvement programmes, were adopted. The results obtained through the structural equation modelling indicated that the diagno stic use of MCSs is positively associated with the goals of cost reduction. In addition, the interactive use of MCSs is positively associated with the objectives of introducing new products, which is consistent with previous research. Additionally, OM tech niques are positively related to cost reduction but have no direct relationship with the introduction of new products.

  7. Management of ground water using isotope techniques

    International Nuclear Information System (INIS)

    Romani, Saleem

    2004-01-01

    Ground water play a major role in national economy and sustenance of life and environment. Prevalent water crisis in India includes falling water table, water quality deterioration, water logging and salinity. Keeping in view the increasing thrust on groundwater resources and the present scenario of availability vis-a vis demand there is a need to reorient our approach to ground water management. The various ground water management options require proper understanding of ground water flow system. Isotopes are increasingly being applied in hydrogeological investigations as a supplementary tool for assessment of aquifer flow and transport characteristics. Isotope techniques coupled with conventional hydrogeological and hydrochemical methods can bring in greater accuracy in the conceptualization of hydrogeological control mechanism. The use of isotope techniques in following areas can certainly be of immense help in implementing various ground water management options in an efficient manner. viz.Interaction between the surface water - groundwater systems to plan conjunctive use of surface and ground water. Establishing hydraulic interconnections between the aquifers in a multi aquifer system. Depth of circulation of water and dating of ground water. Demarcating ground water recharge and discharge areas. Plan ground water development in coastal aquifers to avoid sea water ingress. Development of flood plain aquifer. (author)

  8. Gynecomastia: evolving paradigm of management and comparison of techniques.

    Science.gov (United States)

    Petty, Paul M; Solomon, Matthias; Buchel, Edward W; Tran, Nho V

    2010-05-01

    Since 1997, the authors have used a minimally invasive technique for the management of gynecomastia using ultrasound-assisted liposuction and the arthroscopic shaver to remove breast tissue through a remote incision. This technique has allowed for a consistent, refined, "unoperated" postoperative appearance in this patient population. This study analyzes the outcomes of this procedure and compares the procedure against established techniques. A retrospective study was performed on all patients who underwent surgery for gynecomastia at the authors' institution between January of 1988 and October of 2007. A total of 227 patients were divided into four groups: group 1, open excision only (n = 45); group 2, open excision plus liposuction (n = 56); group 3, liposuction only (n = 50); and group 4, liposuction plus arthroscopic shaver (n = 76). Medical records and photographs were used to compare groups for complications and results. Complications using the liposuction plus arthroscopic shaver technique included seroma (n = 2), hematoma (n = 1), scar revision (n = 1), and skin buttonhole from the arthroscopic shaver (n = 1). There was no difference between groups in the overall incidence of complications (p liposuction plus arthroscopic shaver) had the overall highest mean score, with statistical significance between group 2 (open excision plus liposuction) and group 4 (p gynecomastia is a safe and effective technique, with excellent cosmetic results and an acceptable complication rate.

  9. Incidence, diagnosis and management of eye affections in dogs ...

    African Journals Online (AJOL)

    A retrospective study of ocular affections in dogs was conducted at some selected clinics and hospitals in Southwest Nigeria between 2003 and, 2013 to determine the incidence, pattern of distribution, methods of diagnosis and treatment modalities using descriptive statistical tool. Overall incidence of eye affection in dogs ...

  10. Data Mining Techniques for Customer Relationship Management

    Science.gov (United States)

    Guo, Feng; Qin, Huilin

    2017-10-01

    Data mining have made customer relationship management (CRM) a new area where firms can gain a competitive advantage, and play a key role in the firms’ management decision. In this paper, we first analyze the value and application fields of data mining techniques for CRM, and further explore how data mining applied to Customer churn analysis. A new business culture is developing today. The conventional production centered and sales purposed market strategy is gradually shifting to customer centered and service purposed. Customers’ value orientation is increasingly affecting the firms’. And customer resource has become one of the most important strategic resources. Therefore, understanding customers’ needs and discriminating the most contributed customers has become the driving force of most modern business.

  11. Management techniques that keep outages on schedule

    International Nuclear Information System (INIS)

    Taylor, R.B.

    1987-01-01

    During the immature operation of the Pickering Units 5 through 8, significant numbers of outages have been required to deal with warranty inspections and equipment problems. Techniques have been developed to ensure that outages are properly planned and managed so that outage time is minimized, overtime is minimized, and capacity factor is maximized, while ensuring that personnel safety is not compromised. Successful outage planning and execution requires the commitment of many on-station and off-station resources groups. Coordination of all of these groups is required both before and during the outage to ensure outage time is not lost due to unavailability of men or equipment at the time they are required. This paper details the control processes that must be used prior to, during, and after an outage to ensure that time is not lost unnecessarily during outages. Successful outage management at Pickering Nuclear Generating Station can be subdivided into three stages; preoutage planning, outage execution, and postoutage review

  12. The influence of incident management teams on the deployment of wildfire suppression resources

    Science.gov (United States)

    Michael Hand; Hari Katuwal; David E. Calkin; Matthew P. Thompson

    2017-01-01

    Despite large commitments of personnel and equipment to wildfire suppression, relatively little is known about the factors that affect how many resources are ordered and assigned to wildfire incidents and the variation in resources across incident management teams (IMTs). Using detailed data on suppression resource assignments for IMTs managing the highest complexity...

  13. Factors affecting fire suppression costs as identified by incident management teams

    Science.gov (United States)

    Janie Canton-Thompson; Brooke Thompson; Krista Gebert; David Calkin; Geoff Donovan; Greg Jones

    2006-01-01

    This study uses qualitative sociological methodology to discover information and insights about the role of Incident Management Teams in wildland fire suppression costs. We interviewed 48 command and general staff members of Incident Management Teams throughout the United States. Interviewees were asked about team structure, functioning, and decision making as a...

  14. Coordinated Traffic Incident and Congestion Management (TIM-CM) : Mitigating Regional Impacts of Major Traffic Incidents in the Seattle I-5 Corridor

    Science.gov (United States)

    2018-02-02

    Within the Seattle metropolitan area, traffic incident management (TIM) operations provide a multi-jurisdictional and coordinated strategy to detect, respond to, and clear traffic incidents so that traffic flow can be restored quickly and safely. The...

  15. Current approaches to managing aggressive incidents among in ...

    African Journals Online (AJOL)

    Background: Aggressive behavior and incidents in psychiatric wards are ... Results: Seventy five people were admitted in the acute psychiatric wards during this ... Although the study sample is small and convenience-based, the dearth of ...

  16. Risk assessment of several incidents in nuclear waste management facilities

    International Nuclear Information System (INIS)

    Buetow, E.; Memmert, G.; Storck, R.; Weymann, J.; Matthies, M.; Vogt, K.J.

    1981-01-01

    Regarding surface facilities two incidents of MAVA (failure of the filter in the exhaust gas system, fire in the bituminization system) and one incident in the Krypton storage and regarding underground systems the water inlet in the pit building have been evaluated. According to the calculations only the two nuclides Tc-99 and J-129 can involve a considerable exposure. The barrier system of overlying rocks and the pit system as a whole is largely redundant and diverse. (DG) [de

  17. Ion-induced nanopatterns on semiconductor surfaces investigated by grazing incidence x-ray scattering techniques

    Energy Technology Data Exchange (ETDEWEB)

    Carbone, D; Metzger, T H [ID01, ESRF, 6 rue Jules Horowitz, F-38043 Grenoble Cedex (France); Biermanns, A; Pietsch, U [Festkoerperphysik, Universitaet Siegen, D-57068 Siegen (Germany); Ziberi, B; Frost, F [Leibniz-Institut fuer Oberflaechenmodifizierung e.V., D-04318 Leipzig (Germany); Plantevin, O [Universite Paris-Sud, Centre de Spectrometrie Nucleaire et de Spectrometrie de Masse, UMR 8609, F-91405 Orsay (France)], E-mail: gcarbone@esrf.fr

    2009-06-03

    In this review we cover and describe the application of grazing incidence x-ray scattering techniques to study and characterize nanopattern formation on semiconductor surfaces by ion beam erosion under various conditions. It is demonstrated that x-rays under grazing incidence are especially well suited to characterize (sub)surface structures on the nanoscale with high spatial and statistical accuracy. The corresponding theory and data evaluation is described in the distorted wave Born approximation. Both ex situ and in situ studies are presented, performed with the use of a specially designed sputtering chamber which allows us to follow the temporal evolution of the nanostructure formation. Corresponding results show a general stabilization of the ordering wavelength and the extension of the ordering as a function of the ion energy and fluence as predicted by theory. The in situ measurements are especially suited to study the early stages of pattern formation, which in some cases reveal a transition from dot to ripple formation. For the case of medium energy ions crystalline ripples are formed buried under a semi-amorphous thick layer with a ripple structure at the surface being conformal with the crystalline/amorphous interface. Here, the x-ray techniques are especially advantageous since they are non-destructive and bulk-sensitive by their very nature. In addition, the GI x-ray techniques described in this review are a unique tool to study the evolving strain, a topic which remains to be explored both experimentally and theoretically.

  18. Effective classroom teaching methods: a critical incident technique from millennial nursing students' perspective.

    Science.gov (United States)

    Robb, Meigan

    2014-01-11

    Engaging nursing students in the classroom environment positively influences their ability to learn and apply course content to clinical practice. Students are motivated to engage in learning if their learning preferences are being met. The methods nurse educators have used with previous students in the classroom may not address the educational needs of Millennials. This manuscript presents the findings of a pilot study that used the Critical Incident Technique. The purpose of this study was to gain insight into the teaching methods that help the Millennial generation of nursing students feel engaged in the learning process. Students' perceptions of effective instructional approaches are presented in three themes. Implications for nurse educators are discussed.

  19. Managing bioengineering complexity with AI techniques.

    Science.gov (United States)

    Beal, Jacob; Adler, Aaron; Yaman, Fusun

    2016-10-01

    Our capabilities for systematic design and engineering of biological systems are rapidly increasing. Effectively engineering such systems, however, requires the synthesis of a rapidly expanding and changing complex body of knowledge, protocols, and methodologies. Many of the problems in managing this complexity, however, appear susceptible to being addressed by artificial intelligence (AI) techniques, i.e., methods enabling computers to represent, acquire, and employ knowledge. Such methods can be employed to automate physical and informational "routine" work and thus better allow humans to focus their attention on the deeper scientific and engineering issues. This paper examines the potential impact of AI on the engineering of biological organisms through the lens of a typical organism engineering workflow. We identify a number of key opportunities for significant impact, as well as challenges that must be overcome. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  20. Palliative care nurses' recognition and assessment of patients with delirium symptoms: a qualitative study using critical incident technique.

    Science.gov (United States)

    Hosie, Annmarie; Agar, Meera; Lobb, Elizabeth; Davidson, Patricia M; Phillips, Jane

    2014-10-01

    Delirium is prevalent in palliative care inpatient settings and management is often challenging. Despite nurses' integral patient care role, little is known about palliative care nurses' capacity to recognise, assess and respond to patients' delirium symptoms. To explore the experiences, views and practices of inpatient palliative care nurses in delirium recognition and assessment. 30 nurses from nine Australian specialist palliative care inpatient services. Critical incident technique (CIT) guided a series of semi-structured interviews. Prior to interviews participants were given a vignette of a palliative care inpatient with an unrecognised hypoactive delirium, to prompt their recollection and recounting of a similar clinical incident. Clearly recalled and described incidents were analysed using thematic content analysis. 20 of 30 participants recalled and described 28 relevant delirium incidents. Two themes and six sub-themes provide a general description of participants' experiences, views and practice in delirium recognition and assessment. Participants experience distress related to caring for patients with delirium and express compassion and empathy for delirious patients. Enhancing their delirium knowledge, strengthening collaborative multidisciplinary team relationships and better communication are important supports. Some participants, usually those in advance practice roles, describe more comprehensive assessment capabilities that incorporate clinical expertise with whole person awareness, yet systematic and structured delirium screening and assessment processes and application of the delirium diagnosis criteria are largely missing. Use of ambiguous terminology to describe delirium symptoms contributes to ineffective practice. The findings of this study expands our understanding of how palliative care nurses' capacity to recognise and assess patients' delirium symptoms in the inpatient setting could be strengthened. Copyright © 2014 Elsevier Ltd. All

  1. Responding to Terrorist Incidents in Your Community: Flammable-Liquid Fire Fighting Techniques for Municipal and Rural Firefighters

    Energy Technology Data Exchange (ETDEWEB)

    Denise Baclawski

    2010-03-08

    The University of Nevada, Reno Fire Science Academy (FSA) applied for grant funding to develop and deliver programs for municipal, rural, and volunteer firefighters. The FSA specializes in preparing responders for a variety of emergency events, including flammable liquid fires resulting from accidents, intentional acts, or natural disasters. Live fire training on full scale burnable props is the hallmark of FSA training, allowing responders to practice critical skills in a realistic, yet safe environment. Unfortunately, flammable liquid live fire training is often not accessible to municipal, rural, or volunteer firefighters due to limited department training budgets, even though most department personnel will be exposed to flammable liquid fire incidents during the course of their careers. In response to this training need, the FSA developed a course during the first year of the grant (Year One), Responding to Terrorist Incidents in Your Community: Flammable-Liquid Fire Fighting Techniques for Municipal and Rural Firefighters. During the three years of the grant, a total of 2,029 emergency responders received this training. In Year Three, two new courses, a train-the-trainer for Responding to Terrorist Incidents in Your Community and Management of Large-Scale Disasters for Public Officials were developed and pilot tested during the Real-World Disaster Management Conference held at the FSA in June of 2007. Two research projects were conducted during Years Two and Three. The first, conducted over a two year period, evaluated student surveys regarding the value of the flammable liquids training received. The second was a needs assessment conducted for rural Nevada. Both projects provided important feedback and a basis for curricula development and improvements.

  2. Evaluation of the incidence on insufficient cytology results comparing different ultrasound-guided aspiration techniques for thyroid nodules

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Seong Hyng; Park, Jun Hyun; Park, Ji Kang [Dept. of Radiology, Jeju National University Hospital, Jeju National University School of Medicine, Jeju (Korea, Republic of)

    2013-07-15

    We compared the incidence of insufficient thyroid cytology due to blood-stained materials or low cellularity in terms of aspiration technique, especially focusing on the degree of suction pressure and needle size. Three experienced radiologists performed ultrasound-guided aspiration for thyroid nodules in 1174 thyroid nodules consecutively. Three different techniques were used; (A) using a 25 gauge needle with mainly capillary technique in 269 nodules; (B) using a 25 gauge needle with 3 cc syringe and minimal suction pressure in 303 nodules; (C) using a 22-23 gauge needle with 10 cc syringe and aspirator in 602 nodules. The differences of the incidence of the insufficient cytology among the three aspiration techniques and relationships of the incidence and needle size/degree of suction pressure was statistically analyzed using the Mann-Whitney U test and the chi-square test with linear-by-linear association. Overall, the difference in insufficient cytology was significant across the three aspiration technique (p = 0.004), and the incidence tended to increase significantly with increase of needle size and degree of suction pressure (p < 0.001). A pairwise comparison of aspiration techniques found significant differences (p = 0.003) between techniques (A) and (C), and no differences between technique (B) and (C) (p 0.07) and between techniques (A) and (B) (p = 0.10). The incidence of insufficient cytology was significantly low in the capillary technique, and it increased significantly with the increase of needle size and degree of suction pressure.

  3. Evaluation of the incidence on insufficient cytology results comparing different ultrasound-guided aspiration techniques for thyroid nodules

    International Nuclear Information System (INIS)

    Kim, Seong Hyng; Park, Jun Hyun; Park, Ji Kang

    2013-01-01

    We compared the incidence of insufficient thyroid cytology due to blood-stained materials or low cellularity in terms of aspiration technique, especially focusing on the degree of suction pressure and needle size. Three experienced radiologists performed ultrasound-guided aspiration for thyroid nodules in 1174 thyroid nodules consecutively. Three different techniques were used; (A) using a 25 gauge needle with mainly capillary technique in 269 nodules; (B) using a 25 gauge needle with 3 cc syringe and minimal suction pressure in 303 nodules; (C) using a 22-23 gauge needle with 10 cc syringe and aspirator in 602 nodules. The differences of the incidence of the insufficient cytology among the three aspiration techniques and relationships of the incidence and needle size/degree of suction pressure was statistically analyzed using the Mann-Whitney U test and the chi-square test with linear-by-linear association. Overall, the difference in insufficient cytology was significant across the three aspiration technique (p = 0.004), and the incidence tended to increase significantly with increase of needle size and degree of suction pressure (p < 0.001). A pairwise comparison of aspiration techniques found significant differences (p = 0.003) between techniques (A) and (C), and no differences between technique (B) and (C) (p 0.07) and between techniques (A) and (B) (p = 0.10). The incidence of insufficient cytology was significantly low in the capillary technique, and it increased significantly with the increase of needle size and degree of suction pressure.

  4. Acute Appendicitis: Incidence and Management in Nigeria | Alatise ...

    African Journals Online (AJOL)

    Appendicitis is the leading cause of surgical emergency admission in most hospital in Nigeria. It accounts for about 15-40% of all emergency surgery done in most centers in the country. All age groups can develop the disease including the fetus in utero, but the incidence is higher in the second and third decade of life.

  5. Defining Incident Management Processes for CSIRTs: A Work in Progress

    Science.gov (United States)

    2004-10-01

    royalty -free government-purpose license to use, duplicate, or disclose the work, in whole or in part and in any manner, and to have or permit others to...Methodology of Incident Handling.” InfoSecurity 2001 Conference Program. Malaysian National Computer Confederation, 2001. 22 CMU/SEI-2004-TR-015

  6. Incidence and management of pancreatic leakage after pancreatoduodenectomy

    NARCIS (Netherlands)

    de Castro, S. M. M.; Busch, O. R. C.; van Gulik, T. M.; Obertop, H.; Gouma, D. J.

    2005-01-01

    Background: Optimal management of severe pancreatic leakage after pancreatoduodenectomy can reduce morbidity and mortality. Completion pancreatectomy may be adequate but leads to endocrine insufficiency. This study evaluated an alternative management strategy for pancreatic leakage. Methods: Outcome

  7. Using the critical incident technique in community-based participatory research: a case study.

    Science.gov (United States)

    Belkora, Jeffrey; Stupar, Lauren; O'Donnell, Sara

    2011-01-01

    Successful community-based participatory research involves the community partner in every step of the research process. The primary study for this paper took place in rural, Northern California. Collaborative partners included an academic researcher and two community based resource centers that provide supportive services to people diagnosed with cancer. This paper describes our use of the Critical Incident Technique (CIT) to conduct Community-based Participatory Research. We ask: Did the CIT facilitate or impede the active engagement of the community in all steps of the study process? We identified factors about the Critical Incident Technique that were either barriers or facilitators to involving the community partner in every step of the research process. Facilitators included the CIT's ability to accommodate involvement from a large spectrum of the community, its flexible design, and its personal approach. Barriers to community engagement included training required to conduct interviews, depth of interview probes, and time required. Overall, our academic-community partners felt that our use of the CIT facilitated community involvement in our Community-Based Participatory Research Project, where we used it to formally document the forces promoting and inhibiting successful achievement of community aims.

  8. Incidence of Artifacts and Deviating Values in Research Data Obtained from an Anesthesia Information Management System in Children.

    Science.gov (United States)

    Hoorweg, Anne-Lee J; Pasma, Wietze; van Wolfswinkel, Leo; de Graaff, Jurgen C

    2018-02-01

    Vital parameter data collected in anesthesia information management systems are often used for clinical research. The validity of this type of research is dependent on the number of artifacts. In this prospective observational cohort study, the incidence of artifacts in anesthesia information management system data was investigated in children undergoing anesthesia for noncardiac procedures. Secondary outcomes included the incidence of artifacts among deviating and nondeviating values, among the anesthesia phases, and among different anesthetic techniques. We included 136 anesthetics representing 10,236 min of anesthesia time. The incidence of artifacts was 0.5% for heart rate (95% CI: 0.4 to 0.7%), 1.3% for oxygen saturation (1.1 to 1.5%), 7.5% for end-tidal carbon dioxide (6.9 to 8.0%), 5.0% for noninvasive blood pressure (4.0 to 6.0%), and 7.3% for invasive blood pressure (5.9 to 8.8%). The incidence of artifacts among deviating values was 3.1% for heart rate (2.1 to 4.4%), 10.8% for oxygen saturation (7.6 to 14.8%), 14.1% for end-tidal carbon dioxide (13.0 to 15.2%), 14.4% for noninvasive blood pressure (10.3 to 19.4%), and 38.4% for invasive blood pressure (30.3 to 47.1%). Not all values in anesthesia information management systems are valid. The incidence of artifacts stored in the present pediatric anesthesia practice was low for heart rate and oxygen saturation, whereas noninvasive and invasive blood pressure and end-tidal carbon dioxide had higher artifact incidences. Deviating values are more often artifacts than values in a normal range, and artifacts are associated with the phase of anesthesia and anesthetic technique. Development of (automatic) data validation systems or solutions to deal with artifacts in data is warranted.

  9. Responses to professional identity threat: Identity management strategies in incident narratives of health care professionals.

    Science.gov (United States)

    van Os, Annemiek; de Gilder, Dick; van Dyck, Cathy; Groenewegen, Peter

    2015-01-01

    The purpose of this paper is to explore sensemaking of incidents by health care professionals through an analysis of the role of professional identity in narratives of incidents. Using insights from social identity theory, the authors argue that incidents may create a threat of professional identity, and that professionals make use of identity management strategies in response to this identity threat. The paper draws on a qualitative analysis of incident narratives in 14 semi-structured interviews with physicians, nurses, and residents at a Dutch specialist hospital. The authors used an existing framework of identity management strategies to categorize the narratives. The analysis yielded two main results. First, nurses and residents employed multiple types of identity management strategies simultaneously, which points to the possible benefit of combining different strategies. Second, physicians used the strategy of patronization of other professional groups, a specific form of downward comparison. The authors discuss the implications of the findings in terms of the impact of identity management strategies on the perpetuation of hierarchical differences in health care. The authors argue that efforts to manage incident handling may profit from considering social identity processes in sensemaking of incidents. This is the first study that systematically explores how health care professionals use identity management strategies to maintain a positive professional identity in the face of incidents. This study contributes to research on interdisciplinary cooperation in health care.

  10. Microgrids: Energy management by loss minimization technique

    Energy Technology Data Exchange (ETDEWEB)

    Basu, A.K. [Electrical Engineering Dept., Jadavpur University & 20/2, Khanpur Road, Kolkata 700047 (India); Chowdhury, S.; Chowdhury, S.P. [Electrical Engineering Department, University of Cape Town & Private Bag X3, Menzies Building, Room-517, Rondebosch, Cape Town 7701 (India)

    2011-07-01

    Energy management is a techno-economic issue, which dictates, in the context of microgrids, how optimal investment in technology front could bring optimal power quality and reliability (PQR) of supply to the consumers. Investment in distributed energy resources (DERs), with their connection to the utility grid at optimal locations and with optimal sizes, saves energy in the form of line loss reduction. Line loss reduction is the indirect benefit to the microgrid owner who may recover it as an incentive from utility. The present paper focuses on planning of optimal siting and sizing of DERs based on minimization of line loss. Optimal siting is done, here, on the loss sensitivity index (LSI) method and optimal sizing by differential evolution (DE) algorithms, which is, again, compared with particle swarm optimization (PSO) technique. Studies are conducted on 6-bus and 14-bus radial networks under islanded mode of operation with electric demand profile. Islanding helps planning of DER capacity of microgrid, which is self-sufficient to cater its own consumers without utility's support.

  11. Making the connection: advancing traffic incident management in transportation planning : a primer.

    Science.gov (United States)

    2013-07-01

    "The intent of this primer is to inform and guide traffic incident management (TIM) professionals and transportation planners to initiate and develop collaborative relationships and advance TIM programs through the metropolitan planning process. The ...

  12. Report: Improvements Needed in CSB’s Identity and Access Management and Incident Response Security Functions

    Science.gov (United States)

    Report #18-P-0030, October 30, 2017. Weaknesses in the Identity and Access Management and Incident Response metric domains leave the CSB vulnerable to attacks occurring and not being detected in a timely manner.

  13. Simulation analysis of route diversion strategies for freeway incident management : final report.

    Science.gov (United States)

    1995-02-01

    The purpose of this project was to investigate whether simulation models could : be used as decision aids for defining traffic diversion strategies for effective : incident management. A methodology was developed for using such a model to : determine...

  14. Development of a Traffic Management Decision Support Tool for Freeway Incident Traffic Management (FITM) Plan Deployment : Research Summary

    Science.gov (United States)

    2017-12-01

    In designing an effective traffic management plan for non-recurrent congestion, it is critical for responsible highway agencies to have some vital information, such as estimated incident duration, resulting traffic queues, and the expected delays. Ov...

  15. The key incident monitoring and management system - history and role in quality improvement.

    Science.gov (United States)

    Badrick, Tony; Gay, Stephanie; Mackay, Mark; Sikaris, Ken

    2018-01-26

    The determination of reliable, practical Quality Indicators (QIs) from presentation of the patient with a pathology request form through to the clinician receiving the report (the Total Testing Process or TTP) is a key step in identifying areas where improvement is necessary in laboratories. The Australasian QIs programme Key Incident Monitoring and Management System (KIMMS) began in 2008. It records incidents (process defects) and episodes (occasions at which incidents may occur) to calculate incident rates. KIMMS also uses the Failure Mode Effects Analysis (FMEA) to assign quantified risk to each incident type. The system defines risk as incident frequency multiplied by both a harm rating (on a 1-10 scale) and detection difficulty score (also a 1-10 scale). Between 2008 and 2016, laboratories participating rose from 22 to 69. Episodes rose from 13.2 to 43.4 million; incidents rose from 114,082 to 756,432. We attribute the rise in incident rate from 0.86% to 1.75% to increased monitoring. Haemolysis shows the highest incidence (22.6% of total incidents) and the highest risk (26.68% of total risk). "Sample is suspected to be from the wrong patient" has the second lowest frequency, but receives the highest harm rating (10/10) and detection difficulty score (10/10), so it is calculated to be the 8th highest risk (2.92%). Similarly, retracted (incorrect) reports QI has the 10th highest frequency (3.9%) but the harm/difficulty calculation confers the second highest risk (11.17%). TTP incident rates are generally low (less than 2% of observed episodes), however, incident risks, their frequencies multiplied by both ratings of harm and discovery difficulty scores, concentrate improvement attention and resources on the monitored incident types most important to manage.

  16. Intelligent techniques in engineering management theory and applications

    CERN Document Server

    Onar, Sezi

    2015-01-01

    This book presents recently developed intelligent techniques with applications and theory in the area of engineering management. The involved applications of intelligent techniques such as neural networks, fuzzy sets, Tabu search, genetic algorithms, etc. will be useful for engineering managers, postgraduate students, researchers, and lecturers. The book has been written considering the contents of a classical engineering management book but intelligent techniques are used for handling the engineering management problem areas. This comprehensive characteristics of the book makes it an excellent reference for the solution of complex problems of engineering management. The authors of the chapters are well-known researchers with their previous works in the area of engineering management.

  17. Surgical Tips in Frozen Abdomen Management: Application of Coliseum Technique.

    Science.gov (United States)

    Kyriazanos, Ioannis D; Manatakis, Dimitrios K; Stamos, Nikolaos; Stoidis, Christos

    2015-01-01

    Wound dehiscence is a serious postoperative complication, with an incidence of 0.5-3% after primary closure of a laparotomy incision, and represents an acute mechanical failure of wound healing. Relatively recently the concept of "intentional open abdomen" was described and both clinical entities share common pathophysiological and clinical pathways ("postoperative open abdominal wall"). Although early reconstruction is the target, a significant proportion of patients will develop adhesions between abdominal viscera and the anterolateral abdominal wall, a condition widely recognized as "frozen abdomen," where delayed wound closure appears as the only realistic alternative. We report our experience with a patient who presented with frozen abdomen after wound dehiscence due to surgical site infection and application of the "Coliseum technique" for its definitive surgical management. This novel technique represents an innovative alternative to abdominal exploration, for cases of "malignant" frozen abdomen due to peritoneal carcinomatosis. Lifting the edges of the surgical wound upwards and suspending them under traction by threads from a retractor positioned above the abdomen facilitates approach to the peritoneal cavity, optimizes exposure of intra-abdominal organs, and prevents operative injury to the innervation and blood supply of abdominal wall musculature, a crucial step for subsequent hernia repair.

  18. Fault Management Techniques in Human Spaceflight Operations

    Science.gov (United States)

    O'Hagan, Brian; Crocker, Alan

    2006-01-01

    This paper discusses human spaceflight fault management operations. Fault detection and response capabilities available in current US human spaceflight programs Space Shuttle and International Space Station are described while emphasizing system design impacts on operational techniques and constraints. Preflight and inflight processes along with products used to anticipate, mitigate and respond to failures are introduced. Examples of operational products used to support failure responses are presented. Possible improvements in the state of the art, as well as prioritization and success criteria for their implementation are proposed. This paper describes how the architecture of a command and control system impacts operations in areas such as the required fault response times, automated vs. manual fault responses, use of workarounds, etc. The architecture includes the use of redundancy at the system and software function level, software capabilities, use of intelligent or autonomous systems, number and severity of software defects, etc. This in turn drives which Caution and Warning (C&W) events should be annunciated, C&W event classification, operator display designs, crew training, flight control team training, and procedure development. Other factors impacting operations are the complexity of a system, skills needed to understand and operate a system, and the use of commonality vs. optimized solutions for software and responses. Fault detection, annunciation, safing responses, and recovery capabilities are explored using real examples to uncover underlying philosophies and constraints. These factors directly impact operations in that the crew and flight control team need to understand what happened, why it happened, what the system is doing, and what, if any, corrective actions they need to perform. If a fault results in multiple C&W events, or if several faults occur simultaneously, the root cause(s) of the fault(s), as well as their vehicle-wide impacts, must be

  19. Traffic incident management in construction and maintenance work zones.

    Science.gov (United States)

    2009-01-01

    In 2004, the Federal Highway Administration published updated rules governing work zone safety and mobility; all highway construction and maintenance projects using federal-aid highway funds are required to develop transportation management plans (TM...

  20. Increased situation awareness in major incidents-radio frequency identification (RFID) technique: a promising tool.

    Science.gov (United States)

    Jokela, Jorma; Rådestad, Monica; Gryth, Dan; Nilsson, Helené; Rüter, Anders; Svensson, Leif; Harkke, Ville; Luoto, Markku; Castrén, Maaret

    2012-02-01

    In mass-casualty situations, communications and information management to improve situational awareness is a major challenge for responders. In this study, the feasibility of a prototype system that utilizes commercially available, low-cost components, including Radio Frequency Identification (RFID) and mobile phone technology, was tested in two simulated mass-casualty incidents. The feasibility and the direct benefits of the system were evaluated in two simulated mass-casualty situations: one in Finland involving a passenger ship accident resulting in multiple drowning/hypothermia patients, and another at a major airport in Sweden using an aircraft crash scenario. Both simulations involved multiple agencies and functioned as test settings for comparing the disaster management's situational awareness with and without using the RFID-based system. Triage documentation was done using both an RFID-based system, which automatically sent the data to the Medical Command, and a traditional method using paper triage tags. The situational awareness was measured by comparing the availability of up-to date information at different points in the care chain using both systems. Information regarding the numbers and status or triage classification of the casualties was available approximately one hour earlier using the RFID system compared to the data obtained using the traditional method. The tested prototype system was quick, stable, and easy to use, and proved to work seamlessly even in harsh field conditions. It surpassed the paper-based system in all respects except simplicity of use. It also improved the general view of the mass-casualty situations, and enhanced medical emergency readiness in a multi-organizational medical setting. The tested technology is feasible in a mass-casualty incident; further development and testing should take place.

  1. A Few Techniques for Time Management

    OpenAIRE

    Zerihun, Dr. Temesgen Belayneh; Krishna, Dr. S Murali

    2012-01-01

    Tomorrow is always the busiest day of the week- Jonathon Lazear.Lack of time is a common complaint in western society. In response, there has been a proliferation of books, articles, and seminars on time management, along with their assertions, prescriptions and anecdotes. However, what exactly is time management? Despite the epidemic of time management training programs, there is currently a lack of agreement about the definition of time management and a dearth of literature summarizing tim...

  2. Preparedness of emergency departments in northwest England for managing chemical incidents: a structured interview survey

    Directory of Open Access Journals (Sweden)

    Walter Darren

    2007-12-01

    Full Text Available Abstract Background A number of significant chemical incidents occur in the UK each year and may require Emergency Departments (EDs to receive and manage contaminated casualties. Previously UK EDs have been found to be under-prepared for this, but since October 2005 acute hospital Trusts have had a statutory responsibility to maintain decontamination capacity. We aimed to evaluate the level of preparedness of Emergency Departments in North West England for managing chemical incidents. Methods A face-to-face semi-structured interview was carried out with the Nurse Manager or a nominated deputy in all 18 Emergency Departments in the Region. Results 16/18 departments had a written chemical incident plan but only 7 had the plan available at interview. All had a designated decontamination area but only 11 felt that they were adequately equipped. 12/18 had a current training programme for chemical incident management and 3 had no staff trained in decontamination. 13/18 could contain contaminated water from casualty decontamination and 6 could provide shelter for casualties before decontamination. Conclusion We have identified major inconsistencies in the preparedness of North West Emergency Departments for managing chemical incidents. Nationally recognized standards on incident planning, facilities, equipment and procedures need to be agreed and implemented with adequate resources. Issues of environmental safety and patient dignity and comfort should also be addressed.

  3. Management of white spots: resin infiltration technique and microabrasion

    Directory of Open Access Journals (Sweden)

    Jeong-Hye Son

    2011-01-01

    Full Text Available This case report compared the effectiveness of resin infiltration technique (Icon, DMG with microabrasion (Opalustre, Ultradent Products, Inc. in management of white spot lesions. It demonstrates that although neither microabrasion nor resin infiltration technique can remove white spot lesions completely, resin infiltration technique seems to be more effective than microabrasion. Therefore resin infiltration technique can be chosen preferentially for management of white spot lesions and caution should be taken for case selection.

  4. Evaluation of undergraduate clinical learning experiences in the subject of pediatric dentistry using critical incident technique

    Directory of Open Access Journals (Sweden)

    S Vyawahare

    2013-01-01

    Full Text Available Introduction: In pediatric dentistry, the experiences of dental students may help dental educators better prepare graduates to treat the children. Research suggests that student′s perceptions should be considered in any discussion of their education, but there has been no systematic examination of India′s undergraduate dental students learning experiences. Aim: This qualitative investigation aimed to gather and analyze information about experiences in pediatric dentistry from the students′ viewpoint using critical incident technique (CIT. Study Design: The sample group for this investigation came from all 240 3 rd and 4 th year dental students from all the four dental colleges in Indore. Using CIT, participants were asked to describe at least one positive and one negative experience in detail. Results: They described 308 positive and 359 negative experiences related to the pediatric dentistry clinic. Analysis of the data resulted in the identification of four key factors related to their experiences: 1 The instructor; 2 the patient; 3 the learning process; and 4 the learning environment. Conclusion: The CIT is a useful data collection and analysis technique that provides rich, useful data and has many potential uses in dental education.

  5. Evaluation of undergraduate clinical learning experiences in the subject of pediatric dentistry using critical incident technique.

    Science.gov (United States)

    Vyawahare, S; Banda, N R; Choubey, S; Parvekar, P; Barodiya, A; Dutta, S

    2013-01-01

    In pediatric dentistry, the experiences of dental students may help dental educators better prepare graduates to treat the children. Research suggests that student's perceptions should be considered in any discussion of their education, but there has been no systematic examination of India's undergraduate dental students learning experiences. This qualitative investigation aimed to gather and analyze information about experiences in pediatric dentistry from the students' viewpoint using critical incident technique (CIT). The sample group for this investigation came from all 240 3rd and 4th year dental students from all the four dental colleges in Indore. Using CIT, participants were asked to describe at least one positive and one negative experience in detail. They described 308 positive and 359 negative experiences related to the pediatric dentistry clinic. Analysis of the data resulted in the identification of four key factors related to their experiences: 1) The instructor; 2) the patient; 3) the learning process; and 4) the learning environment. The CIT is a useful data collection and analysis technique that provides rich, useful data and has many potential uses in dental education.

  6. IMI - An information system for effective Multidisciplinary Incident Management

    NARCIS (Netherlands)

    Lee, M.D.E. van der; Vugt, M. van der

    2004-01-01

    The field of crisis response and disaster management can be characterized, upon many other factors, by distributed operations, not daily routine work and multidisciplinary aspects. In designing and developing information systems for crisis response these factors need special attention. On behalf of

  7. Incidence of fistula after management of perianal abscess

    Directory of Open Access Journals (Sweden)

    Riyadh Mohamad Hasan

    2016-10-01

    Full Text Available Background: Perianal fistula is among the most common anorectal diseases encountered in adults, men are more prone to be affected than women. There is a close relationship of abscess and fistula in etiology, anatomy, pathophysiology, therapy, complications and morbidity, it is appropriate to consider them as one entity. Aim of study: To determine the incidence of fistula formation and recurrent abscess in a sample of Iraqi patients in Baghdad and decide whether primary fistulotomy should be performed at the time of incision and drainage of perianal abscesses. Patients and methods: A retrospective study of 68 patients with perianal abscess operations conducted in Baghdad. They underwent incision and drainage under either local or general anesthesia at Al-Kindy Teaching Hospitals and private hospitals over a 15-year period from January 2000 to December 2015. Their ages ranged from 20 to 68 years (40.21 ± 1.34 males (63/68 (92.64% were more than females (5/68 (7.35%. Patients were treated with incision over the abscess under anesthesia and drainage of the abscess was done. The patients were followed up for an average 18 months (range 12–24 months after abscess drainage or until a fistula appeared and abscess recurrence. Results: The study group comprised of 68 (92.64% patients with perianal abscess with a median age 39 years (range 20–68 years. The mean follow-up period was identified to be 18 months (range 12–24 months. Males (63/68 (92.64% were more than females (5/68 (7.35%. The incidence of fistula formation after follow up, the patients with perianal abscess after incision and drainage was 31/68 (45.58% and males (30/31 (44.11% were more than females (1/31 (1.47%. The most common site was posterior then left lateral position. The percentage of patients with recurrent abscess n = 6 (8.82%were lower than fistula formation n = 31 (45.58%. The percentage of males n = 4/6 (5.88% were more than females 2/6 (2.94%. Conclusions: The

  8. Relaxation techniques for pain management in labour.

    Science.gov (United States)

    Smith, Caroline A; Levett, Kate M; Collins, Carmel T; Armour, Mike; Dahlen, Hannah G; Suganuma, Machiko

    2018-03-28

    Many women would like to avoid pharmacological or invasive methods of pain management in labour and this may contribute to the popularity of complementary methods of pain management. This review examined currently available evidence on the use of relaxation therapies for pain management in labour. This is an update of a review first published in 2011. To examine the effects of mind-body relaxation techniques for pain management in labour on maternal and neonatal well-being during and after labour. We searched Cochrane Pregnancy and Childbirth's Trials Register (9 May 2017), the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library, Issue 5 2017), MEDLINE (1966 to 24 May 2017), CINAHL (1980 to 24 May 2017), the Australian New Zealand Clinical Trials Registry (18 May 2017), ClinicalTrials.gov (18 May 2017), the ISRCTN Register (18 May 2017), the WHO International Clinical Trials Registry Platform (ICTRP) (18 May 2017), and reference lists of retrieved studies. Randomised controlled trials (including quasi randomised and cluster trials) comparing relaxation methods with standard care, no treatment, other non-pharmacological forms of pain management in labour or placebo. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked them for accuracy. We attempted to contact study authors for additional information. We assessed evidence quality with GRADE methodology. This review update includes 19 studies (2519 women), 15 of which (1731 women) contribute data. Interventions examined included relaxation, yoga, music and mindfulness. Approximately half of the studies had a low risk of bias for random sequence generation and attrition bias. The majority of studies had a high risk of bias for performance and detection bias, and unclear risk of bias for, allocation concealment, reporting bias and other bias. We assessed the evidence from these studies as ranging from low to very low quality, and

  9. Traffic incident and crisis management : challenges and obstacles in information sharing

    NARCIS (Netherlands)

    Steenbruggen, J.G.M.; Nijkamp, P.; Smits, J.M.; Mohabir, G.

    2012-01-01

    Disaster Management and Traffic Incident Management involves the coordinated interactions of many public and private actors. On many levels, there is clearly a strong relation be-tween the road infrastructure and the effective handling of large scale disasters. To support these tasks in an effective

  10. Congestive heart failure, spouses' support and the couple's sleep situation: a critical incident technique analysis.

    Science.gov (United States)

    Broström, Anders; Strömberg, Anna; Dahlström, Ulf; Fridlund, Bengt

    2003-03-01

    Sleep related breathing disorders are common as well as a poor prognostic sign associated with higher mortality in patients with congestive heart failure (CHF). These patients often have a shorter total duration of sleep, disturbed sleep structure and increased daytime sleepiness, which can negatively affect all dimensions of the life situation. The spouse has an important role in supporting the patient in relation to sleep disorders, but this role may be adversely affected by the sleep situation of the couple. The aim of this study was to describe decisive situations that influence spouses' support to patients with CHF in relation to the couple's sleep situation. A qualitative descriptive design using critical incident technique was employed. Incidents were collected by means of interviews with 25 spouses of patients with CHF, strategically selected from two hospital-based specialist clinics in southern Sweden. Two main areas emerged in the analysis: support stimulating situations and support inhibiting situations. Support stimulating situations described how spouses' support was positively affected by their own adaptation in psychosocial or practical situations, and receiving help from others. Support inhibiting situations described how the spouses' support was negatively affected by sleep disturbances as a result of the patient's symptoms, anxiety in relation to the disease, limitations as a result of the sleeping habits, dissatisfaction with care related to the sleep situation, and being left to cope alone with the problems. An increased understanding of the stimulating and inhibiting situations influencing spouses' support for patients with CHF can guide health care personnel in deciding if an intervention is needed to improve the sleep situation for patient and spouse.

  11. Unplanned extubations in an intensive care unit: Findings from a critical incident technique.

    Science.gov (United States)

    Danielis, Matteo; Chiaruttini, Simona; Palese, Alvisa

    2018-05-15

    Patients on mechanical ventilation are at risk of experiencing a potentially life-threatening unplanned extubation in the intensive care unit, which can lead to arrhythmias, bronchial aspiration, difficulty in reintubation or even sudden cardiac arrest. Although incidence and outcomes of the phenomenon have been documented in several quantitative studies, no studies have investigated the antecedents as experienced by critical care nurses. To gain a greater understanding of the antecedents of unplanned extubations. A qualitative study design involving the critical-incident technique. A total of 10 registered nurses who reported one or more episodes of unplanned extubations were involved in an in-depth interview. According to the nurses' experience, episodes of unplanned extubations are determined by predisposing, precipitating and mediating factors. The predisposing factors have been recognised in the (a) weaning programme (expected/unexpected decreased sedation) and in the (b) patient factors (increased needs due to discomfort, restlessness and desire to communicate). The precipitating factors have been divided into (a) organisational (failures in multi-professional communication), (b) environmental (excessive environmental chaos and barriers preventing direct surveillance) and (c) nursing care factors (ensuring privacy by creating barriers, avoiding disturbing other patients and poor nurse-to-patient ratio). Among the mediating factors, which are affected by the precipitating factors, decreased surveillance and mechanical restraints' use have been identified. Identifying risk factors of unplanned extubation, specifically those that are modifiable, such as increasing interprofessional communication, reducing excessive environment chaos, implementing strategies aimed at overcoming barriers threatening direct surveillance and ensuring appropriate nurse-to-patient ratio, can prevent the occurrence of these events. Copyright © 2018 Elsevier Ltd. All rights reserved.

  12. Dental anxiety: Investigative and management techniques often ...

    African Journals Online (AJOL)

    Background: Information on the pattern of dental anxiety management in Nigeria is currently not available. Aim: The study was designed to determine the awareness and frequency of application of dental anxiety assessment questionnaires as well as the current pattern in the management of dental anxiety in Nigeria.

  13. Representation of Knowledge on Some Management Accounting Techniques in Textbooks

    Science.gov (United States)

    Golyagina, Alena; Valuckas, Danielius

    2016-01-01

    This paper examines the coverage of management accounting techniques in several popular management accounting texts, assessing each technique's claimed position within practice, its benefits and limitations, and the information sources substantiating these claims. Employing the notion of research genres, the study reveals that textbooks in their…

  14. Development of a Traffic Management Decision Support Tool for Freeway Incident Traffic Management (FITM) Plan Deployment

    Science.gov (United States)

    2017-12-01

    Traffic incidents have long been recognized as the main contributor to congestion in highway networks. Thus, contending with non-recurrent congestion has been a priority task for most highway agencies over the past decades. Under most incident scenar...

  15. Transforming dose management techniques through technology

    International Nuclear Information System (INIS)

    Bennett, M.

    1995-01-01

    The management of occupational dose exposure has been transformed in recent years though the use of facilities such as computerised databases, remote instrumentation and electronic data transfer. Use of this technology has allowed increases both in the amount of data capable of being processed and in the speed at which the data is made available to operators and Health Physics personnel. The dose management system being used in support of the UK's naval nuclear plants has incorporated advances in the areas of dosimetry, data handling and data analysis. Physical dispersion of sites servicing the nuclear plants means that effective communication links have also been vital for good dose management. This paper focuses on some of the most recent dose management technology - the use of virtual reality models linked with a predictive computer code for work planning, a remote area monitoring system with diagnostic software, a personnel dosimetry telemetry system, and electronically linked computer databases. (author)

  16. 282 Effective Classroom Management Techniques for Secondary ...

    African Journals Online (AJOL)

    FIRST LADY

    2011-01-18

    Jan 18, 2011 ... classroom management effectiveness is a powerful motivator of student's learning. As regards the ... attainment of organizational goals. ... reciprocal behaviour that occurs between individuals such as exchange of information ...

  17. Transforming dose management techniques through technology

    International Nuclear Information System (INIS)

    Bennett, M.

    1996-01-01

    The management of occupational dose exposure has been transformed in recent years through the use of facilities such as computerized databases, remote instrumentation and electronic data transfer. Use of this technology has allowed increases both in the amount of data capable of being processed and in the speed at which the data is made available to operators and Health Physics personnel. These developments have significantly improved the quality and efficiency of dose management. The dose management system being used in support of the UK's naval nuclear plants has incorporated advances in the areas of dosimetry, data handling and data analysis. Physical dispersion of sites servicing the nuclear plants means that effective communication links have also been vital for good dose management. (author)

  18. Control systems, personnel policies and management initiatives to limit pollution incidents

    International Nuclear Information System (INIS)

    Martin, B.F.

    1991-01-01

    After the regulatory requirements are met, an important collateral step in the continuing Hazardous Waste/Environmental Management cycle of activities is to minimize the possibility of a pollution incident, spill, contamination, mislabeling, mishandling or exposure, since this minimizes a major contingent liability of the company. Human failure accounts for 88% of accidents, 10% occur from mechanical failure and only 2% are unpreventable force majeure. This implies that fully 98% of all accidents can be prevented or minimized. Good engineering, production, management and educational practices can be formulated to minimize the occurrence and effects of accidental pollution incidents. Hazardous Material/Environmental Management tends to focus on technical and regulatory objectives, a reactionary mode caused in part by the rapidly changing regulatory environment and the need to continually adapt to these changes. Management functions such as personnel management and situational management get shortchanged in research and in practice. What is needed is a system that incorporates change readily, adapts personnel to change easily and mobilizes all the human resources of a company in meeting environmental and regulatory goals in the same way other goals of the company are met. Feedback Loop/Control System concepts have been applied to management practice in the popular Management By Objectives School as well as other schools of management practice. An Environmental Management program is proposed which incorporates feedback loop/ control systems to facilitate operations and training objectives and requirements. By incorporating Environmental and Hazardous Waste goals with other management goals in a system involving all levels of management and workers on the same team, the proposed system will reduce the probability of accidental pollution incidents and thus the contingent liability of a spill or other incident

  19. 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.

  20. Peripartum cardiomyopathy: definition, incidence, etiopathogenesis, diagnosis, and management.

    Science.gov (United States)

    Garg, Jalaj; Palaniswamy, Chandrasekar; Lanier, Gregg M

    2015-01-01

    Peripartum cardiomyopathy (PPCM) is a serious pregnancy-associated disorder of unknown etiology. The precise cellular and molecular mechanisms underlying PPCM are unclear. A heightened awareness among health care providers can result in early diagnosis of heart failure in late pregnancy and the early postpartum period. Though the symptoms of dyspnea and fatigue can result from normal physiologic changes during pregnancy, an electrocardiogram and brain natriuretic peptide level should be obtained in these patients, in addition to baseline laboratory tests such as a complete blood count, and basic metabolic and hepatic function panels. If the electrocardiogram and brain natriuretic peptide level are abnormal, an echocardiogram should be obtained. The role of endomyocardial biopsy for the diagnosis of PPCM is controversial. Patients should be started on diuretics if volume overloaded, and beta-blockers (preferably metoprolol) if no contraindications exist; angiotensin-converting enzyme inhibitors and angiotensin receptor blockers should be avoided during pregnancy or lactation. There are no standard, universally accepted guidelines for the management of PPCM. Although experimental therapies like bromocriptine, pentoxifylline and immunoglobulins have shown promising results, large double-blind randomized trials are essential to confirm the results of smaller studies. In patients with persistent severe left ventricular (LV) dysfunction, advanced therapies like mechanical circulatory support and heart transplantation should be considered. Owing to recent data demonstrating deterioration of LV systolic function after initial recovery, it is essential to maintain long-term follow up of these patients regardless of initial recovery of LV function. We present a comprehensive review of the literature etiopathogenesis, diagnosis, and management of PPCM.

  1. Quality of the Critical Incident Technique in practice: Interrater reliability and users' acceptance under real conditions

    Directory of Open Access Journals (Sweden)

    ANNA KOCH

    2009-03-01

    Full Text Available The Critical Incident Technique (CIT is a widely used task analysis method in personnel psychology. While studies on psychometric properties of the CIT so far primarily took into account relevance ratings of task-lists or attributes, and hence, only a smaller or adapted part of the CIT, little is known about the psychometric properties of the complete CIT in its most meaningful and fruitful way. Therefore, the aim of the present study was to assess interrater reliability and the participants’ view of the CIT under real conditions and especially to provide data for the key step of the CIT: the classification of behavior descriptions into requirements. Additionally, the cost-benefit-ratio and practicability were rated from the participants’ views as an important indicator for the acceptance of the task analysis approach in practice. Instructors of German Institutions for Statutory Accidents Insurance and Prevention as well as their supervisors took part in a job analysis with the CIT. Moderate interrater reliability for the relevance rating was found while the classification step yielded unexpectedly low coefficients for interrater reliability. The cost-benefit-ratio and practicability of the complete CIT were rated very positive. The results are discussed in relation to determinants that facilitate or impede the application of task analysis procedures.

  2. Factors precipitating the risk of aspiration in hospitalized patients: findings from a multicentre critical incident technique study.

    Science.gov (United States)

    Palese, Alvisa; Lesa, Lucia; Stroppolo, Giulia; Lupieri, Giulia; Tardivo, Stefano; Brusaferro, Silvio

    2017-04-01

    To elucidate factors, other than those clinical, precipitating the risk of aspiration in hospitalized patients. The Critical Incident Technique was adopted for this study in 2015. Three departments located in two academic hospitals in the northeast of Italy, equipped with 800 and 1500 beds, respectively. A purposeful sample of 12 registered nurses (RN), all of whom (i) had reported one or more episodes of aspiration during the longitudinal survey, (ii) had worked ≥3 years in the department, and (iii) were willing to participate, were included. Antecedent factors involved in episodes of aspiration as experienced by RNs were collected through an open-ended interview, and qualitatively analysed. In addition to clinical factors, other factors interacting with each other may precipitate the risk of aspiration episodes during hospitalization: at the nursing care level (misclassifying patients, transferring tasks to other healthcare professionals and standardizing processes to remove potential threats); at the family level (misclassifying patients, dealing with the cultural relevance of eating) and at the environmental level (positioning the patient, managing time pressures, distracting patient while eating, dealing with food consistency and irritating oral medication). At the hospital level, an adequate nursing workforce and models of care delivery, as well as time for initial and continuing patient and family assessment are required. At the unit level, patient-centred models of care aimed at reducing care standardization are also recommended; in addition, nursing, family and environmental factors should be recorded in the incident reports documenting episodes of aspiration. © The Author 2016. Published by Oxford University Press in association with the International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  3. Economic Techniques of Occupational Health and Safety Management

    Science.gov (United States)

    Sidorov, Aleksandr I.; Beregovaya, Irina B.; Khanzhina, Olga A.

    2016-10-01

    The article deals with the issues on economic techniques of occupational health and safety management. Authors’ definition of safety management is given. It is represented as a task-oriented process to identify, establish and maintain such a state of work environment in which there are no possible effects of hazardous and harmful factors, or their influence does not go beyond certain limits. It was noted that management techniques that are the part of the control mechanism, are divided into administrative, organizational and administrative, social and psychological and economic. The economic management techniques are proposed to be classified depending on the management subject, management object, in relation to an enterprise environment, depending on a control action. Technoeconomic study, feasibility study, planning, financial incentives, preferential crediting of enterprises, pricing, profit sharing and equity, preferential tax treatment for enterprises, economic regulations and standards setting have been distinguished as economic techniques.

