Professionally responsible intrapartum management of patients with major mental disorders.

Science.gov (United States)

Babbitt, Kriste E; Bailey, Kala J; Coverdale, John H; Chervenak, Frank A; McCullough, Laurence B

2014-01-01

Pregnant women with major mental disorders present obstetricians with a range of clinical challenges, which are magnified when a psychotic or agitated patient presents in labor and there is limited time for decision making. This article provides the obstetrician with an algorithm to guide professionally responsible decision making with these patients. We searched for articles related to the intrapartum management of pregnant patients with major mental disorders, using 3 main search components: pregnancy, chronic mental illness, and ethics. No articles were found that addressed the clinical ethical challenges of decision making during the intrapartum period with these patients. We therefore developed an ethical framework with 4 components: the concept of the fetus as a patient; the presumption of decision-making capacity; the concept of assent; and beneficence-based clinical judgment. On the basis of this framework we propose an algorithm to guide professionally responsible decision making that asks 5 questions: (1) Does the patient have the capacity to consent to treatment?; (2) Is there time to attempt restoration of capacity?; (3) Is there an opportunity for substituted judgment?; (4) Is the patient accepting treatment?; (5) Is there an opportunity for active assent?; and (6) coerced clinical management as the least worst alternative. The algorithm is designed to support a deliberative, clinically comprehensive, preventive-ethics approach to guide obstetricians in decision making with this challenging population of patients. Copyright © 2014 Mosby, Inc. All rights reserved.

Challenges and opportunities associated with waste management in India

Science.gov (United States)

Kumar, Sunil; Smith, Stephen R.; Fowler, Geoff; Velis, Costas; Kumar, S. Jyoti; Arya, Shashi; Rena; Kumar, Rakesh

2017-01-01

India faces major environmental challenges associated with waste generation and inadequate waste collection, transport, treatment and disposal. Current systems in India cannot cope with the volumes of waste generated by an increasing urban population, and this impacts on the environment and public health. The challenges and barriers are significant, but so are the opportunities. This paper reports on an international seminar on ‘Sustainable solid waste management for cities: opportunities in South Asian Association for Regional Cooperation (SAARC) countries’ organized by the Council of Scientific and Industrial Research-National Environmental Engineering Research Institute and the Royal Society. A priority is to move from reliance on waste dumps that offer no environmental protection, to waste management systems that retain useful resources within the economy. Waste segregation at source and use of specialized waste processing facilities to separate recyclable materials has a key role. Disposal of residual waste after extraction of material resources needs engineered landfill sites and/or investment in waste-to-energy facilities. The potential for energy generation from landfill via methane extraction or thermal treatment is a major opportunity, but a key barrier is the shortage of qualified engineers and environmental professionals with the experience to deliver improved waste management systems in India. PMID:28405362

Challenges and opportunities associated with waste management in India.

Science.gov (United States)

Kumar, Sunil; Smith, Stephen R; Fowler, Geoff; Velis, Costas; Kumar, S Jyoti; Arya, Shashi; Rena; Kumar, Rakesh; Cheeseman, Christopher

2017-03-01

India faces major environmental challenges associated with waste generation and inadequate waste collection, transport, treatment and disposal. Current systems in India cannot cope with the volumes of waste generated by an increasing urban population, and this impacts on the environment and public health. The challenges and barriers are significant, but so are the opportunities. This paper reports on an international seminar on 'Sustainable solid waste management for cities: opportunities in South Asian Association for Regional Cooperation (SAARC) countries' organized by the Council of Scientific and Industrial Research-National Environmental Engineering Research Institute and the Royal Society. A priority is to move from reliance on waste dumps that offer no environmental protection, to waste management systems that retain useful resources within the economy. Waste segregation at source and use of specialized waste processing facilities to separate recyclable materials has a key role. Disposal of residual waste after extraction of material resources needs engineered landfill sites and/or investment in waste-to-energy facilities. The potential for energy generation from landfill via methane extraction or thermal treatment is a major opportunity, but a key barrier is the shortage of qualified engineers and environmental professionals with the experience to deliver improved waste management systems in India.

Challenges in diabetes mellitus type 2 management in Nepal

DEFF Research Database (Denmark)

Gyawali, Bishal; Ferrario, Alessandra; van Teijlingen, Edwin

2016-01-01

references. Results Diabetes mellitus type 2 is emerging as a major health care problem in Nepal, with rising prevalence and its complications especially in urban populations. Several challenges in diabetes management were identified, including high cost of treatment, limited health care facilities, and lack...... on the prevalence, cost and treatment of diabetes mellitus type 2 and its complications in Nepal and to critically assess the challenges to be addressed to contain the epidemic and its negative economic impact. Design A comprehensive review of available evidence and data sources on prevalence, risk factors, cost...

Challenges in Request Management

DEFF Research Database (Denmark)

Sommer, Anita Friis

2014-01-01

and its customers. The study provides an insight into a new area of supply chain management, including the process activity flow and challenges involved across the process. Furthermore, the method is dyadic including the customer in the case study, which is rare in related research....... profitability. This research study seeks to investigate the challenges of RQM in practice. Existing demand chain management literature is used as a basis for developing a RQM framework. RQM is investigated through an explorative research design in a dyadic B2B case study including a global industrial company......Request management (RQM) is a new term used for managing customer requests for new products. It is the counterpart to typical product development processes, which has no direct customer involvement. It is essential to manage customer requests in a structured and efficient way to obtain...

Challenges for the comprehensive management of Cloud Services in a PaaS framework

NARCIS (Netherlands)

Garcia-Gomez, S.; Jimenez-Ganan, M.; Taher, Y.; Momm, C.; Junker, F.; Biro, J.; Menychtas, A.; Andrikopoulos, V.; Strauch, S.

2012-01-01

The 4CaaSt project aims at developing a PaaS framework that enables flexible definition, marketing, deployment and management of Cloud-based services and applications. This paper describes the major challenges tackled by 4CaaSt for the comprehensive management of applications and services in a PaaS.

Homeland Security. Management Challenges Facing Federal Leadership

Science.gov (United States)

2002-12-01

Security Management Challenges Facing Federal Leadership 5a. CONTRACT NUMBER 5b. GRANT NUMBER 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT...including attention to management practices and key success factors. HOMELAND SECURITY Management Challenges Facing Federal Leadership www.gao.gov/cgi...significant management and coordination challenges if it is to provide this leadership and be successful in preventing and responding to any future

Challenges in diabetes mellitus type 2 management in Nepal

DEFF Research Database (Denmark)

Gyawali, Bishal; Ferrario, Alessandra; van Teijlingen, Edwin

2016-01-01

on the prevalence, cost and treatment of diabetes mellitus type 2 and its complications in Nepal and to critically assess the challenges to be addressed to contain the epidemic and its negative economic impact. DESIGN: A comprehensive review of available evidence and data sources on prevalence, risk factors, cost......, complications, treatment, and management of diabetes mellitus type 2 in Nepal was conducted through an online database search for articles published in English between January 2000 and November 2015. Additionally, we performed a manual search of articles and reference lists of published articles for additional...... references. RESULTS: Diabetes mellitus type 2 is emerging as a major health care problem in Nepal, with rising prevalence and its complications especially in urban populations. Several challenges in diabetes management were identified, including high cost of treatment, limited health care facilities...

The Green Challenge in Constrution Management

DEFF Research Database (Denmark)

Christensen, Knud

1999-01-01

In the years to come,the building and constuction industry,will be met with an increasing amaount of environmental management demands.Contractors can prepare themselves to meet these challenges by devoloping environmental management systems.......In the years to come,the building and constuction industry,will be met with an increasing amaount of environmental management demands.Contractors can prepare themselves to meet these challenges by devoloping environmental management systems....

Past and future challenges in managing European seas

Directory of Open Access Journals (Sweden)

Thorsten Blenckner

2015-03-01

Full Text Available Marine environments have undergone large-scale changes in recent decades as a result of multiple anthropogenic pressures, such as overfishing, eutrophication, habitat fragmentation, etc., causing often nonlinear ecosystem responses. At the same time, management institutions lack the appropriate measures to address these abrupt transformations. We focus on existing examples from social-ecological systems of European seas that can be used to inform and advise future management. Examples from the Black Sea and the Baltic Sea on long-term ecosystem changes caused by eutrophication and fisheries, as well as changes in management institutions, illustrate nonlinear dynamics in social-ecological systems. Furthermore, we present two major future challenges, i.e., climate change and energy intensification, that could further increase the potential for nonlinear changes in the near future. Practical tools to address these challenges are presented, such as ensuring learning, flexibility, and networking in decision-making processes across sectors and scales. A combination of risk analysis with a scenario-planning approach might help to identify the risks of ecosystem changes early on and may frame societal changes to inform decision-making structures to proactively prevent drastic surprises in European seas.

Knowledge Management Challenges For Global Business

OpenAIRE

Veli Denizhan Kalkan

2011-01-01

Managing organizational knowledge effectively is a prerequisite for securing competitive advantages in the global marketplace. The field of knowledge management brings out important challenges for global business practices. Based on a comprehensive academic and popular literature review, this paper identifies six main knowledge management challenges faced by global business today. These are developing a working definition of knowledge, dealing with tacit knowledge and utilization of informati...

Managing the Fukushima Challenge

Science.gov (United States)

Suzuki, Atsuyuki

2014-01-01

The Fukushima Daiichi accident raises a fundamental question: Can science and technology prevent the inevitability of serious accidents, especially those with low probabilities and high consequences? This question reminds us of a longstanding challenge with the trans-sciences, originally addressed by Alvin Weinberg well before the Three Mile Island and Chernobyl accidents. This article, revisiting Weinberg's issue, aims at gaining insights from the accident with a special emphasis on the sociotechnical or human behavioral aspects lying behind the accident's causes. In particular, an innovative method for managing the challenge is explored referring to behavioral science approaches to a decision-making process on risk management; such as managing human behavioral risks with information asymmetry, seeking a rational consensus with communicative action, and pursuing procedural rationality through interactions with the outer environment. In short, this article describes the emerging need for Japan to transform its national safety management institutions so that these might be based on interactive communication with parties inside and outside Japan. PMID:24954604

Challenges faced in rural hospitals: the experiences of nurse managers in Uganda.

Science.gov (United States)

Kakyo, T A; Xiao, L D

2018-04-19

The aim of this study was to understand nurse ward managers perceived challenges in the rural healthcare setting in Uganda. The health workforce, essential medicines and equipment and political unrest are the main factors affecting the international community in addressing the hefty disease burden in World Health Organization African regions. Nurse ward managers have an important role to play to mitigate these factors in health facilities in these regions through leadership, supervision and support for staff. This study utilized interpretive phenomenology based on Gadamer's hermeneutical principles. Eleven nurse managers from two rural public hospitals in Uganda were interviewed. Those with more than a 2-year experience in their management role were invited to participate in the study. Nurse managers pointed out four major challenges with staffing, while they worked in the rural healthcare settings. These are summarized into themes: 'Numbers do matter'; 'I cannot access them when I need them at work'; 'Challenges in dealing with negative attitudes'; and 'Questioning own ability to manage health services'. Health facilities in rural areas face extremely low staff-to-patient ratio, a high level of workload, lack of essential medicines and equipment, low salaries and delayed payment for staff. Nurse managers demonstrated situation-based performance to minimize the impact of these challenges on the quality and safety of patient care, but they had less influence on policy and resource development. It is imperative to mobilize education for nurse ward managers to enable them to improve leadership, management skills and to have a greater impact on policy and resource development. © 2018 International Council of Nurses.

The quest for nuclear technology and the challenges of knowledge management in Nigeria

International Nuclear Information System (INIS)

Mundu, A.; Umar, A.M.

2004-01-01

The major milestones in the quest for nuclear technology were highlighted, followed by a review of nuclear application in research and development, health, water resource management and agriculture.the past activities of the national INIS centre particularly with respect to submission of input, promotion and knowledge management were examined. And a repositioned INIS centre to meet the challenges of nuclear information management and the emerging trend in knowledge management was presented with specific target in the short and the long term. (author)

Challenges for municipal solid waste management practices in Vietnam

Directory of Open Access Journals (Sweden)

Nguyen Duc Luong

2013-11-01

Full Text Available Municipal solid waste (MSW management is currently one of the major environmental problems facing by Vietnam. Improper management of MSW has caused adverse impacts on the environment, community health, and social-economic development. This study attempts to provide a review of the generation and characterization, disposal and treatment technologies of MSW to evaluate the current status and identify the problems of MSW management practices in Vietnam. Finally, this study is concluded with fruitful recommendations which may be useful in encouraging the responsible agencies to work towards the further improvement of the existing MSW management system.Doi: http://dx.doi.org/10.12777/wastech.1.1.17-21Citation:  Luong, N.D., Giang, H.M., Thanh, B.X. and Hung, N.T.  2013. Challenges for municipal solid waste management practices in Vietnam. Waste Technology 1(1:6-9.Doi: http://dx.doi.org/10.12777/wastech.1.1.17-21

Pregnancy and pituitary disorders: Challenges in diagnosis and management

Directory of Open Access Journals (Sweden)

Bashir A Laway

2013-01-01

Full Text Available Pregnancy is associated with normal physiological changes in endocrine system that assists fetal survival as well as preparation of labor. The pituitary gland is one of the most affected organs in which major changes in anatomy and physiology take place. Due to overlapping clinical and biochemical features of pregnancy, sometimes the diagnosis of pituitary disorders may be challenging. It is important to know what normal parameters of changes occur in endocrine system in order to diagnose and manage complex endocrine problems in pregnancy. In our present review, we will focus on pituitary disorders that occur exclusively during pregnancy like Sheehan′s syndrome and lymphocytic hypophysitis and pre-existing pituitary disorders (like prolactinoma, Cushing′s disease and acromegaly, which poses significant challenge to endocrinologists.

EMERGING CHALLENGES IN THE MANAGEMENT OF CONTEMPORARY PUBLIC SPACES IN URBAN NEIGHBOURHOODS

Directory of Open Access Journals (Sweden)

Rajjan Man Chitrakar

2017-03-01

Full Text Available The lack of management has led to the degrading quality of public space in modern cities around the globe. Contemporary public spaces are facing challenges in terms of maintaining them as a “social space” so that they are accessible and functional for the users. Using Kathmandu as a case study, this paper explores the challenges the contemporary public spaces within urban neighbourhoods are facing in their management. The study reveals that the regulation of use is a major concern of public space management in the new neighbourhoods of Kathmandu as evident in the limited accessibility and utility of public space, due to control and commercialisation. The use of public space has also been affected by the lack of regular maintenance. The root cause of these problems lies in weak urban governance at the neighbourhood level, which has led the local community-based organisations to take a role in neighbourhood management. These findings confirm that the management of public space is a critical issue of urban development with commonalities existing across geographical regions that demand adequate consideration from the stakeholders.

Clinical Parameters and Challenges of Managing Cervicofacial ...

African Journals Online (AJOL)

Introduction: Necrotizing fasciitis is a severe soft tissue infection. In our environment, patients presenting with this infection are usually financially incapacitated and, therefore, their management can be challenging. This paper aimed to document the pattern and challenges encountered in the management of cervicofacial ...

Project management of life-science research projects: project characteristics, challenges and training needs.

Science.gov (United States)

Beukers, Margot W

2011-02-01

Thirty-four project managers of life-science research projects were interviewed to investigate the characteristics of their projects, the challenges they faced and their training requirements. A set of ten discriminating parameters were identified based on four project categories: contract research, development, discovery and call-based projects--projects set up to address research questions defined in a call for proposals. The major challenges these project managers are faced with relate to project members, leadership without authority and a lack of commitment from the respective organization. Two-thirds of the project managers indicated that they would be interested in receiving additional training, mostly on people-oriented, soft skills. The training programs that are currently on offer, however, do not meet their needs. Copyright © 2010 Elsevier Ltd. All rights reserved.

The Management of Managers: Challenges in a Small Economy

Science.gov (United States)

Gilbert, John; Boxall, Peter

2009-01-01

Purpose: The purpose of this paper is to discuss the findings of a study of the management of senior managers. The aim is to describe the ways in which firms in a small economy, such as New Zealand, manage their managers and analyse how they deal with the strategic challenges that are involved. Design/methodology/approach: The study applies the…

Challenges for nurse managers in China.

Science.gov (United States)

Wong, Frances Kam Yuet

2010-07-01

To critically review the challenges facing nurse leaders in China during healthcare reform. China is now undergoing a major reform aimed at enhancing the accessibility and quality of its healthcare at a level that is affordable to the people. Nurses have a key role to play in this reform. Key documents produced by the government of China were critically reviewed using the strengths, weaknesses, opportunities and threats (SWOT) framework. A number of factors, including the insufficient number of nurses and the medical orientation of the health system, have hindered the development of nursing. However, healthcare reform has created new opportunities for nurses and nursing. This paper reviews the strengths, weaknesses, opportunities and threats faced by nurse managers in China. It identifies barriers but also possibilities for nurse leaders to advance nursing and make nurses visible in this era of transforming healthcare. Many of the issues identified in this review, such as the enhancement of quality and accessibility of care, are important to nurse leaders around the world. However, this article reveals the particular challenges faced by nurse leaders in China, with its unique social and historical background.

Managing voluntary turnover through challenging assignments

NARCIS (Netherlands)

Preenen, P.T.Y.; de Pater, I.E.; van Vianen, A.E.M.; Keijzer, L.

2011-01-01

This study examines employees’ challenging assignments as manageable means to reduce turnover intentions, job search behaviors, and voluntary turnover. Results indicate that challenging assignments are negatively related to turnover intentions and job search behaviors and that these relationships

Managing voluntary turnover through challenging assignments

NARCIS (Netherlands)

Preenen, P.T.Y.; Pater, I.E. de; Vianen, A.E.M. van; Keijzer, L.

2011-01-01

This study examines employees' challenging assignments as manageable means to reduce turnover intentions, job search behaviors, and voluntary turnover. Results indicate that challenging assignments are negatively related to turnover intentions and job search behaviors and that these relationships

The match between institutional elderly care management research and management challenges - a systematic literature review.

Science.gov (United States)

Kokkonen, Kaija; Rissanen, Sari; Hujala, Anneli

2012-11-08

Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents. This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents. The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents. Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers' and policymakers' scientific literacy needs to be enhanced.

The match between institutional elderly care management research and management challenges - a systematic literature review

Science.gov (United States)

2012-01-01

Background Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents. Methods This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents. Results The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents. Conclusions Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers’ and policymakers’ scientific literacy needs to be enhanced. PMID:23137416

The match between institutional elderly care management research and management challenges - a systematic literature review

Directory of Open Access Journals (Sweden)

Kokkonen Kaija

2012-11-01

Full Text Available Abstract Background Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents. Methods This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents. Results The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents. Conclusions Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers’ and policymakers’ scientific literacy needs to be enhanced.

Management between Passion and Challenges

Directory of Open Access Journals (Sweden)

Gheorghe Popovici

2015-12-01

Full Text Available The paper presents the results of the survey on the management between passion and challenges practised by new managers in the Mountainous Banat. In this post-crisis period, managers have become more cautions and more reluctant, on the one hand, and they have had to become more creative in using the resources at their disposal, on the other hand. The paper proposes a new “profile” of manager for the near future. The two categories of managers, focused on survival and driven by unconventional evolution, exist in parallel and that is why this study presents the results and recommendations for another type of management, which the present and future managers may or not take into account.

Development of the German network for transporting electricity: A major challenge for managers

International Nuclear Information System (INIS)

Feix, Olivier

2013-01-01

The catastrophe at the Japanese nuclear power plant in Fukushima has deeply altered Germany's energy policy. The news from Japan forced the federal government to step up its efforts so as to expand more quickly the share of renewable sources in the German energy mix and, on short notice, put an end to nuclear power. This Energiewende, as the Germans call it, is a major policy priority for the government and an outstanding project that mobilizes all of German society. This turning point in energy policy has entailed rewriting several laws so as to provide a legal framework for the transition. Most stakeholders expect that important amendments will be made to the texts directly related to production facilities. What is noticeable and even surprising is the scope of the changes in laws about electricity grids, in particular about managing and developing the network for transporting electricity

50 top IT project management challenges

CERN Document Server

Doraiswamy, Premanand

2012-01-01

This book offers a focused and concise summary of 50 challenges facing today's IT project manager. The authors draw on years of practical experience (rather than classroom theory) to outline these challenges and offer useful tips and advice on how to deal with them.

KNOWLEDGE MANAGEMENT CHALLENGES IN NEW BUSINESS DEVELOPMENT

DEFF Research Database (Denmark)

Jensen, Ole Kjeldal; Ahmed-Kristensen, Saeema; Jensen, Nevena

2011-01-01

The empirical study this paper is based upon, aimed to identify and describe knowledge management challenges, throughout the new business development process. This paper reports findings from the study, as well as the framework used for analysing the KM challenges, which can be applied to other...... in the early phases. Furthermore, two new roles of the early phase, besides instigating projects, were found. This study contributes to the development of support tools for knowledge management in industry and to research with a deeper understanding of the new business development process....... case studies for comparison. Six interviews and 2 full-day workshops, gathering the perspectives of 76 people from an energy-utilities company forms the empirical background of the study. Six categories of knowledge management challenges were identified and, within each, central issues were extracted...

Implementing Environmental Management Accounting: Status and Challenges

DEFF Research Database (Denmark)

Cost Accounting - and its Interaction with Eco-Efficiency Performance Measurement and Indicators; Stefan Schaltegger and Marcus Wagner. 4. Environmental Accounting Dimensions: Pros and Cons of Trajectory Convergence and Increased Efficiency; Pontus Cerin and Staffan Laestadius. 5. Process and Content......Table of contents Preface. 1. Environmental Management Accounting: Innovation or Managerial Fad?; Pall Rikhardsson, Martin Bennett, Jan Jaap Bouma and Stefan Schaltegger. Section 1 Progress. 2. Challenges for Environmental Management Accounting; Roger L. Burritt 3. Current Trends in Environmental......: Visualizing the Policy Challenges of Environmental Management Accounting; Dick Osborn. Section 2 Exploring EMA implementation issues. 6. Environmental Performance and the Quality of Corporate Environmental Reports: The Role of Environmental Management Accounting; Marcus Wagner. 7. Environmental Risk...

Management challenges in an information communication ...

African Journals Online (AJOL)

Information Communication Technologies (ICTs) play an important role in reforming education. This study concentrated on the key managerial challenges to leaders when faced with introducing, accepting and managing new technology in their schools. The purpose of the study was to describe the management approach ...

Urban solid waste management in Chongqing: Challenges and opportunities

International Nuclear Information System (INIS)

Yuan Hui; Wang Li'ao; Su Fenwei; Hu Gang

2006-01-01

The dual influences of the resource supply and protection in ecological environments will pose a significant challenge to China's sustainable development. Solid waste management offers opportunities to improve profits by conserving resources and improving environmental performance. This paper examines municipal solid waste (MSW) management in urban Chongqing, the nation's fourth largest municipality after Beijing, Shanghai and Tianjin. In this paper, we will provide information on the quantity and composition of MSW, as well as give an overview of different methods for collection, transport, treatment and disposal of MSW. At present the daily amount of MSW generated per person is about 1.08 kg; food waste accounts for about 59% of total MSW. MSW in Chongqing has a higher moisture content (64.1%) and a lower LHV (3728 kJ/kg) than other cities in Asia, which is an obstruction for incineration. Landfills are the main method of disposal in Chongqing, but pollution caused by simple landfills and lack of backup MSW disposal capacity are becoming major problems in the main districts of Chongqing. In this paper, the challenges being faced and opportunities to MSW in Chongqing are analyzed and some suggestions are given for improving the MSW system in the future

Hand hygiene management among nurses: collective health challenges

Directory of Open Access Journals (Sweden)

João Manuel Graveto

Full Text Available ABSTRACT Objective: To describe the determining factors in hand hygiene management among nurses and identify associated collective health challenges. Method: Cross-sectional descriptive study. Data were collected using a questionnaire that was applied in four internal medicine units of a hospital of reference in Portugal. Results: The sample was composed of 50 nurses aged 26 to 55 years (mean age of 34.88 years; 80% were women, 58% had a Bachelor’s degree, and had 5-30 years of nursing practice (X̄ =11.94;±5.92. The vast majority of nurses (90% reported complying with the existing recommendations on hand hygiene in pre-established moments. However, none of the nurses were able to identify all the moments for hand hygiene using water and soap or alcohol-based handrub. Conclusion: This study shows that continuous training, adequate materials/structures in the units, and redesigned administration/supervision practices are determining factors to achieve higher levels of adherence to hand hygiene among nurses, as well as increased quality and safety in care delivery, which is a current collective health challenge.

The medical leadership challenge in healthcare is an identity challenge.

Science.gov (United States)

Andersson, Thomas

2015-01-01

The purpose of this article is to describe and analyse the identity challenges that physicians with medical leadership positions face. Four qualitative case studies were performed to address the fact that identity is processual, relational and situational. Physicians with managerial roles were interviewed, as well as their peers, supervisors and subordinates. Furthermore, observations were made to understand how different identities are displayed in action. This study illustrates that medical leadership implies identity struggles when physicians have manager positions, because of the different characteristics of the social identities of managers and physicians. Major differences are related between physicians as autonomous individuals in a system and managers as subordinates to the organizational system. There are psychological mechanisms that evoke the physician identity more often than the managerial identity among physicians who are managers, which explains why physicians who are managers tend to remain foremost physicians. The implications of the findings, that there are major identity challenges by being both a physician and manager, suggest that managerial physicians might not be the best prerequisite for medical leadership, but instead, cooperative relationships between physicians and non-physician managers might be a less difficult way to support medical leadership. Acknowledging and addressing identity challenges can be important both in creating structures in organizations and designing the training for managers in healthcare (both physicians and non-physicians) to support medical leadership. Medical leadership is most often related to organizational structure and/or leadership skills, but this paper discusses identity requirements and challenges related to medical leadership.

Smart garments in chronic disease management: progress and challenges

Science.gov (United States)

Khosla, Ajit

2012-10-01

This paper presents the progress made developments in the area of Smart Garments for chronic disease management over last 10 years. A large number of health monitoring smart garments and wearable sensors have been manufactured to monitor patient's physiological parameters such as electrocardiogram, blood pressure, body temperature, heart rate, oxygen saturation, while patient is not in hospital. In last few years with the advancement in smartphones and cloud computing it is now possible to send the measure physiological data to any desired location. However there are many challenges in the development of smart garment systems. The two major challenges are development of new lightweight power sources and there is a need for global standardization and a road map for development of smart garments. In this paper we will discuss current state-of-theart smart garments and wearable sensor systems. Also discussed will be the new emerging trends in smart garment research and development.

A challenge for computing in the 21. century: Radwaste knowledge management

International Nuclear Information System (INIS)

Umeki, H.

2007-01-01

Integrated nuclear waste management, including waste disposal, is a technical area characterised by a breadth of required multidisciplinary knowledge that is wider than almost any other industry - covering geology to radiation physics, materials science to microbiology, archaeology to engineering, public communication to advanced IT. It also has an unparalleled depth in time, in terms of project implementation (around 100 years - matched maybe by some medieval cathedrals) and the associated safety case (millions of years - longer than the existence of modern man). If anything, this is even more critical in Japan; which depends on a major nuclear power industry, has complex (and dynamic) geology and a policy of repository siting based on solicitation of volunteer municipalities. The technical challenge of Knowledge Management in such an area, which is suffering more than most from the information explosion caused by the exponentially increasing capacities of modern technology, are truly daunting. In order to take control of the situation, the main R and D organisation in this area (Japan Atomic Energy Agency; JAEA) is planning to develop a Knowledge Management System (KMS) that will ride the wave of cutting edge technology in: Database development and management; Search engines; Expert systems; Management support systems; Security and archiving. This initiative will be complemented by a major reassessment of the modelling approach to performance assessment of repositories and the technology for communication of such complex issues with a wide range of different audiences. The requirements as specified go beyond anything doable with existing technology, so an initial goal will be to build up a team capable of anticipating the areas of active technology development that will provide the required tools - and then tailoring them to provide the infrastructure needed for these very ambitious projects. Although this particular application is of limited scope, the general

CHALLENGES IN THE MANAGEMENT OF GLAUCOMA IN A DEVELOPING COUNTRY; A QUALITATIVE STUDY OF PROVIDERS' PERSPECTIVES.

Science.gov (United States)

Adekoya, B J; Adepoju, F G; Moshood, K F; Balarabe, A H

2015-01-01

Glaucoma management is challenging to patients as well as to the eye care providers. The study is aimed at describing the challenges faced by providers using qualitative methods. In-depth interviews were conducted with selected Ophthalmologists and resident doctors in ophthalmology at centres offering medical and surgical glaucoma services in Lagos state, Nigeria, according to established qualitative methods. This was done using semi-structured, open ended questions to explore the providers' perspective on glaucoma burden, challenges in the management, surgery for glaucoma, acceptance of glaucoma surgery by patients, and recommendations for improving glaucoma services. The discussions were recorded with the aid of a micro-cassette recorder. Familiarisation was done to identify key ideas in the data, then, the main themes and sub-themes were identified. Quotes that reflect the themes and sub-themes were then identified in the data. In-depth interviews were conducted with a total of 11 ophthalmologists and resident doctors in training. Majority were of the opinion that glaucoma is a significant burden constituting about 35% of outpatient visits. Identified patient related challenges include; late presentation, lack of glaucoma awareness, delay in referral from optometrists, and poor compliance with medications. Shortages in needed equipment were also identified. Availability, affordability and counterfeiting of drugs were the major challenges related to medical treatment. Majority of the participants agreed that surgery should be offered to the patients as soon as the diagnosis of glaucoma is made. However, continuous monitoring of the patient on medical treatment is another line of option for them in early cases; if they are convinced the patients will be compliant. Some respondents considered the current number of glaucoma surgeries as adequate, while some think otherwise. Reasons put forward for reluctance to offer glaucoma surgery include; late presentation, lack

Dune management challenges on developed coasts

Science.gov (United States)

Elko, Nicole A.; Brodie, Kate; Stockdon, Hilary F.; Nordstrom, Karl F.; Houser, Chris; McKenna, Kim; Moore, Laura; Rosati, Julie D.; Ruggiero, Peter; Thuman, Roberta; Walker, Ian J.

2015-01-01

From October 26-28, 2015, nearly 100 members of the coastal management and research communities met in Kitty Hawk, NC, USA to bridge the apparent gap between the coastal dune research of scientists and engineers and the needs of coastal management practitioners. The workshop aimed to identify the challenges involved in building and managing dunes on developed coasts, assess the extent to which scientific knowledge can be applied to the management community, and identify approaches to provide means to bridge the gap between needs and potential solutions.

Conservation biology in Asia: the major policy challenges.

Science.gov (United States)

McNeely, Jeffrey A; Kapoor-Vijay, Promila; Zhi, Lu; Olsvig-Whittaker, Linda; Sheikh, Kashif M; Smith, Andrew T

2009-08-01

With about half the world's human population and booming economies, Asia faces numerous challenges to its biodiversity. The Asia Section of the Society for Conservation Biology has identified some key policy issues in which significant progress can be made. These include developing new sources of funding for forest conservation; identifying potential impacts of energy alternatives on the conservation of biodiversity; curbing the trade in endangered species of plants and animals; a special focus on the conservation of mountain biodiversity; enhancing relevant research; ensuring that conservation biology contributes to major international conventions and funding mechanisms; using conservation biology to build a better understanding of zoonotic diseases; more effectively addressing human-animal conflicts; enhancing community-based conservation; and using conservation biology to help address the pervasive water-deficit problems in much of Asia. These challenges can be met through improved regional cooperation among the relevant stakeholders.

The challenges of managing migration

Energy Technology Data Exchange (ETDEWEB)

Tacoli, Cecilia

2005-10-15

Migration and urbanisation are driven by economic growth and social change, but also by deepening inequalities. Managing migration should not be equated with curbing it, as this inevitably reduces migrants' rights. But managing population movement whilst respecting the rights of migrants and nonmigrants, supporting the contribution of migration to poverty reduction and economic growth in sending and receiving areas and reducing the human and material costs of movement means that fundamental challenges need to be addressed.

Challenge Problem Development and Evaluation Management

National Research Council Canada - National Science Library

Schrag, Robert

2001-01-01

This final report describes work performed by Information Extraction & Transport (IET), Inc. on Challenge Problem Development and Evaluation Management for the Defense Advanced Research Projects Agency's...

Human resource management and technological challenges

CERN Document Server

Davim, J

2014-01-01

This book focuses on the challenges and changes that new technologies bring to human resources (HR) of modern organizations. It examines the technological implications of the last changes taking place and how they affect the management and motivation of human resources belonging to these organizations. It looks for ways to understand and perceive how organizational HR, individually and as a team, conceptualize, invent, adapt, define and use organizational technology, as well as how they are constrained by features of it. The book provides discussion and the exchange of information on principles, strategies, models, techniques, methodologies and applications of human resources management and technological challenges and changes in the field of industry, commerce and services.

Progress and challenges of disaster health management in China: a scoping review.

Science.gov (United States)

Zhong, Shuang; Clark, Michele; Hou, Xiang-Yu; Zang, Yuli; FitzGerald, Gerard

2014-01-01

Despite the importance of an effective health system response to various disasters, relevant research is still in its infancy, especially in middle- and low-income countries. This paper provides an overview of the status of disaster health management in China, with its aim to promote the effectiveness of the health response for reducing disaster-related mortality and morbidity. A scoping review method was used to address the recent progress of and challenges to disaster health management in China. Major health electronic databases were searched to identify English and Chinese literature that were relevant to the research aims. The review found that since 2003 considerable progress has been achieved in the health disaster response system in China. However, there remain challenges that hinder effective health disaster responses, including low standards of disaster-resistant infrastructure safety, the lack of specific disaster plans, poor emergency coordination between hospitals, lack of portable diagnostic equipment and underdeveloped triage skills, surge capacity, and psychological interventions. Additional challenges include the fragmentation of the emergency health service system, a lack of specific legislation for emergencies, disparities in the distribution of funding, and inadequate cost-effective considerations for disaster rescue. One solution identified to address these challenges appears to be through corresponding policy strategies at multiple levels (e.g. community, hospital, and healthcare system level).