  4. Nonbronchial systemic arteries: incidence and endovascular interventional management for hemoptysis

    International Nuclear Information System (INIS)

    Jiang Sen; Zhu Xiaohua; Sun Xiwen; You Zhengqian; Ma Jun; Yu Dong; Peng Gang; Jie Bing; Sun Chunyi

    2009-01-01

    Objective: To investigate the incidence and relation to primary diseases of the nonbronchial systemic arteries (NBSA) supply to the pulmonary lesions, and to evaluate the clinical value of transcatheter arterial embolization (TAE) of the responsibly NBSA for hemoptysis. Methods: The aortography and subclavian artery angiography were performed in 139 patients with hemoptysis, including pulmonary tuberculosis in 66 cases (2 cases with post-thoracoplasty, 1 case with post-lobectomy, and 1 case with ventricular septal defect), bronchiectasis in 41 (1 case with post-lobectomy and 1 case with post-ligation of patent ductus arteriosus), bronchiogenic carcinoma in 15, unknown hemoptysis in 7, silicosis in 3, broncholithiasis in 3, bronchial cysts in 1, empyema in 1, postoperative lung cancer in 1, and chronic pulmonary embolism in 1, respectively. TAE was performed in patients with the discoverable responsible NBSA. The frequency, distribution and relation to primary diseases of the responsible NBSA were evaluated and the clinical results and complications were observed. Follow-up time ranged from 6 months to 5 years. Results: Seventy-three patients (52.5%) had nonbronchial systemic contributions, including 5 cases of post-thoracotomy with pulmonary lesions, 1 case complicating with ventricular septal defect, 1 case with post-ligation of patent ductus arteriosus, and 1 case of chronic pulmonary embolism. The total number of NBSA were 181 including posterior intercostal arteries (n=88), internal thoracic arteries (n=27), inferior phrenic arteries (n=21), proper esophageal arteries (n=20), lateral thoracic arteries (n=9), subscapular arteries (n=7), costocervical trunks (n=5) and thyrocervical trunks (n=4). Main responsible NBSA were posterior intercostal arteries (n=75) and branches of subclavian and axillary artery (n=44) in patients with pulmonary tuberculosis, and proper esophageal arteries (n=16) and inferior phrenic arteries (n=17) in bronchiectasis. The clinical

  5. National incidence, management and survival of urachal carcinoma

    Directory of Open Access Journals (Sweden)

    Dearbhaile C. Collins

    2016-10-01

    Full Text Available Urachal carcinoma is an uncommon cancer whose rarity has precluded its study and evidence-based management strategies are lacking. This study assessed all urachal carcinomas in Ireland and clinical parameters in order to improve understanding. Urachal carcinomas diagnosed from 1994 to 2011 were identified from the National Cancer Registry in Ireland. Data obtained included patient age, gender, diagnostic year, pathology, tumor stage, patient treatment strategies and survival. Twenty-six urachal carcinomas were identified, the majority being adenocarcinoma. This comprised 0.3% of all invasive bladder tumors. Patients were predominantly male (62% and over 50 years of age (58%. Twenty-two patients (85% underwent surgery, with only six (23% undergoing chemotherapy. On average, median overall survival was 2.6 years (range 0-15.2 yrs. Survival was longer in women (5 vs. 1.9 yrs, patients under 50 years of age (3.6 vs. 1.9 yrs, those without confirmed metastasis (4.1 vs. 0.7 yrs and those who received chemotherapy (3.6 vs. 2.6 yrs. The overall survival of urachal carcinoma in Ireland is less than expected from published literature. This study highlights the need for centralization of rare tumors with international collaboration to identify the optimal treatment strategy and improve outcome.

  6. Power management techniques for integrated circuit design

    CERN Document Server

    Chen, Ke-Horng

    2016-01-01

    This book begins with the premise that energy demands are directing scientists towards ever-greener methods of power management, so highly integrated power control ICs (integrated chip/circuit) are increasingly in demand for further reducing power consumption. * A timely and comprehensive reference guide for IC designers dealing with the increasingly widespread demand for integrated low power management * Includes new topics such as LED lighting, fast transient response, DVS-tracking and design with advanced technology nodes * Leading author (Chen) is an active and renowned contributor to the power management IC design field, and has extensive industry experience * Accompanying website includes presentation files with book illustrations, lecture notes, simulation circuits, solution manuals, instructors manuals, and program downloads.

  7. Management Competences, not Tools and Techniques

    DEFF Research Database (Denmark)

    Rose, Jeremy; Pedersen, Keld; Hosbond, Jens Henrik

    2007-01-01

    in practice. This study, in contrast, uses a qualitative grounded theory approach to develop the basis for an alternative theoretical perspective: that of competence. A competence approach to understanding software project management places the responsibility for success firmly on the shoulders of the people...... competences and desired project outcomes, we collected data through interviews, focus groups and one large plenary meeting with most of the company's project managers. Data analysis employed content analysis for concept (variable) development and causal mapping to trace relationships between variables....... In this way we were able to build up a picture of the competences project managers use in their daily work at WM-data, which we argue is also partly generaliseable to theory. The discrepancy between the two perspectives is discussed, particularly in regard to the current orientation of the software...

  8. Development techniques of computerized maintenance Management system

    Energy Technology Data Exchange (ETDEWEB)

    Oh, Yon Woo; Kim, S D; Soong, W S; Kim, G H; Oh, W H; Kim, Y G

    2000-05-01

    Normal operation of the facility is one of the key factors in the accomplishments of research goals. As confirmed by a case study of the influence of the facility operation condition on the research results, emphasis should be put on the facility preserve management. Facilities should be maintained in solid operational condition and their malfunctions should be repaired as soon as possible. The purpose of this project is to make propositions on the development of the facility preserve management system which is to maximize the efficiency of the budget execution, manpower organization and maintenance planning, and is to minimize the duration of the operational pause due to malfunctions with the least disbursement.

  9. Development techniques of computerized maintenance Management system

    International Nuclear Information System (INIS)

    Oh, Yon Woo; Kim, S.D.; Soong, W.S.; Kim, G.H.; Oh, W.H.; Kim, Y.G.

    2000-05-01

    Normal operation of the facility is one of the key factors in the accomplishments of research goals. As confirmed by a case study of the influence of the facility operation condition on the research results, emphasis should be put on the facility preserve management. Facilities should be maintained in solid operational condition and their malfunctions should be repaired as soon as possible. The purpose of this project is to make propositions on the development of the facility preserve management system which is to maximize the efficiency of the budget execution, manpower organization and maintenance planning, and is to minimize the duration of the operational pause due to malfunctions with the least disbursement

  10. ISWHM: Tools and Techniques for Software and System Health Management

    Science.gov (United States)

    Schumann, Johann; Mengshoel, Ole J.; Darwiche, Adnan

    2010-01-01

    This presentation presents status and results of research on Software Health Management done within the NRA "ISWHM: Tools and Techniques for Software and System Health Management." Topics include: Ingredients of a Guidance, Navigation, and Control System (GN and C); Selected GN and C Testbed example; Health Management of major ingredients; ISWHM testbed architecture; and Conclusions and next Steps.

  11. Alternative techniques for environmental project management

    International Nuclear Information System (INIS)

    Reeves, S.

    1994-01-01

    Beginning in the late 1970s and early 1980s, increased regulation and recognition of ground water as an important natural resource led industry to address subsurface contamination at many sites. This caused the industry's dependence on environmental consultants to increase drastically. Initially, the accepted practice for addressing environmental concerns was to rely upon consultants to determine appropriate work scope, budgets, procedures and regulatory interaction. While significant advances have been made in technology and consulting services, improvement in project management and cost containment have been limited. In order to effectively manage environmental projects, it is imperative that business risks and standardized project management practices be factored into environmental solutions. A standardized environmental project management program was developed and applied to projects at petroleum marketing facilities throughout the United States. Following development and implementation, detailed studies were conducted to measure the value of standardization in reducing costs and enhancing efficiencies. The results indicate significant improvement in both reducing project costs and in enhancing the efficiency of consultants

  12. EP&R Standards Project Report: Technical Review of National Incident Management Standards

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.

    2007-04-24

    The importance and necessity for a fully developed and implemented National Incident Management System (NIMS) has been demonstrated in recent years by the impact of national events such as Hurricane Katrina in 2005. Throughout the history of emergency response to major disasters, especially when multiple response organizations are involved, there have been systemic problems in the consistency and uniformity of response operations. Identifying national standards that support the development and implementation of NIMS is key to helping solve these systemic problems. The NIMS seeks to provide uniformity and consistency for incident management by using common terminology and protocols that will enable responders to coordinate their efforts to ensure an efficient response.

  13. Health-Related Quality of Life in Children with Celiac Disease: A Study Based on the Critical Incident Technique

    Directory of Open Access Journals (Sweden)

    Carlo Catassi

    2013-11-01

    Full Text Available Celiac Disease (CD is a chronic autoimmune disease triggered by dietary gluten. Gluten avoidance, which is the only available treatment for CD, could impact on quality of life of children with CD. We present the results of a qualitative study on the emotional impact of gluten free diet (GFD on the everyday life of children affected with CD. We investigated 76 celiac patients aged 2–18 years (average age: 9.5 years. By using the Critical Incident Technique (CIT, we defined emotions related to difficulties and awkward situations experienced by the patients. Written answers to open-ended questions from either children (older than 8 years and parents (children younger than 8 years were analyzed qualitatively. We found 80 dilemmas experienced in three different arenas (food situations at school, meals at home, meals outside and characterized lived experiences of children with CD in everyday life (specific emotions, difficulties in relationships and in management of daily life. Children with CD experience strong emotions related to the GFD, permeating several aspects of everyday life. These dilemmas may be missed by a conventional, questionnaire-based approach to the psycho-social consequences of CD treatment.

  14. Qualitative techniques for managing operational risk

    OpenAIRE

    Delfiner, Miguel; Pailhé, Cristina

    2009-01-01

    Qualitative techniques are essential tools for identifying and assessing operational risk (OR). Their relevance in assessing OR can be understood due to the lack of a quantitative static model capable of capturing the dynamic operational risk profile which is shaped by managerial decisions. An operational risk profile obtained solely from historical loss data could further change due to corrective actions implemented by the bank after the occurrence of those events. This document introduces s...

  15. Pediatric interventional radiology: Indications, techniques, and management

    International Nuclear Information System (INIS)

    Towbin, R.B.; Ball, W.S. Jr.

    1987-01-01

    This course develops a practical approach to pediatric interventional radiology. Radiologic intervention in the pediatricage group is possible by attending to the care and special needs of the child. The authors also emphasize their approach to patient preparation, sedation and anesthesia, nursing care, monitoring of the patient during the procedure, and follow-up care. The course is divided into nonvascular and vascular sections. The discussion of nonvascular procedures focus on the chest and the GU and GI systems. Biopsy techniques and drainage of effusions and abscesses within the chest are discussed. A variety of GU procedures are presented including insertion of a nephrostomy tube and percutaneous tract dilation for placement of internal stents, percutaneous stone removal, and percutaneous surgery for pyeloplasty. The authors approach to percutaneous pyeloplasty is briefly discussed. Intervention within the GI system includes percutaenous aspiration, drainage, and biopsies. Emphasis is placed on the selection of embolic agents and catheter delivery systems, techniques, and current treatment concepts. The authors describe experience with embolization of vascular malformations, renovascular disease, uncontrollable hemorrhage, and selected neoplastic processes. Comments on the indications for and techniques of transluminal angioplasty and fibrinolytic therapy in children conclude the lecture

  16. Two incidents that changed quality management in the Australian livestock export industry

    Directory of Open Access Journals (Sweden)

    Peter R. Stinson

    2008-03-01

    Full Text Available Quality assurance in Australia's livestock export industry arose from a need to address animal welfare concerns. It was initially instigated by industry in the form of an accreditation scheme which contained standards, auditing requirements and training requirements. Two major incidents in long haul shipping of livestock demonstrated that risk management in the industry cannot be achieved through compliance with standards alone. A thorough investigation of the first incident recommended the introduction of formal risk management to complement a standards regime. This approach is applicable to the management of major risks, such as heat stress and disease. It is also especially suited to commercial risks, such as the rejection of cargo and where voyage or market specific treatments are needed and depend upon the expertise of the exporter. However, before these recommendations on risk management could be fully implemented, a significant public incident occurred which altered the direction of quality assurance in industry. The Australian response was to transfer authority to government regulators with a tightening of standards. This focuses on the need to ensure ownership of quality assurance programmes by the exporter. Formal risk management has been a casualty of the second incident and, unfortunately, has not been introduced.

  17. Using Pareto Analysis with Trend Analysis: Statistical Techniques to Investigate Incident Reports within a Housing System

    Science.gov (United States)

    Luna, Andrew L.

    1998-01-01

    The purpose of this study was to determine trends and difficulties concerning student incident reports within the residence halls as they relate to the incident reporting system from the Department of Housing and Residential Life at a Southeastern Doctoral I Granting Institution. This study used the frequency distributions of each classified…

  18. Critical Incident Stress Management (CISM) in complex systems: cultural adaptation and safety impacts in healthcare.

    Science.gov (United States)

    Müller-Leonhardt, Alice; Mitchell, Shannon G; Vogt, Joachim; Schürmann, Tim

    2014-07-01

    In complex systems, such as hospitals or air traffic control operations, critical incidents (CIs) are unavoidable. These incidents can not only become critical for victims but also for professionals working at the "sharp end" who may have to deal with critical incident stress (CIS) reactions that may be severe and impede emotional, physical, cognitive and social functioning. These CIS reactions may occur not only under exceptional conditions but also during every-day work and become an important safety issue. In contrast to air traffic management (ATM) operations in Europe, which have readily adopted critical incident stress management (CISM), most hospitals have not yet implemented comprehensive peer support programs. This survey was conducted in 2010 at the only European general hospital setting which implemented CISM program since 2004. The aim of the article is to describe possible contribution of CISM in hospital settings framed from the perspective of organizational safety and individual health for healthcare professionals. Findings affirm that daily work related incidents also can become critical for healthcare professionals. Program efficiency appears to be influenced by the professional culture, as well as organizational structure and policies. Overall, findings demonstrate that the adaptation of the CISM program in general hospitals takes time but, once established, it may serve as a mechanism for changing professional culture, thereby permitting the framing of even small incidents or near misses as an opportunity to provide valuable feedback to the system. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. What Helps and Hinders Indigenous Student Success in Higher Education Health Programmes: A Qualitative Study Using the Critical Incident Technique

    Science.gov (United States)

    Curtis, Elana; Wikaire, Erena; Kool, Bridget; Honey, Michelle; Kelly, Fiona; Poole, Phillippa; Barrow, Mark; Airini; Ewen, Shaun; Reid, Papaarangi

    2015-01-01

    Tertiary institutions aim to provide high quality teaching and learning that meet the academic needs for an increasingly diverse student body including indigenous students. "Tatou Tatou" is a qualitative research project utilising Kaupapa "Maori" research methodology and the Critical Incident Technique interview method to…

  20. Health professionals' beliefs about domestic abuse and the issue of disclosure: a critical incident technique study.

    Science.gov (United States)

    Taylor, Julie; Bradbury-Jones, Caroline; Kroll, Thilo; Duncan, Fiona

    2013-09-01

    Domestic abuse is increasingly recognised as a serious, worldwide public health concern. There is a significant body of literature regarding domestic abuse, but little is known about health professionals' beliefs about domestic abuse disclosure. In addition, the intersection between health professionals' beliefs and abused women's views remains uninvestigated. We report on a two-phase, qualitative study using Critical Incident Technique (CIT) that aimed to explore community health professionals' beliefs about domestic abuse and the issue of disclosure. We investigated this from the perspectives of both health professionals and abused women. The study took place in Scotland during 2011. The study was informed theoretically by the Common Sense Model of Self-Regulation of Health and Illness (CSM). This model is typically used in disease-orientated research. In our innovative use, however, CSM was used to study the social phenomenon, domestic abuse. The study involved semi-structured, individual CIT interviews with health professionals and focus groups with women who had experienced domestic abuse. Twenty-nine health professionals (Midwives, Health Visitors and General Practitioners) participated in the first phase of the study. In the second phase, three focus groups were conducted with a total of 14 women. Data were analysed using a combination of an inductive classification and framework analysis. Findings highlight the points of convergence and divergence between abused women's and health professionals' beliefs about abuse. Although there was some agreement, they do not always share the same views. For example, women want to be asked about abuse, but many health professionals do not feel confident or comfortable discussing the issue. Overall, the study shows the dynamic interaction between women's and health professionals' beliefs about domestic abuse and readiness to discuss and respond to it. Understanding these complex dynamics assists in the employment of

  1. [Incidence of phlebitis due to peripherally inserted venous catheters: impact of a catheter management protocol].

    Science.gov (United States)

    Ferrete-Morales, C; Vázquez-Pérez, M A; Sánchez-Berna, M; Gilabert-Cerro, I; Corzo-Delgado, J E; Pineda-Vergara, J A; Vergara-López, S; Gómez-Mateos, J

    2010-01-01

    To assess the impact on the incidence of PPIVC by implementing a catheter management protocol and to determine risk factors for PPIVC development in hospitalized patients. A total of 3978 episodes of venous catheterization were prospectively included from September 2002 to December 2007. A catheter management protocol was implemented during this period of time. The incidence and variables associated to the occurrence of PPIVC were determined. The incidence of PPIVC from 2002 to 2007 was 4.8%, 4.3%, 3.6%, 2.5%, 1.3% and 1.8% (phistory of phlebitis was the only factor independently associated to phlebitis due to peripherally inserted central venous catheters (AOR 3.24; CI at 95% CI= 1.05-9.98, p=0.04). A catheter management protocol decreases the incidence of PPIVC in hospitalized patients. The risk of PPIVC increases for peripherally inserted central venous catheters when the patients have a history of phlebitis and for peripheral venous catheters when amiodarone or cefotaxime are infused. Catheterization of peripheral veins performed during morning shifts is associated with a lower incidence of PPIVC when compared with night shift catheterizations.

  2. Causal Factors and Adverse Events of Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

    Science.gov (United States)

    Reveley, Mary S.; Briggs, Jeffrey L.; Evans, Joni K.; Jones, Sharon M.; Kurtoglu, Tolga; Leone, Karen M.; Sandifer, Carl E.

    2011-01-01

    Causal factors in aviation accidents and incidents related to system/component failure/malfunction (SCFM) were examined for Federal Aviation Regulation Parts 121 and 135 operations to establish future requirements for the NASA Aviation Safety Program s Integrated Vehicle Health Management (IVHM) Project. Data analyzed includes National Transportation Safety Board (NSTB) accident data (1988 to 2003), Federal Aviation Administration (FAA) incident data (1988 to 2003), and Aviation Safety Reporting System (ASRS) incident data (1993 to 2008). Failure modes and effects analyses were examined to identify possible modes of SCFM. A table of potential adverse conditions was developed to help evaluate IVHM research technologies. Tables present details of specific SCFM for the incidents and accidents. Of the 370 NTSB accidents affected by SCFM, 48 percent involved the engine or fuel system, and 31 percent involved landing gear or hydraulic failure and malfunctions. A total of 35 percent of all SCFM accidents were caused by improper maintenance. Of the 7732 FAA database incidents affected by SCFM, 33 percent involved landing gear or hydraulics, and 33 percent involved the engine and fuel system. The most frequent SCFM found in ASRS were turbine engine, pressurization system, hydraulic main system, flight management system/flight management computer, and engine. Because the IVHM Project does not address maintenance issues, and landing gear and hydraulic systems accidents are usually not fatal, the focus of research should be those SCFMs that occur in the engine/fuel and flight control/structures systems as well as power systems.

  3. EAP-based critical incident stress management: utilization of a practice-based assessment of incident severity level in responding to workplace trauma.

    Science.gov (United States)

    DeFraia, Gary S

    2013-01-01

    Central to the field of trauma psychology is assessment of the impact of critical incidents on individuals, as measured by individual symptoms of stress. Accordingly, the trauma literature reflects a proliferation of clinical impact of event scales. Workplace incidents however, affect not only individual employees, but also work organizations, requiring a multi-level response. Critical incident stress management (CISM) is the most prevalent multi-level incident response strategy utilized by organizations, often through specialized CISM units operating within their employee assistance programs (EAPs). While EAP-based CISM units seeks to support both individuals and organizations, studies focused on individual stress dominate the literature, mirroring assessment scales that tend to emphasize clinical as opposed to organizational practice. This research contributes to less-prevalent studies exploring incident characteristics as disruptive to organizations, rather than clinical symptoms as disruptive to individuals. To measure incident disruption, an EAP-based CISM unit developed a critical incident severity scale. By analyzing this unit's extensive practice database, this exploratory study examines how critical incident severity level varies among various types of incidents. Employing the methodology of clinical data mining, this practice-based research generates evidence-informed practice recommendations in the areas of EAP-based CISM intake assessment, organizational consultation and incident response planning.

  4. Transforming dose management techniques through technology

    International Nuclear Information System (INIS)

    Bennett, M.; Morrissey, M.

    1995-01-01

    The development of real-time radiation dosimetry, improved remote monitoring capability and the use of computerized databases and electronic data transfer has led to a significant improvement in effective dose management. This paper describes how these advances have improved occupational dose control for personnel supporting the United Kingdom's naval nuclear plants. Until recently health physics personnel have experienced high levels of occupational exposure compared to other groups, because of manual survey work, but new technology, such as virtual reality models linked with predictive computer codes and other computer based innovations in remote monitoring and telemetry based dosimetry, is reversing this situation. (UK)

  5. Principles of Emergency Department facility design for optimal management of mass-casualty incidents.

    Science.gov (United States)

    Halpern, Pinchas; Goldberg, Scott A; Keng, Jimmy G; Koenig, Kristi L

    2012-04-01

    The Emergency Department (ED) is the triage, stabilization and disposition unit of the hospital during a mass-casualty incident (MCI). With most EDs already functioning at or over capacity, efficient management of an MCI requires optimization of all ED components. While the operational aspects of MCI management have been well described, the architectural/structural principles have not. Further, there are limited reports of the testing of ED design components in actual MCI events. The objective of this study is to outline the important infrastructural design components for optimization of ED response to an MCI, as developed, implemented, and repeatedly tested in one urban medical center. In the authors' experience, the most important aspects of ED design for MCI have included external infrastructure and promoting rapid lockdown of the facility for security purposes; an ambulance bay permitting efficient vehicle flow and casualty discharge; strategic placement of the triage location; patient tracking techniques; planning adequate surge capacity for both patients and staff; sufficient command, control, communications, computers, and information; well-positioned and functional decontamination facilities; adequate, well-located and easily distributed medical supplies; and appropriately built and functioning essential services. Designing the ED to cope well with a large casualty surge during a disaster is not easy, and it may not be feasible for all EDs to implement all the necessary components. However, many of the components of an appropriate infrastructural design add minimal cost to the normal expenditures of building an ED. This study highlights the role of design and infrastructure in MCI preparedness in order to assist planners in improving their ED capabilities. Structural optimization calls for a paradigm shift in the concept of structural and operational ED design, but may be necessary in order to maximize surge capacity, department resilience, and patient and

  6. Smothering in UK free-range flocks. Part 1: incidence, location, timing and management.

    Science.gov (United States)

    Barrett, J; Rayner, A C; Gill, R; Willings, T H; Bright, A

    2014-07-05

    Smothering in poultry is an economic and welfare-related concern. This study presents the first results from a questionnaire addressing the incidence, location, timing and management of smothering of free-range farm managers from two commercial egg companies (representing 35 per cent of the UK free-range egg supply). Overall, nearly 60 per cent of farm mangers experienced smothering in their last flock, with an average of 25.5 birds lost per incidence, although per cent mortality due to smothering was low (x̄=1.6 per cent). The majority of farm managers also reported that over 50 per cent of all their flocks placed had been affected by smothering. The location and timing of smothering (excluding smothering in nest boxes) tended to be unpredictable and varied between farms. Blocking off corners/nest boxes and walking birds more frequently were identified as popular smothering reduction measures, although there was a wide variety of reduction measures reported overall. The motivation to implement reduction measures was related to a farm manager's previous experience of smothering. To our knowledge, this is the first study to provide a representative industry estimate on the incidence, location, timing and management of smothering. The results suggest that smothering is a common problem, unpredictable between flocks with no clear, effective reduction strategies. A follow-up study will investigate the correlations among smothering, disease and other welfare problems and may shed further light on management solutions. British Veterinary Association.

  7. Economic effects of access management techniques in North Carolina.

    Science.gov (United States)

    2010-12-21

    The NCDOT has made significant strides to reduce collisions and increase capacity along : strategic highway corridors across the state. Efforts have led to the implementation of many : different access management techniques along corridors, such as i...

  8. Error-Based Accidents and Security Incidents in Nuclear Materials Management

    International Nuclear Information System (INIS)

    Pond, Daniel J.; Greitzer, Frank L.

    2005-01-01

    Hazard and risk assessments, along with human error analysis and mitigation techniques, have long been mainstays of effective safety programs. These tools have revealed that worker errors contributing to or resulting in accidents are often the consequence of ineffective system conditions, process features, or individual employee characteristics. At Los Alamos National Laboratory (LANL), security, safety, human error, and organizational analysts determined that the system-induced human errors that make accidents more likely also are contributing to security incidents. A similar set of system conditions has been found to underlie deliberate, non-malevolent deviations from proper security practices - termed breaches - that also can result in a security incident. In fiscal-year (FY) 2002, LANL's Security Division therefore established the ESTHER (Enhanced Security Through Human Error Reduction) program to identify and reduce the influence of the factors that underlie employee errors and breaches and, in turn, security incidents. Recognizing the potential benefits of this program and approach, in FY2004 the Department of Energy (DOE) Office of Security Policy (DOE-SO) funded an expansion of ESTHER implementation to the causal assessment and reporting of security incidents at other DOE sites. This presentation will focus on three applications of error/breach assessment and mitigation techniques. One use is proactive, accomplished through the elimination of contributors to error, whereas two are reactive, implemented in response to accidents or security incidents as well as to near misses, to prevent recurrence. The human performance and safety bases of these techniques will be detailed. Associated tools - including computer-based assessment training and web-based incident reporting modules developed by Pacific Northwest National Laboratory - will be discussed

  9. Methods and techniques of nuclear in-core fuel management

    International Nuclear Information System (INIS)

    Jong, A.J. de.

    1992-04-01

    Review of methods of nuclear in-core fuel management (the minimal critical mass problem, minimal power peaking) and calculational techniques: reactorphysical calculations (point reactivity models, continuous refueling, empirical methods, depletion perturbation theory, nodal computer programs); optimization techniques (stochastic search, linear programming, heuristic parameter optimization). (orig./HP)

  10. Understanding Pupil Behaviour: Classroom Management Techniques for Teachers

    Science.gov (United States)

    Lewis, Ramon

    2009-01-01

    This book describes a system of successful classroom behaviour management techniques developed by the author over more than twenty-five years. It outlines the difficulties confronting teachers trying to manage pupils' misbehaviour in schools and describes four types of pupil who can be helped to behave responsibly. In "Understanding Pupil…

  11. Coping Styles as Mediators of Teachers' Classroom Management Techniques

    Science.gov (United States)

    Lewis, Ramon; Roache, Joel; Romi, Shlomo

    2011-01-01

    This study reports the relationships between coping styles of Australian teachers and the classroom based classroom management techniques they use to cope with student misbehaviour. There is great interest internationally in improving educational systems by upgrading the quality of teachers' classroom management. However, the relationship between…

  12. Building Alliance Capability: Management Techniques for Superior Alliance Performance

    NARCIS (Netherlands)

    J.A.J. Draulans (Johan); A-P. de Man (Ard-Pieter); H.W. Volberda (Henk)

    2003-01-01

    textabstractDespite the fact that they represent a growing element of business strategy, alliances between organisations quite often result in failure. This is partly due to the fact that firms have not built up adequate capabilities to manage alliances. Special management techniques have to be

  13. Building alliance capability : management techniques for superior alliance performance

    NARCIS (Netherlands)

    Draulans, J.; Man, de A.P.; Volberda, H.W.

    2003-01-01

    Despite the fact that they represent a growing element of business strategy, alliances between organisations quite often result in failure. This is partly due to the fact that firms have not built up adequate capabilities to manage alliances. Special management techniques have to be implemented in

  14. Competency mapping and visualisation techniques in change management

    OpenAIRE

    Schöpfel , Joachim; Creusot , Jacques

    2008-01-01

    Purpose: The article describes techniques that may facilitate change management in the library. Approach: The paper is based on practical experience and evidence from the INIST library department in France. Findings: Based on standard inventories of LIS professions and competencies, we present techniques for the mapping and visualisation of individual or team-centred job functions and skills. These techniques can help and facilitate communication, information and participation and are useful ...

  15. A management plan for hospitals and medical centers facing radiation incidents

    Directory of Open Access Journals (Sweden)

    Fereshteh Davari

    2015-01-01

    Full Text Available Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  16. A management plan for hospitals and medical centers facing radiation incidents.

    Science.gov (United States)

    Davari, Fereshteh; Zahed, Arash

    2015-09-01

    Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  17. A Review of the Usefulness of R & D Management Techniques.

    Science.gov (United States)

    1981-09-01

    Logistics Air Force Institute of Technology, WAFB, OH I1. CONTROLLING OFFICE N-34E AND ADDRESS 12. REPORT DATE Department of Communication and Humanities...First, upper level managers sometimes fail to accurately translate their understanding of corporate objectives and goals into the technical envi...could also be classified as a "style" of management. A management technique according to John Argenti is "a recognized method of analyzing or solving a

  18. Developing Flanagan's critical incident technique to elicit indicators of high and low quality nursing care from patients and their nurses.

    Science.gov (United States)

    Norman, I J; Redfern, S J; Tomalin, D A; Oliver, S

    1992-05-01

    This paper discusses a development of Flanagan's critical incident technique (CIT) to elicit indicators of high and low quality nursing from patients and their nurses on medical, surgical and elderly care wards. Stages in undertaking the CIT are identified and presuppositions held by most researchers about the nature of the technique are identified. The paper describes how the authors moved to a different set of presuppositions during the course of the study. Preliminary analysis of interview transcripts revealed that critical incidents need not always be demarcated scenes with a clear beginning and end, but may arise from respondents summarizing their overall experience within their description of one incident. Characteristically respondents were unable to give a detailed account of such incidents but validity may be established by the fact that respondents appear to recount what actually happened as they saw it, and what they said was clearly important to them. The researchers found that the most appropriate basic unit of analysis was not the incident itself but 'happenings' revealed by incidents that are 'critical' by virtue of being important to respondents with respect to the quality of nursing care. The importance of CIT researchers achieving an understanding of the 'meaning' of critical happenings to respondents is emphasized. Analysis of the interview transcripts is facilitated by the use of INGRES, a relational database computer program which should enable a 'personal theory' of quality nursing for each respondent, both patients and nurses, to be described. The study suggests that the CIT is a flexible technique which may be adapted to meet the demands of nursing research. If carefully applied, the CIT seems capable of capitalizing on respondents' own stories and avoids the loss of information which occurs when complex narratives are reduced to simple descriptive categories. Patients and nurses have unique perspectives on nursing and their views are of

  19. Employing 3R Techniques in Managing Cement Industry Waste

    Directory of Open Access Journals (Sweden)

    Lamyaa Mohammed Dawood

    2018-01-01

    Full Text Available Waste management conserves human health, ownership, environment, and keeps valuable natural resources. Lean-green waste of an organization’s operations can be decreased through implementation 3R (Reduce, Reuse, and Recycling techniques by reduction of manufacturing system wastes. This research aims to integrate lean-green waste of the manufacturing system throughout employing 3R techniques and weighted properties method in order to manage waste. Al-Kufa cement plant is employed as a case study. Results are generated using Edraw Max Version 7 and Excel. Overall results show reduce technique of lean-green waste management has major contribution of 55 % and recycling technique has minor contribution 18 %. Defects waste has major integration of lean-green waste, while air emissions waste has minor integration of lean-green waste.

  20. Construction techniques and management methods for BWR plants

    International Nuclear Information System (INIS)

    Shimizu, Yohji; Tateishi, Mizuo; Hayashi, Yoshishige

    1989-01-01

    Toshiba is constantly striving for safer and more efficient plant construction to realize high-quality BWR plants within a short construction period. To achieve these aims, Toshiba has developed and improved a large number of construction techniques and construction management methods. In the area of installation, various techniques have been applied such as the modularization of piping and equipment, shop installation of reactor internals, etc. Further, installation management has been upgraded by the use of pre-installation review programs, the development of installation control systems, etc. For commissioning, improvements in commissioning management have been achieved through the use of computer systems, and testing methods have also been upgraded by the development of computer systems for the recording and analysis of test data and the automatic adjustment of controllers in the main control system of the BWR. This paper outlines these construction techniques and management methods. (author)

  1. Management of broken instrument by file bypass technique

    Directory of Open Access Journals (Sweden)

    Sultana Parveen

    2017-02-01

    Full Text Available Different devices and techniques have been developed to retrieve fractured instruments during the endodontic procedures. This case report describes the management of a broken instrument, which was accidentally broken during cleaning and shaping of the root canal in right 2nd molar tooth. A # 25 stainless steel K-file was separated in mesiobuccal canal of the treated tooth. At first, a radiograph was taken to confirm the level of separation of the instrument. The instrument was found to be separated at the apical 3rd of the mesial canal and then file bypass technique was performed. Calcium hydroxide dressing was given for 7 days followed by obturation with guttapercha cone and zinc oxide eugenol sealer in lateral condensation technique. It can be concluded that bypass technique can be considered as simple and effective technique for the management of broken instrument into the root canal.

  2. Early Detection and Localization of Downhole Incidents in Managed Pressure Drilling

    DEFF Research Database (Denmark)

    Willersrud, Anders; Imsland, Lars; Blanke, Mogens

    2015-01-01

    Downhole incidents such as kick, lost circulation, pack-off, and hole cleaning issues are important contributors to downtime in drilling. In managed pressure drilling (MPD), operations margins are typically narrower, implying more frequent incidents and more severe consequences. Detection...... and handling of symptoms of downhole drilling contingencies at an early stage are therefore crucial for the reliability and safety of MPD operations. In this paper we describe a method for early detection and localization of such incidents, based on a fit for purpose model of the downhole pressure hydraulics...... successfully been tested on experimental data from a medium-scale horizontal flow loop in Sta- vanger, Norway. The flow loop represents a 700 m borehole with emulation of the following downhole contingencies: drillstring washout, drill bit nozzle plugging, gas influx and fluid loss. In the tests...

  3. Workload management and geographic disorientation in aviation incidents: A review of the ASRS data base

    Science.gov (United States)

    Williams, Henry P.; Tham, Mingpo; Wickens, Christopher D.

    1993-01-01

    NASA's Aviation Safety Reporting System (ASRS) incident reports are reviewed in two related areas: pilots' failures to appropriately manage tasks, and breakdowns in geographic orientation. Examination of 51 relevant reports on task management breakdowns revealed that altitude busts and inappropriate runway usee were the most frequently reported consequences. Task management breakdowns appeared to occur at all levels of expertise, and prominent causal factors were related to breakdowns in crew communications, over-involvement with the flight management system and, for small (general aviation) aircraft, preoccupation with weather. Analysis of the 83 cases of geographic disorientation suggested that these too occurred at all levels of pilot experience. With regard to causal factors, a majority was related to poor cockpit resource management, in which inattention led to a loss of geographic awareness. Other leading causes were related to poor weather and poor decision making. The potential of the ASRS database for contributing to research and design issues is addressed.

  4. Surgical site infections following transcatheter apical aortic valve implantation: incidence and management

    Directory of Open Access Journals (Sweden)

    Baillot Richard

    2012-11-01

    Full Text Available Abstract Objective The present study was undertaken to examine the incidence and management of surgical site infection (SSI in patients submitted to transapical transcatheter aortic valve implantation (TA-TAVI. Methods From April 2007 to December 2011, 154 patients underwent TA-TAVI with an Edwards Sapien bioprosthesis (ES at the Institut Universitaire de Cardiologie et Pneumologie de Québec (IUCPQ as part of a multidisciplinary program to prospectively evaluate percutaneous aortic valve implantation. Patient demographics, perioperative variables, and postoperative complications were recorded in a prospective registry. Results Five (3.2% patients in the cohort presented with an SSI during the study period. The infections were all hospital-acquired (HAI and were considered as organ/space SSI’s based on Center for Disease Control criteria (CDC. Within the first few weeks of the initial procedure, these patients presented with an abscess or chronic draining sinus in the left thoracotomy incision and were re-operated. The infection spread to the apex of the left ventricle in all cases where pledgeted mattress sutures could be seen during debridement. Patients received multiple antibiotic regimens without success until the wound was surgically debrided and covered with viable tissue. The greater omentum was used in three patients and the pectoralis major muscle in the other two. None of the patients died or had a recurrent infection. Three of the patients were infected with Staphylococcus epidermidis, one with Staphylococcus aureus, and one with Enterobacter cloacae. Patients with surgical site infections were significantly more obese with higher BMI (31.4±3.1 vs 26.2±4.4 p=0.0099 than the other patients in the cohort. Conclusions While TA-TAVI is a minimally invasive technique, SSIs, which are associated with obesity, remain a concern. Debridement and rib resection followed by wound coverage with the greater omentum and/or the pectoralis major

  5. Surgical site infections following transcatheter apical aortic valve implantation: incidence and management.

    Science.gov (United States)

    Baillot, Richard; Fréchette, Éric; Cloutier, Daniel; Rodès-Cabau, Josep; Doyle, Daniel; Charbonneau, Éric; Mohammadi, Siamak; Dumont, Éric

    2012-11-13

    The present study was undertaken to examine the incidence and management of surgical site infection (SSI) in patients submitted to transapical transcatheter aortic valve implantation (TA-TAVI). From April 2007 to December 2011, 154 patients underwent TA-TAVI with an Edwards Sapien bioprosthesis (ES) at the Institut Universitaire de Cardiologie et Pneumologie de Québec (IUCPQ) as part of a multidisciplinary program to prospectively evaluate percutaneous aortic valve implantation. Patient demographics, perioperative variables, and postoperative complications were recorded in a prospective registry. Five (3.2%) patients in the cohort presented with an SSI during the study period. The infections were all hospital-acquired (HAI) and were considered as organ/space SSI's based on Center for Disease Control criteria (CDC). Within the first few weeks of the initial procedure, these patients presented with an abscess or chronic draining sinus in the left thoracotomy incision and were re-operated. The infection spread to the apex of the left ventricle in all cases where pledgeted mattress sutures could be seen during debridement. Patients received multiple antibiotic regimens without success until the wound was surgically debrided and covered with viable tissue. The greater omentum was used in three patients and the pectoralis major muscle in the other two. None of the patients died or had a recurrent infection. Three of the patients were infected with Staphylococcus epidermidis, one with Staphylococcus aureus, and one with Enterobacter cloacae. Patients with surgical site infections were significantly more obese with higher BMI (31.4±3.1 vs 26.2±4.4 p=0.0099) than the other patients in the cohort. While TA-TAVI is a minimally invasive technique, SSIs, which are associated with obesity, remain a concern. Debridement and rib resection followed by wound coverage with the greater omentum and/or the pectoralis major muscle were used successfully in these patients.

  6. Incidental durotomy in lumbar spine surgery - incidence, risk factors and management

    Directory of Open Access Journals (Sweden)

    Adam D.

    2015-03-01

    Full Text Available Incidental durotomy is a common complication of lumbar spine operations for degenerative disorders. Its incidence varies depending on several risk factors and regarding the intra and postoperative management, there is no consensus. Our objective was to report our experience with incidental durotomy in patients who were operated on for lumbar disc herniation, lumbar spinal stenosis and revision surgeries. Between 2009 and 2012, 1259 patients were operated on for degenerative lumbar disorders. For primary operations, the surgical approach was mino-open, interlamar, uni- or bilateral, as for recurrences, the removal of the compressive element was intended: the epidural scar and the disc fragment. 863 patients (67,7% were operated on for lumbar disc herniation, 344 patients (27,3% were operated on for lumbar spinal stenosis and 52 patients (5% were operated for recurrences. The operations were performed by neurosurgeons with the same professional degree but with different operative volume. Unintentional durotomy occurred in 20 (2,3% of the patients with herniated disc, in 14 (4,07% of the patients with lumbar spinal stenosis and in 12 (23% of the patients who were operated on for recurrences. The most frequent risk factors were: obesity, revised surgery and the physician’s low operative volume. Intraoperative dural fissures were repaired through suture (8 cases, by applying muscle, fat graft or by applying curaspon, tachosil. There existed 4 CSF fistulas which were repaired at reoperation. Incidental dural fissures during operations for degenerative lumbar disorders must be recognized and immediately repaired to prevent complications such as CSF fistula, osteodiscitis and increased medical costs. Preventing, identifying and treating unintentional durotomies can be best achieved by respecting a neat surgical technique and a standardized treatment protocol.

  7. Strategic Management Tools and Techniques Usage: a Qualitative Review

    Directory of Open Access Journals (Sweden)

    Albana Berisha Qehaja

    2017-01-01

    Full Text Available This paper is one of the few studies to review the empirical literature on strategic management tools and techniques usage. There are many techniques, tools and methods, models, frameworks, approaches and methodologies, available to support strategic managers in decision making. They are developed and designed to support managers in all stages of strategic management process to achieve better performance. Management schools provide knowledge of these tools. But their use in organizations should be seen in practice‑based context. Consequently, some questions arise: Do they use these strategic tools and techniques in their workplace? Which strategic tools and techniques are used more in organizations? To answer these questions we have made a review of empirical studies using textual narrative synthesis method. Initially, this study presents a tabulation with a summary of empirical research for the period 1990–2015. The included studies are organized clustering them by enterprise size and sector and by country level development. A synopsis of the ten most used strategic tools and techniques worldwide resulted as follows: SWOT analysis, benchmarking, PEST analysis, “what if” analysis, vision and mission statements, Porter’s five forces analysis, business financial analysis, key success factors analysis, cost‑benefit analysis and customer satisfaction.

  8. Supply chain management under fuzziness recent developments and techniques

    CERN Document Server

    Öztayşi, Başar

    2014-01-01

    Supply Chain Management Under Fuzziness presents recently developed fuzzy models and techniques for supply chain management. These include: fuzzy PROMETHEE, fuzzy AHP, fuzzy ANP, fuzzy VIKOR, fuzzy DEMATEL, fuzzy clustering, fuzzy linear programming, and fuzzy inference systems. The book covers both practical applications and new developments concerning these methods. This book offers an excellent resource for researchers and practitioners in supply chain management and logistics, and will provide them with new suggestions and directions for future research. Moreover, it will support graduate students in their university courses, such as specialized courses on supply chains and logistics, as well as related courses in the fields of industrial engineering, engineering management and business administration.

  9. PROACTIVE APPROACH TO THE INCIDENT AND PROBLEM MANAGEMENT IN COMMUNICATION NETWORKS

    Directory of Open Access Journals (Sweden)

    Vjeran Strahonja

    2007-06-01

    Full Text Available Proactive approach to communication network maintenance has the capability of enhancing the integrity and reliability of communication networks, as well as of reducing maintenance costs and overall number of incidents. This paper presents approaches to problem and incident prevention with the help of root-cause analysis, aligning that with the goal to foresee software performance. Implementation of proactive approach requires recognition of enterprise's current level of maintenance better insights into available approaches and tools, as well as their comparison, interoperability, integration and further development. The approach we are proposing and elaborating in this paper lies on the construction of a metamodel of the problem management of information technology, particularly the proactive problem management. The metamodel is derived from the original ITIL specification and presented in an object-oriented fashion by using structure (class diagrams conform to UML notation. Based on current research, appropriate metrics based on the concept of Key Performance Indicators is suggested.

  10. Integrating an incident management system within a continuity of operations programme: case study of the Bank of Canada.

    Science.gov (United States)

    Loop, Carole

    2013-01-01

    Carrying out critical business functions without interruption requires a resilient and robust business continuity framework. By embedding an industry-standard incident management system within its business continuity structure, the Bank of Canada strengthened its response plan by enabling timely response to incidents while maintaining a strong focus on business continuity. A total programme approach, integrating the two disciplines, provided for enhanced recovery capabilities. While the value of an effective and efficient response organisation is clear, as demonstrated by emergency events around the world, incident response structures based on normal operating hierarchy can experience unique challenges. The internationally-recognised Incident Command System (ICS) model addresses these issues and reflects the five primary incident management functions, each contributing to the overall strength and effectiveness of the response organisation. The paper focuses on the Bank of Canada's successful implementation of the ICS model as its incident management and continuity of operations programmes evolved to reflect current best practices.

  11. Hoshin Kanri: a technique for strategic quality management.

    Science.gov (United States)

    Tennant, C; Roberts, P A

    2000-01-01

    This paper describes a technique for Strategic Quality Management (SQM), known as Hoshin Kanri, which has been operated as a management system in many Japanese companies since the 1960s. It represents a core aspect of Japanese companies' management systems, and is stated as: the means by which the overall control system and Total Quality Management (TQM) are deployed. Hoshin Kanri is not particularly unique in its concept of establishing and tracking individual goals and objectives, but the manner in which the objectives and the means to achieve them are developed and deployed is. The problem with applying the concept of Strategic Quality Management (SQM) using Hoshin Kanri, is that it can tend to challenge the traditional authoritarian strategic planning models, which have become the paradigms of modern business. Yet Hoshin Kanri provides an appropriate tool for declaration of the strategic vision for the business while integrating goals and targets in a single holistic model. There have been various adaptations of Hoshin Kanri to align the technique to Western thinking and management approaches, yet outside Japan its significance has gone largely unreported. It is proposed that Hoshin Kanri is an effective methodology for SQM, which has a number of benefits over the more conventional planning techniques. The benefits of Hoshin Kanri as a tool for Strategic Quality Management (SQM) compared to conventional planning systems include: integration of strategic objectives with tactical daily management, the application of the plan-do-check-act cycle to business process management, parallel planning and execution methodology, company wide approach, improvements in communication, increased consensus and buy-in to goal setting, and cross-functional-management integration.

  12. An intelligent content discovery technique for health portal content management.

    Science.gov (United States)

    De Silva, Daswin; Burstein, Frada

    2014-04-23

    Continuous content management of health information portals is a feature vital for its sustainability and widespread acceptance. Knowledge and experience of a domain expert is essential for content management in the health domain. The rate of generation of online health resources is exponential and thereby manual examination for relevance to a specific topic and audience is a formidable challenge for domain experts. Intelligent content discovery for effective content management is a less researched topic. An existing expert-endorsed content repository can provide the necessary leverage to automatically identify relevant resources and evaluate qualitative metrics. This paper reports on the design research towards an intelligent technique for automated content discovery and ranking for health information portals. The proposed technique aims to improve efficiency of the current mostly manual process of portal content management by utilising an existing expert-endorsed content repository as a supporting base and a benchmark to evaluate the suitability of new content A model for content management was established based on a field study of potential users. The proposed technique is integral to this content management model and executes in several phases (ie, query construction, content search, text analytics and fuzzy multi-criteria ranking). The construction of multi-dimensional search queries with input from Wordnet, the use of multi-word and single-word terms as representative semantics for text analytics and the use of fuzzy multi-criteria ranking for subjective evaluation of quality metrics are original contributions reported in this paper. The feasibility of the proposed technique was examined with experiments conducted on an actual health information portal, the BCKOnline portal. Both intermediary and final results generated by the technique are presented in the paper and these help to establish benefits of the technique and its contribution towards effective

  13. Comparing badger (Meles meles) management strategies for reducing tuberculosis incidence in cattle.

    Science.gov (United States)

    Smith, Graham C; McDonald, Robbie A; Wilkinson, David

    2012-01-01

    Bovine tuberculosis (bTB), caused by Mycobacterium bovis, continues to be a serious economic problem for the British cattle industry. The Eurasian badger (Meles meles) is partly responsible for maintenance of the disease and its transmission to cattle. Previous attempts to manage the disease by culling badgers have been hampered by social perturbation, which in some situations is associated with increases in the cattle herd incidence of bTB. Following the licensing of an injectable vaccine, we consider the relative merits of management strategies to reduce bTB in badgers, and thereby reduce cattle herd incidence. We used an established simulation model of the badger-cattle-TB system and investigated four proposed strategies: business as usual with no badger management, large-scale proactive badger culling, badger vaccination, and culling with a ring of vaccination around it. For ease of comparison with empirical data, model treatments were applied over 150 km(2) and were evaluated over the whole of a 300 km(2) area, comprising the core treatment area and a ring of approximately 2 km. The effects of treatment were evaluated over a 10-year period comprising treatment for five years and the subsequent five year period without treatment. Against a background of existing disease control measures, where 144 cattle herd incidents might be expected over 10 years, badger culling prevented 26 cattle herd incidents while vaccination prevented 16. Culling in the core 150 km(2) plus vaccination in a ring around it prevented about 40 cattle herd breakdowns by partly mitigating the negative effects of culling, although this approach clearly required greater effort. While model outcomes were robust to uncertainty in parameter estimates, the outcomes of culling were sensitive to low rates of land access for culling, low culling efficacy, and the early cessation of a culling strategy, all of which were likely to lead to an overall increase in cattle disease.

  14. Comparing badger (Meles meles management strategies for reducing tuberculosis incidence in cattle.

    Directory of Open Access Journals (Sweden)

    Graham C Smith

    Full Text Available Bovine tuberculosis (bTB, caused by Mycobacterium bovis, continues to be a serious economic problem for the British cattle industry. The Eurasian badger (Meles meles is partly responsible for maintenance of the disease and its transmission to cattle. Previous attempts to manage the disease by culling badgers have been hampered by social perturbation, which in some situations is associated with increases in the cattle herd incidence of bTB. Following the licensing of an injectable vaccine, we consider the relative merits of management strategies to reduce bTB in badgers, and thereby reduce cattle herd incidence. We used an established simulation model of the badger-cattle-TB system and investigated four proposed strategies: business as usual with no badger management, large-scale proactive badger culling, badger vaccination, and culling with a ring of vaccination around it. For ease of comparison with empirical data, model treatments were applied over 150 km(2 and were evaluated over the whole of a 300 km(2 area, comprising the core treatment area and a ring of approximately 2 km. The effects of treatment were evaluated over a 10-year period comprising treatment for five years and the subsequent five year period without treatment. Against a background of existing disease control measures, where 144 cattle herd incidents might be expected over 10 years, badger culling prevented 26 cattle herd incidents while vaccination prevented 16. Culling in the core 150 km(2 plus vaccination in a ring around it prevented about 40 cattle herd breakdowns by partly mitigating the negative effects of culling, although this approach clearly required greater effort. While model outcomes were robust to uncertainty in parameter estimates, the outcomes of culling were sensitive to low rates of land access for culling, low culling efficacy, and the early cessation of a culling strategy, all of which were likely to lead to an overall increase in cattle disease.

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

    African Journals Online (AJOL)

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

  16. A Rationale and Bibliography for Classroom Management and Intervention Techniques.

    Science.gov (United States)

    Karr-Kidwell, PJ

    This 51-item bibliography offers a selection of writings on issues and problems related to classroom management and discipline. Most citations concern works written between 1972-1983. Intervention techniques in dealing with deviant behavior are highlighted along with discipline and control in the classroom. Articles on methods of behavior…

  17. Using Powerpoint Animations to Teach Operations Management Techniques and Concepts

    Science.gov (United States)

    Treleven, Mark D.; Penlesky, Richard J.; Callarman, Thomas E.; Watts, Charles A.; Bragg, Daniel J.

    2014-01-01

    This article examines the value of using complex animated PowerPoint presentations to teach operations management techniques and concepts. To provide context, literature covering the use of PowerPoint animations in business education is briefly reviewed. The specific animations employed in this study are identified and their expected benefits to…

  18. Self Management Techniques and Disclosure of Sero Status

    Science.gov (United States)

    Falaye, Ajibola; Afolayan, Joel Adeleke

    2015-01-01

    This study looked at using Self Management Technique (SMT) to promote self-disclosure of Sero status in Kwara State, Nigeria. A pre-test, post-test and control group quasi experimental design using a 2x2x2 factorial matrix was adopted. Sixty participants were sampled by balloting from two HIV/AIDS screening centres. Four instruments were used such…

  19. Safety management: a few techniques and their application

    International Nuclear Information System (INIS)

    Soundararajan, S.

    2016-01-01

    Industrial safety practice has grown in its stature tremendously since the age of industrial revolution. A number of modern techniques are available to strengthen design safety features, to review operational safety, and to critically appraise and upgrade practices of occupational safety and health management. This talk focuses on three prominent yet simple techniques and their usefulness in the overall safety management of a workplace. Any industrial set-up undergoes different stages in its life cycle-conceptual design, actual design, construction, fabrication and installation, commissioning, operation, shutdown/re-start up and decommissioning. Checklist procedure is a safety tool that can be applied at any of these stages. Thus it is a quite useful technique in safety management and accident prevention. It can serve as a form of approval from one step to another in the course of any routine or specific task. Safety Audit or Safety Review is a critical safety management appraisal tool. It gives a reasonable indication of how well a company's safety programme works, how hazards are recognised, how well employees are motivated and so on. It gives a clear picture about where a company stands as far as framing and implementation of its SHE policy is concerned. Each of the above tools is complementing each other and required to be applied at appropriate juncture in sustaining good safety management system at the workplace

  20. Contribution of the radioactive tracer techniques to the littoral management

    International Nuclear Information System (INIS)

    Alami, R.