New LHCb Management readies for run 2 challenges

CERN Multimedia

Antonella Del Rosso

2014-01-01

As of 1 July, LHCb, one of the four biggest experiments at the LHC, will have a new Management. Ahead are the huge challenges of run 2 and the following long technical shutdown during which LHCb will undergo a major upgrade. In the meantime, the discovery of new physics could be a dream within reach…   New LHCb Spokesperson, Guy Wilkinson.   “We have to make sure that the detector wakes up after its long hibernation and goes back to data taking in the most efficient way and that we are able to process all these data to produce high-quality physics results,” says Guy Wilkinson, new Spokesperson of the LHCb collaboration. Although this already sounds like a considerable “to-do” list for the coming months, it’s just the beginning of a much longer and ambitious plan. “The previous management has done an excellent job in analysing the data we took during run 1. They also put on a very sound footing the LHCb upgrade, whi...

Challenges and Issues in Knowledge Management

DEFF Research Database (Denmark)

"Challenges and Issues in Knowledge Management" - the fifth volume in the "Research on Management Consulting" series - presents sixteen chapters that explore these various perspectives, focusing on knowledge management within the context of the management consulting industry, the dynamics...... associated with knowledge sharing and dissemination, methodological approaches to studying knowledge in organizations, and reflections on knowledge management and management consulting. As the chapters underscore, it is important to ensure that KM initiatives are aligned with the needs of the organization...... and its members, that the KM system is "owned" by organizational members with particular emphasis on executive sponsorship and team member acceptance, and that it be understood as an ongoing process rather than simply another management objective or faddish consulting tool. The focus, therefore, should...

Research challenges for energy data management (panel)

DEFF Research Database (Denmark)

Pedersen, Torben Bach; Lehner, Wolfgang

2013-01-01

This panel paper aims at initiating discussion at the Second International Workshop on Energy Data Management (EnDM 2013) about the important research challenges within Energy Data Management. The authors are the panel organizers, extra panelists will be recruited before the workshop...

Sustainable Materials Management (SMM) Electronics Challenge Data

Science.gov (United States)

On September 22, 2012, EPA launched the SMM Electronics Challenge. The Challenge encourages electronics manufacturers, brand owners and retailers to strive to send 100 percent of the used electronics they collect from the public, businesses and within their own organizations to third-party certified electronics refurbishers and recyclers. The Challenge??s goals are to: 1). Ensure responsible recycling through the use of third-party certified recyclers, 2). Increase transparency and accountability through public posting of electronics collection and recycling data, and 3). Encourage outstanding performance through awards and recognition. By striving to send 100 percent of used electronics collected to certified recyclers and refurbishers, Challenge participants are ensuring that the used electronics they collect will be responsibly managed by recyclers that maximize reuse and recycling, minimize exposure to human health and the environment, ensure the safe management of materials by downstream handlers, and require destruction of all data on used electronics. Electronics Challenge participants are publicly recognized on EPA's website as a registrant, new participant, or active participant. Awards are offered in two categories - tier and champion. Tier awards are given in recognition of achieving all the requirements under a gold, silver or bronze tier. Champion awards are given in two categories - product and non-product. For champion awards, a product is an it

Strategies to address management challenges in larger intensive care units.

Science.gov (United States)

Matlakala, M C; Bezuidenhout, M C; Botha, A D H

2015-10-01

To illustrate the need for and suggest strategies that will enhance sustainable management of a large intensive care unit (ICU). The challenges faced by intensive care nursing in South Africa are well documented. However, there appear to be no strategies available to assist nurses to manage large ICUs or for ICU managers to deal with problems as they arise. Data sources to illustrate the need for strategies were challenges described by ICU managers in the management of large ICUs. A purposive sample of managers was included in individual interviews during compilation of evidence regarding the challenges experienced in the management of large ICUs. The challenges were presented at the Critical Care Society of Southern Africa Congress held on 28 August to 2 September 2012 in Sun City North-West province, South Africa. Five strategies are suggested for the challenges identified: divide the units into sections; develop a highly skilled and effective nursing workforce to ensure delivery of quality nursing care; create a culture to retain an effective ICU nursing team; manage assets; and determine the needs of ICU nurses. ICUs need measures to drive the desired strategies into actions to continuously improve the management of the unit. Future research should be aimed at investigating the effectiveness of the strategies identified. This research highlights issues relating to large ICUs and the strategies will assist ICU managers to deal with problems related to large unit sizes, shortage of trained ICU nurses, use of agency nurses, shortage of equipment and supplies and stressors in the ICU. The article will make a contribution to the body of nursing literature on management of ICUs. © 2014 John Wiley & Sons Ltd.

The Office of Science Data-Management Challenge

Energy Technology Data Exchange (ETDEWEB)

Mount, Richard P.; /SLAC

2005-10-10

Science--like business, national security, and even everyday life--is becoming more and more data intensive. In some sciences the data-management challenge already exceeds the compute-power challenge in its needed resources. Leadership in applying computing to science will necessarily require both world-class computing and world-class data management. The Office of Science program needs a leadership-class capability in scientific data management. Currently two-thirds of Office of Science research and development in data management is left to the individual scientific programs. About $18M/year is spent by the programs on data-management research and development targeted at their most urgent needs. This is to be compared with the $9M/year spent on data management by DOE computer science. This highly mission-directed approach has been effective, but only in meeting just the highest-priority needs of individual programs. A coherent, leadership-class, program of data management is clearly warranted by the scale and nature of the Office of Science programs. More directly, much of the Office of Science portfolio is in desperate need of such a program; without it, data management could easily become the primary bottleneck to scientific progress within the next five years. When grouped into simulation-intensive science, experiment/observation-intensive science, and information-intensive science, the Office of Science programs show striking commonalities in their data-management needs. Not just research and development but also packaging and hardening as well as maintenance and support are required. Meeting these needs is a medium- to long-term effort requiring a well-planned program of evolving investment. We propose an Office of Science Data-Management Program at an initial scale of $32M/year of new funding. The program should be managed by a Director charged with creating and maintaining a forward-looking approach to multiscience data-management challenges. The program

Managing the Challenges of Leadership in ERP Implementations: An Exploratory Study of the Leadership Challenges Encountered by Project Managers Involved in ERP Implementation Projects

Science.gov (United States)

Wanjagi, James K.

2013-01-01

Increasingly, organizations are conducting more Enterprise Resource Planning (ERP) projects in order to promote organizational efficiencies. Meanwhile, minimal research has been conducted on the leadership challenges faced by project managers during the ERP project implementations and how these challenges are managed. The existing project…

Nigerian Election Management Bodies and their Associated Election Challenges

Directory of Open Access Journals (Sweden)

Moses Etila Shaibu

2018-01-01

Full Text Available The paper examined the challenges that confront Election Management Bodies (EMBs in conducting free and fair elections in Nigeria. It aligns with the position of extant literature on the subject that elections in Nigeria have been anything but free and fair, and argues that all the EMBs that have so far conducted elections in Nigeria are complicit in perpetrating electoral malpractices. In other words, though there are external factors that undermine the conduct of free, fair and credible elections in Nigeria, EMBs in Nigeria also present themselves as willing tools in the hands of politicians to compromise the integrity of the electoral process. The number of litigations and level of both international and local denunciations that attend every election in Nigeria underscores the magnitude of electoral malfeasance inherent in the elections conducted by successive EMBs in Nigeria. The paper analysed the major challenges that inhibit the conduct of free and fair elections in Nigeria and proffered solutions to them. Relying heavily on the documentary methods of data collection, the paper concludes that until all these challenges confronting EMBs in Nigeria in the conduct of free and fair elections are comprehensively addressed, credible elections will continue to be a mirage in the country.

Sustainable Digital Environments: What Major Challenges Is Humankind Facing?

Directory of Open Access Journals (Sweden)

Roland W. Scholz

2016-07-01

Full Text Available This paper identifies and discusses the benefits, threats, and vulnerabilities related to the digital revolution. It aims to motivate research and its funding regarding digital threats and vulnerabilities related, in particular, to anticipating unintended, undesirable rebound effects, tipping points, critically fast evolutionary change rates, trade-offs, etc. A brief analysis of the history of the mind and technology reveals slow technological development over tens of thousands of years (including the invention of a place-value digital number system. Then, a small series of groundbreaking ideas (e.g., binary logic, Shannon’s symbolic analysis of relay and switching circuits, architectures of computing enabled the industry-driven invention of programmable computing machines. Ultimately, the mastery of electron and semiconductor physics allowed for economical and seemingly unlimited storage capacity that made digital tools available to all domains of society. Based on the historical analysis, a coupled human-environment systems perspective (that includes a hierarchy assumption ranging from the human cell to the human species enables the identification of several potential challenges to society and science. First, digital nano-engineering promotes genetic modifications (i.e., directed evolution, and synthetic biology enables a new level of the appropriation of nature. The understanding of cell-based biocomputers may call for new forms of logic. These and other challenges require thorough sustainability research in order to anticipate major changes on all levels of human systems. Second, the human individual is exposed to new forms of vulnerability. In particular, the potential epigenetic effects resulting from the excessive use of digital information of historically unknown speed, density, and contents and the loss of (the Western common-law right to privacy resulting from big data (whose ownership is often unknown should become subjects of

Project management - challenges in dealing with academic and non-academic partners

Science.gov (United States)

Henkel, Daniela; Eisenhauer, Anton; Drossou-Berendes, Alexandra

2016-04-01

Modern research projects on national, European and international level are challenged by an increasing requirement of inter and trans-disciplinarily, societal relevance and educational outreach as well as market oriented applications. In particular, to be successful in European research in the frame of HORIZON 2020, the EU Framework Programme for Research and Innovation, it is crucial that relatively large international research consortia involve academic and non-academic partners, NGOs, private and non-private institutions as well as industrial companies. For the management and organisation of such consortia coordinators have to deal with significant differences between multi-national and multi-sectorial administrations and research environments, in order to secure a successful implementation of the project. This often costs research and non-academic partners tremendous efforts, not to say excessive demands. Based on the experiences made in the frame of an Innovative Training Network (ITN) project within the HORIZON 2020 Marie Skłodowska-Curie Actions, this presentation identifies organisational pitfalls and major challenges of the project management for European funded research involving multi-national academic and non-academic research partners. Possible strategies are discussed to circumvent and avoid conflicts already at the beginning of the project.

Turning Weaknesses into Strengths: Nordic Tourism, Potentials for Growth and Major Challenges

Directory of Open Access Journals (Sweden)

Ruhet Genc

2010-03-01

Full Text Available Nordic region is a geographical area which is characterized by a combination of nature, culture, history and technology and regarded as a common entity in political, economical and historical sense. Although rich in its resources, Nordic tourism has not actualized its potential in full. The present paper aims to identify weaknesses of the region, to outline a new set of directions for improving Nordic tourism and to delineate major challenges. Its geographical and natural beauties, cultural characteristics, technological advancement and policy development are identified as assets for tourism advancement in the region. Winter tourism, adventure tourism, nature-based tourism and cultural tourism are demonstrated as potential routes of growth. Marketing strategies and changing trends are discussed as major challenges, with suggestions for implementation.

Solid waste management challenges for cities in developing countries

Energy Technology Data Exchange (ETDEWEB)

Abarca Guerrero, Lilliana, E-mail: l.abarca.guerrero@tue.nl [Built Environment Department, Eindhoven University of Technology, Den Dolech, 25612 AZ Eindhoven (Netherlands); Maas, Ger, E-mail: g.j.maas@tue.nl [Built Environment Department, Eindhoven University of Technology, Den Dolech, 25612 AZ Eindhoven (Netherlands); Hogland, William, E-mail: william.hogland@lnu.se [School of Natural Sciences, Linnaeus University, SE-391 82 Kalmar (Sweden)

2013-01-15

Highlights: Black-Right-Pointing-Pointer Stakeholders. Black-Right-Pointing-Pointer Factors affecting performance waste management systems. Black-Right-Pointing-Pointer Questionnaire as Annex for waste management baseline assessment. - Abstract: Solid waste management is a challenge for the cities' authorities in developing countries mainly due to the increasing generation of waste, the burden posed on the municipal budget as a result of the high costs associated to its management, the lack of understanding over a diversity of factors that affect the different stages of waste management and linkages necessary to enable the entire handling system functioning. An analysis of literature on the work done and reported mainly in publications from 2005 to 2011, related to waste management in developing countries, showed that few articles give quantitative information. The analysis was conducted in two of the major scientific journals, Waste Management Journal and Waste Management and Research. The objective of this research was to determine the stakeholders' action/behavior that have a role in the waste management process and to analyze influential factors on the system, in more than thirty urban areas in 22 developing countries in 4 continents. A combination of methods was used in this study in order to assess the stakeholders and the factors influencing the performance of waste management in the cities. Data was collected from scientific literature, existing data bases, observations made during visits to urban areas, structured interviews with relevant professionals, exercises provided to participants in workshops and a questionnaire applied to stakeholders. Descriptive and inferential statistic methods were used to draw conclusions. The outcomes of the research are a comprehensive list of stakeholders that are relevant in the waste management systems and a set of factors that reveal the most important causes for the systems' failure. The information

Solid waste management challenges for cities in developing countries

International Nuclear Information System (INIS)

Abarca Guerrero, Lilliana; Maas, Ger; Hogland, William

2013-01-01

Highlights: ► Stakeholders. ► Factors affecting performance waste management systems. ► Questionnaire as Annex for waste management baseline assessment. - Abstract: Solid waste management is a challenge for the cities’ authorities in developing countries mainly due to the increasing generation of waste, the burden posed on the municipal budget as a result of the high costs associated to its management, the lack of understanding over a diversity of factors that affect the different stages of waste management and linkages necessary to enable the entire handling system functioning. An analysis of literature on the work done and reported mainly in publications from 2005 to 2011, related to waste management in developing countries, showed that few articles give quantitative information. The analysis was conducted in two of the major scientific journals, Waste Management Journal and Waste Management and Research. The objective of this research was to determine the stakeholders’ action/behavior that have a role in the waste management process and to analyze influential factors on the system, in more than thirty urban areas in 22 developing countries in 4 continents. A combination of methods was used in this study in order to assess the stakeholders and the factors influencing the performance of waste management in the cities. Data was collected from scientific literature, existing data bases, observations made during visits to urban areas, structured interviews with relevant professionals, exercises provided to participants in workshops and a questionnaire applied to stakeholders. Descriptive and inferential statistic methods were used to draw conclusions. The outcomes of the research are a comprehensive list of stakeholders that are relevant in the waste management systems and a set of factors that reveal the most important causes for the systems’ failure. The information provided is very useful when planning, changing or implementing waste management systems

Capability challenges of facility management (FM) personnel toward sustainability agenda

Science.gov (United States)

Halim, Ahmad Ilyas Ahmad; Sarpin, Norliana; Kasim, Narimah Binti; Zainal, Rozlin Binti

2017-10-01

The industries business play a significant role to contribute toward economic growth in develop and developing country. However, they always face serious problems such as time overrun, waste generation, and cost overrun during their operation and maintenance. Traditional practice is found unable to control that situation. These challenges accent the need for practitioners to rethink and improve their process management. This show that industries business has major potential when applying sustainable development by focusing on three pillars (economic, environment, and social). By adopting sustainability, it can reduce energy consumption and waste, while increasing productivity, financial return and corporate standing in community. FM personnel are most suitable position to lead organizations toward sustainability implementation. However, lack of skill and capability among FM personnel to achieve sustainable goal had become barrier that need to overcome. This paper focus to identify capability challenges of FM personnel toward sustainability. A multiple researches were conducted and data were gathered through literature review from previous studies.

Investigating the challenges of biodiversity management of Sefidkuh ...

African Journals Online (AJOL)

Investigating the challenges of biodiversity management of Sefidkuh Khoramabad protected area ... Journal of Fundamental and Applied Sciences ... The basis of managing protected areas in Iran is based on protection, research, training and ...

International human resources management challenges and changes

CERN Document Server

2015-01-01

This book covers the issues related to human resource management (HRM) in an international context. It gives perspectives and future direction in International HRM research. The chapters explore the models, tools and processes used by international organizations in order to assist international managers to better face the challenges and changes in HRM. It is suitable to HR managers, engineers, entrepreneurs, practitioners, academics and researchers in the field.

Moral challenges in managed care

Directory of Open Access Journals (Sweden)

Leandri Hattingh

2015-11-01

Full Text Available Managed health care in South Africa is faced with complex moral challenges, where different stakeholders appeal to different ethics principles to guide decision making. The traditional bio-medical ethics principles of beneficence, non-maleficence and respect for autonomy are typically emphasised in clinical practice, while third party funders appeal to the principle of justice to guide the allocation of limited, pooled resources. Health care professionals working in managed care are particularly exposed to these conflicts, vis-à-vis incongruence between the ethics guidelines from their professional bodies and the legislation pertaining to managed care. Common understanding of the claims and responsibilities of each of the stakeholders may promote a more coherent, sustainable health care system. 

Demand side management. Benefits and challenges

International Nuclear Information System (INIS)

Strbac, Goran

2008-01-01

In this paper, the major benefits and challenges of electricity demand side management (DSM) are discussed in the context of the UK electricity system. The relatively low utilisation of generation and networks (of about 50%) means that there is significant scope for DSM to contribute to increasing the efficiency of the system investment. The importance of the diversity of electricity load is discussed and the negative effects of DSM on load diversity illustrated. Ageing assets, the growth in renewable and other low-carbon generation technologies and advances in information and communication technologies are identified as major additional drivers that could lead to wider applications of DSM in the medium term. Potential benefits of DSM are discussed in the context of generation and of transmission and distribution networks. The provision of back-up capacity by generation may not be efficient as it will be needed relatively infrequently, and DSM may be better placed to support security. We also present an analysis of the value of DSM in balancing generation and demand in a future UK electricity system with significant variable renewable generation. We give a number of reasons for the relatively slow uptake of DSM, particularly in the residential, commercial and small business sectors. They include a lack of metering, information and communication infrastructure, lack of understanding of the benefits of DSM, problems with the competitiveness of DSM when compared with traditional approaches, an increase in the complexity of system operation and inappropriate market incentives. (author)

The Glen Canyon Dam adaptive management program: progress and immediate challenges

Science.gov (United States)

Hamill, John F.; Melis, Theodore S.; Boon, Philip J.; Raven, Paul J.

2012-01-01

Adaptive management emerged as an important resource management strategy for major river systems in the United States (US) in the early 1990s. The Glen Canyon Dam Adaptive Management Program (‘the Program’) was formally established in 1997 to fulfill a statutory requirement in the 1992 Grand Canyon Protection Act (GCPA). The GCPA aimed to improve natural resource conditions in the Colorado River corridor in the Glen Canyon National Recreation Area and Grand Canyon National Park, Arizona that were affected by the Glen Canyon dam. The Program achieves this by using science and a variety of stakeholder perspectives to inform decisions about dam operations. Since the Program started the ecosystem is now much better understood and several biological and physical improvements have been achieved. These improvements include: (i) an estimated 50% increase in the adult population of endangered humpback chub (Gila cypha) between 2001 and 2008, following previous decline; (ii) a 90% decrease in non-native rainbow trout (Oncorhynchus mykiss), which are known to compete with and prey on native fish, as a result of removal experiments; and (iii) the widespread reappearance of sandbars in response to an experimental high-flow release of dam water in March 2008.Although substantial progress has been made, the Program faces several immediate challenges. These include: (i) defining specific, measurable objectives and desired future conditions for important natural, cultural and recreational attributes to inform science and management decisions; (ii) implementing structural and operational changes to improve collaboration among stakeholders; (iii) establishing a long-term experimental programme and management plan; and (iv) securing long-term funding for monitoring programmes to assess ecosystem and other responses to management actions. Addressing these challenges and building on recent progress will require strong and consistent leadership from the US Department of the Interior

JPL's Approach for Helping Flight Project Managers Meet Today's Management Challenges

Science.gov (United States)

Leising, Charles J.

2004-01-01

All across NASA project managers are facing tough new challenges. NASA has imposed increased oversight and the number of projects at Centers such as JPL has exploded from a handful of large projects to a much greater number of smaller ones. Experienced personnel are retiring at increasing rates and younger, less experienced managers are being rapidly promoted up the ladder. Budgets are capped, competition among NASA Centers and Federally Funded Research and Development Centers (FFRDCs) has increased significantly and there is no longer any tolerance to cost overruns. On top of all this, implementation schedules have been reduced by 25 to 50% to reduce run-out costs, making it even more difficult to define requirements, validate heritage assumptions and make accurate cost estimates during the early phases of the life-cycle.JPL's executive management, under the leadership of the Associate Director for Flight Projects and Mission Success, have attempted to meet these challenges by improving operations in five areas: (1) increased standardization, where it is judged to have significant benefit; (2) better balance and more effective partnering between projects and the line management; (3) increased infrastructure support; (4) improved management training; and (5) more effective review and oversight.

The Challenges of Leading an International Branch Campus: The "Lived Experience" of In-Country Senior Managers

Science.gov (United States)

Healey, Nigel M.

2016-01-01

In recent years, an increasing number of major universities have set up international branch campuses (IBCs). There are now more than 200 IBCs, with more under development. Little is known about the unique challenges that face IBC managers, who are normally seconded from the home university to set up and operate the satellite campus in a new and…

Sustainable Materials Management (SMM) Federal Green Challenge (FGC) Data

Data.gov (United States)

U.S. Environmental Protection Agency — The Federal Green Challenge (FGC) is a national effort under EPA's Sustainable Materials Management (SMM) Program, challenging EPA and other federal agencies...

The Grand Challenge of Basin-Scale Groundwater Quality Management Modelling

Science.gov (United States)

Fogg, G. E.

2017-12-01

The last 50+ years of agricultural, urban and industrial land and water use practices have accelerated the degradation of groundwater quality in the upper portions of many major aquifer systems upon which much of the world relies for water supply. In the deepest and most extensive systems (e.g., sedimentary basins) that typically have the largest groundwater production rates and hold fresh groundwaters on decadal to millennial time scales, most of the groundwater is not yet contaminated. Predicting the long-term future groundwater quality in such basins is a grand scientific challenge. Moreover, determining what changes in land and water use practices would avert future, irreversible degradation of these massive freshwater stores is a grand challenge both scientifically and societally. It is naïve to think that the problem can be solved by eliminating or reducing enough of the contaminant sources, for human exploitation of land and water resources will likely always result in some contamination. The key lies in both reducing the contaminant sources and more proactively managing recharge in terms of both quantity and quality, such that the net influx of contaminants is sufficiently moderate and appropriately distributed in space and time to reverse ongoing groundwater quality degradation. Just as sustainable groundwater quantity management is greatly facilitated with groundwater flow management models, sustainable groundwater quality management will require the use of groundwater quality management models. This is a new genre of hydrologic models do not yet exist, partly because of the lack of modeling tools and the supporting research to model non-reactive as well as reactive transport on large space and time scales. It is essential that the contaminant hydrogeology community, which has heretofore focused almost entirely on point-source plume-scale problems, direct it's efforts toward the development of process-based transport modeling tools and analyses capable

ARL and Association 3.0: Ten Management Challenges

Science.gov (United States)

Funk, Carla J.

2009-01-01

Association management in today's "association 3.0" environment presents some new challenges and new perspectives on old ones. This paper summarizes 10 such challenges including collaboration, diversity, innovation, transparency, financial stability, member benefits, knowledge-based decision-making, a demand-driven association model, pro-activity…

Distance management – a challenge in participatory interventions in virtual organizations

DEFF Research Database (Denmark)

Ipsen, Christine; Gish, Liv; Poulsen, Signe

2014-01-01

Virtual organizations challenge the first line managers as they have to be able to manage from afar as distance managers. Investigating distance management in participatory multi-level interventions this paper presents a case study of four SMEs which have applied the multi-level participatory Po......WRS program (Prevention of Work-Related Stress) over a six month period. Interviews were conducted with employees, in-house process facilitators, project managers and first line managers. The results show that distance managers are even more challenged in interventions especially regarding coordination...

Transforming management of tropical coastal seas to cope with challenges of the 21st century.

Science.gov (United States)

Sale, Peter F; Agardy, Tundi; Ainsworth, Cameron H; Feist, Blake E; Bell, Johann D; Christie, Patrick; Hoegh-Guldberg, Ove; Mumby, Peter J; Feary, David A; Saunders, Megan I; Daw, Tim M; Foale, Simon J; Levin, Phillip S; Lindeman, Kenyon C; Lorenzen, Kai; Pomeroy, Robert S; Allison, Edward H; Bradbury, R H; Corrin, Jennifer; Edwards, Alasdair J; Obura, David O; Sadovy de Mitcheson, Yvonne J; Samoilys, Melita A; Sheppard, Charles R C

2014-08-15

Over 1.3 billion people live on tropical coasts, primarily in developing countries. Many depend on adjacent coastal seas for food, and livelihoods. We show how trends in demography and in several local and global anthropogenic stressors are progressively degrading capacity of coastal waters to sustain these people. Far more effective approaches to environmental management are needed if the loss in provision of ecosystem goods and services is to be stemmed. We propose expanded use of marine spatial planning as a framework for more effective, pragmatic management based on ocean zones to accommodate conflicting uses. This would force the holistic, regional-scale reconciliation of food security, livelihoods, and conservation that is needed. Transforming how countries manage coastal resources will require major change in policy and politics, implemented with sufficient flexibility to accommodate societal variations. Achieving this change is a major challenge - one that affects the lives of one fifth of humanity. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

The challenge of the radioactive waste management

International Nuclear Information System (INIS)

Dupuis, M. C.

2008-01-01

The problem of waste management has gained relevance with the development of electronuclear production and the increased social awareness on the need to protect the environment. While most developed countries have found solutions for the disposal of waste of low intensity and duration, the storage of used fuel and other kind of waste of higher intensity and duration is one of the main challenges for the next decade. Scientific research focuses on long term safety, while questions on the need for new governance are raised at the socio political level. Organizations such as the AEN have strengthened international cooperation to overcome the scientific, technical and socio-political challenges related to the nuclear waste management. (Author) 15 refs

MO-B-201-01: Overcoming the Challenges of Motion Management in Current Lung SBRT Practice

Energy Technology Data Exchange (ETDEWEB)

Shang, C. [Boca Raton Regional Hospital (United States)

2016-06-15

The motion management in stereotactic body radiation therapy (SBRT) is a key to success for a SBRT program, and still an on-going challenging task. A major factor is that moving structures behave differently than standing structures when examined by imaging modalities, and thus require special considerations and employments. Understanding the motion effects to these different imaging processes is a prerequisite for a decent motion management program. The commonly used motion control techniques to physically restrict tumor motion, if adopted correctly, effectively increase the conformity and accuracy of hypofractionated treatment. The effective application of such requires one to understand the mechanics of the application and the related physiology especially related to respiration. The image-guided radiation beam control, or tumor tracking, further realized the endeavor for precision-targeting. During tumor tracking, the respiratory motion is often constantly monitored by non-ionizing beam sources using the body surface as its surrogate. This then has to synchronize with the actual internal tumor motion. The latter is often accomplished by stereo X-ray imaging or similar techniques. With these advanced technologies, one may drastically reduce the treated volume and increase the clinicians’ confidence for a high fractional ablative radiation dose. However, the challenges in implementing the motion management may not be trivial and is dependent on each clinic case. This session of presentations is intended to provide an overview of the current techniques used in managing the tumor motion in SBRT, specifically for routine lung SBRT, proton based treatments, and newly-developed MR guided RT. Learning Objectives: Through this presentation, the audience will understand basic roles of commonly used imaging modalities for lung cancer studies; familiarize the major advantages and limitations of each discussed motion control methods; familiarize the major advantages and

MO-B-201-01: Overcoming the Challenges of Motion Management in Current Lung SBRT Practice

International Nuclear Information System (INIS)

Shang, C.

2016-01-01

The motion management in stereotactic body radiation therapy (SBRT) is a key to success for a SBRT program, and still an on-going challenging task. A major factor is that moving structures behave differently than standing structures when examined by imaging modalities, and thus require special considerations and employments. Understanding the motion effects to these different imaging processes is a prerequisite for a decent motion management program. The commonly used motion control techniques to physically restrict tumor motion, if adopted correctly, effectively increase the conformity and accuracy of hypofractionated treatment. The effective application of such requires one to understand the mechanics of the application and the related physiology especially related to respiration. The image-guided radiation beam control, or tumor tracking, further realized the endeavor for precision-targeting. During tumor tracking, the respiratory motion is often constantly monitored by non-ionizing beam sources using the body surface as its surrogate. This then has to synchronize with the actual internal tumor motion. The latter is often accomplished by stereo X-ray imaging or similar techniques. With these advanced technologies, one may drastically reduce the treated volume and increase the clinicians’ confidence for a high fractional ablative radiation dose. However, the challenges in implementing the motion management may not be trivial and is dependent on each clinic case. This session of presentations is intended to provide an overview of the current techniques used in managing the tumor motion in SBRT, specifically for routine lung SBRT, proton based treatments, and newly-developed MR guided RT. Learning Objectives: Through this presentation, the audience will understand basic roles of commonly used imaging modalities for lung cancer studies; familiarize the major advantages and limitations of each discussed motion control methods; familiarize the major advantages and

Management Challenges Fiscal Year 2016

Science.gov (United States)

2017-01-01

address supply chain vulnerabilities and its strategic competitors. Office of Inspector General Management Challenges 48 │ FY 2016 Installations...has allowed U.S. firms to harness the creativity of the global market. However, these supply chains create vulnerabilities and are subject to...manipulation by strategic competitors. One of the vulnerabilities within the global supply chain is the widespread existence of counterfeit parts

Challenges in the management of cervicofacial necrotizing fasciitis ...

African Journals Online (AJOL)

Background: Necrotizing fascitis is uncommon but a life threatening cervico-facial infection, which is characterized by aggressive spread of inflammation and necrosis of the tissues. In our environment clinical presentation is often late and patient's management at this stage is very challenging. We present the challenges in ...

Status and challenges for radioactive waste management

International Nuclear Information System (INIS)

Riotte, H.

2011-01-01

In its 2008 Nuclear Energy Outlook the NEA reviewed the status of radioactive waste management world-wide and noted that the technology for disposal of short-lived low- and intermediate-level radioactive waste is well developed. The review concluded that all OECD countries with major nuclear programmes either operate corresponding waste disposal facilities or are in an advanced stage of developing them. By contrast, the developmental progress of HLW/SNF management programmes varies widely between countries; not to mention that there is currently no repository operating that could take spent nuclear fuel or high-level waste from reprocessing. In its collective opinion 'Moving forward with geological disposal' the NEA noted that deep underground disposal in geological formations is seen worldwide as the only sustainable endpoint for the management of these types of waste, as it affords unparalleled protection without reliance on active safety monitoring and controls. While waste management programmes in some countries are well matured and countries like Finland, France and Sweden aim to operate geologic repositories in the next decade, others need to develop their national strategies, plans and corresponding actions for managing radioactive waste further. Periodically reviewed national waste management plans, as legally required for EU member countries by a recent Directive, can provide a co-operation framework for all national institutional players and a means to measure progress. In implementing sustainable solutions for the long-term management of HLW/SNF, specific challenges lay in establishing an efficient policy and regulatory framework that (a) defines a desired level of safety over the various time scales to be considered and (b) allows for sustainable decision making procedures by involving public and stakeholder in a flexible, step-wise implementation process. Technical confidence in the safety of a repository needs to be demonstrated in a modern

Steam generator life cycle management challenges - on-going and new build

International Nuclear Information System (INIS)

Spekkens, P.

2009-01-01

Ontario Power Generation (OPG) is committed to the safe, reliable, and cost-effective operation of its fleet of CANDU plants. Steam Generators (SGs) are a major component of the heat transport system in these plants and maintaining their health is an essential element to achieving plant safety, reliability and economic performance. OPG has been actively engaged in formal life cycle management of its SGs for about 15 years. Over this time, we have developed stable, mature, detailed life cycle plans for each of our plants on a unit by unit, and in some cases, SG by SG, basis. These plans have been externally reviewed over the years by our regulator and by other third-party experts, and they've been acknowledged as being among the best life cycle plans anywhere. Although we are pleased that our life cycle plans are as detailed and mature as they are, we certainly aren't fully satisfied because they're not perfect. Even if they were perfect at any point in time, they wouldn't be for very long because the environment is constantly changing, both the technical environment and the business environment. This paper presents some of these challenges and offers some possible solutions or suggestions based on OPG's experience. The paper describes the background on SG life cycle management in OPG, i.e. what it is and how we do it. Then it presents challenges in the following areas: despite having some very detailed and technically strong life cycle plans, we still face some technical issues; in addition, we face challenges in integrating these plans into the overall business processes within the company; up until now, our life cycle planning has been aimed at early-and mid-life in our units. But our units are aging and we are now within sight, at least in a life cycle management sense, of a point at which decisions need to be made on refurbishment, life extension or retirement of the units. We need to adjust our life cycle management approach as we approach those major

Management of systemic lupus erythematosus during pregnancy: challenges and solutions

Directory of Open Access Journals (Sweden)

Knight CL

2017-03-01

Full Text Available Caroline L Knight, Catherine Nelson-Piercy Division of Women’s Health, Women’s Health Academic Centre, King’s College London and King’s Health Partners, St Thomas’ Hospital, London, UK Abstract: Systemic lupus erythematosus (SLE is a chronic, multisystem autoimmune disease predominantly affecting women, particularly those of childbearing age. SLE provides challenges in the prepregnancy, antenatal, intrapartum, and postpartum periods for these women, and for the medical, obstetric, and midwifery teams who provide their care. As with many medical conditions in pregnancy, the best maternal and fetal–neonatal outcomes are obtained with a planned pregnancy and a cohesive multidisciplinary approach. Effective prepregnancy risk assessment and counseling includes exploration of factors for poor pregnancy outcome, discussion of risks, and appropriate planning for pregnancy, with consideration of discussion of relative contraindications to pregnancy. In pregnancy, early referral for hospital-coordinated care, involvement of obstetricians and rheumatologists (and other specialists as required, an individual management plan, regular reviews, and early recognition of flares and complications are all important. Women are at risk of lupus flares, worsening renal impairment, onset of or worsening hypertension, preeclampsia, and/or venous thromboembolism, and miscarriage, intrauterine growth restriction, preterm delivery, and/or neonatal lupus syndrome (congenital heart block or neonatal lupus erythematosus. A cesarean section may be required in certain obstetric contexts (such as urgent preterm delivery for maternal and/or fetal well-being, but vaginal birth should be the aim for the majority of women. Postnatally, an ongoing individual management plan remains important, with neonatal management where necessary and rheumatology follow-up. This article explores the challenges at each stage of pregnancy, discusses the effect of SLE on pregnancy and

Aging management of major light water reactor components

International Nuclear Information System (INIS)

Shah, V.N.; Sinha, U.P.; Ware, A.G.

1992-01-01

Review of technical literature and field experience has identified stress corrosion cracking as one of the major degradation mechanisms for the major light water reactor components. Three of the stress corrosion cracking mechanisms of current concern are (a) primary water stress corrosion cracking (PWSCC) in pressurized water reactors, and (b) intergranular stress corrosion cracking (IGSCC) and (c) irradiation-assisted stress corrosion cracking (IASCC) in boiling water reactors. Effective aging management of stress corrosion cracking mechanisms includes evaluation of interactions between design, materials, stressors, and environment; identification and ranking of susceptible sites; reliable inspection of any damage; assessment of damage rate; mitigation of damage; and repair and replacement using corrosion-resistant materials. Management of PWSCC includes use of lower operating temperatures, reduction in residual tensile stresses, development of reliable inspection techniques, and use of Alloy 690 as replacement material. Management of IGSCC of nozzle and attachment welds includes use of Alloy 82 as weld material, and potential use of hydrogen water chemistry. Management of IASCC also includes potential use of hydrogen water chemistry

Challenges of solid waste management and environmental ...

African Journals Online (AJOL)

Challenges of solid waste management and environmental sanitation in Ibadan North ... African Journal for the Psychological Study of Social Issues ... inadequate manpower and welfare, poor provision of health services, negative attitudes, ...

Letter to Congressional Leaders on Top Defense Management Challenges

National Research Council Canada - National Science Library

2000-01-01

... Budget Committee and you on Department of Defense (DoD) management challenges. The joint letter requested that we update our previous assessments of the most significant management problems facing the DoD...

Meeting the challenges of case management with remote patient monitoring technology.

Science.gov (United States)

Cherry, J C; Colliflower, S J; Tsiperfal, A

2000-01-01

The article presents an overview of some of the current trends in health care and the challenges faced by nurse case managers who are providing disease management services. It discusses some of the emerging technologies available today for innovative case management. In particular, this article describes a program run by a healthcare system in Sacramento, California that uses an Internet-based technology to enhance their nurse case management model. The article demonstrates how the Health Hero platform enables interactive communication between nurse case managers and their patients, thereby meeting some of the challenges the nurse case managers are faced with in the modern disease-management world.

Urban management: Addressing the housing and utility challenge

Directory of Open Access Journals (Sweden)

Nikitina Oksana

2016-01-01

Full Text Available The authors have studied the three aspects of urban management: apartment buildings, major repair management, requirements for facility management companies to be licensed and waste management. The paper presents all the mentioned above aspects and possible negative circumstances and proposes solutions to the problems.

Knowledge of Childhood Autism and Challenges of Management among Medical Doctors in Kaduna State, Northwest Nigeria

Directory of Open Access Journals (Sweden)

E. E. Eseigbe

2015-01-01

Full Text Available Autism is a neurodevelopmental disorder with serious implications in childhood. There is a significant gap in the identification and provision of health and social services for autism in Africa. The knowledge of autism among health care providers and identifying challenges associated with its management could facilitate bridging the gap and ensuring better outcomes. A self-administered tool, the Knowledge about Childhood Autism among Health Workers (KCAHW questionnaire, was used in assessing knowledge of autism among 175 medical doctors (participants attending an annual scientific meeting in northwest Nigeria. Other parameters assessed were sociodemographic and professional characteristics of the participants and challenges encountered in the management of autism. Out of 175 questionnaires distributed, 167 (95.4% were returned. Good knowledge (KCAHW score ≥15 was significantly associated with being a paediatrician or psychiatrist and practicing in a tertiary health facility (P<0.05, while poor knowledge (KCAHW score <15 was significant among general practitioners (P<0.05. The highest knowledge gap was associated with onset of autism and its comorbidities (KCAHW Domain 4 while the least was concerning communication impairments (KCAHW Domain 2. Major challenges encountered in autism management were dearth of specialist services, cost of evaluation, and poor caregiver perspectives of autism.

Organizational flexibility as a challenge of contemporary management. Determinants and methods of measurement

Directory of Open Access Journals (Sweden)

Piotr Buła

2011-12-01

Full Text Available Purpose: This paper has been aimed at defining contemporary management flexibility determinants and the methods of its measurement. Problem investigated: This paper presents an analysis of organizational flexibility determinants related to the contemporary concepts and challenges within the area of management. The discussion includes two types of measurement of organizational flexibility based on declarative tests and quantitative criteria. The described methods are subject to evaluation. The paper also presents authors' own proposal for determinants classification, organizational flexibility assessment and an exemplary application. Methodology: The paper has been based on the results of research on organizational flexibility conducted by the Department of Business Studies Aalborg University (Denmark and Wrocław University of Economics (Poland. Conclusion: Organizational flexibility constitutes one of the major challenges of contemporary management. This issue has already been extensively discussed, however, despite numerous publications and relevant research projects many issues still need to be resolved. One of them is organizational flexibility measurement. In the first place, it needs a description of flexibility determinants relevant to a certain organization. There are no objective methods that would allow a description of the set of determinants since they are dependent on organization's special features and individually set objectives. In addition, it should be noted that those factors are subject to change, in line with the development of theory and concepts of management. The very flexibility measurement requires simultaneous application of various methods of factor analysis and polling stakeholder opinions.

The NIOSH Radiation Dose Reconstruction Project: managing technical challenges.

Science.gov (United States)

Moeller, Matthew P; Townsend, Ronald D; Dooley, David A

2008-07-01

Approximately two years after promulgation of the Energy Employees Occupational Illness Compensation Program Act, the National Institute for Occupational Safety and Health Office of Compensation and Analysis Support selected a contractor team to perform many aspects of the radiation dose reconstruction process. The project scope and schedule necessitated the development of an organization involving a comparatively large number of health physicists. From the initial stages, there were many technical and managerial challenges that required continuous planning, integration, and conflict resolution. This paper identifies those challenges and describes the resolutions and lessons learned. These insights are hopefully useful to managers of similar scientific projects, especially those requiring significant data, technical methods, and calculations. The most complex challenge has been to complete defensible, individualized dose reconstructions that support timely compensation decisions at an acceptable production level. Adherence to applying claimant-favorable and transparent science consistent with the requirements of the Act has been the key to establishing credibility, which is essential to this large and complex project involving tens of thousands of individual stakeholders. The initial challenges included garnering sufficient and capable scientific staff, developing an effective infrastructure, establishing necessary methods and procedures, and integrating activities to ensure consistent, quality products. The continuing challenges include maintaining the project focus on recommending a compensation determination (rather than generating an accurate dose reconstruction), managing the associated very large data and information management challenges, and ensuring quality control and assurance in the presence of an evolving infrastructure. The lessons learned concern project credibility, claimant favorability, project priorities, quality and consistency, and critical

Nuclear material management: challenges and prospects

International Nuclear Information System (INIS)

Rieu, J.; Besnainou, J.; Leboucher, I.; Chiguer, M.; Capus, G.; Greneche, D.; Durret, L.F.; Carbonnier, J.L.; Delpech, M.; Loaec, Ch.; Devezeaux de Lavergne, J.G.; Granger, S.; Devid, S.; Bidaud, A.; Jalouneix, J.; Toubon, H.; Pochon, E.; Bariteau, J.P.; Bernard, P.; Krellmann, J.; Sicard, B.

2008-01-01

The articles in this dossier were derived from the papers of the yearly S.F.E.N. convention, which took place in Paris, 12-13 March 2008. They deal with the new challenges and prospects in the field of nuclear material management, throughout the nuclear whole fuel cycle, namely: the institutional frame of nuclear materials management, the recycling, the uranium market, the enrichment market, the different scenarios for the management of civil nuclear materials, the technical possibilities of spent fuels utilization, the option of thorium, the convention on the physical protection of nuclear materials and installations, the characterisation of nuclear materials by nondestructive nuclear measurements, the proliferation from civil installations, the use of plutonium ( from military origin) and the international agreements. (N.C.)

Managing change in Higher Educational Institutions in South Africa: Some challenges

Directory of Open Access Journals (Sweden)

L. Froneman

2003-12-01

Full Text Available Higher Education has a vital role in developing an internationally competitive economy, a more affluent society and a sturdy democracy. The newly released National Plan for Higher Education in South Africa should recognise the current social and economic status in the country to realign its mission, and to reconsider the location and target audience of the various institutions in the country, to optimally serve the educational needs of the communities. The proposals in the National Plan, however, attempts to attain in a few years what other stabilised countries took years. That poses major challenges to education management. The aim of this paper is to evaluate some aspects of the managerial skills in the national education authorities. By analysing the National Plan, and testing the views of a number of teaching staff, the conclusion is that there are serious doubts regarding the management acumen in the educational leadership and that various important aspects are left out in the Plan.

Modern slavery challenges to supply chain management

OpenAIRE

Gold, Stefan; Trautrims, Alexander; Trodd, Zoe

2015-01-01

Purpose\\ud – This paper aims to draw attention to the challenges modern slavery poses to supply chain management. Although many international supply chains are (most often unknowingly) connected to slave labour activities, supply chain managers and researchers have so far neglected the issue. This will most likely change as soon as civil society lobbying and new legislation impose increasing litigation and reputational risks on companies operating international supply chains. \\ud \\ud Design/m...

Self-management in young adults with bipolar disorder: Strategies and challenges.

Science.gov (United States)

Nicholas, Jennifer; Boydell, Katherine; Christensen, Helen

2017-02-01

Early adoption of effective self-management strategies for bipolar disorder (BD) results in better clinical outcomes and increased quality of life. Therefore, facilitation of these strategies in young adults who are early in their illness course is vital. However, an understanding of self-management practices and needs of young adults with BD is lacking. This study explores young adult's perspectives of disorder self-management practices and challenges. Young adults with BD completed an online survey about disorder management strategies and challenges. Self-management was investigated through self-report and ratings of literature-derived strategies. Results were analysed using descriptive statistics and qualitative thematic analysis. Eighty-nine participants aged 18-30 (M=24.4; SD=3.9) completed the survey. Adherence to treatment, disorder psychoeducation, and sleep-management were the strategies rated most helpful. Six participant-reported self-management strategies were identified (1) Maintaining a healthy lifestyle; (2) Treatment attendance and adherence; (3) Participation in meaningful activities; (4) Engagement with social support; (5) Meditation and relaxation practices; and (6) Symptom monitoring. The most common self-management challenges experienced by young adults concerned the nature of the disorder, interpersonal relationships, and stigma. Participants likely represent a sub-set of young adults engaged with healthcare and therefore may not be representative of the population. Strategies reported vital by those successfully managing their disorder are not adequately utilised by young adults with BD. Both differences in strategy use and perceived self-management challenges represent important areas of clinical support and intervention. This increased understanding will help facilitate self-management skill development in this population. Copyright © 2016 Elsevier B.V. All rights reserved.

New challenges for Life Sciences flight project management

Science.gov (United States)

Huntoon, C. L.

1999-01-01

Scientists have conducted studies involving human spaceflight crews for over three decades. These studies have progressed from simple observations before and after each flight to sophisticated experiments during flights of several weeks up to several months. The findings from these experiments are available in the scientific literature. Management of these flight experiments has grown into a system fashioned from the Apollo Program style, focusing on budgeting, scheduling and allocation of human and material resources. While these areas remain important to the future, the International Space Station (ISS) requires that the Life Sciences spaceflight experiments expand the existing project management methodology. The use of telescience with state-the-art information technology and the multi-national crews and investigators challenges the former management processes. Actually conducting experiments on board the ISS will be an enormous undertaking and International Agreements and Working Groups will be essential in giving guidance to the flight project management Teams forged in this matrix environment must be competent to make decisions and qualified to work with the array of engineers, scientists, and the spaceflight crews. In order to undertake this complex task, data systems not previously used for these purposes must be adapted so that the investigators and the project management personnel can all share in important information as soon as it is available. The utilization of telescience and distributed experiment operations will allow the investigator to remain involved in their experiment as well as to understand the numerous issues faced by other elements of the program The complexity in formation and management of project teams will be a new kind of challenge for international science programs. Meeting that challenge is essential to assure success of the International Space Station as a laboratory in space.

The Future Regulatory Challenges of Liquidity Risk Management

OpenAIRE

Petr Teply

2011-01-01

Liquidity risk management ranks to key concepts applied in finance. Liquidity is defined as a capacity to obtain funding when needed, while liquidity risk means as a threat to this capacity to generate cash at fair costs. In the paper we present challenges of liquidity risk management resulting from the 2007- 2009 global financial upheaval. We see five main regulatory liquidity risk management issues requiring revision in coming years: liquidity measurement, intra-day and...

Challenges of Refugee Health Care: Perspectives of Medical Interpreters, Case Managers, and Pharmacists

Directory of Open Access Journals (Sweden)

Fabiana Kotovicz

2018-01-01

Full Text Available Purpose: Our objective was to identify perceived challenges in the provision of health care for refugees from the perspective of medical interpreters, case managers, and pharmacists working with refugee patients in Milwaukee, Wisconsin. Methods: Two 60-minute focus groups were performed exploring challenges in refugee health care using a literature-based semi-structured protocol. Focus groups were transcribed and de-identified prior to independent analysis by two of the investigators. Using a memoing-process qualitative approach, major concepts, cross-cutting themes, and subthemes were established and ultimately developed a narrative. The project protocol was approved as not human subject research by the local institutional review board. Results: Four overarching themes regarding health care for refugee patients were identified: 1 difficulty balancing the dynamic of autonomy versus support for refugees; 2 educational needs of refugee families outpacing available resources; 3 challenges for refugees developing trust; and 4 diversity of cultures, education levels, and experiences among refugee families. Language barriers in accessing health care services and insufficient time to meet educational needs of refugees were major challenges outside of the clinic visit setting. Poor health literacy and difficulties communicating health needs and building trust within the interactive triad of refugee, physician, and interpreter impacted clinic visits. Conclusions: Refugee patients and other participants in refugee care work to navigate a complicated path to equitable health care for a vulnerable population. Continued pursuit of strategies that increase time allocation, education, and support for all parties are needed as we seek to improve health outcomes for newly arrived refugee families.

Challenges of Managing Animals in Disasters in the U.S.

OpenAIRE

Heath, Sebastian; Linnabary, Robert

2015-01-01

Simple Summary This article describes common challenges to managing animals in disasters in the US, summarizes how some of these challenges are being met and makes recommendations on how to overcome others. Many predictable adverse situations affecting animals and their owners can be prevented when communities develop a comprehensive emergency management strategy that integrates animal care into planning, preparedness, mitigation, and recovery activities, as well as response. Abstract Common ...

Challenges in Shifting Management Responsibility From Parents to Adolescents With Sickle Cell Disease.

Science.gov (United States)

Kayle, Mariam; Tanabe, Paula; Shah, Nirmish R; Baker-Ward, Lynne; Docherty, Sharron L

This study explored the challenges faced by adolescents with sickle cell disease (SCD) and their parents and the work they engage in to progressively shift from parent management to independent adolescent self-management. A qualitative descriptive focus-group design with semi-structured interviews was used with adolescents (11-18 years) with SCD (HbSS genotype) and their parents/primary caregivers. Interviews were analyzed using content analysis. Two adolescent focus groups, with a total of 14 adolescents, and two parent focus groups, with a total of 15 parents, described adaptive challenges. Adolescents' adaptive challenges included mastering complex symptom management, communicating about SCD and symptoms, and maintaining control. Parents' adaptive challenges included giving over the complex management, communicating the management with the adolescent, balancing protection against risk with fostering independence, changing a comfortable rhythm, and releasing the adolescent into an "SCD-naive" world. Adolescents' adaptive work included pushing back at parents, defaulting back to parental care, stepping up with time, learning how SCD affects them, and educating friends about SCD. Parents' adaptive work included engaging the adolescent in open dialogue and co-managing with the adolescent. Shifting management responsibility from parents to adolescents imposes adaptive challenges for both. Future research is needed to develop and test interventions that improve adaptive capacity in adolescents and parents. Health care providers need to assess the parent-child relationship and their progress in shifting the management responsibility, facilitate discussions to arrive at a shared understanding of the challenges, and collaborate on adaptive work to address these challenges. Copyright © 2016 Elsevier Inc. All rights reserved.

Management challenges faced by managers of New Zealand long-term care facilities.

Science.gov (United States)

Madas, E; North, N

2000-01-01

This article reports on a postal survey of 78 long-term care managers in one region of New Zealand, of whom 45 (58%) responded. Most long-term care managers (73.2%) were middle-aged females holding nursing but not management qualifications. Most long-term care facilities (69%) tended to be stand-alone facilities providing a single type of care (rest home or continuing care hospital). The most prominent issues facing managers were considered to be inadequate funding to match the growing costs of providing long-term care and occupancy levels. Managers believed that political/regulatory, economic and social factors influenced these issues. Despite a turbulent health care environment and the challenges facing managers, long-term care managers reported they were coping well and valued networking.

Knowledge management challenges in new business development

NARCIS (Netherlands)

Berends, J.J.; Vanhaverbeke, W.P.M.; Kirschbaum, R.

2007-01-01

This paper's focus is on the knowledge management challenges that come along with technology-based new business development (NBD). NBD thrives upon the exploration of knowledge, under radical uncertainty. Furthermore, existing knowledge may both enable and constrain the radical innovation process.

Water Utility Management Strategies in Turkey: The current situation and the challenges

Science.gov (United States)

Alp, E.; Aksoy, M. N.; Koçer, B.

2013-12-01

As the effects of climate change becomes more prominent, current challenges related to water and wastewater management is becoming more serious. Providing water that satisfies environmental and safety standards in terms of quantity and quality is needed to maintain human life without compromising the need of future generations. Besides providing safe and affordable water, necessary treatment should be achieved according to several important factors such as receiving body standards, discharge standards, water reuse options. Therefore, management of water becomes more crucial than ever that states have to provide accessibility of safe water with affordable cost to its citizens with the means of effective utility management, including water treatment facilities, wastewater treatment facilities, water supply facilities and water distribution systems. Water utilities encounter with several challenges related to cost, infrastructure, population, legislation, workforce and resource. This study aims to determine the current situation and the necessary strategies to improve utility management in Turkish municipalities in a sustainable manner. US Environment Protection Agency (EPA) has formed a tool on effective utility management that assists utilities to provide a solution for both current and future challenges. In this study, we used EPA's guidelines and developed a survey consists of 60 questions under 10 sub-topics (Product Quality, Employee & Leadership Development, Stakeholder Understanding & Support, Operational Optimization, Infrastructure Stability, Financial Viability, Community Sustainability, Customer Satisfaction, Operational Resiliency, and Water Resource Adequacy). This survey was sent to the managers of 25 metropolitan municipalities in Turkey to assess the current condition of municipalities. After the evaluation of the survey results for each topic, including the importance given by managers, facilities were rated according to their level of achievement

Personal and professional challenges confronted by hospital staff following hurricane sandy: a qualitative assessment of management perspectives.

Science.gov (United States)

Morris, Andrea M; Ricci, Karen A; Griffin, Anne R; Heslin, Kevin C; Dobalian, Aram

2016-05-05

Adequate hospital staffing during and after a disaster is critical to meet increased health care demands and to ensure continuity of care and patient safety. However, when a disaster occurs, staff may become both victim and responder, decreasing their ability and willingness to report for work. This qualitative study assessed the personal and professional challenges that affected staff decisions to report to work following a natural disaster and examined the role of management in addressing staff needs and concerns. Semi-structured interviews were conducted with individuals who filled key management roles in the United States Department of Veterans Affairs New York Harbor Healthcare System's response to Superstorm Sandy and during the facility's initial recovery phase. All interviews were audio recorded and transcribed. Three major themes were identified: 1) Barriers to reporting ("Barriers"), 2) Facilitators to reporting ("Facilitators"), and 3) Responses to staff needs and concerns ("Responses"). Atlas.ti 7.1.6 software program was used for the management and analysis of the transcripts. Results indicated that staff encountered several barriers that impeded their ability to report to work at mobile vans at the temporarily nonoperational Manhattan campus or at two other VA facilities in Brooklyn and the Bronx in the initial post-Sandy period including transportation problems, personal property damage, and communication issues. In addition, we found evidence of facilitators to reporting as expressed through descriptions of professional duty. Our findings also revealed that management was aware of the challenges that staff was facing and made efforts to reduce barriers and accommodate staff affected by the storm. During and after a disaster event, hospital staff is often confronted with challenges that affect decisions to report for work and perform effectively under potentially harsh conditions. This study examined barriers and facilitators that hospital staff

Sedimentary Geology Context and Challenges for Cyberinfrastructure Data Management

Science.gov (United States)

Chan, M. A.; Budd, D. A.

2014-12-01

A cyberinfrastructure data management system for sedimentary geology is crucial to multiple facets of interdisciplinary Earth science research, as sedimentary systems form the deep-time framework for many geoscience communities. The breadth and depth of the sedimentary field spans research on the processes that form, shape and affect the Earth's sedimentary crust and distribute resources such as hydrocarbons, coal, and water. The sedimentary record is used by Earth scientists to explore questions such as the continental crust evolution, dynamics of Earth's past climates and oceans, evolution of the biosphere, and the human interface with Earth surface processes. Major challenges to a data management system for sedimentary geology are the volume and diversity of field, analytical, and experimental data, along with many types of physical objects. Objects include rock samples, biological specimens, cores, and photographs. Field data runs the gamut from discrete location and spatial orientation to vertical records of bed thickness, textures, color, sedimentary structures, and grain types. Ex situ information can include geochemistry, mineralogy, petrophysics, chronologic, and paleobiologic data. All data types cover multiple order-of-magnitude scales, often requiring correlation of the multiple scales with varying degrees of resolution. The stratigraphic framework needs dimensional context with locality, time, space, and depth relationships. A significant challenge is that physical objects represent discrete values at specific points, but measured stratigraphic sections are continuous. In many cases, field data is not easily quantified, and determining uncertainty can be difficult. Despite many possible hurdles, the sedimentary community is anxious to embrace geoinformatic resources that can provide better tools to integrate the many data types, create better search capabilities, and equip our communities to conduct high-impact science at unprecedented levels.

Challenges of Integrated Water Resources Management in Indonesia

Directory of Open Access Journals (Sweden)

Mohamad Ali Fulazzaky

2014-07-01

Full Text Available The increased demands for water and land in Indonesia as a consequence of the population growth and economic development has reportedly have been accelerated from the year to year. The spatial and temporal variability of human induced hydrological changes in a river basin could affect quality and quantity of water. The challenge is that integrated water resources management (IWRM should cope with complex issues of water in order to maximize the resultant economic and social welfare in an equitable manner, without compromising the sustainability of vital ecosystems. Even though the government of Indonesia has adopted new paradigm for water resources management by the enactment of Law No. 7/2004 on water resources, the implementation of IWRM may face the technical and managerial challenges. This paper briefly reviews the implementation of IWRM and related principles and provides an overview of potential water-related issues and progress towards implementation of IWRM in Indonesia. The availability of water and a broader range of water-related issues are identified. The recommended actions for improving the future IWRM are suggested. Challenges to improve the capacity buildings of IWRM related to enabling environment, institutional frameworks and management instruments are verified to contribute to the future directions for efficient problem-solving ability.

The importance of fungi and mycology for addressing major global challenges*

OpenAIRE

Lange, Lene

2014-01-01

In the new bioeconomy, fungi play a very important role in addressing major global challenges, being instrumental for improved resource efficiency, making renewable substitutes for products from fossil resources, upgrading waste streams to valuable food and feed ingredients, counteracting life-style diseases and antibiotic resistance through strengthening the gut biota, making crop plants more robust to survive climate change conditions, and functioning as host organisms for production of new...

Experiences addressing health-related financial challenges with disease management among African American women with asthma

Science.gov (United States)

Patel, Minal R.; Caldwell, Cleopatra H.; Id-Deen, Effat; Clark, Noreen M.

2018-01-01

Objective Despite economic hardship, compliance with self-management regimens is still evident among individuals and families managing chronic disease. The purpose of this study was to describe how women with asthma address cost-related challenges to management of their condition. Methods In 2012 and 2013, four focus groups were conducted in Southeast Michigan with 26 African American women with asthma, recruited based on maximum variation sampling procedures. A semi-structured interview protocol was employed by trained facilitators. Coded transcripts were analyzed for themes regarding means to reduce the impact of the cost of asthma management. Results Major themes identified were acceptance of the status quo; stockpiling and sharing medicines; utilizing community assistance programs; reaching out to healthcare providers and social networks for help; foregoing self-management; and utilizing urgent care. Conclusions Awareness of strategies that are helpful to patients in reducing out-of-pocket costs may better equip service providers and others to develop interventions to make useful strategies more widely available. PMID:24471517

Experiences addressing health-related financial challenges with disease management among African American women with asthma.

Science.gov (United States)

Patel, Minal R; Caldwell, Cleopatra H; Id-Deen, Effat; Clark, Noreen M

2014-06-01

Despite economic hardship, compliance with self-management regimens is still evident among individuals and families managing chronic disease. The purpose of this study was to describe how women with asthma address cost-related challenges to management of their condition. In 2012 and 2013, four focus groups were conducted in Southeast Michigan with 26 African American women with asthma, recruited based on maximum variation sampling procedures. A semi-structured interview protocol was employed by trained facilitators. Coded transcripts were analyzed for themes regarding means to reduce the impact of the cost of asthma management. Major themes identified were acceptance of the status quo; stockpiling and sharing medicines; utilizing community assistance programs; reaching out to healthcare providers and social networks for help; foregoing self-management; and utilizing urgent care. Awareness of strategies that are helpful to patients in reducing out-of-pocket costs may better equip service providers and others to develop interventions to make useful strategies more widely available.

Challenges of nurses' empowerment in the management of patient aggression: A qualitative study

Directory of Open Access Journals (Sweden)

Tahereh Ramezani

2017-01-01

Full Text Available Background: Patients' aggression in the mental care setting is a global health problem with major psychological, physical, and economic consequences; nurse empowerment to manage this aggressive behavior is an important step in psychiatric nursing. The aim of this study was to explore psychiatric nurses' experiences of the challenges of empowerment in the management of patients' aggression. Materials and Methods: This qualitative study was performed among 20 nurses working in a major referral psychiatric center in Iran during 2014–2016. The purposive sampling method was used for selecting the participants. Data were collected through semi-structured interviews, observations, and filed notes. Inductive content analysis was used for data analysis. Results: Three categories and ten subcategories were identified: inefficient organizational policy (limited human resources, mandatory shifts, shortage of protective equipment, lack of motivational sparks; insufficient job growth (failure to implement training programs, insufficient effort for job competence, lack of clinical guidelines; and deficiencies in the organizational culture (inadequate autonomy and authority, lack of the culture of prevention, culture of fault and blame after an incident. Conclusions: Psychiatric nurses were not satisfied with organizational empowering conditions for the management of patients' aggression and reported low levels of access to learning opportunity, receiving support and essential resources that led to unnecessary use of containment measures. Managers must make every effort to create organizational context that make it possible to empower nurses for optimal practice.

Plant genetic resources management in Ghana: Some challenges in ...

African Journals Online (AJOL)

Plant genetic resources management in Ghana: Some challenges in legumes. ... Ghana Journal of Agricultural Science ... The Plant Genetic Resources Research Institute, serving as the national gene bank of Ghana, together with other stakeholders, had made strenuous efforts in managing the legume genetic resources in ...

Effectiveness of infrastructure asset management: challenges for public agencies

NARCIS (Netherlands)

Schraven, Daan; Hartmann, Andreas; Dewulf, Geert P.M.R.

2011-01-01

Purpose: The aim of this research is to better understand the decisions in infrastructure asset management at public agencies and the challenges of these agencies to improve the effectiveness of their decision making. Design/methodology/approach: Based on a literature review on asset management at

The nuclear knowledge management: challenges and perspectives

International Nuclear Information System (INIS)

Gonzalez Garcia, Alejandro; Fernandez Rondon, Manuel

2007-01-01

The knowledge management has a one of its goals to keep and to drive the key organizational competence's to the development of products and services with high scientific and technological value, as proactive reply to a dynamic and complex environment. The International Atomic Energy Agency and nuclear institutions of Member Countries recognize that the pacific use of nuclear technology is supported on the nuclear knowledge collection and that its effective management is oriented to guarantee the continuos availability of scientific and technological information and high qualified people. Recently some nuclear Cuban institutions have started some projects to implement nuclear and organizational knowledge management process. In this paper some challenges and perspectives are presented for the nuclear knowledge management in Cuba and in the world context

Asset management trends and challenges

Energy Technology Data Exchange (ETDEWEB)

Rijks, E. [Continuon, Arnhem (Netherlands); Ford, G.L. [PowerNex Associates Inc., Toronto, ON (Canada); Sanchis, G. [Reseau de Transport d' Electricite, Paris (France)

2007-07-01

Recent business and regulatory changes in the electric power industry have affected the operation of electric utilities. Most have accepted competition and commercialization. Various strategies have emerged as companies strive to improve performance and retain profitability in an environment where competition or regulatory pressure is reducing revenues at a time when customer expectation is increasing. As focus shifts away from engineering excellence towards commercial performance, the new business ideology for electric utilities is to optimize asset management. This paper identified asset management technology trends, opportunities and challenges. Although many utilities are currently comfortable with their existing asset management processes, regulators are increasingly scrutinizing utilities as they seek approval for rates and investments in aging infrastructure. Much more rigorous financial analysis methods are needed to justify the large investments that are needed. In addition, the credibility of the processes and methods used by utilities will be increasingly questioned. In recognition of the growing importance of asset management, several initiatives have been launched to provide forums for sharing information and to provide a unifying force to asset management methods. The International Council on Large Electric Systems (CIGRE) was one of the first to recognize the importance of asset management. This paper summarized recent CIGRE activities as well as the developments of publicly available specification (PAS) 55 in the United Kingdom. It was concluded that utilities that adopt standardized approaches will be more credible in the eyes of regulatory authorities. 3 refs., 4 figs.

Sustainable Nutrient Management in Chinese Agriculture:Challenges and Perspective

Institute of Scientific and Technical Information of China (English)

无

2006-01-01

China has to raise agricultural productivity in its limited and shrinking farmland to guarantee food security for its huge and ever-growing population. Sustainable soil nutrient management is of paramount importance to the world's most populous country. Critical challenges the country is facing in sustaining soil fertility and in alleviating the hazardous impact of intensive fertilizer use are discussed in this paper. It is emphatically pointed out that national strategies as well as area-specific action plans with respect to scientific nutrient management are urgently needed to balance productivity and sustainability in the future. Relevant proposals for addressing those challenges are also presented.

The Challenges of Managing Transnational Education Partnerships: The Views of "Home-Based" Managers vs "In-Country" Managers

Science.gov (United States)

Healey, Nigel Martin

2018-01-01

Purpose: The purpose of this paper is to investigate the challenges of managing transnational education (TNE) partnerships from the perspective of the home university managers. Design/methodology/approach: The study adopts a qualitative, "insider researcher" methodology. It uses a sample set of eight mangers who operate from the home…

Solid waste management challenges for cities in developing countries

NARCIS (Netherlands)

Abarca Guerrero, L.; Maas, G.J.; Hogland, W

2013-01-01

Solid waste management is a challenge for the cities’ authorities in developing countries mainly due to the increasing generation of waste, the burden posed on the municipal budget as a result of the high costs associated to its management, the lack of understanding over a diversity of factors that

Migrating from user fees to social health insurance: exploring the prospects and challenges for hospital management.

Science.gov (United States)

Atinga, Roger A; Mensah, Sylvester A; Asenso-Boadi, Francis; Adjei, Francis-Xavier Andoh

2012-06-22

In 2003 Ghana introduced a social health insurance scheme which resulted in the separation of purchasing of health services by the health insurance authority on the one hand and the provision of health services by hospitals at the other side of the spectrum. This separation has a lot of implications for managing accredited hospitals. This paper examines whether decoupling purchasing and service provision translate into opportunities or challenges in the management of accredited hospitals. A qualitative exploratory study of 15 accredited district hospitals were selected from five of Ghana's ten administrative regions for the study. A semi-structured interview guide was designed to solicit information from key informants, Health Service Administrators, Pharmacists, Accountants and Scheme Managers of the hospitals studied. Data was analysed thematically. The results showed that under the health insurance scheme, hospitals are better-off in terms of cash flow and adequate stock levels of drugs. Adequate stock of non-drugs under the scheme was reportedly intermittent. The major challenges confronting the hospitals were identified as weak purchasing power due to low tariffs, non computerisation of claims processing, unpredictable payment pattern, poor gate-keeping systems, lack of logistics and other new and emerging challenges relating to moral hazards and the use of false identity cards under pretence for medical care. Study's findings have a lot of policy implications for proper management of hospitals. The findings suggest rationalisation of the current tariff structure, the application of contract based payment system to inject efficiency into hospitals management and piloting facility based vetting systems to offset vetting loads of the insurance authority. Proper gate-keeping mechanisms are also needed to curtail the phenomenon of moral hazard and false documentation.

Challenges and Needs for Support in Managing Occupational Health and Safety from Managers’ Viewpoints

Directory of Open Access Journals (Sweden)

Sari Tappura

2014-09-01

Full Text Available Proper working conditions and successful occupational health and safety (OHS management help organizations achieve their targets and support the quality of working life and performance. Work-related stress, conflicts, work ability issues, ill health, and other challenging OHS situations in the workplace may impede the well-being and productivity of employees. According to OHS legislation, employers are responsible for managing risks and solving problems in the work community. Challenging situations can be viewed from the perspective of efficiency, since their economic effects may be remarkable. The objective of this study is to describe the challenging OHS situations managers encounter and the support they require in these situations. The results are based on thematic interviews and inquiries with top, middle, and front-line managers in three Finnish public sector service organizations. The most challenging OHS management situations are related to the administration of work under high economic pressure and constant changes in the work community, managing employee workload and time pressures, providing feedback, facilitating collaboration, and managing conflict. The managers’ own understandings, competences, and resources, as well as organizational supports, have an effect on successful resolutions of challenging OHS management situations.

Water Management in Africa and the Middle East: Challenges and ...

International Development Research Centre (IDRC) Digital Library (Canada)

Book cover Water Management in Africa and the Middle East: Challenges and ... key issues and trends, and map out strategies for further research and action. ... and adaptive water management: Innovative solutions from the Global South”.

Challenges in managing and sustaining urban slum health ...

African Journals Online (AJOL)

Challenges in managing and sustaining urban slum health programmes in Kenya. ... These were hardly implemented in the projects, according to the data gathered. ... Conclusion: Land and income were big issues according to the responses.

Identity Management Mismatch Challenges in the Danish Municipality Administration System

DEFF Research Database (Denmark)

Andersen, Mads Schaarup; Christensen, Henrik Bærbak

2010-01-01

Integrating a COTS product in a company’s product portfolio is appealing from a business perspective but highly challenging from the perspective of the software architecture. In this paper we outline research challenges regarding authorization in the identity management part of the Danish...