    1994-01-01

    The construction of a harbor or its extending, the management of entrance channels and their maintenance (e.g. dredging works), the littoral development for industrial or tourist purposes, the management of urban or industrial rejects are very expensive and have a great impact on the environment, the optimization of which requires to begin with understanding and making sure of the sedimentary mechanisms occurring under the natural conditions. The tracer techniques are, in such cases, a precious tool and a unique help to the decision makers. The profits made by using such techniques in Morocco, which is a seaboard country, have led the C entre National de l'Energie, des Sciences et des Techniques Nucleaires (CNESTEN) to set up a unit which is operational in this field. 7 figs., 8 refs (F.M.)

  1. Occult pneumothorax in Chinese patients with significant blunt chest trauma: incidence and management.

    Science.gov (United States)

    Lee, Ka L; Graham, Colin A; Yeung, Janice H H; Ahuja, Anil T; Rainer, Timothy H

    2010-05-01

    Occult pneumothorax (OP) is a pneumothorax not visualised on a supine chest X-ray (CXR) but detected on computed tomography (CT) scanning. With increasing CT use for trauma, more OP may be detected. Management of OP remains controversial, especially for patients undergoing mechanical ventilation. This study aimed to identify the incidence of OP using thoracic CT as the gold standard and describe its management amongst Hong Kong Chinese trauma patients. Analysis of prospectively collected trauma registry data. Consecutive significantly injured trauma patients admitted through the emergency department (ED) suffering from blunt chest trauma who underwent thoracic computed tomography (TCT) between in calendar years 2007 and 2008 were included. An OP was defined as the identification (by a specialist radiologist) of a pneumothorax on TCT that had not been previously detected on supine CXR. 119 significantly injured patients were included. 56 patients had a pneumothorax on CXR and a further 36 patients had at least one OP [OP incidence 30% (36/119)]. Bilateral OP was present in 8/36 patients, so total OP numbers were 44. Tube thoracostomy was performed for 8/44 OP, all were mechanically ventilated in the ED. The remaining 36 OP were managed expectantly. No patients in the expectant group had pneumothorax progression, even though 8 patients required subsequent ventilation in the operating room for extrathoracic surgery. The incidence of OP (seen on TCT) in Chinese patients in Hong Kong after blunt chest trauma is higher than that typically reported in Caucasians. Most OP were managed expectantly without significant complications; no pneumothorax progressed even though some patients were mechanically ventilated. (c) 2010 Elsevier Ltd. All rights reserved.

  2. Development of automatic techniques for GPS data management

    International Nuclear Information System (INIS)

    Park, Pil Ho

    2001-06-01

    It is necessary for GPS center to establish automatization as effective management of GPS network including data gathering, data transformation, data backup, data sending to IGS (International GPS Service for geodynamics), and precise ephemerides gathering. The operating program of GPS center has been adopted at KCSC (Korea Cadastral Survey Corporation), NGI (National Geography Institute), MOMAF (Ministry of Maritime Affairs and Fisheries) without self-development of core technique. The automatic management of GPS network is consists of GPS data management and data processing. It is also fundamental technique, which should be accomplished by every GPS centers. Therefore, this study carried out analyzing of Japanese GPS center, which has accomplished automatization by module considering applicability for domestic GPS centers

  3. Radioimmunoassay techniques and reproductive management of livestock in North Africa

    International Nuclear Information System (INIS)

    Lahlou-Kassi, A.; Lakhdissi, H.

    1984-01-01

    The report summarizes the principal applications of progesterone radioimmunoassay (P 4 -RIA) in Morocco for evaluating and improving fertility in cattle, sheep and camels. In cattle, P 4 -RIA of blood or milk helped to determine the time for onset of sexual functions after parturition and the incidence of silent oestrus. It is especially important to assess the first factor in semi-extensively managed herds, while the second factor occurs mainly in intensively managed herds. P 4 -RIA is an important tool in fertility improvement programmes involving induction and synchronization of oestrus and testing for early pregnancy. In sheep, P 4 -RIA helped to define the optimum age at first mating of ewe lambs and the optimum mating season of the year for adult ewes. In camels, analysis of the profile of plasma progesterone before and after mating suggests that P 4 -RIA could be used for early pregnancy testing. (author)

  4. Implementation of the National Incident Management System (NIMS)/Incident Command System (ICS) in the Federal Radiological Monitoring and Assessment Center(FRMAC) - Emergency Phase

    International Nuclear Information System (INIS)

    NSTec Environmental Restoration

    2007-01-01

    Homeland Security Presidential Directive HSPD-5 requires all federal departments and agencies to adopt a National Incident Management System (NIMS)/Incident Command System (ICS) and use it in their individual domestic incident management and emergency prevention, preparedness, response, recovery, and mitigation programs and activities, as well as in support of those actions taken to assist state and local entities. This system provides a consistent nationwide template to enable federal, state, local, and tribal governments, private-sector, and nongovernmental organizations to work together effectively and efficiently to prepare for, prevent, respond to, and recover from domestic incidents, regardless of cause, size, or complexity, including acts of catastrophic terrorism. This document identifies the operational concepts of the Federal Radiological Monitoring and Assessment Center's (FRMAC) implementation of the NIMS/ICS response structure under the National Response Plan (NRP). The construct identified here defines the basic response template to be tailored to the incident-specific response requirements. FRMAC's mission to facilitate interagency environmental data management, monitoring, sampling, analysis, and assessment and link this information to the planning and decision staff clearly places the FRMAC in the Planning Section. FRMAC is not a mitigating resource for radiological contamination but is present to conduct radiological impact assessment for public dose avoidance. Field monitoring is a fact-finding mission to support this effort directly. Decisions based on the assessed data will drive public protection and operational requirements. This organizational structure under NIMS is focused by the mission responsibilities and interface requirements following the premise to provide emergency responders with a flexible yet standardized structure for incident response activities. The coordination responsibilities outlined in the NRP are based on the NIMS

  5. Hands on versus remote techniques in waste management and decommissioning

    International Nuclear Information System (INIS)

    Asquith, J.D.

    1994-01-01

    The nuclear industry has many requirements for planned and uplanned physical interactions with radioactive materials or their environment. In each case a choice must be made as to whether the interaction should be made directly by the operator using a 'hands on' technique, wearing any necessary protective clothing, or by entirely remote techniques. In facilities where remote handling equipment has already been provided and planned for, remote techniques are usually the obvious choice. However in radioactive waste management and decommissioning there are many cases where unexpected requirements emerge, often for relatively short term activities, where the choice is more complex. This paper takes a look at the various factors which should be considered in order to make these decisions, an overview of the types of remote equipment available in the UK and some examples of the benefits which have resulted when remote techniques have been adopted in Britain

  6. 12 CFR 250.181 - Reports of change in control of bank management incident to a merger.

    Science.gov (United States)

    2010-01-01

    ... 12 Banks and Banking 3 2010-01-01 2010-01-01 false Reports of change in control of bank management... change in control of bank management incident to a merger. (a) A State member bank has inquired whether Pub. L. 88-593 (78 Stat. 940) requires reports of change in control of bank management in situations...

  7. Mathematical model as means of optimization of the automation system of the process of incidents of information security management

    Directory of Open Access Journals (Sweden)

    Yulia G. Krasnozhon

    2018-03-01

    Full Text Available Modern information technologies have an increasing importance for development dynamics and management structure of an enterprise. The management efficiency of implementation of modern information technologies directly related to the quality of information security incident management. However, issues of assessment of the impact of information security incidents management on quality and efficiency of the enterprise management system are not sufficiently highlighted neither in Russian nor in foreign literature. The main direction to approach these problems is the optimization of the process automation system of the information security incident management. Today a special attention is paid to IT-technologies while dealing with information security incidents at mission-critical facilities in Russian Federation such as the Federal Tax Service of Russia (FTS. It is proposed to use the mathematical apparatus of queueing theory in order to build a mathematical model of the system optimization. The developed model allows to estimate quality of the management taking into account the rules and restrictions imposed on the system by the effects of information security incidents. Here an example is given in order to demonstrate the system in work. The obtained statistical data are shown. An implementation of the system discussed here will improve the quality of the Russian FTS services and make responses to information security incidents faster.

  8. On the Appropriateness of Incident Management Systems in Developing Countries: A Case from the UAE

    Directory of Open Access Journals (Sweden)

    Faouzi Kamoun

    2010-12-01

    Full Text Available Road traffic incidents are eliciting growing public concerns due to their devastating social, economical, and environmental impacts. The severity of these random events is particularly alarming in developing countries, where the situation is just worsening. Recently, Incident Management Systems (IMSs have been proposed as powerful tools to enhance the coordination and management of rescue operations during traffic accidents. However, most of the available commercial IMS solutions are designed for large metropolitan cities and within the contexts of developed nations. This paper explores the issues of appropriateness and customization of IMS solutions in developing countries through an exploratory inquiry consisting of a case study from the United Arab Emirates (UAE. The paper also explores the important issues related to managing the organizational changes that an IMS introduces to the operations of the command and control room. This contribution calls for the development of more comprehensive theoretical frameworks that can guide towards the implementation of appropriate IMS solutions in developing countries. Our research highlights the need for developing countries to acquire appropriate IMS solutions that are tailored to the local organizational work context in which these systems will be used. The experience reported herein can also inspire other public safety agencies in developing countries to consider the option of developing customized IMS solutions that best suit their needs.

  9. European Clearinghouse. Incidents related to reactivity management. Contributing factors, failure modes and corrective actions

    International Nuclear Information System (INIS)

    Bruynooghe, Christiane; Noel, Marc

    2009-01-01

    This work is part of the European Clearinghouse on Nuclear Power Plant Operational Experience Feedback (NPP-OEF) activity carried out at the Joint Research Centre/Institute for Energy (JRC/IE) with the participation of nine EU Regulatory Authorities. It investigates the 1999 Shika-1 criticality event together with other shortcomings in reactivity management reported to the IAE4 Incident Reporting System in the period 1981-2008. The aim of the work was to identify reactivity control failure modes, reactor status and corrective actions. Initiating factors and associated root causes were also analysed. Five of the 7 factors identified for all events were present in the 1999 Shika-1 event where criticality has been unexpectedly reached and maintained during 15 minutes. Most of the events resulted in changes in procedures, material or staff and management training. The analysis carried out put in evidence that in several instances appropriate communication based on operational experience feedback would have prevented incident to occur. This paper also summarises the action taken at power plants and by the regulatory bodies in different countries to avoid repetition of similar events. It identifies insights that might be useful to reduce the likelihood of operational events caused by shortcomings in reactivity management. (orig.)

  10. Critical analysis of procurement techniques in construction management sectors

    Science.gov (United States)

    Tiwari, Suman Tiwari Suresh; Chan, Shiau Wei; Faraz Mubarak, Muhammad

    2018-04-01

    Over the last three decades, numerous procurement techniques have been one of the highlights of the Construction Management (CM) for ventures, administration contracting, venture management as well as design and construct. Due to the development and utilization of those techniques, various researchers have explored the criteria for their choice and their execution in terms of time, cost and quality. Nevertheless, there is a lack of giving an account on the relationship between the procurement techniques and the progressed related issues, for example, supply chain, sustainability, innovation and technology development, lean construction, constructability, value management, Building Information Modelling (BIM) as well as e-procurement. Through chosen papers from the reputable CM-related academic journals, the specified scopes of these issues are methodically assessed with the objective to explore the status and trend in procurement related research. The result of this paper contributes theoretically as well as practically to the researchers and industrialist in order to be aware and appreciate the development of procurement techniques.

  11. TECHNIQUE OF OPTIMAL AUDIT PLANNING FOR INFORMATION SECURITY MANAGEMENT SYSTEM

    Directory of Open Access Journals (Sweden)

    F. N. Shago

    2014-03-01

    Full Text Available Complication of information security management systems leads to the necessity of improving the scientific and methodological apparatus for these systems auditing. Planning is an important and determining part of information security management systems auditing. Efficiency of audit will be defined by the relation of the reached quality indicators to the spent resources. Thus, there is an important and urgent task of developing methods and techniques for optimization of the audit planning, making it possible to increase its effectiveness. The proposed technique gives the possibility to implement optimal distribution for planning time and material resources on audit stages on the basis of dynamics model for the ISMS quality. Special feature of the proposed approach is the usage of a priori data as well as a posteriori data for the initial audit planning, and also the plan adjustment after each audit event. This gives the possibility to optimize the usage of audit resources in accordance with the selected criteria. Application examples of the technique are given while planning audit information security management system of the organization. The result of computational experiment based on the proposed technique showed that the time (cost audit costs can be reduced by 10-15% and, consequently, quality assessments obtained through audit resources allocation can be improved with respect to well-known methods of audit planning.

  12. Tissue printing technique in nitrocelullose membranes: a rapid detection technique for estimating incidence of PVX, PVY, PVS and PLRV viruses infecting potato (Solanum spp.

    Directory of Open Access Journals (Sweden)

    Mónica Guzmán

    2002-07-01

    Full Text Available The ELISA serological technique has been used since the 1970s as a quantative technique for the detection of many groups of virus which infect plants. The immune-impression (IMI in nitrocelullose membrane qualitative technique has been implemented more recently for the detection of different viral groups. In this work, the IMI technique has been adapted for the detection of PVX, PVY PVS and PLRV viruses which attack different species and varieties of potato crop (Solanum spp., such as Egg yolk, Capiro, Morita, Pastusa, Monserrate, Tuquerreña, ICA Puracé and ICA Nariño, all from the Nariño department. The four viruses mentioned above can cause 30% and 60% losses in production, be they acting alone or synergistically. This means that they can easily reduce the economic benefits of a country like Colombia, characterised as being a great potato producer (i.e. more than 2.8 million tons per year. The IMI technique was compared with the ELISA technique (Enzymne Linked Immunosorbent Assay using the same samples, leading to confirmation of the test's sensitivity for detecting the virus. From a total of 800 samples analyzed by IMI from different areas in the Nariño department, 72% incidence for PVY, 38.7% for PVX, 85.6% for PVS and 91.1% for PLRV was found; these estimates were similar or greater than those obtained using ELISA. These results are new for Colombia in terms of imple-menting the easy and sensitive IMI technique for detecting these four viral groups infecting the potato as well as estimating their incidence in Nariño, one of Colombia's most important potato-producing departments. The opportune and flexible detection of virus leads to an effective response to eradicating contaminated material, both material in the field as well as that from in vitro culture. Results lead to it being suggested that implementing IMI could bringing wide benefits for potato seed certification programmes, as they maintain sensitivity and specificity, they

  13. Electrical failure during cardiopulmonary bypass: an evaluation of incidence, causes, management and guidelines for preventative measures.

    LENUS (Irish Health Repository)

    Hargrove, M

    2012-02-03

    The incidence of electrical failure during cardiopulmonary bypass (CPB) has been reported to occur in approximately 1 per 1000 cases. While the resultant morbidity and mortality is low, electrical failure is a life-threatening scenario. We report three major electrical failures during CPB in a patient population of 3500 over a 15-year period. These cases involved mains failure and generator shut down, mains failure and generator power surge, and failure of the uninterruptable power supply (UPS), which caused protected sockets to shut down. Protocols for preventative maintenance, necessary equipment, battery backup and guidelines for the successful management of such accidents during CPB are discussed.

  14. Risk Management Techniques and Practice Workshop Workshop Report

    Energy Technology Data Exchange (ETDEWEB)

    Quinn, T; Zosel, M

    2008-12-02

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

  15. Students' perceptions of effective learning experiences in dental school: a qualitative study using a critical incident technique.

    Science.gov (United States)

    Victoroff, Kristin Zakariasen; Hogan, Sarah

    2006-02-01

    Students' views of their educational experience can be an important source of information for curriculum assessment. Although quantitative methods, particularly surveys, are frequently used to gather such data, fewer studies have employed qualitative methods to examine students' dental education experiences. The purpose of this study is to explore characteristics of effective learning experiences in dental school using a qualitative method. All third-year (seventy) and fourth-year (seventy) dental students enrolled in one midwestern dental school were invited to participate. Fifty-three dental students (thirty-five male and eighteen female; thirty-two third-year and twenty-one fourth-year) were interviewed using a critical incident interview technique. Each student was asked to describe a specific, particularly effective learning incident that he or she had experienced in dental school and a specific, particularly ineffective learning incident, for comparison. Each interview was audiotaped. Students were assured that only the interviewer and one additional researcher would have access to the tapes. Data analysis resulted in identification of key themes in the data describing characteristics of effective learning experiences. The following characteristics of effective learning experiences were identified: 1) instructor characteristics (personal qualities, "checking-in" with students, and an interactive style); 2) characteristics of the learning process (focus on the "big picture," modeling and demonstrations, opportunities to apply new knowledge, high-quality feedback, focus, specificity and relevance, and peer interactions); and 3) learning environment (culture of the learning environment, technology). Common themes emerged across a wide variety of learning incidents. Although additional research is needed, the characteristics of effective learning experiences identified in this study may have implications for individual course design and for the dental school

  16. Management of excessive gingival display: Lip repositioning technique

    Directory of Open Access Journals (Sweden)

    Upasana Sthapak

    2015-01-01

    Full Text Available The lips form the frame of a smile and define the esthetic zone. Excessive gingival display during smile is often referred to as "gummy smile". A successful management of excessive gingival display with lip repositioning procedure has shown excellent results. The procedure involves removing a strip of partial thickness mucosa from maxillary vestibule, then suturing it back to the lip mucosa at the level of mucogingival junction. This technique results in restricted muscle pull and a narrow vestibule, thereby reducing the gingival display. In this case gummy smile was treated by modification of Rubinstein and Kostianovsky′s surgical lip repositioning technique which resulted in a harmonious smile.

  17. Real-time emergency forecasting technique for situation management systems

    Science.gov (United States)

    Kopytov, V. V.; Kharechkin, P. V.; Naumenko, V. V.; Tretyak, R. S.; Tebueva, F. B.

    2018-05-01

    The article describes the real-time emergency forecasting technique that allows increasing accuracy and reliability of forecasting results of any emergency computational model applied for decision making in situation management systems. Computational models are improved by the Improved Brown’s method applying fractal dimension to forecast short time series data being received from sensors and control systems. Reliability of emergency forecasting results is ensured by the invalid sensed data filtering according to the methods of correlation analysis.

  18. [Incidence of acute agitation and variation in acute agitation management by emergency services].

    Science.gov (United States)

    Casado Flórez, Isabel; Sánchez Santos, Luis; Rodríguez Calzada, Rafael; Rico-Villademoros, Fernando; Roset Arissó, Pere; Corral Torres, Ervigio

    2017-07-01

    To describe the management of acute agitation by Spanish emergency medical services (EMS) and assess the incidence of acute agitation. Observational descriptive study based on aggregate data from unpublished internal EMS reports. Seven participating emergency services received 4 306 213 emergency calls in 2013; 111 599 (2.6%, or 6.2 calls per 1000 population) were categorized as psychiatric emergencies. A total of 84 933 interventions (4.2%, or 4 per 1000 population) were required; 37 951 of the calls concerned agitated patients (1.9%, or 2 cases per 1000 population). Only 3 EMS mandated a specific procedure for their responders to use in such cases. The agitated patient is a common problem for EMS responders. Few teams apply specific procedures for managing these patients.

  19. Decision-support information system to manage mass casualty incidents at a level 1 trauma center.

    Science.gov (United States)

    Bar-El, Yaron; Tzafrir, Sara; Tzipori, Idan; Utitz, Liora; Halberthal, Michael; Beyar, Rafael; Reisner, Shimon

    2013-12-01

    Mass casualty incidents are probably the greatest challenge to a hospital. When such an event occurs, hospitals are required to instantly switch from their routine activity to conditions of great uncertainty and confront needs that exceed resources. We describe an information system that was uniquely designed for managing mass casualty events. The web-based system is activated when a mass casualty event is declared; it displays relevant operating procedures, checklists, and a log book. The system automatically or semiautomatically initiates phone calls and public address announcements. It collects real-time data from computerized clinical and administrative systems in the hospital, and presents them to the managing team in a clear graphic display. It also generates periodic reports and summaries of available or scarce resources that are sent to predefined recipients. When the system was tested in a nationwide exercise, it proved to be an invaluable tool for informed decision making in demanding and overwhelming situations such as mass casualty events.

  20. Outcome of 7-S, TQM technique for healthcare waste management.

    Science.gov (United States)

    Ullah, Junaid Habib; Ahmed, Rashid; Malik, Javed Iqbal; Khan, M Amanullah

    2011-12-01

    To assess the present waste management system of healthcare facilities (HCFs) attached with Shalamar Hospital, Lahore by applying the 7-S technique of Total Quality Management (TQM) and to find out the outcome after imparting training. Interventional quasi-experimental study. The Shalamar Hospital, Lahore, Punjab, Pakistan, November, 2009 to November, 2010. Mckinsey's 7-S, technique of TQM was applied to assess the 220 HCFs from Lahore, Gujranwala and Sheikhupura districts for segregation, collection, transportation and disposal (SCTD) of hospital waste. Direct interview method was applied. Trainings were provided in each institution. After one year action period, the status of four areas of concern was compared before and after training. The parameters studied were segregation, collection, transportation and disposal systems in the 220 HCFs. Each of these were further elaborated by strategy, structure, system, staff, skill, style and stakeholder/shared value factors. Standard error of difference of proportion was applied to assess significance using 95% confidence level. There was marked improvement in all these areas ranging from 20% to 77% following a training program of 3 months. In case of disposal of the waste strategy, structure and system an increase of 60%, 65% and 75% was observed after training. The 7-S technique played a vital role in assessing the hospital waste management system. Training for the healthcare workers played a significant role in healthcare facilities.

  1. Operation of emergency operating centers during mass casualty incidents in taiwan: a disaster management perspective.

    Science.gov (United States)

    Wen, Jet-Chau; Tsai, Chia-Chou; Chen, Mei-Hsuan; Chang, Wei-Ta

    2014-10-01

    On April 27, 2011, a train derailed and crashed in Taiwan, causing a mass casualty incident (MCI) that was similar to a previous event and with similar consequences. In both disasters, the emergency operating centers (EOCs) could not effectively integrate associated agencies to deal with the incident. The coordination and utilization of resources were inefficient, which caused difficulty in command structure operation and casualty evacuation. This study was designed to create a survey questionnaire with problem items using disaster management phases mandated by Taiwan's Emergency Medical Care Law (EMCL), use statistical methods (t test) to analyze the results and issues the EOCs encountered during the operation, and propose solutions for those problems. Findings showed that EOCs lacked authority to intervene or coordinate with associated agencies. Also, placing emphasis on the recovery phase should improve future prevention and response mechanisms. To improve the response to MCIs, the EMCL needs to be amended to give EOCs the lead during disasters; use feedback from the recovery phase to improve future disaster management and operation coordination; and establish an information-sharing platform across agencies to address all aspects of relief work.(Disaster Med Public Health Preparedness. 2014;0:1-6).

  2. [Teaching non-technical skills for critical incidents: Crisis resource management training for medical students].

    Science.gov (United States)

    Krüger, A; Gillmann, B; Hardt, C; Döring, R; Beckers, S K; Rossaint, R

    2009-06-01

    Physicians have to demonstrate non-technical skills, such as communication and team leading skills, while coping with critical incidents. These skills are not taught during medical education. A crisis resource management (CRM) training was established for 4th to 6th year medical students using a full-scale simulator mannikin (Emergency Care Simulator, ECS, METI). The learning objectives of the course were defined according to the key points of Gaba's CRM concept. The training consisted of theoretical and practical parts (3 simulation scenarios with debriefing). Students' self-assessment before and after the training provided the data for evaluation of the training outcome. A total of 65 students took part in the training. The course was well received in terms of overall course quality, debriefings and didactic presentation, the mean overall mark being 1.4 (1: best, 6: worst). After the course students felt significantly more confident when facing incidents in clinical practice. The main learning objectives were achieved. The effectiveness of applying the widely used ECS full-scale simulator in interdisciplinary teaching has been demonstrated. The training exposes students to crisis resource management issues and motivates them to develop non-technical skills.

  3. A dynamic plasmonic manipulation technique assisted by phase modulation of an incident optical vortex beam

    International Nuclear Information System (INIS)

    Yuan, G H; Wang, Q; Tan, P S; Lin, J; Yuan, X-C

    2012-01-01

    A novel phase modulation method for dynamic manipulation of surface plasmon polaritons (SPPs) with a phase engineered optical vortex (OV) beam illuminating on nanoslits is experimentally demonstrated. Because of the unique helical phase carried by an OV beam, dynamic control of SPP multiple focusing and standing wave generation is realized by changing the OV beam’s topological charge constituent with the help of a liquid-crystal spatial light modulator. Measurement of SPP distributions with near-field scanning optical microscopy showed an excellent agreement with numerical predictions. The proposed phase modulation technique for manipulating SPPs features has seemingly dynamic and reconfigurable advantages, with profound potential for development of SPP coupling, routing, multiplexing and high-resolution imaging devices on plasmonic chips. (paper)

  4. Contemporary management of carotid blowout syndrome utilizing endovascular techniques.

    Science.gov (United States)

    Manzoor, Nauman F; Rezaee, Rod P; Ray, Abhishek; Wick, Cameron C; Blackham, Kristine; Stepnick, David; Lavertu, Pierre; Zender, Chad A

    2017-02-01

    To illustrate complex interdisciplinary decision making and the utility of modern endovascular techniques in the management of patients with carotid blowout syndrome (CBS). Retrospective chart review. Patients treated with endovascular strategies and/or surgical modalities were included. Control of hemorrhage, neurological, and survival outcomes were studied. Between 2004 and 2014, 33 patients had 38 hemorrhagic events related to head and neck cancer that were managed with endovascular means. Of these, 23 were localized to the external carotid artery (ECA) branches and five localized to the ECA main trunk; nine were related to the common carotid artery (CCA) or internal carotid artery (ICA), and one event was related to the innominate artery. Seven events related to the CCA/ICA or innominate artery were managed with endovascular sacrifice, whereas three cases were managed with a flow-preserving approach (covered stent). Only one patient developed permanent hemiparesis. In two of the three cases where the flow-preserving approach was used, the covered stent eventually became exposed via the overlying soft tissue defect, and definitive management using carotid revascularization or resection was employed to prevent further hemorrhage. In cases of soft tissue necrosis, vascularized tissues were used to cover the great vessels as applicable. The use of modern endovascular approaches for management of acute CBS yields optimal results and should be employed in a coordinated manner by the head and neck surgeon and the neurointerventionalist. 4. Laryngoscope, 2016 127:383-390, 2017. © 2016 The American Laryngological, Rhinological and Otological Society, Inc.

  5. Demand Management Based on Model Predictive Control Techniques

    Directory of Open Access Journals (Sweden)

    Yasser A. Davizón

    2014-01-01

    Full Text Available Demand management (DM is the process that helps companies to sell the right product to the right customer, at the right time, and for the right price. Therefore the challenge for any company is to determine how much to sell, at what price, and to which market segment while maximizing its profits. DM also helps managers efficiently allocate undifferentiated units of capacity to the available demand with the goal of maximizing revenue. This paper introduces control system approach to demand management with dynamic pricing (DP using the model predictive control (MPC technique. In addition, we present a proper dynamical system analogy based on active suspension and a stability analysis is provided via the Lyapunov direct method.

  6. A comparative study of open technique and Z-plasty in management of pilonidal sinus

    Directory of Open Access Journals (Sweden)

    Siddhartha Priyadarshi

    2014-01-01

    Full Text Available Introduction: Pilonidal sinus is one of the common problems encountered in general surgical practices and the management of this disease is variable, contentious and problematic. Principles of treatment require eradication of the sinus tract; complete healing and prevention of recurrence. Although several surgical techniques have been described over the years, the management remains controversial. Aims and Objectives: The aim of this study was to compare the two techniques of the open method and Z-plasty in the management of pilonidal sinus, in terms of incidence of post-operative pain, total hospital stay, total recovery time, complications and recurrence rate. Materials and Methods: This is a prospective comparative study which was conducted in the surgical department of a teaching hospital. A total of 50 cases were included in this study. Of these, 25 cases were operated by the open technique and 25 by excision and Z-plasty. Observation and Result: The mean age at presentation was 29.44 years. Male genders followed by age between 20 and 30 years were the most common predisposing factors. The mean body mass index, early and late post-operative complications were comparable between the two groups. Mean hospital stay and total recovery time was significantly more in open technique group compared with Z-plasty group. Visual analog score was also significantly more in open technique group when compared with Z-plasty group. Conclusion: Excision with Z-plasty was better technique in terms of lesser hospital stay, lesser recovery time, less post-operative pain.

  7. Cyber crisis management: a decision-support framework for disclosing security incident information

    NARCIS (Netherlands)

    Kulikova, Olga; Heil, Ronald; van den Berg, Jan; Pieters, Wolter

    2012-01-01

    The growing sophistication and frequency of cyber attacks force modern companies to be prepared beforehand for potential cyber security incidents and data leaks. A proper incident disclosure strategy can significantly improve timeliness and effectiveness of incident response activities, reduce legal

  8. Developing an incident management system to support Ebola response -- Liberia, July-August 2014.

    Science.gov (United States)

    Pillai, Satish K; Nyenswah, Tolbert; Rouse, Edward; Arwady, M Allison; Forrester, Joseph D; Hunter, Jennifer C; Matanock, Almea; Ayscue, Patrick; Monroe, Benjamin; Schafer, Ilana J; Poblano, Luis; Neatherlin, John; Montgomery, Joel M; De Cock, Kevin M

    2014-10-17

    The ongoing Ebola virus disease (Ebola) outbreak in West Africa is the largest and most sustained Ebola epidemic recorded, with 6,574 cases. Among the five affected countries of West Africa (Liberia, Sierra Leone, Guinea, Nigeria, and Senegal), Liberia has had the highest number cases (3,458). This epidemic has severely strained the public health and health care infrastructure of Liberia, has resulted in restrictions in civil liberties, and has disrupted international travel. As part of the initial response, the Liberian Ministry of Health and Social Welfare (MOHSW) developed a national task force and technical expert committee to oversee the management of the Ebola-related activities. During the third week of July 2014, CDC deployed a team of epidemiologists, data management specialists, emergency management specialists, and health communicators to assist MOHSW in its response to the growing Ebola epidemic. One aspect of CDC's response was to work with MOHSW in instituting incident management system (IMS) principles to enhance the organization of the response. This report describes MOHSW's Ebola response structure as of mid-July, the plans made during the initial assessment of the response structure, the implementation of interventions aimed at improving the system, and plans for further development of the response structure for the Ebola epidemic in Liberia.

  9. Applications of Graph Spectral Techniques to Water Distribution Network Management

    Directory of Open Access Journals (Sweden)

    Armando di Nardo

    2018-01-01

    Full Text Available Cities depend on multiple heterogeneous, interconnected infrastructures to provide safe water to consumers. Given this complexity, efficient numerical techniques are needed to support optimal control and management of a water distribution network (WDN. This paper introduces a holistic analysis framework to support water utilities on the decision making process for an efficient supply management. The proposal is based on graph spectral techniques that take advantage of eigenvalues and eigenvectors properties of matrices that are associated with graphs. Instances of these matrices are the adjacency matrix and the Laplacian, among others. The interest for this application is to work on a graph that specifically represents a WDN. This is a complex network that is made by nodes corresponding to water sources and consumption points and links corresponding to pipes and valves. The aim is to face new challenges on urban water supply, ranging from computing approximations for network performance assessment to setting device positioning for efficient and automatic WDN division into district metered areas. It is consequently created a novel tool-set of graph spectral techniques adapted to improve main water management tasks and to simplify the identification of water losses through the definition of an optimal network partitioning. Two WDNs are used to analyze the proposed methodology. Firstly, the well-known network of C-Town is investigated for benchmarking of the proposed graph spectral framework. This allows for comparing the obtained results with others coming from previously proposed approaches in literature. The second case-study corresponds to an operational network. It shows the usefulness and optimality of the proposal to effectively manage a WDN.

  10. Technical Review of Law Enforcement Standards and Guides Relative to Incident Management

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Salter, R.; Stanton, J. R.; Fisher, D.

    2009-03-24

    In an effort to locate potential law enforcement-related standards that support incident management, a team from the Pacific Northwest National Laboratory (PNNL) contacted representatives from the National Institute of Standards-Office of Law Enforcement Standards (NIST-OLES), National Institute of Justice (NIJ), Federal Bureau of Investigation (FBI), Secret Service, ASTM International committees that have a law enforcement focus, and a variety of individuals from local and regional law enforcement organizations. Discussions were held with various state and local law enforcement organizations. The NIJ has published several specific equipment-related law enforcement standards that were included in the review, but it appears that law enforcement program and process-type standards are developed principally by organizations that operate at the state and local level. Input is provided from state regulations and codes and from external non-government organizations (NGOs) that provide national standards. The standards that are adopted from external organizations or developed independently by state authorities are available for use by local law enforcement agencies on a voluntary basis. The extent to which they are used depends on the respective jurisdictions involved. In some instances, use of state and local disseminated standards is mandatory, but in most cases, use is voluntary. Usually, the extent to which these standards are used appears to depend on whether or not jurisdictions receive certification from a “governing” entity due to their use and compliance with the standards. In some cases, these certification-based standards are used in principal but without certification or other compliance monitoring. In general, these standards appear to be routinely used for qualification, selection for employment, and training. In these standards, the term “Peace Officer” is frequently used to refer to law enforcement personnel. This technical review of national law

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

    Science.gov (United States)

    Abrahamsen, Håkon B

    2015-06-10

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

  12. Working relationships between obstetric care staff and their managers: a critical incident analysis.

    Science.gov (United States)

    Chipeta, Effie; Bradley, Susan; Chimwaza-Manda, Wanangwa; McAuliffe, Eilish

    2016-08-26

    Malawi continues to experience critical shortages of key health technical cadres that can adequately respond to Malawi's disease burden. Difficult working conditions contribute to low morale and frustration among health care workers. We aimed to understand how obstetric care staff perceive their working relationships with managers. A qualitative exploratory study was conducted in health facilities in Malawi between October and December 2008. Critical Incident Analysis interviews were done in government district hospitals, faith-based health facilities, and a sample of health centres' providing emergency obstetric care. A total of 84 service providers were interviewed. Data were analyzed using NVivo 8 software. Poor leadership styles affected working relationships between obstetric care staff and their managers. Main concerns were managers' lack of support for staff welfare and staff performance, lack of mentorship for new staff and junior colleagues, as well as inadequate supportive supervision. All this led to frustrations, diminished motivation, lack of interest in their job and withdrawal from work, including staff seriously considering leaving their post. Positive working relationships between obstetric care staff and their managers are essential for promoting staff motivation and positive work performance. However, this study revealed that staff were demotivated and undermined by transactional leadership styles and behavior, evidenced by management by exception and lack of feedback or recognition. A shift to transformational leadership in nurse-manager relationships is essential to establish good working relationships with staff. Improved providers' job satisfaction and staff retentionare crucial to the provision of high quality care and will also ensure efficiency in health care delivery in Malawi.

  13. Quality of nursing care perceived by patients and their nurses: an application of the critical incident technique. Part 1.

    Science.gov (United States)

    Redfern, S; Norman, I

    1999-07-01

    The aims of the study were to identify indicators of quality of nursing care from the perceptions of patients and nurses, and to determine the congruence between patients' and nurses' perceptions. The paper is presented in two parts. Part 1 includes the background and methods to the study and the findings from the comparison of patients' and nurses' perceptions. Part 2 describes the perceptions of patients and nurses, and the conclusions drawn from the study as a whole. Patients and nurses in hospital wards were interviewed using the critical incident technique. We grouped 4546 indicators of high and low quality nursing care generated from the interview transcripts into 316 subcategories, 68 categories and 31 themes. Congruence between patients' and nurses' perceptions of quality was high and significant, although there was some difference of emphasis.

  14. Management accounting techniques and corporate performance of manufacturing industries

    Directory of Open Access Journals (Sweden)

    Ardiansyah Rasyid

    2017-03-01

    Full Text Available This research is to investigate that some factors that affect the new adoption in management accounting techniques on the Indonesia manufacturing industries, specifically in Jakarta, Bogor, Depok, Tangerang and Bekasi regions. The research can give a clearer portrait of how some factors can significantly affect the adoption of management accounting techniques. The research used some questioners which were sent to respondents who work in manufacturing industries as a middle level management. The methods used to distribute the questioners to respondents were by door to door, by e-mail and by media telecommunication (what’s app or close relationship up to hundreds questioners. We obtained 45 respondents but we eliminated one respondent, because they are not suitable to the research requirements. The research model contains the two paths. The first path contains 7 variables that divided by six exogenous variables to affect one endogenous variable and the next path model is from the three variables, that are divided to the one mediating variable and the other one exogenous variables to affect one endogenous variable (like path modelling. The research result shows that high competition does not affect the new accounting adoption but the other five variables; cost system changing, technology changes, organization climate, consumer demand and size significantly affect the new accounting adoption. For the next path, the research finds that the new accounting adoption can significantly affect corporate performance and also corporate performance measurement perception.

  15. Using project management techniques in hydro-relicensing

    International Nuclear Information System (INIS)

    Dominie, D.; Richard, J.

    1991-01-01

    This paper reports that to answer a pressing need for managing today's complex process and requirements of hydro relicensing, Central Maine Power Company has applied the principles of project management, including the use of computerized scheduling to its hydro relicensing efforts. This approach involves early inter-departmental cooperation in mapping out critical path scheduling by requiring the project team to: Outline the scope of the project in its entirety. Clarify and define components of the project. Quantify and categorize assumptions and dependencies. Identify constraints. The computer-generated schedule of this cooperative planning effort provides a graphic representation of the team's plan and become the focal point for refinements and adjustments necessary to complete an application on time. The use of project management techniques facilities team understanding of the realities and limitations in the relicensing process. These techniques encourage cooperative action, and use a solution-oriented process resulting in a product which can be a useful tool in communicating with resource agencies and regulators

  16. Research on monitoring and management information integration technique in waste treatment and management

    International Nuclear Information System (INIS)

    Kong Jinsong; Yu Ren; Mao Wei

    2013-01-01

    The integration of the waste treatment process and the device status monitoring information and management information is a key problem required to be solved in the information integration of the waste treatment and management. The main content of the monitoring and management information integration is discussed in the paper. The data exchange techniques, which are based on the OPC, FTP and data push technology, are applied to the different monitoring system respectively, according to their development platform, to realize the integration of the waste treatment process and device status monitoring information and management information in a waste treatment center. (authors)

  17. Isotope techniques in water resources development and management. Proceedings

    International Nuclear Information System (INIS)

    1999-01-01

    The 10th International Symposium on Isotope Techniques in Water Resources Development and Management was organized by the International Atomic Energy Agency in co-operation with UNESCO, WMO and International Association of Hydrological Sciences and was held at IAEA Headquarters, Vienna, during 10-14 May 1999. The symposium provided an international forum for assessing the status and recent advances in isotope applications to water resources and an exchange of information on the following main themes: processes at the interface between the atmosphere and hydrosphere; investigations in surface waters and groundwaters: their origin, dynamics, interrelations; problems and techniques for investigating sedimentation; water resources issues: pollution, source and transport of contaminants, salinization, water-rock interaction and processes in geothermal systems; isotope data interpretation and evaluation methodologies: modelling approaches. The proceedings contain the 46 papers presented and extended synopses of poster presentations; each of them was indexed individually

  18. Skin carcinomas: Radiobiological principles, radiotherapeutic techniques and clinical management

    International Nuclear Information System (INIS)

    Schmidt-Ullrich, Rupert K.; Johnson, Christopher R.

    1997-01-01

    Purpose/Objective: The course will be divided into three major topics: (1) Review of radiobiological principles as they apply to the radiotherapeutic management of skin carcinomas; (2) review of radiotherapeutic techniques including beam qualities, beam collimation, tissue dose profiles, and the relative indications of external beam irradiation vs. brachytherapy; (3) comprehensive review of the tumor biology of skin malignancies, including malignant melanoma, and of the relative indications for radiotherapeutic and/or surgical management. (1) Review of critical data which have led to currently applied principles of time-dose-volume concepts in the radiotherapeutic management of skin carcinomas. Emphasis will be placed on the relative importance of fraction size and overall treatment time on tumor control probability and acute and late normal tissue toxicity. (2) Considering that radiotherapy in the management of skin carcinomas is often used to minimize patient disfiguration and to preserve critical body functions (e.g. eye lids) the technical aspects of radiotherapy delivery are most critical. Careful evaluation of the extent of the lesions including evaluation of their depth of invasion will determine the quality of the radiation beams, orthovoltage and low energy electrons being the most useful. Beam harding for orthovoltage beams and secondary and tertiary (skin) collimation of appropriate electron beams are critical. For more extensive and deeply invasive lesions contour-shaping through customized bolus material is essential. Equally important is the familiarity with custom shielding of critical structures, such as eyes, ears, oral cavity and central nervous system structures. Brachytherapy applications in the treatment of skin carcinomas is limited but should be considered when implants with high dose uniformity can be constructed. (3) The discussion of clinical management will start with a discussion of properties and routes of spread of the diverse

  19. Female genital tract graft-versus-host disease: incidence, risk factors and recommendations for management.

    Science.gov (United States)

    Zantomio, D; Grigg, A P; MacGregor, L; Panek-Hudson, Y; Szer, J; Ayton, R

    2006-10-01

    Female genital tract graft-versus-host disease (GVHD) is an under-recognized complication of allogeneic stem cell transplantation impacting on quality of life. We describe a prospective surveillance programme for female genital GVHD to better characterize incidence, risk factors and clinical features and the impact of a structured intervention policy. A retrospective audit was conducted on the medical records of all female transplant recipients surviving at least 6 months at a single centre over a 5-year period. Patients commenced topical vaginal oestrogen early post transplant with hormone replacement as appropriate for age, prior menopausal status and co-morbidities. A genital tract management programme included regular gynaecological review and self-maintenance of vaginal capacity by dilator or intercourse. The incidence of genital GVHD was 35% (95% confidence interval (CI) (25, 50%)) at 1 year and 49% (95% CI (36, 63%)) at 2 years. Topical therapy was effective in most cases; no patient required surgical intervention to divide vaginal adhesions. The main risk factor was stem cell source with peripheral blood progenitor cells posing a higher risk than marrow (hazard ratio=3.07 (1.22, 7.73), P=0.017). Extensive GVHD in other organs was a common association. We conclude that female genital GVHD is common, and early detection and commencement of topical immunosuppression with dilator use appears to be highly effective at preventing progression.

  20. An Examination of Commercial Aviation Accidents and Incidents Related to Integrated Vehicle Health Management

    Science.gov (United States)

    Reveley, Mary S.; Briggs, Jeffrey L.; Thomas, Megan A.; Evans, Joni K.; Jones, Sharon M.

    2011-01-01

    The Integrated Vehicle Health Management (IVHM) Project is one of the four projects within the National Aeronautics and Space Administration's (NASA) Aviation Safety Program (AvSafe). The IVHM Project conducts research to develop validated tools and technologies for automated detection, diagnosis, and prognosis that enable mitigation of adverse events during flight. Adverse events include those that arise from system, subsystem, or component failure, faults, and malfunctions due to damage, degradation, or environmental hazards that occur during flight. Determining the causal factors and adverse events related to IVHM technologies will help in the formulation of research requirements and establish a list of example adverse conditions against which IVHM technologies can be evaluated. This paper documents the results of an examination of the most recent statistical/prognostic accident and incident data that is available from the Aviation Safety Information Analysis and Sharing (ASIAS) System to determine the causal factors of system/component failures and/or malfunctions in U.S. commercial aviation accidents and incidents.

  1. Trends in the incidence, clinical presentation, and management of traumatic rupture of the corpus cavernosum.

    Science.gov (United States)

    Ekwere, Paul D; Al Rashid, Mohammed

    2004-02-01

    Recent observations in our hospital of apparent increase in frequency prompted a revisit to the subject of fracture of penis. In a retrospective review, patients' age, marital status, and causal activities; clinical presentations; methods of management; operative findings; and postoperative complications were analyzed for changing trends. Literature was also reviewed briefly. Nineteen episodes of penile fracture in 18 patients exceed the previous incidence by more than 58%. Most were due to noncoital causes (73.7%); more unmarried people (31.6%) were affected. Most presented with the classic symptoms/signs, and tears were repaired by degloving through subcoronal incisions; one was treated conservatively. The higher morbidity observed was attributed to higher rates of hematoma and wound infections, probably enhanced by poor hemostasis and early persistent, postoperative erections. Painful erections, painful coitus, and deformities, however subsided within weeks, with no long-term ill effects. The incidence of penile fracture, postoperative hematoma, and infections has increased; about 32% of the patients were unmarried. The prominence of masturbation as a cause of penile fracture and increased ratio of noncoital to coital causes are highlighted. Degloving through subcoronal incisions remains an acceptable method of approach for repair in line with cultural practices in Saudi Arabia.

  2. Incidence and management of life-threatening adverse events during cardiac catheterization for congenital heart disease.

    Science.gov (United States)

    Lin, C Huie; Hegde, Sanjeet; Marshall, Audrey C; Porras, Diego; Gauvreau, Kimberlee; Balzer, David T; Beekman, Robert H; Torres, Alejandro; Vincent, Julie A; Moore, John W; Holzer, Ralf; Armsby, Laurie; Bergersen, Lisa

    2014-01-01

    Continued advancements in congenital cardiac catheterization and interventions have resulted in increased patient and procedural complexity. Anticipation of life-threatening events and required rescue measures is a critical component to preprocedural preparation. We sought to determine the incidence and nature of life-threatening adverse events in congenital and pediatric cardiac catheterization, risk factors, and resources necessary to anticipate and manage events. Data from 8905 cases performed at the 8 participating institutions of the Congenital Cardiac Catheterization Project on Outcomes were captured between 2007 and 2010 [median 1,095/site (range 133-3,802)]. The incidence of all life-threatening events was 2.1 % [95 % confidence interval (CI) 1.8-2.4 %], whereas mortality was 0.28 % (95 % CI 0.18-0.41 %). Fifty-seven life-threatening events required cardiopulmonary resuscitation, whereas 9 % required extracorporeal membrane oxygenation. Use of a risk adjustment model showed that age events. Using this model, standardized life-threatening event ratios were calculated, thus showing that one institution had a life-threatening event rate greater than expected. Congenital cardiac catheterization and intervention can be performed safely with a low rate of life-threatening events and mortality; preprocedural evaluation of risk may optimize preparation of emergency rescue and bailout procedures. Risk predictors (age < 1, hemodynamic vulnerability, and procedure risk category) can enhance preprocedural patient risk stratification and planning.

  3. Visceral artery aneurysms: Incidence, management, and outcome analysis in a tertiary care center over one decade

    Energy Technology Data Exchange (ETDEWEB)

    Pitton, Michael B.; Dappa, Evelyn; Jungmann, Florian; Kloeckner, Roman; Schotten, Sebastian; Wirth, Gesine M.; Mildenberger, Peter; Kreitner, Karl-Friedrich; Oberholzer, Katja; Dueber, Christoph [University Hospital of Mainz, Department of Diagnostic and Interventional Radiology, Mainz (Germany); Mittler, Jens; Lang, Hauke [University Hospital of Mainz, Department of Abdominal, Visceral and Transplantation Surgery, Mainz (Germany)

    2015-07-15

    To evaluate the incidence, management, and outcome of visceral artery aneurysms (VAA) over one decade. 233 patients with 253 VAA were analyzed according to location, diameter, aneurysm type, aetiology, rupture, management, and outcome. VAA were localized at the splenic artery, coeliac trunk, renal artery, hepatic artery, superior mesenteric artery, and other locations. The aetiology was degenerative, iatrogenic after medical procedures, connective tissue disease, and others. The rate of rupture was much higher in pseudoaneurysms than true aneurysms (76.3 % vs.3.1 %). Fifty-nine VAA were treated by intervention (n = 45) or surgery (n = 14). Interventions included embolization with coils or glue, covered stents, or combinations of these. Thirty-five cases with ruptured VAA were treated on an emergency basis. There was no difference in size between ruptured and non-ruptured VAA. After interventional treatment, the 30-day mortality was 6.7 % in ruptured VAA compared to no mortality in non-ruptured cases. Follow-up included CT and/or MRI after a mean period of 18.0 ± 26.8 months. The current status of the patient was obtained by a structured telephone survey. Pseudoaneurysms of visceral arteries have a high risk for rupture. Aneurysm size seems to be no reliable predictor for rupture. Interventional treatment is safe and effective for management of VAA. (orig.)

  4. Flexible use and technique extension of logistics management

    Science.gov (United States)

    Xiong, Furong

    2011-10-01

    As we all know, the origin of modern logistics was in the United States, developed in Japan, became mature in Europe, and expanded in China. This is a historical development of the modern logistics recognized track. Due to China's economic and technological development, and with the construction of Shanghai International Shipping Center and Shanghai Yangshan International Deepwater development, China's modern logistics industry will attain a leap-forward development of a strong pace, and will also catch up with developed countries in the Western modern logistics level. In this paper, the author explores the flexibility of China's modern logistics management techniques to extend the use, and has certain practical and guidance significances.

  5. Mobility management techniques for the next-generation wireless networks

    Science.gov (United States)

    Sun, Junzhao; Howie, Douglas P.; Sauvola, Jaakko J.

    2001-10-01

    The tremendous demands from social market are pushing the booming development of mobile communications faster than ever before, leading to plenty of new advanced techniques emerging. With the converging of mobile and wireless communications with Internet services, the boundary between mobile personal telecommunications and wireless computer networks is disappearing. Wireless networks of the next generation need the support of all the advances on new architectures, standards, and protocols. Mobility management is an important issue in the area of mobile communications, which can be best solved at the network layer. One of the key features of the next generation wireless networks is all-IP infrastructure. This paper discusses the mobility management schemes for the next generation mobile networks through extending IP's functions with mobility support. A global hierarchical framework model for the mobility management of wireless networks is presented, in which the mobility management is divided into two complementary tasks: macro mobility and micro mobility. As the macro mobility solution, a basic principle of Mobile IP is introduced, together with the optimal schemes and the advances in IPv6. The disadvantages of the Mobile IP on solving the micro mobility problem are analyzed, on the basis of which three main proposals are discussed as the micro mobility solutions for mobile communications, including Hierarchical Mobile IP (HMIP), Cellular IP, and Handoff-Aware Wireless Access Internet Infrastructure (HAWAII). A unified model is also described in which the different micro mobility solutions can coexist simultaneously in mobile networks.

  6. Management of gingiva hyperpigmentasi with combine of scalpel scraping technique and gingivo abrasion technique (Case report

    Directory of Open Access Journals (Sweden)

    Shek Wendy

    2016-06-01

    Full Text Available Aesthetic factor is an important factor in supporting the person's appearance, especially when a person smiles. Beautifull smiles form of harmonization between the teeth and gums as part of the oral cavity. One of overall aspect that has an important role in providing the overall aesthetic impression is normal gum color that pink coral. Brown or black gums are often become the complaint that interfere with appearance, especially in patients who have a habit of smoking. Pigmentation caused by melanin hyperpigmentation and usually does not present a medical problems, so patients are not aware of it. Surgical method with the scalpel scraping technique and gingivo abrasion technique using high speed carbide bur has been widely used as a method of gingival depigmentation. This method is easily done, simple and can be done in a relatively short time. In this case report presented regarding the management of patients with gingival hyperpigmentation of the maxilla and mandible were treated with surgical method using a scalpel scraping technique combined with gingivo abrasion technique using high speed carbide bur. The result, after 4 weeks follow up, color of the patient's gingival was pink and there is none recurrence of the pigmentation.

  7. Hepatic adenoma: incidence and management between the year 2002-2006 Hospital R. Calderon Guardia

    International Nuclear Information System (INIS)

    Pages Zamora, Alberto

    2008-01-01

    The incidence and management of hepatic adenoma at the Hospital Calderon Guardia are analyzed between the years 2002-2006. The main hepatic pathologies diagnosed by biopsy are shown. The relationship of hepatic adenoma with the above risk factors and presentation of each case of hepatic adenoma found are analyzed. The media diagnosed in this type of pathology were investigated. The evolution and control of each case of hepatic adenoma have been studied. The results of the management of each case are compared with the recommended in literature. The ideal management of this type of pathology is analyzed. Among the conclusions is given benign liver pathology as the most frequent cause of liver biopsy in the Hospital Calderon Guardia. Metastatic disease of the digestive tract has been the primary neoplastic disease at the hepatic level. Focal nodular hyperplasia has been the biopsy of benign tumor that is performed more frequently. Hepatic adenoma has been a rare entity, but with significant mortality rates. All cases were presented as solitary lesions. It is more common in women of childbearing age but can occur also in older people and in men. A close relationship has existed between the use of oral gestagens and the incidence of hepatic adenoma. Hepatic adenomas and its complications have been related to its size. Most cases of hepatic adenoma were presented with symptoms. The preoperative studies have shown high sensitivity in the detection of lesions, but little specificity. A protocol for the study of hepatic masses is required. A relationship between the size of the adenoma and possible complications was demonstrated. The reason for surgery in most cases has been the possibility of malignancy in the liver injury. The correlation between preoperative diagnosis and the end was unsuccessful in 75 percent of cases. The mortality related to the procedures did not exist, but if a case of morbidity. The study of liver masses should be more exhaustive to improve

  8. Skin carcinomas: radiobiological principles, radiotherapeutic techniques and clinical management

    International Nuclear Information System (INIS)

    Schmidt-Ullrich, Rupert K. A.; Johnson, Christopher R.

    1995-01-01

    Purpose/Objective: The course will be divided into three major topics: (1) Review of radiobiological principles as they apply to the radiotherapeutic management of skin carcinomas; (2) review of radiotherapeutic techniques including beam qualities, beam collimation, tissue dose profiles, and the relative indications of external beam irradiation vs. brachytherapy; (3) comprehensive review of the tumor biology of skin malignancies, including malignant melanoma, and of the relative indications for radiotherapeutic and/or surgical management. (1) Review of critical data which have lead to currently applied principles of time-dose-volume concepts in the radiotherapeutic management of skin carcinomas. Emphasis will be placed on the relative importance of fraction size and overall treatment time on tumor control probability and acute and late normal tissue toxicity. (2) Considering that radiotherapy in the management of skin carcinomas is often used to minimize patient disfiguration and to preserve critical body functions (e.g. eye lids) the technical aspects of radiotherapy delivery are most critical. Careful evaluation of the extent of the lesions including evaluation of their depth of invasion will determine the quality of the radiation beams, orthovoltage and low energy electrons being the most useful. Beam harding for orthovoltage beams and secondary and tertiary (skin) collimation of appropriate electron beams are critical. For more extensive and deeply invasive lesions contour-shaping through customized bolus material is essential. Equally important is the familiarity with custom shielding of critical structures, such as eyes, ears, oral cavity and central nervous system structures. Brachytherapy applications in the treatment of skin carcinomas is limited but should be considered when implants with high dose uniformity can be constructed. (3) The discussion of clinical management will start with a discussion of tumor biological properties of the diverse malignant

  9. Management of area-wide integrated pest management programmes that integrate the sterile insect technique

    International Nuclear Information System (INIS)

    Dyck, V.A.; Vreysen, M.J.B.; Reyes Flores, J.; Regidor Fernandez, E.E.; Teruya, T.; Barnes, B.; Gomez Riera, P.; Lindquist, D.; Loosjes, M.

    2005-01-01

    Effective management of area-wide integrated pest management (AW-IPM) programmes that integrate the sterile insect technique (SIT) is key to success. Programme planning includes collection of baseline data and a feasibility assessment. The optimal management structure is where the programme can be implemented effectively and flexibly, independent of government politics, bureaucracy, and even corruption that impede timely goal achievement. Ideally, programmes include both public and private management, and require strong and steady financial support. Governments and donors are the most common sources of funds, but a mixture of public, community, and private funds is now the trend. Interrupted cash flow severely restrains programme performance. Physical support of programme operations must be reliable, and led by a maintenance professional. It is essential to have full-time, well-paid, and motivated staff led by a programme manger with technical and management experience. Programme failure is usually due to poor management and inadequate public support, and not to poor technology. (author)

  10. Bronchoscopic techniques in the management of patients with tuberculosis

    Directory of Open Access Journals (Sweden)

    Michele Mondoni

    2017-11-01

    Full Text Available Tuberculosis (TB is one of the leading causes of morbidity and mortality worldwide. Early diagnosis and treatment are key to prevent Mycobacterium tuberculosis transmission. Bronchoscopy can play a primary role in pulmonary TB diagnosis, particularly for suspected patients with scarce sputum or sputum smear negativity, and with endobronchial disease. Bronchoscopic needle aspiration techniques are accurate and safe means adopted to investigate hilar and mediastinal lymph nodes in cases of suspected TB lymphadenopathy. Tracheobronchial stenosis represents the worst complication of endobronchial tuberculosis. Bronchoscopic procedures are less invasive therapeutic strategies than conventional surgery to be adopted in the management of TB-related stenosis.We conducted a non-systematic review aimed at describing the scientific literature on the role of bronchoscopic techniques in the diagnosis and therapy of patients with TB.We focused on three main areas of interventions: bronchoscopic diagnosis of smear negative/sputum scarce TB patients, endobronchial TB diagnosis and treatment and needle aspiration techniques for intrathoracic TB lymphadenopathy. We described experiences on bronchoalveolar lavage, bronchial washing, and biopsy techniques for the diagnosis of patients with tracheobronchial and pulmonary TB; furthermore, we described the role played by conventional and ultrasound-guided transbronchial needle aspiration in the diagnosis of suspected hilar and mediastinal TB adenopathy. Finally, we assessed the role of the bronchoscopic therapy in the treatment of endobronchial TB and its complications, focusing on dilation techniques (such as balloon dilation and airway stenting and ablative procedures (both heat and cold therapies. Keywords: Bronchoscopy, Tuberculosis, Endoscopic ultrasound-guided fine needle aspiration, Tracheobronchial stenosis

  11. System study of alternative waste management techniques: Final report

    International Nuclear Information System (INIS)

    1986-01-01

    This report summarizes the important results achieved in conjunction with the Research and Development Priority ''Alternative Waste Management Techniques'' sponsored by the Federal Ministry of Research and Technology from 1981 to 1984. The subject of these studies was solely ''direct disposal'' of spent fuel elements. For this purpose a reference concept was selected from a variety of possible processes and engineered in detailed form by firms in the nuclear industry. Those who worked on the engineering concepts consider this waste management method technically feasible. Several disposal casks have been fabricated. The basic licensability of direct disposal can be evaluated on the basis of the documentation developed by the companies. The direct disposal method was compared with the ''integrated waste management concept'' using reference fuel cycles with respect to the following criteria: radiological safety and nuclear material safeguards and, in addition, economic and energy-policy aspects. It was found that with respect to radiological safety, including the long-term safety of the final repository, there are no significant differences between the two fuel cycles with and without reprocessing. With respect to the nuclear material safeguards of a final repository containing spent fuel elements, there are still a number of unanswered questions. From an economic standpoint, direct disposal will be more economical in the foreseeable future than integrated waste management. Quantification of the effects of one or the other waste management method on the national economy is not necessarily possible. Reprocessing is supported primarily by technological and energy-policy considerations. On the basis of the results, the conclusion is reached that reprocessing should be pursued further, but that at the same time direct disposal should be developed to the point of practical maturity

  12. The comparative incidence of reported concussions presenting for follow-up management in South African Rugby Union.

    Science.gov (United States)

    Shuttleworth-Edwards, Ann B; Noakes, Timothy D; Radloff, Sarah E; Whitefield, Victoria J; Clark, Susan B; Roberts, Craig O; Essack, Fathima B; Zoccola, Diana; Boulind, Melissa J; Case, Stephanie E; Smith, Ian P; Mitchell, Julia L G

    2008-09-01

    The objective of this study was to compare the seasonal concussion incidence for school, university, club and provincial level Rugby Union players in South Africa. The study presents a retrospective statistical analysis of the number of reported concussions documented annually for groups of Rugby Union players as a proportion of those who received preseason neurocognitive assessment. Between 2002 and 2006, concussion management programs using computerized neuropsychological assessment were implemented for clinical and research purposes by psychologists in selected South African institutions involved in Rugby Union from school through to the professional level. The incidence figures were based on 175 concussive episodes reported for 165 athletes who were referred for neurocognitive assessment from a population of 1366 athletes who received preseason baseline testing. Concussion management routines varied according to the protocols adopted by the different psychologists and rugby organizations. It was expected that the incidence of concussion would vary significantly due to level of play and different management protocols. There was wide disparity in the manner in which concussion follow-up was managed by the various organizations. Within broadly comparable cohorts, tighter control was associated with a relatively higher concussion incidence for athletes per rugby playing season, with average institutional figures ranging from 4% to 14% at school level and 3% to 23% at adult level. This analysis suggests that concussion goes unrecognized and therefore incorrectly managed in a number of instances. Recommendations for optimal identification of concussed athletes for follow-up management are presented.

  13. The incidence of breast cancer following mantle field radiation therapy as a function of dose and technique

    International Nuclear Information System (INIS)

    Tinger, Alfred; Wasserman, Todd H.; Klein, Eric E.; Miller, Elizabeth A.; Roberts, Tracy; Piephoff, James V.; Kucik, Nancy A.

    1997-01-01

    Purpose: There is an increased incidence of breast cancer following mantle field radiation therapy for Hodgkin's disease (HD). We reviewed the experience at the Mallinckrodt Institute of Radiology (MIR) for radiation factors related to the development of breast cancer after mantle field radiation therapy for HD. Methods: The radiation therapy records of 152 women treated with mantle field irradiation for HD at MIR between 1966-1985 were reviewed for the development of breast cancer and treatment-related factors. All patients had a minimum of 5 years of follow-up. The treatment era (1966-1974 vs. 1975-1985), stage of HD, mediastinal dose, axillary dose, maximum dose from the anterior field (anterior d max dose), the anterior-posterior:posterior-anterior (AP:PA) ratio, age at the time of treatment, length of follow-up, and history of splenectomy were analyzed as possible contributing factors for the development of breast cancer. The observed number of breast cancers was compared to the expected number based on age-adjusted incidences from the Connecticut Tumor Registry. Results: Ten breast cancers occurred in the population. Eight involved an upper outer quadrant. In a multivariate analysis, the development of breast cancer was significantly associated with axillary dose. Patients in the early treatment era were at an increased risk for the development of breast cancer due to high anterior d max and breast doses from weighting the fields anteriorly on a low energy linear accelerator. The use of current radiation therapy techniques was not related to an increased risk of breast cancer with a median follow-up of 13 years. Conclusions: A high dose to the axilla and the anterior d max point is significantly associated with the development of breast cancer after mantle field irradiation for HD. Efforts to protect the breast from high doses will likely lessen the increased risk of breast cancer in women treated with radiation therapy for HD

  14. Reflections on Leadership and Governance from the Incident Manager of Liberia's Ebola Response.

    Science.gov (United States)

    Nyenswah, Tolbert

    The 2014-2016 epidemic of Ebola virus disease occurred in a region with a recent history of civil war, unstable health systems, and widespread poverty. Despite these contextual challenges, the national Ebola response in Liberia controlled transmission under strong leadership that was able to rapidly coordinate activities, to manage local and international players, and to adapt upon recognizing missteps. Such leadership has persisted to improve public health capacity in post-Ebola Liberia. This article highlights the progress made toward developing a resilient health security system with capacity to prevent, detect, and respond to disease threats before they reach epidemic level. In particular, Liberia's development of a Global Health Security Agenda roadmap, a Joint External Evaluation (JEE) report for International Health Regulation (2005) core capacities, and recent establishment of a National Public Health Institute are described. To better protect the country's population and the greater global community from health threats, emerging institutions and policies in Liberia will depend on leadership and governance that draws from the successes and lessons learned during the Ebola outbreak. The author provides insight based on his role as incident manager of Liberia's Ebola response.

  15. National Incident Management System (NIMS) Standards Review Panel Workshop Summary Report

    Energy Technology Data Exchange (ETDEWEB)

    Stenner, Robert D.; Kirk, Jennifer L.; Stanton, James R.; Shebell, Peter; Schwartz, Deborah S.; Judd, Kathleen S.; Gelston, Gariann M.

    2006-02-07

    The importance and need for full compliant implementation of NIMS nationwide was clearly demonstrated during the Hurricane Katrina event, which was clearly expressed in Secretary Chertoff's October 4, 2005 letter addressed to the State's governors. It states, ''Hurricane Katrina was a stark reminder of how critical it is for our nation to approach incident management in a coordinated, consistent, and efficient manner. We must be able to come together, at all levels of government, to prevent, prepare for, respond to, and recover from any emergency or disaster. Our operations must be seamless and based on common incident management doctrine, because the challenges we face as a nation are far greater than capabilities of any one jurisdiction.'' The NIMS is a system/architecture for organizing response on a ''national'' level. It incorporations ICS as a main component of that structure (i.e., it institutionalizes ICS in NIMS). In a paper published on the NIMS Website, the following statements were made: ''NIMS represents a core set of doctrine, principles, terminology, and organizational processes to enable effective, efficient and collaborative incident management at all levels. To provide the framework for interoperability and compatibility, the NIMS is based on a balance between flexibility and standardization.'' Thus the NIC is challenged with the need to adopt quality SDO generated standards to support NIMS compliance, but in doing so maintain the flexibility necessary so that response operations can be tailored for the specific jurisdictional and geographical needs across the nation. In support of this large and complex challenge facing the NIC, the Pacific Northwest National Laboratory (PNNL) was asked to provide technical support to the NIC, through their DHS Science and Technology ? Standards Portfolio Contract, to help identify, review, and develop key standards for NIMS compliance. Upon

  16. Final Documentation: Incident Management And Probabilities Courses of action Tool (IMPACT).

    Energy Technology Data Exchange (ETDEWEB)

    Edwards, Donna M.; Ray, Jaideep; Tucker, Mark D.; Whetzel, Jonathan; Cauthen, Katherine Regina

    2018-03-01

    This report pulls together the documentation produced for the IMPACT tool, a software-based decision support tool that provides situational awareness, incident characterization, and guidance on public health and environmental response strategies for an unfolding bio-terrorism incident.

  17. Cyber crisis management: a decision-support framework for disclosing security incident information

    OpenAIRE

    Kulikova, Olga; Heil, Ronald; van den Berg, Jan; Pieters, Wolter

    2012-01-01

    The growing sophistication and frequency of cyber attacks force modern companies to be prepared beforehand for potential cyber security incidents and data leaks. A proper incident disclosure strategy can significantly improve timeliness and effectiveness of incident response activities, reduce legal fines, and restore confidence and trust of a company's key stakeholders. In this paper, four factors that shape organizational preferences regarding incident information disclosure are introduced....

  18. Distributed cluster management techniques for unattended ground sensor networks

    Science.gov (United States)

    Essawy, Magdi A.; Stelzig, Chad A.; Bevington, James E.; Minor, Sharon

    2005-05-01

    Smart Sensor Networks are becoming important target detection and tracking tools. The challenging problems in such networks include the sensor fusion, data management and communication schemes. This work discusses techniques used to distribute sensor management and multi-target tracking responsibilities across an ad hoc, self-healing cluster of sensor nodes. Although miniaturized computing resources possess the ability to host complex tracking and data fusion algorithms, there still exist inherent bandwidth constraints on the RF channel. Therefore, special attention is placed on the reduction of node-to-node communications within the cluster by minimizing unsolicited messaging, and distributing the sensor fusion and tracking tasks onto local portions of the network. Several challenging problems are addressed in this work including track initialization and conflict resolution, track ownership handling, and communication control optimization. Emphasis is also placed on increasing the overall robustness of the sensor cluster through independent decision capabilities on all sensor nodes. Track initiation is performed using collaborative sensing within a neighborhood of sensor nodes, allowing each node to independently determine if initial track ownership should be assumed. This autonomous track initiation prevents the formation of duplicate tracks while eliminating the need for a central "management" node to assign tracking responsibilities. Track update is performed as an ownership node requests sensor reports from neighboring nodes based on track error covariance and the neighboring nodes geo-positional location. Track ownership is periodically recomputed using propagated track states to determine which sensing node provides the desired coverage characteristics. High fidelity multi-target simulation results are presented, indicating the distribution of sensor management and tracking capabilities to not only reduce communication bandwidth consumption, but to also

  19. Duration and predictors of emergency surgical operations - basis for medical management of mass casualty incidents

    Directory of Open Access Journals (Sweden)

    Huber-Wagner S

    2009-12-01

    Full Text Available Abstract Background Hospitals have a critically important role in the management of mass causality incidents (MCI, yet there is little information to assist emergency planners. A significantly limiting factor of a hospital's capability to treat those affected is its surgical capacity. We therefore intended to provide data about the duration and predictors of life saving operations. Methods The data of 20,815 predominantly blunt trauma patients recorded in the Trauma Registry of the German-Trauma-Society was retrospectively analyzed to calculate the duration of life-saving operations as well as their predictors. Inclusion criteria were an ISS ≥ 16 and the performance of relevant ICPM-coded procedures within 6 h of admission. Results From 1,228 patients fulfilling the inclusion criteria 1,793 operations could be identified as life-saving operations. Acute injuries to the abdomen accounted for 54.1% followed by head injuries (26.3%, pelvic injuries (11.5%, thoracic injuries (5.0% and major amputations (3.1%. The mean cut to suture time was 130 min (IQR 65-165 min. Logistic regression revealed 8 variables associated with an emergency operation: AIS of abdomen ≥ 3 (OR 4,00, ISS ≥ 35 (OR 2,94, hemoglobin level ≤ 8 mg/dL (OR 1,40, pulse rate on hospital admission 120/min (OR 1,39, blood pressure on hospital admission Conclusions The mean operation time of 130 min calculated for emergency life-saving surgical operations provides a realistic guideline for the prospective treatment capacity which can be estimated and projected into an actual incident admission capacity. Knowledge of predictive factors for life-saving emergency operations helps to identify those patients that need most urgent operative treatment in case of blunt MCI.

  20. Advanced techniques using the plant as indicator of irrigation management

    Directory of Open Access Journals (Sweden)

    Barbara dos Santos Esteves

    2015-05-01

    Full Text Available The methodologies which are considered the most promising for irrigation management are those based on the analysis of the water status of the plants themselves. This justifies the study and improvement of indicators based on automatic and continuous measures to enable real-time monitoring data, as indices from sap flow, dendrometry and leaf turgor pressure techniques. The aim of this paper is to analyze such methodologies in order to demonstrate their principles, advantages and challenges. In conclusion, the methodologies analyzed still have many technological advances and challenges before being presented to the final user. The future research should work these tools for elaboration of technical indexes that allow their simplification, on the instrumental point of view, and the interpretation of their results.

  1. Safety management in NPPs using an evolutionary algorithm technique

    International Nuclear Information System (INIS)

    Mishra, Alok; Patwardhan, Anand; Verma, A.K.

    2007-01-01

    The general goal of safety management in Nuclear Power Plants (NPPs) is to make requirements and activities more risk effective and less costly. The technical specification and maintenance (TS and M) activities in a plant are associated with controlling risk or with satisfying requirements, and are candidates to be evaluated for their resource effectiveness in risk-informed applications. Accordingly, the risk-based analysis of technical specification (RBTS) is being considered in evaluating current TS. The multi-objective optimization of the TS and M requirements of a NPP based on risk and cost, gives the pareto-optimal solutions, from which the utility can pick its decision variables suiting its interest. In this paper, a multi-objective evolutionary algorithm technique has been used to make a trade-off between risk and cost both at the system level and at the plant level for loss of coolant accident (LOCA) and main steam line break (MSLB) as initiating events

  2. GIS-based tools to identify tradeoffs between waste management and remediation strategies from radiological dispersal device incidents

    Energy Technology Data Exchange (ETDEWEB)

    Lemieux, P.; Wood, J.; Snyder, E. [U.S. Environmental Protection Agency, Research Triangle Park, NC (United States); Boe, T. [Oak Ridge Inst. for Science and Education, Research Triangle Park, NC (United States); Schulthiesz, D.; Peake, T.; Ierardi, M. [U.S. Environmental Protection Agency, Washington, DC (United States); Hayes, C.; Rodgers, M. [Eastern Research Group, Inc., Morrisville, NC (United States)

    2011-07-01

    Management of waste and debris from the detonation of a Radiological Dispersal Device (RDD) will likely comprise a significant portion of the overall remediation effort and possibly contribute to a significant portion of the overall remediation costs. As part of the recent National Level Exercise, Liberty RadEx, that occurred in Philadelphia in April 2010, a methodology was developed by EPA to generate a first-order estimate of a waste inventory for the hypothetical RDD from the exercise scenario. Determination of waste characteristics and whether the generated waste is construction and demolition (C&D) debris, municipal solid waste (MSW), hazardous waste, mixed waste, or low level radioactive waste (LLRW), and characterization of the wastewater that is generated from the incident or subsequent cleanup activities will all influence the cleanup costs and timelines. Decontamination techniques, whether they involve chemical treatment, abrasive removal, or aqueous washing, will also influence the waste generated and associated cleanup costs and timelines. This paper describes the ongoing effort to develop a tool to support RDD planning and response activities by assessing waste quantities and characteristics as a function of potential mitigation strategies and targeted cleanup levels. (author)

  3. GIS-based tools to identify tradeoffs between waste management and remediation strategies from radiological dispersal device incidents

    International Nuclear Information System (INIS)

    Lemieux, P.; Wood, J.; Snyder, E.; Boe, T.; Schulthiesz, D.; Peake, T.; Ierardi, M.; Hayes, C.; Rodgers, M.

    2011-01-01

    Management of waste and debris from the detonation of a Radiological Dispersal Device (RDD) will likely comprise a significant portion of the overall remediation effort and possibly contribute to a significant portion of the overall remediation costs. As part of the recent National Level Exercise, Liberty RadEx, that occurred in Philadelphia in April 2010, a methodology was developed by EPA to generate a first-order estimate of a waste inventory for the hypothetical RDD from the exercise scenario. Determination of waste characteristics and whether the generated waste is construction and demolition (C&D) debris, municipal solid waste (MSW), hazardous waste, mixed waste, or low level radioactive waste (LLRW), and characterization of the wastewater that is generated from the incident or subsequent cleanup activities will all influence the cleanup costs and timelines. Decontamination techniques, whether they involve chemical treatment, abrasive removal, or aqueous washing, will also influence the waste generated and associated cleanup costs and timelines. This paper describes the ongoing effort to develop a tool to support RDD planning and response activities by assessing waste quantities and characteristics as a function of potential mitigation strategies and targeted cleanup levels. (author)

  4. Managing mild casualties in mass-casualty incidents: lessons learned from an aborted terrorist attack.

    Science.gov (United States)

    Bloch, Yuval H; Leiba, Adi; Veaacnin, Nurit; Paizer, Yohanan; Schwartz, Dagan; Kraskas, Ahuva; Weiss, Gali; Goldberg, Avishay; Bar-Dayan, Yaron

    2007-01-01

    Mildly injured and "worried well" patients can have profound effects on the management of a mass-casualty incident. The objective of this study is to describe the characteristics and lessons learned from an event that occurred on 28 August 2005 near the central bus station in Beer-Sheva, Israel. The unique profile of injuries allows for the examination of the medical and operational aspects of the management of mild casualties. Data were collected during and after the event, using patient records and formal debriefings. They were processed focusing on the characteristics of patient complaints, medical response, and the dynamics of admission. A total of 64 patients presented to the local emergency department, including two critical casualties. The remaining 62 patients were mildly injured or suffered from stress. Patient presentation to the emergency department was bi-phasic; during the first two hours following the attack (i.e., early phase), the rate of arrival was high (one patient every three minutes), and anxiety was the most frequent chief complaint. During the second phase, the rate of arrival was lower (one patient every 27 minutes), and the typical chief complaint was somatic. Additionally, tinnitus and complaints related to minor trauma also were recorded frequently. Psychiatric consultation was obtained for 58 (91%) of the patients. Social services were involved in the care of 47 of the patients (73%). Otolaryngology and surgery consultations were obtained for 45% and 44%, respectively. The need for some medical specialties (e.g., surgery and orthopedics) mainly was during the first phase, whereas others, mainly psychiatry and otolaryngology, were needed during both phases. Only 13 patients (20%) needed a consultation from internal medicine. Following a terrorist attack, a large number of mildly injured victims and those experiencing stress are to be expected, without a direct relation to the effectiveness of the attack. Mildly injured patients tend to

  5. The Effects of Different Breastfeeding Training Techniques Given for Primiparous Mothers Before Discharge on the Incidence of Cracked Nipples.

    Science.gov (United States)

    Eksioglu, Aysun; Yesil, Yesim; Demir Gungor, Dilek; Ceber Turfan, Esin

    2017-06-01

    This research investigated the effects of different breastfeeding training techniques for primiparous mothers before discharge on the incidence of cracked nipples. This was a controlled intervention study that was carried out between 2015 and 2016 on 90 mothers living in İzmir. The mothers were divided into three groups: the demonstration-based training group, brochure group, and routine care-receiving group. The mothers in the "brochure group" were provided with breastfeeding training brochures. Mothers in the demonstration-based training group received one-to-one training using designed doll and puppet tools. The rate of cracked nipples at age 2 weeks was 63.3% in the routine care-receiving group, 56.7% in the brochure group, and 20% in the demonstration-based training group. At the end of the fourth week, the rate was 30% in the routine care-receiving group and less than 10% in the other two groups (p raining group than in the other two groups (p roups in the percentage of exclusive breastfeeding. The results documented that breastfeeding training based on one-to-one demonstration utilizing specially designed audiovisual tools was more effective than the other two methods in the prevention of nipple cracks.

  6. Quality of nursing care perceived by patients and their nurses: an application of the critical incident technique. Part 2.

    Science.gov (United States)

    Redfern, S; Norman, I

    1999-07-01

    The aims of the study were to identify indicators of quality of nursing care from the perceptions of patients and nurses, and to determine the congruence between patients' and nurses' perceptions. The paper is presented in two parts. Part 1 included the background and methods to the study and the findings from the comparison of patients' and nurses' perceptions. Part 2 describes the perceptions of patients and nurses, and draws conclusions drawn from the study as a whole. Patients and nurses in hospital wards were interviewed using the critical incident technique. We grouped 4546 indicators of high and low quality nursing care generated from the interview transcripts into 316 subcategories, 68 categories and 31 themes. The themes were grouped into eight clusters: therapeutic context for care, attitudes and sensitivity, teaching and leadership, motivation to nurse, monitoring and informing, high-dependency care, efficiency and thoroughness, reflection and anticipation. As shown in Part 1 of the paper, congruence between patients' and nurses' perceptions of quality was high and significant, although there was some difference of emphasis. The findings support an emerging theory of interpersonal competence and quality in nursing care.

  7. [Use of the critical incident technique in the development of a measurement tool for satisfaction in psychiatry].

    Science.gov (United States)

    Pourin, C; Daucourt, V; Barberger-Gateau, P

    2001-06-01

    Health care centers will have to set up a regular survey of their patients' satisfaction, in addition to the discharge questionnaire. Few instruments for measuring satisfaction are at present available. A working group associating 10 psychiatric hospitals in Aquitaine conducted a study on the specificity of this measure in psychiatry. To record the patient's perception on the stay in order to identify areas of satisfaction and dissatisfaction as perceived and reported by himself, using a qualitative approach. The critical incident technique was used in 3 volunteer hospitals, in patients hospitalised in psychiatric wards selected by their doctor. Interview using a semi-structured questionnaire were conducted by an investigator external to the departments. Data were analysed in a qualitative way. 32 interviews could be analysed, and 215 events were extracted. These events were classified in 12 themes. The events identified from these interviews have allowed identification of new areas of patient satisfaction, which could be used to build additional items centered on patients' preoccupations.

  8. Quality Management techniques embedded in Agile Project Development

    Directory of Open Access Journals (Sweden)

    Dovleac Raluca

    2017-01-01

    Full Text Available It used to be hard to make your dream come true and start a business but now, thanks to the dotcom boom and the rapid development of emerging technologies everybody has the chance to become the next Steve Jobs. Quality management tools and creativity techniques gave birth to the startup trend that transforms a brilliant idea into an innovative product. A common practice amongst startups is Agile development. In this paper, after analyzing the Agile approach and the tools used to ensure quality for every stage of a product’s development life cycle and the results of using the Agile approach looking out for advantages and short comings as well, we proposed a PDCA inspired tool which embeds both quality and creativity techniques to help developers ensure quality for each stage of a product’s life cycle as well as help them better organize their activities to reach the desired goals. We validated this approach by implementing it to the case of the Vitraly startup.

  9. Optimized inspection techniques and structural analysis in lifetime management

    International Nuclear Information System (INIS)

    Aguado, M.T.; Marcelles, I.

    1993-01-01

    Preservation of the option of extending the service lifetime of a nuclear power plant beyond its normal design lifetime requires correct remaining lifetime management from the very beginning of plant operation. The methodology used in plant remaining lifetime management is essentially based on the use of standard inspections, surveillance and monitoring programs and calculations, such as thermal-stress and fracture mechanics analysis. The inspection techniques should be continuously optimized, in order to be able to detect and dimension existing defects with the highest possible degree of accuracy. The information obtained during the inspection is combined with the historical data of the components: design, quality, operation, maintenance, and transients, and with the results of destructive testing, fracture mechanics and thermal fatigue analysis. These data are used to estimate the remaining lifetime of nuclear power plant components, systems and structures with the highest degree possible of accuracy. The use of this methodology allows component repairs and replacements to be reduced or avoided and increases the safety levels and availability of the nuclear power plant. Use of this strategy avoids the need for heavy investments at the end of the licensing period

  10. Impacts of radiation management techniques on the North Atlantic Oscillation

    Science.gov (United States)

    Adakudlu, Muralidhar; Helge Otterå, Odd; Tjiputra, Jerry; Muri, Helene; Grini, Alf; Schulz, Michael

    2017-04-01

    The effectiveness of various climate engineering techniques in limiting the global warming signal to reasonable levels has been the topic of state-of-the-art research on climate change. Using an Earth system model, we show that these techniques have the potential to bring down the high CO2 concentration climate in RCP8.5 to a moderate climate similar to RCP4.5 in terms of global temperature. Nevertheless, their influence on the regional aspects of atmospheric circulation is not clear. The regional circulation patterns in the atmosphere are largely characterized by the natural variability modes, such as the North Atlantic Oscillation (NAO). In this study, we assess the impacts of three radiation managment techniques, namely, Stratospheric Aerosol Injection (SAI), Marine Sky Brightening (MSB) and Cirrus Cloud Thinning (CCT), on the structure and features of the NAO. The results indicate an east-northeastward shift as well as intensification of the NAO spatial pattern in the global warming scenarios of RCP4.5 and RCP8.5, with the signal being most intense in the latter. The climate engineering forcings when applied to the RCP8.5 case tend to reduce the strength of the NAO with little impact on its position. The CCT case appears to have the maximum effect on the NAO signal. The patterns of cloud radiative forcing, expressed as the difference between net radiative forcing at TOA under average conditions and clear sky conditions, reveal a northeastward shift of the radiative heating in the north Atlantic region. This implies a possible link between the changes in the NAO signal and the cloud radiative forcing.

  11. Management of In-Field Patient Tracking and Triage by Using Near-Field Communication in Mass Casualty Incidents.

    Science.gov (United States)

    Cheng, Po-Liang; Su, Yung-Cheng; Hou, Chung-Hung; Chang, Po-Lun

    2017-01-01

    Near field communications (NFC) is an emerging technology that may potentialy assist with disaster management. A smartphone-based app was designed to help track patient flow in real time. A table-drill was held as a brief evaluation and it showed significant imporvement in both efficacy and accuracy of patient management. It is feasible to use NFC-embedded smartphones to clarify the ambiguous and chaotic patient flow in a mass casualty incident.

  12. Incidence of laminitis and survey of dietary and management practices in pleasure horses and ponies in south-eastern Australia.

    Science.gov (United States)

    Potter, S J; Bamford, N J; Harris, P A; Bailey, S R

    2017-10-01

    The aims of this study were to (1) report the incidence of laminitis among a population of horses and ponies attending Pony Clubs in Victoria, Australia, and (2) describe the dietary and management practices of the sample population. Researchers visited 10 Pony Clubs over a 10-month period. Horse and pony owners completed a questionnaire to provide information on management relating to diet and exercise. Owners were also asked to report their animal's history of laminitis, if any. From a survey population of 233 horses and ponies, 15.0% of animals (35 individuals) were reported to have suffered from at least one episode of laminitis. Of the animals that had suffered from laminitis, more than half had experienced multiple episodes. The majority of previously laminitic horses and ponies (71.4%) had not experienced an episode of laminitis within the past 12 months; however, 14.2% had experienced an incident within the past month. The proportion of ponies affected by laminitis (31/142; 21.8%) was significantly higher (P horses affected by laminitis (4/91; 4.4%). The incidence of laminitis within the pony group sampled was 6.5 cases per 100 pony years, while the incidence in horses was 0.55 cases per 100 horse years. This study provided information on the incidence of laminitis in the general population of pleasure horses and ponies in south-eastern Australia. It also provided an overview of dietary and management practices. Given the high incidence of animals that had been affected by laminitis (and the associated welfare implications), this study highlights the importance of owner education regarding appropriate feeding and management strategies to reduce the risk of laminitis. © 2017 Australian Veterinary Association.

  13. Subclavian Vein Stenosis/Occlusion Following Transvenous Cardiac Pacemaker and Defibrillator Implantation: Incidence, Pathophysiology and Current Management

    Directory of Open Access Journals (Sweden)

    Brian O'Leary

    2015-08-01

    Full Text Available Subclavian vein stenosis is a common, but usually asymptomatic, complication following cardiac device placement. In addition to reviewing the literature on incidence, pathogenesis and management options for this important clinical problem, we describe two cases of symptomatic subclavian vein occlusion following pacemaker/defibrillator placement and successful treatment with venoplasty and stenting.

  14. Incidence of Artifacts and Deviating Values in Research Data Obtained from an Anesthesia Information Management System in Children

    NARCIS (Netherlands)

    Hoorweg, Anne-Lee J; Pasma, Wietze; van Wolfswinkel, Leo; de Graaff, Jurgen C

    BACKGROUND: Vital parameter data collected in anesthesia information management systems are often used for clinical research. The validity of this type of research is dependent on the number of artifacts. METHODS: In this prospective observational cohort study, the incidence of artifacts in

  15. The Incidence and Management of Conflicts in Secular and Non-Secular Tertiary Institutions in South West Nigeria

    Science.gov (United States)

    Ayodele, Joseph Babatola; Adewumi, Joseph Olukayode

    2007-01-01

    This paper compared the incidence and management of conflicts in secular and non-secular tertiary institutions in Nigeria. The sample of this study was made of sixty staff, and two hundred and forty students randomly selected each from two secular and two non-secular tertiary institutions in south western Nigeria. A validated questionnaire was…

  16. [Telematics equipment for poison control surveillance. Its applications in the health management of relevant chemical incidents].

    Science.gov (United States)

    Butera, R; Locatelli, C; Gandini, C; Minuco, G; Mazzoleni, M C; Giordano, A; Zanuti, M; Varango, C; Petrolini, V; Candura, S M; Manzo, L

    1997-01-01

    Health management of major chemical incidents requires a close collaboration between rescuers (on the disaster site and in the emergency department) and the poison center. The study tested telematic technologies allowing telepresence and teleconsulting, a real time and continuous connection among health care personnel and toxicologists involved in the management of the emergency. The link between the poison center (PC) and the emergency department in the local hospital is provided by a ISDN operating video conferencing system, while the data transmission from the site of the accident to the PC is achieved with a personal computer and GSM cellular data transmission. Toxicological databases and risk assessment software are integrated in the system, to support information sharing. To test such instruments in operative nearly realistic conditions, the main phase of the study has implemented simulated chemical disasters in different locations in Italy. Instruments for telepresence and teleconsulting have been effectively utilized to evaluate from a remote location the scenario and the severity of the accident, by inspecting either specific details or the whole scene, to enable PC guiding the triage of the victims before and after hospitalization, to utilize and share data, such as intervention protocols or patient records, and to document all the activities. In summary, this experience shows that the telematic link allows the toxicologists of the poison center to rapidly understand the situation, and to correctly learn about the conditions of patients with the help of images. The results of this study indicate the valuable benefits of telematic instruments for the health care in case of major chemical disasters occurring in a remote geographical location or in an area which lacks local toxicological experts, where specialized expertise can be achieved by the use of telematic technologies.

  17. Analysis on incidence and management of complications after femtosecond laser-assisted small incision lenticule extraction

    Directory of Open Access Journals (Sweden)

    Cai-Hong Li

    2018-04-01

    Full Text Available AIM: To evaluate the safety and postoperative complications of femtosecond laser-assisted small incision lenticule extraction(SMILE. METHODS: Retrospective case series. A total of 1127 patients(2 236 eyeswho were treated with SMILE for myopia or myopia astigmatism between June 2016 and May 2017 were enrolled in this study. Eyes that developed postoperative complications were noted and identified. The incidence, risk factors, management and prognosis were analyzed. The follow-up was 6mo.RESULTS: The rate of postoperative complications was 8.05%, included diffuse lamellar keratitis(3.31%, delayed visual acuity(2.59%, minor interface residue(0.63%, and ghost images(1.52%. These complications had an impact on best corrected visual acuity(BCVAat 3mo in only 1 eye with decentered ablation and was re-treated with topography-guided laser-assisted subepithelial keratomileusis(LASEK. Good visual outcomes were achieved in all eyes finally. CONCLUSION: Although few eyes suffered postoperative complications, SMILE is an acceptable safe surgery. Careful surgical skill, appropriate surgical parameter, and rational postoperative medication can decrease the risk of complication.

  18. Acute ureterolithiasis: Incidence of secondary signs on unenhanced helical CT and influence on patient management

    Energy Technology Data Exchange (ETDEWEB)

    Ege, G. E-mail: gurkanege@yahoo.com; Akman, H.; Kuzucu, K.; Yildiz, S

    2003-12-01

    AIM: The purpose of this study was to determine the incidence of secondary signs associated with ureteral stones on unenhanced helical computed tomography (CT) of patients with acute renal colic, and to correlate these with patient management and outcome. MATERIALS AND METHODS: One hundred and ten patients with ureterolithiasis were evaluated prospectively for the secondary signs of obstruction on unenhanced helical CT. Our attention was focused primarily on the presence or absence of seven secondary signs on unenhanced helical CT, including hydronephrosis, unilateral renal enlargement, perinephric oedema, unilateral absence of the white pyramid, hydroureter, periureteral oedema and lateroconal fascial thickening. RESULTS: Of the 110 patients, 91 (82.7%) had hydroureter, 88 (80%) had hydronephrosis, 65 (59%) had periureteric oedema and 63 (57.2%) had unilateral renal enlargement. Ninety stones passed spontaneously and 21 required intervention. CONCLUSION: Secondary signs of urinary tract obstruction are useful and supportive findings in interpretation of the CT examination. In our experience, the most reliable signs indicating ureteral obstruction are hydroureter, hydronephrosis, periureteral oedema and unilateral renal enlargement, respectively. In addition, stones larger than 6 mm, located within the proximal two thirds of the ureter, and seen associated with five or more the secondary signs of obstruction, are more likely to require endoscopic removal and/or lithotripsy.

  19. Incidence, risk factors and management of severe post-transsphenoidal epistaxis.

    Science.gov (United States)

    De Los Reyes, Kenneth M; Gross, Bradley A; Frerichs, Kai U; Dunn, Ian F; Lin, Ning; Rincon-Torroella, Jordina; Annino, Donald J; Laws, Edward R

    2015-01-01

    Among the major complications of transsphenoidal surgery, less attention has been given to severe postoperative epistaxis, which can lead to devastating consequences. In this study, we reviewed 551 consecutive patients treated over a 4 year period by the senior author to evaluate the incidence, risk factors, etiology and management of immediate and delayed post-transsphenoidal epistaxis. Eighteen patients (3.3%) developed significant postoperative epistaxis - six immediately and 12 delayed (mean postoperative day 10.8). Fourteen patients harbored macroadenomas (78%) and 11 of 18 (61.1%) had complex nasal/sphenoid anatomy. In the immediate epistaxis group, 33% had acute postoperative hypertension. In the delayed group, one had an anterior ethmoidal pseudoaneurysm, and one had restarted anticoagulation on postoperative day 3. We treated the immediate epistaxis group with bedside nasal packing followed by operative re-exploration if conservative measures were unsuccessful. The delayed group underwent bedside nasal hemostasis; if unsuccessful, angiographic embolization was performed. After definitive treatment, no patients had recurrent epistaxis. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Contemporary, age-based trends in the incidence and management of patients with early-stage kidney cancer.

    Science.gov (United States)

    Tan, Hung-Jui; Filson, Christopher P; Litwin, Mark S

    2015-01-01

    Although kidney cancer incidence and nephrectomy rates have risen in tandem, clinical advances have generated new uncertainty regarding the optimal management of patients with small renal tumors, especially the elderly. To clarify existing practice patterns, we assessed contemporary trends in the incidence and management of patients with early-stage kidney cancer. Using Surveillance, Epidemiology, and End Results data, we identified adult patients diagnosed with T1aN0M0 kidney cancer from 2000 to 2010. We determined age-adjusted and age-specific incidence and management rates (i.e., nonoperative, ablation, partial nephrectomy [PN], and radical nephrectomy) per 100,000 adults and determined the average annual percent change (AAPC). Finally, we compared management groups using multinomial logistic regression accounting for patient characteristics, cancer information, and county-level measures for health. From 2000 to 2010, we identified 41,645 adults diagnosed with T1aN0M0 kidney cancer. Overall incidence increased from 3.7 to 7.0 per 100,000 adults (AAPC = 7.0%, Pmanagement and ablation approached nephrectomy rates for those aged 75 to 84 years and became the predominant strategy for patients older than 84 years. Adjusting for clinical, oncological, and environmental factors, older patients less frequently underwent PN and more often received ablative or nonoperative management (P<0.001). As the incidence of early-stage kidney cancer rises, patients are increasingly treated with nonoperative and nephron-sparing strategies, especially among the most elderly. The broader array of treatment options suggests opportunities to better personalize kidney cancer care for seniors. Published by Elsevier Inc.

  1. Auditing organizational communication: evaluating the methodological strengths and weaknesses of the critical incident technique, network analysis, and the communication satisfaction questionnaire

    NARCIS (Netherlands)

    Koning, K.H.

    2016-01-01

    This dissertation focuses on the methodology of communication audits. In the context of three Dutch high schools, we evaluated several audit instruments. The first study in this dissertation focuses on the question whether the rationale of the critical incident technique (CIT) still applies when it

  2. An evolutionary outlook of air traffic flow management techniques

    Science.gov (United States)

    Kistan, Trevor; Gardi, Alessandro; Sabatini, Roberto; Ramasamy, Subramanian; Batuwangala, Eranga

    2017-01-01

    In recent years Air Traffic Flow Management (ATFM) has become pertinent even in regions without sustained overload conditions caused by dense traffic operations. Increasing traffic volumes in the face of constrained resources has created peak congestion at specific locations and times in many areas of the world. Increased environmental awareness and economic drivers have combined to create a resurgent interest in ATFM as evidenced by a spate of recent ATFM conferences and workshops mediated by official bodies such as ICAO, IATA, CANSO the FAA and Eurocontrol. Significant ATFM acquisitions in the last 5 years include South Africa, Australia and India. Singapore, Thailand and Korea are all expected to procure ATFM systems within a year while China is expected to develop a bespoke system. Asia-Pacific nations are particularly pro-active given the traffic growth projections for the region (by 2050 half of all air traffic will be to, from or within the Asia-Pacific region). National authorities now have access to recently published international standards to guide the development of national and regional operational concepts for ATFM, geared to Communications, Navigation, Surveillance/Air Traffic Management and Avionics (CNS+A) evolutions. This paper critically reviews the field to determine which ATFM research and development efforts hold the best promise for practical technological implementations, offering clear benefits both in terms of enhanced safety and efficiency in times of growing air traffic. An evolutionary approach is adopted starting from an ontology of current ATFM techniques and proceeding to identify the technological and regulatory evolutions required in the future CNS+A context, as the aviation industry moves forward with a clearer understanding of emerging operational needs, the geo-political realities of regional collaboration and the impending needs of global harmonisation.

  3. Analysis of eighty-four commercial aviation incidents - Implications for a resource management approach to crew training

    Science.gov (United States)

    Murphy, M. R.

    1980-01-01

    A resource management approach to aircrew performance is defined and utilized in structuring an analysis of 84 exemplary incidents from the NASA Aviation Safety Reporting System. The distribution of enabling and associated (evolutionary) and recovery factors between and within five analytic categories suggests that resource management training be concentrated on: (1) interpersonal communications, with air traffic control information of major concern; (2) task management, mainly setting priorities and appropriately allocating tasks under varying workload levels; and (3) planning, coordination, and decisionmaking concerned with preventing and recovering from potentially unsafe situations in certain aircraft maneuvers.

  4. Integrated Incident Management System (IIMS) web client application development, deployment and evaluation: an evaluation of a potential IIMS deployment in Western New York : final report.

    Science.gov (United States)

    2015-09-30

    Incident Management (IM) is an area of transportation management that can significantly decrease the congestion and increase the : efficiency of transportation networks in non-ideal conditions. In this study, the existing state of the Integrated Inci...

  5. Process mining techniques: an application to time management

    Science.gov (United States)

    Khowaja, Ali Raza

    2018-04-01

    In an environment people have to make sure that all of their work are completed within a given time in accordance with its quality. In order to achieve the real phenomenon of process mining one needs to understand all of these processes in a detailed manner. Personal Information and communication has always been a highlighting issue on internet but for now information and communication tools within factual life refers to their daily schedule, location analysis, environmental analysis and, more generally, social media applications support these systems which makes data available for data analysis generated through event logs, but also for process analysis which combines environmental and location analysis. Process mining can be used to exploit all these real live processes with the help of the event logs which are already available in those datasets through user censored data or may be user labeled data. These processes could be used to redesign a user's flow and understand all these processes in a bit more detailed manner. In order to increase the quality of each of the processes that we go through our daily lives is to give a closer look to each of the processes and after analyzing them, one should make changes to get better results. On the contrarily, we applied process mining techniques on seven different subjects combined in a single dataset collected from Korea. Above all, the following paper comments on the efficiency of processes in the event logs referring to time management's sphere of influence.

  6. Incidence, management, and course of cancer in patients with inflammatory bowel disease.

    Science.gov (United States)

    Algaba, Alicia; Guerra, Iván; Marín-Jiménez, Ignacio; Quintanilla, Elvira; López-Serrano, Pilar; García-Sánchez, María Concepción; Casis, Begoña; Taxonera, Carlos; Moral, Ignacio; Chaparro, María; Martín-Rodríguez, Daniel; Martín-Arranz, María Dolores; Manceñido, Noemí; Menchén, Luis; López-Sanromán, Antonio; Castaño, Ángel; Bermejo, Fernando

    2015-04-01

    Patients with inflammatory bowel disease [IBD] are at increased risk for developing some types of neoplasia. Our aims were to determin the risk for cancer in patients with IBD and to describe the relationship with immunosuppressive therapies and clinical management after tumor diagnosis. Retrospective, multicenter, observational, 5-year follow-up, cohort study. Relative risk [RR] of cancer in the IBD cohort and the background population, therapeutic strategies, and cancer evolution were analyzed. A total of 145 cancers were diagnosed in 133 of 9100 patients with IBD (global cumulative incidence 1.6% vs 2.4% in local population; RR = 0.67; 95% confidence interval [CI]: 0.57-0.78). Patients with IBD had a significantly increased RR of non-melanoma skin cancer [RR = 3.85; 2.53-5.80] and small bowel cancer [RR = 3.70; 1.23-11.13]. After cancer diagnosis, IBD treatment was maintained in 13 of 27 [48.1%] patients on thiopurines, in 2 of 3 on methotrexate [66.6%], none on anti-TNF-α monotherapy [n = 6] and 4 of 12 [33.3%] patients on combined therapy. Rate of death and cancer remission during follow-up did not differ [p > 0.05] between patients who maintained the treatment compared with patients who withdrew [5% vs 8% and 95% vs 74%, respectively]. An association between thiopurines [p = 0.20] or anti-TNF-α drugs [p = 0.77] and cancer was not found. Patients with IBD have an increased risk for non-melanoma skin cancer and small bowel cancer. Immunosuppresive therapy is not related to a higher overall risk for cancer or worse tumor evolution in patients who maintain these drugs after cancer diagnosis. Copyright © 2015 European Crohn’s and Colitis Organisation (ECCO). Published by Oxford University Press. All rights reserved. For permissions, please email: journals.permissions@oup.com.

  7. Evaluation of fleet management techniques for timber highway bridges

    Science.gov (United States)

    Brent M. Phares; Travis K. Hosteng; Justin Dahlberg; Michael A. Ritter

    2011-01-01

    The general condition of the nation's bridges presents a complex management issue when considering cost, safety, and time. Consequently, the management of those bridges can become an overwhelming task. The need for a management system that is specific to rural systems may help to improve the management of this significant number of bridges. Although individual...

  8. Incidence of stress on top management and its impact upon health and work area

    Directory of Open Access Journals (Sweden)

    Dana Maria Staňková

    2009-01-01

    Full Text Available Within the frame of this paper the key theoretical knowledge to the selected topic is described, the presentation of partial results and discussion on the issue of the psychological aspects of managerial work, focusing on stress and its manifestations are submitted. The aim of this research was to identify the most frequent stress symptoms in the physiological, emotional and behavioral field and to define the main factors which cause them in work and private life terms. For the purpose of this research of stress effects on health area a questionnaire technology of our own design was chosen. For a deeper understanding of sources of an increased psychological stress in managerial activities a technique of interviews with the top managers was used. Research investigation has showed the action of stress on the senior managers, particularly increased during the current economic recession. The most significant signs of stress are manifested in physiological area, especially by fatigue, headache, digestion problems and sleep disturbances, as in the emotional area by anxiety, excessive concern and overall irritability. At the same time stress impacts also the behavioral area, where it has a negative impact to the work and family life. In the course of processing this subject, an absolutely obvious need occurred for a deeper processing of this large area of work stress, which will be subsequently dealing with, and whose output will be, the methodology of anti-stress strategy for HR (Human Resources managers and Senior Executives of companies to prevent stress, promote health and quality of living conditions in the workplace.

  9. Application of Real-Time Automated Traffic Incident Response Plan Management System: A Web Structure for the Regional Highway Network in China

    Directory of Open Access Journals (Sweden)

    Yongfeng Ma

    2014-01-01

    Full Text Available Traffic incidents, caused by various factors, may lead to heavy traffic delay and be harmful to traffic capacity of downstream sections. Traffic incident management (TIM systems have been developed widely to respond to traffic incidents intelligently and reduce the losses. Traffic incident response plans, as an important component of TIM, can effectively guide responders as to what and how to do in traffic incidents. In the paper, a real-time automated traffic incident response plan management system was developed, which could generate and manage traffic incident response plans timely and automatically. A web application structure and a physical structure were designed to implement and show these functions. A standard framework of data storage was also developed to save information about traffic incidents and generated response plans. Furthermore, a conformation survey and case-based reasoning (CBR were introduced to identify traffic incident and generate traffic incident response plans automatically, respectively. Twenty-three traffic crash-related incidents were selected and three indicators were used to measure the system performance. Results showed that 20 of 23 cases could be retrieved effectively and accurately. The system is practicable to generate traffic incident response plans and has been implemented in China.

  10. Using incident response trees as a tool for risk management of online financial services.

    Science.gov (United States)

    Gorton, Dan

    2014-09-01

    The article introduces the use of probabilistic risk assessment for modeling the incident response process of online financial services. The main contribution is the creation of incident response trees, using event tree analysis, which provides us with a visual tool and a systematic way to estimate the probability of a successful incident response process against the currently known risk landscape, making it possible to measure the balance between front-end and back-end security measures. The model is presented using an illustrative example, and is then applied to the incident response process of a Swedish bank. Access to relevant data is verified and the applicability and usability of the proposed model is verified using one year of historical data. Potential advantages and possible shortcomings are discussed, referring to both the design phase and the operational phase, and future work is presented. © 2014 Society for Risk Analysis.

  11. Development of a highway incident management operational and training guide : phase II.

    Science.gov (United States)

    2014-08-01

    The overall goal of both phases of this project was to reduce responder fatalities and injuries, as well as to prevent : secondary crashes, especially those involving incident responders. The phases of this project worked toward this goal : by creati...