Challenges and outcomes of management of anterior abdominal ...

African Journals Online (AJOL)

Challenges and outcomes of management of anterior abdominal wall defects in a Nigerian tertiary hospital. ... African Journal of Paediatric Surgery ... Postoperative complication rate was 32.1% and overall mortality was 30.4%, with the ...

Management challenges in creating value from business analytics

OpenAIRE

Vidgen, Richard; Shaw, S.; Grant, D.G.

2017-01-01

The popularity of big data and business analytics has increased tremendously in the last decade and a key challenge for organizations is in understanding how to leverage them to create business value. However, while the literature acknowledges the importance of these topics little work has addressed them from the organization’s point of view. This paper investigates the challenges faced by organizational managers seeking to become more data and information-driven in order to create value. Emp...

Shaping a sustainable energy future for India: Management challenges

International Nuclear Information System (INIS)

Bhattacharyya, Subhes C.

2010-01-01

Most of the studies on the Indian energy sector focus on the possible future scenarios of Indian energy system development without considering the management dimension to the problem-how to ensure a smooth transition to reach the desired future state. The purpose of this paper is to highlight some sector management concerns to a sustainable energy future in the country. The paper follows a deductive approach and reviews the present status and possible future energy outlooks from the existing literature. This is followed by a strategy outline to achieve long-term energy sustainability. Management challenges on the way to such a sustainable future are finally presented. The paper finds that the aspiration of becoming an economic powerhouse and the need to eradicate poverty will necessarily mean an increase in energy consumption unless a decoupling of energy and GDP growth is achieved. Consequently, the energy future of the country is eminently unsustainable. A strategy focussing on demand reduction, enhanced access, use of local resources and better management practices is proposed here. However, a sustainable path faces a number of challenges from the management and policy perspectives.

Infectious disease in cervids of North America: data, models, and management challenges.

Science.gov (United States)

Conner, Mary Margaret; Ebinger, Michael Ryan; Blanchong, Julie Anne; Cross, Paul Chafee

2008-01-01

Over the past two decades there has been a steady increase in the study and management of wildlife diseases. This trend has been driven by the perception of an increase in emerging zoonotic diseases and the recognition that wildlife can be a critical factor for controlling infectious diseases in domestic animals. Cervids are of recent concern because, as a group, they present a number of unique challenges. Their close ecological and phylogenetic relationship to livestock species places them at risk for receiving infections from, and reinfecting livestock. In addition, cervids are an important resource; revenue from hunting and viewing contribute substantially to agency budgets and local economies. A comprehensive coverage of infectious diseases in cervids is well beyond the scope of this chapter. In North America alone there are a number of infectious diseases that can potentially impact cervid populations, but for most of these, management is not feasible or the diseases are only a potential or future concern. We focus this chapter on three diseases that are of major management concern and the center of most disease research for cervids in North America: bovine tuberculosis, chronic wasting disease, and brucellosis. We discuss the available data and recent advances in modeling and management of these diseases.

Hazardous and toxic waste management in Botswana: practices and challenges.

Science.gov (United States)

Mmereki, Daniel; Li, Baizhan; Meng, Liu

2014-12-01

Hazardous and toxic waste is a complex waste category because of its inherent chemical and physical characteristics. It demands for environmentally sound technologies and know-how as well as clean technologies that simultaneously manage and dispose it in an environmentally friendly way. Nevertheless, Botswana lacks a system covering all the critical steps from importation to final disposal or processing of hazardous and toxic waste owing to limited follow-up of the sources and types of hazardous and toxic waste, lack of modern and specialised treatment/disposal facilities, technical know-how, technically skilled manpower, funds and capabilities of local institutions to take lead in waste management. Therefore, because of a lack of an integrated system, there are challenges such as lack of cooperation among all the stakeholders about the safe management of hazardous and toxic waste. Furthermore, Botswana does not have a systematic regulatory framework regarding monitoring and hazardous and toxic waste management. In addition to the absence of a systematic regulatory framework, inadequate public awareness and dissemination of information about hazardous and toxic waste management, slower progress to phase-out persistent and bio-accumulative waste, and lack of reliable and accurate information on hazardous and toxic waste generation, sources and composition have caused critical challenges to effective hazardous and toxic waste management. It is, therefore, important to examine the status of hazardous and toxic waste as a waste stream in Botswana. By default; this mini-review article presents an overview of the current status of hazardous and toxic waste management and introduces the main challenges in hazardous and toxic waste management. Moreover, the article proposes the best applicable strategies to achieve effective hazardous and toxic waste management in the future. © The Author(s) 2014.

Institutional Management of Core Facilities during Challenging Financial Times

OpenAIRE

Haley, Rand

2011-01-01

The economic downturn is likely to have lasting effects on institutions of higher education, prioritizing proactive institutional leadership and planning. Although by design, core research facilities are more efficient and effective than supporting individual pieces of research equipment, cores can have significant underlying financial requirements and challenges. This paper explores several possible institutional approaches to managing core facilities during challenging financial times.

Institutional management of core facilities during challenging financial times.

Science.gov (United States)

Haley, Rand

2011-12-01

The economic downturn is likely to have lasting effects on institutions of higher education, prioritizing proactive institutional leadership and planning. Although by design, core research facilities are more efficient and effective than supporting individual pieces of research equipment, cores can have significant underlying financial requirements and challenges. This paper explores several possible institutional approaches to managing core facilities during challenging financial times.

Scientific and social challenges for the management of fire-prone wildland-urban interfaces

Science.gov (United States)

Gill, A. Malcolm; Stephens, Scott L.

2009-09-01

At their worst, fires at the rural-urban or wildland-urban interface cause tragic loss of human lives and homes, but mitigating these fire effects through management elicits many social and scientific challenges. This paper addresses four interconnected management challenges posed by socially disastrous landscape fires. The issues concern various assets (particularly houses, human life and biodiversity), fuel treatments, and fire and human behaviours. The topics considered are: 'asset protection zones'; 'defensible space' and urban fire spread in relation to house ignition and loss; 'stay-or-go' policy and the prediction of time available for safe egress and the possible conflict between the creation of defensible space and wildland management objectives. The first scientific challenge is to model the effective width of an asset protection zone of an urban area. The second is to consider the effect of vegetation around a house, potentially defensible space, on fire arrival at the structure. The third scientific challenge is to present stakeholders with accurate information on rates of spread, and where the fire front is located, so as to allow them to plan safe egress or preparation time in their particular circumstances. The fourth scientific challenge is to be able to predict the effects of fires on wildland species composition. Associated with each scientific challenge is a social challenge: for the first two scientific challenges the social challenge is to co-ordinate fuel management within and between the urban and rural or wildland sides of the interface. For the third scientific challenge, the social challenge is to be aware of, and appropriately use, fire danger information so that the potential for safe egress from a home can be estimated most accurately. Finally, the fourth social challenge is to for local residents of wildland-urban interfaces with an interest in biodiversity conservation to understand the effects of fire regimes on biodiversity, thereby

Scientific and social challenges for the management of fire-prone wildland-urban interfaces

International Nuclear Information System (INIS)

Gill, A Malcolm; Stephens, Scott L

2009-01-01

At their worst, fires at the rural-urban or wildland-urban interface cause tragic loss of human lives and homes, but mitigating these fire effects through management elicits many social and scientific challenges. This paper addresses four interconnected management challenges posed by socially disastrous landscape fires. The issues concern various assets (particularly houses, human life and biodiversity), fuel treatments, and fire and human behaviours. The topics considered are: 'asset protection zones'; 'defensible space' and urban fire spread in relation to house ignition and loss; 'stay-or-go' policy and the prediction of time available for safe egress and the possible conflict between the creation of defensible space and wildland management objectives. The first scientific challenge is to model the effective width of an asset protection zone of an urban area. The second is to consider the effect of vegetation around a house, potentially defensible space, on fire arrival at the structure. The third scientific challenge is to present stakeholders with accurate information on rates of spread, and where the fire front is located, so as to allow them to plan safe egress or preparation time in their particular circumstances. The fourth scientific challenge is to be able to predict the effects of fires on wildland species composition. Associated with each scientific challenge is a social challenge: for the first two scientific challenges the social challenge is to co-ordinate fuel management within and between the urban and rural or wildland sides of the interface. For the third scientific challenge, the social challenge is to be aware of, and appropriately use, fire danger information so that the potential for safe egress from a home can be estimated most accurately. Finally, the fourth social challenge is to for local residents of wildland-urban interfaces with an interest in biodiversity conservation to understand the effects of fire regimes on biodiversity, thereby

New Challenges for Asset Managers in the Danish Social Housing Sector

DEFF Research Database (Denmark)

Haugbølle, Kim; Engberg, Lars A.

2004-01-01

During the 1990s, the social housing sector in Denmark has undergone a number of changes. New trends are forcing asset managers to rethink their roles and strategies. In this changing context, asset managers have been confronted with strategic challenges on three topics: 1. New modes of tenants......’ involvement. 2. New partnerships with the building industry. 3. Moving towards a European internal market of construction products. The paper explores and analyses these three challenges by drawing on a number of case studies as well as a re-analysis of current research on management of renewal and building...

Neuroanaesthetic and perioperative challenges in the management of giant encephaloceles

Directory of Open Access Journals (Sweden)

V Bhatnagar

2013-01-01

Full Text Available There are complex issues involved in the surgical management of giant occipital encephaloceles, especially in neonates and young infants. Airway management can cause technical difficulties due to location of lesion, associated abnormalities and the position to be maintained during surgery. We present perioperative challenges we faced in the management of one such case.

Supply Chain Management on IBS Implementation in Klang Valley Construction Industry: Challenges and Issues

Science.gov (United States)

Azrizal Fauzi, Mohd; Hasim, Sulaiman; Awang, Anizah; Ridzuan, Ahmad Ruslan Mohd; Nur Yunus, Juzailah

2017-12-01

Industrialized Building System (IBS) is a system where the components of the building are manufactured in a factory and it will be transported to the site to form the structures. The supply chain management (SCM) is a system where the delivery flows of the IBS products from manufacturers to the site. The aim of this research is to identify the major challenges and to analyze the issues on IBS implementation in SCM in Klang Valley from the manufacturers perspective. The methodology used in this paper is based on primary data through questionnaire and interview. Questionnaires were sent to the Manufacturers. It can be concluded that this paper attempts to present more on the challenges and issues that those companies of manufacturers faced during their success journey in finding integration in their supply chain. The main contributions of this paper are integrating all the supply chain integration challenges and issues on IBS. Therefore, these contributions will be helpful for the organization of manufacturers and IBS players that establish the integration in their SCM.

Ethical challenges within Veterans Administration healthcare facilities: perspectives of managers, clinicians, patients, and ethics committee chairpersons.

Science.gov (United States)

Foglia, Mary Beth; Pearlman, Robert A; Bottrell, Melissa; Altemose, Jane K; Fox, Ellen

2009-04-01

To promote ethical practices, healthcare managers must understand the ethical challenges encountered by key stakeholders. To characterize ethical challenges in Veterans Administration (VA) facilities from the perspectives of managers, clinicians, patients, and ethics consultants. We conducted focus groups with patients (n = 32) and managers (n = 38); semi-structured interviews with managers (n = 31), clinicians (n = 55), and ethics committee chairpersons (n = 21). Data were analyzed using content analysis. Managers reported that the greatest ethical challenge was fairly distributing resources across programs and services, whereas clinicians identified the effect of resource constraints on patient care. Ethics committee chairpersons identified end-of-life care as the greatest ethical challenge, whereas patients identified obtaining fair, respectful, and caring treatment. Perspectives on ethical challenges varied depending on the respondent's role. Understanding these differences can help managers take practical steps to address these challenges. Further, ethics committees seemingly, are not addressing the range of ethical challenges within their institutions.

Accommodating the Challenges of Climate Change Adaptation and Governance in Conventional Risk Management: Adaptive Collaborative Risk Management (ACRM)

OpenAIRE

Bradley May; Ryan Plummer

2011-01-01

Risk management is a well established tool for climate change adaptation. It is facing new challenges with the end of climate stationarity and the need to meaningfully engage people in governance issues. The ways in which conventional approaches to risk management can respond to these challenges are explored. Conventional approaches to risk management are summarized, the manner in which they are being advanced as a tool for climate change adaptation is described, and emerging themes in risk m...

Adaptive Embedded Systems – Challenges of Run-Time Resource Management

DEFF Research Database (Denmark)

Understanding and efficiently controlling the dynamic behavior of adaptive embedded systems is a challenging endavor. The challenges come from the often very complicated interplay between the application, the application mapping, and the underlying hardware architecture. With MPSoC, we have...... the technology to design and fabricate dynamically reconfigurable hardware platforms. However, such platforms will pose new challenges to tools and methods to efficiently explore these platforms at run-time. This talk will address some of the challenges of run-time resource management in adaptive embedded...... systems....

INTEGRATION CHALLENGES OF UNIVERSITY AND INFORMATION MANAGEMENT SYSTEM (UIMS TO MOODLE

Directory of Open Access Journals (Sweden)

Jyldyzbek J. Jakshylykov

2016-06-01

Full Text Available Introduction: in 2006 an International Ataturk Ala-Too University (IAAU began to adopt internationally recognised Bologna system, which was initiated by the Ministry of Science and Education of Kyrgyz Republic because of problems of managerial and educational problems at universities in Kyrgyzstan. Consequently, IAAU had to improve its information and grading system and created University Information and Manage¬ment System (UIMS, which was developed by the university professional team including the author. At the same time, the university began to apply a Moodle software, which delivers open source management system programs, in order to appropriately manage teaching proc esses and manage courses online. Materials and Methods: the methodological basis of the research are descriptive method, analysis, and comparison. Results: however, the IAAU faced some challenged issues in the application of the two innovation, which was the integration challenges of those Moodle and UIMS. Hence, the main purpose of this study is to demonstrate benefits of Moodle and UIMS linking challenges. at first, this paper informs Moodle functions, features, advantages and disadvantages in a shortly manner and UIMS management features and primary functions, which included six fundamentally crucial processes with some graphical representations. In addition, the analysis and methodologies of two systems through identifying advantages and disadvantages for the possible integ ration. Discussion and Conclusions: at the end, some challenged issues were identified from analysis results, also Moodle and UIMS benefits were demonstrated in the International Ataturk Ala-Too University.

Challenges to a successful waste management programme

International Nuclear Information System (INIS)

Le Bars, Y.

2005-01-01

I have chosen to testify about my personal experience as a practitioner in the development and implementation of sensitive public policies and about some of the lessons I have learnt in various related fields. Those fields do not only include Andra, but also the exchanges from which I benefit within EDRAM, the club (that I currently chair) of agency directors responsible for those programmes, as well as within the Forum for Stakeholder Confidence (FSC) of the DECD/NEA. Last but not least, I would also introduce some lessons from my previous activities in the city planning, and in the management of water projects. In order to succeed, a sound policy relating to a sustainable radioactive-waste management must be able to take up a certain number of challenges. Three of those challenges seem essential to me: combining the technical and social aspects of the issue; organizing a suitable context in which the definition and the implementation of the policy will take place; and achieving a solid implementation locally. (author)

Changes in Business Structures: Challenges for Management of Libyan Industry

NARCIS (Netherlands)

Abouazoum, Alafi; de Bruijn, E.J.; Steenhuis, H.J.; Kaynak, E.; Harcar, T.D.

2008-01-01

Libya has become a transition economy due to global industrial and political changes in the past decades. Being for long time under government control has created a number of challenges for the management of the SOEs. The most challenging aspect is firm performance improvement. Based on a pilot

Migrating from user fees to social health insurance: exploring the prospects and challenges for hospital management

Science.gov (United States)

2012-01-01

Background In 2003 Ghana introduced a social health insurance scheme which resulted in the separation of purchasing of health services by the health insurance authority on the one hand and the provision of health services by hospitals at the other side of the spectrum. This separation has a lot of implications for managing accredited hospitals. This paper examines whether decoupling purchasing and service provision translate into opportunities or challenges in the management of accredited hospitals. Methods A qualitative exploratory study of 15 accredited district hospitals were selected from five of Ghana’s ten administrative regions for the study. A semi-structured interview guide was designed to solicit information from key informants, Health Service Administrators, Pharmacists, Accountants and Scheme Managers of the hospitals studied. Data was analysed thematically. Results The results showed that under the health insurance scheme, hospitals are better-off in terms of cash flow and adequate stock levels of drugs. Adequate stock of non-drugs under the scheme was reportedly intermittent. The major challenges confronting the hospitals were identified as weak purchasing power due to low tariffs, non computerisation of claims processing, unpredictable payment pattern, poor gate-keeping systems, lack of logistics and other new and emerging challenges relating to moral hazards and the use of false identity cards under pretence for medical care. Conclusion Study’s findings have a lot of policy implications for proper management of hospitals. The findings suggest rationalisation of the current tariff structure, the application of contract based payment system to inject efficiency into hospitals management and piloting facility based vetting systems to offset vetting loads of the insurance authority. Proper gate-keeping mechanisms are also needed to curtail the phenomenon of moral hazard and false documentation. PMID:22726666

Migrating from user fees to social health insurance: exploring the prospects and challenges for hospital management

Directory of Open Access Journals (Sweden)

Atinga Roger A

2012-06-01

Full Text Available Abstract Background In 2003 Ghana introduced a social health insurance scheme which resulted in the separation of purchasing of health services by the health insurance authority on the one hand and the provision of health services by hospitals at the other side of the spectrum. This separation has a lot of implications for managing accredited hospitals. This paper examines whether decoupling purchasing and service provision translate into opportunities or challenges in the management of accredited hospitals. Methods A qualitative exploratory study of 15 accredited district hospitals were selected from five of Ghana’s ten administrative regions for the study. A semi-structured interview guide was designed to solicit information from key informants, Health Service Administrators, Pharmacists, Accountants and Scheme Managers of the hospitals studied. Data was analysed thematically. Results The results showed that under the health insurance scheme, hospitals are better-off in terms of cash flow and adequate stock levels of drugs. Adequate stock of non-drugs under the scheme was reportedly intermittent. The major challenges confronting the hospitals were identified as weak purchasing power due to low tariffs, non computerisation of claims processing, unpredictable payment pattern, poor gate-keeping systems, lack of logistics and other new and emerging challenges relating to moral hazards and the use of false identity cards under pretence for medical care. Conclusion Study’s findings have a lot of policy implications for proper management of hospitals. The findings suggest rationalisation of the current tariff structure, the application of contract based payment system to inject efficiency into hospitals management and piloting facility based vetting systems to offset vetting loads of the insurance authority. Proper gate-keeping mechanisms are also needed to curtail the phenomenon of moral hazard and false documentation.

Dependent leaders : Role-specific challenges for middle managers

NARCIS (Netherlands)

Voorn, Bart

2018-01-01

Mocked and ridiculed by many, praised by few, middle managers have challenging roles in organizations. It is typified by unique dependencies on different aspects of their work circumstances, including their superiors’ leadership, assigned goals, and tenure. Empirical research exploring specific

How is it going? Peformance assessment in major projects

DEFF Research Database (Denmark)

Maylor, Harvey; Johnson, Mark; Turner, Neil

2017-01-01

an enhanced service performance model. This was then tested using a survey and a structural equation model derived. Development of this yielded new classifications but most importantly, provided a more meaningful method for measuring the performance of operational transformation projects. Specifically......Determining the performance of a major project is a challenge for both practitioners and scholars. In the context of operational change projects the challenge is exacerbated by the service-intensive nature of the transformation, temporal disconnects between contracting and delivery and lack...... management in major projects from an OM perspective....

Blockchains for Business Process Management - Challenges and Opportunities

OpenAIRE

Mendling, Jan; Weber, Ingo; van der Aalst, Wil; Brocke, Jan vom; Cabanillas, Cristina; Daniel, Florian; Debois, Soren; Di Ciccio, Claudio; Dumas, Marlon; Dustdar, Schahram; Gal, Avigdor; Garcia-Banuelos, Luciano; Governatori, Guido; Hull, Richard; La Rosa, Marcello

2017-01-01

Blockchain technology offers a sizable promise to rethink the way inter-organizational business processes are managed because of its potential to realize execution without a central party serving as a single point of trust (and failure). To stimulate research on this promise and the limits thereof, in this paper we outline the challenges and opportunities of blockchain for Business Process Management (BPM). We first reflect how blockchains could be used in the context of the established BPM l...

Initiatives and Challenges in Consequence Management after a WMD Attack

Science.gov (United States)

2004-08-01

Challenges in Consequence Management people to seek shelter or other protection when possible, to avoid exposure to weapons of mass destruction effects . The...Potential Effects .........................................9 V. Methods for Managing the Consequences of WMD Use.................14 VI. Toward a...mass destruction (WMD). Consequence management1 is a process to mitigate the effects of the use of weapons of mass destruction, including

Challenges and outcomes of management of anterior abdominal wall defects in a Nigerian tertiary hospital

Directory of Open Access Journals (Sweden)

Lukman O Abdur-Rahman

2011-01-01

Full Text Available Background : Abdominal wall defect presents a great challenge when it is large, ruptured, or associated with other anomalies. Objective : To review the challenges and outcome of management of anterior abdominal wall defects (AAWD. Materials and Methods : A retrospective review of omphalocele and gastroschisis managed over 8 years at our institution. Results : Omphalocele (n=49 and gastroschisis (n=7 constituted 2.4% of total admission. The median age was 23.5 hours, with male-female ratio of 1:1.1. Term infants were 91.7% and more than 75% weighed above 2.5 kg. The mean maternal age was 28.5±5.87 years and mean parity was 3.1±2.0, with P values of 0.318 and 0.768, respectively. More than 92.9% of infants were out-born, 46 pregnancies (82.1% were booked, and 51 (91.1% had at least one ultrasound scan, but only 1 (1.8% was diagnosed with gastroschisis. Ruptured omphalocele were 11 (6 major, 5 minor in number, 3 of which presented with enterocutaneous fistula, and 3 (6.1% were syndromic omphalocele. Positive blood culture confirmed septicaemia in 21 cases (37.5%. Surgical repair was done in 35 cases (62.5%, 44.6% as emergency, and 17.9% as elective. Non-operative management was done in 21 patients (37.5% and 5 (8.9% were discharged against medical advice. Median length of hospital stay was 10 days (mean, 15.98±14.38. Postoperative complication rate was 32.1% and overall mortality was 30.4%, with the highest case fatality among gastroschisis (57.1% and omphalocele major (32.1%. Conclusions: There were large numbers of out-born infants due to poor prenatal diagnosis in spite of high instances of antenatal ultrasound scan. Many patients presented with complications that resulted in poor outcome.

Contemporary careers management: critical challenges for human resource management

Directory of Open Access Journals (Sweden)

Carlos Fernando Torres Oviedo

2015-01-01

Full Text Available This review article lays out some conceptual guidelines regarding careers in organizations. Special emphasis has been made on the transformation that this practice has experienced since the late twentieth century, given the new working conditions created by the technological, economic, and cultural changes that have taken place. The literature shows a more dynamic and complex stage for people and organizations in the current historical moment. It was found that, under the current conditions, people guide their own careers, aiming at achieving higher levels within and/or outside the organization. This poses new challenges and ways of thinking about managing people, leading to the development of alternative practices. Finally, as a suggestion, some questions to be addressed by those responsible of human management are presented, aimed at building reciprocal relationships that contribute to mutual development.

Forest Management Challenges for Sustaining Water Resources in the Anthropocene

Directory of Open Access Journals (Sweden)

Ge Sun

2016-03-01

Full Text Available The Earth has entered the Anthropocene epoch that is dominated by humans who demand unprecedented quantities of goods and services from forests. The science of forest hydrology and watershed management generated during the past century provides a basic understanding of relationships among forests and water and offers management principles that maximize the benefits of forests for people while sustaining watershed ecosystems. However, the rapid pace of changes in climate, disturbance regimes, invasive species, human population growth, and land use expected in the 21st century is likely to create substantial challenges for watershed management that may require new approaches, models, and best management practices. These challenges are likely to be complex and large scale, involving a combination of direct and indirect biophysical watershed responses, as well as socioeconomic impacts and feedbacks. We discuss the complex relationships between forests and water in a rapidly changing environment, examine the trade-offs and conflicts between water and other resources, and propose new management approaches for sustaining water resources in the Anthropocene.

Management challenges in children with both epilepsy and intellectual disability.

Science.gov (United States)

Buelow, Janice M; Shore, Cheryl P

2010-01-01

People who have both epilepsy and intellectual disability have significant problems requiring skilled health care management. Clinical nurse specialists have the unique opportunity to work with these people and their families to help them develop self-management and family management skills. In this article, we describe some factors associated with intellectual disability and epilepsy. In addition, we address the management challenges associated with this dual diagnoses in 3 areas: (1) problems associated with the management of seizure and prescription management, (2) problems associated with the seizure management other than prescriptions, and (3) life management issues. Finally, we suggest ways that clinical nurse specialists can foster development of management skills.

[Improving treatment adherence in kidney transplantation: a major challenge].

Science.gov (United States)

Kessler, Michèle

2014-06-01

The kidney transplant recipient is faced not only with the perspective of taking immunosuppressive drugs lifelong, but also the possibility of other long-term treatments prescribed for preexisting conditions, complications, or side effects. Proper management, and most importantly patient adherence, can become a complex challenge. Here we recall current definitions and describe methods for measuring treatment adherence, followed by a discussion on the prevalence of non-adherence in kidney transplant recipients, its effect on graft survival, and factors predictive of non-adherence. Ways of improving adherence are examined, leading to the conviction that helping patients take their medications regularly would probably have a greater impact on graft survival than marketing a new immunosuppressive agent. Copyright © 2014 Association Société de néphrologie. Published by Elsevier SAS. All rights reserved.

Management as a science-based profession: a grand societal challenge

NARCIS (Netherlands)

Romme, A.G.L.

2017-01-01

The purpose of this paper is to explore how the quest for management as a science-based profession, conceived as a grand societal challenge, can be revitalized. A reflective approach is adopted by questioning some of the key assumptions made by management scholars, especially those that undermine

The pattern and challenges of infertility management in Lagos, Nigeria

African Journals Online (AJOL)

Background: Infertility remains a threat to successful reproduction by couples desirous of pregnancy. Objective: To determine the pattern of infertility cases amongst infertile couples seeking care in Lagos University Teaching Hospital as well as challenges in their management. Methods: A review of the management of ...

Challenges faced by nurses in managing pain in a critical care setting.

Science.gov (United States)

Subramanian, Pathmawathi; Allcock, Nick; James, Veronica; Lathlean, Judith

2012-05-01

To explore nurses' challenges in managing pain among ill patients in critical care. Pain can lead to many adverse medical consequences and providing pain relief is central to caring for ill patients. Effective pain management is vital since studies show patients admitted to critical care units still suffer from significant levels of acute pain. The effective delivery of care in clinical areas remains a challenge for nurses involved with care which is dynamic and constantly changing in critically ill. Qualitative prospective exploratory design. This study employed semi structured interviews with nurses, using critical incident technique. Twenty-one nurses were selected from critical care settings from a large acute teaching health care trust in the UK. A critical incident interview guide was constructed from the literature and used to elicit responses. Framework analysis showed that nurses perceived four main challenges in managing pain namely lack of clinical guidelines, lack of structured pain assessment tool, limited autonomy in decision making and the patient's condition itself. Nurses' decision making and pain management can influence the quality of care given to critically ill patients. It is important to overcome the clinical problems that are faced when dealing with pain experience. There is a need for nursing education on pain management. Providing up to date and practical strategies may help to reduce nurses' challenges in managing pain among critically ill patients. Broader autonomy and effective decision making can be seen as beneficial for the nurses besides having a clearer and structured pain management guidelines. © 2011 Blackwell Publishing Ltd.

Waste management in Greenland: current situation and challenges

DEFF Research Database (Denmark)

Eisted, Rasmus; Christensen, Thomas Højlund

2011-01-01

Waste management in Greenland (56 000 inhabitants) is characterized by landfilling, incineration and export to Denmark of small quantities of metals and hazardous waste. The annual amount of waste is estimated to about 50 000 tons but actual data are scarce. Data on the waste composition is basic...... are small and equipped with only moderate flue gas cleaning technology. This report summarizes the current waste management situation in Greenland and identifies important challenges in improving the waste management....... is basically lacking. The scattered small towns and settlements, the climate and the long transport distances between towns and also to recycling industries abroad constitute a complex situation with respect to waste management. The landfills have no collection of gas and leachate and the incinerators...

Sustainable Materials Management (SMM) Food Recovery Challenge (FRC) Data

Data.gov (United States)

U.S. Environmental Protection Agency — As part of EPA's Food Recovery Challenge (FRC), organizations pledge to improve their sustainable food management practices and report their results. The FRC is part...

New perspectives in small-scale fisheries management: challenges ...

African Journals Online (AJOL)

This is in response to the recognition that conventional fisheries management is not equipped to deal with the complexities, uncertainties and challenges prevalent in small-scale fishery systems. Consequently, a new fisheries paradigm is emerging based on the principles and ideas underpinning systems thinking, ...

Collaborative Management of Complex Major Construction Projects: AnyLogic-Based Simulation Modelling

Directory of Open Access Journals (Sweden)

Na Zhao

2016-01-01

Full Text Available Complex supply chain system collaborative management of major construction projects effectively integrates the different participants in the construction project. This paper establishes a simulation model based on AnyLogic to reveal the collaborative elements in the complex supply chain management system and the modes of action as well as the transmission problems of the intent information. Thus it is promoting the participants to become an organism with coordinated development and coevolution. This study can help improve the efficiency and management of the complex system of major construction projects.

Knowledge Management: Trends and Challenges

Directory of Open Access Journals (Sweden)

Ljubo Đula

2010-07-01

Full Text Available The main theme of this paper is based on the principle goal of the European Union, which is “to become the most competitive and dynamic knowledge-based economy in the world, capable of sustainable economic growth with more and better jobs and greater social cohesion”. The competitive advantage of the “new economy” has been transferred from material and financial resources to non-material and non-financial goods. The crucial challenge for the 21st century company is defining, evaluating, improving, appraisal and management of knowledge. Intellectual capital is the fundamental lever, the basic resource, the underlying potential, the underlying factor of all the elements, i.e. of the business system vertically. Special attention is paid to the intellectual capital as the synergy element of the business system, which can bring about vertical integration. Every company has at its disposal knowledge, abilities, values and recognisability that can be turned into value. If managing with that resource can contribute to a competitive advantage, productivity increase and market value increase, then it is no longer a choice, but a necessity. Because of that, the question is not whether it is necessary to manage intellectual capital, but how to do it.

Challenges in the Management of Bronchial Asthma Among Adults ...

African Journals Online (AJOL)

Challenges in the Management of Bronchial Asthma Among Adults in Nigeria: A Systematic ... Annals of Medical and Health Sciences Research ... Nigerian Thoracic Society, pharmaceutical industries, and the health‑care workers in general.

Challenges encountered by critical care unit managers in the large intensive care units.

Science.gov (United States)

Matlakala, Mokgadi C; Bezuidenhout, Martie C; Botha, Annali D H

2014-04-04

Nurses in intensive care units (ICUs) are exposed regularly to huge demands interms of fulfilling the many roles that are placed upon them. Unit managers, in particular, are responsible for the efficient management of the units and have the responsibilities of planning, organising, leading and controlling the daily activities in order to facilitate the achievement of the unit objectives. The objective of this study was to explore and present the challenges encountered by ICU managers in the management of large ICUs. A qualitative, exploratory and descriptive study was conducted at five hospital ICUs in Gauteng province, South Africa. Data were collected through individual interviews from purposively-selected critical care unit managers, then analysed using the matic coding. Five themes emerged from the data: challenges related to the layout and structure of the unit, human resources provision and staffing, provision of material resources, stressors in the unit and visitors in the ICU. Unit managers in large ICUs face multifaceted challenges which include the demand for efficient and sufficient specialised nurses; lack of or inadequate equipment that goes along with technology in ICU and supplies; and stressors in the ICU that limit the efficiency to plan, organise, lead and control the daily activities in the unit. The challenges identified call for multiple strategies to assist in the efficient management of large ICUs.

Challenges encountered by critical care unit managers in the large intensive care units

Directory of Open Access Journals (Sweden)

Mokgadi C. Matlakala

2014-04-01

Full Text Available Background: Nurses in intensive care units (ICUs are exposed regularly to huge demands interms of fulfilling the many roles that are placed upon them. Unit managers, in particular, are responsible for the efficient management of the units and have the responsibilities of planning, organising, leading and controlling the daily activities in order to facilitate the achievement of the unit objectives. Objectives: The objective of this study was to explore and present the challenges encountered by ICU managers in the management of large ICUs. Method: A qualitative, exploratory and descriptive study was conducted at five hospital ICUs in Gauteng province, South Africa. Data were collected through individual interviews from purposively-selected critical care unit managers, then analysed using the matic coding. Results: Five themes emerged from the data: challenges related to the layout and structure of the unit, human resources provision and staffing, provision of material resources, stressors in the unit and visitors in the ICU. Conclusion: Unit managers in large ICUs face multifaceted challenges which include the demand for efficient and sufficient specialised nurses; lack of or inadequate equipment that goes along with technology in ICU and supplies; and stressors in the ICU that limit the efficiency to plan, organise, lead and control the daily activities in the unit. The challenges identified call for multiple strategies to assist in the efficient management of large ICUs.

Policy challenges for wildlife management in a changing climate

Science.gov (United States)

Mark L. Shaffer

2014-01-01

Try as it might, wildlife management cannot make wild living things adapt to climate change. Management can, however, make adaptation more or less likely. Given that policy is a rule set for action, policy will play a critical role in society’s efforts to help wildlife cope with the challenge of climate change. To be effective, policy must provide clear goals and be...

A qualitative exploration of the major challenges facing pharmacovigilance in Saudi Arabia.