  12. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records

    Science.gov (United States)

    2012-01-01

    Background Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. Methods The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. Results During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71%) was more common than physical abuse (29%). The most (44%) incidents of workplace violence (including both verbal and physical abuse) occurred in adult male prisons, although the most (50%) incidents of physical abuse occurred in a forensic hospital. Most (90%) of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as ‘high risk’ work duties for verbal abuse and physical abuse, respectively. Most (93%) of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46%) or low (52%) Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury – there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%). Few (6%) victims of verbal abuse sought help from a health professional. Conclusions Among employees of a large correctional health service, verbal abuse in the workplace was substantially more common than physical

  13. Workplace violence in a large correctional health service in New South Wales, Australia: a retrospective review of incident management records

    Directory of Open Access Journals (Sweden)

    Cashmore Aaron W

    2012-08-01

    Full Text Available Abstract Background Little is known about workplace violence among correctional health professionals. This study aimed to describe the patterns, severity and outcomes of incidents of workplace violence among employees of a large correctional health service, and to explore the help-seeking behaviours of staff following an incident. Methods The study setting was Justice Health, a statutory health corporation established to provide health care to people who come into contact with the criminal justice system in New South Wales, Australia. We reviewed incident management records describing workplace violence among Justice Health staff. The three-year study period was 1/7/2007-30/6/2010. Results During the period under review, 208 incidents of workplace violence were recorded. Verbal abuse (71% was more common than physical abuse (29%. The most (44% incidents of workplace violence (including both verbal and physical abuse occurred in adult male prisons, although the most (50% incidents of physical abuse occurred in a forensic hospital. Most (90% of the victims were nurses and two-thirds were females. Younger employees and males were most likely to be a victim of physical abuse. Preparing or dispensing medication and attempting to calm and/or restrain an aggressive patient were identified as ‘high risk’ work duties for verbal abuse and physical abuse, respectively. Most (93% of the incidents of workplace violence were initiated by a prisoner/patient. Almost all of the incidents received either a medium (46% or low (52% Severity Assessment Code. Few victims of workplace violence incurred a serious physical injury – there were no workplace deaths during the study period. However, mental stress was common, especially among the victims of verbal abuse (85%. Few (6% victims of verbal abuse sought help from a health professional. Conclusions Among employees of a large correctional health service, verbal abuse in the workplace was substantially more

  14. Greenhouse gas mitigation using poultry litter management techniques in Bangladesh

    International Nuclear Information System (INIS)

    Mainali, Brijesh; Emran, Saad Been; Silveira, Semida

    2017-01-01

    Poultry activities have expanded significantly in Bangladesh in recent years. The litter generated from rural poultry farms is often dumped in low ground neighboring areas resulting in greenhouse gas emissions, as well as water and air pollution. This study estimates the GHG emissions of a typical rural layer poultry farm in Bangladesh, and identifies the GHG emissions reduction potential when poultry litter management techniques are used to produce biogas, generating electricity and bio-fertilizer. Life-cycle assessment (LCA) has been used for a systematic evaluation of GHG-emissions considering the local supply chain in a typical rural layer poultry farm. The analysis shows that the GHG-emissions at the poultry farm amount to 1735 KgCO_2_e_q/10000 eggs produced if the litter is untreated. With the installation of an anaerobic digester, the emission intensity could be reduced by 65% if the gas is used to replace LPG for cooking purposes. If 100% digested slurry is utilized as bio-fertilizer, the emissions intensity could be further reduced by 17 times compared to the case without slurry utilization. These results justify the consideration of national programs to improve conditions in poultry farms in Bangladesh. - Highlights: • This study estimates GHG-emissions reduction potential of utilizing poultry litter for energy production in a rural farm. • Energy/mass flow and GHG balances are evaluated considering the local supply chain. • On-farm activities significantly affect GHG emissions among others across the supply chain. • Biogas production and use of slurry as bio-fertilizer significantly reduces the emission intensity. • Results from LCA and sensitivity analysis have been discussed to identify key influential parameters.

  15. Information systems project management: methods, tools, and techniques

    OpenAIRE

    Mcmanus, John; Wood-Harper, Trevor

    2004-01-01

    Information Systems Project Management offers a clear and logical exposition of how to plan, organise and monitor projects effectively in order to deliver quality information systems within time, to budget and quality. This new book by John McManus and Trevor Wood-Harper is suitable for upper level undergraduates and postgraduates studying project management and Information Systems. Practising managers will also find it to be a valuable tool in their work. Managing information systems pro...

  16. The development of an audit technique to assess the quality of safety barrier management

    International Nuclear Information System (INIS)

    Guldenmund, Frank; Hale, Andrew; Goossens, Louis; Betten, Jeroen; Duijm, Nijs Jan

    2006-01-01

    This paper describes the development of a management model to control barriers devised to prevent major hazard scenarios. Additionally, an audit technique is explained that assesses the quality of such a management system. The final purpose of the audit technique is to quantify those aspects of the management system that have a direct impact on the reliability and effectiveness of the barriers and, hence, the probability of the scenarios involved. First, an outline of the management model is given and its elements are explained. Then, the development of the audit technique is described. Because the audit technique uses actual major hazard scenarios and barriers within these as its focus, the technique achieves a concreteness and clarity that many other techniques often lack. However, this strength is also its limitation, since the full safety management system is not covered with the technique. Finally, some preliminary experiences obtained from several test sites are compiled and discussed

  17. The development of an audit technique to assess the quality of safety barrier management

    Energy Technology Data Exchange (ETDEWEB)

    Guldenmund, Frank [Safety Science Group, Delft University of Technology (Netherlands)]. E-mail: f.w.guldenmund@tbm.tudelft.nl; Hale, Andrew [Safety Science Group, Delft University of Technology (Netherlands); Goossens, Louis [Safety Science Group, Delft University of Technology (Netherlands); Betten, Jeroen [Safety Science Group, Delft University of Technology (Netherlands); Duijm, Nijs Jan [Riso National Laboratory (Denmark)

    2006-03-31

    This paper describes the development of a management model to control barriers devised to prevent major hazard scenarios. Additionally, an audit technique is explained that assesses the quality of such a management system. The final purpose of the audit technique is to quantify those aspects of the management system that have a direct impact on the reliability and effectiveness of the barriers and, hence, the probability of the scenarios involved. First, an outline of the management model is given and its elements are explained. Then, the development of the audit technique is described. Because the audit technique uses actual major hazard scenarios and barriers within these as its focus, the technique achieves a concreteness and clarity that many other techniques often lack. However, this strength is also its limitation, since the full safety management system is not covered with the technique. Finally, some preliminary experiences obtained from several test sites are compiled and discussed.

  18. Study of molecule-metal interfaces by means of the normal incidence X-ray standing wave technique

    International Nuclear Information System (INIS)

    Mercurio, Giuseppe

    2012-01-01

    Functional surfaces based on monolayers of organic molecules are currently subject of an intense research effort due to their applications in molecular electronics, sensing and catalysis. Because of the strong dependence of organic based devices on the local properties of the molecule-metal interface, a direct investigation of the interface chemistry is of paramount importance. In this context, the bonding distance, measured by means of the normal incidence X-ray standing wave technique (NIXSW), provides a direct access to the molecule-metal interactions. At the same time, NIXSW adsorption heights are used to benchmark different density functional theory (DFT) schemes and determine the ones with predictive power for similar systems. This work investigates the geometric and chemical properties of different molecule/metal interfaces, relevant to molecular electronics and functional surfaces applications, primarily by means of the NIXSW technique. All NIXSW data are analyzed with the newly developed open source program Torricelli, which is thoroughly documented in the thesis. In order to elucidate the role played by the substrate within molecule/metal interfaces, the prototype organic molecule 3,4,9,10-perylene-tetracarboxylic-dianhydride (PTCDA) is explored on the Ag(110) surface. The molecule results more distorted and at smaller bonding distances on the more reactive Ag(110) surface, in comparison with the Ag(100), the Ag(111) and Au(111) substrates. This conclusion follows from the detailed molecular adsorption geometry obtained from the differential analysis of nonequivalent carbon and oxygen species (including a careful error analysis). Subsequently, the chemisorptive PTCDA/Ag(110) interaction is tuned by the co-deposition of an external alkali metal, namely K. As a consequence, the functional groups of PTCDA unbind from the surface, which, in turn, undergoes major reconstruction. In fact, the resulting nanopatterned surface consists of alternated up and down

  19. Problem-solving and developing quality management methods and techniques on the example of automotive industry

    OpenAIRE

    Jacek Łuczak; Radoslaw Wolniak

    2015-01-01

    The knowledge about methods and techniques of quality management together with their effective use can be definitely regarded as an indication of high organisational culture. Using such methods and techniques in an effective way can be attributed to certain level of maturity, as far as the quality management system in an organisation is concerned. There is in the paper an analysis of problem-solving methods and techniques of quality management in the automotive sector in Poland. The survey wa...

  20. Technical management techniques for identification and control of industrial safety and pollution hazards

    Science.gov (United States)

    Campbell, R.; Dyer, M. K.; Hoard, E. G.; Little, D. G.; Taylor, A. C.

    1972-01-01

    Constructive recommendations are suggested for pollution problems from offshore energy resources industries on outer continental shelf. Technical management techniques for pollution identification and control offer possible applications to space engineering and management.

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

    Science.gov (United States)

    McIntosh, Tania

    2006-01-01

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

  2. Crew resource management: using aviation techniques to improve operating room safety.

    Science.gov (United States)

    Ricci, Michael A; Brumsted, John R

    2012-04-01

    Since the publication of the Institute of Medicine report estimating nearly 100,000 deaths per year from medical errors, hospitals and physicians have a renewed focus upon error reduction. We implemented a surgical crew resource management (CRM) program for all operating room (OR) personnel. In our academic medical center, 19,000 procedures per year are performed in 27 operating rooms. Mandatory CRM training was implemented for all peri-operative personnel. Aviation techniques introduced included a pre-operative checklist and brief, post-operative debrief, read and initial files, and various other aviation-based techniques. Compliance with conduct of the brief/debrief was monitored as well as wrong-site surgeries and retained foreign body events. The malpractice insurance database for claims was also queried for the period prior to and after training. Initial training was accomplished for 517 people, including all anesthesiologists, surgeons, nurses, technicians, and OR assistants. Pre-operative briefing increased from 6.7 to 99% within 4 mo. Wrong site surgeries and retained foreign bodies decreased from a high of seven in 2007 to none in 2008, but, after 14 mo without additional training, these rose to five in 2009. Malpractice expenses (payouts and legal fees) totaled $793,000 (2003-2007), but have been zero since 2008. CRM training and implementation had an impact on reducing the incidence of wrong site surgery and retained foreign bodies in our operating rooms. However, constant reinforcement and refresher training is necessary for sustained results. Though no one technique can prevent all errors, CRM can effect culture change, producing a safer environment.

  3. Application of Incident Command Structure to clinical trial management in the academic setting: principles and lessons learned.

    Science.gov (United States)

    Reynolds, Penny S; Michael, Mary J; Spiess, Bruce D

    2017-02-09

    Clinical trial success depends on appropriate management, but practical guidance to trial organisation and planning is lacking. The Incident Command System (ICS) is the 'gold standard' management system developed for managing diverse operations in major incident and public health arenas. It enables effective and flexible management through integration of personnel, procedures, resources, and communications within a common hierarchical organisational structure. Conventional ICS organisation consists of five function modules: Command, Planning, Operations, Logistics, and Finance/Administration. Large clinical trials will require a separate Regulatory Administrative arm, and an Information arm, consisting of dedicated data management and information technology staff. We applied ICS principles to organisation and management of the Prehospital Use of Plasma in Traumatic Haemorrhage (PUPTH) trial. This trial was a multidepartmental, multiagency, randomised clinical trial investigating prehospital administration of thawed plasma on mortality and coagulation response in severely injured trauma patients. We describe the ICS system as it would apply to large clinical trials in general, and the benefits, barriers, and lessons learned in utilising ICS principles to reorganise and coordinate the PUPTH trial. Without a formal trial management structure, early stages of the trial were characterised by inertia and organisational confusion. Implementing ICS improved organisation, coordination, and communication between multiple agencies and service groups, and greatly streamlined regulatory compliance administration. However, unfamiliarity of clinicians with ICS culture, conflicting resource allocation priorities, and communication bottlenecks were significant barriers. ICS is a flexible and powerful organisational tool for managing large complex clinical trials. However, for successful implementation the cultural, psychological, and social environment of trial participants must be

  4. Using remote sensing and modeling techniques to investigate the annual parasite incidence of malaria in Loreto, Peru

    Science.gov (United States)

    Mousam, Aneela; Maggioni, Viviana; Delamater, Paul L.; Quispe, Antonio M.

    2017-10-01

    Between 2001 and 2010 significant progress was made towards reducing the number of malaria cases in Peru; however, the country saw an increase between 2011 and 2015. This work attempts to uncover the associations among various climatic and environmental variables and the annual malaria parasite incidence in the Peruvian region of Loreto. A Multilevel Mixed-effects Poisson Regression model is employed, focusing on the 2009-2013 period, when trends in malaria incidence shifted from decreasing to increasing. The results indicate that variations in elevation (β = 0.78; 95% confidence interval (CI), 0.75-0.81), soil moisture (β = 0.0021; 95% CI, 0.0019-0.0022), rainfall (β = 0.59; 95% CI, 0.56-0.61), and normalized difference vegetation index (β = 2.13; 95% CI, 1.83-2.43) is associated with higher annual parasite incidence, whereas an increase in temperature (β = -0.0043; 95% CI, - 0.0044- 0.0041) is associated with a lower annual parasite incidence. The results from this study are particularly useful for healthcare workers in Loreto and have the potential of being integrated within malaria elimination plans.

  5. Food risk management quality: Consumer evaluations of past and emerging food safety incidents

    NARCIS (Netherlands)

    Kleef, van E.; Ueland, O.; Theodoridis, G.; Rowe, G.; Pfenning, U.; Houghton, J.R.; Dijk, van H.; Chryssochoidis, G.; Frewer, L.J.

    2009-01-01

    In European countries, there has been growing consumer distrust regarding the motives of food safety regulators and other actors in the food chain, partly as a result of recent food safety incidents. If consumer confidence in food safety is to be improved, a systematic understanding of what

  6. Characterization of post-disaster environmental management for Hazardous Materials Incidents: Lessons learnt from the Tianjin warehouse explosion, China.

    Science.gov (United States)

    Zhang, Hui; Duan, Huabo; Zuo, Jian; Song, MingWei; Zhang, Yukui; Yang, Bo; Niu, Yongning

    2017-09-01

    Hazardous Materials Incidents (HMIs) have attracted a growing public concern worldwide. The health risks and environmental implications associated with HMIs are almost invariably severe, and underscore the urgency for sound management. Hazardous Materials Explosion incidents (HMEIs) belong to a category of extremely serious HMIs. Existing studies placed focuses predominately on the promptness and efficiency of emergency responses to HMIs and HMEIs. By contrast, post-disaster environmental management has been largely overlooked. Very few studies attempted to examine the post-disaster environmental management plan particularly its effectiveness and sufficiency. In the event of the Tianjin warehouse explosion (TWE), apart from the immediate emergency response, the post-disaster environmental management systems (P-EMSs) have been reported to be effective and sufficient in dealing with the environmental concerns. Therefore, this study aims to critically investigate the P-EMSs for the TWE, and consequently to propose a framework and procedures for P-EMSs in general for HMIs, particularly for HMEIs. These findings provide a useful reference to develop P-EMSs for HMIs in the future, not only in China but also other countries. Copyright © 2017. Published by Elsevier Ltd.

  7. [The effect of colored syringes and a colored sheet on the incidence of syringe swaps during anesthetic management].

    Science.gov (United States)

    Hirabayashi, Yoshihiro; Kawakami, Takayuki; Suzuki, Hideo; Igarashi, Takashi; Saitoh, Kazuhiko; Seo, Norimasa

    2005-09-01

    Syringe swap is an important problem in anesthetic care, causing harm to patients. We examined the effect of colored syringe and a colored sheet on the incidence of syringe swaps during anesthetic management. We determined the color code. The blue-syringe contains local anesthetics; yellow-syringe, sympathomimetic drugs; and white-syringe with a red label fixed opposite the scale, muscle relaxants. The colored sheet displays the photographs of the syringe with drug name, dose and volume. The colored syringe and colored sheet were supplied for use from February 2004. We compared the incidence of syringe swaps during the period from February 2004 to January 2005 with that from February 2003 to January 2004. Although five syringe swaps were recorded from February 2003 to January 2004, in 5901 procedures, we encountered no syringe swaps from February 2004 to January 2005, in 6078 procedures. The colored syringe and colored sheet significantly decreased the incidence of syringe swaps during anesthetic management (P sheet together with colored syringes can prevent syringe swaps during anesthesia.

  8. Information System of Resolution of Procedural Incidents and Management of the Modifications Made to the Electronic Court Registration

    Directory of Open Access Journals (Sweden)

    Ştefan Gheorghe PENTIUC

    2011-01-01

    Full Text Available This information system was made for its use by the staff responsible for random distribution of cases to the courts. The Information System of Resolution of Procedural Incidents and Management of the Modifications Made to the Electronic Court Registration consists of three new developed modules: the management module is a Web application which chronicles the modifications made in the electronic court registration, regarding the random assignment of cases,the resolution of procedural incidents, which is a Web service whose logic implements a logic Semantic Web application and the module of confirming judges which is a windows service running on the judges’ workstations. The Web service implements a Semantic Web application which processes the knowledgebase achieved through OWL ontology (Ontology Web Language by applying inferences leading to the correct solution. If this does not solve the problem, a set of associated Jena rules are used to infer and generate new knowledge. It also uses the SPARQL(SPARQL Protocol and RDF Query Language language that allows queries on the knowledge,similar to the classic query languages of databases. The novelty of the new conceived, designed and implemented system consists in accessing the domain knowledge as a web service to solve the procedural incidents occurred in electronic court registration.

  9. Preventing construction worker injury incidents through the management of personal stress and organizational stressors.

    Science.gov (United States)

    Leung, Mei-yung; Chan, Isabelle Yee Shan; Yu, Jingyu

    2012-09-01

    Construction workers (CWs) are positioned at the lowest level of an organization and thus have limited control over their work. For this reason, they are often deprived of their due rewards and training or sometimes are even compelled to focus on production at the expense of their own safety. These organizational stressors not only cause the CWs stress but also impair their safety behaviors. The impairment of safety behaviors is the major cause of CW injury incidents. Hence, to prevent injury incidents and enhance safety behaviors of CWs, the current study aimed to identify the impact of various organizational stressors and stress on CW safety behaviors and injury incidents. To achieve this aim, we surveyed 395 CWs. Using factor analysis, we identified five organizational stressors (unfair reward and treatment, inappropriate safety equipment, provision of training, lack of goal setting, and poor physical environment), two types of stress (emotional and physical), and safety behaviors. The results of correlation and regression analyses revealed the following: (1) injury incidents were minimized by safety behaviors but escalated by a lack of goal setting, (2) safety behaviors were maximized by moderate levels of emotional stress (i.e., an inverted U-shape relationship between these two variables) and increased in line with physical stress and inappropriate safety equipment, (3) emotional stress was positively predicted by the provision of training and inappropriate safety equipment, and (4) physical stress was predicted only by inappropriate safety equipment. Based on these results, we suggest various recommendations to construction stakeholders on how to prevent CW injury incidents. Copyright © 2011 Elsevier Ltd. All rights reserved.

  10. Software-Enabled Project Management Techniques and Their Relationship to the Triple Constraints

    Science.gov (United States)

    Elleh, Festus U.

    2013-01-01

    This study investigated the relationship between software-enabled project management techniques and the triple constraints (time, cost, and scope). There was the dearth of academic literature that focused on the relationship between software-enabled project management techniques and the triple constraints (time, cost, and scope). Based on the gap…

  11. Purchasing and inventory management techniques for optimizing inventory investment

    International Nuclear Information System (INIS)

    McFarlane, I.; Gehshan, T.

    1993-01-01

    In an effort to reduce operations and maintenance costs among nuclear plants, many utilities are taking a closer look at their inventory investment. Various approaches for inventory reduction have been used and discussed, but these approaches are often limited to an inventory management perspective. Interaction with purchasing and planning personnel to reduce inventory investment is a necessity in utility efforts to become more cost competitive. This paper addresses the activities that purchasing and inventory management personnel should conduct in an effort to optimize inventory investment while maintaining service-level goals. Other functions within a materials management organization, such as the warehousing and investment recovery functions, can contribute to optimizing inventory investment. However, these are not addressed in this paper because their contributions often come after inventory management and purchasing decisions have been made

  12. Review of Spatial Indexing Techniques for Large Urban Data Management

    DEFF Research Database (Denmark)

    Azri, Suhaibah; Ujang, Uznir; Anton, François

    Pressure on land development in urban areas causes progressive efforts in spatial planning and management. The physical expansion of urban areas to accommodate rural migration implies a massive impact to social, economical and political situations of major cities. Most of the models used...... in managing urban areas are moving towards sustainable urban development in order to fulfill current necessities while preserving the resources for future generations. However, in order to manage large amounts of urban spatial data, an efficient spatial data constellation method is needed. With the ease...... of three dimensional (3D) spatial data usage in urban areas as a new source of data input, practical spatial data indexing is necessary to improve data retrieval and management. Current two dimensional (2D) spatial indexing approaches seem not applicable to the current and future spatial developments...

  13. Gender differences and job stress management techniques of library ...

    African Journals Online (AJOL)

    This study aimed at ascertaining gender and work related stress among library ... library staff indicated non-conducive work environment as the cause of job stress. ... flexible work hours and developing healthy life styles as management tips.

  14. Combining objective and subjective techniques for assessing quality of management

    International Nuclear Information System (INIS)

    Arueti, S.; Okrent, D.

    1987-01-01

    The basic assumption is that utility and plant corporate management have a significant role in plant safety which may be quantifiable. From this point of view we try to identify symptoms and paths through which management effectiveness affects plant safety, partly in terms of measureable parameters. Some of the available data are analyzed in light of the proposed parameters, in order to examine possible correlations. Preliminary proposals are made of methods for including management performance as a variable in future PRA studies. This paper focuses primarily on measures of management quality from relating to what are frequently called performance indicators, such as SALP ratings, number of scrams, ESF actuations and safety system failures and challanges; forced outages; availability; enforcement actions; and licensee event reports (LERs). (orig./HP)

  15. Comparative techniques for nuclear fuel cycle waste management systems

    International Nuclear Information System (INIS)

    Pelto, P.J.; Voss, J.W.

    1979-09-01

    A safety assessment approach for the evaluation of predisposal waste management systems is described and applied to selected facilities in the light water reactor (LWR) once-through fuel cycle and a potential coprocessed UO 2 -PuO 2 fuel cycle. This approach includes a scoping analysis on pretreatment waste streams and a more detailed analysis on proposed waste management processes. The primary evaluation parameters used in this study include radiation exposures to the public from radionuclide releases from normal operations and potential accidents, occupational radiation exposure from normal operations, and capital and operating costs. On an overall basis, the waste management aspects of the two fuel cycles examined are quite similar. On an individual facility basis, the fuel coprocessing plant has the largest waste management impact

  16. Determination of x-ray spectra incident on and transmitted through whole excised breast for improved mammographic exposing technique

    International Nuclear Information System (INIS)

    Haus, A.G.; Metz, C.E.; Doi, K.; Bernstein, J.

    1976-01-01

    Measurements were made of x-ray spectra incident on and transmitted through whole excised fresh breast tissue. The spectra and corresponding radiographs show that hardening of the x-ray beam from a molybdenum anode x-ray tube by a 0.5 mm Al filter instead of the conventional 0.03 mm Mo filter allows shorter exposure times and reduces patient radiation exposure. With the Al filter, acceptable image contrast is preserved in mammography of thick or dense breasts

  17. Prophylactic antibiotics are associated with a lower incidence of pneumonia in cardiac arrest survivors treated with targeted temperature management

    DEFF Research Database (Denmark)

    Gagnon, David J; Nielsen, Niklas; Fraser, Gilles L

    2015-01-01

    INTRODUCTION: Prophylactic antibiotics (PRO) reduce the incidence of early-onset pneumonia in comatose patients with structural brain injury, but have not been examined in cardiac arrest survivors undergoing targeted temperature management (TTM). We investigated the effect of PRO on the development...... of pneumonia in that population. METHODS: We conducted a retrospective cohort study comparing patients treated with PRO to those not receiving PRO (no-PRO) using Northern Hypothermia Network registry data. Cardiac arrest survivors ≥ 18 years of age with a GCS...-34 °C were enrolled in the registry. Differences were analyzed in univariate analyses and with logistic regression models to evaluate independent associations of clinical factors with incidence of pneumonia and good functional outcome. RESULTS: 416 of 1240 patients (33.5%) received PRO. Groups were...

  18. Incidence and Management of Uncomplicated Recurrent Urinary Tract Infections in a National Sample of Women in the United States.

    Science.gov (United States)

    Suskind, Anne M; Saigal, Christopher S; Hanley, Janet M; Lai, Julie; Setodji, Claude M; Clemens, J Quentin

    2016-04-01

    To determine the incidence and characteristics of women with uncomplicated recurrent urinary tract infections (UTIs) and to explore whether the use of culture-driven treatment affects rates of UTI-related complications and resource utilization. Using MarketScan claims from 2003 to 2011, we identified UTI-naive women ages 18-64 with incident-uncomplicated recurrent UTIs. Recurrent UTIs were defined as 3 UTI visits associated with antibiotics during a 12-month period. Cases were excluded if they had a UTI in the preceding year, or if they had any complicating factors (eg, abnormality of the urinary tract, neurologic condition, pregnancy, diabetes, or currently taking immunosuppression). We next assessed use of urine cultures, imaging, and cystoscopy, and performed propensity score matching with logistic regression to determine whether having a urine culture associated with >50% of UTIs affected rates of complications and downstream resource utilization. We identified 48,283 women with incident-uncomplicated recurrent UTIs, accounting for an overall incidence of 102 per 100,000 women, highest among women ages 18-34 and 55-64. Sixty-one percent of these women had at least 1 urine culture, 6.9% had imaging, and 2.8% had cystoscopy. Having a urine culture >50% of the time was associated with fewer UTI-related hospitalizations and lower rates of intravenous antibiotic use, whereas demonstrating higher rates of UTI-related office visits and pyelonephritis. The incidence of uncomplicated recurrent UTIs increases with age. Urine culture-directed care is beneficial in reducing high-cost services including UTI-related hospitalizations and intravenous antibiotic use, making urine cultures a valuable component to management of these patients. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Development of Energy Management System Based on Internet of Things Technique

    OpenAIRE

    Wen-Jye Shyr; Chia-Ming Lin and Hung-Yun Feng

    2017-01-01

    The purpose of this study was to develop an energy management system for university campuses based on the Internet of Things (IoT) technique. The proposed IoT technique based on WebAccess is used via network browser Internet Explore and applies TCP/IP protocol. The case study of IoT for lighting energy usage management system was proposed. Structure of proposed IoT technique included perception layer, equipment layer, control layer, application layer and network layer.

  20. Vuosaari Harbour Road Tunnel Traffic Management and Incident Detection System Design Issues

    Directory of Open Access Journals (Sweden)

    Caj Holm

    2006-11-01

    Full Text Available Helsinki is constructing in Vuosaari a new modem and effectivecargo harbour. All cargo harbour activities will be concentratedthere. The total project includes the harbour, a logisticsarea, traffic connections (road, railway and fairway and aBusiness Park. The road connection goes through the Porvarinlahtiroad tunnel. The harbour will commence operatingin 2008. This paper gives an oveTView of the tunnel design phasefunctional studies and risk analysis tunnel incident detectionsystem design issues and some specific environmental featuresof the tunnel.

  1. Memory Compression Techniques for Network Address Management in MPI

    Energy Technology Data Exchange (ETDEWEB)

    Guo, Yanfei; Archer, Charles J.; Blocksome, Michael; Parker, Scott; Bland, Wesley; Raffenetti, Ken; Balaji, Pavan

    2017-05-29

    MPI allows applications to treat processes as a logical collection of integer ranks for each MPI communicator, while internally translating these logical ranks into actual network addresses. In current MPI implementations the management and lookup of such network addresses use memory sizes that are proportional to the number of processes in each communicator. In this paper, we propose a new mechanism, called AV-Rankmap, for managing such translation. AV-Rankmap takes advantage of logical patterns in rank-address mapping that most applications naturally tend to have, and it exploits the fact that some parts of network address structures are naturally more performance critical than others. It uses this information to compress the memory used for network address management. We demonstrate that AV-Rankmap can achieve performance similar to or better than that of other MPI implementations while using significantly less memory.

  2. Management of excessive movable tissue: a modified impression technique.

    Science.gov (United States)

    Shum, Michael H C; Pow, Edmond H N

    2014-08-01

    Excessive movable tissue is a challenge in complete denture prosthetics. A modified impression technique is presented with polyvinyl siloxane impression material and a custom tray with relief areas and perforations in the area of the excessive movable tissue. Copyright © 2014 Editorial Council for the Journal of Prosthetic Dentistry. Published by Elsevier Inc. All rights reserved.

  3. What have we learned about intelligent transportation systems? Chapter 2, What have we learned about freeway incident and emergency management and electronic toll collection?

    Science.gov (United States)

    2000-12-01

    The intelligent infrastructure is often the most visible manifestation of intelligent transportation systems (ITS) along with roads, freeways, and incident management is often among the first ITS elements implemented. They can significantly contribut...

  4. Management Science/Industrial Engineering Techniques to Reduce Food Costs.

    Science.gov (United States)

    Greenberg, Murray

    This paper examines the contributions of Industrial Engineering and Management Science toward reduction in the cost of production and distribution of food. Food processing firms were requested to respond to a questionnaire which asked for examples of their use of various operations research tools and information on the number of operations…

  5. The success of various management techniques used in South ...

    African Journals Online (AJOL)

    Background. Despite the availability of international guidelines for the treatment of type 1 diabetes mellitus (T1DM) in children, important aspects of treatment are not accessible to all young patients in South Africa (SA). Objective. To investigate factors in diabetes management strategies that are associated with poor ...

  6. Managing Multiuser Database Buffers Using Data Mining Techniques

    NARCIS (Netherlands)

    Feng, L.; Lu, H.J.

    2004-01-01

    In this paper, we propose a data-mining-based approach to public buffer management for a multiuser database system, where database buffers are organized into two areas – public and private. While the private buffer areas contain pages to be updated by particular users, the public

  7. Decision making for wildfires: A guide for applying a risk management process at the incident level

    Science.gov (United States)

    Mary A. Taber; Lisa M. Elenz; Paul G. Langowski

    2013-01-01

    This publication focuses on the thought processes and considerations surrounding a risk management process for decision making on wildfires. The publication introduces a six element risk management cycle designed to encourage sound risk-informed decision making in accordance with Federal wildland fire policy, although the process is equally applicable to non-Federal...

  8. Strategic Management Tools and Techniques: A Comparative Analysis of Empirical Studies

    Directory of Open Access Journals (Sweden)

    Albana Berisha Qehaja

    2017-01-01

    Full Text Available There is no doubt that strategic management tools and techniques are important parts of the strategic management process. Their use in organizations should be observed in a practice-based context. This paper analyzes the empirical studies on the usage of strategic management tools and techniques. Hence, the main aim of this study is to investigate and analyze which enterprises, according to their country development level, use more strategic management tools and techniques and which of these are used the most. Also, this paper investigates which strategic management tools and techniques are used globally according to the results of empirical studies. The study presents a summary of empirical studies for the period 1990–2015. The research results indicate that more strategic tools and techniques are used in developed countries, followed by developing countries and fewest in countries in transition. This study is likely to contribute to the field of strategic management because it summarizes the most used strategic tools and techniques at the global level according to varying stages of countries’ economic development. Also, the findings from this study may be utilized to maximize the full potential of enterprises and reduce the cases of entrepreneurship failures, through creating awareness of the importance of using strategic management tools and techniques.

  9. Information technology - Security techniques - Information security management systems - Requirements

    CERN Document Server

    International Organization for Standardization. Geneva

    2005-01-01

    ISO/IEC 27001:2005 covers all types of organizations (e.g. commercial enterprises, government agencies, not-for profit organizations). ISO/IEC 27001:2005 specifies the requirements for establishing, implementing, operating, monitoring, reviewing, maintaining and improving a documented Information Security Management System within the context of the organization's overall business risks. It specifies requirements for the implementation of security controls customized to the needs of individual organizations or parts thereof. ISO/IEC 27001:2005 is designed to ensure the selection of adequate and proportionate security controls that protect information assets and give confidence to interested parties. ISO/IEC 27001:2005 is intended to be suitable for several different types of use, including the following: use within organizations to formulate security requirements and objectives; use within organizations as a way to ensure that security risks are cost effectively managed; use within organizations to ensure comp...

  10. Jihadist Terrorist Use of Strategic Communication Management Techniques

    Science.gov (United States)

    2008-12-01

    also contributed articles and book chapters on communication management, media work, public relations, terrorism, and asymmetric war fighting...experience (learning by doing) and the audience viewing the video with secondhand experience (learning by imitation) (Salem & Reid & Chen 2008). The...Big Difference. New York: Back Bay Books . Golan, G. (2006). Inter-Media Agenda Setting and Global News Coverage. Journalism Studies, 7(2), 323–333

  11. Crisis management during the SOCATRI incident in July 2008: lessons learned by the IRSN

    International Nuclear Information System (INIS)

    Champion, D.

    2010-01-01

    This report describes the successive events which occurred in July 2008 in the SOCATRI plant where a uranium-bearing solution was accidentally released, causing a temporary pollution of two rivers. Then, he reports how this event has been managed, firstly through a mobilization of public authorities and early decisions, secondly through sampling and measurements performed by the IRSN (the management of the obtained results is also commented), thirdly through expertise investigations by the IRSN, fourthly through relationship with local authorities, and finally through media and public information. For each of these aspects, the author discusses the lessons learned, and proposes ways to improve the management of such an accident

  12. Contemporary behavior management techniques in clinical pediatric dentistry: out with the old and in with the new?

    Science.gov (United States)

    Oliver, Kelly; Manton, David John

    2015-01-01

    Effective behavior management guides children through the complex social context of dentistry utilizing techniques based on a current understanding of the social, emotional, and cognitive development of children. Behavior management techniques facilitate effective communication and establish social and behavioral guidelines for the dental environment. Contemporary parenting styles, expectations, and attitudes of modern parents and society have influenced the use of behavior management techniques with a prevailing emphasis on communicative techniques and pharmacological management over aversive techniques.

  13. Poultry Waste Management Techniques in Urban Agriculture and its Implications: A Case of Metropolitan Lagos, Nigeria

    OpenAIRE

    Vide Adedayo

    2012-01-01

    This study examines the existing poultry waste management and utilization technique in urban vegetable farms. It analyses the implications of the management pattern on yield and revenue and further determines the socio-economic differentials of farmers on management pattern. Socio-economic survey was carried out to determine relationship between socio economic characteristics of farmers and poultry waste management while field experiments and estimations were done to determine poultry waste p...

  14. Updated Decision Support Tool for the Management of Waste and Debris from Radiological Incidents

    International Nuclear Information System (INIS)

    Lemieux, P.; Thorneloe, S.; Hayes, C.; Rodgers, M.; Christman, R.

    2009-01-01

    Unique challenges exist for the handling, transport, and disposal of debris resulting from homeland security incidents, disasters or other national emergencies. Access to guidance for facilitating decision making in the safe and timely disposal of debris is critical to helping restore a community or region and prevent further contamination or spread of disease. For a radiological dispersal device (RDD) or other radiological incident, proper characterization of the quantity, properties, and level of contamination of debris and decontamination residue can have a significant impact on cleanup costs and timelines. A suite of decision support tools (DSTs) is being developed by the U.S. EPA's Office of Research and Development to assist individuals responsible for making decisions associated with handling, transport, treatment, and disposal of such debris. The DSTs are location-specific to help identify specific facilities and contacts for making final disposal decisions. The DSTs provide quick reference to technical information, regulations, and other information to provide decision makers with assistance in guiding disposal decisions that are important for the protection of public health, first responders, and the environment. This tool is being developed in partnership with other U.S. government agencies, EPA program offices, industry, and state and local emergency response programs. (authors)

  15. Waste Management Decision-Making Process During a Homeland Security Incident Response

    Science.gov (United States)

    A step-by-step guide on how to make waste management-related decisions including how waste can be minimized, collected and treated, as well as where waste can be sent for staging, storage and final disposal.

  16. Incidents in Czechoslovakian "Socialist Management" between 1956 and 1989. Conflict and Reconciliation

    Czech Academy of Sciences Publication Activity Database

    Vilímek, Tomáš; Tůma, Oldřich

    42/43, Spring-Summer (2016), s. 187-240 ISSN 1310-9456 Institutional support: RVO:68378114 Keywords : socialist management * centrally planned economy * Czechoslovakia 1956-1989 Subject RIV: AB - History

  17. The Application of Isotope Techniques in Nutrient Assessment and Management in Riverine Systems. Present and Future

    Energy Technology Data Exchange (ETDEWEB)

    Ito, M.; Newman, B. D. [International Atomic Energy Agency, Isotope Hydrology Section, Vienna (Austria); Hadwen, W. L. [Australian Rivers Institute, Griffith School of Environment, Griffith University - Nathan Campus, Brisbane, Queensland (Australia); Rogers, K. [National Isotope Center, GNS Science, Lower Hutt (New Zealand); Mayer, B. [Department of Geoscience, University of Calgary, Calgary, Alberta (Canada); Hein, T. [Wasser Cluster Lunz, Interuniversitary Center for Aquatic Research, Lunz-See, and University of Natural Resources and Applied Life Sciences, Institute of Hydrobiology and Aquatic Ecosystem Management, Vienna (Austria); Stellato, L. [Centre for Isotopic Research on Cultural and Environmental Heritage (CIRCE), Seconda Universita degli Studi di Napoli, Caserta (Italy); Ohte, N. [Graduate School of Agricultural and Life Sciences, University of Tokyo, Tokyo (Japan); Mclaughlin, K. [Southern California Coastal Water Research Project, Costa Mesa, California (United States)

    2013-05-15

    A variety of sources contribute to nutrients in rivers and nutrients may subsequently take various pathways and undergo different transformation processes. We first review representative types of isotopes and the roles of isotope techniques that have been or could be used for nutrient assessment and management. We then present technical, financial and logistical matters to be considered in selecting appropriate isotope techniques for nutrient assessment and management. Lastly we propose several approaches on the application of isotope techniques to make more effective the studies and management of nutrients in rivers in the near future. (author)

  18. The Dermal Apron Technique for Immediate Implant Socket Management: A Novel Technique.

    Science.gov (United States)

    Levin, Barry P

    2016-01-01

    With immediate implant placement and provisionalization (IIP) in the esthetic zone, measures to counter hard and soft tissue loss are frequently necessary. To reduce the morbidity associated with bone and connective tissue procurement, various exogenous materials are utilized. The "Dermal Apron Technique" presented in this article demonstrates the use of a composite bone particulate (allograft/xenograft) plus a dermal allograft, adapted around screw-retained temporary crowns and secured within a subperiosteal pouch. The purpose is to augment the thickness of peri-implant mucosa for the purpose of preserving ridge dimensions and preventing mucosal recession. Controlled studies are required to further support its use. Clinical significance: Soft tissue health and harmony are critical for successful implant therapy in the esthetic regions of the dentition. Often, autogenous soft tissue grafts are used to augment peri-implant soft tissues. The Dermal Apron Technique is a method, that in specific situations, obviates the need for autogenous grafting. This reduces treatment time and morbidity associated with procurement of these grafts. The Dermal Apron Technique is used simultaneous with immediate placement and provisionalization and can improve long-term esthetic outcomes for patients. © 2016 Wiley Periodicals, Inc.

  19. Surveillance of Otitis Media With Effusion in Thai Children With Cleft Palate: Cumulative Incidence and Outcome of the Management.

    Science.gov (United States)

    Ungkanont, Kitirat; Boonyabut, Panrasee; Komoltri, Chulaluk; Tanphaichitr, Archwin; Vathanophas, Vannipa

    2018-04-01

    To study the incidence and outcome of management of otitis media with effusion in Thai children with cleft palate. Retrospective cohort study in the tertiary care center. Ninety-five children with cleft palate were referred for ear evaluation, from June 1997 to January 2015. Fifteen children (15.8%) had associated craniofacial syndromic anomalies. Cumulative incidence of otitis media with effusion, rate of ventilation tube insertion, duration of indwelling tubes, hearing outcome, and complications of ventilation tubes. Ear examinations were done every 8 to 12 weeks throughout the study. Cumulative incidence of otitis media with effusion was 53.7% in children within 12 months of age and 81.1% within 24 months of age. At the end of the study, all of the patients had at least 1 episode of otitis media with effusion. Eighty-eight children (92.6%) had palatoplasty, and there was no significant difference in the incidence of otitis media before and after palatoplasty. The mean hearing level at recruitment was 40.8 ±18.4 dB. Ventilation tube insertion was done in 76 patients (80%). The median time for indwelling tubes was 11.7 months. Rate of ventilation tube insertion was 0.5/year. The mean hearing level at last follow-up was 23.5 ± 14 dB. Otorrhea through tube was found in 24 cases (31.6%). Otitis media with effusion was common in Thai children with cleft palate. Surveillance of middle ear effusion and ventilation tube insertion contributed to a favorable hearing outcome.

  20. Statistical and Economic Techniques for Site-specific Nematode Management.

    Science.gov (United States)

    Liu, Zheng; Griffin, Terry; Kirkpatrick, Terrence L

    2014-03-01

    Recent advances in precision agriculture technologies and spatial statistics allow realistic, site-specific estimation of nematode damage to field crops and provide a platform for the site-specific delivery of nematicides within individual fields. This paper reviews the spatial statistical techniques that model correlations among neighboring observations and develop a spatial economic analysis to determine the potential of site-specific nematicide application. The spatial econometric methodology applied in the context of site-specific crop yield response contributes to closing the gap between data analysis and realistic site-specific nematicide recommendations and helps to provide a practical method of site-specifically controlling nematodes.

  1. Study of evaluation techniques of software configuration management and reliability

    Energy Technology Data Exchange (ETDEWEB)

    Youn, Cheong; Baek, Y. W.; Kim, H. C.; Han, H. C.; Choi, C. R. [Chungnam National Univ., Taejon (Korea, Republic of)

    2001-03-15

    The Study of activities to solve software safety and quality must be executed in base of establishing software development process for digitalized nuclear plant. Especially study of software testing and Verification and Validation must executed. For this purpose methodologies and tools which can improve software qualities are evaluated and software Testing, V and V and Configuration Management which can be applied to software life cycle are investigated. This study establish a guideline that can be used to assure software safety and reliability requirements in digitalized nuclear plant systems.

  2. Pipeline risk management manual ideas, techniques, and resources

    CERN Document Server

    Muhlbauer, W Kent

    2004-01-01

    Here's the ideal tool if you're looking for a flexible, straightforward analysis system for your everyday design and operations decisions. This new third edition includes sections on stations, geographical information systems, ""absolute"" versus ""relative"" risks, and the latest regulatory developments. From design to day-to-day operations and maintenance, this unique volume covers every facet of pipeline risk management, arguably the most important, definitely the most hotly debated, aspect of pipelining today.Now expanded and updated, this widely accepted standard reference guide

  3. Pediatric Enteric Feeding Techniques: Insertion, Maintenance, and Management of Problems

    International Nuclear Information System (INIS)

    Nijs, Els L. F.; Cahill, Anne Marie

    2010-01-01

    Enteral feeding is considered a widespread, well-accepted means of delivering nutrition to adults and children who are unable to consume food by mouth or who need support in maintaining adequate nutrition for a variety of reasons, including acute and chronic disease states. Delivery of enteral feeding to nutritionally deprived patients may be achieved by several means. In this article, the indications and insertion of enteral access in children will be reviewed. In addition, common complications and management of problems will be discussed.

  4. Hydrogen management techniques in German LWR-containments

    International Nuclear Information System (INIS)

    Berg, H.P.; Froehmel, T.

    1993-01-01

    Investigations are described which are necessary to develop an accident management concept for German PWRs, in particular possible solutions of the hydrogen problem resulting from a core melting accident. This work is an important part of the Nuclear Regulatory Research Programme initiated and financed by the Federal Office for Radiation Protection (BfS). Two fundamental strategies are discussed: prevention of the formation of inflammable gas mixtures by making the atmosphere of the containment inert, and mitigation of the consequence of possible combustion by limiting the local hydrogen concentration. (Z.S.) 1 fig

  5. Temporal trends in outpatient management of incident pulmonary embolism and associated mortality.

    Science.gov (United States)

    Klil-Drori, Adi J; Coulombe, Janie; Suissa, Samy; Hirsch, Andrew; Tagalakis, Vicky

    2018-01-01

    In clinical trial settings, outpatient management of pulmonary embolism (PE) is feasible and safe, but less is known on its use in routine care. We determined trends in outpatient management of PE and associated mortality in a large non-select patient population. All residents of Quebec, Canada with a first-ever work-up for suspected PE in the emergency department (ED) over 10years were included. Patients could transition to outpatient management and from unconfirmed to confirmed PE in a time-varying fashion. Comparing the years 2005-9 with 2000-4, we assessed the odds ratio (OR) for outpatient management, and relative risk (RR) for all-cause mortality, readmissions for PE, and major bleeding in 30days. We adjusted the RR for a mortality risk score. Of 15,217 patients included, 7583 were outpatients (7.5% confirmed PE) and 7634 were inpatients (60.6% confirmed PE). In all, 10.9% of patients with confirmed PE were outpatients, but outpatient management of confirmed PE was more likely in the latter study period (OR 1.73, 95%CI 1.44-2.09). Among outpatients with confirmed PE, mortality (RR 0.84, 95%CI 0.15-4.61) and readmission (RR 1.25, 95%CI 0.45-3.48) rates were stable, and only 3 major bleeding events were noted. Inpatients with confirmed PE had stable mortality rates (RR 0.95, 95%CI 0.72-1.24). Outpatient PE management increased over 10years while remaining fairly uncommon. Nevertheless, stable mortality and readmission rates indicate this practice is safe in routine care, and add to the growing evidence in support of outpatient PE management. Copyright © 2017 Elsevier Ltd. All rights reserved.

  6. Using total quality management approach to improve patient safety by preventing medication error incidences*.

    Science.gov (United States)

    Yousef, Nadin; Yousef, Farah

    2017-09-04

    Whereas one of the predominant causes of medication errors is a drug administration error, a previous study related to our investigations and reviews estimated that the incidences of medication errors constituted 6.7 out of 100 administrated medication doses. Therefore, we aimed by using six sigma approach to propose a way that reduces these errors to become less than 1 out of 100 administrated medication doses by improving healthcare professional education and clearer handwritten prescriptions. The study was held in a General Government Hospital. First, we systematically studied the current medication use process. Second, we used six sigma approach by utilizing the five-step DMAIC process (Define, Measure, Analyze, Implement, Control) to find out the real reasons behind such errors. This was to figure out a useful solution to avoid medication error incidences in daily healthcare professional practice. Data sheet was used in Data tool and Pareto diagrams were used in Analyzing tool. In our investigation, we reached out the real cause behind administrated medication errors. As Pareto diagrams used in our study showed that the fault percentage in administrated phase was 24.8%, while the percentage of errors related to prescribing phase was 42.8%, 1.7 folds. This means that the mistakes in prescribing phase, especially because of the poor handwritten prescriptions whose percentage in this phase was 17.6%, are responsible for the consequent) mistakes in this treatment process later on. Therefore, we proposed in this study an effective low cost strategy based on the behavior of healthcare workers as Guideline Recommendations to be followed by the physicians. This method can be a prior caution to decrease errors in prescribing phase which may lead to decrease the administrated medication error incidences to less than 1%. This improvement way of behavior can be efficient to improve hand written prescriptions and decrease the consequent errors related to administrated

  7. Management of the droopy tip: a comparison of three alar cartilage-modifying techniques.

    Science.gov (United States)

    Foda, Hossam M T

    2003-10-01

    The droopy tip is a common nasal deformity in which the tip is inferiorly rotated. Five hundred consecutive rhinoplasty cases were studied to assess the incidence and causes of the droopy tip deformity and to evaluate the role of three alar cartilage-modifying techniques--lateral crural steal, lateral crural overlay, and tongue in groove--in correcting such a deformity. The external rhinoplasty approach was used in all cases. Only one of the three alar cartilage-modifying techniques was used in each case, and the degree of tip rotation and projection was measured both preoperatively and postoperatively. The incidence of droopy tip was 72 percent, and the use of an alar cartilage-modifying technique was required in 85 percent of these cases to achieve the desired degree of rotation. The main causes of droopy tip included inferiorly oriented alar cartilages (85 percent), overdeveloped scrolls of upper lateral cartilages (73 percent), high anterior septal angle (65 percent), and thick skin of the nasal lobule (56 percent). The lateral crural steal technique increased nasal tip rotation and projection, the lateral crural overlay technique increased tip rotation and decreased tip projection, and the tongue-in-groove technique increased tip rotation without significantly changing the amount of projection. The lateral crural overlay technique resulted in the highest degrees of rotation, followed by the lateral crural steal and finally the tongue-in-groove technique. According to these results, the lateral crural steal technique is best indicated in cases with droopy underprojected nasal tip, the lateral crural overlay technique in cases of droopy overprojected nasal tip, and the tongue-in-groove technique in cases where the droopy nasal tip is associated with an adequate amount of projection.

  8. Public health incident management: logistical and operational aspects of the 2009 initial outbreak of H1N1 influenza in Mexico.

    Science.gov (United States)

    Cruz, Miguel A; Hawk, Nicole M; Poulet, Christopher; Rovira, Jose; Rouse, Edward N

    2015-01-01

    Hosting an international outbreak response team can pose a challenge to jurisdictions not familiar with incident management frameworks. Basic principles of team forming, organizing, and executing mission critical activities require simple and flexible communication that can be easily understood by the host country's public health leadership and international support agencies. Familiarity with incident command system principles before a public health emergency could save time and effort during the initial phases of the response and aid in operationalizing and sustaining complex field activities throughout the response. The 2009 initial outbreak of H1N1 in Mexico highlighted the importance of adequately organizing and managing limited resources and expertise using incident management principles. This case study describes logistical and operational aspects of the response and highlights challenges faced during this response that may be relevant to the organization of public health responses and incidents requiring international assistance and cooperation.

  9. 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.

  10. Use of Mitomycin C to reduce the incidence of encapsulated cysts following ahmed glaucoma valve implantation in refractory glaucoma patients: a new technique.

    Science.gov (United States)

    Zhou, Minwen; Wang, Wei; Huang, Wenbin; Zhang, Xiulan

    2014-09-06

    To evaluate the surgical outcome of Ahmed glaucoma valve (AGV) implantation with a new technique of mitomycin C (MMC) application. This is a retrospective study. All patients with refractory glaucoma underwent FP-7 AGV implantation. Two methods of MMC application were used. In the traditional technique, 6 × 4 mm cotton soaked with MMC (0.25-0.33 mg/ml) was placed in the implantation area for 2-5mins; in the new technique, the valve plate first was encompassed with a thin layer of cotton soaked with MMC, then inserted into the same area. A 200 ml balanced salt solution was applied for irrigation of MMC. The surgical success rate, intraocular pressure (IOP), number of anti-glaucoma medications used, and postoperative complications were analyzed between the groups. The surgical outcomes of two MMC applied techniques were compared. The new technique group had only one case (2.6%) of encapsulated cyst formation out of 38 eyes, while there were eight (19.5%) cases out of 41 eyes the in traditional group. The difference was statistically significant (P = 0.030). According to the definition of success rate, there was 89.5% in the new technique group and 70.7% in the traditional group at the follow-up end point. There was a significant difference between the two groups (P = 0.035). Mean IOP in the new technique group were significantly lower than those of the traditional group at 3 and 6 months (P < 0.05). By using a thin layer of cotton soaked with MMC to encompass the valve plate, the new MMC application technique could greatly decrease the incidence of encapsulated cyst and increase the success rate following AGV implantation.

  11. Convergent engineering techniques for management of nuclear processes

    International Nuclear Information System (INIS)

    Carabulea, A.; Popa, I.

    1995-01-01

    The paper briefly presents the concept of convergent arhemo-systematical engineering, its advantages in comparison with classical methods of research, design, manufacture. The convergent engineering application supposes the usage of the advanced methods, techniques and equipment corresponding to the domain and specific for the corresponding branch of computer science. Starting from the convergent engineering principles and concept, the paper proposes two models applicable for new products and also for improving and optimizing the existing ones. The models are based on two levels of feedback corresponding to two levels of control and they assume the utilization of expert and robot-expert systems. The economical efficiency of the application of the convergent engineering method is evaluated for the case of a nuclear power plant by calculation the main technical and economical indicators. (Author) 2 Figs., 5 Refs

  12. Bile Duct Leaks from the Intrahepatic Biliary Tree: A Review of Its Etiology, Incidence, and Management

    Directory of Open Access Journals (Sweden)

    Sorabh Kapoor

    2012-01-01

    Full Text Available Bile leaks from the intrahepatic biliary tree are an important cause of morbidity following hepatic surgery and trauma. Despite reduction in mortality for hepatic surgery in the last 2 decades, bile leaks rates have not changed significantly. In addition to posted operative bile leaks, leaks may occur following drainage of liver abscess and tumor ablation. Most bile leaks from the intrahepatic biliary tree are transient and managed conservatively by drainage alone or endoscopic biliary decompression. Selected cases may require reoperation and enteric drainage or liver resection for management.

  13. Energy management techniques: SRP cooling water distribution system

    International Nuclear Information System (INIS)

    Edenfield, A.B.

    1979-10-01

    Cooling water for the nuclear reactors at the Savannah River Plant is supplied by a pumping and distribution system that includes about 50 miles of underground pipeline. The energy management program at SRP has thus far achieved a savings of about 5% (186 x 10 9 Btu) of the energy consumed by the electrically powered cooling water pumps; additional savings of about 14% (535 x 10 9 Btu) can be achieved by capital expenditures totaling about $3.7 million. The present cost of electricity for operation of this system is about $25 million per year. A computer model of the system was adapted and field test data were used to normalize the program to accurately represent pipeline physical characteristics. Alternate pumping schemes are analyzed to determine projected energy costs and impact on system safety and reliability

  14. A Hybrid MCDM Technique for Risk Management in Construction Projects

    Directory of Open Access Journals (Sweden)

    Kajal Chatterjee

    2018-02-01

    Full Text Available Multi-stakeholder based construction projects are subject to potential risk factors due to dynamic business environment and stakeholders’ lack of knowledge. When solving project management tasks, it is necessary to quantify the main risk indicators of the projects. Managing these requires suitable risk mitigation strategies to evaluate and analyse their severity. The existence of information asymmetry also causes difficulties with achieving Pareto efficiency. Hence, to ensure balanced satisfaction of all participants, risk evaluation of these projects can be considered as an important part of the multi-criteria decision-making (MCDM process. In real-life problems, evaluation of project risks is often uncertain and even incomplete, and the prevailing methodologies fail to handle such situations. To address the problem, this paper extends the analytical network process (ANP methodology in the D numbers domain to handle three types of ambiguous information’s, viz. complete, uncertain, and incomplete, and assesses the weight of risk criteria. The D numbers based approach overcomes the deficiencies of the exclusiveness hypothesis and completeness constraint of Dempster–Shafer (D–S theory. Here, preference ratings of the decision matrix for each decision-maker are determined using a D numbers extended consistent fuzzy preference relation (D-CFPR. An extended multi-attributive border approximation area comparison (MABAC method in D numbers is then developed to rank and select the best alternative risk response strategy. Finally, an illustrative example from construction sector is presented to check the feasibility of the proposed approach. For checking the reliability of alternative ranking, a comparative analysis is performed with different MCDM approaches in D numbers domain. Based on different criteria weights, a sensitivity analysis of obtained ranking of the hybrid D-ANP-MABAC model is performed to verify the robustness of the proposed

  15. Proceedings of the National Conference on Energy Resource Management. Volume 1: Techniques, Procedures and Data Bases

    Science.gov (United States)

    Brumfield, J. O. (Editor); Schiffman, Y. M. (Editor)

    1982-01-01

    Topics dealing with the integration of remotely sensed data with geographic information system for application in energy resources management are discussed. Associated remote sensing and image analysis techniques are also addressed.

  16. Comparing Student Perceptions of Coping Strategies and School Interventions in Managing Bullying and Cyberbullying Incidents

    Science.gov (United States)

    Paul, Simone; Smith, Peter K.; Blumberg, Herbert H.

    2012-01-01

    A total of 407 students in a central London secondary school participated in a survey of different approaches to managing traditional bullying and cyberbullying. Student perceptions of individual coping strategies and school interventions for traditional bullying and cyberbullying were measured. Rankings of the strategies for traditional bullying…

  17. 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...

  18. Strategic Priorities, Company Performance and Attitudes Towards Management Accounting Techniques: an Empirical Study

    OpenAIRE

    Ekholm, Bo-Göran

    2004-01-01

    The study investigates whether there is an association between different combinations of emphasis on generic strategies (product differentiation and cost efficiency) and perceived usefulness of management accounting techniques. Previous research has found that cost leadership is associated with traditional accounting techniques and product differentiation with a variety of modern management accounting approaches. The present study focuses on the possible existence of a strategy that mixes the...

  19. Quality management techniques in public sector organizations: the role of managerial autonomy and organizational culture

    OpenAIRE

    Demuzere, Sara; Verhoest, Koen; Bouckaert, Geert

    2008-01-01

    According to NPM, more effective and efficient public services can be delivered if public sector organizations are granted more managerial autonomy and if they use various (private sector) management techniques. To date, only very limited attention has been paid to the link between managerial autonomy and the use of management techniques. With this study, we seek to fill this gap in the extensive NPM literature by examining the extent to which managerial autonomy has an effect on the use of m...

  20. Clinical management of the induction of labor in intrauterine fetal death: evaluation of incidence of cesarean section and related conditions

    Directory of Open Access Journals (Sweden)

    Maria Isabel do Nascimento

    2014-03-01

    Full Text Available OBJECTIVE: To assess the incidence and conditions associated with cesarean section in a cohort of pregnant women with intrauterine fetal death (IUFD, and clinical management to anticipate the childbirth. METHODS: It was a retrospective cohort study with 163 mothers with IUFD, at the second half of pregnancy, who were managed to anticipate childbirth using pharmacological preparations and/or a mechanical method (Foley catheter in a teaching hospital in Rio de Janeiro State, Brazil. Cox regression was used to evaluate the effect of the clinical methods on the kind of delivery. RESULTS: The Subgroups A (misoprostol or Oxytocin, B (misoprostol and Oxytocin, and C (Foley catheter alone or combined with misoprostol and/or Oxytocin were formed according to the applied methods. Nine out of 163 cases ended with cesarean section. The incidence of cesarean section was 3.5 per 1,000 people-hours, meaning that a pregnant woman with IUFD had a 15.6% risk of cesarean section during the first 48 hours of clinical management to anticipate childbirth. The conditions significantly associated with the mode of delivery were placental abruption (HR: 44.97, having two or more previous cesarean deliveries (HR: 10.03, and mechanical method with Foley catheter (HR: 5.01. CONCLUSION: Cesarean section was an essential conduct in this cohort and followed previous cesarean delivery and placental abruption. The effect of the mechanical method on the abdominal route suggests that the Foley catheter method was used in the most difficult cases and that the surgery was performed to ensure maternal health.

  1. Investment, regulation, and uncertainty: managing new plant breeding techniques.

    Science.gov (United States)

    Smyth, Stuart J; McDonald, Jillian; Falck-Zepeda, Jose

    2014-01-01

    As with any technological innovation, time refines the technology, improving upon the original version of the innovative product. The initial GM crops had single traits for either herbicide tolerance or insect resistance. Current varieties have both of these traits stacked together and in many cases other abiotic and biotic traits have also been stacked. This innovation requires investment. While this is relatively straight forward, certain conditions need to exist such that investments can be facilitated. The principle requirement for investment is that regulatory frameworks render consistent and timely decisions. If the certainty of regulatory outcomes weakens, the potential for changes in investment patterns increases.   This article provides a summary background to the leading plant breeding technologies that are either currently being used to develop new crop varieties or are in the pipeline to be applied to plant breeding within the next few years. Challenges for existing regulatory systems are highlighted. Utilizing an option value approach from investment literature, an assessment of uncertainty regarding the regulatory approval for these varying techniques is undertaken. This research highlights which technology development options have the greatest degree of uncertainty and hence, which ones might be expected to see an investment decline.

  2. Geospatial Techniques for Improved Water Management in Jordan

    Directory of Open Access Journals (Sweden)

    Jawad T. Al-Bakri

    2016-04-01

    Full Text Available This research shows a case from Jordan where geospatial techniques were utilized for irrigation water auditing. The work was based on assessing records of groundwater abstraction in relation to irrigated areas and estimated crop water consumption in three water basins: Yarmouk, Amman-Zarqa and Azraq. Mapping of irrigated areas and crop water requirements was carried out using remote sensing data of Landsat 8 and daily weather records. The methodology was based on visual interpretation and the unsupervised classification for remote sensing data, supported by ground surveys. Net (NCWR and gross (GCWR crop water requirements were calculated by merging crop evapotranspiration (ETc, calculated from daily weather records, with maps of irrigated crops. Gross water requirements were compared with groundwater abstractions recorded at a farm level to assess the levels of abstraction in relation to groundwater safe yield. Results showed that irrigated area and GCWR were higher than officially recorded cropped area and abstracted groundwater. The over abstraction of groundwater was estimated to range from 144% to 360% of the safe yield in the three basins. Overlaying the maps of irrigation and groundwater wells enabled the Ministry of Water and Irrigation (MWI to detect and uncover violations and illegal practices of irrigation, in the form of unlicensed wells, incorrect metering of pumped water and water conveyance for long distances. Results from the work were utilized at s high level of decision-making and changes to the water law were made, with remote sensing data being accredited for monitoring water resources in Jordan.

  3. Whole-body computed tomography in polytrauma: techniques and management

    International Nuclear Information System (INIS)

    Linsenmaier, Ulrich; Kroetz, Michael; Rock, Clemens; Rieger, Johannes; Pfeifer, Klaus Juergen; Reiser, Maximilian; Haeuser, Hannes; Bohndorf, Klaus

    2002-01-01

    An interdisciplinary team should be involved in the diagnosis and management of severely injured patients. The adoption of criteria for starting treatment for multiple trauma avoids underestimation of seriousness of injury. These criteria are established by the circumstances of the accident, the patterns of trauma, and the vital findings. Basic diagnosis comprises a limited number of plain films in the trauma room, including supine chest, lateral cervical spine, and pelvis, and ultrasound of abdomen, pleura, and pericardium. Organ diagnosis using CT is complementary and depends on the clinical findings and findings from the basic investigations. We recommend spiral CT (skull base 2/2/4 mm, cerebrum 8/8/8 mm native) and after intravenous contrast medium thoracic (5/7.5/5 mm) and abdominal CT (8/12/8 mm). Image reconstruction of bony structures can be added. The CT and the trauma center should be in close proximity; time-consuming transfers must be avoided. If this is not possible, a CT can be integrated in the trauma room. Our hospital trauma registry contains over 2200 entries. A quality committee has been established and external quality control is implemented. (orig.)

  4. Whole-body computed tomography in polytrauma: techniques and management

    Energy Technology Data Exchange (ETDEWEB)

    Linsenmaier, Ulrich; Kroetz, Michael; Rock, Clemens; Rieger, Johannes; Pfeifer, Klaus Juergen; Reiser, Maximilian [Department of Radiology, Klinikum der Universitaet Muenchen (Germany); Haeuser, Hannes; Bohndorf, Klaus [Department of Radiology, Klinikum Augsburg (Germany)

    2002-07-01

    An interdisciplinary team should be involved in the diagnosis and management of severely injured patients. The adoption of criteria for starting treatment for multiple trauma avoids underestimation of seriousness of injury. These criteria are established by the circumstances of the accident, the patterns of trauma, and the vital findings. Basic diagnosis comprises a limited number of plain films in the trauma room, including supine chest, lateral cervical spine, and pelvis, and ultrasound of abdomen, pleura, and pericardium. Organ diagnosis using CT is complementary and depends on the clinical findings and findings from the basic investigations. We recommend spiral CT (skull base 2/2/4 mm, cerebrum 8/8/8 mm native) and after intravenous contrast medium thoracic (5/7.5/5 mm) and abdominal CT (8/12/8 mm). Image reconstruction of bony structures can be added. The CT and the trauma center should be in close proximity; time-consuming transfers must be avoided. If this is not possible, a CT can be integrated in the trauma room. Our hospital trauma registry contains over 2200 entries. A quality committee has been established and external quality control is implemented. (orig.)

  5. Craniofacial fibrous dysplasia - A review of current management techniques

    Directory of Open Access Journals (Sweden)

    Yadavalli Guruprasad

    2012-01-01

    Full Text Available Fibrous dysplasia is a pathologic condition of bone of unknown etiology with no apparent familial, hereditary or congenital basis. Lichtenstein first coined the term in 1938 and in 1942 he and Jaffe separated it from other fibro-osseous lesions. It is a bone tumor that, although benign, has the potential to cause significant cosmetic and functional disturbance, particularly in the craniofacial skeleton. Its management poses significant challenges to the surgeon. Craniofacial fibrous dysplasia is 1 of 3 types of fibrous dysplasia that can affect the bones of the craniofacial complex, including the mandible and maxilla. Fibrous dysplasia is a skeletal developmental disorder of the bone-forming mesenchyme that manifests as a defect in osteoblastic differentiation and maturation. It is a lesion of unknown etiology, uncertain pathogenesis, and diverse histopathology. Fibrous dysplasia represents about 2, 5% of all bone tumors and over 7% of all benign tumours. Over the years, we have gained a better understanding of its etiology, clinical behavior, and both surgical and non-surgical treatments.

  6. Role of radiation therapy in the management of plasma cell tumors. [Incidence of complications

    Energy Technology Data Exchange (ETDEWEB)

    Mill, W.B.; Griffith, R.

    1980-02-15

    A retrospective review is reported of 128 patients presenting with multiple myeloma and 16 patients presenting with solitary plasmacytoma. Ninety-one percent of 116 evaluable patients treated for palliation of painful bone disease received some degree of subjective pain relief. The radiation dose most frequently prescribed was between 1500 and 2000 rad. Of the 278 ports treated, only 17 (6.1%) were re-treated to the same area at a later date. There was no increase in incidence of re-treatment with lower radiation doses. Ten of the 13 patients treated for a solitary plasmacytoma with a minimum follow-up period of three years have local tumor control. The median survival in the solitary plasmacytomas is five and one-half years. Data from the literature on 27 additional solitary plasmacytomas combined with our data suggest an improved local control and a decrease in dissemination with doses greater than 5000 rad. It is concluded that low doses of radiation are usually adequate to treat painful bone lesions of multiple myeloma and doses of 5000 to 6500 rad in six to seven weeks are recommended for solitary plasmacytomas.

  7. Incidence and predictors of hospitalization or death in patients managed in multidisciplinary heart failure clinics

    DEFF Research Database (Denmark)

    Gustafsson, Finn; Schou, Morten; Videbaek, Lars

    2009-01-01

    AND RESULTS: A total of 4012 consecutive outpatients referred for HF management in 18 Danish HF clinics were included. Clinical data were collected prospectively. Outcome data were obtained from a validated, national registry. Mean follow-up time was 580 days. The mean age of patients was 69 years, 83% had...... creatinine 1.03 (1.02-1.04), NYHA III and IV 1.32 (1.15-1.52), and hospitalization prior to referral to the HF clinic 1.81 (1.57-2.08). CONCLUSIONS: Event rates in this cohort were lower than most published data from HF clinic populations. Factors such as advanced age, NYHA class, and prior hospitalization...... predict poor outcome in patients managed in multidisciplinary HF clinics....

  8. Managing the Cost Overrun Risks of Hydroelectric Dams: An Application of Reference Class Forecasting Techniques

    OpenAIRE

    Omotola Awojobi; Glenn P. Jenkins

    2015-01-01

    Hydropower investments have been subject to intense criticism over environmental issues and the common experience with cost uncertainty. In this study we address the issue of uncertainty in cost projections by applying reference class forecasting (RCF) in order to improve the reliability of costs used for making decisions under uncertainty. This technique makes it possible to closely link contingency estimates to the likely incidence of uncertainty of construction costs for hydroelectric dams...

  9. Multinational corporations and infectious disease: Embracing human rights management techniques.

    Science.gov (United States)

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

    2014-01-01

    by companies, governments and civil society provides a roadmap for engaging business enterprises in rights-based disease management strategies to mitigate disease transmission rates and improve human welfare outcomes.

  10. Emerging technologies and techniques in the management of cancer

    International Nuclear Information System (INIS)

    Shah, Omar Javed

    2007-01-01

    Full text: The term cancer is used to describe a multitude of diseases all of which are linked by loss of control of normal growth and replication of cells. It is a major cause of death worldwide. If diagnosed early many cancers, particularly tumour such as skin cancers, can be cured by local treatment such as surgery or radiotherapy. Due to local invasion or dissemination of tumors via the lymphatics or blood, majority of solid malignant tumors are not curable by local measures alone. The successful treatment of a patient with cancer involves close co-operation between surgical oncologist, radiation oncologist, medical oncologist, general practitioner, nurses and support care workers, including clinical psychologists. The role of the surgeon is central to this; obtaining tissue for adequate histological analysis and identification of patients who can be cured by resection is a major component of management. Apart from curative resection of primary tumors, excision of secondary deposits can also offer long term disease control. Pancreatic ductal adenocarcinoma is a common malignancy of the gastrointestinal tract and is the tenth most common cancer for both genders. In the year 2006, in U.S, almost 34 thousand patients developed this disease and in the same year about 32 thousand succumbed to this disease. These figures demonstrate dismal prognosis of the disease and the reasons for the low survival rates are mainly due to aggressive biology, early development of peri-neural infiltration, angio-invasion and wide spread dissemination of the tumour. Despite recent advances in the field of medical and radiation oncology and the introduction of neo-adjuvant regimens surgery remains the single most important modality for the treatment of pancreatic ductal adenocarcinoma. This presentation will focus on the current status of surgical treatment of pancreatic ductal adenocarcinoma and highlight the new developments in this field

  11. Risk Management Technique for design and operation of facilities and equipment

    Science.gov (United States)

    Fedor, O. H.; Parsons, W. N.; Coutinho, J. De S.

    1975-01-01

    The Risk Management System collects information from engineering, operating, and management personnel to identify potentially hazardous conditions. This information is used in risk analysis, problem resolution, and contingency planning. The resulting hazard accountability system enables management to monitor all identified hazards. Data from this system are examined in project reviews so that management can decide to eliminate or accept these risks. This technique is particularly effective in improving the management of risks in large, complex, high-energy facilities. These improvements are needed for increased cooperation among industry, regulatory agencies, and the public.

  12. A study of parental presence/absence technique for child dental behaviour management

    NARCIS (Netherlands)

    Boka, V.; Arapostathis, K.; Charitoudis, G.; Veerkamp, J.; van Loveren, C.; Kotsanos, N.

    2017-01-01

    Aim: To examine the effectiveness of parental presence/absence (PPA) technique on the dental behaviour management of children. Materials and methods: This randomised control study recruited 61 child dental patients with uncooperative behaviour (Frankl 1 or 2) managed with AAPD-endorsed

  13. Managing Age Discrimination: An Examination of the Techniques Used when Seeking Employment

    Science.gov (United States)

    Berger, Ellie D.

    2009-01-01

    Purpose: This article examines the age-related management techniques used by older workers in their search for employment. Design and Methods: Data are drawn from interviews with individuals aged 45-65 years (N = 30). Results: Findings indicate that participants develop "counteractions" and "concealments" to manage perceived age discrimination.…

  14. Managing water resources in Malaysia: the use of isotope technique and its potential

    International Nuclear Information System (INIS)

    Keizrul Abdullah

    2006-01-01

    This keynote address discusses the following subjects; state of Malaysia water resources, water related problem i.e floods, water shortage (droughts), water quality, river sedimentation, water resources management and the ongoing and potential application of isotope techniques in river management

  15. Information Landscaping: Information Mapping, Charting, Querying and Reporting Techniques for Total Quality Knowledge Management.

    Science.gov (United States)

    Tsai, Bor-sheng

    2003-01-01

    Total quality management and knowledge management are merged and used as a conceptual model to direct and develop information landscaping techniques through the coordination of information mapping, charting, querying, and reporting. Goals included: merge citation analysis and data mining, and apply data visualization and information architecture…

  16. The Application of Operations Research Techniques to the Evaluation of Military Management Information Systems.

    Science.gov (United States)

    systems such as management information systems . To provide a methodology yielding quantitative results which may assist a commander and his staff in...this analysis, it is proposed that management information systems be evaluated as a whole by a technique defined as the semantic differential. Each

  17. Applying BI Techniques To Improve Decision Making And Provide Knowledge Based Management

    Directory of Open Access Journals (Sweden)

    Alexandra Maria Ioana FLOREA

    2015-07-01

    Full Text Available The paper focuses on BI techniques and especially data mining algorithms that can support and improve the decision making process, with applications within the financial sector. We consider the data mining techniques to be more efficient and thus we applied several techniques, supervised and unsupervised learning algorithms The case study in which these algorithms have been implemented regards the activity of a banking institution, with focus on the management of lending activities.

  18. Study and development of equipment supervision technique system and its management software for nuclear electricity production

    International Nuclear Information System (INIS)

    Zhang Liying; Zou Pingguo; Zhu Chenghu; Lu Haoliang; Wu Jie

    2008-01-01

    The equipment supervision technique system, which standardized the behavior of supervision organizations in planning and implementing of equipment supervision, is built up based on equipment supervision technique documents, such as Quality Supervision Classifications, Special Supervision Plans and Supervision Guides. Furthermore, based on the research, the equipment supervision management information system is developed by Object Oriented Programming, which consists of supervision information, supervision technique, supervision implementation, quality statistics and analysis module. (authors)

  19. Suitability of online 3D visualization technique in oil palm plantation management

    Science.gov (United States)

    Mat, Ruzinoor Che; Nordin, Norani; Zulkifli, Abdul Nasir; Yusof, Shahrul Azmi Mohd

    2016-08-01

    Oil palm industry has been the backbone for the growth of Malaysia economy. The exports of this commodity increasing almost every year. Therefore, there are many studies focusing on how to help this industry increased its productivity. In order to increase the productivity, the management of oil palm plantation need to be improved and strengthen. One of the solution in helping the oil palm manager is by implementing online 3D visualization technique for oil palm plantation using game engine technology. The potential of this application is that it can helps in fertilizer and irrigation management. For this reason, the aim of this paper is to investigate the issues in managing oil palm plantation from the view of oil palm manager by interview. The results from this interview will helps in identifying the suitable issues could be highlight in implementing online 3D visualization technique for oil palm plantation management.

  20. First Approximations of Prescribed Fire Risks Relative to Other Management Techniques Used on Private Lands.

    Directory of Open Access Journals (Sweden)

    Dirac Twidwell

    Full Text Available Fire is widely recognized as a critical ecological and evolutionary driver that needs to be at the forefront of land management actions if conservation targets are to be met. However, the prevailing view is that prescribed fire is riskier than other land management techniques. Perceived risks associated with the application of fire limits its use and reduces agency support for prescribed burning in the private sector. As a result, considerably less cost-share support is given for prescribed fire compared to mechanical techniques. This study tests the general perception that fire is a riskier technique relative to other land management options. Due to the lack of data available to directly test this notion, we use a combination of approaches including 1 a comparison of fatalities resulting from different occupations that are proxies for techniques employed in land management, 2 a comparison of fatalities resulting from wildland fire versus prescribed fire, and 3 an exploration of causal factors responsible for wildland fire-related fatalities. This approach establishes a first approximation of the relative risk of fatality to private citizens using prescribed fire compared to other management techniques that are readily used in ecosystem management. Our data do not support using risks of landowner fatalities as justification for the use of alternative land management techniques, such as mechanical (machine-related equipment, over prescribed fire. Vehicles and heavy machinery are consistently leading reasons for fatalities within occupations selected as proxies for management techniques employed by ranchers and agricultural producers, and also constitute a large proportion of fatalities among firefighters. Our study provides the foundation for agencies to establish data-driven decisions regarding the degree of support they provide for prescribed burning on private lands.

  1. High Incidence of De Novo and Subclinical Atrial Fibrillation in Patients With Hypertrophic Cardiomyopathy and Cardiac Rhythm Management Device.

    Science.gov (United States)

    Wilke, Iris; Witzel, Katrin; Münch, Julia; Pecha, Simon; Blankenberg, Stephan; Reichenspurner, Hermann; Willems, Stephan; Patten, Monica; Aydin, Ali

    2016-07-01

    Atrial fibrillation (AF) is an important prognostic parameter in patients with hypertrophic cardiomyopathy (HCM). Though cardiac rhythm management (CRM) devices (e.g., ICD, pacemaker or implantable loop recorder) can detect subclinical AF, data describing the incidence of AF are rare. We therefore investigated the incidence and clinical impact of de novo and subclinical AF detected by CRM devices in patients with HCM. In our retrospective single-center study, we included patients with HCM and need for CRM devices. The primary endpoint of the study was the incidence of clinical and subclinical de novo AF. During follow-up, patients were screened for adverse events like stroke, ventricular arrhythmia, heart failure, or death. From 192 HCM patients, 44 patients received a CRM device (38 ICDs, 5 pacemakers, 1 implantable loop recorder). In 14 of these patients (32%), AF had been documented before device implantation. Thirty (68%) patients were free from AF at the time of implantation. During a median follow-up of 595 days (interquartile range, 367-890 days), de novo AF was recorded in 16 of these 30 patients (53%). Fourteen (88%) of the 16 patients with de novo AF were free from any clinical symptoms, so these patients were classified to have subclinical AF. In logistic regression analysis, age was the only significant predictor for an increased risk of AF. AF is common in patients with HCM who need a CRM device. More than 50% of these patients develop de novo AF that was predominantly subclinical in our cohort. © 2016 Wiley Periodicals, Inc.

  2. Arthroscopic management of posterior instability: evolution of technique and results.

    Science.gov (United States)

    Savoie, Felix H; Holt, M Shaun; Field, Larry D; Ramsey, J Randall

    2008-04-01

    , and its attached superior glenohumeral ligament, the coracohumeral ligament, the inferior glenohumeral ligament complex, and the infraspinatus, in addition to the posterior labrum and capsule, allows excellent outcomes to be achieved with arthroscopic posterior reconstruction techniques. Level IV, therapeutic case series.

  3. Real-Time, Label-Free Detection of Biomolecular Interactions in Sandwich Assays by the Oblique-Incidence Reflectivity Difference Technique

    Directory of Open Access Journals (Sweden)

    Yung-Shin Sun

    2014-12-01

    Full Text Available One of the most important goals in proteomics is to detect the real-time kinetics of diverse biomolecular interactions. Fluorescence, which requires extrinsic tags, is a commonly and widely used method because of its high convenience and sensitivity. However, in order to maintain the conformational and functional integrality of biomolecules, label-free detection methods are highly under demand. We have developed the oblique-incidence reflectivity difference (OI-RD technique for label-free, kinetic measurements of protein-biomolecule interactions. Incorporating the total internal refection geometry into the OI-RD technique, we are able to detect as low as 0.1% of a protein monolayer, and this sensitivity is comparable with other label-free techniques such as surface plasmon resonance (SPR. The unique advantage of OI-RD over SPR is no need for dielectric layers. Moreover, using a photodiode array as the detector enables multi-channel detection and also eliminates the over-time signal drift. In this paper, we demonstrate the applicability and feasibility of the OI-RD technique by measuring the kinetics of protein-protein and protein-small molecule interactions in sandwich assays.

  4. Moisture Management in an Active Sportswear: Techniques and Evaluation—A Review Article

    Science.gov (United States)

    Senthilkumar, Mani; Sampath, M. B.; Ramachandran, T.

    2012-10-01

    Moisture management property is an important aspect of any fabric meant for active sportswear, which decides the comfort level of that fabric. Every human being sweats during different kinds of activities. An important feature of any fabric is how it transports this water out of the body, so as to make the wearer feel comfortable. This paper reports the concept of moisture management, various production techniques and evaluation of the moisture management characteristics on fabrics for active sportswear.

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

    Science.gov (United States)

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

    2017-03-01

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

  6. Risks management in the hospital environment: incidence and risk factors associated with falls and pressure injuries in a clinical unit

    Directory of Open Access Journals (Sweden)

    Rayane Oliveira Cedraz

    2018-03-01

    Full Text Available Abstract Objective: To evaluate the incidence and risk factors associated with falls and pressure injuries in a clinical unit. Methods: A quantitative, cross-sectional, descriptive-exploratory study was conducted at a university hospital in Rio de Janeiro using secondary data from patient records and information of registers of patients treated in 2015/2016. Data were analyzed using descriptive and inferential statistics. Results: Of the 157 treated patients, women, cardiovascular (43.9% and oncological diseases (35.0% predominated. The risk and incidences of falls and pressure injuries were higher in men. There were significant associations of gender with the risk of falling, the occurrence of falls and pressure injuries, and between the length of hospital stay and risk of falling. Conclusion: Risk management is essential to promote patient safety and improve quality of health care. Nurse staff plays a fundamental role in the process of guiding activities, updating the nursing team and evaluating interventions. The use of tools, such as protocols and indicators, allows the optimization of the work process and the achievement of these goals.

  7. Comparison of TEAR and TFRC throughput for Drop tail and RED Queue Management Techniques

    Directory of Open Access Journals (Sweden)

    Parminderjeet Singh

    2014-12-01

    Full Text Available The comparison of throughput for TEAR (TCP emulation at receivers and TFRC TCP friendly rate control in MANETs is done with varying Active queue Management Techniques. The analysis reveals that for bandwidth constraint links, TEAR and TFRC perform far better than normal traffic propagation through TCP. In case of TEAR, the processing and route congestion algorithm load is shared by the receiver resulting in lesser load at the transmitters. In TFRC the TCP traffic is propagated via an algorithm to curb acknowledgement congestions. The effect of these two techniques is monitored on Droptail and RED, two of the most common Active Queue Management Techniques.

  8. Improvement of ground water management and protection through the use of isotope and Nuclear Techniques

    International Nuclear Information System (INIS)

    El Samad, O.

    2009-01-01

    To establish nuclear techniques for the study and management of water resources including technology transfer; to develop a national strategy for the use of isotope techniques in water management and development studies; to develop a water mangement framework; to solve problems related to water shortage, overexploitation, management and rapid quality deterioration; to evaluate the sources, recharge rates and renewal of ground water reservoires; to resolve the problems of mixed aquifers, the quantity of mixing and the exchange reactions between groundwater reservoirs and their matrix; to strengthen the role of the CNRS within national instituions and water authorities. (author)

  9. Informing Parents about the Pharmacological and Invasive Behavior Management Techniques Used in Pediatric Dentistry

    Directory of Open Access Journals (Sweden)

    Mehrysa Paryab

    2014-06-01

    Full Text Available Background and aims. Parental acceptance and consent are important parameters in selecting the required behavior management technique during pediatric dental treatment. The present study sought to assess the effect of three different informing methods on the parental acceptance, consent and concern regarding the pharmacological and invasive behavior management techniques used in pediatric dentistry. Materials and methods. Ninety mothers of 3-6-year-old uncooperative children were selected and randomly assigned to three study groups. The parents in each group were initially asked to answer three questions related to their levels of ‘acceptance’, ‘consent’, and ‘concern’ toward the five behavior management techniques. Then, the information about the techniques was presented through a piece of writing in group I, verbal presentation in group II and showing a film in group III. At last, the parents answered the same three questions again. Score changes were analyzed by using ANOVA, correlations, Mann-Whitney U and Kruskal-Wallis methods. Results. There were no statistically significant differences in score changes of parental acceptance, consent and concern between the three groups, overall and in relation to each behaviour management technique (P > 0.05. Mothers with academic education revealed more statistically significant concern following presentation of information by film (P < 0.05. Conclusion. None of the presentation methods had a significant preference over the others; in selecting the behavioral management techniques, it is advisable to observe individual factors, such as the level of education of the mothers.

  10. ACE Inhibitor-Induced Angioedema of the Intestine: Case Report, Incidence, Pathophysiology, Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Gavin Oudit

    2001-01-01

    Full Text Available A case report of fosinopril-induced angioedema of the intestine with a chronic course accompanied by multiple acute exacerbations is described. Angiotensin-converting enzyme (ACE inhibitor-induced angioedema of the intestine (AIAI occurs in a minority of patients taking an ACE inhibitor. The clinical presentation encompasses acute abdominal symptoms, pronounced bowel edema and ascites with occasional facial and/or oropharyngeal swelling. AIAI is diagnosed based on the temporal relationship between the symptomatic presentation and drug use, absence of alternative diagnoses including other causes of angioedema, and the prompt resolution of symptoms upon discontinuation of the ACE inhibitor. Prompt radiological investigation (abdominal computerized tomography and/or ultrasound is critical in making an early diagnosis and in preventing unnecessary surgical intervention. There is a female predominance of AIAI, which may reflect the interaction of estradiol with the various pathways involved in the pathophysiology of AIAI. Management of AIAI consists mainly of conservative measures and discontinuation of the ACE inhibitor. Angiotensin II receptor antagonists should not be considered as appropriate alternatives. Awareness and knowledge of AIAI are important because of the increasing use of ACE inhibitors, current delays in making the diagnosis, obvious management strategies once the diagnosis is made and the dysutility of alternative diagnoses, which may lead to considerable morbidity. AIAI must be considered in patients taking ACE inhibitors who develop gastrointestinal complaints irrespective of the duration of the therapy.

  11. Decontamination and management of human remains following incidents of hazardous chemical release.

    Science.gov (United States)

    Hauschild, Veronique D; Watson, Annetta; Bock, Robert

    2012-01-01

    To provide specific guidance and resources for systematic and orderly decontamination of human remains resulting from a chemical terrorist attack or accidental chemical release. A detailed review and health-based decision criteria protocol is summarized. Protocol basis and logic are derived from analyses of compound-specific toxicological data and chemical/physical characteristics. Guidance is suitable for civilian or military settings where human remains potentially contaminated with hazardous chemicals may be present, such as sites of transportation accidents, terrorist operations, or medical examiner processing points. Guidance is developed from data-characterizing controlled experiments with laboratory animals, fabrics, and materiel. Logic and specific procedures for decontamination and management of remains, protection of mortuary affairs personnel, and decision criteria to determine when remains are sufficiently decontaminated are presented. Established procedures as well as existing materiel and available equipment for decontamination and verification provide reasonable means to mitigate chemical hazards from chemically exposed remains. Unique scenarios such as those involving supralethal concentrations of certain liquid chemical warfare agents may prove difficult to decontaminate but can be resolved in a timely manner by application of the characterized systematic approaches. Decision criteria and protocols to "clear" decontaminated remains for transport and processing are also provided. Once appropriate decontamination and verification have been accomplished, normal procedures for management of remains and release can be followed.

  12. Applying of Reliability Techniques and Expert Systems in Management of Radioactive Accidents

    International Nuclear Information System (INIS)

    Aldaihan, S.; Alhbaib, A.; Alrushudi, S.; Karazaitri, C.

    1998-01-01

    Accidents including radioactive exposure have variety of nature and size. This makes such accidents complex situations to be handled by radiation protection agencies or any responsible authority. The situations becomes worse with introducing advanced technology with high complexity that provide operator huge information about system working on. This paper discusses the application of reliability techniques in radioactive risk management. Event tree technique from nuclear field is described as well as two other techniques from nonnuclear fields, Hazard and Operability and Quality Function Deployment. The objective is to show the importance and the applicability of these techniques in radiation risk management. Finally, Expert Systems in the field of accidents management are explored and classified upon their applications

  13. Current Trends in the Oncologic and Surgical Managements of Breast Cancer in Women with Implants: Incidence, Diagnosis, and Treatment.

    Science.gov (United States)

    Veronesi, Paolo; De Lorenzi, Francesca; Loschi, Pietro; Rietjens, Mario; Veronesi, Umberto

    2016-04-01

    Breast augmentation is the most common cosmetic surgery in the United States, and thousands of augmented patients develop breast cancer each year. The possible effects of implants on cancer incidence, diagnosis, and treatment usually generate a disarming confusion. The present paper represents an update of the more recent oncologic and surgical strategies, aiming to support plastic and general surgeons in such challenging aspects. Several aspects of breast cancer management in augmented women are investigated, including (1) risk estimation and cancer characteristics, stage at diagnosis, and prognosis; (2) cancer diagnosis with clinical examination, mammography, ultrasound, and magnetic resonance imaging; (3) cancer treatment including breast conservation, intraoperative radiotherapy, sentinel node biopsy and mastectomy, and reconstruction. A brief resume of recommendations and conclusions is suggested, elucidating correct trends in the oncologic management of augmented patients and refusing well-established misconceptions: (1) breast augmentation does not increase the risk of breast cancer incidence, and it does not influence the prognosis; (2) possible risks exist in cancer detection due to technical difficulties; (3) sentinel lymph node detection is feasible; (4) intraoperative radiotherapy represents a good chance for conserving treatment; (5) immediate reconstruction with submuscular-subfascial implants is the most common procedure after mastectomy, and biological substitutes could support this procedure. Breast clinicians should be alerted because of high expectations of this subgroup of patients, accustomed to emphasize the aesthetic result. This journal requires that the authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

  14. FEMA's Earthquake Incident Journal: A Web-Based Data Integration and Decision Support Tool for Emergency Management

    Science.gov (United States)

    Jones, M.; Pitts, R.

    2017-12-01

    For emergency managers, government officials, and others who must respond to rapidly changing natural disasters, timely access to detailed information related to affected terrain, population and infrastructure is critical for planning, response and recovery operations. Accessing, analyzing and disseminating such disparate information in near real-time are critical decision support components. However, finding a way to handle a variety of informative yet complex datasets poses a challenge when preparing for and responding to disasters. Here, we discuss the implementation of a web-based data integration and decision support tool for earthquakes developed by the Federal Emergency Management Agency (FEMA) as a solution to some of these challenges. While earthquakes are among the most well- monitored and measured of natural hazards, the spatially broad impacts of shaking, ground deformation, landslides, liquefaction, and even tsunamis, are extremely difficult to quantify without accelerated access to data, modeling, and analytics. This web-based application, deemed the "Earthquake Incident Journal", provides real-time access to authoritative and event-specific data from external (e.g. US Geological Survey, NASA, state and local governments, etc.) and internal (FEMA) data sources. The journal includes a GIS-based model for exposure analytics, allowing FEMA to assess the severity of an event, estimate impacts to structures and population in near real-time, and then apply planning factors to exposure estimates to answer questions such as: What geographic areas are impacted? Will federal support be needed? What resources are needed to support survivors? And which infrastructure elements or essential facilities are threatened? This presentation reviews the development of the Earthquake Incident Journal, detailing the data integration solutions, the methodology behind the GIS-based automated exposure model, and the planning factors as well as other analytical advances that

  15. Incidence of root rot diseases of soybean in Multan Pakistan and its management by the use of plant growth promoting rhizobacteria

    International Nuclear Information System (INIS)

    Haq, M.I.; Tahir, M.I.; Mahmood, S.

    2012-01-01

    Eight villages in Multan district were surveyed to record incidence of disease and losses of soybean (Glycine max L.) caused by root rot fungi. The root incidence ranged 10-17% and losses ranged 6.75-15.5%. The evaluation of four PGPR isolates was used in combination with organic amendment for the management of root-rot disease incidence and to reduce the population of root pathogenic fungi and to increase the yield in field. This study demonstrated effective biological control by the PGPR isolates tested, thereby indicating the possibility of application of rhizobacteria for control of soil bor ne diseases of soybean in Pakistan and other countries. (author)

  16. Application of nuclear techniques in improving agricultural productivity with particular reference to pasture management

    International Nuclear Information System (INIS)

    Majid Ajorlo; Ramdzani Abdullah

    2009-01-01

    Nuclear techniques are appropriate tools to settle problems for agriculture or natural resources which cannot be solved using conventional agricultural techniques. In this paper, the research activities carried out and the achievements so far obtained in the agricultural specialties -all by using nuclear techniques- with particular reference to pasture management are discussed. Insect pest control by Sterile Insect Techniques (SIT); soil and water management using neutron moisture probes; determining N-fixation capacity of legumes using N-15 isotope and nuclear methods; soil erosion measurement using of fallout radionuclide such as Cs-137; monitoring the movement of saline water in salt-affected land using isotopes of chlorine; livestock production and health by RIA and ELISA are some of achievements so far obtained in improving agricultural productivity. The ultimate goal of the nuclear technique investigation in agriculture is to use the resources efficiently in obtaining higher plant and livestock yields while increasing the quality and protecting them against insects, diseases and weeds. (Author)

  17. Pain during awake craniotomy for brain tumor resection. Incidence, causes, consequences and management.

    Science.gov (United States)

    Fontaine, D; Almairac, F

    2017-06-01

    Awake craniotomy for brain tumor resection is usually well-tolerated and most of the patients are satisfied. However, in studies reporting the patients' postoperative perception of the awake craniotomy procedure, about half of them have experienced some degree of intraoperative pain. Pain was mild (intensity between 1 and 2 on the visual analogical score) short lasting in most cases, and did not challenge the procedure. Pain was reported as moderate in about 25% and exceptionally severe. We conducted a preliminary survey among French centers (n=9) routinely performing awake craniotomy. Neurosurgeons' opinions were concordant with patient's reports. Intraoperative pain exceptionally challenged the awake craniotomy procedure or led to changes in the resection strategy. For neurosurgeons, the most challenging causes of intraoperative pain were the patient's inadequate installation, the contact of surgical tools with pain-sensitive intracranial structures, especially the dura mater of the skull base, falx cerebri, and the leptomeninges of the lateral fissure and neighboring sulci. Strategies to deal with these causes included focusing the patient on the intraoperative functional tests to distract their attention away from the pain, and avoiding contacts with the pain-sensitive intracranial structures during the awake phase. Adequate preoperative patient information and preparation, trained anesthesiologists and application of recommendations for awake craniotomy procedures as well as adaptation of surgical technique to avoid contact with pain-sensitive intracranial structures are key factors to prevent intraoperative pain and ensure patient's postoperative satisfaction. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  18. Incidence of Neonatal Hyperphenylalaninemia Based on High-performance Liquid Chromatography Confirmatory Technique in Mazandaran Province, Northern Iran (2007–2015

    Directory of Open Access Journals (Sweden)

    Ali Abbaskhanian

    2017-01-01

    Full Text Available Background: Classic phenylketonuria (PKU is a metabolic disorder. The purpose of this study was to assess epidemiological factors of PKU phenotypes in a neonatal screening program for Mazandaran, Iran. Methods: In this descriptive-retrospective study from 2007 to 2015, neonates PKU level was conducted by phenylalanine level based on a biochemical technique by ELISA and then by confirmatory methods high performance liquid chromatography. Results: Of the 407,244 screened newborns (48.7% girls and 51.3% boys, 14 girls and 13 boys were diagnosed definitely from 465 suspicious cases of PKU. The incidence of PKU was 0.66 in 10,000, which was noted in different severity (severe PKU - 1:67,874, mild PKU - 1:45,249, and HPA - 1:33,937. In addition, we did not detect any cases of nonclassic PKU. Conclusions: Although the consanguineous marriage pattern is a major cause of hyperphenylalaninemia (HPA particularly in Iranian, there was no significant difference between groups in this study. Now, screening should be executed for all of the family that they have the familial history of PKU in Iran. According to varies actual of prevalence and incidence rate of PKU reported a real patient and taking PKU with mild PKU and HPA, it is recommended, the will provide the PKU reports based on the severity of the disease.

  19. Incidence of Neonatal Hyperphenylalaninemia Based on High-performance Liquid Chromatography Confirmatory Technique in Mazandaran Province, Northern Iran (2007–2015)

    Science.gov (United States)

    Abbaskhanian, Ali; Zamanfar, Daniel; Afshar, Parvaneh; Asadpoor, Einollah; Rouhanizadeh, Hamed; Jafarnia, Ali; Shokzadeh, Mohammad

    2017-01-01

    Background: Classic phenylketonuria (PKU) is a metabolic disorder. The purpose of this study was to assess epidemiological factors of PKU phenotypes in a neonatal screening program for Mazandaran, Iran. Methods: In this descriptive-retrospective study from 2007 to 2015, neonates PKU level was conducted by phenylalanine level based on a biochemical technique by ELISA and then by confirmatory methods high performance liquid chromatography. Results: Of the 407,244 screened newborns (48.7% girls and 51.3% boys), 14 girls and 13 boys were diagnosed definitely from 465 suspicious cases of PKU. The incidence of PKU was 0.66 in 10,000, which was noted in different severity (severe PKU - 1:67,874, mild PKU - 1:45,249, and HPA - 1:33,937). In addition, we did not detect any cases of nonclassic PKU. Conclusions: Although the consanguineous marriage pattern is a major cause of hyperphenylalaninemia (HPA) particularly in Iranian, there was no significant difference between groups in this study. Now, screening should be executed for all of the family that they have the familial history of PKU in Iran. According to varies actual of prevalence and incidence rate of PKU reported a real patient and taking PKU with mild PKU and HPA, it is recommended, the will provide the PKU reports based on the severity of the disease. PMID:29184644

  20. A Computer-Based Glucose Management System Reduces the Incidence of Forgotten Glucose Measurements: A Retrospective Observational Study.

    Science.gov (United States)

    Okura, Tsuyoshi; Teramoto, Kei; Koshitani, Rie; Fujioka, Yohei; Endo, Yusuke; Ueki, Masaru; Kato, Masahiko; Taniguchi, Shin-Ichi; Kondo, Hiroshi; Yamamoto, Kazuhiro

    2018-04-17

    Frequent glucose measurements are needed for good blood glucose control in hospitals; however, this requirement means that measurements can be forgotten. We developed a novel glucose management system using an iPod ® and electronic health records. A time schedule system for glucose measurement was developed using point-of-care testing, an iPod ® , and electronic health records. The system contains the glucose measurement schedule and an alarm sounds if a measurement is forgotten. The number of times measurements were forgotten was analyzed. Approximately 7000 glucose measurements were recorded per month. Before implementation of the system, the average number of times measurements were forgotten was 4.8 times per month. This significantly decreased to 2.6 times per month after the system started. We also analyzed the incidence of forgotten glucose measurements as a proportion of the total number of measurements for each period and found a significant difference between the two 9-month periods (43/64,049-24/65,870, P = 0.014, chi-squared test). This computer-based blood glucose monitoring system is useful for the management of glucose monitoring in hospitals. Johnson & Johnson Japan.

  1. Discrimination and quantification of implanted solar wind in Genesis collector shards using grazing incidence synchrotron x-ray techniques: New detector initial results

    International Nuclear Information System (INIS)

    Kitts, K.; Choi, Y.; Sutton, S.R.; Ghose, S.; Burnett, D.; Eng, P.

    2008-01-01

    Accurate knowledge of the composition of the Sun provides a baseline, which allows an understanding of how the solar system has evolved over time and how solar processes and solar wind mechanics behave. Unfortunately, the errors in photospheric abundances are too large for many planetary science problems and this hampers our understanding of these different processes. Analyses of solar wind implanted in meteorites or lunar soils have provided more precise data [e.g. 1 and references therein] but the extent to which alteration processes on these bodies complicate such information is only now being determined. Therefore, in order to obtain pristine solar wind samples, NASA developed and launched the Genesis Discovery Mission. Unfortunately, the probe crash-landed shattering the 300 collector plates into 15,000+ pieces complicating the analysis and necessitating the development of new analytical techniques and equipment. Thus, shards from the Genesis collector array and their appropriate flight spares are currently being characterized via grazing-incidence synchrotron x-ray techniques at the Advanced Photon Source at Argonne National Laboratory. The goals are (1) determine solar wind fluences of the elements Ca-Ge by grazing-incidence angle-resolved x-ray fluorescence (XRF) and x-ray reflectivity, (2) improve data reduction via the development of XRF spectral deconvolution routines and develop modeling algorithms for reflectivity and fluorescence yield analysis in order to determine element specific depth profiles from which absolute concentration may be extracted and (3) designing and developing a new multi-element silicon multi-channel (SMCD) detector system. These improvements will increase our sensitivity by a factor of three or more, reduce measurement time at a given sensitivity to one-eighth and the minimum detection limit would be reduced by a factor of 3 to ∼3 x 10 8 atoms/cm 2 .

  2. Discrimination and quantification of contamination and implanted solar wind in Genesis collector shards using grazing incidence synchrotron x-ray techniques: Initial results

    International Nuclear Information System (INIS)

    Kitts, K.; Sutton, S.; Eng, P.; Ghose, S.; Burnett, D.

    2006-01-01

    Grazing incidence X-ray fluorescence is a non-destructive technique that can differentiate the embedded solar wind component from surface contamination and collector background in the Genesis shards. Initial solar Fe abundance in D30554 is 8 x 10 12 /cm 2 . Accurate knowledge of the composition of the Sun provides a baseline, which allows an understanding of how the solar system has evolved over time and how solar processes and solar wind mechanics behave. Unfortunately, the errors in photospheric abundances are too large for many planetary science problems and this hampers our understanding of these different processes. Analyses of solar wind implanted in meteorites or lunar soils have provided more precise data but alteration processes on these bodies may complicate such information. In response to this need for pristine solar wind samples, NASA developed and launched the Genesis Probe. Unfortunately, the probe smashed into the Utah desert shattering the 300 collector plates into 15,000+ pieces all of which are now coated in a both a fine terrestrial dust and Si and Ge powder from the disrupted collectors themselves. The solar wind penetration depth is 100-200 nm and the superposed contamination layers are typically 40-50 nm. Stringent cleaning regimes have the potential of removing the solar wind itself. The best solution is to have sufficient spatial resolution to separately analyze the surface contamination and penetrated solar wind. To that end, three Genesis collector array shards and their appropriate flight spares were characterized via grazing incidence x-ray fluorescence and x-ray reflectivity. The goals were (1) to evaluate the various cleaning methods used to eliminate contamination, (2) to identify the collector substrates most suited for this technique, (3) to determine whether the solar wind signature could be deconvolved from the collector background signature, and (4) to measure the relative abundances of Ca to Ge in the embedded solar wind.

  3. Management of an incident of failed sterilization of surgical instruments in a dental clinic in Hong Kong

    Directory of Open Access Journals (Sweden)

    Vincent Chi-Chung Cheng

    2013-11-01

    Conclusion: Rapid response is extremely crucial in minimizing the impact of this incident and relieving the anxiety of the affected patients. Proper recording and documentation of autoclave cycles and regular auditing should be enforced to prevent similar incidents.

  4. Evaluation of the Role of Music as a Nonpharmacological Technique in Management of Child Patients.

    Science.gov (United States)

    Gupta, Neha; Gupta, Himanshu; Gupta, Prahlad; Gupta, Nidhi

    2017-03-01

    Behavior management and reducing anxiety and pain are very important for success of treatment. Hence, apart from pharmacological management, such as conscious sedation, nonpharmacological interventions like music play a significant role. This study aims to evaluate the effects of music in reducing anxiety, pain, and behavior management. This study was conducted at the Department of Pedodontics in 2015. It consisted of 60 patients, age ranging from 3 to 7 years, who required dental treatment with local anesthesia. They were divided into three groups of 20 each. Group I consisted of upbeat music distraction group. Group II consisted of relaxing music distraction group. Group III consisted of control group. We scheduled the treatment in two visits. We used Venham picture test, North Carolina behavior rating scale, and visual analog scale test for the study. Baseline heart rate was also recorded. No significant differences were found among the three groups based on three scales used in the study. Management of child patient in dental clinic is a challenge for clinician. Apart from various pharmacological techniques, management of pediatric patients using audio music distraction has been introduced. However, music did not produce a reduction in pain, anxiety, or disruptive behavior. Various pharmacological techniques are present for the management of pediatric patients. Apart from it, there is need of introducing nonpharmacological techniques to reduce pain, anxiety, and to alter behavior of child. By this study, we have tried to evaluate the usefulness of music in child management.

  5. Intra-abdominal sepsis following pancreatic resection: incidence, risk factors, diagnosis, microbiology, management, and outcome.

    Science.gov (United States)

    Behrman, Stephen W; Zarzaur, Ben L

    2008-07-01

    Intra-abdominal sepsis (IAS) following pancreatectomy is associated with the need for therapeutic intervention and may result in mortality. We retrospectively reviewed patients developing IAS following elective pancreatectomy. Risk factors for the development of sepsis were assessed. The microbiology of these infections was ascertained. The number and type of therapeutic interventions required and infectious-related mortality were recorded. One hundred ninety-six patients had a pancreatectomy performed, 32 (16.3%) of who developed IAS. Infected abdominal collections were diagnosed and therapeutically managed at a mean of 11.8 days after the index procedure (range, 4-33). Eleven of 32 (34%) of these infections were diagnosed on or before postoperative day 6, 10 of who had Whipple procedures. Statistically significant risk factors included an overt pancreatic fistula (18.8% vs 5.5%) and a soft pancreatic remnant (74.2% vs 42.3%), but not the lack of intra-abdominal drainage, an antecedent immunocompromised state, postoperative hemorrhage, or the preoperative placement of a biliary stent. Fifty-five per cent had polymicrobial infections and 26 per cent of isolates were resistant organisms. Nineteen per cent and 48 per cent of patients had an isolate positive for fungus and a Gram-positive organism, respectively. Forty-seven therapeutic interventions were used, including 10 reoperations. Length of stay was significantly prolonged in those with IAS (28.5 vs 15.2 days) and mortality was higher (15.6% vs 1.8%). We conclude: 1) septic morbidity after pancreatectomy is associated with a soft pancreatic remnant and an overt pancreatic fistula and in this series resulted in a prolonged length of stay and a significant increase in procedure-related mortality; 2) infected fluid collections may occur very early in the postoperative period before frank abscess formation, and an early threshold for diagnostic imaging and/or therapeutic intervention should be entertained in those

  6. Transmural coil embolization—alternative technique for management of arterial perforation during subintimal angioplasty

    Directory of Open Access Journals (Sweden)

    Karthikeyan Damodharan

    2016-01-01

    Full Text Available Subintimal angioplasty of lower limb arterial occlusion carries a relatively higher risk of vessel perforation compared to transluminal angioplasty. Vessel perforation is a potentially life threatening complication which requires prompt recognition and management. They are usually managed by endovascular techniques such as low-pressure balloon tamponade, covered stents, and coil embolization of the ruptured artery. We describe a technique of treating vessel perforation following balloon angioplasty. Patient developed a large perforation of the proximal superficial femoral artery (SFA after balloon inflation during subintimal angioplasty of complete SFA occlusion. Following failure of balloon tamponade in sealing the perforation, we successfully treated it by deploying an embolization coil at the site of perforation through the vessel wall followed by balloon tamponade. Our technique could be a useful relatively inexpensive alternative treatment option in the management of vessel perforation compared to covered stents.

  7. Breakaway technique training as a means of increasing confidence in managing aggression in neuroscience nursing.

    Science.gov (United States)

    Lamont, Scott; Brunero, Scott; Bailey, Alanah; Woods, Karen

    2012-08-01

    The objective of this paper was to evaluate breakaway technique training with neuroscience nursing staff as a measure of increased confidence and safety in managing aggression. A quasi experimental design was used in a sample of neuroscience nursing staff (n=31), participating in 2×1h breakaway technique workshops. The workshops consisted of supervised skills training in safe breakaway techniques. A pre- and postintervention-matched questionnaire measuring confidence and safety around managing aggressive patients, and exposure to and confidence in dealing with breakaways, was self administered. Statistically significant increases in confidence and safety in working with aggressive patients, and confidence levels for safe breakaways were reported. Qualitative comments demonstrated a desire for ongoing skills workshops. This study provides early evidence of the importance of incorporating breakaway training into existing training programs which aim to minimise and manage aggression and violence in generalist settings.

  8. Neuropathic pain other than CRPS in children and adolescents: incidence, referral, clinical characteristics, management, and clinical outcomes.