Science.gov (United States)

Aljadhey, Hisham; Mahmoud, Mansour A; Alshammari, Thamir M; Al-Dhaeefi, Mohammed; Le Louet, Herve; Perez-Gutthann, Susana; Pitts, Peter J

2015-09-01

To explore the challenges facing pharmacovigilance in Saudi Arabia and formulate recommendations to improve it from the perspective of healthcare professionals in Saudi Arabia. This was a qualitative study of 4 focus group discussions with pharmacists, physicians, and academicians held under the auspices of the King Saud University School of Pharmacy and the Center for Medicine in the Public Interest, Riyadh, Saudi Arabia. A total of 29 eligible healthcare professionals were invited to participate in the discussion. The predefined themes of the study were the current practice and major challenges facing pharmacovigilance in regulatory bodies, hospitals, the community, and academia, as well as recommendations to improve pharmacovigilance practice.  Of the 29 participants invited, 27 attended the discussion. Challenges facing regulatory bodies included complicated adverse drug reactions (ADR) reporting forms, lack of feedback on ADRs submitted to the Saudi Food and Drug Authority, lack of decisions from the local authority to withdraw medications, and lack of data on pharmacovigilance. The challenges to pharmacovigilance in hospitals included the lack of knowledge of the significance of ADR reporting, workload, blaming culture, and lack of collaboration between regulatory bodies and hospitals. However, challenges facing pharmaceutical industries included the lack of drug manufacturers in Saudi Arabia and lack of interest in pharmacovigilance. Recommendations to improve pharmacovigilance included the need for communication, stronger regulatory requirements, the need for research, the need for unified ADRs reporting, and continuous education and training.  The study has identified the challenges facing pharmacovigilance in Saudi Arabia and made certain recommendations to overcome them. These recommendations might be helpful for regulatory bodies to enhance spontaneous reporting and promote pharmacovigilance.

Cultural and family challenges to managing type 2 diabetes in immigrant Chinese Americans.

Science.gov (United States)

Chesla, Catherine A; Chun, Kevin M; Kwan, Christine M L

2009-10-01

Although Asians demonstrate elevated levels of type 2 diabetes, little attention has been directed to their unique cultural beliefs and practices regarding diabetes. We describe cultural and family challenges to illness management in foreign-born Chinese American patients with type 2 diabetes and their spouses. This was an interpretive comparative interview study with 20 foreign-born Chinese American couples (n = 40) living with type 2 diabetes. Multiple (six to seven) semistructured interviews with each couple in individual, group, and couple settings elicited beliefs about diabetes and narratives of care within the family and community. Interpretive narrative and thematic analysis were completed. A separate respondent group of 19 patients and spouses who met the inclusion criteria reviewed and confirmed the themes developed from the initial couples. Cultural and family challenges to diabetes management within foreign-born Chinese American families included how 1) diabetes symptoms challenged family harmony, 2) dietary prescriptions challenged food beliefs and practices, and 3) disease management requirements challenged established family role responsibilities. Culturally nuanced care with immigrant Chinese Americans requires attentiveness to the social context of disease management. Patients' and families' disease management decisions are seldom made independent of their concerns for family well-being, family face, and the reciprocal responsibilities required by varied family roles. Framing disease recommendations to include cultural concerns for balance and significant food rituals are warranted.

Vasoplegic syndrome: A challenge to anaesthetic management

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Amarjyoti Hazarika

2015-01-01

Full Text Available Perioperative hypotension is a well-recognized and relatively common problem during surgery. Vasoplegic syndrome is one such condition which is characterized by severe persistent hypotension with normal to high cardiac output and low systemic resistance. It is commonly seen in patients undergoing cardiac surgery on cardiopulmonary bypass. However, this syndrome has also been reported in off pump surgeries. Management of intraoperative hypotension may be challenging for an anaesthesiologist, if it does not respond or poorly respond to conventional therapy. We report the management of a hypertensive patient posted for spine surgery in prone position, who developed severe hypotension under anaesthesia refractory to treatment.

challenges in management of warfarin anti-coagulation in advanced

African Journals Online (AJOL)

2013-07-01

Jul 1, 2013 ... ADVANCED HIV/AIDS PATIENTS WITH VENOUS THROMBOTIC EVENTS – A. CASE SERIES ... Objective: To describe clinical presentations and challenges in the management of. VTE in ..... Performance outcomes of a ...

Baltic Sea hazardous substances management: results and challenges.

Science.gov (United States)

Selin, Henrik; VanDeveer, Stacy D

2004-05-01

The introduction into the Baltic Sea of hazardous substances that are persistent, bioaccumulate, and are toxic is an important environmental and human health problem. Multilateral efforts to address this problem have primarily been taken under the Helsinki Commission (HELCOM). This article examines past HELCOM efforts on hazardous substances, and discusses future challenges regarding their management. The article finds that past actions on hazardous substances have had a positive effect on improving Baltic environmental quality and reducing human health risks, although there are remaining issues and difficulties that need to be addressed. In particular, four related future challenges for HELCOM management of hazardous substances are identified and discussed: i) the need to engender further implementation and building public and private sector capacities; ii) the need to improve data availability, quality and comparability across the region and international fora; iii) the need to strengthen existing regulations and incorporate new issues; and iv) the need to effectively coordinate HELCOM activities with efforts on hazardous substances in other international fora.

V&V of Fault Management: Challenges and Successes

Science.gov (United States)

Fesq, Lorraine M.; Costello, Ken; Ohi, Don; Lu, Tiffany; Newhouse, Marilyn

2013-01-01

This paper describes the results of a special breakout session of the NASA Independent Verification and Validation (IV&V) Workshop held in the fall of 2012 entitled "V&V of Fault Management: Challenges and Successes." The NASA IV&V Program is in a unique position to interact with projects across all of the NASA development domains. Using this unique opportunity, the IV&V program convened a breakout session to enable IV&V teams to share their challenges and successes with respect to the V&V of Fault Management (FM) architectures and software. The presentations and discussions provided practical examples of pitfalls encountered while performing V&V of FM including the lack of consistent designs for implementing faults monitors and the fact that FM information is not centralized but scattered among many diverse project artifacts. The discussions also solidified the need for an early commitment to developing FM in parallel with the spacecraft systems as well as clearly defining FM terminology within a project.

21st century challenges and opportunities for nuclear waste management

International Nuclear Information System (INIS)

McKinley, I.G.

2009-01-01

The technical arguments for massive expansion of nuclear power generation are convincing, but such a renaissance requires public acceptance. For diehard nuclear opponents, criticism now focuses on its Achilles heel - the unsolved (and often claimed to be insoluble) problem of disposal of the resultant long-lived waste. In fact, the geological disposal of nuclear waste can be managed safely with existing technology and should really be touted as one of the advantages of this option. Clearly, there is a major challenge in communicating disposal safety to key stakeholders in order to realise this benefit. Nevertheless, the growth of environmental concern about global warming and the present economic climate may present opportunities to initiate dialogue with relevant communities, allowing the attractions of hosting future disposal facilities to be seen. Rather than being the archetypal focus for NIMBY reactions, maybe within a few years we can look forward to growing competition to host geological repositories for radioactive waste.(Author)

Challenges for current University management

Directory of Open Access Journals (Sweden)

Pedro Rodríguez Vargas

2016-03-01

Full Text Available The Ecuadorian university through a change of era, this complex pathway mediated by globalization imposes imminently. The aim of this paper is to present a review of literature on the main aspects of management that are generated for the interaction University - context. This scan was performed on secondary sources, and grounded in scienti?c data abstraction. College education is an information and training process that allows the scientific, technological, economic, political, social and cultural development of a region or country; however, some phenomena such as globalization, technological revolution or multiculturalism are key to this, same that can be considered as a problem or a challenge.

Setting priorities for the proactive management of longterm challenges and opportunities in Asset Life Cycle Management

NARCIS (Netherlands)

Ruitenburg, Richard Jacob; Braaksma, Anne Johannes Jan; van Diepen, T.

2016-01-01

Asset Life Cycle Management concerns the effective management of physical assets over their complete lifetimes, typically lasting decades. Therefore, a large number and a wide variety of challenges and opportunities may need to be dealt with proactively, using limited resources. Therefore, we

First Nations people's challenge in managing coronary artery disease risk.

Science.gov (United States)

King, Kathryn M; Sanguins, Julianne; McGregor, Lisa; LeBlanc, Pamela

2007-10-01

First Nations peoples bring a particular history and cultural perspective to healing and well-being that significantly influences their health behaviors. The authors used grounded theory methods to describe and explain how ethnocultural affiliation and gender influence the process that 22 First Nations people underwent when making lifestyle changes related to their coronary artery disease (CAD) risk. The transcribed interviews revealed a core variable, meeting the challenge. Meeting the challenge of CAD risk management was influenced by intrapersonal, interpersonal (relationships with others), extrapersonal (i.e., the community and government), sociodemographic, and gendered factors. Salient elements for the participants included their beliefs about origins of illness, the role of family, challenges to accessing information, financial and resource management, and the gendered element of body image. Health care providers need to understand the historical, social, and culturally embedded factors that influence First Nations people's appraisal of their CAD.

Scientific data management challenges, technology and deployment

CERN Document Server

Rotem, Doron

2010-01-01

Dealing with the volume, complexity, and diversity of data currently being generated by scientific experiments and simulations often causes scientists to waste productive time. Scientific Data Management: Challenges, Technology, and Deployment describes cutting-edge technologies and solutions for managing and analyzing vast amounts of data, helping scientists focus on their scientific goals. The book begins with coverage of efficient storage systems, discussing how to write and read large volumes of data without slowing the simulation, analysis, or visualization processes. It then focuses on the efficient data movement and management of storage spaces and explores emerging database systems for scientific data. The book also addresses how to best organize data for analysis purposes, how to effectively conduct searches over large datasets, how to successfully automate multistep scientific process workflows, and how to automatically collect metadata and lineage information. This book provides a comprehensive u...

Multi-Institution Research Centers: Planning and Management Challenges

Science.gov (United States)

Spooner, Catherine; Lavey, Lisa; Mukuka, Chilandu; Eames-Brown, Rosslyn

2016-01-01

Funding multi-institution centers of research excellence (CREs) has become a common means of supporting collaborative partnerships to address specific research topics. However, there is little guidance for those planning or managing a multi-institution CRE, which faces specific challenges not faced by single-institution research centers. We…

The challenge of fracture management in osteoporotic bones

African Journals Online (AJOL)

Conclusion: Osteoporotic fractures are a challenge to orthopaedic and trauma ... operative management careful planning as team work and use of newer .... function and quality of life in these elderly patients. .... on the balance of the above risks and benefits for each ... cement meant to reinforce bone seems optimal solution.

Knowledge management at the IAEA - Challenges and opportunities

International Nuclear Information System (INIS)

Yanev, Y.L.; Cherif, S.

2004-01-01

Full text: 'Knowledge Management caters to the critical issues of organizational adaptation, survival and competence in face of increasingly discontinuous change of environment. Essentially, it embodies organizational processes that seek synergistic combination of data and information processing capacity of information technologies, and the creative and innovative capacity of human beings' (Malhotra 1997). International organizations are coming to view knowledge as their most valuable and strategic resource, and bringing that knowledge to bear on problems and opportunities as their most important capability. It is being realised that to remain geared to the evolving needs of their Member States it is a must to explicitly manage all intellectual resources and capabilities of the organization. To this end, many international organizations have initiated a range of knowledge management projects and programs. The primary focus of these efforts has been on developing new applications of information technology to support the digital capture, storage, retrieval and distribution of an organization's documented knowledge but also capturing valuable tacit knowledge existing within peoples' heads, augmented or shared via interpersonal interaction and social relationships. Numerous technical and organizational initiatives have been aligned and integrated, providing a comprehensive infrastructure to support knowledge management processes. But while the appropriate infrastructure can enhance an organization's ability to create and exploit knowledge, it does not insure that the organization is making the best investment of its resources or that it is managing the right knowledge in the right way. Against the background of these trends and the opportunities and challenges they present, the Agency has been active in establishing knowledge management as a crosscutting activity that includes both assisting Member States in managing their own nuclear knowledge assets but also in

Renal cell carcinoma in pregnancy: Still a management challenge

African Journals Online (AJOL)

I.C. Akpayak

Received 14 June 2014; received in revised form 6 January 2015; accepted 3 February ... the dilemma faced by the patient and the challenge of deciding the appropriate management option. .... Cancer principles and practice of oncology.

Challenges in the Management of a Patient with Myxoedema Coma ...

African Journals Online (AJOL)

Myxoedema coma is a rare life-threatening disease, and it is essential that it is managed appropriately to reduce the associated high mortality. However, in the setting where efficient healthcare delivery is hampered by inadequacies, the management of such cases may pose a significant challenge. We present the case of a ...

Prevention and management of work disability in Asia Pacific: challenges and opportunities.

Science.gov (United States)

Feuerstein, Michael

2011-03-01

The economic growth in Asia Pacific brings with it challenges and opportunities in many areas of work and health. As economies grow and work demands increase so do accidents, injures and work disability. Burns, chemical exposures, and construction related injuries are often catastrophic in severity and lead to work disability, major acute medical and subsequent rehabilitation efforts. In addition to these acute injuries, musculoskeletal and chronic illnesses are also sources of work disability. Industrial injuries and health problems are often explained and managed based on the classic unidimensional hazard prevention model. In contrast, work disability is a multi-factorial problem and requires more complex conceptualizations than an exposure outcome model. The economic impact of disability, limitations of the widely used impairment based disability determination method, lack of adherence to wide scale implementation of evidence based clinical approaches, the need for meaningful stakeholder involvement and the potential of a multivariable view of work disability, in all aspects of work disability prevention, management and policy are discussed in the context of Asia Pacific economic growth. With ideal alignment of diverse goals and incentives along with consideration of past efforts in disability prevention and management, new models, processes and policies can be created as commerce in these countries continues to grow.

Professional Education Management and Socio-Institutional Reality: problems and challenges

Directory of Open Access Journals (Sweden)

Eduardo Pinto e Silva

2008-03-01

Full Text Available The democratic management of educational practices is a theoretical and practical matter, which has been discussed in several institutional spheres (PARO, 2003; BORGES, GIUBILEI & OLIVEIRA, 2006. This paper deals with education management and is based on a case study about technical and professional education of agents of Municipal Guard (SILVA, 2005. This kind of education is affected by structural problems in the public institution (SANTOS, 1987 and in the macro judicial system (PINHEIRO, 1997, also being harmed by a process of social and work precariousness (ANTUNES, 1999; 2005. All these aspects represent challenges that have to be overcame. Thus, our propose of democratic professional education management (SILVA, 2005; HELOANI & SILVA, 2006 opposes the bureaucratic and alienating management. It demands listening to the collective subject and assuming a reflexive praxis about the professional activities and the socio-institutional reality. We consider that the challenge of creating a democratic professional management and a critical collective conscience, articulated with innovative actions, is part of a horizon of possibilities, even when it is mediated by institutional, organizational and cultural dimensions (SILVA JÚNIOR & FERRETTI, 2004.

Challenges in the management of the blood supply.

Science.gov (United States)

Williamson, Lorna M; Devine, Dana V

2013-05-25

Although blood suppliers are seeing short-term reductions in blood demand as a result of initiatives in patient blood management, modelling suggests that during the next 5-10 years, blood availability in developed countries will need to increase again to meet the demands of ageing populations. Increasing of the blood supply raises many challenges; new approaches to recruitment and retainment of future generations of blood donors will be needed, and care will be necessary to avoid taking too much blood from these donors. Integrated approaches in blood stock management between transfusion services and hospitals will be important to minimise wastage--eg, by use of supply chain solutions from industry. Cross-disciplinary systems for patient blood management need to be developed to lessen the need for transfusion--eg, by early identification and reversal of anaemia with haematinics or by reversal of the underlying cause. Personalised medicine could be applied to match donors to patients, not only with extended blood typing, but also by using genetically determined storage characteristics of blood components. Growing of red cells or platelets in large quantities from stem cells is a possibility in the future, but challenges of cost, scaling up, and reproducibility remain to be solved. Copyright © 2013 Elsevier Ltd. All rights reserved.

Implementation of the Integrated Management of Childhood Illnesses strategy: challenges and recommendations in Botswana.

Science.gov (United States)

Mupara, Lucia U; Lubbe, Johanna C

2016-01-01

Under-five mortality has been a major public health challenge from time immemorial. In response to this challenge, the World Health Organization and the United Nations Children's Fund developed the Integrated Management of Childhood Illnesses (IMCI) strategy and presented it to the whole world as a key approach to reduce child morbidity and mortality. Botswana started to implement the IMCI strategy in 1998. Reductions in the under-five mortality rate (U5MR) have been documented, although the reduction is not on par with the expected Millennium Development Goal 4 predictions. A quantitative study was done to identify the problems IMCI implementers face when tending children under 5 years in the Gaborone Health District of Botswana. The study population was made up of all the IMCI-trained and registered nurses, and systematic sampling was used to randomly select study participants. Questionnaires were used to collect data. The study findings indicated challenges related to low training coverage, health systems, and the unique features of the IMCI strategy. The comprehensive implementation of the IMCI strategy has the potential to significantly influence the U5MR in Botswana.

Implementation of the Integrated Management of Childhood Illnesses strategy: challenges and recommendations in Botswana

Directory of Open Access Journals (Sweden)

Lucia U. Mupara

2016-02-01

Full Text Available Background: Under-five mortality has been a major public health challenge from time immemorial. In response to this challenge, the World Health Organization and the United Nations Children's Fund developed the Integrated Management of Childhood Illnesses (IMCI strategy and presented it to the whole world as a key approach to reduce child morbidity and mortality. Botswana started to implement the IMCI strategy in 1998. Reductions in the under-five mortality rate (U5MR have been documented, although the reduction is not on par with the expected Millennium Development Goal 4 predictions. Design: A quantitative study was done to identify the problems IMCI implementers face when tending children under 5 years in the Gaborone Health District of Botswana. The study population was made up of all the IMCI-trained and registered nurses, and systematic sampling was used to randomly select study participants. Questionnaires were used to collect data. Results: The study findings indicated challenges related to low training coverage, health systems, and the unique features of the IMCI strategy. Conclusions: The comprehensive implementation of the IMCI strategy has the potential to significantly influence the U5MR in Botswana.

Risk Management Challenges in Large-scale Energy PSS

DEFF Research Database (Denmark)

Tegeltija, Miroslava; Oehmen, Josef; Kozin, Igor

2017-01-01

data and representation of the results to the decision makers play an important role. Second, we introduce a selection of alternative, so-called “post-probabilistic”, risk management methods developed across different scientific fields to cope with uncertainty due to lack of knowledge. Possibilities......Probabilistic risk management approaches have a long tradition in engineering. A large variety of tools and techniques based on the probabilistic view of risk is available and applied in PSS practice. However, uncertainties that arise due to lack of knowledge and information are still missing...... for overcoming industrial PSS risk management challenges are suggested through application of post-probabilistic methods. We conclude with the discussion on the importance for the field to consider their application....

Management of maxillofacial trauma in emergency: An update of challenges and controversies

Directory of Open Access Journals (Sweden)

Anson Jose

2016-01-01

Full Text Available Trauma management has evolved significantly in the past few decades thereby reducing mortality in the golden hour. However, challenges remain, and one such area is maxillofacial injuries in a polytrauma patient. Severe injuries to the maxillofacial region can complicate the early management of a trauma patient owing to the regions proximity to the brain, cervical spine, and airway. The usual techniques of airway breathing and circulation (ABC management are often modified or supplemented with other methods in case of maxillofacial injuries. Such modifications have their own challenges and pitfalls in an already difficult situation.

New challenges for grizzly bear management in Yellowstone National Park

Science.gov (United States)

van Manen, Frank T.; Gunther, Kerry A.

2016-01-01

A key factor contributing to the success of grizzly bear Ursus arctos conservation in the Greater Yellowstone Ecosystem has been the existence of a large protected area, Yellowstone National Park. We provide an overview of recovery efforts, how demographic parameters changed as the population increased, and how the bear management program in Yellowstone National Park has evolved to address new management challenges over time. Finally, using the management experiences in Yellowstone National Park, we present comparisons and perspectives regarding brown bear management in Shiretoko National Park.

Managing the twenty-first century reference department challenges and prospects

CERN Document Server

Katz, Linda S

2014-01-01

Learn the skills needed to update and manage a reference department that efficiently meets the needs of clients today?and tomorrow! Managing the Twenty-First Century Reference Department: Challenges and Prospects provides librarians with the knowledge and skills they need to manage an effective reference service. Full of useful and practical ideas, this book presents successful methods for recruiting and retaining capable reference department staff and management, training new employees and adapting current services to an evolving field. Expert practitioners address the changing role of the r

Managing an outpatient parenteral antibiotic therapy team: challenges and solutions.

Science.gov (United States)

Halilovic, Jenana; Christensen, Cinda L; Nguyen, Hien H

2014-01-01

Outpatient parenteral antimicrobial therapy (OPAT) programs should strive to deliver safe, cost effective, and high quality care. One of the keys to developing and sustaining a high quality OPAT program is to understand the common challenges or barriers to OPAT delivery. We review the most common challenges to starting and managing an OPAT program and give practical advice on addressing these issues.

Challenges in global ballast water management

International Nuclear Information System (INIS)

Endresen, Oyvind; Lee Behrens, Hanna; Brynestad, Sigrid; Bjoern Andersen, Aage; Skjong, Rolf

2004-01-01

Ballast water management is a complex issue raising the challenge of merging international regulations, ship's specific configurations along with ecological conservation. This complexity is illustrated in this paper by considering ballast water volume, discharge frequency, ship safety and operational issues aligned with regional characteristics to address ecological risk for selected routes. A re-estimation of ballast water volumes gives a global annual level of 3500 Mton. Global ballast water volume discharged into open sea originating from ballast water exchange operations is estimated to approximately 2800 Mton. Risk based decision support systems coupled to databases for different ports and invasive species characteristics and distributions can allow for differentiated treatment levels while maintaining low risk levels. On certain routes, the risk is estimated to be unacceptable and some kind of ballast water treatment or management should be applied

Managing major chemical accidents in China: Towards effective risk information

International Nuclear Information System (INIS)

He Guizhen; Zhang Lei; Lu Yonglong; Mol, Arthur P.J.

2011-01-01

Chemical industries, from their very inception, have been controversial due to the high risks they impose on safety of human beings and the environment. Recent decades have witnessed increasing impacts of the accelerating expansion of chemical industries and chemical accidents have become a major contributor to environmental and health risks in China. This calls for the establishment of an effective chemical risk management system, which requires reliable, accurate and comprehensive data in the first place. However, the current chemical accident-related data system is highly fragmented and incomplete, as different responsible authorities adopt different data collection standards and procedures for different purposes. In building a more comprehensive, integrated and effective information system, this article: (i) reviews and assesses the existing data sources and data management, (ii) analyzes data on 976 recorded major hazardous chemical accidents in China over the last 40 years, and (iii) identifies the improvements required for developing integrated risk management in China.

Status and Challenges of Managing Risks in the U.S. Department of Energy Environmental Management Program

International Nuclear Information System (INIS)

Aaberg, Rosanne L.; Andrews, William B.; Bollinger, Mark E.; McGinn, Wilson; Picel, Kurt; Stenner, Robert D.; White, Michael K.; Young, Alvin L.

2003-01-01

Even in the United States, where various methods of risk assessment, risk management, and risk communication have been attempted over the years, these disciplines continue to evolve to meet the needs of decision makers faced with legacy wastes. This chapter provides an overview of the Cold War legacy challenges as currently understood by the U.S. Department of Energy (DOE), as well as the risk-based methodologies currently being applied to assist the DOE in managing those challenges. In the past decade (1990s), the DOE created a single organization within their waste management structure to coordinate their risk activities: the Office of Environmental Management's Center for Risk Excellence. The chapter describes the formation, operation, and contributions of that organization, which was created to encourage the use of risk-based approaches to DOE site management and to provide consistency in the use of such approaches across the DOE complex. Of particular interest are the effective communication concepts developed by this organization for summarizing site risk and risk-related information as risk profiles

Optimizing transuranic waste management-challenges and opportunities

International Nuclear Information System (INIS)

Triay, I.R.; Wu, C.F.; Moody, D.C.; Jennings, S.G.

2002-01-01

The opening of the Waste Isolation Pilot Plant (WIPP) for disposal of transuranic (TRU) waste in March of 1999, the granting of the Hazardous Waste Facility Permit in November 1999, and over two years of operational experience have demonstrated the Department of Energy's (DOE'S) capability in closing the nuclear energy cycle. While these achievements resolved several scientific, engineering, regulatory and political issues, the DOE has identified a new set of challenges that represent opportunities for improving programmatic efficiency, cost-effectiveness, and operational safety in managing the nation's TRU waste. The DOE has recognized that the complex administrative and regulatory requirements for characterization, transportation and disposal of TRU waste are costly (1). A review by the National Academy of Sciences (NAS) states that these requirements lead to inefficient waste characterization, handling and transportation operations that in turn can lead to unnecessary radiation exposure to workers without a commensurate decrease in risk to the public and the environment (2). This paper provides an overview of the status of the WJPP repository, explains the principles of the proposed commercial business approach, and describes some of the proposed major enhancements of the TRU waste transportation systems. The DOE is developing a remote-handled (RH) waste program to enable emplacement of RH waste at WPP. This program includes appropriate facility modifications and regulatory changes (3).

Health system challenges for the management of cardiovascular disease and diabetes: an empirical qualitative study from Syria.

Science.gov (United States)

Ahmad, Balsam; Fouad, Fouad M; Elias, Madonna; Zaman, Shahaduz; Phillimore, Peter; Maziak, Wasim

2015-01-01

To explore through empirical qualitative data health system barriers to effective management of cardiovascular disease and diabetes in Syria before the crisis, and how such analysis can inform the building of a post-crisis system. Data were collected through document review, semi-structured key informant interviews, and fieldwork in clinics. Institutional commitment to address the increasing burden of CVD and diabetes in Syria was limited and uncoordinated. Challenges included an increasingly split healthcare system, with private provision for those who could afford it, and a residual state health sector for the majority. Public trust in the system had been declining. We conclude that lack of effective management of CVD and diabetes indicated weaknesses of the state and its retracting role in providing effective healthcare. Such weaknesses that existed before the crisis are now compounded by new challenges resulting from wide destruction of the health system due to the ongoing war. The rebuilding of post-conflict heath care system may benefit from insights into the structural problems of the pre-crisis system.

Managing pain in the workplace: a focus group study of challenges, strategies and what matters most to workers with low back pain.

Science.gov (United States)

Tveito, Torill Helene; Shaw, William S; Huang, Yueng-Hsiang; Nicholas, Michael; Wagner, Gregory

2010-01-01

Most working adults with low back pain (LBP) continue to work despite pain, but few studies have assessed self-management strategies in this at-work population. The purpose of this study was to identify workplace challenges and self-management strategies reported by workers remaining at work despite recurrent or persistent LBP, to be used as a framework for the development of a workplace group intervention to prevent back disability. Workers with LBP (n = 38) participated in five focus groups, and audio recordings of sessions were analysed to assemble lists of common challenges and coping strategies. A separate analysis provided a general categorisation of major themes. Workplace pain challenges fell within four domains: activity interference, negative self-perceptions, interpersonal challenges and inflexibility of work. Self-management strategies consisted of modifying work activities and routines, reducing pain symptoms, using cognitive strategies and communicating pain effectively. Theme extraction identified six predominant themes: knowing your work setting, talking about pain, being prepared for a bad day, thoughts and emotions, keeping moving and finding leeway. To retain workers with LBP, this qualitative investigation suggests future intervention efforts should focus on worker communication and cognitions related to pain, pacing of work and employer efforts to provide leeway for altered job routines.

Major diseases of ornamental plants and their management

International Nuclear Information System (INIS)

Akhtar, M.A.; Zakria, M.; Sohail, F.

2003-01-01

Major diseases of ornamental plants are caused by infections agents (biotic) or non-infectious (abiotic) agents. Infectious agents are bacteria, fungi, nematodes and virus. Non infectious agents are nutritional imbalances, environmental stresses and chemical toxicities. Grouping of the diseases has been done on symptomatology basis. Disease management in ornamental plants has been described through cultural practices, chemical and other control strategies. (author)

Contemporary management practices and challenges: The Scandinavian perspective

DEFF Research Database (Denmark)

Ulhøi, John Parm; Madsen, Henning

2001-01-01

Managers are facing the challenge of an ever-changing environment, ranging from increasing globalization, through the technologization of physical processes, to virtual ways of communicating. The response to this has been a gradual shift from rule-based to value-based management styles...... and practices. In order to obtain an insight into how far this development has proceeded, a structured survey of about 1500 top, middle and line managers from the private and public sectors was carried out. Among other interesting results, the study suggests that 'softer' as well as externally oriented roles...... in general are gaining increasing importance at the expense of rules and control. Moreover, managers from the private sector seem to be more steeped in traditional 'hard' managerial roles related to the operational level than their public-sector counterparts. Put another way, evidence supports the conclusion...

Risk Management Challenges in Large-scale Energy PSS

DEFF Research Database (Denmark)

Tegeltija, Miroslava; Oehmen, Josef; Kozin, Igor

2017-01-01

Probabilistic risk management approaches have a long tradition in engineering. A large variety of tools and techniques based on the probabilistic view of risk is available and applied in PSS practice. However, uncertainties that arise due to lack of knowledge and information are still missing...... adequate representations. We focus on a large-scale energy company in Denmark as one case of current product/servicesystems risk management best practices. We analyze their risk management process and investigate the tools they use in order to support decision making processes within the company. First, we...... identify the following challenges in the current risk management practices that are in line with literature: (1) current methods are not appropriate for the situations dominated by weak knowledge and information; (2) quality of traditional models in such situations is open to debate; (3) quality of input...

Challenges facing water management in China

International Nuclear Information System (INIS)

Varis, O.; Vakkilainen, P.

2000-01-01

The amount of water per person in northern China is less than half of that in Egypt, a country with very scarce water resources. Clearly, then, China is one of the regions on our planet that is going to have to face severe problems of water supply in the future. Rapid urbanisation and industrialisation growing agricultural output, environmental degradation, climatic instability, a large population density and worsening regional disparities are all factors that will challenge the management and utilisation of China's water resources in the years to come. (orig.)

Management challenges with the maintenance of tourism experience concept innovations

DEFF Research Database (Denmark)

Eide, Dorthe; Fuglsang, Lars; Sundbo, Jon

2017-01-01

that there is a need to focus on challenges that tourism management faces over time when it wishes to maintain innovations in an experience concept. Maintaining such innovations needs to be investigated from an organisational perspective. There are many reasons why it can be challenging to maintain innovative...... experience-based tourism. The case vignettes illuminate how “maintenance” is an important construct within experience innovation research....

Handbook of Research on E-Transformation and Human Resources Management Technologies: Organizational Outcomes and Challenges

NARCIS (Netherlands)

Bondarouk, Tatiana; Ruel, Hubertus Johannes Maria; Guiderdoni-Jourdain, Karine; Oiry, Ewan

2009-01-01

Digital advancements and discoveries are now challenging traditional human resource management services within businesses. The Handbook of Research on E-Transformation and Human Resources Management Technologies: Organizational Outcomes and Challenges provides practical, situated, and unique

NNC - managing major projects and the lessons learned

International Nuclear Information System (INIS)

Clements, J.M.

1989-01-01

The formation and development of NNC Ltd (formerly National Nuclear Corporation Ltd) is explained. Its role in the building of 16 nuclear power stations in the UK is outlined. For the last two of these, Heysham-B and Torness, NNC's role as station designer and manager of the nuclear island construction and at Torness as whole site overseers is described. The NNC negotiated and placed all the major contracts for the two stations and developed a budgetary control program through which the Central and South of Scotland Electricity Generating Boards were able to participate in the allotment of budget cover for each contract and for any anticipated variations and claims. Each project had a manager and about 20 responsible engineers plus contract engineers. The government decisions to change to PWR type reactors and to privatise the electricity industry have resulted in changes and structural management in NNC Ltd. (UK)

South African Academic Health--the future challenge.

Science.gov (United States)

van Zyl, G J

2004-02-01

In South Africa, significant changes in Academic Health have taken place since the first democratic elections in 1994. Academic Health came from a separated academic hospital, departmental-based curriculum and research focussed on achievement, and an abundance of money, to a position of integrated service delivery with specific reference to primary health care, separation of service levels, a new integrated curriculum, research focussed according to the need and contract research, and financial constraints with limited budgets. The management of this change is a task challenging the manager in all fields of Academic Health. Leaders need to know their environment and organisation to be able to manage change. Academic Health centres are experiencing major changes as a result of the effects of managed care, reduced rate and growing expenditure on health services. In addition to restructuring of the clinical services, Academic Health centres are being challenged to sustain their academic mission and priorities in the face of resource constraints. In order to tackle these challenges, institutions need physicians in administrative positions at all levels who can provide leadership and thoughtful managerial initiatives. The future challenge for managers focuses on service delivery, research, health education and training, Academic Health management, professionalism and financial management.

Financial management challenges for general hospital psychiatry 2001.

Science.gov (United States)

Goldberg, R J

2001-01-01

Psychiatry programs are facing significant business and financial challenges. This paper provides an overview of these management challenges in five areas: departmental, hospital, payment system, general finance, and policy. Psychiatric leaders will require skills in a variety of business management areas to ensure their program success. Many programs will need to develop new compensation models with more of an emphasis on revenue collection and overhead management. Programs which cannot master these areas are likely to go out of business. For academic programs, incentive systems must address not only clinical productivity, but academic and teaching output as well. General hospital programs will need to develop increased sophistication in differential cost accounting in order to be able to advocate for their patients and program in the current management climate. Clinical leaders will need the skills (ranging from actuarial to negotiations) to be at the table with contract development, since those decisions are inseparable from clinical care issues. Strategic planning needs to consider the value of improving integration with primary care, along with the ability to understand the advantages and disadvantages of risk-sharing models. Psychiatry leaders need to define and develop useful reports shared with clinical division leadership to track progress and identify problems and opportunities. Leaders should be responsible for a strategy for developing appropriate information system architecture and infrastructure. Finally, it is hoped that some leaders will emerge who can further our needs to address inequities in mental health fee schedules and parity issues which affect our program viability.

DOE Low-Level Waste Management Program perspective on technology transfer: opportunities and challenges

International Nuclear Information System (INIS)

Large, D.E.

1982-01-01

The Department of Energy's Low-Level Waste Management Program (DOE LLWMP) perspective in regard to transfer of LLWMP technology to current and potential users in both the commercial and defense sectors is discussed. Past, present, and future opportunities and challenges for the whole nuclear waste management are indicated. Elements considered include: historical and evolutionary events and activities; the purpose of the Program and its inherent opportunities and challenges; achievements and expected accomplishments; supporters and interactors; packaging and delivering technology; implementing and serving potential users; determining and meeting users' needs; and identifying and responding to opportunities and challenges. The low-level waste management effort to improve shallow land burial technology began in FY 1977 and has expanded to include waste treatment and alternative disposal methods. Milestones have been established and are used as principal management control items. This technology, the Program Product, is described and is made available. This year, the Program has drafted criteria for inclusion in a DOE order for radioactive waste management operations at DOE sites

Embracing the challenge of competition

International Nuclear Information System (INIS)

MacDonald, C.