    Science.gov (United States)

    Kachko, Ludmyla; Ben Ami, Shiri; Lieberman, Alon; Shor, Rita; Tzeitlin, Elena; Efrat, Rachel

    2014-06-01

    Chronic pain in children and adolescents is common, but proportion of neuropathic pain (NP), a heterogeneous group of diseases with major impact on health-related quality of life, significant economic burden, and limited treatment options, is unclear. Many studies have focused only on complex regional pain syndrome (CRPS). Our aim was to examine the incidence, clinical features, management, and outcome of non-CRPS NP in patients referred to a chronic pediatric pain clinic (CPPC) at a tertiary-care hospital. Retrospective analyses of the patient's files with non-CRPS NP from 2008 until 2012. Twenty patients (9.9-22.0 years; 10.7% of new referrals) were treated with non-CRPS NP (postoperative 8/20, trauma-related 5/20, disease-related 7/20). The number of consultations performed and the number of medications used before CPPC were significantly higher than in CPPC (Z = 0.75, P = 0.005; Z = 1.68, P = 0.003; respectively, Wilcoxon test). The number of diagnostic procedures was not statistically significant. Invasive treatments were used in 50% of patients. Full/partial recovery was accomplished in 95%. anova with repeated measures yielded a highly significant difference between the initial and final visual analog scale (VAS) scores (8.2 ± 1.3; 1.19 ± 2.01, respectively; P CRPS NP is crucial to timely and correct diagnosis and effective management, but even children with delayed diagnosis still have a good outcome. The management of this condition by an experienced team is recommended. © 2014 John Wiley & Sons Ltd.

  9. A hollow definitive obturator fabrication technique for management of partial maxillectomy.

    Science.gov (United States)

    Patil, Pravinkumar Gajanan; Patil, Smita Pravinkumar

    2012-11-01

    Maxillary obturator prosthesis is the most frequent treatment option for management of partial or total maxillectomy. Heavy weight of the obturators is often a dislocating factor. Hollowing the prosthesis to reduce its weight is the well established fact. The alternate technique to hollow-out the prosthesis has been described in this article which is a variation of previously described processing techniques. A pre-shaped wax-bolus was incorporated inside the flasks during packing of the heat-polymerized acrylic resin to automatically create the hollow space. The processing technique described is a single step flasking procedure to construct a closed-hollow-obturator prosthesis as a single unit. To best understand the technique, this article describes management of a patient who had undergone partial maxillectomy secondary to squamous cell carcinoma rehabilitated with a hollow-obturator prosthesis.

  10. Management of the flabby ridge using a modified window technique and polyvinylsiloxane impression material

    Directory of Open Access Journals (Sweden)

    Nawaf Labban

    2018-01-01

    Full Text Available Flabby ridge is a common clinical finding affecting the alveolar ridges of the mandibular or maxillary arches. The anterior region of maxilla is the most affected area in edentulous patients. Dentures on flabby ridges have compromised stability, support, and retention unless adequate measures for its management are employed. Methods applied for flabby ridge management, include surgical removal and augmentation, special impression techniques, balanced distribution of occlusal loads and implant therapy. Special impressions often involve window technique for static impression of flabby area, which present multiple challenges. The purpose of this technique report is to present a modified window technique for the impression of anterior maxillary flabby tissues for improved and controlled application of polyvinylsiloxane impression material that are routinely available in dental practice.

  11. Managing the Testing Process Practical Tools and Techniques for Managing Hardware and Software Testing

    CERN Document Server

    Black, Rex

    2011-01-01

    New edition of one of the most influential books on managing software and hardware testing In this new edition of his top-selling book, Rex Black walks you through the steps necessary to manage rigorous testing programs of hardware and software. The preeminent expert in his field, Mr. Black draws upon years of experience as president of both the International and American Software Testing Qualifications boards to offer this extensive resource of all the standards, methods, and tools you'll need. The book covers core testing concepts and thoroughly examines the best test management practices

  12. The use of production management techniques in the construction of large scale physics detectors

    CERN Document Server

    Bazan, A; Estrella, F; Kovács, Z; Le Flour, T; Le Goff, J M; Lieunard, S; McClatchey, R; Murray, S; Varga, L Z; Vialle, J P; Zsenei, M

    1999-01-01

    The construction process of detectors for the Large Hadron Collider (LHC) experiments is large scale, heavily constrained by resource availability and evolves with time. As a consequence, changes in detector component design need to be tracked and quickly reflected in the construction process. With similar problems in industry engineers employ so-called Product Data Management (PDM) systems to control access to documented versions of designs and managers employ so- called Workflow Management software (WfMS) to coordinate production work processes. However, PDM and WfMS software are not generally integrated in industry. The scale of LHC experiments, like CMS, demands that industrial production techniques be applied in detector construction. This paper outlines the major functions and applications of the CRISTAL system (Cooperating Repositories and an information System for Tracking Assembly Lifecycles) in use in CMS which successfully integrates PDM and WfMS techniques in managing large scale physics detector ...

  13. Pengaruh Competitor Accounting Sebagai Strategic Management Accounting Techniques Terhadap Competitive Advantage Dan Organization Performance

    OpenAIRE

    Alan, Hartanto

    2015-01-01

    The purpose of this study was to know the affect of Competitor Accounting as a Strategic Management Accounting Techniques toward Competitive Advantage and Organization Performance on manufacturing companies in Surabaya and Sidoarjo. In this study primary data was used by using questionnaire distributed to manufacturing companies in Surabaya and Sidoarjo. This study used path modeling analysis technique with PLS tools. From the examination showed that there were positive and significant affect...

  14. Problem-solving and developing quality management methods and techniques on the example of automotive industry

    Directory of Open Access Journals (Sweden)

    Jacek Łuczak

    2015-12-01

    Full Text Available The knowledge about methods and techniques of quality management together with their effective use can be definitely regarded as an indication of high organisational culture. Using such methods and techniques in an effective way can be attributed to certain level of maturity, as far as the quality management system in an organisation is concerned. There is in the paper an analysis of problem-solving methods and techniques of quality management in the automotive sector in Poland. The survey was given to the general population, which in case of the study consisted of companies operating in Poland that had certified quality management systems against ISO/TS 16949. The results of the conducted survey and the conclusions of the author can show actual and potential OEM suppliers (both 1st and 2nd tier in which direction their strategies for development and improvement of quality management systems should go in order to be effective. When the universal character of methods and techniques used in the surveyed population of companies is taken into consideration, it can be assumed that the results of the survey are also universal for all organisations realising the TQM strategy. The results of the research confirmed that methods which are also the basis for creating key system documents are the most relevant ones, i.e. flowcharts and FMEA, and moreover process monitoring tools (SPC and problem solving methods -above all 8D.

  15. Prevention and management of postoperative nausea and vomiting: a look at complementary techniques.

    Science.gov (United States)

    Mamaril, Myrna E; Windle, Pamela E; Burkard, Joseph F

    2006-12-01

    Complementary modalities, used alone or in combination with pharmacologic therapies, play an important role in the prevention and management of postoperative nausea and vomiting (PONV) and post discharge nausea and vomiting (PDNV). This article will review the evidence for the effective use of complementary modalities: acupuncture and related techniques, aromatherapy, and music therapy that may be integrated in the perianesthesia nurse's plan of care to prevent or manage PONV.

  16. Just-in-Time techniques as applied to hazardous materials management

    OpenAIRE

    Spicer, John S.

    1996-01-01

    Approved for public release; distribution is unlimited This study investigates the feasibility of integrating JIT techniques in the context of hazardous materials management. This study provides a description of JIT, a description of environmental compliance issues and the outgrowth of related HAZMAT policies, and a broad perspective on strategies for applying JIT to HAZMAT management. http://archive.org/details/justintimetechn00spic Lieutenant Commander, United States Navy

  17. Multi-criterion analysis technique in a process of quality management

    OpenAIRE

    A. Gwiazda

    2007-01-01

    Purpose: The aim of this paper is to present the critical analysis of some multi-criteria techniques applied in the area of quality management. It is strongly stated that some solutions in this scientific area characterizes the non-methodological approaches.Design/methodology/approach: The research methodology, in presented work, has been based on the theoretical analysis of the quality tools management and on the empirical researches.Findings: The proposals of improvement the main quality to...

  18. Incidence of tracheobronchomalacia associated with pulmonary emphysema. Detection with paired inspiratory-expiratory multidetector computed tomography using a low-dose technique

    International Nuclear Information System (INIS)

    Inoue, Masanori; Hasegawa, Ichiro; Nakano, Keiko; Yamaguchi, Kazuhiro; Kuribayashi, Sachio

    2009-01-01

    The purpose of this study was to evaluate the frequency of tracheobronchomalacia (TBM) associated with pulmonary emphysema with paired inspiratory-expiratory multidetector computed tomography (MDCT) using a low-dose technique. This study included 56 consecutive patients (55 men, 1 woman; mean age 68.9 years) with pulmonary emphysema who had undergone paired inspiratory-expiratory CT scanning with a low-dose technique (40 mA). All images were retrospectively examined by two thoracic radiologists in a blinded fashion. The diagnosis of TBM was based on the standard criterion of >50% reduction in the cross-sectional area of the tracheobronchial lumen at the end-expiratory phase. A mild TBM criterion of >30% reduction was also reviewed. All patients underwent pulmonary function tests. The relation between the forced expiratory volume in 1 s (FEV 1.0% ) and TBM was statistically analyzed. Four (7.1%) and eight (14.3%) patients were diagnosed as TBM based on the standard and mild criteria, respectively. In four patients, the percentages of luminal narrowing were 63.4% and 51.2%, respectively for tracheomalacia and 59.2% and 62.0%, respectively, for bronchomalacia. The FEV 1.0% values between patients with and without TBM showed no statistical difference. The incidence of TBM associated with pulmonary emphysema was 7.1% with the standard criterion. It is possible that TBM has been underdiagnosed in a number of patients with pulmonary emphysema. (author)

  19. Real-time detection of dielectric anisotropy or isotropy in unconventional oil-gas reservoir rocks supported by the oblique-incidence reflectivity difference technique.

    Science.gov (United States)

    Zhan, Honglei; Wang, Jin; Zhao, Kun; Lű, Huibin; Jin, Kuijuan; He, Liping; Yang, Guozhen; Xiao, Lizhi

    2016-12-15

    Current geological extraction theory and techniques are very limited to adequately characterize the unconventional oil-gas reservoirs because of the considerable complexity of the geological structures. Optical measurement has the advantages of non-interference with the earth magnetic fields, and is often useful in detecting various physical properties. One key parameter that can be detected using optical methods is the dielectric permittivity, which reflects the mineral and organic properties. Here we reported an oblique-incidence reflectivity difference (OIRD) technique that is sensitive to the dielectric and surface properties and can be applied to characterization of reservoir rocks, such as shale and sandstone core samples extracted from subsurface. The layered distribution of the dielectric properties in shales and the uniform distribution in sandstones are clearly identified using the OIRD signals. In shales, the micro-cracks and particle orientation result in directional changes of the dielectric and surface properties, and thus, the isotropy and anisotropy of the rock can be characterized by OIRD. As the dielectric and surface properties are closely related to the hydrocarbon-bearing features in oil-gas reservoirs, we believe that the precise measurement carried with OIRD can help in improving the recovery efficiency in well-drilling process.

  20. Comparison of the incidence of intracranial hemorrhage in two different planning techniques for stereotactic electrode placement in the deep brain stimulation.

    Science.gov (United States)

    Piacentino, M; Zambon, G; Pilleri, M; Bartolomei, L

    2013-03-01

    Intracranial hemorrhage is an infrequent but potentially devastating complication associated with the placement of electrodes for deep brain stimulation (DBS). The objective of this retrospective review is to compare the risk of hemorrhage before and after the introduction of image-guided neuronavigation for the implant of electrodes for DBS. We reviewed all DBS implant performed at our Institute between 1998 and 2010. In 63 of the 106 patients, the targeting was based on ventriculography and merge of CT/MRI. After 2006, in the latter 43 procedures, we introduced targeting based on the merging of angio CT and MRI.. In both implant techniques, microelectrode recording (MER) was used to better define the target. All DBS procedures were performed by a single surgeon (M.P.). Patients had postoperative imaging (MRI or CT) 4-24 h following surgery. In the group of patients implanted with the first targeting technique, 3 hematomas occurred and all of them solved with sequelae (one residual weakness and two hemiplegias.) After the introduction of neuronavigator, 2 hemorrhages occurred, one solved without sequelae while the second resulted in epileptic seizures. Although the incidence of hemorrhage occurred before and after the use of neuronavigation is the same, the severity is lower in the neuronavigated procedures. Targeting based on the merging of CT angiography and MRI T1/T2 seemed to increase the safety of the lead placement reducing the risk of sequelae related to bleeding. The use of MER was not found to be correlated with an increased hemorrhage rate.

  1. In situ electrochemical impedance spectroscopy/synchrotron radiation grazing incidence X-ray diffraction-A powerful new technique for the characterization of electrochemical surfaces and interfaces

    Energy Technology Data Exchange (ETDEWEB)

    De Marco, Roland [Nanochemistry Research Institute, Department of Applied Chemistry, Curtin University of Technology, GPO Box U 1987, Perth, WA 6845 (Australia)]. E-mail: r.demarco@exchange.curtin.edu.au; Jiang, Z.-T. [Nanochemistry Research Institute, Department of Applied Chemistry, Curtin University of Technology, GPO Box U 1987, Perth, WA 6845 (Australia); Martizano, Jay [Nanochemistry Research Institute, Department of Applied Chemistry, Curtin University of Technology, GPO Box U 1987, Perth, WA 6845 (Australia); Lowe, Alex [Nanochemistry Research Institute, Department of Applied Chemistry, Curtin University of Technology, GPO Box U 1987, Perth, WA 6845 (Australia); Pejcic, Bobby [Nanochemistry Research Institute, Department of Applied Chemistry, Curtin University of Technology, GPO Box U 1987, Perth, WA 6845 (Australia); Riessen, Arie van [Materials Research Group, Department of Applied Physics, Curtin University of Technology, GPO Box U 1987, Perth, WA 6845 (Australia)

    2006-08-15

    A marriage of electrochemical impedance spectroscopy (EIS) and in situ synchrotron radiation grazing incidence X-ray diffraction (SR-GIXRD) has provided a powerful new technique for the elucidation of the mechanistic chemistry of electrochemical systems. In this study, EIS/SR-GIXRD has been used to investigate the influence of metal ion buffer calibration ligands, along with natural organic ligands in seawater, on the behaviour of the iron chalcogenide glass ion-selective electrode (ISE). The SR-GIXRD data demonstrated that citrate - a previously reported poor iron calibration ligand for the analysis of seawater - induced an instantaneous and total dissolution of crystalline GeSe and Sb{sub 2}Se{sub 3} in the modified surface layer (MSL) of the ISE, while natural organic ligands in seawater and a mixture of ligands in a mimetic seawater ligand system protected the MSL's crystalline inclusions of GeSe and Sb{sub 2}Se{sub 3} from oxidative attack. Expectedly, the EIS data showed that citrate induced a loss in the medium frequency time constant for the MSL of the ISE, while seawater's natural organic ligands and the mimetic ligand system preserved the medium frequency EIS response characteristics of the ISE's MSL. The new EIS/SR-GIXRD technique has provided insights into the suitability of iron calibration ligands for the analysis of iron in seawater.

  2. The use of production management techniques in the construction of large scale physics detectors

    International Nuclear Information System (INIS)

    Bazan, A.; Chevenier, G.; Estrella, F.

    1999-01-01

    The construction process of detectors for the Large Hadron Collider (LHC) experiments is large scale, heavily constrained by resource availability and evolves with time. As a consequence, changes in detector component design need to be tracked and quickly reflected in the construction process. With similar problems in industry engineers employ so-called Product Data Management (PDM) systems to control access to documented versions of designs and managers employ so-called Product Data Management (PDM) systems to control access to documented versions of designs and managers employ so-called Workflow Management Software (WfMS) to coordinate production work processes. However, PDM and WfMS software are not generally integrated in industry. The scale of LHC experiments, like CMS, demands that industrial production techniques be applied in detector construction. This paper outlines the major functions and applications of the CRISTAL system (Cooperating Repositories and an Information System for Tracking Assembly Lifecycles) in use in CMS which successfully integrates PDM and WfMS techniques in managing large scale physics detector construction. This is the first time industrial production techniques have been deployed to this extent in detector construction

  3. Design and Testing of BACRA, a Web-Based Tool for Middle Managers at Health Care Facilities to Lead the Search for Solutions to Patient Safety Incidents

    Science.gov (United States)

    Mira, José Joaquín; Vicente, Maria Asuncion; Fernandez, Cesar; Guilabert, Mercedes; Ferrús, Lena; Zavala, Elena; Silvestre, Carmen; Pérez-Pérez, Pastora

    2016-01-01

    Background Lack of time, lack of familiarity with root cause analysis, or suspicion that the reporting may result in negative consequences hinder involvement in the analysis of safety incidents and the search for preventive actions that can improve patient safety. Objective The aim was develop a tool that enables hospitals and primary care professionals to immediately analyze the causes of incidents and to propose and implement measures intended to prevent their recurrence. Methods The design of the Web-based tool (BACRA) considered research on the barriers for reporting, review of incident analysis tools, and the experience of eight managers from the field of patient safety. BACRA’s design was improved in successive versions (BACRA v1.1 and BACRA v1.2) based on feedback from 86 middle managers. BACRA v1.1 was used by 13 frontline professionals to analyze incidents of safety; 59 professionals used BACRA v1.2 and assessed the respective usefulness and ease of use of both versions. Results BACRA contains seven tabs that guide the user through the process of analyzing a safety incident and proposing preventive actions for similar future incidents. BACRA does not identify the person completing each analysis since the password introduced to hide said analysis only is linked to the information concerning the incident and not to any personal data. The tool was used by 72 professionals from hospitals and primary care centers. BACRA v1.2 was assessed more favorably than BACRA v1.1, both in terms of its usefulness (z=2.2, P=.03) and its ease of use (z=3.0, P=.003). Conclusions BACRA helps to analyze incidents of safety and to propose preventive actions. BACRA guarantees anonymity of the analysis and reduces the reluctance of professionals to carry out this task. BACRA is useful and easy to use. PMID:27678308

  4. Design and Testing of BACRA, a Web-Based Tool for Middle Managers at Health Care Facilities to Lead the Search for Solutions to Patient Safety Incidents.

    Science.gov (United States)

    Carrillo, Irene; Mira, José Joaquín; Vicente, Maria Asuncion; Fernandez, Cesar; Guilabert, Mercedes; Ferrús, Lena; Zavala, Elena; Silvestre, Carmen; Pérez-Pérez, Pastora

    2016-09-27

    Lack of time, lack of familiarity with root cause analysis, or suspicion that the reporting may result in negative consequences hinder involvement in the analysis of safety incidents and the search for preventive actions that can improve patient safety. The aim was develop a tool that enables hospitals and primary care professionals to immediately analyze the causes of incidents and to propose and implement measures intended to prevent their recurrence. The design of the Web-based tool (BACRA) considered research on the barriers for reporting, review of incident analysis tools, and the experience of eight managers from the field of patient safety. BACRA's design was improved in successive versions (BACRA v1.1 and BACRA v1.2) based on feedback from 86 middle managers. BACRA v1.1 was used by 13 frontline professionals to analyze incidents of safety; 59 professionals used BACRA v1.2 and assessed the respective usefulness and ease of use of both versions. BACRA contains seven tabs that guide the user through the process of analyzing a safety incident and proposing preventive actions for similar future incidents. BACRA does not identify the person completing each analysis since the password introduced to hide said analysis only is linked to the information concerning the incident and not to any personal data. The tool was used by 72 professionals from hospitals and primary care centers. BACRA v1.2 was assessed more favorably than BACRA v1.1, both in terms of its usefulness (z=2.2, P=.03) and its ease of use (z=3.0, P=.003). BACRA helps to analyze incidents of safety and to propose preventive actions. BACRA guarantees anonymity of the analysis and reduces the reluctance of professionals to carry out this task. BACRA is useful and easy to use.

  5. Working Environment and Software Configuration Management Assimiliation using Traceability Enhancement Technique

    International Nuclear Information System (INIS)

    Iqbal, H.; Javed, A.; Majeed, M. N.

    2015-01-01

    Software Configuration Management (SCM) Systems are very useful in coordinating group effort in large and complex software systems. As a result of change in user requirement, market needs, tools, technology or new business goals emanate out, changes are continuously induced while developing the software product. For change management, Traceability technique and SCM are two prominent practices in the software development process. SCM helps in managing configuration items while traceability helps in tracing the knowledge about the configuration items. In this paper we propose a model of the SCM system with the working environment when changes are introduced in multiple artifacts and by which high quality products are developed. (author)

  6. Incidence and Management Costs of Freshwater Aquatic Nuisance Species at Projects Operated by the U.S. Army Corps of Engineers

    Science.gov (United States)

    2010-07-01

    the occurrence of ANS impacts (Yes or No) from freshwater algae, large aquatic plants, fish, zebra mussels, Asiatic clams, water fleas, crayfish...2005. Freshwater aquatic nuisance species impacts and management costs and benefits at federal water resources projects. ERDC/TN ANSRP-06-3...ER D C/ EL T R- 10 -1 3 Aquatic Nuisance Species Research Program Incidence and Management Costs of Freshwater Aquatic Nuisance Species

  7. Emergency imaging after a mass casualty incident: role of the radiology department during training for and activation of a disaster management plan

    NARCIS (Netherlands)

    Berger, Ferco H.; Körner, Markus; Bernstein, Mark P.; Sodickson, Aaron D.; Beenen, Ludo F.; McLaughlin, Patrick D.; Kool, Digna R.; Bilow, Ronald M.

    2016-01-01

    In the setting of mass casualty incidents (MCIs), hospitals need to divert from normal routine to delivering the best possible care to the largest number of victims. This should be accomplished by activating an established hospital disaster management plan (DMP) known to all staff through prior

  8. Management of odontogenic cysts by endonasal endoscopic techniques: A systematic review and case series.

    Science.gov (United States)

    Marino, Michael J; Luong, Amber; Yao, William C; Citardi, Martin J

    2018-01-01

    Odontogenic cysts and tumors of the maxilla may be amendable to management by endonasal endoscopic techniques, which may reduce the morbidity associated with open procedures and avoid difficult reconstruction. To perform a systematic review that evaluates the feasibility and outcomes of endoscopic techniques in the management of different odontogenic cysts. A case series of our experience with these minimally invasive techniques was assembled for insight into the technical aspects of these procedures. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was used to identify English-language studies that reported the use of endoscopic techniques in the management of odontogenic cysts. Several medical literature data bases were searched for all occurrences in the title or abstract of the terms "odontogenic" and "endoscopic" between January 1, 1950, and October 1, 2016. Publications were evaluated for the technique used, histopathology, complications, recurrences, and the follow-up period. A case series of patients who presented to a tertiary rhinology clinic and who underwent treatment of odontogenic cysts by an endoscopic technique was included. A systematic review identified 16 case reports or series that described the use of endoscopic techniques for the treatment of odontogenic cysts, including 45 total patients. Histopathologies encountered were radicular (n = 16) and dentigerous cysts (n = 10), and keratocystic odontogenic tumor (n = 12). There were no reported recurrences or major complications for a mean follow-up of 29 months. A case series of patients in our institution identified seven patients without recurrence for a mean follow-up of 10 months. Endonasal endoscopic treatment of various odontogenic cysts are described in the literature and are associated with effective treatment of these lesions for an average follow-up period of >2 years. These techniques have the potential to reduce morbidity associated with the resection of these

  9. Bleeding after expandable nitinol stent placement in patients with esophageal and upper gastrointestinal obstruction: incidence, management, and predictors.

    Science.gov (United States)

    Oh, Se Jin; Song, Ho-Young; Nam, Deok Ho; Ko, Heung Kyu; Park, Jung-Hoon; Na, Han Kyu; Lee, Jong Jin; Kang, Min Kyoung

    2014-11-01

    Placement of self-expandable nitinol stents is useful for the treatment of esophageal and upper gastrointestinal (GI) obstruction. However, complications such as stent migration, tumor overgrowth, and bleeding occur. Although stent migration and tumor overgrowth are well documented in previous studies, the occurrence of bleeding has not been fully evaluated. To evaluate the incidence, management strategies, and predictors of bleeding after placement of self-expandable nitinol stents in patients with esophageal and upper GI obstruction. We retrospectively reviewed the medical records and results of computed tomography and endoscopy of 1485 consecutive patients with esophageal and upper GI obstructions who underwent fluoroscopically guided stent placement. Bleeding occurred in 25 of 1485 (1.7%) patients 0 to 348 days after stent placement. Early stent-related bleeding occurred in 10 patients (40%) and angiographic embolization was used for 5/10. Late bleeding occurred in 15 patients (60%) and endoscopic hemostasis was used for 7/15. Twenty-two of 25 (88%) patients with bleeding had received prior radiotherapy and/or chemotherapy. Bleeding is a rare complication after placement of expandable nitinol stents in patients with esophageal and upper GI obstruction, but patients with early bleeding may require embolization for control. Care must be exercised on placing stents in patients who have received prior radiotherapy or chemotherapy. © The Foundation Acta Radiologica 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  10. Increasing Acceptance of Behavioral Child Management Techniques: What Do Parents Say?

    Science.gov (United States)

    Pemberton, Joy R.; Borrego, Joaquin

    2007-01-01

    Consumers' willingness to accept treatments is an important concern of clinicians and clinical researchers, particularly when treating children. However, few studies have directly asked parents to give reasons for accepting or refusing treatments. In the current study, 82 parents read descriptions of six behavioral child management techniques,…

  11. The effect of HRM on the relationship between quality management techniques and performance

    DEFF Research Database (Denmark)

    do Nascimento Gambi, Lillian; Jørgensen, Frances; Cecílio Gerolamo, Mateus

    2014-01-01

    . The study shows that the relationship between quality management techniques and performance is influenced by HRM approaches, but provides counterevidence to the prevailing assumption that commitment-oriented HRM is generally more appropriate to increase performance than a control-oriented approach. Rather...

  12. Laparoscopic Heller Myotomy and Dor Fundoplication for Esophageal Achalasia: Technique and Perioperative Management.

    Science.gov (United States)

    Andolfi, Ciro; Fisichella, P Marco

    2016-11-01

    Surgical correction of achalasia using laparoscopic Heller myotomy with Dor fundoplication is argued to be the gold standard treatment for patients with achalasia. The goal of this technical report is to illustrate our preferred approach to patients with achalasia and to provide the reader with a detailed description of our operative technique, its rationale, and our pre and postoperative management.

  13. Cultural Variations in Mothers' Acceptance of and Intent to Use Behavioral Child Management Techniques

    Science.gov (United States)

    Mah, Janet W. T.; Johnston, Charlotte

    2012-01-01

    We examined cultural differences in mothers' acceptance of and intent to use behavioral parenting techniques for managing disruptive child behavior, and the possible roles of parenting styles and implicit theories in explaining these cultural differences. A community sample of 117 Euro-Canadian and Chinese-immigrant mothers of boys aged 4- to…

  14. Using GPS instruments and GIS techniques in data management for insect pest control programs

    International Nuclear Information System (INIS)

    2006-01-01

    This interactive tutorial CD entitled 'Using GPS Instruments and GIS Techniques in Data Management for Insect Pest Control Programs' was developed by Micha silver of the Arava Development Co., Sapir, Israel, and includes step-by-step hands on lessons on the use of GPS/GIS in support of area-wide pest control operations

  15. Mobility Based Key Management Technique for Multicast Security in Mobile Ad Hoc Networks

    Directory of Open Access Journals (Sweden)

    B. Madhusudhanan

    2015-01-01

    Full Text Available In MANET multicasting, forward and backward secrecy result in increased packet drop rate owing to mobility. Frequent rekeying causes large message overhead which increases energy consumption and end-to-end delay. Particularly, the prevailing group key management techniques cause frequent mobility and disconnections. So there is a need to design a multicast key management technique to overcome these problems. In this paper, we propose the mobility based key management technique for multicast security in MANET. Initially, the nodes are categorized according to their stability index which is estimated based on the link availability and mobility. A multicast tree is constructed such that for every weak node, there is a strong parent node. A session key-based encryption technique is utilized to transmit a multicast data. The rekeying process is performed periodically by the initiator node. The rekeying interval is fixed depending on the node category so that this technique greatly minimizes the rekeying overhead. By simulation results, we show that our proposed approach reduces the packet drop rate and improves the data confidentiality.

  16. [Management of spinal metastasis by minimal invasive surgery technique: Surgical principles, indications: A literature review].

    Science.gov (United States)

    Toquart, A; Graillon, T; Mansouri, N; Adetchessi, T; Blondel, B; Fuentes, S

    2016-06-01

    Spinal metastasis are getting more frequent. This raises the question of pain and neurological complications, which worsen the functional and survival prognosis of this oncological population patients. The surgical treatment must be the most complete as possible: to decompress and stabilize without delaying the management of the oncological disease. Minimal invasive surgery techniques are by definition, less harmful on musculocutaneous plan than opened ones, with a comparable efficiency demonstrated in degenerative and traumatic surgery. So they seem to be applicable and appropriate to this patient population. We detailed different minimal invasive techniques proposed in the management of spinal metastasis. For this, we used our experience developed in degenerative and traumatic pathologies, and we also referred to many authors, establishing a literature review thanks to Pubmed, Embase. Thirty eight articles were selected and allowed us to describe different techniques: percutaneous methods such as vertebro-/kyphoplasty and osteosynthesis, as well as mini-opened surgery, through a posterior or anterior way. We propose a surgical approach using these minimal invasive techniques, first according to the predominant symptom (pain or neurologic failure), then characteristics of the lesions (number, topography, type…) and the deformity degree. Whatever the technique, the main goal is to stabilize and decompress, in order to maintain a good quality of life for these fragile patients, without delaying the medical management of the oncological disease. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  17. Pattern of parental acceptance of management techniques used in pediatric dentistry.

    Science.gov (United States)

    Peretz, Benjamin; Kharouba, Johnny; Blumer, Sigalit

    2013-01-01

    To evaluate parents' acceptance of management techniques in Israeli pediatric dental clinics. Ninety parents who accompanied their children to three pediatric dental clinics provided information on selected parameters including their attitudes about management techniques. 68.9% of the parents preferred to stay in the treatment room. The most accepted technique was positive reinforcement (81.1%) followed by tell-show-do (TSD) (76.7%, with younger parents more accepting than older, p = 0.049). The least accepted techniques were restraint (1.1%) and voice control (7.8%, especially by parents with the highest dental anxiety, p = 0.002). Sedation was unacceptable by 15.6% of the parents: those with the lowest dental anxiety agreed to sedation significantly more than those with greater dental anxiety (p = 0.031). Parents preferred more positive approaches and management techniques that involve demonstrations geared for the child's level of understanding. Restraint and voice control were more strongly rejected than sedation.

  18. Case study: Proposed application of project management techniques for construction of nuclear power plant in Malaysia

    International Nuclear Information System (INIS)

    Syahirah Abdul Rahman; Phongsakorn Prak Tom; Wan Abd Hadi Wan Abu Bakar; Shaharum Ramli

    2010-01-01

    This study discusses the techniques of project management for the construction of nuclear power plants that can be used in Malaysia. Nuclear power reactors are expected to apply is the categories of Gen III + reactor where it is safer and more modern than the first generation of reactors built in the 1970s. The objective of this study is that the construction of this reactor to be completed by the stipulated time and not exceed the cost estimates. In addition, project management is also able to meet all the specifications and achieve the quality standard. In this study, the techniques used in project management to ensure the success of construction projects of nuclear power plants are a Gantt Chart, CPM/ PERT and Microsoft Project. From the study, found that these techniques can assist in facilitating the management of the project for the construction of nuclear power plants to ensure that the estimated time and cost can be managed more effectively as well as quality of care. (author)

  19. Investigation of energy management strategies for photovoltaic systems - An analysis technique

    Science.gov (United States)

    Cull, R. C.; Eltimsahy, A. H.

    1982-01-01

    Progress is reported in formulating energy management strategies for stand-alone PV systems, developing an analytical tool that can be used to investigate these strategies, applying this tool to determine the proper control algorithms and control variables (controller inputs and outputs) for a range of applications, and quantifying the relative performance and economics when compared to systems that do not apply energy management. The analysis technique developed may be broadly applied to a variety of systems to determine the most appropriate energy management strategies, control variables and algorithms. The only inputs required are statistical distributions for stochastic energy inputs and outputs of the system and the system's device characteristics (efficiency and ratings). Although the formulation was originally driven by stand-alone PV system needs, the techniques are also applicable to hybrid and grid connected systems.

  20. Risk Management in Csr Unit of Shams Hospital Using FMEA Technique -Tabriz

    Directory of Open Access Journals (Sweden)

    Mohammad Saadati

    2015-08-01

    Full Text Available Background and Objectives : Since one of the effective ways to prevent infections is the proper sterilization of instruments, CSR is one of the most important units in hospitals. Thus, risk management has a high priority in CSR. The aim of this study was to identify and prevent potential risks in CSR unit in Shams Hospital using FMEA technique. Material and Methods : This is a descriptive and interventional study. Using FMEA technique, potential risks were identified. Risks were prioritized and corrective interventions were implemented to reduce risks. Results : The current study identified 69 risks that 10 risks were marked as high priority. Corrective activities were suggested by risk management teams which were applied. Conclusion : The results showed that flaws in safety policies, equipment and physical conditions were the most important risk factors. Implementing risk management plan and clear safety policies could be useful. ​

  1. Application of fisheries management techniques to assessing impacts: task I report

    International Nuclear Information System (INIS)

    McKenzie, D.H.; Baker, K.S.; Fickeisen, D.H.; Metzger, R.M.; Skalski, J.R.

    1979-03-01

    Task I efforts examined the available fisheries management techniques and assessed their potential application in a confirmatory monitoring program. The objective of such monitoring programs is to confirm that the prediction of an insignificant impact (usually made in the FES) was correct. Fisheries resource managers have developed several tools for assessing the fish population response to stress (exploitation) and they were thought potentially useful for detecting nuclear power plant impacts. Techniques in three categories were examined; catch removal, population dynamics, and nondestructive censuses, and the report contains their description, examples of application, advantages, and disadvantages. The techniques applied at nuclear power plant sites were examined in detail to provide information on implementation and variability of specific approaches. The most suitable techniques to incorporate into a monitoring program confirming no impact appear to be those based on Catch Per Unity Effort (CPUE) and hydroacoustic data. In some specific cases, age and growth studies and indirect census techniques may be beneficial. Recommendations for task II efforts to incorporate these techniques into monitoring program designs are presented. These include development of guidelines for; (1) designing and implementing a data collection program; (2) interpreting these data and assessing the occurrence of impact, and (3) establishment of the monitoring program's ability to detect changes in the affected populations

  2. Using a Voltage Domain Programmable Technique for Low-Power Management Cell-Based Design

    Directory of Open Access Journals (Sweden)

    Ching-Hwa Cheng

    2011-09-01

    Full Text Available The Multi-voltage technique is an effective way to reduce power consumption. In the proposed cell-based voltage domain programmable (VDP technique, the high and low voltages applied to logic gates are programmable. The flexible voltage domain reassignment allows the chip performance and power consumption to be dynamically adjusted. In the proposed technique, the power switches possess the feature of flexible programming after chip manufacturing. This VDP method does not use an external voltage regulator to regulate the supply voltage level from outside of the chip but can be easily integrated within the design. This novel technique is proven by use of a video decoder test chip, which shows 55% and 61% power reductions compared to conventional single-Vdd and low-voltage designs, respectively. This power-aware performance adjusting mechanism shows great power reduction with a good power-performance management mechanism.

  3. Exploring the perception of aid organizations' staff about factors affecting management of mass casualty traffic incidents in Iran: a grounded theory study.

    Science.gov (United States)

    Bazeli, Javad; Aryankhesal, Aidin; Khorasani-Zavareh, Davoud

    2017-07-01

    Traffic incidents are of main health issues all around the world and cause countless deaths, heavy casualties, and considerable tangible and intangible damage. In this regard, mass casualty traffic incidents are worthy of special attention as, in addition to all losses and damage, they create challenges in the way of providing health services to the victims. The present study is an attempt to explore the challenges and facilitators in management of mass casualty traffic incidents in Iran. This qualitative grounded theory study was carried out with participation of 14 purposively selected experienced managers, paramedics and staff of aid organizations in different provinces of Iran in 2016. Semi-structured interviews were conducted in order to develop the theory. The transcribed interviews were analyzed through open, axial and selective coding. Despite the recent and relatively good improvements in facilities and management procedure of mass casualty traffic incidents in Iran, several problems such as lack of coordination, lack of centralized and integrated command system, large number of organizations participating in operations, duplicate attempts and parallel operations carried out by different organizations, intervention of lay people, and cultural factors halt provision of effective health services to the victims. It is necessary to improve the theoretical and practical knowledge of the relief personnel and paramedics, provide public with education about first aid and improve driving culture, prohibit laypeople from intervening in aid operations, and increase quality and quantity of aid facilities.

  4. FUNCTIONAL MODEL OF THE MATERIAL RESOURCES MANAGEMENT FOR PROJECTS OF THE CREATION OF NEW TECHNIQUES

    Directory of Open Access Journals (Sweden)

    S. Yu. Danshyna

    2016-01-01

    Full Text Available The article is devoted to problem of material management arising in the implementation of projects for the development and creation (modernization of the new techniques. The uniqueness of the projects, their limit on the cost and time does not allow the use of traditional approaches to resource management. Such projects are often implemented in the development of companies; where it is not possible to abandon the traditional operating methods of management. The aim of the article is a formalization of the process of material management of projects, a description of its information flows for integrate into the project management practices and for improve the efficiency of material management. For the systematization of information arising from the material resources management, invited the set-theoretic representation of the management process. According with the requirements of project management standards were described the sets and defined rules of their transformation. Specification of the set-theoretic representation helped to establish the area and limits of the modelling process. Further decomposition process became the basis of the functional model, constructed in accordance with the methodology IDEF 0. A graphical representation of the model allows you to visualize the process at different levels of detail. For specification of issues related to the organization and promotion of material flow, were developed functional models of sub-processes and were described the identified data-flows. For the harmonization of process and project approaches formulated conditions for evaluating the efficiency of material management. The developed models can be the basis for designing the structure of companies, for regulation of their project activities, as well as for establishing an information system of management resources of projects.

  5. Reverse waffle cone technique in management of stent dislodgement into intracranial aneurysms.

    Science.gov (United States)

    Luo, Chao-Bao; Lai, Yen-Jun; Teng, Michael Mu-Huo; Chang, Feng-Chi; Lin, Chung-Jung; Guo, Wan-Yuo

    2013-09-01

    Stent-assisted coil embolization (SACE) is a common method to manage intracranial wide-neck aneurysm. Using this technique, a stent must be successfully deployed into the parent artery to cross the aneurysm neck. We describe the reverse waffle cone technique in management of intra-procedural stent dislodgement during SACE of internal carotid artery (ICA) wide-neck aneurysms. Two patients with unruptured wide-neck ICA aneurysms underwent SACE. Intra-procedural forward stent migration occurred during catheterization with proximal stent dislodgement and migration into the aneurysm sac. Navigation of a second stent to bridge the aneurysm neck failed in one patient because the second stent was impeded by the dislodged stent. Using the reverse waffle cone technique, a microcatheter was navigated into the aneurysm sacs. Coils were safely detached into each aneurysm sac without any device assistance. The two wide-neck aneurysms were successfully treated with preservation of flow to the internal carotid arteries. The complication of intra-procedural distal stent migration and dislodgement, with proximal stent prolapse into an aneurysm sac, may not result in a failure to coil the aneurysm. The reverse waffle cone technique provides an effective treatment in the management of this complication. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Life Cycle Assessments of Manure Management Techniques for the Baltic Sea Regions

    DEFF Research Database (Denmark)

    Hamelin, Lorie; Baky, A; Cano-Bernal, J

    The report summarizes the key results of the consequential life cycle assessments (LCAs) carried out for a variety of manure management techniques over the Baltic Sea Regions (BSR). For all manure management technologies assessed, the environmental impacts (in terms of potential to global warming......, acidification of aquatic & terrestrial systems as well as phosphorus and nitrogen enrichment) are evaluated along the whole “manure management chain”, quantified and compared to the applying reference manure management system. The LCA results presented in this report cover 4 main manure types (dairy cow slurry....... Assessed separation technologies include concentration technologies, state-of-the-art decanter centrifuge and source-separation technologies. The energy production technologies addressed consist of thermal gasification, incineration and anaerobic digestion (for which a myriad of carbon co...

  7. Management of Gustilo Anderson III B open tibial fractures by primary fascio-septo-cutaneous local flap and primary fixation: The ′fix and shift′ technique

    Directory of Open Access Journals (Sweden)

    P R Ramasamy

    2017-01-01

    Full Text Available Background: Open fractures of tibia have posed great difficulty in managing both the soft tissue and the skeletal components of the injured limb. Gustilo Anderson III B open tibial fractures are more difficult to manage than I, II, and III A fractures. Stable skeletal fixation with immediate soft tissue cover has been the key to the successful outcome in treating open tibial fractures, in particular, Gustilo Anderson III B types. If the length of the open wound is larger and if the exposed surface of tibial fracture and tibial shaft is greater, then the management becomes still more difficult. Materials and Methods: Thirty six Gustilo Anderson III B open tibial fractures managed between June 2002 and December 2013 with "fix and shift" technique were retrospectively reviewed. All the 36 patients managed by this technique had open wounds measuring >5 cm (post debridement. Under fix and shift technique, stable fixation involved primary external fixator application or primary intramedullary nailing of the tibial fracture and immediate soft tissue cover involved septocutaneous shift, i.e., shifting of fasciocutaneous segments based on septocutaneous perforators. Results: Primary fracture union rate was 50% and reoperation rate (bone stimulating procedures was 50%. Overall fracture union rate was 100%. The rate of malunion was 14% and deep infection was 16%. Failure of septocutaneous shift was 2.7%. There was no incidence of amputation. Conclusion: Management of Gustilo Anderson III B open tibial fractures with "fix and shift" technique has resulted in better outcome in terms of skeletal factors (primary fracture union, overall union, and time for union and malunion and soft tissue factors (wound healing, flap failure, access to secondary procedures, and esthetic appearance when compared to standard methods adopted earlier. Hence, "fix and shift" could be recommended as one of the treatment modalities for open III B tibial fractures.

  8. Management of Gustilo Anderson III B open tibial fractures by primary fascio-septo-cutaneous local flap and primary fixation: The 'fix and shift' technique.

    Science.gov (United States)

    Ramasamy, P R

    2017-01-01

    Open fractures of tibia have posed great difficulty in managing both the soft tissue and the skeletal components of the injured limb. Gustilo Anderson III B open tibial fractures are more difficult to manage than I, II, and III A fractures. Stable skeletal fixation with immediate soft tissue cover has been the key to the successful outcome in treating open tibial fractures, in particular, Gustilo Anderson III B types. If the length of the open wound is larger and if the exposed surface of tibial fracture and tibial shaft is greater, then the management becomes still more difficult. Thirty six Gustilo Anderson III B open tibial fractures managed between June 2002 and December 2013 with "fix and shift" technique were retrospectively reviewed. All the 36 patients managed by this technique had open wounds measuring >5 cm (post debridement). Under fix and shift technique, stable fixation involved primary external fixator application or primary intramedullary nailing of the tibial fracture and immediate soft tissue cover involved septocutaneous shift, i.e., shifting of fasciocutaneous segments based on septocutaneous perforators. Primary fracture union rate was 50% and reoperation rate (bone stimulating procedures) was 50%. Overall fracture union rate was 100%. The rate of malunion was 14% and deep infection was 16%. Failure of septocutaneous shift was 2.7%. There was no incidence of amputation. Management of Gustilo Anderson III B open tibial fractures with "fix and shift" technique has resulted in better outcome in terms of skeletal factors (primary fracture union, overall union, and time for union and malunion) and soft tissue factors (wound healing, flap failure, access to secondary procedures, and esthetic appearance) when compared to standard methods adopted earlier. Hence, "fix and shift" could be recommended as one of the treatment modalities for open III B tibial fractures.

  9. Management strategy evaluation of pheromone-baited trapping techniques to improve management of invasive sea lamprey

    Science.gov (United States)

    Dawson, Heather; Jones, Michael L.; Irwin, Brian J.; Johnson, Nicholas; Wagner, Michael C.; Szymanski, Melissa

    2016-01-01

    We applied a management strategy evaluation (MSE) model to examine the potential cost-effectiveness of using pheromone-baited trapping along with conventional lampricide treatment to manage invasive sea lamprey. Four pheromone-baited trapping strategies were modeled: (1) stream activation wherein pheromone was applied to existing traps to achieve 10−12 mol/L in-stream concentration, (2) stream activation plus two additional traps downstream with pheromone applied at 2.5 mg/hr (reverse-intercept approach), (3) trap activation wherein pheromone was applied at 10 mg/hr to existing traps, and (4) trap activation and reverse-intercept approach. Each new strategy was applied, with remaining funds applied to conventional lampricide control. Simulating deployment of these hybrid strategies on fourteen Lake Michigan streams resulted in increases of 17 and 11% (strategies 1 and 2) and decreases of 4 and 7% (strategies 3 and 4) of the lakewide mean abundance of adult sea lamprey relative to status quo. MSE revealed performance targets for trap efficacy to guide additional research because results indicate that combining lampricides and high efficacy trapping technologies can reduce sea lamprey abundance on average without increasing control costs.

  10. Developing nondestructive techniques for managing conflicts between fisheries and double-crested cormorant colonies

    Science.gov (United States)

    Suzuki, Yasuko; Roby, Daniel D.; Lyons, Donald E.; Courtot, Karen; Collis, Ken

    2015-01-01

    Double-crested cormorants (Phalacrocorax auritus) have been identified as the source of significant mortality to juvenile salmonids (Oncorhynchus spp.) in the Columbia River Basin. Management plans for reducing the size of a large colony on East Sand Island (OR, USA) in the Columbia River estuary are currently being developed. We evaluated habitat enhancement and social attraction as nondestructive techniques for managing cormorant nesting colonies during 2004–2007. We tested these techniques on unoccupied plots adjacent to the East Sand Island cormorant colony. Cormorants quickly colonized these plots and successfully raised young. Cormorants also were attracted to nest and raised young on similar plots at 2 islands approximately 25 km from East Sand Island; 1 island had a history of successful cormorant nesting whereas the other was a site where cormorants had previously nested unsuccessfully. On a third island with no history of cormorant nesting or nesting attempts, these techniques were unsuccessful at attracting cormorants to nest. Our results suggest that some important factors influencing attraction of nesting cormorants using these techniques include history of cormorant nesting, disturbance, and presence of breeding cormorants nearby. These techniques may be effective in redistributing nesting cormorants away from areas where fish stocks of conservation concern are susceptible to predation, especially if sites with a recent history of cormorant nesting are available within their foraging or dispersal range. Published 2015. Wiley Periodicals, Inc. This article is a US Government work and, as such, is in the public domain in the United States of America.

  11. Spatial-Temporal Hotspot Pattern Analysis of Provincial Environmental Pollution Incidents and Related Regional Sustainable Management in China in the Period 1995–2012

    Directory of Open Access Journals (Sweden)

    Lei Ding

    2015-10-01

    Full Text Available Spatial-temporal hotspot pattern analysis of environmental pollution incidents provides an indispensable source of information for the further development of incident prevention measures. In this study, the spatial-temporal patterns of environmental pollution incidents in China in the period of 1995–2012 were analyzed, using the Spatial Getis-Ord statistic and an Improved Prediction Accuracy Index (IAPI. The results show that, in this period, the occurrence of environmental incidents exhibited a dynamic growth pattern but then dropped and continued to drop after the year 2006, which was considered a crucial turning point. Not coincidentally, this corresponds to the year when the State Council issued its National Environmental Emergency Plan, and following the examination of major incidents, special actions were taken to strengthen the control of incidents and emergency responses. The results from Getis-Ord General G statistical analysis show that the spatial agglomeration phenomenon was statistically significant after 1999 and that the level of spatial agglomeration was rising, while the Getis-Ord Gi* statistical analysis reveals that environmental pollution incidents were mainly agglomerated in the Pan Yangtze River Delta and Pan Pearl River Delta regions. Accordingly, the spatial-temporal hotspot pattern based on the IAPI values at the provincial scale could be categorized into: stable hotspots, unstable hotspots, and cold-spot areas. The stable hotspots category was further divided into three subtypes: industrial distribution type, industrial transfer type, and extensive economic growth type. Finally, the corresponding measures for sustainable management were proposed: stable hotspots were classified as essential regions requiring the immediate prevention and control of environmental pollution incidents; unstable hotspots were characterized by their need for ongoing and continual prevention measures, and cold-spots were those areas that

  12. Implementation of quality improvement techniques for management and technical processes in the ACRV project

    Science.gov (United States)

    Raiman, Laura B.

    1992-12-01

    Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

  13. Implementation of quality improvement techniques for management and technical processes in the ACRV project

    Science.gov (United States)

    Raiman, Laura B.

    1992-01-01

    Total Quality Management (TQM) is a cooperative form of doing business that relies on the talents of everyone in an organization to continually improve quality and productivity, using teams and an assortment of statistical and measurement tools. The objective of the activities described in this paper was to implement effective improvement tools and techniques in order to build work processes which support good management and technical decisions and actions which are crucial to the success of the ACRV project. The objectives were met by applications in both the technical and management areas. The management applications involved initiating focused continuous improvement projects with widespread team membership. The technical applications involved applying proven statistical tools and techniques to the technical issues associated with the ACRV Project. Specific activities related to the objective included working with a support contractor team to improve support processes, examining processes involved in international activities, a series of tutorials presented to the New Initiatives Office and support contractors, a briefing to NIO managers, and work with the NIO Q+ Team. On the technical side, work included analyzing data from the large-scale W.A.T.E.R. test, landing mode trade analyses, and targeting probability calculations. The results of these efforts will help to develop a disciplined, ongoing process for producing fundamental decisions and actions that shape and guide the ACRV organization .

  14. Percutaneous rendezvous technique for the management of a bile duct injury.

    Science.gov (United States)

    Meek, James; Fletcher, Savannah; Crumley, Kristen; Culp, W C; Meek, Mary

    2018-02-01

    The rendezvous technique typically involves combined efforts of interventional radiology, endoscopy, and surgery. It can be done solely percutaneously, whereby the interventionalist gains desired access to one point in the body by approaching it from two different access sites. We present the case of a woman who underwent cholecystectomy complicated by a bile duct injury. A percutaneous rendezvous procedure enabled placement of an internal-external drain from the intrahepatic ducts through the biloma and distal common bile duct and into the duodenum. Thus, a percutaneous rendezvous technique is feasible for managing a bile duct injury when endoscopic retrograde cholangio-pancreatography or percutaneous transhepatic cholangiogram alone has been unsuccessful.

  15. Percutaneous rendezvous technique for the management of a bile duct injury

    Directory of Open Access Journals (Sweden)

    James Meek, DO

    2018-02-01

    Full Text Available The rendezvous technique typically involves combined efforts of interventional radiology, endoscopy, and surgery. It can be done solely percutaneously, whereby the interventionalist gains desired access to one point in the body by approaching it from two different access sites. We present the case of a woman who underwent cholecystectomy complicated by a bile duct injury. A percutaneous rendezvous procedure enabled placement of an internal-external drain from the intrahepatic ducts through the biloma and distal common bile duct and into the duodenum. Thus, a percutaneous rendezvous technique is feasible for managing a bile duct injury when endoscopic retrograde cholangio-pancreatography or percutaneous transhepatic cholangiogram alone has been unsuccessful.

  16. Managing age discrimination: an examination of the techniques used when seeking employment.

    Science.gov (United States)

    Berger, Ellie D

    2009-06-01

    This article examines the age-related management techniques used by older workers in their search for employment. Data are drawn from interviews with individuals aged 45-65 years (N = 30). Findings indicate that participants develop "counteractions" and "concealments" to manage perceived age discrimination. Individuals counteract employers' ageist stereotypes by maintaining their skills and changing their work-related expectations and conceal age by altering their résumés, physical appearance, and language used. This research suggests that there is a need to reexamine the hiring practices of employers and to improve legislation in relation to their accountability.

  17. Developing and managing embedded systems and products methods, techniques, tools, processes, and teamwork

    CERN Document Server

    Fowler, Kim

    2014-01-01

    This Expert Guide gives you the knowledge, methods and techniques to develop and manage embedded systems successfully.  It shows that teamwork, development procedures, and program management require unique and wide ranging skills to develop a system, skills that most people can attain with persistence and effort. With this book you will: Understand the various business aspects of a project from budgets and schedules through contracts and market studiesUnderstand the place and timing for simulations, bench tests, and prototypes, and understand the differences between various formal metho

  18. Importance of brachytherapy technique in the management of primary carcinoma of the vagina

    International Nuclear Information System (INIS)

    Stock, R.G.; Mychalczak, B.; Armstrong, J.G.; Hoskins, W.; Harrison, L.B.

    1991-01-01

    Primary vaginal carcinoma is a rare malignancy. There is little information regarding the optimal treatment. Management has primarily been with external-beam radiation therapy and brachytherapy. This paper examines the importance of brachytherapy and the significance of its techniques in the treatment of this disease. Brachytherapy plays an important part in the management of primary vaginal carcinoma. External-beam radiation therapy alone is not an adequate treatment for this disease. For stages II and III disease, there is a trend toward improved disease-free survival with the use of a temporary interstitial implant compared to an intracavitary application

  19. Acute incidents during anaesthesia

    African Journals Online (AJOL)

    management of acute incidents and the prevention of ... High or total (complete) spinal blocks in obstetric .... Pain and opioid analgesics lead to delayed ... Step up postoperative care and use ... recognise suprasternal and supraclavicular.

  20. Clinical review: Bleeding - a notable complication of treatment in patients with acute coronary syndromes: incidence, predictors, classification, impact on prognosis, and management

    Science.gov (United States)

    2013-01-01

    This article focuses on the incidence, predictors, classification, impact on prognosis, and management of bleeding associated with the treatment of acute coronary syndrome. The issue of bleeding complications is related to the continual improvement of ischemic heart disease treatment, which involves mainly (a) the widespread use of coronary angiography, (b) developments in percutaneous coronary interventions, and (c) the introduction of new antithrombotics. Bleeding has become an important health and economic problem and has an incidence of 2.0% to 17%. Bleeding significantly influences both the short- and long-term prognoses. If a group of patients at higher risk of bleeding complications can be identified according to known risk factors and a risk scoring system can be developed, we may focus more on preventive measures that should help us to reduce the incidence of bleeding. PMID:24093465

  1. Management of First Branchial Cleft Anomalies via a Cartilage-Splitting Technique.

    Science.gov (United States)

    Schmidt, Richard; Conrad, David; Field, Erin; O'Reilly, Robert

    2015-06-01

    First branchial cleft anomalies are uncommon lesions that often present as periauricular infections. They have high recurrence rates, due in part to scarring secondary to prior infections and their management. These lesions have a close relationship with the facial nerve, and most authors recommend its identification and dissection because of this relationship. Nonetheless, facial nerve palsy has been reported in up to 15% of cases. We describe a novel technique for the management of first branchial cleft anomalies. Such lesions that presented in an infra- or postauricular location were approached via an incision through the cartilage of the pinna, between the tragus and antitragus. This technique affords direct access to the lesion without the need for facial nerve dissection. Six patients were treated. Five had prior surgery, including 3 with previous attempts at excision. There were no complications. The median follow-up was 35 months. One patient developed a recurrence. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  2. The development of quality management techniques in civil engineering design and site supervision

    International Nuclear Information System (INIS)

    Cowan, A.J.

    1991-01-01

    Quality assurance techniques have developed considerably over the past few years, and in particular the application of Quality Management within a service industry such as civil engineering has evolved into a well developed management control system. James Williamson and Partners were the first members of the Association of Consulting Engineers successfully to achieve third party accreditation with BSI for civil and structural design. The initial system was generated for work on Torness Power Station in the early 1980s, and the firm has, in the last ten years, developed a flexible quality system to effectively control and co-ordinate complex projects. This paper discusses the use of quality assurance (QA) techniques in a civil engineering design office, looking at a few areas where the requirements of BS 5750 and BS 5882 are difficult to interpret. Some observations are also made on the adoption of QA for site supervision. (author)

  3. Fiberoptic endoscopic-assisted diverticulotomy: a novel technique for the management of Zenker's diverticulum.

    Science.gov (United States)

    Altman, Jason I; Genden, Eric M; Moche, Jason

    2005-05-01

    Endoscopic diverticulotomy is rapidly becoming the procedure of choice for treatment of Zenker's diverticulum. The endoscopic approach has resulted in significant decreases in patient morbidity, time to resumption of oral intake, and overall cost as compared with open treatment. However, a small but significant patient population is unable to accommodate the rigid laryngoscope and therefore requires open treatment. We present a novel technique, flexible fiberoptic endoscopic-assisted diverticulotomy, for the management of patients who are unable to undergo rigid endoscopy.

  4. Pengaruh Customer Accounting Sebagai Strategic Management Accounting Techniques Dan Customer Orientation Terhadap Organizational Performance

    OpenAIRE

    Lisa, Valentine

    2015-01-01

    This Study was done to examine the affect of customer accounting as strategic management accounting techniques and customer orientation to organizational performance. This study used primary data from questionnaires which were distributed to 50 manufacturing companies in Surabaya and Sidoarjo. The data collected would be analyzed by using Partial Least Square method to test the hypothesis. The result showed there were positive and significant influence from customer accounting and customer o...

  5. Outcome of 7-S, TQM technique for health care waste management

    International Nuclear Information System (INIS)

    Ullah, J.H.; Malik, J.I.

    2011-01-01

    To assess the present waste management system of health care facilities (HCFs) attached with Shalamar Hospital, Lahore by applying the 7-S technique of Total Quality Management (TQM) and to find out the outcome after imparting training. Study Design: Interventional quasi-experimental study. Place and Duration of Study: The Shalamar Hospital, Lahore, Punjab, Pakistan, November, 2009 to November, 2010. Methodology: Mckinsey's 7-S, technique of TQM was applied to assess the 220 HCFs from Lahore, Gujranwala and Sheikhupura districts for segregation, collection, transportation and disposal (SCTD) of hospital waste. Direct interview method was applied. Trainings were provided in each institution. After one year action period, the status of four areas of concern was compared before and after training. The parameters studied were segregation, collection, transportation and disposal systems in the 220 HCFs. Each of these were further elaborated by strategy, structure, system, staff, skill, style and stake holder/shared value factors. Standard error of difference of proportion was applied to assess significance using 95% confidence level. Results: There was marked improvement in all these areas ranging from 20% to 77% following a training program of 3 months. In case of disposal of the waste strategy, structure and system an increase of 60%, 65% and 75% was observed after training. Conclusion: The 7-S technique played a vital role in assessing the hospital waste management system. Training for the health care workers played a significant role in health care facilities. (author)

  6. Review of Sealed Source Designs and Manufacturing Techniques Affecting Disused Source Management

    International Nuclear Information System (INIS)

    2012-10-01

    This publication presents an investigation on the influence of the design and technical features of sealed radioactive sources (SRSs) on predisposal and disposal activities when the sources become disused. The publication also addresses whether design modifications could contribute to safer and/or more efficient management of disused sources without compromising the benefits provided by the use of the sealed sources. This technical publication aims to collect information on the most typical design features and manufacturing techniques of sealed radioactive sources and examines how they affect the safe management of disused sealed radioactive sources (DSRS). The publication also aims to assist source designers and manufacturers by discussing design features that are important from the waste management point of view. It has been identified that most SRS manufacturers use similar geometries and materials for their designs and apply improved and reliable manufacturing techniques e.g. double- encapsulation. These designs and manufacturing techniques have been proven over time to reduce contamination levels in fabrication and handling, and improve source integrity and longevity. The current source designs and materials ensure as well as possible that SRSs will maintain their integrity in use and when they become disused. No significant improvement options to current designs have been identified. However, some design considerations were identified as important to facilitate source retrieval, to increase the possibility of re-use and to ensure minimal contamination risk and radioactive waste generation at recycling. It was also concluded that legible identifying markings on a source are critical for DSRS management. The publication emphasizes the need for a common understanding of the radioactive source's recommended working life (RWL) for manufacturers and regulators. The conditions of use (COU) are important for the determination of RWL. A formal system for specification

  7. An Analysis Of The Benefits And Application Of Earned Value Management (EVM) Project Management Techniques For Dod Programs That Do Not Meet Dod Policy Thresholds

    Science.gov (United States)

    2017-12-01

    VALUE MANAGEMENT (EVM) PROJECT MANAGEMENT TECHNIQUES FOR DOD PROGRAMS THAT DO NOT MEET DOD POLICY THRESHOLDS December 2017 By: Randy Schneider...Joint applied project 4. TITLE AND SUBTITLE AN ANALYSIS OF THE BENEFITS AND APPLICATION OF EARNED VALUE MANAGEMENT (EVM) PROJECT MANAGEMENT ...performance reporting. The immediate objective of this research project was to examine the question: Can the application of EVM-Lite project management

  8. Stenotic ligature: a simple technique for managing distal hypoperfusion ischemic syndrome following arteriovenous fistulas

    Directory of Open Access Journals (Sweden)

    Ene Cristian Roata

    2018-05-01

    Full Text Available Introduction. Distal Hypoperfusion Ischemic Syndrome (DHIS is a multifactorial debilitating condition causing peripheral ischemia and potentially tissue necrosis. In an effort to further refine its surgical treatment we aim to describe a modified, simple and reliable technique for managing DHIS in patients with arteriovenous fistulas. Materials and Methods. Twenty-nine consecutive patients with DHIS operated by a single surgical team over a period of 7 years were included in the study. All patients underwent the same surgical technique: stenotic ligature. Outcomes were analyzed clinically and the effectiveness of the procedure was proven using McNemar test. Clinical variables were statistically analyzed in SPSS 17.0 for Windows. Results. The technique we used consists in performing a stenosing ligature on the vein, using a 0-silk suture, and adjusting the suture in order to achieve either a radial pulse or capillary pulse, while maintaining a good thrill at palpation of the vein. The procedure was successful in 83% of patients proved by immediate symptomatic relief. Paired data analysis showed significant decrease of all symptoms: cold extremity (p=0,021, paraesthesia (p<0,001, pain (p<0,001. History of coronary artery disease, arteriopathy or the absence of radial pulse is statistically correlated with an increased risk of developing DHIS. Conclusions. Stenotic ligature is a simple, cheap and reliable technique for managing DHIS with lower septic risks which can be easily performed under local anesthesia.

  9. Radio Resource Management Techniques for eMBB and mMTC services in 5G Dense Small Cell Scenarios

    DEFF Research Database (Denmark)

    Mahmood, Nurul Huda; Lauridsen, Mads; Berardinelli, Gilberto

    2016-01-01

    requirements. This article provides an overview of key radio resource management techniques for 5G dense small cells and demonstrates how these techniques can contribute to fulfilling some of the important 5G requirements. Preliminary system level simulation results indicate that a mean throughput gain...... design requirements. Dense small cells with multiple antenna nodes are believed to be key elements in meeting these challenging requirements. 5G will thus feature an adaptable air interface with carefully designed radio resource management techniques that can optimize each link according to its service...... of around 65%, and up to 84% in latency reduction can be achieved utilizing the discussed resource management techniques....

  10. Sterile insect technique. Principles and practice in area-wide integrated pest management

    International Nuclear Information System (INIS)

    Dyck, V.A.; Hendrichs, J.; Robinson, A.S.

    2005-01-01

    For several major insect pests, the environment-friendly sterile insect technique (SIT) is being applied as a component of area-wide integrated pest management (AW-IPM) programmes. This technology, using radiation to sterilize insects, was first developed in the USA, and is currently applied on six continents. For four decades it has been a major subject for research and development in the Joint FAO/IAEA Programme on Nuclear Techniques in Food and Agriculture, involving both research and the transfer of this technology to Member States so that they can benefit from improved plant, animal and human health, cleaner environments, increased production of plants and animals in agricultural systems, and accelerated economic development. The socio-economic impacts of AW-IPM programmes that integrate the SIT have confirmed the usefulness of this technology. Numerous publications related to the integration of the SIT in pest management programmes, arising from research, coordinated research projects, field projects, symposia, meetings, and training activities have already provided much information to researchers, pest-control practitioners, programme managers, plant protection and animal health officers, and policy makers. However, by bringing together and presenting in a generic fashion the principles, practice, and global application of the SIT, this book will be a major reference source for all current and future users of the technology. The book will also serve as a textbook for academic courses on integrated pest management. Fifty subject experts from 19 countries contributed to the chapters, which were all peer reviewed before final editing

  11. Innovative Techniques for Estimating Illegal Activities in a Human-Wildlife-Management Conflict

    Science.gov (United States)

    Cross, Paul; St. John, Freya A. V.; Khan, Saira; Petroczi, Andrea

    2013-01-01

    Effective management of biological resources is contingent upon stakeholder compliance with rules. With respect to disease management, partial compliance can undermine attempts to control diseases within human and wildlife populations. Estimating non-compliance is notoriously problematic as rule-breakers may be disinclined to admit to transgressions. However, reliable estimates of rule-breaking are critical to policy design. The European badger (Meles meles) is considered an important vector in the transmission and maintenance of bovine tuberculosis (bTB) in cattle herds. Land managers in high bTB prevalence areas of the UK can cull badgers under license. However, badgers are also known to be killed illegally. The extent of illegal badger killing is currently unknown. Herein we report on the application of three innovative techniques (Randomized Response Technique (RRT); projective questioning (PQ); brief implicit association test (BIAT)) for investigating illegal badger killing by livestock farmers across Wales. RRT estimated that 10.4% of farmers killed badgers in the 12 months preceding the study. Projective questioning responses and implicit associations relate to farmers' badger killing behavior reported via RRT. Studies evaluating the efficacy of mammal vector culling and vaccination programs should incorporate estimates of non-compliance. Mitigating the conflict concerning badgers as a vector of bTB requires cross-disciplinary scientific research, departure from deep-rooted positions, and the political will to implement evidence-based management. PMID:23341973

  12. Innovative techniques for estimating illegal activities in a human-wildlife-management conflict.

    Directory of Open Access Journals (Sweden)

    Paul Cross

    Full Text Available Effective management of biological resources is contingent upon stakeholder compliance with rules. With respect to disease management, partial compliance can undermine attempts to control diseases within human and wildlife populations. Estimating non-compliance is notoriously problematic as rule-breakers may be disinclined to admit to transgressions. However, reliable estimates of rule-breaking are critical to policy design. The European badger (Meles meles is considered an important vector in the transmission and maintenance of bovine tuberculosis (bTB in cattle herds. Land managers in high bTB prevalence areas of the UK can cull badgers under license. However, badgers are also known to be killed illegally. The extent of illegal badger killing is currently unknown. Herein we report on the application of three innovative techniques (Randomized Response Technique (RRT; projective questioning (PQ; brief implicit association test (BIAT for investigating illegal badger killing by livestock farmers across Wales. RRT estimated that 10.4% of farmers killed badgers in the 12 months preceding the study. Projective questioning responses and implicit associations relate to farmers' badger killing behavior reported via RRT. Studies evaluating the efficacy of mammal vector culling and vaccination programs should incorporate estimates of non-compliance. Mitigating the conflict concerning badgers as a vector of bTB requires cross-disciplinary scientific research, departure from deep-rooted positions, and the political will to implement evidence-based management.

  13. Innovative techniques for estimating illegal activities in a human-wildlife-management conflict.

    Science.gov (United States)

    Cross, Paul; St John, Freya A V; Khan, Saira; Petroczi, Andrea

    2013-01-01

    Effective management of biological resources is contingent upon stakeholder compliance with rules. With respect to disease management, partial compliance can undermine attempts to control diseases within human and wildlife populations. Estimating non-compliance is notoriously problematic as rule-breakers may be disinclined to admit to transgressions. However, reliable estimates of rule-breaking are critical to policy design. The European badger (Meles meles) is considered an important vector in the transmission and maintenance of bovine tuberculosis (bTB) in cattle herds. Land managers in high bTB prevalence areas of the UK can cull badgers under license. However, badgers are also known to be killed illegally. The extent of illegal badger killing is currently unknown. Herein we report on the application of three innovative techniques (Randomized Response Technique (RRT); projective questioning (PQ); brief implicit association test (BIAT)) for investigating illegal badger killing by livestock farmers across Wales. RRT estimated that 10.4% of farmers killed badgers in the 12 months preceding the study. Projective questioning responses and implicit associations relate to farmers' badger killing behavior reported via RRT. Studies evaluating the efficacy of mammal vector culling and vaccination programs should incorporate estimates of non-compliance. Mitigating the conflict concerning badgers as a vector of bTB requires cross-disciplinary scientific research, departure from deep-rooted positions, and the political will to implement evidence-based management.

  14. The relationship between the implementation of voluntary Five-Star occupational health and safety management system and the incidence of fatal and permanently disabling injury

    DEFF Research Database (Denmark)

    Hedlund, Frank Huess

    2014-01-01

    This paper examines two properties of the South African NOSA 5-Star System, a voluntary occupational health and safety (OHS) management system. The first property is the association between system implementation and final OHS outcomes measured as incidence rates of fatal and permanently disabling...... of their positive impact on OHS. It is clear though, that such systems cannot substitute authority enforcement activities.......This paper examines two properties of the South African NOSA 5-Star System, a voluntary occupational health and safety (OHS) management system. The first property is the association between system implementation and final OHS outcomes measured as incidence rates of fatal and permanently disabling...... injury. The second is the association between the Star audit rating and rates of serious occupational injury. Although there are many uncertainties involved the paper argues that companies committed to the NOSA system experienced fewer fatal and permanently disabling injuries than the general...

  15. Uncertainty Management for Diagnostics and Prognostics of Batteries using Bayesian Techniques

    Science.gov (United States)

    Saha, Bhaskar; Goebel, kai

    2007-01-01

    Uncertainty management has always been the key hurdle faced by diagnostics and prognostics algorithms. A Bayesian treatment of this problem provides an elegant and theoretically sound approach to the modern Condition- Based Maintenance (CBM)/Prognostic Health Management (PHM) paradigm. The application of the Bayesian techniques to regression and classification in the form of Relevance Vector Machine (RVM), and to state estimation as in Particle Filters (PF), provides a powerful tool to integrate the diagnosis and prognosis of battery health. The RVM, which is a Bayesian treatment of the Support Vector Machine (SVM), is used for model identification, while the PF framework uses the learnt model, statistical estimates of noise and anticipated operational conditions to provide estimates of remaining useful life (RUL) in the form of a probability density function (PDF). This type of prognostics generates a significant value addition to the management of any operation involving electrical systems.

  16. Snowball Vs. House-to-House Technique for Measuring Annual Incidence of Kala-azar in the Higher Endemic Blocks of Bihar, India: A Comparison.

    Science.gov (United States)

    Siddiqui, Niyamat A; Rabidas, Vidya N; Sinha, Sanjay K; Verma, Rakesh B; Pandey, Krishna; Singh, Vijay P; Ranjan, Alok; Topno, Roshan K; Lal, Chandra S; Kumar, Vijay; Sahoo, Ganesh C; Sridhar, Srikantaih; Pandey, Arvind; Das, Pradeep

    2016-09-01

    Visceral Leishmaniasis, commonly known as kala-azar, is widely prevalent in Bihar. The National Kala-azar Control Program has applied house-to-house survey approach several times for estimating Kala-azar incidence in the past. However, this approach includes huge logistics and operational cost, as occurrence of kala-azar is clustered in nature. The present study aims to compare efficiency, cost and feasibility of snowball sampling approach to house-to-house survey approach in capturing kala-azar cases in two endemic districts of Bihar, India. A community based cross-sectional study was conducted in two highly endemic Primary Health Centre (PHC) areas, each from two endemic districts of Bihar, India. Snowball technique (used to locate potential subjects with help of key informants where subjects are hard to locate) and house-to-house survey technique were applied to detect all the new cases of Kala-azar during a defined reference period of one year i.e. June, 2010 to May, 2011. The study covered a total of 105,035 households with 537,153 populations. Out of total 561 cases and 17 deaths probably due to kala-azar, identified by the study, snowball sampling approach captured only 221 cases and 13 deaths, whereas 489 cases and 17 deaths were detected by house-to-house survey approach. Higher value of McNemar's χ² statistics (64; phouse-to-house survey approach than snowball sampling and relative difference (>1) indicates that most of the kala-azar cases missed by snowball sampling were captured by house-to-house approach with 13% of omission. Snowball sampling was not found sensitive enough as it captured only about 50% of VL cases. However, it captured about 77% of the deaths probably due to kala-azar and was found more cost-effective than house-to-house approach. Standardization of snowball approach with improved procedure, training and logistics may enhance the sensitivity of snowball sampling and its application in national Kala-azar elimination programme as cost

  17. Management of third branchial pouch anomalies - an evolution of a minimally invasive technique.

    Science.gov (United States)

    Wong, Phui Yee; Moore, Andrew; Daya, Hamid

    2014-03-01

    The management of third branchial pouch anomalies has evolved in recent times with the popularisation of the endoscopic diathermy technique to sclerose the pyriform fossa sinus opening. We present our experience in managing 3 children with third branchial pouch anomalies and propose a minimally invasive management algorithm avoiding open neck surgery. Retrospective case review of 3 patients including demographics, mode of presentation, investigations, management and complications. Three children, two male and one female of mean age 9.6 years presented with painful left anterior neck swelling. Axial neck imaging showed a superficial abscess with air locules and a sinus tract leading towards the left pharynx. Diagnosis was confirmed by endoscopic examination of the pyriform fossa revealing a sinus opening. Two patients underwent open excision; one combined with diathermy to the sinus opening. The last patient was diagnosed at his initial presentation and managed with endoscopic diathermy of the sinus opening combined with percutaneous needle aspiration of the neck abscess at the same sitting. One patient had two recurrences, the first after initial open surgery and the second after the first cautery. Two patients developed temporary hoarseness after the procedure, which resolved within two weeks. All patients were free from recurrences at follow-up. Introduction of the technique of endoscopic diathermy to the pyriform fossa sinus opening in children with third branchial pouch anomalies has revolutionised their management avoiding open and potentially morbid surgery. Our algorithm takes this further by advocating percutaneous needle aspiration of the infective component and performing diathermy to the sinus opening at the first presentation. Crown Copyright © 2013. Published by Elsevier Ireland Ltd. All rights reserved.

  18. Anastomotic Strictures after Esophageal Atresia Repair: Incidence, Investigations, and Management, Including Treatment of Refractory and Recurrent Strictures

    Directory of Open Access Journals (Sweden)

    Renato Tambucci

    2017-05-01

    Full Text Available Improved surgical techniques, as well as preoperative and postoperative care, have dramatically changed survival of children with esophageal atresia (EA over the last decades. Nowadays, we are increasingly seeing EA patients experiencing significant short- and long-term gastrointestinal morbidities. Anastomotic stricture (AS is the most common complication following operative repair. An esophageal stricture is defined as an intrinsic luminal narrowing in a clinically symptomatic patient, but no symptoms are sensitive or specific enough to diagnose an AS. This review aims to provide a comprehensive view of AS in EA children. Given the lack of evidence-based data, we critically analyzed significant studies on children and adults, including comments on benign strictures with other etiologies. Despite there is no consensus about the goal of the luminal diameter based on the patient’s age, esophageal contrast study, and/or endoscopy are recommended to assess the degree of the narrowing. A high variability in incidence of ASs is reported in literature, depending on different definitions of AS and on a great number of pre-, intra-, and postoperative risk factor influencing the anastomosis outcome. The presence of a long gap between the two esophageal ends, with consequent anastomotic tension, is determinant for stricture formation and its response to treatment. The cornerstone of treatment is endoscopic dilation, whose primary aims are to achieve symptom relief, allow age-appropriate capacity for oral feeding, and reduce the risk of pulmonary aspiration. No clear advantage of either balloon or bougie dilator has been demonstrated; therefore, the choice is based on operator experience and comfort with the equipment. Retrospective evidences suggest that selective dilatations (performed only in symptomatic patients results in significantly less number of dilatation sessions than routine dilations (performed to prevent symptoms with equal long

  19. Contents of management plans for incidents and accidents involving the transport of radioactive substances. Guide no. 17, Version of 22/12/2014

    International Nuclear Information System (INIS)

    2014-01-01

    This guide presents the essential topics to be developed in a management plan for incidents and accidents involving the transport of radioactive substances for civil use. It does not aim to be exhaustive and could be added to by each party involved in the transport, who can make the necessary adaptations and additions, taking account of the particularities of its shipments and its organisation, as well as those of the company or group to which it belongs. The radioactive substances transport incident and accident management plan is a document comprising a descriptive part and an operational part. It presents the overall response of the party involved in the transport operation to an incident or accident situation concerning one of its shipments and the steps it intends to make in order to support the authorities in charge of this situation, in the best possible conditions. This response is designed to cover the cases of incidents or accidents whether or not they lead to a radiological emergency situation. The guide exclusively concerns: - road transport; - rail transport; - the 'road' and 'rail' parts of multimodal transport operations. The case of an incident or an accident occurring during a particular stop such as a transit site, in a transhipment area (port, airport, railway station, etc.), or in a transport infrastructure, is also covered by the radioactive substances transport incident and accident management plan, which then supports the entities in charge of managing this situation (operator of the transhipment area or the transport infrastructure and - as applicable - their supervisory authorities). The level of risk associated with transport incidents and accidents varies widely, according to the nature and quantities of the materials being carried, the number of shipments made and the package model used. The incident and accident management plan must therefore be tailored to the specific nature of the shipments by the party concerned. The radioactive

  20. Management of Multi-Casualty Incidents in Mountain Rescue: Evidence-Based Guidelines of the International Commission for Mountain Emergency Medicine (ICAR MEDCOM).

    Science.gov (United States)

    Blancher, Marc; Albasini, François; Elsensohn, Fidel; Zafren, Ken; Hölzl, Natalie; McLaughlin, Kyle; Wheeler, Albert R; Roy, Steven; Brugger, Hermann; Greene, Mike; Paal, Peter

    2018-02-15

    Blancher, Marc, François Albasini, Fidel Elsensohn, Ken Zafren, Natalie Hölzl, Kyle McLaughlin, Albert R. Wheeler III, Steven Roy, Hermann Brugger, Mike Greene, and Peter Paal. Management of multi-casualty incidents in mountain rescue. High Alt Med Biol. 00:000-000, 2018. Multi-Casualty Incidents (MCI) occur in mountain areas. Little is known about the incidence and character of such events, and the kind of rescue response. Therefore, the International Commission for Mountain Emergency Medicine (ICAR MEDCOM) set out to provide recommendations for the management of MCI in mountain areas. Details of MCI occurring in mountain areas related to mountaineering activities and involving organized mountain rescue were collected. A literature search using (1) PubMed, (2) national mountain rescue registries, and (3) lay press articles on the internet was performed. The results were analyzed with respect to specific aspects of mountain rescue. We identified 198 MCIs that have occurred in mountain areas since 1956: 137 avalanches, 38 ski lift accidents, and 23 other events, including lightning injuries, landslides, volcanic eruptions, lost groups of people, and water-related accidents. General knowledge on MCI management is required. Due to specific aspects of triage and management, the approach to MCIs may differ between those in mountain areas and those in urban settings. Mountain rescue teams should be prepared to manage MCIs. Knowledge should be reviewed and training performed regularly. Cooperation between terrestrial rescue services, avalanche safety authorities, and helicopter crews is critical to successful management of MCIs in mountain areas.

  1. Hardware-related infections after deep brain stimulation surgery: review of incidence, severity and management in 212 single-center procedures in the first year after implantation.

    Science.gov (United States)

    Piacentino, Massimo; Pilleri, Manuela; Bartolomei, Luigi

    2011-12-01

    Device-related infection is a common occurrence after deep brain stimulation (DBS) surgery, and may result in additional interventions and a loss of efficacy of therapy. This retrospective review aimed to evaluate the incidence, severity and management of device-related infections in 212 DBS procedures performed in our institute. Data on 106 patients, in whom 212 DBS procedures were performed between 2001 and 2011 at our institute by a single neurosurgeon (M.P.), were reviewed to assess the incidence, severity, management and clinical characteristics of infections in the first year after the implantation of a DBS system. Infections occurred in 8.5% of patients and 4.2% of procedures. Of the nine infections, eight involved the neurostimulator and extensions, and one the whole system. The infections occurred 30.7 days after implantation: 7 within 30 days and 2 within 6 months. Infected and uninfected patients were comparable in terms of age, sex, indication for DBS implantation and neurostimulator location. In eight cases, the system components involved were removed and re-implanted after 3 months, while in one case the complete hardware was removed and not re-implanted. The overall incidence of postoperative infections after DBS system implantation was 4.2%; this rate decreased over time. All infections required further surgery. Correct and timely management of partial infections may result in successful salvage of part of the system.

  2. A Soft Casting Technique for Managing Pediatric Hand and Foot Burns.

    Science.gov (United States)

    Choi, Young Mee; Nederveld, Cindy; Campbell, Kristen; Moulton, Steven

    2018-04-04

    Hand and foot burns in children are difficult to dress. The authors have developed a soft casting technique to manage burns to these areas. The aim of this study is to report the outcomes using weekly dressing changes with a soft casting technique to manage pediatric hand and foot burns in the outpatient setting. A retrospective chart review was performed on children with burns to the hands or feet, who underwent dressing changes with a soft casting technique at the Children's Hospital Colorado Burn Center. Soft casting was performed by placing antibiotic ointment-impregnated nonadherent gauze over the burn wound(s), wrapping the extremity using rolled gauze, applying soft cast pad, plaster, soft cast tape, and an elastic bandage. This was changed weekly. Two hundred ninety-eight children with hand burns had a mean age of 16.8 ± 2 months. Two hundred forty-eight children had partial thickness burn injuries (83%), 50 had full thickness burn injuries (17%), and the mean total body surface area (TBSA) was 1 ± 2.4%. The mean time to heal was 10.1 ± 1.7 days for all subjects. Sixty-six children with foot burns were identified with a mean age of 24 ± 2.6 months. Forty-six children had partial thickness injuries (70%), 20 had full thickness burn injuries (30%), and the mean TBSA was 2.3 ± 2.9%. The mean time to heal was 14.1 ± 2.2 days for all subjects. Weekly dressing changes using a soft casting technique are effective for the outpatient management of pediatric hand and foot burns. This method avoids costly inpatient hospital care, reduces the number of painful dressing changes, and allows children to heal in their own environment.

  3. Comparative Analysis between Podography and Radiography in the Management of Idiopathic Clubfeet by Ponseti Technique.

    Science.gov (United States)

    Trivedi, Vikas; Badhwar, Sumit; Dube, Abhay S

    2017-02-01

    Idiopathic clubfoot is one of the most common and oldest congenital foot anomalies. There are controversies regarding its optimum management protocol and methodologies to be employed for its functional outcome evaluation. This paper attempts to propose a simple, reasonable and easily reproducible technique of podography for clinical and functional evaluation of clubfoot treated by the popular Ponseti technique. To compare the Foot Bimalleolar (FBM) angle method (podography) and radiography with respect to management of idiopathic clubfoot by Ponseti's Technique and its functional evaluation. Sixty feet of 48 patients with idiopathic clubfoot deformity were assessed in terms of FBM by podography (foot print on paper and FBM angle drawing) and radiologically; before starting treatment, after 6 weeks and at 6 monthly intervals with a maximum follow up period of 4.8 years (Range 1.2 to 4.8 years). Mean age at start of treatment was 1.5 years (2 months to 2.5 years). Functional evaluation was done by Magone's scoring system. After treatment, 92 percent patients had good correction (FBM greater than 70 degrees) which correlated well with post treatment Magone's score of greater than 80 (good to excellent) in nearly 85 percent of cases. Radiologically, talocalcaneal angles in both the views improved in only 60 percent of cases. Radiological criteria show inconsistent correlation with functional outcome for feet treated by Ponseti's Technique. Podography (FBM angle analysis) is a very simple, objective, cost effective, radiation free, easily reproducible and highly reliable clinical criterion for the assessment of deformity correction in club foot by Ponseti's Technique with an excellent correlation with functional outcome.

  4. Prioritized rule based load management technique for residential building powered by PV/battery system

    Directory of Open Access Journals (Sweden)

    T.R. Ayodele

    2017-06-01

    Full Text Available In recent years, Solar Photovoltaic (PV system has presented itself as one of the main solutions to the electricity poverty plaguing the majority of buildings in rural communities with solar energy potential. However, the stochasticity associated with solar PV power output owing to vagaries in weather conditions is a major challenge in the deployment of the systems. This study investigates approach for maximizing the benefits of a Stand-Alone Photovoltaic-Battery (SAPVB system via techniques that provide for optimum energy gleaning and management. A rule-based load management scheme is developed and tested for a residential building. The approach allows load prioritizing and shifting based on certain rules. To achieve this, the residential loads are classified into Critical Loads (CLs and Uncritical Loads (ULs. The CLs are given higher priority and therefore are allowed to operate at their scheduled time while the ULs are of less priority, hence can be shifted to a time where there is enough electric power generation from the PV arrays rather than the loads being operated at the time period set by the user. Four scenarios were created to give insight into the applicability of the proposed rule based load management scheme. The result revealed that when the load management technique is not utilized as in the case of scenario 1 (Base case, the percentage satisfaction of the critical and uncritical loads by the PV system are 49.8% and 23.7%. However with the implementation of the load management scheme in scenarios 2, 3 and 4, the percentage satisfaction of the loads (CLs, ULs are (93.8%, 74.2%, (90.9%, 70.1% and (87.2%, 65.4% for scenarios 2, 3 and 4, respectively.

  5. Strategies to introduce Data Management techniques into the German university curriculum

    Science.gov (United States)

    Söding, E.; Fleischer, D.

    2017-12-01

    Data Management is high on the agenda of the German Research Organizations and Universities. While many organizations have committed to high level data management plans, these plans are often loosely binding and not followed adequately. As a consequence, few practical concepts are in place, implementing a sustainable reliable processing, archiving and publication of research data. While many institutions struggle with the organizational level, at which data management is implemented, Students are educated and time is lost, teaching them relevance, techniques and strategies in dealing in a thoughtful and ahead looking manner with their research data. Within a new research project we are tackling this problem in a two-fold way. 1. we are involving technical university personnel, who are working in labs, producing scientific data, in data management processes. This requires teaching, analysis of lab practices and the development of applications for support. 2. We are developing new teaching material, in order to introduce such DM strategies into regular practical courses conducted in such labs, by starting small scale experiments on long term time series. These can be analyzed by student within practical courses, and will demonstrate the practical use of DM practices in the courses. While the focus is on natural science labs, we also strive to create material for other disciplines using e.g. text analysis techniques, in particular in linguistics and history. By doing so, we are touching not only the traditional data-heavy disciplines, but try to bridge responsibility for this task over several disciplines and faculties, in order to raise broad acceptance and recognition in the whole university for the benefits of structured Data Management plans in projects.

  6. Low level waste management: a compilation of models and monitoring techniques. Volume 1

    International Nuclear Information System (INIS)

    Mosier, J.E.; Fowler, J.R.; Barton, C.J.

    1980-04-01

    In support of the National Low-Level Waste (LLW) Management Research and Development Program being carried out at Oak Ridge National Laboratory, Science Applications, Inc., conducted a survey of models and monitoring techniques associated with the transport of radionuclides and other chemical species from LLW burial sites. As a result of this survey, approximately 350 models were identified. For each model the purpose and a brief description are presented. To the extent possible, a point of contact and reference material are identified. The models are organized into six technical categories: atmospheric transport, dosimetry, food chain, groundwater transport, soil transport, and surface water transport. About 4% of the models identified covered other aspects of LLW management and are placed in a miscellaneous category. A preliminary assessment of all these models was performed to determine their ability to analyze the transport of other chemical species. The models that appeared to be applicable are identified. A brief survey of the state-of-the-art techniques employed to monitor LLW burial sites is also presented, along with a very brief discussion of up-to-date burial techniques

  7. Low level waste management: a compilation of models and monitoring techniques. Volume 1

    Energy Technology Data Exchange (ETDEWEB)

    Mosier, J.E.; Fowler, J.R.; Barton, C.J. (comps.)

    1980-04-01

    In support of the National Low-Level Waste (LLW) Management Research and Development Program being carried out at Oak Ridge National Laboratory, Science Applications, Inc., conducted a survey of models and monitoring techniques associated with the transport of radionuclides and other chemical species from LLW burial sites. As a result of this survey, approximately 350 models were identified. For each model the purpose and a brief description are presented. To the extent possible, a point of contact and reference material are identified. The models are organized into six technical categories: atmospheric transport, dosimetry, food chain, groundwater transport, soil transport, and surface water transport. About 4% of the models identified covered other aspects of LLW management and are placed in a miscellaneous category. A preliminary assessment of all these models was performed to determine their ability to analyze the transport of other chemical species. The models that appeared to be applicable are identified. A brief survey of the state-of-the-art techniques employed to monitor LLW burial sites is also presented, along with a very brief discussion of up-to-date burial techniques.

  8. Comparison based on environmental effects of nitrogen management techniques in a manure digestate case study.

    Science.gov (United States)

    Paccanelli, Nicola; Teli, Aronne; Scaglione, Davide; Insabato, Gabriele; Casula, Alessandro

    2015-01-01

    Due to climate issues and favourable energy market, biogas is spreading as a manure management technique. Digestate is rich in nutrient and has to be handled in order to respect the 'nitrate directive' that limits nitrogen field application in areas defined as vulnerable. In this study, we compared different nitrogen management scenarios: a non-treatment option, a biological short-cut nitrification, a complete autotrophic process (anammox) and ammonia stripping from membrane filtration concentrate. The environmental effect comparison was obtained with 'Cross media effects analysis' and life cycle assessment (LCA). The results were different in some aspects, especially the impacts on eutrophication. According to cross media, the best process is DENO 2, while LCA shows similar impacts for all techniques and the best solution would be the no-treatment option. The main reason to adopt a digestate treatment technique is the lack of area for a correct disposal. If LCA eutrophication results are multiplied with the hectares necessary for each technology, a result similar to that of cross media is obtained.

  9. A comparison between audio and audiovisual distraction techniques in managing anxious pediatric dental patients

    Directory of Open Access Journals (Sweden)

    Prabhakar A

    2007-01-01

    Full Text Available Pain is not the sole reason for fear of dentistry. Anxiety or the fear of unknown during dental treatment is a major factor and it has been the major concern for dentists for a long time. Therefore, the main aim of this study was to evaluate and compare the two distraction techniques, viz, audio distraction and audiovisual distraction, in management of anxious pediatric dental patients. Sixty children aged between 4-8 years were divided into three groups. Each child had four dental visits - screening visit, prophylaxis visit, cavity preparation and restoration visit, and extraction visit. Child′s anxiety level in each visit was assessed using a combination of four measures: Venham′s picture test, Venham′s rating of clinical anxiety, pulse rate, and oxygen saturation. The values obtained were tabulated and subjected to statistical analysis. It was concluded that audiovisual distraction technique was more effective in managing anxious pediatric dental patient as compared to audio distraction technique.

  10. Survival of the Fittest: An Active Queue Management Technique for Noisy Packet Flows

    Directory of Open Access Journals (Sweden)

    Shirish S. Karande

    2007-01-01

    Full Text Available We present a novel active queue management (AQM technique to demonstrate the efficacy of practically harnessing the predictive utility of SSR indications for improved video communication. We consider a network within which corrupted packets are relayed over multiple hops, but a certain percentage of packets needs to be dropped at an intermediate node due to congestion. We propose an AQM technique, survival of the fittest (SOTF, to be employed at the relay node, within which we use packet state information, available from SSR indications and checksums, to drop packets with the highest corruption levels. On the basis of actual 802.11b measurements we show that such a side information (SI aware processing within the network can provide significant performance benefits over an SI-unaware scheme, random queue management (RQM, which is forced to randomly discard packets. With trace-based simulations, we show the utility of the proposed AQM technique in improving the error recovery performance of cross-layer FEC schemes. Finally, with the help of H.264-based video simulations these improvements are shown to translate into a significant improvement in video quality.

  11. Operational Research Techniques Used for Addressing Biodiversity Objectives into Forest Management: An Overview

    Directory of Open Access Journals (Sweden)

    Marta Ezquerro

    2016-10-01

    Full Text Available The integration of biodiversity into forest management has traditionally been a challenge for many researchers and practitioners. In this paper, we have provided a survey of forest management papers that use different Operations Research (OR methods in order to integrate biodiversity objectives into their planning models. One hundred and seventy-nine references appearing in the ISI Web of Science database in the last 30 years have been categorized and evaluated according to different attributes like model components, forest management elements, or biodiversity issues. The results show that many OR methods have been applied to deal with this challenging objective. Thus, up to 18 OR techniques, divided into four large groups, which have been employed in four or more articles, have been identified. However, it has been observed how the evolution of these papers in time apparently tended to increase only until 2008. Finally, two clear trends in this set of papers should be highlighted: the incorporation of spatial analysis tools into these operational research models and, second, the setting up of hybrid models, which combine different techniques to solve this type of problem.

  12. Laparoendoscopic management of concomitant gallbladder stones and common bile duct stones: what is the best technique?

    Science.gov (United States)

    El-Geidie, Ahmed Abdel-Raouf

    2011-08-01

    The intraoperative use of endoscopic retrograde cholangiopancreatography (ERCP) during laparoscopic cholecystectomy (LC) is a safe, single-stage option for the management of concomitant gallstones (GS) and common bile duct stones (CBDS). This study aims to compare between 2 techniques of combined laparoendoscopic management, which are laparoendoscopic Rendez-vous (LC/LERV) technique and standard ERCP after the completion of LC intraoperative endoscopic sphincterotomy (IOES). Patients with GS and suspected CBDS were included. They were divided into 2 groups; LC/LERV and LC/IOES. Both groups were compared for failure of endoscopic sphincterotomy/stone extraction, operative time, conversion rate, mortality/morbidity, and length of hospital stay. Between October 2007 and February 2010, 98 patients with GS and CBDS were eligible for inclusion in the study. They were prospectively randomized into 2 groups; LC/LERV (N=45) and LC/IOES (N=53). There were no differences in preoperative parameters between both groups. There was a significant difference in operative time (shorter for LC/IOES). No difference was noted in success/failure rate, post-ERCP pancreatitis. Both Standard ERCP after the completion of LC and LC/LERV are valid single-session management for CBD stones, but LC-ERCP may be preferred.

  13. Australian, Irish and Swedish women’s perceptions of what assisted them to breastfeed for six months: exploratory design using critical incident technique

    Directory of Open Access Journals (Sweden)

    Yvonne L. Hauck

    2016-10-01

    Full Text Available Abstract Background Breastfeeding initiation rates in some developed countries are high (98 % in Sweden and 96 % in Australia whereas in others, they are not as favourable (46 % to 55 % in Ireland. Although the World Health Organization recommends exclusively breastfeeding for six months, 15 % of Australian women, 11 % of Swedish women and less than 7 % of Irish women achieve this goal. Awareness of what women in different countries perceive as essential breastfeeding support is a gap in our knowledge. Methods Our aim was to explore Australian, Irish and Swedish women’s perceptions of what assisted them to continue breastfeeding for six months. An exploratory design using critical incident techniques was used. Recruitment occurred through advertisements in local newspapers and on social networking platforms. Initial sampling was purposive, followed by snowball sampling. Telephone interviews were conducted with 64 Irish, 139 Swedish and 153 Australian women who responded to one question “what has assisted you to continue breastfeeding for at least six months?” Content analysis was conducted and common categories determined to allow comparison of frequencies and priority ranking. Results Categories reflected the individual mother, her inner social network, her outer social network (informal support either face to face or online, and societal support (health professionals, work environment and breastfeeding being regarded as the cultural norm. Categories ranked in the top five across the three countries were ‘informal face to face support’ and ‘maternal determination’. Swedish and Australian women ranked “health professional support” higher (first and third respectively than Irish women who ranked ‘informal online support’ as second compared to ninth and tenth for Swedish and Australian women. Conclusions The support required to assist breastfeeding women is complex and multi-faceted. Although common international

  14. Radiotracer and sealed source techniques for sediment management. Report of the consultants meeting

    International Nuclear Information System (INIS)

    2008-01-01

    Radioisotopes as tracers and sealed sources have been a useful and often irreplaceable tool for sediment transport studies. Gamma scattering and transmission gauges are used for sediment monitoring. Computational fluid dynamics (CFD) modelling is now an essential tool for the management of the natural systems and are increasingly used to study the fate and behaviour of particulates and contaminants. Radiotracer techniques are often employed to validate CFD models to enhance confidence in the predictive value of the models. Experimental tracing and numerical modelling are complementary methods of studying complex systems. During the last few decades, many radiotracer studies for the investigation of sediment transport in natural systems have been conducted worldwide, and various techniques for tracing and monitoring sediment have been developed by individual tracer groups. However, the developed techniques and methods for sediment tracing have not been compiled yet as a technical document, which is essential for the preservation of the knowledge and transfer of the technology to developing countries. Standard procedures or guidelines for the tracer experiments, which are vital for the reliability of the experiments and the acceptance of end-users, have not been established by the international tracer community either. The use of radiotracers in sediment transport studies demands the additional attention of the community to further develop these techniques and to ensure their transfer to developing countries. The Consultants' Meeting on 'Radiotracer and sealed source techniques for sediment management' was convened at the headquarters of the International Atomic Energy Agency (IAEA) in Vienna, Austria, from 21 to 25 April 2008. Experts from Argentina, Brazil, France, India, Republic of Korea and United Kingdom have been invited to discuss the current status of the tracer and nucleonic gauge technologies as applied for sediment transport investigations and to evaluate

  15. Radiotracer and sealed source techniques for sediment management. Report of the consultants meeting

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-07-01

    Radioisotopes as tracers and sealed sources have been a useful and often irreplaceable tool for sediment transport studies. Gamma scattering and transmission gauges are used for sediment monitoring. Computational fluid dynamics (CFD) modelling is now an essential tool for the management of the natural systems and are increasingly used to study the fate and behaviour of particulates and contaminants. Radiotracer techniques are often employed to validate CFD models to enhance confidence in the predictive value of the models. Experimental tracing and numerical modelling are complementary methods of studying complex systems. During the last few decades, many radiotracer studies for the investigation of sediment transport in natural systems have been conducted worldwide, and various techniques for tracing and monitoring sediment have been developed by individual tracer groups. However, the developed techniques and methods for sediment tracing have not been compiled yet as a technical document, which is essential for the preservation of the knowledge and transfer of the technology to developing countries. Standard procedures or guidelines for the tracer experiments, which are vital for the reliability of the experiments and the acceptance of end-users, have not been established by the international tracer community either. The use of radiotracers in sediment transport studies demands the additional attention of the community to further develop these techniques and to ensure their transfer to developing countries. The Consultants' Meeting on 'Radiotracer and sealed source techniques for sediment management' was convened at the headquarters of the International Atomic Energy Agency (IAEA) in Vienna, Austria, from 21 to 25 April 2008. Experts from Argentina, Brazil, France, India, Republic of Korea and United Kingdom have been invited to discuss the current status of the tracer and nucleonic gauge technologies as applied for sediment transport investigations and to evaluate

  16. Application of simulation techniques for accident management training in nuclear power plants

    International Nuclear Information System (INIS)

    2003-05-01

    core. These capabilities include the optimized use of design margins as well as complementary measures for the prevention of accident progression, its monitoring, and the mitigation of severe accidents. Finally, level 5 includes off-site emergency response measures, the objective of which is to mitigate the radiological consequences of significant releases of radioactive material. Accident management is defined in the IAEA Safety Report on Development and Implementation of Accident Management Programmes in Nuclear Power Plants. The IAEA definitions are in line with the definitions of severe accident management in OECD/NEA documents as given, for example. This report describes simulation techniques used in the training of personnel involved in accident management of NPPs. This concerns both the plant personnel and the persons involved in the management of off-site releases. The report pertains to light water reactors (LWRs) and pressurized heavy water reactors (PHWRs), but it can equally be applied to power reactors of other types. The report is intended for use by experts responsible for planning, developing, executing or supervising the training of personnel involved in the implementation of AMPs in NPPs. It concentrates on existing techniques, but future prospects are also discussed. Various simulation techniques are considered, from incorporating graphical interfaces into existing severe accident codes to full-scope replica simulators. Both preventive and mitigative accident management measures, different training levels and different target personnel groups are taken into account. Based on the available information compiled worldwide, present views on the applicability of simulation techniques for the training of personnel involved in accident management are provided in this report. Apart from the introduction, this report consists of four sections and three appendices. In Section 2, specific aspects of accident management are summarized. Basic approaches in the

  17. Stress Management Apps With Regard to Emotion-Focused Coping and Behavior Change Techniques: A Content Analysis.

    Science.gov (United States)

    Christmann, Corinna Anna; Hoffmann, Alexandra; Bleser, Gabriele

    2017-02-23

    Chronic stress has been shown to be associated with disease. This link is not only direct but also indirect through harmful health behavior such as smoking or changing eating habits. The recent mHealth trend offers a new and promising approach to support the adoption and maintenance of appropriate stress management techniques. However, only few studies have dealt with the inclusion of evidence-based content within stress management apps for mobile phones. The aim of this study was to evaluate stress management apps on the basis of a new taxonomy of effective emotion-focused stress management techniques and an established taxonomy of behavior change techniques. Two trained and independent raters evaluated 62 free apps found in Google Play with regard to 26 behavior change and 15 emotion-focused stress management techniques in October 2015. The apps included an average of 4.3 behavior change techniques (SD 4.2) and 2.8 emotion-focused stress management techniques (SD 2.6). The behavior change technique score and stress management technique score were highly correlated (r=.82, P=.01). The broad variation of different stress management strategies found in this sample of apps goes in line with those found in conventional stress management interventions and self-help literature. Moreover, this study provided a first step toward more detailed and standardized taxonomies, which can be used to investigate evidence-based content in stress management interventions and enable greater comparability between different intervention types. ©Corinna Anna Christmann, Alexandra Hoffmann, Gabriele Bleser. Originally published in JMIR Mhealth and Uhealth (http://mhealth.jmir.org), 23.02.2017.

  18. Photoselective Vaporisation of the Bladder for the Management of Radiation Cystitis - Technique and Initial Outcomes.

    Science.gov (United States)

    Pascoe, Claire; Christidis, Daniel; Manning, Todd; Lamb, Benjamin W; Murphy, Declan G; Lawrentschuk, Nathan

    2018-05-16

    Objective To describe our technique utilising photoselective vaporisation of the bladder (PVB) for the management of haemorrhagic cystitis and initial results of 12 patients. Materials and Method An audit of theatre records of a single surgeon was performed to identify patients who had undergone PVB for management of radiation-cystitis. Rigid cystoscopy was performed. Ureteric catheters were placed and active bleeding sites targeted to optimise vision. Ablation was commenced using the vaporize function. When lasering around delicate structures the coagulation function was used. Ureteric catheters remained in situ for 24h. An 18Fr Foley catheter was placed. When urine output was clear continuous bladder irrigation was ceased. Both uretetric catheters and Foley catheter were removed prior to the 24hour mark. Results 12 patients were identified. 8 had previously required blood transfusion secondary to bladder haemorrhage. 9 were successfully treated and 2 saw improvement in haematuria but required a repeat procedure at 3 weeks post operatively. 4 went on to receive hyperbaric oxygenation as consolidative therapy. 1 patient was unsuccessfully treated and went on to cystectomy. There were no mortalities. No patients sustained bladder perforation or damage to surrounding structures. Conclusion Radiation cystitis can be life threatening and remains a challenge for the urologist with traditional intra-vescical treatments such as aluminium or formalin having variable results. We present an alternate technique using PVB to ablate the bladder mucosa, with good results. Consolidation with hyperbaric oxygen therapy may be considered. Our study is limited by small sample size and the presence of bilateral ureteric catheters leaving the bladder free from urine may impact immediate post operative outcomes. These initial results are promising however further prospective evaluation with a larger cohort and pre and post operative cystograms would enable better evaluation of this

  19. Scientific or rule-of-thumb techniques of ground-water management--Which will prevail?

    Science.gov (United States)

    McGuinness, Charles Lee

    1969-01-01

    Emphasis in ground-water development, once directed largely to quantitatively minor (but sociologically vital) service of human and stock needs, is shifting: aquifers are treated as possible regulating reservoirs managed conjunctively with surface water. Too, emphasis on reducing stream pollution is stimulating interest in aquifers as possible waste-storage media. Such management of aquifers requires vast amounts of data plus a much better understanding of aquifer-system behavior than now exists. Implicit in this deficiency of knowledge is a need for much new research, lest aquifers be managed according to ineffective rule-of-thumb standards, or even abandoned as unmanageable. The geohydrologist's task is to define both internal and boundary characteristics of aquifer systems. Stratigraphy is a primary determinant of these characteristics, but stratigraphically minor features may make aquifers transcend stratigraphic boundaries. For example, a structurally insignificant fracture may carry more water than a major fault; a minor stratigraphic discontinuity may be a major hydrologic boundary. Hence, there is a need for ways of defining aquifer boundaries and quantifying aquifer and confining-bed characteristics that are very different from ordinary stratigraphic techniques. Among critical needs are techniques for measuring crossbed permeability; for extrapolating and interpolating point data on direction and magnitude of permeability in defining aquifer geometry; and for accurately measuring geochemical properties of water and aquifer material, and interpreting those measurements in terms of source of water, rate of movement, and waste-sorbing capacities of aquifers and of confining beds--in general, techniques adequate for predicting aquifer response to imposed forces whether static, hydraulic, thermal, or chemical. Only when such predictions can be made routinely can aquifer characteristics be inserted into a master model that incorporates both the hydrologic and

  20. Virtual Power Plant and Microgrids controller for Energy Management based on optimization techniques

    Directory of Open Access Journals (Sweden)

    Maher G. M. Abdolrasol

    2017-06-01

    Full Text Available This paper discuss virtual power plant (VPP and Microgrid controller for energy management system (EMS based on optimization techniques by using two optimization techniques namely Backtracking search algorithm (BSA and particle swarm optimization algorithm (PSO. The research proposes use of multi Microgrid in the distribution networks to aggregate the power form distribution generation and form it into single Microgrid and let these Microgrid deal directly with the central organizer called virtual power plant. VPP duties are price forecast, demand forecast, weather forecast, production forecast, shedding loads, make intelligent decision and for aggregate & optimizes the data. This huge system has been tested and simulated by using Matlab simulink. These paper shows optimizations of two methods were really significant in the results. But BSA is better than PSO to search for better parameters which could make more power saving as in the results and the discussion.