1998-01-01

The new and creative solutions that Edmonton Power is using to meet the challenges of deregulation, competition and demand for customer choice in the electric power industry are discussed. Among these creative initiatives, in 1997 Edmonton Power extended account management services to 850 accounts to deliver commercial and operational analysis of energy consumption and management. Another major focus of effort has been the introduction of time of use (TOU) pricing options to commercial and industrial customers above 150 kWh. This required the installation of the latest hourly metering technology and the establishment of new price plans and contracts. Two major challenges were highlighted: (1) the mismatch between the prices utilities pay at the power pool and what the customer pays at the meter, and (2) the increased volatility of hour to hour price changes are just some of the risks that will have to be resolved under the new market structure

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

International Nuclear Information System (INIS)

Anon.

1991-01-01

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

Radioactive waste management practices in India: achievements and challenges

International Nuclear Information System (INIS)

Wattal, P.K.; Basu, S.

2013-01-01

Safe and effective management of radioactive waste has been given utmost importance from the very inception of nuclear industry in India. This article gives an account of the basic principles, practices being followed in our country to achieve this objective. A brief description of the existing methods for management of diverse kinds of radioactive wastes including high level radioactive waste and also the research and development activities to address the future challenges is presented in the article. (author)

Learning to manage complexity through simulation: students' challenges and possible strategies.

Science.gov (United States)

Gormley, Gerard J; Fenwick, Tara

2016-06-01

Many have called for medical students to learn how to manage complexity in healthcare. This study examines the nuances of students' challenges in coping with a complex simulation learning activity, using concepts from complexity theory, and suggests strategies to help them better understand and manage complexity.Wearing video glasses, participants took part in a simulation ward-based exercise that incorporated characteristics of complexity. Video footage was used to elicit interviews, which were transcribed. Using complexity theory as a theoretical lens, an iterative approach was taken to identify the challenges that participants faced and possible coping strategies using both interview transcripts and video footage.Students' challenges in coping with clinical complexity included being: a) unprepared for 'diving in', b) caught in an escalating system, c) captured by the patient, and d) unable to assert boundaries of acceptable practice.Many characteristics of complexity can be recreated in a ward-based simulation learning activity, affording learners an embodied and immersive experience of these complexity challenges. Possible strategies for managing complexity themes include: a) taking time to size up the system, b) attuning to what emerges, c) reducing complexity, d) boundary practices, and e) working with uncertainty. This study signals pedagogical opportunities for recognizing and dealing with complexity.

Challenges in the management of hypertension and heart failure

NARCIS (Netherlands)

Beeftink, MMA

2017-01-01

The research described in this thesis addresses several challenges in the management of hypertension and heart failure with preserved ejection fraction (HFpEF). It mainly focusses on the influence of antihypertensive medication on the diagnostic work-up strategy of hypertension, the shortcomings of

Salient Beliefs in Majoring in Management Information Systems: An Elicitation Study

Science.gov (United States)

Chipidza, Wallace; Green, Gina; Riemenschneider, Cindy

2016-01-01

Research utilizing the Theory of Planned Behavior to understand behavior should first elicit beliefs about the phenomenon from the target population. In order to understand the reasons why students choose to major or not major in Management Information Systems (MIS), we elicited beliefs from 136 students attending university in the United States…

Managing an outpatient parenteral antibiotic therapy team: challenges and solutions

Directory of Open Access Journals (Sweden)

Halilovic J

2014-06-01

Full Text Available Jenana Halilovic,1 Cinda L Christensen,2 Hien H Nguyen31University of the Pacific Thomas J Long School of Pharmacy, Stockton, CA, USA; 2Department of Pharmaceutical Services, University of California, Davis Health System, Sacramento, CA, USA; 3Division of Infectious Diseases, Section of Hospital Medicine, University of California, Davis Health System, Sacramento, CA, USAAbstract: Outpatient parenteral antimicrobial therapy (OPAT programs should strive to deliver safe, cost effective, and high quality care. One of the keys to developing and sustaining a high quality OPAT program is to understand the common challenges or barriers to OPAT delivery. We review the most common challenges to starting and managing an OPAT program and give practical advice on addressing these issues.Keywords: OPAT, quality, safety, program management

Progress and challenges to the global waste management system.

Science.gov (United States)

Singh, Jagdeep; Laurenti, Rafael; Sinha, Rajib; Frostell, Björn

2014-09-01

Rapid economic growth, urbanization and increasing population have caused (materially intensive) resource consumption to increase, and consequently the release of large amounts of waste to the environment. From a global perspective, current waste and resource management lacks a holistic approach covering the whole chain of product design, raw material extraction, production, consumption, recycling and waste management. In this article, progress and different sustainability challenges facing the global waste management system are presented and discussed. The study leads to the conclusion that the current, rather isolated efforts, in different systems for waste management, waste reduction and resource management are indeed not sufficient in a long term sustainability perspective. In the future, to manage resources and wastes sustainably, waste management requires a more systems-oriented approach that addresses the root causes for the problems. A specific issue to address is the development of improved feedback information (statistics) on how waste generation is linked to consumption. © The Author(s) 2014.

Babesia major: protection of intact calves against homologous challenge by the injection of irradiated piroplasms

International Nuclear Information System (INIS)

Purnell, R.E.; Lewis, D.; Brocklesby, D.W.

1979-01-01

Blood from a splenectomized calf infected with Babesia major was divided into 20 ml aliquots which were γ-irradiated at doses of 0, 23.3, 27.3, 31.4, 35.4 and 39.5 krad and then inoculated into groups of three intact calves. Animals receiving non-irradiated blood had typical mild B. major reactions, but those receiving blood irradiated at 23.3, 27.3 and 31.4 krad and 2 of 3 receiving blood irradiated at 35.4 krad had minimal reactions. The remaining 4 animals had no detectable parasitaemic reactions. When the calves were challenged with a similar number (6.0 x 10 9 ) of homologous parasites, they were all immune with the exception of the 4 animals which had not reacted initially. The immune status of individual cattle was reflected accurately in the results of the micro-ELISA test, which detected a significant rise in serum antibody titre of the 4 susceptible animals 7 days after challenge. (author)

Babesia major: protection of intact calves against homologous challenge by the injection of irradiated piroplasms

Energy Technology Data Exchange (ETDEWEB)

Purnell, R E; Lewis, D; Brocklesby, D W [Agricultural Research Council, Compton (UK). Inst. for Research on Animal Diseases

1979-02-01

Blood from a splenectomized calf infected with Babesia major was divided into 20 ml aliquots which were ..gamma..-irradiated at doses of 0, 23.3, 27.3, 31.4, 35.4 and 39.5 krad and then inoculated into groups of three intact calves. Animals receiving non-irradiated blood had typical mild B. major reactions, but those receiving blood irradiated at 23.3, 27.3 and 31.4 krad and 2 of 3 receiving blood irradiated at 35.4 krad had minimal reactions. The remaining 4 animals had no detectable parasitaemic reactions. When the calves were challenged with a similar number (6.0 x 10/sup 9/) of homologous parasites, they were all immune with the exception of the 4 animals which had not reacted initially. The immune status of individual cattle was reflected accurately in the results of the micro-ELISA test, which detected a significant rise in serum antibody titre of the 4 susceptible animals 7 days after challenge.

CHALLENGES OF MUNICIPAL WASTE MANAGEMENT IN HUNGARY

Directory of Open Access Journals (Sweden)

ZOLTÁN OROSZ

2008-06-01

Full Text Available Aims, tasks and priorities of medium term development plans of national waste management were defined in the National Waste Management Plan, which was made for the period of 2003–2008 in Hungary. Supporting of the European Union is indispensable for carrying out of plan. The most important areas are related to the developing projects of municipal solid waste treatment (increasingthe capacity of landfills, accomplishment of the infrastructure of selective waste collection, building of new composting plants. The national environmental policy does not focus sufficiently on the prevention of waste production. Due to the high expenses of investment and operation the energetic recovery and the incineration of municipal solid waste do not compete with the deposition. We inclined to think that the waste management of Hungary will be deposition-orientated until 2015. The main problems to the next years will be the lack of reprocessing industry of plastic and glass packaging waste. The high number of to-be-recultivated landfills and the attainability of necessary financial sources are also serious problems. There are many questions. What is the future in national waste management? How can we reduce the quantity of dumped waste? What are challenges of national waste management on the short and long term?

Locally advanced rectal cancer: management challenges

Directory of Open Access Journals (Sweden)

Kokelaar RF

2016-10-01

Full Text Available RF Kokelaar, MD Evans, M Davies, DA Harris, J Beynon Department of Colorectal Surgery, Singleton Hospital, Swansea, UK Abstract: Between 5% and 10% of patients with rectal cancer present with locally advanced rectal cancer (LARC, and 10% of rectal cancers recur after surgery, of which half are limited to locoregional disease only (locally recurrent rectal cancer. Exenterative surgery offers the best long-term outcomes for patients with LARC and locally recurrent rectal cancer so long as a complete (R0 resection is achieved. Accurate preoperative multimodal staging is crucial in assessing the potential operability of advanced rectal tumors, and resectability may be enhanced with neoadjuvant therapies. Unfortunately, surgical options are limited when the tumor involves the lateral pelvic sidewall or high sacrum due to the technical challenges of achieving histological clearance, and must be balanced against the high morbidity associated with resection of the bony pelvis and significant lymphovascular structures. This group of patients is usually treated palliatively and subsequently survival is poor, which has led surgeons to seek innovative new solutions, as well as revisit previously discarded radical approaches. A small number of centers are pioneering new techniques for resection of beyond-total mesorectal excision tumors, including en bloc resections of the sciatic notch and composite resections of the first two sacral vertebrae. Despite limited experience, these new techniques offer the potential for radical treatment of previously inoperable tumors. This narrative review sets out the challenges facing the management of LARCs and discusses evolving management options. Keywords: rectal cancer, exenteration, pelvic sidewall, sacrectomy

Methodological Challenges of Research in Nudging

NARCIS (Netherlands)

Kleef, van E.; Trijp, van J.C.M.

2018-01-01

Complex societal issues, related to health and sustainability, provide major challenges to scientists, business managers, and policy makers alike. Despite their diversity, these issues have in common that effective solutions to public health (e.g., reducing prevalence of overweight and obesity) and

Integrating adaptive management and ecosystem services concepts to improve natural resource management: Challenges and opportunities

Science.gov (United States)

Epanchin-Niell, Rebecca S.; Boyd, James W.; Macauley, Molly K.; Scarlett, Lynn; Shapiro, Carl D.; Williams, Byron K.

2018-05-07

resource systems, both must confront the analytical challenges of systems modeling—in terms of complexity, dynamics, and uncertainty.Given this affinity, the integration of ecosystem services analysis and adaptive management poses few conceptual hurdles. In this report, we synthesize discussions from two workshops that considered ways in which adaptive management approaches and ecosystem service concepts may be complementary, such that integrating them into a common framework may lead to improved natural resource management outcomes. Although the literature on adaptive management and ecosystem services is vast and growing, the report focuses specifically on the integration of these two concepts rather than aiming to provide new definitions or an indepth review or primer of the concepts individually.Key issues considered include the bidirectional links between adaptive decision making and ecosystem services, as well as the potential benefits and inevitable challenges arising in the development and use of an integrated framework. Specifically, the workshops addressed the following questions:How can application of ecosystem service analysis within an adaptive decision process improve the outcomes of management and advance understanding of ecosystem service identification, production, and valuation?How can these concepts be integrated in concept and practice?What are the constraints and challenges to integrating adaptive management and ecosystem services?And, should the integration of these concepts be moved forward to wider application—and if so, how?

[Marketing mix in a radiology department: challenges for future radiologists in management].

Science.gov (United States)

Claikens, B

1998-08-01

Radiology has gained an enviable position among medial specialities. Developments in new technology expand its horizons and the volume of radiologic imaging techniques and procedures increase far more than the overall growth in health care services. In this position radiology has become a prime target for restrictions, cutbacks, controlled financing in an area of managed care and new national health care policy based on partially fixed budgets. Future health care takers have to choose the best available diagnostic and therapeutic techniques. Evidence based medicine, cost-utility analysis, diagnostic performance analysis, patient outcome analysis, technology assessment and guidelines for practice are means to guide us through our obligatory choice. Our major objective is to use the most performant available imaging technique or intervention to achieve the best possible outcome for our patient at lower possible costs. A strategic response from radiologists is required to meet the imperatives of this new management situation. They must do far more than interpret imaging procedures. They must work as efficient managers of imaging resources, organise their practices and define their marketing-strategies using the different, so-called, marketing-mix elements. The challenges will be great but the rewards are worth our best efforts. In this article we highlight the marketing responsibilities of future radiologists and their clinical practice in this new socio-economic environment and we present different useful marketing tools.

What Are the Lived Challenges Experienced by Black Females in a STEM Doctoral Program at a Majority White Institution?

Science.gov (United States)

Cleare, Sharlane S.

The purpose of this study is to explore the challenges experienced by Black female STEM doctoral students at a Majority White Institution. This study examined how, and to what extent did the Majority White Institution's STEM environment influenced such challenges. The qualitative phenomenological approach to this investigation utilized the lenses of Black Feminist Thought and Critical Race Feminism Theoretical Frameworks as interconnected lenses by which to conceptualize this phenomenon. This study answered the following question: What are the lived challenges experienced by Black female in a STEM doctoral program at a Majority White Institution? Purposeful and snowball sampling were employed to recruit participants for this investigation. Both sampling methods were selected because of their wide use in qualitative investigations, as well as their proven ability to precisely source quality participants (Biernacki, & Waldorf,1981; Palinkas, Horwitz, Green, Wisdom, Duan, & Hoagwood, (2015). Observations, in-depth semi-structured interviews, and focus groups were conducted with eleven (11) Black females STEM doctoral students currently studying at a large Majority White Institution in the Midwest. The findings from this study suggest that this is a phenomenon worthy of considerable attention. Research in the area of Black females in STEM doctoral programs at Majority White Institutions can be further expanded and updated. Therefore, this study will contribute and supplement existing literature on Black females in STEM doctoral programs at Majority White Institutions. Most importantly, the results obtained from this study can assist Majority White Institutions in the development and enhancement of programs and policies specifically geared towards addressing the needs of this underrepresented minority population segment.

Defining and managing career challenges for mid-career and senior stage pediatric hematologist/oncologists.

Science.gov (United States)

Frugé, Ernest; Margolin, Judith; Horton, Terzah; Venkateswaran, Lakshmi; Lee, Dean; Yee, Donald L; Mahoney, Donald

2010-12-01

A workshop at the 2008 ASPHO Annual Meeting functioned as the first step in a systematic needs assessment of the particular challenges to satisfaction and success in the middle and senior phases of career development for pediatric hematologist/oncologists (PHOs). The 61 ASPHO members who attended were randomly distributed to small discussion groups based on self-identified career stage. Groups completed challenge forms for each issue identified as pertinent to their own stage of professional development. A total of 71 forms with useable data were generated by the groups. The largest number of challenges described (26) clustered around themes of Work-Life Balance followed by Transition and Succession (18), Management and Finances (15), and Keeping up to Date (13). Mid-career groups were more likely to identify Work-Life Balance challenges while senior stage groups were more likely to articulate Succession and Management challenges. The article describes the demographics of the workshop participants, summarizes the content of challenge themes and the associated suggestions for management. It is hoped that this effort will assist educational and career planning efforts by individuals, institutions, and ASPHO as a professional society.

Survey of business process management: challenges and solutions

Science.gov (United States)

Alotaibi, Youseef; Liu, Fei

2017-09-01

The current literature shows that creating a good framework on business process model (PM) is not an easy task. A successful business PM should have the ability to ensure accurate alignment between business processes (BPs) and information technology (IT) designs, provide security protection, manage the rapidly changing business environment and BPs, manage customer power, be flexible for reengineering and ensure that IT goals can be easily derived from business goals and hence an information system (IS) can be easily implemented. This article presents an overview of research in the business PM domain. We have presented a review of the challenges facing business PMs, such as misalignment between business and IT, difficulty of deriving IT goals from business goals, creating secured business PM, reengineering BPs, managing the rapidly changing BP and business environment and managing customer power. Also, it presents the limitations of existing business PM frameworks. Finally, we outline several guidelines to create good business PM and the possible further research directions in the business PM domain.

Challenges of Managing and Planning Peace Education and Peace ...

African Journals Online (AJOL)

This paper examined the challenges of managing and planning peace education and peace culture in Nigeria's educational system. Its presents contemporary definitions of peace education and peace culture as well as highlighted the importance of peace education and peace culture in achieving the national goals and ...

Challenges of stroke management in resource-limited settings: A ...

African Journals Online (AJOL)

A 19-year-old man presented with a 1-year history of headache, generalised body weakness, ... difficulty with mastication, speech impairment, apathy, and urinary incontinence. ... the patient was treated with aspirin, prednisolone, and physiotherapy. ... Based on this case, we discuss the challenges of stroke management in ...

Resource-use conflicts and management challenges for Pugu and ...

African Journals Online (AJOL)

Resource-use conflicts and management challenges for Pugu and Kazimzumbwi forest reserves in Kisarawe and Ilala districts, Tanzania. IOE Malugu. Abstract. No Abstract. Discovery and Innovation Vol. 19 (1&2) 2007: pp. 149-174. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD ...

Wildfire Risk Management: Challenges and Opportunities

Science.gov (United States)

Thompson, M.; Calkin, D. E.; Hand, M. S.; Kreitler, J.

2014-12-01

In this presentation we address federal wildfire risk management largely through the lens of economics, targeting questions related to costs, effectiveness, efficiency, and tradeoffs. Beyond risks to resources and assets such as wildlife habitat, watersheds, and homes, wildfires present financial risk and budgetary instability for federal wildfire management agencies due to highly variable annual suppression costs. Despite its variability, the costs of wildfire management have continued to escalate and account for an ever-growing share of overall agency budgets, compromising abilities to attain other objectives related to forest health, recreation, timber management, etc. Trends associated with a changing climate and human expansion into fire-prone areas could lead to additional suppression costs in the future, only further highlighting the need for an ability to evaluate economic tradeoffs in investments across the wildfire management spectrum. Critically, these economic analyses need to accurately capture the complex spatial and stochastic aspects of wildfire, the inherent uncertainty associated with monetizing environmental impacts of wildfire, the costs and effectiveness of alternative management policies, and linkages between pre-fire investments and active incident management. Investing in hazardous fuels reduction and forest restoration in particular is a major policy lever for pre-fire risk mitigation, and will be a primary focus of our presentation. Evaluating alternative fuel management and suppression policies could provide opportunities for significant efficiency improvements in the development of risk-informed management fire management strategies. Better understanding tradeoffs of fire impacts and costs can help inform policy questions such as how much of the landscape to treat and how to balance investments in treating new areas versus maintaining previous investments. We will summarize current data needs, knowledge gaps, and other factors

The Emergence of Enterprise Systems Management - A Challenge to the IS Curriculum

DEFF Research Database (Denmark)

Møller, Charles; Kræmmergaard, Pernille; Rikhardsson, Pall M.

2005-01-01

This paper proposes four cornerstones of a future Information Systems curriculum. It analyzes the challenges of the IS curriculum based on the development of enterprise systems, and further argues that the practice and the research into enterprise systems have progressed to a new stage resulting...... in the emergence of Enterprise Systems Management (ESM). Enterprise Systems Management calls for new competences and consequently represents new challenges to the IS curriculum. The paper outlines potential teaching issues and discusses the impact on the IS curriculum. Finally the paper suggests ways...

Crossed fused renal ectopia: Challenges in diagnosis and management

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Shailesh Solanki

2013-01-01

Full Text Available Aim: Crossed fused renal ectopia is a rare congenital malformation, which is reported to be usually asymptomatic but may have varied presentations. This survey was conducted to study the clinical profile and the challenges posed in the management of this entity. Materials and Methods: Retrospective analysis of 6 patients diagnosed to have crossed fused renal ectopia during 1997-2010. The diagnosis was confirmed during surgical exploration in one patient. In one patient it was detected on antenatal ultrasonography and in the other 4 patients it was detected during investigations for abdominal pain, abdominal mass, anorectal malformation and urinary tract infection. Results: The left moiety was crossed and fused with the right moiety in 4 cases. Ultrasonography was found to be a good screening investigation with useful diagnostic contributions from CT scans, radionuclide scintigraphy and magnetic resonance urography. Micturating cystourethrography revealed presence of VUR in 4 cases, 3 of whom have undergone ureteric reimplantation. Two patients required pyeloplasty for pelviureteric junction obstruction; in one of these patients the upper ureter was entrapped in the isthmus. In one patient, a non-functioning moiety resulted in nephrectomy. All children were asymptomatic at last follow-up with stable renal functions. Conclusions: Crossed fused renal ectopia was detected in most patients during investigation for other problems. It was found more commonly in boys. The left moiety was crossed to the right in the majority of cases. Associated urological problems were found in most cases and required the appropriate surgical management.

Challenges in the management of intraocular parasitic infections

Directory of Open Access Journals (Sweden)

Ashish Mitra

2015-01-01

Full Text Available Parasitic worms in eye is something which is not very uncommon these days. People who eat undercooked food and have pets at home are at more risk to have parasitic infections. Chemoparalysis has been reported in literature using either viscoelastics or preservative free lidocaine (intracamerally to paralyze the worms that help in retrieval, but still one can face tricky situations while managing such conditions. Importance lies in the management of such cases as it can be really challenging at times and no report exists in the literature which mentions the importance of topical lidocaine along with viscoelastics or preservative free lidocaine for retrieval of the worm.

Blockchains for Business Process Management - Challenges and Opportunities

DEFF Research Database (Denmark)

Mendling, Jan; Weber, Ingo; Van Der Aalst, Wil

2018-01-01

Blockchain technology offers a sizable promise to rethink the way inter-organizational business processes are managed because of its potential to realize execution without a central party serving as a single point of trust (and failure). To stimulate research on this promise and the limits thereof......, in this paper we outline the challenges and opportunities of blockchain for Business Process Management (BPM). We first reflect how blockchains could be used in the context of the established BPM lifecycle and second how they might become relevant beyond. We conclude our discourse with a summary of seven...... research directions for investigating the application of blockchain technology in the context of BPM...

The Face Management Challenges of Sport Celebrity

Directory of Open Access Journals (Sweden)

Diana-Luiza DUMITRIU

2015-03-01

Full Text Available While gaining centrality within the sport field, media accelerated its commodification process and facilitated sport actors becoming competitive on the celebrity market. The aim of this paper is to discuss the reconfiguration that the celebrity logic brought in terms of the mere condition of the sport actor and the face management challenges and remedial strategies that he has to cope with. I will thus focus on two main dimensions that I find to be constitutive for the celebrity status: one related to the augmented media exposure that sport stars are subject to and to the corollary symbolic reconfiguration of the boundaries between his public and his private life, and the second one related to the vulnerability that comes along with the new visibility of the complex repertoire of identities and social roles performed by the sport actors. Within this last dimension of the sport-related celebrity cycle of promotion, I will lay stress not only on the face threatening aspects for the sport stars, but also on the vulnerability transfer within the affinal branding network and the challenges it could bring for the brands that chose to associate their image with a sport celebrity. Thus, I argue that the kaleidoscopic public figures of sport celebrities requires high impression management involvement on their part, as well as more caution on the marketeers part.

Addressing challenges for future strategic-level emergency management: reframing, networking, and capacity-building.

Science.gov (United States)

Bosomworth, Karyn; Owen, Christine; Curnin, Steven

2017-04-01

The mounting frequency and intensity of natural hazards, alongside growing interdependencies between social-technical and ecological systems, are placing increased pressure on emergency management. This is particularly true at the strategic level of emergency management, which involves planning for and managing non-routine, high-consequence events. Drawing on the literature, a survey, and interviews and workshops with Australia's senior emergency managers, this paper presents an analysis of five core challenges that these pressures are creating for strategic-level emergency management. It argues that emphasising 'emergency management' as a primary adaptation strategy is a retrograde step that ignores the importance of addressing socio-political drivers of vulnerabilities. Three key suggestions are presented that could assist the country's strategic-level emergency management in tackling these challenges: (i) reframe emergency management as a component of disaster risk reduction rather than them being one and the same; (ii) adopt a network governance approach; and (iii) further develop the capacities of strategic-level emergency managers. © 2017 The Author(s). Disasters © Overseas Development Institute, 2017.

Big data : opportunities and challenges in asset management : final report.

Science.gov (United States)

2016-08-01

State Departments of Transportation and other transportation agencies collect vast quantities of data but managing, accessing and sharing data has been problematic and well documented. This project reviewed the similar challenges faced by other indus...

Integrated groundwater management: An overview of concepts and challenges

Science.gov (United States)

Jakeman, Anthony J.; Barreteau, Olivier; Hunt, Randall J.; Rinaudo, Jean-Daniel; Ross, Andrew; Jakeman, Anthony J.; Barreteau, Olivier; Hunt, Randall J.; Rinaudo, Jean-Daniel; Ross, Andrew

2016-01-01

Managing water is a grand challenge problem and has become one of humanity’s foremost priorities. Surface water resources are typically societally managed and relatively well understood; groundwater resources, however, are often hidden and more difficult to conceptualize. Replenishment rates of groundwater cannot match past and current rates of depletion in many parts of the world. In addition, declining quality of the remaining groundwater commonly cannot support all agricultural, industrial and urban demands and ecosystem functioning, especially in the developed world. In the developing world, it can fail to even meet essential human needs. The issue is: how do we manage this crucial resource in an acceptable way, one that considers the sustainability of the resource for future generations and the socioeconomic and environmental impacts? In many cases this means restoring aquifers of concern to some sustainable equilibrium over a negotiated period of time, and seeking opportunities for better managing groundwater conjunctively with surface water and other resource uses. However, there are many, often-interrelated, dimensions to managing groundwater effectively. Effective groundwater management is underpinned by sound science (biophysical and social) that actively engages the wider community and relevant stakeholders in the decision making process. Generally, an integrated approach will mean “thinking beyond the aquifer”, a view which considers the wider context of surface water links, catchment management and cross-sectoral issues with economics, energy, climate, agriculture and the environment. The aim of the book is to document for the first time the dimensions and requirements of sound integrated groundwater management (IGM). The primary focus is on groundwater management within its system, but integrates linkages beyond the aquifer. The book provides an encompassing synthesis for researchers, practitioners and water resource managers on the concepts and

Management of International Institutions and NGOs. Frameworks, practices and challenges

OpenAIRE

E. Missoni; D. Alesani

2014-01-01

International Institutions (IIs), International NGOs (INGOs) and Transnational Hybrid Organizations (THOs) play a hugely important role in the modern world economy. Despite having been studied by scholars from a range of disciplines, these organizations have never before been approached from a management perspective. This ambitious book analyzes the management challenges associated with interna- tional cooperation and sheds light on how these organizations have evolved as the political, econo...

NETWORKS OF HEALTH CARE: A CHALLENGE TO SUS MANAGEMENT

Directory of Open Access Journals (Sweden)

Camila Dubow

2013-09-01

Full Text Available The article proposes a critical reflection, based on national law, scholarly, scientific, on the current development of Networks of Health Care, as a strategy for strengthening the Single Health System (SUS. Are weighted inefficiency of traditional ways of organizing care and management, the challenge of Network Health Care for comprehensive care and management mechanisms used in this process. The work provides subsidies for the care practices and health management are reflected, pointing strategies that result in disruptions of paradigms through a refocusing of attention in existing models. For networks of health care can be consolidated, is fundamental to political sensitivity of health managers with a commitment to build a new model of care, through the struggle to consolidate the SUS and the realization of the principles of universality, comprehensiveness and equity.

Internet of Things, Challenges for Demand Side Management

Directory of Open Access Journals (Sweden)

Simona-Vasilica OPREA

2017-01-01

Full Text Available The adoption of any new product means also the apparition of new issues and challenges, and this is especially true when we talk about a mass adoption. The advent of Internet of Things (IoT devices will be, in the authors of this paper opinion, the largest and the fastest product adoption yet to be seen, as several early sources were predicting a volume of 50 billion IoT devices to be active by 2020 [1][2]. While later forecasts reduced the predicted amount to about 20-30 billion devices [3], even for such “reduced” number, demand side management issues are foreseeable, for the potential economic impact of IoT applications in 2025 will be between 3.9 and $11.1 trillion USD [4]. Not only that new patterns will emerge in energy consumption and Internet traffic, but we predict that the sheer amount of data produced by this quantity of IoT devices will give birth to a new sort of demand side management, the demand side management of IoT data. How will this work is yet to be seen but, at the current moment, one can at least identify the bits and pieces that will constitute it. This paper is intended to serve as short guide regarding the possible challenges raised by the adoption of IoT devices. The data types and structures, lifecycle and patterns will be briefly discussed throughout the following article.

Clinical challenges in the management of vaginal prolapse

Science.gov (United States)

Siddiqui, Nazema Y; Edenfield, Autumn L

2014-01-01

Pelvic organ prolapse is highly prevalent, and negatively affects a woman’s quality of life. Women with bothersome prolapse may be offered pessary management or may choose to undergo corrective surgery. In choosing the most appropriate surgical procedure, there are many factors to consider. These may include the location(s) of anatomic defects, the severity of prolapse symptoms, the activity level of the woman, and concerns regarding the durability of the repair. In many instances, women and their surgeons are challenged to weigh the risks and benefits of native tissue versus mesh-augmented repairs. Though mesh-augmented repairs may offer better durability, they are also associated with unique complications, such as mesh erosion. Furthermore, newer surgical techniques of mesh placement via abdominal or vaginal routes may result in different outcomes compared to traditional techniques. Biologic grafts may also be considered to improve durability of a surgical repair, while avoiding potential complications of synthetic mesh. In this article, we review many of the clinical challenges that gynecologic surgeons face in the surgical management of vaginal prolapse. Furthermore, we review data that can help guide decision making when treating women with pelvic organ prolapse. PMID:24474848

Notification: FY 2018 CSB Management Challenges and Internal Control Weaknesses

Science.gov (United States)

December 26, 2017. The OIG is beginning work to update for fiscal year 2018 its list of proposed key management challenges and internal control weaknesses confronting the U.S. Chemical Safety and Hazard Investigation Board (CSB).

Regional consensus opinion for the management of Beta thalassemia major in the Arabian Gulf area

Science.gov (United States)

2013-01-01

Thalassemia syndrome has diverse clinical presentations and a global spread that has far exceeded the classical Mediterranean basin where the mutations arose. The mutations that give rise to either alpha or beta thalassemia are numerous, resulting in a wide spectrum of clinical severity ranging from carrier state to life-threatening, inherited hemolytic anemia that requires regular blood transfusion. Beta thalassemia major constitutes a remarkable challenge to health care providers. The complications arising due to the anemia, transfusional iron overload, as well as other therapy-related complications add to the complexity of this condition. To produce this consensus opinion manuscript, a PubMed search was performed to gather evidence-based original articles, review articles, as well as published work reflecting the experience of physicians and scientists in the Arabian Gulf region in an effort to standardize the management protocol. PMID:24044606

Connectivity, interoperability and manageability challenges in internet of things

Science.gov (United States)

Haseeb, Shariq; Hashim, Aisha Hassan A.; Khalifa, Othman O.; Ismail, Ahmad Faris

2017-09-01

The vision of Internet of Things (IoT) is about interconnectivity between sensors, actuators, people and processes. IoT exploits connectivity between physical objects like fridges, cars, utilities, buildings and cities for enhancing the lives of people through automation and data analytics. However, this sudden increase in connected heterogeneous IoT devices takes a huge toll on the existing Internet infrastructure and introduces new challenges for researchers to embark upon. This paper highlights the effects of heterogeneity challenges on connectivity, interoperability, management in greater details. It also surveys some of the existing solutions adopted in the core network to solve the challenges of massive IoT deployment. The paper finally concludes that IoT architecture and network infrastructure needs to be reengineered ground-up, so that IoT solutions can be safely and efficiently deployed.

Student Outcomes Assessment of a Logistics and Supply Chair Management Major

Science.gov (United States)

Walter, Clyde Kenneth

2012-01-01

Assessment of specialized programs, such as logistics and supply chain management program described here, may pose challenges because previous experience are less widely shared than in the more mainline subjects. This case study provides one model that may guide other faculties facing a similar assignment. The report detailed the steps followed to…

Challenges in the management of glaucoma in developing countries.

Science.gov (United States)

Butt, Nadeem Hafeez; Ayub, Muhammad Hammad; Ali, Muhammad Hassaan

2016-01-01

Glaucoma is the most common optic neuropathy characterized by normal to raised intraocular pressure (IOP), visual field defects, loss of retinal nerve fiber layer, thinning of the neuroretinal rim, and cupping of the optic disc. IOP reduction by medical, laser, or surgical therapies remains the only clinically proven treatment of glaucoma. The challenges in glaucoma management are diverse. They include early detection and diagnosis, setting of appropriate target IOP, choice of treatment, monitoring of quality of life and sight, and compliance with the treatment. Early diagnosis can be made by assessing optic nerve structure using imaging devices and optic nerve function through perimetry. Reducing IOP and controlling its fluctuations are considered to be the most important factors in limiting progression of glaucoma. Selection of the best suitable therapy out of medical, surgical, or laser treatment options is yet another management challenge. Patients suffering from glaucoma experience poor quality of life owing to the diagnosis itself, functional visual loss, inconvenience and cost of treatment, and side effects of treatment. All these factors lead to poor compliance, adherence, and persistence to treatment, and further progression of the disease. It is, therefore, important that ophthalmologists keep all the aforementioned factors in mind when managing patients with glaucoma.

Water management: Current and future challenges and research directions

Science.gov (United States)

Cosgrove, William J.; Loucks, Daniel P.

2015-06-01

Water distinguishes our planet compared to all the others we know about. While the global supply of available freshwater is more than adequate to meet all current and foreseeable water demands, its spatial and temporal distributions are not. There are many regions where our freshwater resources are inadequate to meet domestic, economic development and environmental needs. In such regions, the lack of adequate clean water to meet human drinking water and sanitation needs is indeed a constraint on human health and productivity and hence on economic development as well as on the maintenance of a clean environment and healthy ecosystems. All of us involved in research must find ways to remove these constraints. We face multiple challenges in doing that, especially given a changing and uncertain future climate, and a rapidly growing population that is driving increased social and economic development, globalization, and urbanization. How best to meet these challenges requires research in all aspects of water management. Since 1965, the journal Water Resources Research has played an important role in reporting and disseminating current research related to managing the quantity and quality and cost of this resource. This paper identifies the issues facing water managers today and future research needed to better inform those who strive to create a more sustainable and desirable future.

ManAGEment: the challenges of global age diversity for corporations and governments

NARCIS (Netherlands)

Mahon, John F.; Millar-Schijf, Carla C.J.M.

2014-01-01

Purpose – The purpose of this paper is to investigate the challenges, worldwide of managing an aging workforce. The paper offers suggestions for public policy and for individual organizational approaches to developing, managing and motivating an aging workforce. Design/methodology/approach – The

Managing conflict-generating invasive species in South Africa: Challenges and trade-offs

Directory of Open Access Journals (Sweden)

Tsungai Zengeya

2017-03-01

Full Text Available Background: This paper reviewed the benefits and negative impacts of alien species that are currently listed in the Alien and Invasive Species Regulations of the National Environmental Management: Biodiversity Act (Act no 10 of 2004 and certain alien species that are not yet listed in the regulations for which conflicts of interest complicate management. Objectives: Specifically, it identified conflict-generating species, evaluated the causes and driving forces of these conflicts and assessed how the conflicts have affected management. Method: A simple scoring system was used to classify the alien species according to their relative degree of benefits and negative impacts. Conflict-generating species were then identified and further evaluated using an integrated cognitive hierarchy theory and risk perception framework to identify the value systems (intrinsic and economic and risk perceptions associated with each conflict. Results: A total of 552 alien species were assessed. Most of the species were classified as inconsequential (55% or destructive (29%. Beneficial (10% and conflict-generating (6% species made a minor contribution. The majority (46% of the conflict cases were associated with more than one value system or both values and risk perception. The other conflicts cases were based on intrinsic (40% and utilitarian (14% value systems. Conclusions: Conflicts based on value and risk perceptions are inherently difficult to resolve because authorities need to balance the needs of different stakeholders while meeting the mandate of conserving the environment, ecosystem services and human well-being. This paper uses the identified conflict-generating species to highlight the challenges and trade-offs of managing invasive species in South Africa.

MAINTAINING LONG-TERM MANAGEMENT: Herbicide-resistant weeds challenge some signature cropping systems

Directory of Open Access Journals (Sweden)

Bradley D. Hanson

2014-10-01

Full Text Available Invasive and endemic weeds pose recurring challenges for California land managers. The evolution of herbicide resistance in several species has imposed new challenges in some cropping systems, and these issues are being addressed by UC Cooperative Extension farm advisors, specialists and faculty. There are currently 24 unique herbicide-resistant weed biotypes in the state, dominated by grasses and sedges in flooded rice systems and, more recently, glyphosate-resistant broadleaf and grass weeds in tree and vine systems, roadsides and glyphosate-tolerant field crops. Weed scientists address these complex issues using approaches ranging from basic physiology and genetics research to applied research and extension efforts in grower fields throughout the state. Although solutions to herbicide resistance are not simple and are affected by many biological, economic, regulatory and social factors, California stakeholders need information, training and solutions to address new weed management problems as they arise. Coordinated efforts conducted under the Endemic and Invasive Pests and Disease Strategic Initiative directly address weed management challenges in California's agricultural industries.

Primary sclerosing cholangitis: diagnostic and management challenges

Directory of Open Access Journals (Sweden)

Sirpal S

2017-11-01

Full Text Available Sanjeev Sirpal,1 Natasha Chandok2 1Department of Medicine, Centre Hospitalier de l’Université de Montréal (CHUM, University of Montreal, Montreal, QC, 2Department of Medicine, University of Western Ontario, London, ON, Canada Abstract: Primary sclerosing cholangitis (PSC is a chronic immune-mediated disease affecting intra- and extrahepatic bile ducts, primarily the large biliary ducts. Clinical manifestations are broad, and the spectrum encompasses asymptomatic cholestasis, icteric cholangitis with pruritis, cirrhosis, and cholangiocarcinoma. Though rare, PSC has a propensity to affect young to middle-aged males and is strongly associated with inflammatory bowel disease. There is an unmet need for effective medical treatments for PSC, and to date, the only curative therapy is liver transplantation reserved for those with end-stage liver disease. This article addresses the diagnostic and management challenges of PSC, with a succinct analysis of existing therapies, their limitations, and a glimpse into the future of the management of this multifaceted pathologic entity. Keywords: primary sclerosing cholangitis, management, PSC

Perceptions of human resource professionals of challenges to and strategies for retaining managers

Directory of Open Access Journals (Sweden)

Danielle Uitzinger

2018-01-01

Contribution or value add: This study adds to the insights of HR professionals, line managers and leaders in organisations regarding retention challenges and effective retention strategies for top- and middle-level managers.

Management of fire and industrial safety - challenges during commissioning of a NPP

International Nuclear Information System (INIS)

Maiti, Subhaschandra; Mohan, Nalini; Ghadge, S.G.; Bajaj, S.S.

2006-01-01

Construction and commissioning period of NPP are reduced world over drastically by stringent schedule for financial and economic reasons. For meeting the schedule, commissioning of components and systems are started immediate after installation, while construction activities are continued in parallel at the same place. Parallel activities' and 'Time Constraint' have brought new challenges to 'Management of Fire and Industrial Safely' during commissioning. An innovative approach was used during such phase of commissioning of TAPP-3 and 4. This paper outlines challenges encountered during this phase and special approach and measures used to meet those challenges. This paper also outlines problems encountered during implementation of these measures and subsequent change in approach to ensure smooth and safe execution of activities. Primarily, challenges were conflicting requirements by various agencies to carryout commissioning in parallel with construction activities concurrently. Main challenges were related to fall hazard, chemical hazard, fire hazard, electrical safety, work in confined space, housekeeping problem. Moreover it was within exclusion zone of another operating plant, which added one more dimension to those challenges. Conventional Safely management approach was little short to resolve these challenges. Such challenges were envisaged; analyzed and innovative measures were arrived at. Along with conventional safely analysis like Job Safely or Hazard Analysis (JSA or JHA), Accident Analysis, Accident Trend Analysis, Fire Hazard Analysis (FHA), innovative method like 'Area-Job- Hazard Charting' and 'Ratio Analysis' were used to understand activity dependent time varying hazard scenarios. Based on this analysis, decision were taken to change various existing elements of safely management like safety organizations; standard operating procedures (SOP); emergency operating procedures (EOP); resource allocation, planning and scheduling; safely training; safely

What about self-management post-stroke? Challenges for stroke survivors, spouses and professionals

NARCIS (Netherlands)

Satink, A.J.H.

2016-01-01

Self-management post-stroke is challenging for many persons after a stroke. In this thesis is explored how stroke survivors, spouses and professionals perceived self-management post-stroke and how the process of self-management post-stroke evolved over time. The following studies are conducted: a

The challenges of knowledge management portals application and implementation:An Iranian organizations case study

Directory of Open Access Journals (Sweden)

Sara Sharifi-Yazdi

2010-07-01

Full Text Available This article aims to review, identify and prioritize challenge factors of the implementation of knowledge management portals for Iranian organizations. The study determines several important weakness factors affecting the implications of the knowledge management such as the weakness in organizational strategy, information overcrowd, content management, portals project management, and etc. The study also indicates that the factors have different priorities where managerial factors are in the highest priority and financial factors are in the lowest priority. We also perform factor analysis to summarize seventeen factors into six issues: Financial and information security, Technology and management, Senior management support and strategy, Acceptance, User's motivation and culture, Project management, Change management and training. Knowledge management portal is a brand new concept for Iranian organizations and it is hard to gather information from limited number of organizations or companies for applied knowledge management portals. The results of this study could be useful for knowledge management planners and managers in organizations and clear the prospects to deal with the challenges.

Assessing Outcomes of a Realistic Major Preview in an Introductory Sport Management Course

Science.gov (United States)

Pierce, David; Wanless, Elizabeth; Johnson, James

2014-01-01

This paper assessed the outcomes of a field experience assignment (FEA) in an introductory sport management course designed as a realistic major preview. Student learning outcomes assessed were commitment to the major, intent to pursue the major, expectation of a career in sports, and perceived preparation for a career in sports. A…

Meeting global health challenges through operational research and management science.

Science.gov (United States)

Royston, Geoff

2011-09-01

This paper considers how operational research and management science can improve the design of health systems and the delivery of health care, particularly in low-resource settings. It identifies some gaps in the way operational research is typically used in global health and proposes steps to bridge them. It then outlines some analytical tools of operational research and management science and illustrates how their use can inform some typical design and delivery challenges in global health. The paper concludes by considering factors that will increase and improve the contribution of operational research and management science to global health.

Hospital management autonomy in Chile: the challenges for human resources in health.

Science.gov (United States)

Méndez, Claudio A; Torres A, M Cristina

2010-04-01

In Latin America, some health sector reforms have included steps to the implementation of autonomous hospitals. In Chile, the health system is implementing a reform that introduces a network of self-managed institutions. These organizations will be high complexity centers that involve greater technical diversity, cost centers and mechanisms to evaluate users' satisfaction. For human resources in health, the implementation of these centers creates challenges in the planning of service provision and a change from the traditional management style of the teams to one based on networks. These challenges include the estimation of gaps in medical specialists and in other professions in the health sector. In order to be successful with self-management, Chile needs to establish universal and local policies that address training and the organization of health service provisioning in these institutions.

Knowledge management challenges in new business development : Case study observations

NARCIS (Netherlands)

Berends, Hans; Vanhaverbeke, Wim; Kirschbaum, Robert

2007-01-01

This paper's focus is on the knowledge management challenges that come along with technology-based new business development (NBD). NBD thrives upon the exploration of knowledge, under radical uncertainty. Furthermore, existing knowledge may both enable and constrain the radical innovation process.

Scientific challenges in the field of invasive alien plant management

CSIR Research Space (South Africa)

Van Wilgen, BW

2004-01-01

Full Text Available This article examines scientific challenges in the field of invasion alien plant management in South Africa. Overview of the Working for Water program, Issues of research funding, and Biological control research. It also includes some of the papers...

Sustainable Approaches for Materials Management in Remote, Economically Challenged Areas of the Pacific

Science.gov (United States)

Remote, economically challenged areas in the Commonwealth of the Northern Marianas Islands (CNMI) and American Samoa in the US Pacific island territories face unique challenges with respect to solid waste management. These islands are remote and isolated, with some islands suppo...

Legacy management: An old challenge with a new focus

International Nuclear Information System (INIS)

Gillogly, Mari; ); Sneve, Malgorzata; Smith, Graham

2017-01-01

The NEA Expert Group on Legacy Management (EGLM) aims to promote a practical and optimised approach for the regulatory supervision of nuclear legacy sites and installations. NEA member countries share their experiences and approaches on legacy management and have submitted case studies to the EGLM that illustrate the common challenges and approaches of many countries. The first report of the expert group will be based on these case studies and will be released in late 2017. A new, broader focus on decommissioning and legacy management issues within the NEA is expected to take shape in early 2018, carrying forward the mission to develop and promote a practical and optimised approach for the regulatory supervision of nuclear legacy sites and installations

Design and practice of a comprehensively functional integrated management information system for major construction

Science.gov (United States)

Liu, Yuling; Wang, Xiaoping; Zhu, Yuhui; Fei, Lanlan

2017-08-01

This paper introduces a Comprehensively Functional Integrated Management Information System designed for the Optical Engineering Major by the College of Optical Science and Engineering, Zhejiang University, which combines the functions of teaching, students learning, educational assessment and management. The system consists of 5 modules, major overview, online curriculum, experiment teaching management, graduation project management and teaching quality feedback. The major overview module introduces the development history, training program, curriculums and experiment syllabus and teaching achievements of optical engineering major in Zhejiang University. The Management Information System is convenient for students to learn in a mobile and personalized way. The online curriculum module makes it very easy for teachers to setup a website for new curriculums. On the website, teachers can help students on their problems about the curriculums in time and collect their homework online. The experiment teaching management module and the graduation project management module enables the students to fulfill their experiment process and graduation thesis under the help of their supervisors. Before students take an experiment in the lab, they must pass the pre-experiment quiz on the corresponding module. After the experiment, students need to submit the experiment report to the web server. Moreover, the module contains experiment process video recordings, which are very helpful to improve the effect of the experiment education. The management of the entire process of a student's graduation program, including the project selection, mid-term inspection, progress report of every two weeks, final thesis, et al, is completed by the graduation project management module. The teaching quality feedback module is not only helpful for teachers to know whether the education effect of curriculum is good or not, but also helpful for the administrators of the college to know whether the

Rocky milieu: Challenges of effective integration of clinical risk management into hospitals in Iran

Science.gov (United States)

Farokhzadian, Jamileh; Nayeri, Nahid Dehghan; Borhani, Fariba

2015-01-01

Healthcare risks and clinical risks have been recognized as a major challenge in healthcare. Clinical risks can never be eliminated and can have serious adverse effects on patient safety. Thus, a clinical risk management (CRM) system has been introduced in the healthcare system to improve quality services. The aim of this study was to explore nurses’ experiences related to the challenges of implementing CRM in the organizational context. This qualitative study was based on the conventional content analysis of the Lundman and Graneheim approach, and it consisted of 22 interview sessions with 20 nurses. The purposive sampling method was used to choose the participants from three hospitals affiliated with the Kerman University of Medical Sciences. We used semi-structured interviews and review of relevant documents to collect data. The analysis of the data led to the emergence of “rocky milieu” as the main theme, and it consisted of three categories that, along with their subcategories, explain the challenges of implementing CRM. The three categories and their subcategories were (1) organizational culture and leadership challenges (decision and performance of leadership and cultural resistance to change), (2) limitation of resources (financial, human, and physical and equipment resources), and (3) variations and complexities in working conditions (the emotional, psychological, and social atmosphere and the heaviness of workload). Attempts have been made to establish CRM through clinical governance and accreditation, but organizational challenges have created a rocky milieu for implementing CRM. However, from an organizational context concerning the suitability of healthcare in Iran, there are obvious needs to move toward quality improvement and safe practices through the effective implementation of CRM. PMID:25968444

Rocky milieu: Challenges of effective integration of clinical risk management into hospitals in Iran

Directory of Open Access Journals (Sweden)

Jamileh Farokhzadian

2015-05-01

Full Text Available Healthcare risks and clinical risks have been recognized as a major challenge in healthcare. Clinical risks can never be eliminated and can have serious adverse effects on patient safety. Thus, a clinical risk management (CRM system has been introduced in the healthcare system to improve quality services. The aim of this study was to explore nurses’ experiences related to the challenges of implementing CRM in the organizational context. This qualitative study was based on the conventional content analysis of the Lundman and Graneheim approach, and it consisted of 22 interview sessions with 20 nurses. The purposive sampling method was used to choose the participants from three hospitals affiliated with the Kerman University of Medical Sciences. We used semi-structured interviews and review of relevant documents to collect data. The analysis of the data led to the emergence of “rocky milieu” as the main theme, and it consisted of three categories that, along with their subcategories, explain the challenges of implementing CRM. The three categories and their subcategories were (1 organizational culture and leadership challenges (decision and performance of leadership and cultural resistance to change, (2 limitation of resources (financial, human, and physical and equipment resources, and (3 variations and complexities in working conditions (the emotional, psychological, and social atmosphere and the heaviness of workload. Attempts have been made to establish CRM through clinical governance and accreditation, but organizational challenges have created a rocky milieu for implementing CRM. However, from an organizational context concerning the suitability of healthcare in Iran, there are obvious needs to move toward quality improvement and safe practices through the effective implementation of CRM.

Challenges and strategies for coping with scleroderma: implications for a scleroderma-specific self-management program.

Science.gov (United States)

Milette, Katherine; Thombs, Brett D; Maiorino, Kristina; Nielson, Warren R; Körner, Annett; Peláez, Sandra

2018-05-09

The purpose of this study was to explore challenges faced by patients with systemic sclerosis, also called scleroderma, in coping with their disease and the strategies they used to face those challenges. Five focus groups were held with scleroderma patients (4 groups, n = 34) and health care professionals who have experience treating scleroderma (1 group, n = 8). Participants' discussions were recorded, transcribed and analyzed using thematic analysis. Participants reported challenges accessing information (e.g., knowledgeable specialists), dealing with negative emotions (e.g., stress due to misunderstandings with loved ones), and accessing resources (e.g., helpful products or devices). Strategies for overcoming challenges were also discussed (e.g., advocating for own needs). When faced with significant challenges while coping with scleroderma, patients develop strategies to manage better and improve their quality of life. To help them cope, patients would benefit from easier access to supportive interventions, including tailored scleroderma self-management programs. Although the challenges experienced by patients with scleroderma are unique, findings from this study might help better understand patients' perspectives regarding coping and disease management for other chronic diseases as well. Implications for Rehabilitation People living with rare diseases, including the rare autoimmune disease scleroderma, face unique challenges and often do not have access to disease-specific educational or other support resources. People with scleroderma report that they face challenges in accessing information, including knowledgeable healthcare providers; managing difficult social interactions and negative emotions; and accessing resources. Strategies employed by scleroderma patients to overcome these challenges include seeking connections to other people with scleroderma or scleroderma patient organizations, actively seeking out local resources, and learning to

Challenges in the pharmacological management of epilepsy and its causes in the elderly.

Science.gov (United States)

Ferlazzo, Edoardo; Sueri, Chiara; Gasparini, Sara; Aguglia, Umberto

2016-04-01

Epilepsy represents the third most common neurological disorders in the elderly after cerebrovascular disorders and dementias. The incidence of new-onset epilepsy peaks in this age group. The most peculiar aetiologies of late-onset epilepsy are stroke, dementia, and brain tumours. However, aetiology remains unknown in about half of the patients. Diagnosis of epilepsy may be challenging due to the frequent absence of ocular witnesses and the high prevalence of seizure-mimics (i.e. transient ischemic attacks, syncope, transient global amnesia or vertigo) in the elderly. The diagnostic difficulties are even greater when patients have cognitive impairment or cardiac diseases. The management of late-onset epilepsy deserves special considerations. The elderly can reach seizure control with low antiepileptic drugs (AEDs) doses, and seizure-freedom is possible in the vast majority of patients. Pharmacological management should take into account pharmacokinetics and pharmacodynamics of AEDs and the frequent occurrence of comorbidities and polytherapy in this age group. Evidences from double-blind and open-label studies indicate lamotrigine, levetiracetam and controlled-release carbamazepine as first line treatment in late-onset epilepsy. Copyright © 2016 Elsevier Ltd. All rights reserved.

Information management challenges of the EOS Data and Information System

Science.gov (United States)

Mcdonald, Kenneth R.; Blake, Deborah J.

1991-01-01

An overview of the current information management concepts that are embodied in the plans for the Earth Observing System Data and Information System (EOSDIS) is presented, and some of the technology development and application areas that are envisioned to be particularly challenging are introduced. The Information Management System (IMS) is the EOSDIS element that provides the primary interface between the science users and the data products and services of EOSDIS. The goals of IMS are to define a clear and complete set of functional requirements and to apply innovative methods and technologies to satisfy them. The information management functions are described in detail, and some applicable technolgies are discussed. Some of the general issues affecting the successful development and operation of the information management element are addressed.

Teaching methods in the healthcare management major.

Science.gov (United States)

Petrova, Gergana G; Popov, Teodor N

2009-01-01

Organisation and management are factors of paramount importance in higher education for achieving higher quality of training, better professional adaptation, and more effective career pursuance of the students. The present study analyses the use of various teaching methods for the students in the major of Healthcare Management as they are employed in two medical universities. We conducted a detailed questionnaire survey which included the students in the Healthcare Management major in the Faculty of Public Health (FPH) at Sofia Medical University (SMU) and the Medical Faculty of Plovdiv Medical University (PMU). The students were surveyed for two consecutive academic years (2004/2005 and 2005/2006). The logical units of study were 198 students completing their baccalaureate programs in Healthcare Management: 145 (73.23+/-3.15%) in the FPH, SMU and 53 (26.77+/-3.15%) in the PMU (the greater number of students from the SMU was due to the greater number of students admitted into the Sofia Medical University). The technical units of study were the Faculty of Public Health in the Medical University in Sofia and the Medical faculty in the Medical University in Plovdiv. The survey was carried out using our own questionnaire form comprising 51 questions (open and closed), some of them allowing more than one answer. The collected sociological data were analysed using SPSS v. 13.0, and the diagrams were made using Microsoft Excel' 97. We used the alternative, non-parametric and graphic analyses to illustrate the processes and events at a level of significance P PMU and 26.32+/-1.91% for SMU). This format of teaching is also considered to be the easiest with regard to learning the study material by 22.75+/-3.25% of the PMU graduates and 27.56+/-2.38% of the SMU graduates. The PMU students regard seminars, individual work and discussions as the format that afford the easiest way to acquire knowledge (22.16+/-3.21%, 21.56+/-3.18%, (18.56+/-3.01%, respectively). The most

The pattern and challenges of infertility management in Lagos, Nigeria

African Journals Online (AJOL)

EB

Abstract. Background: Infertility remains a threat to successful reproduction by couples desirous of pregnancy. Objective: To determine the pattern of infertility cases amongst infertile couples seeking care in Lagos University Teaching. Hospital as well as challenges in their management. Methods: A review of the ...

Analysis of Solid Waste Management Logistics and Its Attendant Challenges in Lagos Metropolis

Directory of Open Access Journals (Sweden)

Boye Benedict Ayantoyinbo

2018-06-01

Full Text Available This study examined the relationship between waste management logistics and identified metrics for waste management logistics performance. Secondly, the study assessed the various challenges inhibiting the performance of LAWMA in the State. Random table sampling and purposive sampling were used to select 47 waste collection centres with 10 questionnaires distributed per centre (470 in total across the 20 Local Government Areas (LGA in Lagos State. However, only 339 questionnaires were retrieved from the sampled population. Multiple regression analysis was used to predict the relationship between waste management logistics and identified metrics for waste logistics performance. Descriptive statistics was used to explain the challenges of the Lagos State Waste Management Authority (LAWMA. The results established that the volume of solid waste and commitment of staff are crucial to waste management logistics and one factor that strongly affects waste logistics is traffic in the metropolis. Conclusively, waste collection turnaround must be increased and government and private investors should provide enabling infrastructure and trained personnel for effective solid waste management in Lagos metropolis.

Ergonomics and sustainability – challenges from global supply chains

DEFF Research Database (Denmark)

Hasle, Peter; Jensen, Per Langaa

2012-01-01

The development of globalised supply chains is a major challenge for sustainability. For several years, there has been discussion within the profession whether and how ergonomics and human factors can play a role. Based on our research, we have identified five major challenges from global supply...... chains especially related to the social aspects of sustainability: (1) criteria for social sustainability, (2) the role of key performance indicators in the management of supply chains, (3) the constant changes in supply chains, (4) the challenge in establishing participation, and (5) the development...... of agency and regulatory mechanisms. There are obviously no clear and simple solutions to these challenges. One possible avenue for progress might lie in acquiring a greater understanding of the challenges from global supply chains and developing a strategy which combines social and long-term business...

Challenges in Regulating Radiation Sources and Associated Waste Management

International Nuclear Information System (INIS)

Shehzad, A.

2016-01-01

Radiation sources are widely used in the fields of medical, industry, agriculture, research, etc. Owing to the inherent risk of exposure to ionizing radiations while using the radiation sources and management of associated waste, safety measures are of utmost importance including robust regulatory control. Pakistan Nuclear Regulatory Authority (PNRA) is responsible for supervising all matters pertaining to nuclear safety and radiation protection in the country. Since its inception, PNRA has made rigorous efforts to regulate the radiation facilities for which regulatory framework was further strengthened by taking into account international norms/practices and implemented afterwards. However, due to vibrant use of these facilities, there are numerous challenges being faced while implementing the regulatory framework. These challenges pertains to shielding design of some facilities, control over service provider for QC/repair maintenance of radiation equipment, assessment of patient doses, and establishment of national diagnostic reference levels for radiological procedures. Further, the regulatory framework also delineate requirements to minimize the generation of associated radioactive waste as low as practicable. The requirements also necessitates that certain sealed radioactive sources (SRS) are returned to the supplier upon completion of their useful life, while other radioactive sources are required to be transported for storage at designated radioactive waste storage facilities in the country, which requires commitment from the licensee. This paper will briefly describe the challenges in regulating the radiation sources and issues related to the waste management associated with these facilities. (author)

Analysis of Challenges for Management Education in India Using Total Interpretive Structural Modelling

Science.gov (United States)

Mahajan, Ritika; Agrawal, Rajat; Sharma, Vinay; Nangia, Vinay

2016-01-01

Purpose: The purpose of this paper is to identify challenges for management education in India and explain their nature, significance and interrelations using total interpretive structural modelling (TISM), an innovative version of Warfield's interpretive structural modelling (ISM). Design/methodology/approach: The challenges have been drawn from…

Characterization of Brazilian Industrial Companies’ Processes and Challenges as to Innovation Management

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Marcelo Seido Nagano

2014-09-01

Full Text Available The goal of this study is to investigate the use of product innovation management practices and the challenges faced by organizations when increasing their innovative performance. To this end, we analyzed the relationships between internal organizational elements, as well as the influence of contextual factors (size, field and source of capital in the characterization of innovation management systems and of barriers to innovation faced by each company. We chose this topic due to the fact that management processes that leverage innovative performance are not yet fully understood, and because of the lack of empirical studies that analyze the reality of the practices proposed in the organizational world, especially in Brazil. As a conceptual basis, we presented modern approaches to innovation, which recognize that this should not be seen as an isolated event but as a process. Exploratory qualitative research was carried out by means of a multiple case study. In it, we studied the innovation management systems of four companies which present relevant product development activities in Brazil. As well as a detailed study of the elements of innovation management, this article includes contributions referring to the characterization of organizational challenges faced by organizations when managing their innovation process.

Challenges in Managing Trustworthy Large-scale Digital Science

Science.gov (United States)

Evans, B. J. K.

2017-12-01

The increased use of large-scale international digital science has opened a number of challenges for managing, handling, using and preserving scientific information. The large volumes of information are driven by three main categories - model outputs including coupled models and ensembles, data products that have been processing to a level of usability, and increasingly heuristically driven data analysis. These data products are increasingly the ones that are usable by the broad communities, and far in excess of the raw instruments data outputs. The data, software and workflows are then shared and replicated to allow broad use at an international scale, which places further demands of infrastructure to support how the information is managed reliably across distributed resources. Users necessarily rely on these underlying "black boxes" so that they are productive to produce new scientific outcomes. The software for these systems depend on computational infrastructure, software interconnected systems, and information capture systems. This ranges from the fundamentals of the reliability of the compute hardware, system software stacks and libraries, and the model software. Due to these complexities and capacity of the infrastructure, there is an increased emphasis of transparency of the approach and robustness of the methods over the full reproducibility. Furthermore, with large volume data management, it is increasingly difficult to store the historical versions of all model and derived data. Instead, the emphasis is on the ability to access the updated products and the reliability by which both previous outcomes are still relevant and can be updated for the new information. We will discuss these challenges and some of the approaches underway that are being used to address these issues.

Meeting the challenge of interacting threats in freshwater ecosystems: A call to scientists and managers

Directory of Open Access Journals (Sweden)

Laura S. Craig

2017-12-01

Full Text Available Human activities create threats that have consequences for freshwater ecosystems and, in most watersheds, observed ecological responses are the result of complex interactions among multiple threats and their associated ecological alterations. Here we discuss the value of considering multiple threats in research and management, offer suggestions for filling knowledge gaps, and provide guidance for addressing the urgent management challenges posed by multiple threats in freshwater ecosystems. There is a growing literature assessing responses to multiple alterations, and we build off this background to identify three areas that require greater attention: linking observed alterations to threats, understanding when and where threats overlap, and choosing metrics that best quantify the effects of multiple threats. Advancing science in these areas will help us understand existing ecosystem conditions and predict future risk from multiple threats. Because addressing the complex issues and novel ecosystems that arise from the interaction of multiple threats in freshwater ecosystems represents a significant management challenge, and the risks of management failure include loss of biodiversity, ecological goods, and ecosystem services, we also identify actions that could improve decision-making and management outcomes. These actions include drawing insights from management of individual threats, using threat attributes (e.g., causes and spatio-temporal dynamics to identify suitable management approaches, testing management strategies that are likely to be successful despite uncertainties about the nature of interactions among threats, avoiding unintended consequences, and maximizing conservation benefits. We also acknowledge the broadly applicable challenges of decision-making within a socio-political and economic framework, and suggest that multidisciplinary teams will be needed to innovate solutions to meet the current and future challenge of interacting

Meeting the challenge of interacting threats in freshwater ecosystems: A call to scientists and managers

Science.gov (United States)

Craig, Laura S.; Olden, Julian D.; Arthington, Angela; Entrekin, Sally; Hawkins, Charles P.; Kelly, John J.; Kennedy, Theodore A.; Maitland, Bryan M.; Rosi, Emma J.; Roy, Allison; Strayer, David L.; Tank, Jennifer L.; West, Amie O.; Wooten, Matthew S.

2017-01-01

Human activities create threats that have consequences for freshwater ecosystems and, in most watersheds, observed ecological responses are the result of complex interactions among multiple threats and their associated ecological alterations. Here we discuss the value of considering multiple threats in research and management, offer suggestions for filling knowledge gaps, and provide guidance for addressing the urgent management challenges posed by multiple threats in freshwater ecosystems. There is a growing literature assessing responses to multiple alterations, and we build off this background to identify three areas that require greater attention: linking observed alterations to threats, understanding when and where threats overlap, and choosing metrics that best quantify the effects of multiple threats. Advancing science in these areas will help us understand existing ecosystem conditions and predict future risk from multiple threats. Because addressing the complex issues and novel ecosystems that arise from the interaction of multiple threats in freshwater ecosystems represents a significant management challenge, and the risks of management failure include loss of biodiversity, ecological goods, and ecosystem services, we also identify actions that could improve decision-making and management outcomes. These actions include drawing insights from management of individual threats, using threat attributes (e.g., causes and spatio-temporal dynamics) to identify suitable management approaches, testing management strategies that are likely to be successful despite uncertainties about the nature of interactions among threats, avoiding unintended consequences, and maximizing conservation benefits. We also acknowledge the broadly applicable challenges of decision-making within a socio-political and economic framework, and suggest that multidisciplinary teams will be needed to innovate solutions to meet the current and future challenge of interacting threats in

Endocrine emergencies in critically ill patients: Challenges in diagnosis and management

Directory of Open Access Journals (Sweden)

Sukhminder Jit Singh Bajwa

2012-01-01

Full Text Available Endocrine emergencies pose unique challenges for the attending intensivist while managing critically ill patients. Besides taking care of primary disease state, one has to divert an equal attention to the possible associated endocrinopathies also. One of the common reasons for inability to timely diagnose an endocrinal failure in critically ill patients being the dominance of other severe systemic diseases and their clinical presentation. The timely diagnosis and administration of therapeutic interventions for these endocrine disorders can improve the outcome in critically ill patients. The timely diagnosis and administration of timely therapeutics in common endocrine disorders like severe thyroid disease, acute adrenal insufficiency and diabetic ketoacidosis significantly influence the outcome and prognosis. Careful evaluation of clinical history and a high degree of suspicion are the corner stone to diagnose such problems. Aggressive management of the patient is equally important as the complications are devastating and can prove highly fatal. The present article is an attempt to review some of the common endocrine emergencies in intensive care unit and the challenges associated with their diagnosis and management.

E-Waste Supply Chain in Mexico: Challenges and Opportunities for Sustainable Management

Directory of Open Access Journals (Sweden)

Samantha E. Cruz-Sotelo

2017-03-01

Full Text Available Electronic waste is a widespread environmental problem. From all waste streams, e-waste is registering one of the largest growing rates (between 3% and 5%. In Mexico, the e-waste recovery system comprises a mix of formal and informal sectors not well known to date. The goal of this article was to analyze electronic waste in Mexico through the active actors in the recovery chain. This article presents the evolution of studies on electronic waste in Mexico. The legal regulations and public policies were analyzed, as were the existing practices of electronic waste handling, and some challenges facing this country for waste flow management. A management model is proposed which highlights components that must be considered in the model and the opportunities and challenges to transition from an unbundled handling, which still has practices that lack environmental and technical support, to sustainable management.

E-LEARNING CHANGE MANAGEMENT: Challenges and opportunities

Directory of Open Access Journals (Sweden)

Alaattin PARLAKKILIC

2013-10-01

Full Text Available The role of e-learning technologies entirely depends on the acceptance and execution of required-change in the thinking and behaviour of the users of institutions. The research are constantly reporting that many e-learning projects are falling short of their objectives due to many reasons but on the top is the user resistance to change according to the digital requirements of new era. It is argued that the suitable way for change management in e-learning environment is the training and persuading of users with a view to enhance their digital literacy and thus gradually changing the users’ attitude in positive direction. This paper discusses change management in transition to e-learning system considering pedagogical, cost and technical implications. It also discusses challenges and opportunities for integrating these technologies in higher learning institutions with examples from Turkey GATA (Gülhane Askeri Tıp Akademisi-Gülhane Military Medical Academy.

Medical management of epileptic seizures: challenges and solutions

Directory of Open Access Journals (Sweden)

Sarma AK

2016-02-01

Full Text Available Anand K Sarma,1 Nabil Khandker,1 Lisa Kurczewski,2 Gretchen M Brophy2 1Department of Neurology, 2Departments of Pharmacotherapy & Outcomes Science and Neurosurgery, Virginia Commonwealth University, Richmond, VA, USA Abstract: Epilepsy is one of the most common neurologic illnesses. This condition afflicts 2.9 million adults and children in the US, leading to an economic impact amounting to $15.5 billion. Despite the significant burden epilepsy places on the population, it is not very well understood. As this understanding continues to evolve, it is important for clinicians to stay up to date with the latest advances to provide the best care for patients. In the last 20 years, the US Food and Drug Administration has approved 15 new antiepileptic drugs (AEDs, with many more currently in development. Other advances have been achieved in terms of diagnostic modalities like electroencephalography technology, treatment devices like vagal nerve and deep-brain stimulators, novel alternate routes of drug administration, and improvement in surgical techniques. Specific patient populations, such as the pregnant, elderly, those with HIV/AIDS, and those with psychiatric illness, present their own unique challenges, with AED side effects, drug interactions, and medical–psychiatric comorbidities adding to the conundrum. The purpose of this article is to review the latest literature guiding the management of acute epileptic seizures, focusing on the current challenges across different practice settings, and it discusses studies in various patient populations, including the pregnant, geriatric, those with HIV/AIDS, comatose, psychiatric, and “pseudoseizure” patients, and offers possible evidence-based solutions or the expert opinion of the authors. Also included is information on newer AEDs, routes of administration, and significant AED-related drug-interaction tables. This review has tried to address only some of these issues that any practitioner who

Advances and Challenges for Nutrient Management in China in the 21st Century

NARCIS (Netherlands)

Sims, J.T.; Ma, L.; Oenema, O.; Dou, Z.; Zhang, F.S.

2013-01-01

Managing agricultural nutrients to provide a safe and secure food supply while protecting the environment remains one of the great challenges for the 21st century. The fourth International Nutrient Management Symposium (INMS), held in 2011 at the University of Delaware, addressed these issues via

Clinical challenges in the management of vaginal prolapse

Directory of Open Access Journals (Sweden)

Siddiqui NY

2014-01-01

Full Text Available Nazema Y Siddiqui, Autumn L EdenfieldDivision of Urogynecology and Reconstructive Surgery, Duke University Medical Center, Durham, NC, USAAbstract: Pelvic organ prolapse is highly prevalent, and negatively affects a woman’s quality of life. Women with bothersome prolapse may be offered pessary management or may choose to undergo corrective surgery. In choosing the most appropriate surgical procedure, there are many factors to consider. These may include the location(s of anatomic defects, the severity of prolapse symptoms, the activity level of the woman, and concerns regarding the durability of the repair. In many instances, women and their surgeons are challenged to weigh the risks and benefits of native tissue versus mesh-augmented repairs. Though mesh-augmented repairs may offer better durability, they are also associated with unique complications, such as mesh erosion. Furthermore, newer surgical techniques of mesh placement via abdominal or vaginal routes may result in different outcomes compared to traditional techniques. Biologic grafts may also be considered to improve durability of a surgical repair, while avoiding potential complications of synthetic mesh. In this article, we review many of the clinical challenges that gynecologic surgeons face in the surgical management of vaginal prolapse. Furthermore, we review data that can help guide decision making when treating women with pelvic organ prolapse.Keywords: pelvic organ prolapse, vaginal prolapse, surgery, sacrocolpopexy, sacrospinous ligament fixation, transvaginal mesh, uterosacral ligament suspension

The Role of Serbian Higher Business Education in Overcoming the Challenges of SME Managers

Directory of Open Access Journals (Sweden)

Maja Kočevar

2014-06-01

Full Text Available In this exploratory study, in-depth interviews with Serbian managers of small and medium-sized enterprises (SMEs were conducted to identify their main work-related challenges and the extent to which formal higher business education has helped them to overcome these challenges. Serbian SME managers find the main challenges to be related to HR- and marketing-related issues, followed by country-specific problems, such as dealing with bureaucracy, difficulties in obtaining financial resources, and coping with delayed payments. They see considerable deficits in the current system of higher business education, specifically referring to a lack of practice-oriented teaching methods and insufficient cooperation between the universities and the business sector.

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

Dar es Salaam City and Challenges in Solid Waste Management ...

African Journals Online (AJOL)

The focus of this paper is on challenges facing solid waste management in. Manzese and Sinza wards, in Dar es Salaam city. In this paper different ways of generating, disposing waste and the associated problems are surveyed. About 102 people were interviewed. Different methods were employed in data collection which ...

The Future of Management Education in Australia: Challenges and Innovations

Science.gov (United States)

Hall, Richard; Agarwal, Renu; Green, Roy

2013-01-01

Purpose -- The purpose of this paper is to undertake a survey of the external and internal forces changing the nature of business schools and business education. It aims to investigate how management education responds to increasing productivity, innovation and capability challenges, examine how MBA programs currently meet these demands, and how…

Models meet data: Challenges and opportunities in implementing land management in Earth system models.

Science.gov (United States)

Pongratz, Julia; Dolman, Han; Don, Axel; Erb, Karl-Heinz; Fuchs, Richard; Herold, Martin; Jones, Chris; Kuemmerle, Tobias; Luyssaert, Sebastiaan; Meyfroidt, Patrick; Naudts, Kim

2018-04-01

As the applications of Earth system models (ESMs) move from general climate projections toward questions of mitigation and adaptation, the inclusion of land management practices in these models becomes crucial. We carried out a survey among modeling groups to show an evolution from models able only to deal with land-cover change to more sophisticated approaches that allow also for the partial integration of land management changes. For the longer term a comprehensive land management representation can be anticipated for all major models. To guide the prioritization of implementation, we evaluate ten land management practices-forestry harvest, tree species selection, grazing and mowing harvest, crop harvest, crop species selection, irrigation, wetland drainage, fertilization, tillage, and fire-for (1) their importance on the Earth system, (2) the possibility of implementing them in state-of-the-art ESMs, and (3) availability of required input data. Matching these criteria, we identify "low-hanging fruits" for the inclusion in ESMs, such as basic implementations of crop and forestry harvest and fertilization. We also identify research requirements for specific communities to address the remaining land management practices. Data availability severely hampers modeling the most extensive land management practice, grazing and mowing harvest, and is a limiting factor for a comprehensive implementation of most other practices. Inadequate process understanding hampers even a basic assessment of crop species selection and tillage effects. The need for multiple advanced model structures will be the challenge for a comprehensive implementation of most practices but considerable synergy can be gained using the same structures for different practices. A continuous and closer collaboration of the modeling, Earth observation, and land system science communities is thus required to achieve the inclusion of land management in ESMs. © 2017 John Wiley & Sons Ltd.

Challenges in Incorporating Climate Change Adaptation into Integrated Water Resources Management

Science.gov (United States)

Kirshen, P. H.; Cardwell, H.; Kartez, J.; Merrill, S.

2011-12-01

Over the last few decades, integrated water resources management (IWRM), under various names, has become the accepted philosophy for water management in the USA. While much is still to be learned about how to actually carry it out, implementation is slowly moving forward - spurred by both legislation and the demands of stakeholders. New challenges to IWRM have arisen because of climate change. Climate change has placed increased demands on the creativities of planners and engineers because they now must design systems that will function over decades of hydrologic uncertainties that dwarf any previous hydrologic or other uncertainties. Climate and socio-economic monitoring systems must also now be established to determine when the future climate has changed sufficiently to warrant undertaking adaptation. The requirements for taking some actions now and preserving options for future actions as well as the increased risk of social inequities in climate change impacts and adaptation are challenging experts in stakeholder participation. To meet these challenges, an integrated methodology is essential that builds upon scenario analysis, risk assessment, statistical decision theory, participatory planning, and consensus building. This integration will create cross-disciplinary boundaries for these disciplines to overcome.

Challenges of torrential flood risk management in Serbia

Directory of Open Access Journals (Sweden)

Petrović Ana M.

2015-01-01

Full Text Available Torrential floods are the natural hydrological hazards manifesting as a consequence of extreme rainfall episodes which have a quick response from the watersheds of small areas, steep slopes and intensive soil erosion. Taking in consideration the nature of torrential flood (sudden and destructive occurrence and the fact they are the most frequent natural hazards in Serbia, torrential flood risk management is a real challenge. Instead of partial solutions for flood protection, integrated torrential flood risk management is more meaningful and effective. The key steps should be an improvement of the legal framework on national level and an expansion of technical and biological torrent control works in river basins. Consequences for society can be significantly reduced if there is an efficient forecast and timely warning, rescue and evacuation and if affected population is educated about flood risks and measures which can be undertaken in case of emergency situation. In this paper, all aspects of torrential flood risk management are analyzed. [Projekat Ministarstva nauke Republike Srbije, br. 47007 III

Water Management in Africa and the Middle East: Challenges and ...

International Development Research Centre (IDRC) Digital Library (Canada)

Book cover Water Management in Africa and the Middle East: Challenges and Opportunities. Directeur(s) : Eglal Rached, Eva Rathgeber, and David B. ... HarassMap et Uber Égypte nouent un partenariat pour sensibiliser la population à la question du harcèlement sexuel. L'organisation HarassMap, soutenue par le CRDI, ...

Challenges for Sustainable Land Management through Climate-Smart Agriculture

Science.gov (United States)

Dougill, Andrew; Stringer, Lindsay

2017-04-01

There are increasing pushes for agricultural land management to be both sustainable and climate-smart (in terms of increasing productivity, building resilience to climate change and enhancing carbon storage). Climate-smart agriculture initiatives include conservation agriculture, based on minimum soil disturbance, permanent soil cover and crop rotation, and agroforestry. Such efforts address key international goals of the United Nations Convention to Combat Desertification (UNCCD) and United Nations Framework Convention on Climate Change (UNFCCC), but as yet have not seen widespread uptake. Based on analyses of different project interventions from across a range of southern African countries, we outline the inter-related challenges that are preventing adoption of climate-smart agriculture initiatives. We then identify routes to building multi-stakeholder partnerships and empowering communities through participatory monitoring with the aim of increasing uptake of such sustainable land management practices. Good practice examples remain largely restricted to local-level project interventions with significant donor (or private-sector) support, aligned to short-term community priorities relating to access to inputs or reduced labour requirements. Scaling-up to district- and national-level initiatives is yet to be widely successful due to problems of: limited policy coherence; a lack of communication between stakeholders at different levels; and limited understanding of long-term benefits associated with changes in agricultural practices. We outline opportunities associated with improved communication of climate information, empowerment of district-level adaptation planning and diversification of agricultural livelihood strategies as key routes to guide farmers towards more sustainable, and climate-smart, land management practices. Recent experiences in Malawi, which has experienced significant floods and an El Niño drought year in the last two years, are used to

Dosimetry challenges for implementing emerging technologies

Energy Technology Data Exchange (ETDEWEB)

Yin Fangfang; Oldham, Mark; Cai Jing; Wu Qiuwen, E-mail: Fangfang.yin@duke.ed [Department of Radiation Oncology Duke University Medical Center, Durham, NC 27516 (United States)

2010-11-01

During the last 10 years, radiation therapy technologies have gone through major changes, mainly related introduction of sophisticated delivery and imaging techniques to improve the target localization accuracy and dose conformity. While implementation of these emerging technologies such as image-guided SRS/SBRT, IMRT/IMAT, IGRT, 4D motion management, and special delivery technologies showed substantial clinical gains for patient care, many other factors, such as training/quality, efficiency/efficacy, and cost/effectiveness etc. remain to be challenging. This talk will address technical challenges for dosimetry verification of implementing these emerging technologies in radiation therapy.

THE IMPACT OF BENEFITS AND SERVICES ON MANAGER ENGAGEMENT AND MANAGER RETENTION IN TOURISM INDUSTRY: ENHANCED BY THE EFFECT OF MANAGEMENT LEVEL

OpenAIRE

ALDATMAZ, Ipek; AYKAÇ, Cansu; DICLE, Ülkü

2016-01-01

Manager engagement and retention are vital to the success and organizational performance of manyservice sector organisations. Maintaining manager retention is a major challenge that many hotelenterprises face today. It is critical that organizations give greater importance to manager engagement,motivation and retention and therefore establish an efficient benefits and services strategy for retainingthese core managers for the persistence and achievement of the organization. Employee motivatio...

The Micronesia Challenge: Assessing the Relative Contribution of Stressors on Coral Reefs to Facilitate Science-to-Management Feedback.

Science.gov (United States)

Houk, Peter; Camacho, Rodney; Johnson, Steven; McLean, Matthew; Maxin, Selino; Anson, Jorg; Joseph, Eugene; Nedlic, Osamu; Luckymis, Marston; Adams, Katrina; Hess, Don; Kabua, Emma; Yalon, Anthony; Buthung, Eva; Graham, Curtis; Leberer, Trina; Taylor, Brett; van Woesik, Robert

2015-01-01

Fishing and pollution are chronic stressors that can prolong recovery of coral reefs and contribute to ecosystem decline. While this premise is generally accepted, management interventions are complicated because the contributions from individual stressors are difficult to distinguish. The present study examined the extent to which fishing pressure and pollution predicted progress towards the Micronesia Challenge, an international conservation strategy initiated by the political leaders of 6 nations to conserve at least 30% of marine resources by 2020. The analyses were rooted in a defined measure of coral-reef-ecosystem condition, comprised of biological metrics that described functional processes on coral reefs. We report that only 42% of the major reef habitats exceeded the ecosystem-condition threshold established by the Micronesia Challenge. Fishing pressure acting alone on outer reefs, or in combination with pollution in some lagoons, best predicted both the decline and variance in ecosystem condition. High variances among ecosystem-condition scores reflected the large gaps between the best and worst reefs, and suggested that the current scores were unlikely to remain stable through time because of low redundancy. Accounting for the presence of marine protected area (MPA) networks in statistical models did little to improve the models' predictive capabilities, suggesting limited efficacy of MPAs when grouped together across the region. Yet, localized benefits of MPAs existed and are expected to increase over time. Sensitivity analyses suggested that (i) grazing by large herbivores, (ii) high functional diversity of herbivores, and (iii) high predator biomass were most sensitive to fishing pressure, and were required for high ecosystem-condition scores. Linking comprehensive fisheries management policies with these sensitive metrics, and targeting the management of pollution, will strengthen the Micronesia Challenge and preserve ecosystem services that coral

The Micronesia Challenge: Assessing the Relative Contribution of Stressors on Coral Reefs to Facilitate Science-to-Management Feedback.

Directory of Open Access Journals (Sweden)

Peter Houk

Full Text Available Fishing and pollution are chronic stressors that can prolong recovery of coral reefs and contribute to ecosystem decline. While this premise is generally accepted, management interventions are complicated because the contributions from individual stressors are difficult to distinguish. The present study examined the extent to which fishing pressure and pollution predicted progress towards the Micronesia Challenge, an international conservation strategy initiated by the political leaders of 6 nations to conserve at least 30% of marine resources by 2020. The analyses were rooted in a defined measure of coral-reef-ecosystem condition, comprised of biological metrics that described functional processes on coral reefs. We report that only 42% of the major reef habitats exceeded the ecosystem-condition threshold established by the Micronesia Challenge. Fishing pressure acting alone on outer reefs, or in combination with pollution in some lagoons, best predicted both the decline and variance in ecosystem condition. High variances among ecosystem-condition scores reflected the large gaps between the best and worst reefs, and suggested that the current scores were unlikely to remain stable through time because of low redundancy. Accounting for the presence of marine protected area (MPA networks in statistical models did little to improve the models' predictive capabilities, suggesting limited efficacy of MPAs when grouped together across the region. Yet, localized benefits of MPAs existed and are expected to increase over time. Sensitivity analyses suggested that (i grazing by large herbivores, (ii high functional diversity of herbivores, and (iii high predator biomass were most sensitive to fishing pressure, and were required for high ecosystem-condition scores. Linking comprehensive fisheries management policies with these sensitive metrics, and targeting the management of pollution, will strengthen the Micronesia Challenge and preserve ecosystem

Identification of hazelnut major allergens in sensitive patients with positive double-blind, placebo-controlled food challenge results

DEFF Research Database (Denmark)

Pastorello, Elide A; Vieths, Stefan; Pravettoni, Valerio

2002-01-01

The hazelnut major allergens identified to date are an 18-kd protein homologous to Bet v 1 and a 14-kd allergen homologous to Bet v 2. No studies have reported hazelnut allergens recognized in patients with positive double-blind, placebo-controlled food challenge (DBPCFC) results or in patients...

Managing the cigeo design: a challenge and an opportunity

International Nuclear Information System (INIS)

Muscetti, R.

2015-01-01

INGEROP is working since years on the French Deep Geological Repository's design for Andra, carrying out since 2012 the preliminary design, the global project management and the technical integration for the engineering of the Cigeo project (in a 50-50 consortium with the French company TECHNIP). The article presents some particular organizational aspects that turned out to be more challenging than foreseen in the course of our activities. Starting from the presentation of real examples, some lessons learned are derived as well as practices of interest in solving analogue issues in similar projects, with focus on its application to the management of engineering phase of geological repositories and other 'megaprojects' in different countries. (author)

A Grand Challenge: Immortal Information and Through-Life Knowledge Management (KIM

Directory of Open Access Journals (Sweden)

Alexander Ball

2006-11-01

Full Text Available ‘Immortal information and through-life knowledge management: strategies and tools for the emerging product-service business paradigm’, is a Grand Challenge project involving eleven different UK universities and incorporating substantial industry collaboration. It is investigating a range of issues associated with the move towards a product-service paradigm in the engineering sector, in particular the long-term curation of digital data, learning from production and use, and appropriate governance and management techniques.

Nonoperative management for major blunt hepatic trauma. A case report.

Science.gov (United States)

Mingoli, Andrea; Saracino, Andrea; Brachini, Gioia; Mariotta, Giovanni; Migliori, Emanuele; Silvestri, Vania

2015-03-16

Over the past 20 years the management of blunt liver trauma has evolved from a primary operative approach to a nonoperative one, for both low and high grade injuries, only on the basis of hemodynamic stability. However, in spite of a high success rate of non operative management, it is frequently observed, also in our country, an old fashioned way to approach these patients, based on habit more than observation and evidence based medicine. We present a case of successful nonoperative treatment of a grade IV blunt liver trauma (lacero-contusive injury of V, VI and VII segments) in a 34-year-old woman. Nowadays more than 85% of liver injuries are managed without operative intervention, irrespective of the injury grade. Success rate of the conservative approach ranges from 82% to 100% and almost all complications (14% in high grade injuries) can be managed with interventional radiology procedures, still avoiding major surgery. Today, in the absence of other abdominal injuries requiring surgical exploration, hemodynamic instability from ongoing hemorrhage after primary evaluation and resuscitative treatment, is the only indication to an operative management of traumatic liver injuries.

Efficiency of management of sustainable development – challenges, problems, barriers

Directory of Open Access Journals (Sweden)

Zięba K.

2016-06-01

Full Text Available This paper discusses such issues as the importance of efficiency management of sustainable development. In the authors’ opinion, this matter is currently topical subject due to, among others, on the still high costs of irrational management in the field. Dynamically changing environment forces to search for new solutions for efficiency management of sustainable development, and unfortunately, in many countries it is still a significant problem. For some countries, the efficiency management of sustainable development is difficult. It should be noted that the problem with the inaction of relevant activities of the countries in the field of development of efficiency management of sustainability development will grow, because globalization makes it necessary to generate new solutions emerging to date problems. Facing each country there are so many challenges in the field. However, some countries are aware of the seriousness of the problem and therefore take a number of measures in this regard, often regardless of the amount of costs. This has an impact on their competitiveness. Apparent is also increasing incorporation of new original solutions in the field of sustainable development management.

Modeling and Management of Big Data: Challenges and opportunities

OpenAIRE

Gil, David; Song, Il-Yeol

2016-01-01

The term Big Data denotes huge-volume, complex, rapid growing datasets with numerous, autonomous and independent sources. In these new circumstances Big Data bring many attractive opportunities; however, good opportunities are always followed by challenges, such as modelling, new paradigms, novel architectures that require original approaches to address data complexities. The purpose of this special issue on Modeling and Management of Big Data is to discuss research and experience in modellin...

Traffic Flow Management Wrap-Up

Science.gov (United States)

Grabbe, Shon

2011-01-01

Traffic Flow Management involves the scheduling and routing of air traffic subject to airport and airspace capacity constraints, and the efficient use of available airspace. Significant challenges in this area include: (1) weather integration and forecasting, (2) accounting for user preferences in the Traffic Flow Management decision making process, and (3) understanding and mitigating the environmental impacts of air traffic on the environment. To address these challenges, researchers in the Traffic Flow Management area are developing modeling, simulation and optimization techniques to route and schedule air traffic flights and flows while accommodating user preferences, accounting for system uncertainties and considering the environmental impacts of aviation. This presentation will highlight some of the major challenges facing researchers in this domain, while also showcasing recent innovations designed to address these challenges.

Major Mental Illness in Those Who Sexually Abuse.

Science.gov (United States)

Moulden, Heather M; Marshall, Liam E

2017-11-09

There is evidence showing an increasing prevalence of mental illness in those in conflict with the law. However, there are many factors affecting the detection, treatment, and management of criminals who are mentally ill. Sex offenders with major mental illness present many challenges to those providing treatment and management services. For example, it is important to consider whether sexually offensive behavior is the cause of criminal behavior or whether it is reflective of an antisocial orientation. Recent evidence suggests it may help better understand and inform risk assessment and management. This paper will review the literature on mental illness among sexual offenders, present a typology to aid in the assessment, treatment, and management of sexual offender with mental illness, and highlight important considerations when providing treatment to sexual offenders with mental illness.

Morbidly obese patient with obstructive sleep apnoea for major spine surgery: An anaesthetic challenge

Directory of Open Access Journals (Sweden)

Shruti Redhu

2016-01-01

Full Text Available Morbidly obese patients with clinical features of obstructive sleep apnoea can present a myriad of challenges to the anaesthesiologists which must be addressed to minimise the perioperative risks. Initiation of continuous positive airway pressure (CPAP therapy early in the pre- and post-operative period along with appropriate anaesthetic planning is of paramount importance in such patients. This case report emphasises the usefulness of CPAP therapy, even for a short duration, to minimise morbidity, improve recovery and hasten early discharge from the hospital after major surgery.

Challenges in the Management of Pediatric Central Venous Access Devices in the Community.

LENUS (Irish Health Repository)

Wallace, Elaine

2012-05-25

Central venous access devices (CVADs) play an essential role in the care of critically ill children. Significant challenges exist for teams in managing CVADs particularly in a community setting. The authors aimed to assess the experience of general practitioners (GPs) caring for children with CVADs. From 200 CVADs inserted in a pediatric hospital in 2009, 50 patients were randomly selected and 44 GPs were forwarded a questionnaire. Twenty (46%) GPs responded. The main reasons (n = 22) for using CVADs were medication administration (n = 11), nutrition (n = 6), and blood sampling (n = 5). Thirteen (65%) GPs had no education in CVAD management and 14 (70%) were unaware of existing guidelines. Those identified by GPs as having primary responsibility for care of CVADs in the community included hospital\\/pediatric teams (n = 9), parents (n = 3), GPs (n = 2), public health nurses (n = 1), and palliative care ("home care") teams (n = 1). The main challenges (n = 15) identified by GPs were lack of education (n = 4), line management difficulties (n = 3), infection risk (n = 3), infrequent exposure to CVADs (n = 3), and poor communication (n = 1). GPs felt that these challenges could be addressed through: education (n = 8), increased manpower and community support (n = 1), and improved communication (n = 1). This study highlights the inconsistency and challenges for GPs surrounding CVAD use in children. Further education and support is necessary to assist GPs in their use particularly when providing end-of-life care for children in the community.

Managing flood risks in the Mekong Delta: How to address emerging challenges under climate change and socioeconomic developments

OpenAIRE

Hoang, L.P.; Biesbroek, R.; Tri, V.P.D.; Kummu, M.; van Vliet, M.T.H.; Leemans, R.; Kabat, P.; Ludwig, F.

2018-01-01

Climate change and accelerating socioeconomic developments increasingly challenge flood-risk management in the Vietnamese Mekong River Delta—a typical large, economically dynamic and highly vulnerable delta. This study identifies and addresses the emerging challenges for flood-risk management. Furthermore, we identify and analyse response solutions, focusing on meaningful configurations of the individual solutions and how they can be tailored to specific challenges using expert surveys, conte...

Managed Realignment in Europe: Achievements and Challenges

Science.gov (United States)

Esteves, L. S.

2017-12-01

Environmental and financial sustainability associated with climate change adaptation needs are the key drivers leading to the development of national and regional strategies which promote managed realignment. Managed realignment aims to maximise environmental and socioeconomic benefits by creating space for coastal habitats to evolve more naturally. Therefore, the natural adaptive capacity of coastal habitats and the range of ecosystem services they provide are paramount to the success of these strategies. In Europe, most projects involve the creation of intertidal areas by artificially restoring tidal flow into embanked land. Projects generally involve at least one of the following: removal, breach, or realignment of existing coastal protection, controlled tidal restoration and managed retreat (i.e. relocation from risk areas). Since early 1980s, over 140 managed realignment projects have been implemented (or are under construction) in Europe, mainly in the UK, France, Germany, Netherlands, Belgium and Spain, resulting in approximately 15,800 ha of habitat creation. This paper will present an overview of managed realignment initiatives in Europe, summarise achievements so far and discuss ways to overcome commonly faced challenges, focusing on high-level strategy; delivery of objectives at the project level; and public perception. Projects vary greatly as planning must take into account local social and environmental characteristics and constraints. Evidence of benefits gained in each project and their contribution to high level targets need to be quantified and widely disseminated to help attract public support. However, the lack of information and/or undisputable evidence about the realisation of tangible socioeconomic benefits is still hindering public acceptance. The knowledge about how the many social, economic, and technical aspects interact is evolving fast as new policies are formulated, more projects are implemented, and monitoring data are made available.

Towards Cloud Computing SLA Risk Management: Issues and Challenges

OpenAIRE

Morin, Jean-Henry; Aubert, Jocelyn; Gateau, Benjamin

2012-01-01

Cloud Computing has become mainstream technology offering a commoditized approach to software, platform and infrastructure as a service over the Internet on a global scale. This raises important new security issues beyond traditional perimeter based approaches. This paper attempts to identify these issues and their corresponding challenges, proposing to use risk and Service Level Agreement (SLA) management as the basis for a service level framework to improve governance, risk and compliance i...

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

Science.gov (United States)

Martin, William E; Keogh, Timothy J

2004-01-01

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

Using virtual machine monitors to overcome the challenges of monitoring and managing virtualized cloud infrastructures

Science.gov (United States)

Bamiah, Mervat Adib; Brohi, Sarfraz Nawaz; Chuprat, Suriayati

2012-01-01

Virtualization is one of the hottest research topics nowadays. Several academic researchers and developers from IT industry are designing approaches for solving security and manageability issues of Virtual Machines (VMs) residing on virtualized cloud infrastructures. Moving the application from a physical to a virtual platform increases the efficiency, flexibility and reduces management cost as well as effort. Cloud computing is adopting the paradigm of virtualization, using this technique, memory, CPU and computational power is provided to clients' VMs by utilizing the underlying physical hardware. Beside these advantages there are few challenges faced by adopting virtualization such as management of VMs and network traffic, unexpected additional cost and resource allocation. Virtual Machine Monitor (VMM) or hypervisor is the tool used by cloud providers to manage the VMs on cloud. There are several heterogeneous hypervisors provided by various vendors that include VMware, Hyper-V, Xen and Kernel Virtual Machine (KVM). Considering the challenge of VM management, this paper describes several techniques to monitor and manage virtualized cloud infrastructures.

Challenges of the management of mass casualty: lessons learned from the Jos crisis of 2001.

Science.gov (United States)

Ozoilo, Kenneth N; Pam, Ishaya C; Yiltok, Simon J; Ramyil, Alice V; Nwadiaro, Hyacinth C

2013-10-28

Jos has witnessed a series of civil crises which have generated mass casualties that the Jos University Teaching Hospital has had to respond to from time to time. We review the challenges that we encountered in the management of the victims of the 2001 crisis. We reviewed the findings of our debriefing sessions following the sectarian crisis of September 2001 and identified the challenges and obstacles experienced during these periods. Communication was a major challenge, both within and outside the hospital. In the field, there was poor field triage and no prehospital care. Transportation and evacuation was hazardous, for both injured patients and medical personnel. This was worsened by the imposition of a curfew on the city and its environs. In the hospital, supplies such as fluids, emergency drugs, sterile dressings and instruments, splints, and other consumables, blood and food were soon exhausted. Record keeping was erratic. Staff began to show signs of physical and mental exhaustion as well as features of anxiety and stress. Tensions rose between different religious groups in the hospital and an attempt was made by rioters to attack the hospital. Patients suffered poor subsequent care following resuscitation and/or surgery and there was neglect of patients on admission prior to the crisis as well as non trauma medical emergencies. Mass casualties from disasters that disrupt organized societal mechanisms for days can pose significant challenges to the best of institutional disaster response plans. In the situation that we experienced, our disaster plan was impractical initially because it failed to factor in such a prolongation of both crisis and response. We recommend that institutional disaster response plans should incorporate provisions for the challenges we have enumerated and factor in peculiarities that would emanate from the need for a prolonged response.

Clinical parameters and challenges of managing cervicofacial necrotizing fasciitis in a Sub-Saharan tertiary hospital

Directory of Open Access Journals (Sweden)

Adeola A Olusanya

2015-01-01

Full Text Available Introduction: Necrotizing fasciitis is a severe soft tissue infection. In our environment, patients presenting with this infection are usually financially incapacitated and, therefore, their management can be challenging. This paper aimed to document the pattern and challenges encountered in the management of cervicofacial necrotizing fasciitis (CNF in the University College Hospital, Ibadan. Materials and Methods: Information such as biodata, site of infection, systemic conditions, widest span of defect, management provided, hospital stay, and outcome of management was prospectively collected on all patients with CNF who presented at the Department of Oral and Maxillofacial Surgery between January 2007 and December 2013. The patients were managed according to a devised protocol of antibiotic therapy, serial debridement and honey dressings. Results: Twenty-four cases of CNF were seen. There were 9 males and 15 females while 70.9% of the patients belonged to the low socioeconomic class. The mean span of wound defect was 12.2 (±8.844 cm. The mean hospital stay was 27.8 (±23.1 days, and scar formation was the most common complication encountered. Conclusion: Our study represents the largest series of CNF from a Nigerian health facility presently. The management of necrotizing fascitis in the maxillofacial region poses a significant challenge to both the surgeon and the patient. However, the mortality rate of CNF in our center appears comparatively low.

Challenge theme 7: Information support for management of border security and environmental protection: Chapter 9 in United States-Mexican Borderlands: Facing tomorrow's challenges through USGS science

Science.gov (United States)

Parcher, Jean W.; Page, William R.

2013-01-01

Historically, international borders were located far from the major political and economic capitals of their countries and rarely received adequate planning or infrastructure development. Today, as a result of global economics and increased movement of goods between nations, border regions play a much greater role in commerce, tourism, and transportation. For example, Mexico is the second largest destination for United States exports (Woodrow Wilson Center Mexico Institute, 2009). The rapid population and economic growth along the United States–Mexican border, undocumented human border crossings, and the unique natural diversity of resources in the Borderlands present challenges for border security and environmental protection. Assessing risks and implementing sustainable growth policies to protect the environment and quality of life greatly increase in complexity when the issues cross an international border, where social services, environmental regulations, lifestyles, and cultural beliefs are unique for each country. Shared airsheds, water and biological resources, national security issues, and disaster management needs require an integrated binational approach to assess risks and develop binational management strategies.

Sustainability Management in Agribusiness: Challenges, Concepts, Responsibilities and Performance

Directory of Open Access Journals (Sweden)

Nina Friedrich

2012-12-01

Full Text Available The idea of sustainable management has recently gained growing attention in the agribusiness sector. This is mainly due to a widespread discontent with the industrialization of agricultural production and food processing and growing public pressure on agribusiness firms to implement more sustainable management practices. In this paper we present the results of an explorative empirical study of sustainability management in German agribusiness firms. The study shows that agribusiness firms have developed a broad understanding of sustainability management and perceive a multi-facetted spectrum of societal demands they have to meet. The most important arguments for implementing more sustainable management practices are that companies have to make sure that they are trusted by society in the long run and that the perception of a company by external stakeholders has become more and more important. The companies surveyed know quite a number of sustainability programmes and standards, but the number of companies that actually participate in these initiatives is much smaller. Nonetheless, the majority of the respondents feels that their company is more successful with regard to sustainability management than industry average.

Decentralization Challenges for Management of Cultural Patrimony in Ecuador

Directory of Open Access Journals (Sweden)

Dr.C. Carlos Leonel Escudero-Sánchez

2015-10-01

Full Text Available In Latin America  the new  decentralization policies in  the forms of government  challenging  institutional  processes  and management  practices.  In the context of  Ecuador  responds to  a constitutional  mandate expressed in  the reformulation of  the powers of the  municipal  autonomous governments. Consequently, the main  purpose of the article  is to present  the main  principles  expressed  in the  protection, evaluation and dissemination of cultural heritage.  Therefore  the  exercise of autonomy  and decentralization  is governed  by the principles  of solidarity, subsidiarity,  territorial equity, integration and participation.  Hence,  the main results  are  part of  the systematization of  such  socio-economic, institutional, governance  and participation, legal and financial  management of cultural heritage contexts.Keywords: decentralization, cultural heritage, cultural management, citizen participation.

Intervening: Managerial Issues and Challenges in an Educational Management Development Program.

Science.gov (United States)

Barrilleaux, Louis E.; Schermerhorn, John R., Jr.

The literature on intervention theory tends to overlook the pragmatic managerial issues and challenges of intervening. This paper analyzes the formative period of a school management development program to establish crucial differences between the program director's espoused theory and the actual experience of the intervention. These differences…

21st Century Security Manager

OpenAIRE

Stelian ARION

2010-01-01

We live in world of uncertainty that generates major paradigms changing that affect security risk management. Modern organization’s security risks management can’t be done without a profound knowlegde and daily practice for security governance, security risk management and resilience. 21st Century security manager need to deal with several areas of konwledge in order to succesfully manage security risks. The document presents the advantages, disadvantages and challenges for security managers ...

CHALLENGES OF SUPPLY CHAIN MANAGEMENT

Directory of Open Access Journals (Sweden)

Natalia GALANTON

2017-11-01

Full Text Available The present article highlights the basic characteristics of the supply chain, specific to changes in the business environment of companies at the beginning of the 21st century. Supply chain activities turn natural resources, raw materials and components into a finished product, which is then delivered to the final customer. The supply chain incorporates the production process alongside the raw material acquisition and distribution of finished products, encompassing all the existing process responsible for transforming the materials taken from the supplier to the finished products delivered to customers. Today, competitiveness and performance of an organization are dependent on belonging to an efficient and effective supply-delivery chain where synergies exist due to the establishment and implementation of common goals and strategies by partners. Competition does not take place between independent organizations or between small groups of organizations, but between supply and delivery chains, made up of interconnected networks of producers, distributors and logistics providers. Under these circumstances, supply chain managers must seek solutions to respond promptly to the most important challenges in the field.

Pregnancy and pituitary disorders: Challenges in diagnosis and management

OpenAIRE

Bashir A Laway; Shahnaz A Mir

2013-01-01

Pregnancy is associated with normal physiological changes in endocrine system that assists fetal survival as well as preparation of labor. The pituitary gland is one of the most affected organs in which major changes in anatomy and physiology take place. Due to overlapping clinical and biochemical features of pregnancy, sometimes the diagnosis of pituitary disorders may be challenging. It is important to know what normal parameters of changes occur in endocrine system in order to diagnose and...

Challenges Implementing Work-Integrated Learning in Human Resource Management University Courses

Science.gov (United States)

Rook, Laura

2017-01-01

The examination of work-integrated learning (WIL) programs in the undergraduate Human Resource Management (HRM) curriculum is an area under-represented in the Australian literature. This paper identifies the challenges faced in implementing WIL into the HRM undergraduate curriculum. Qualitative semi-structured interviews were conducted with 38…

Community-based management of environmental challenges in Latin America and the Caribbean

Directory of Open Access Journals (Sweden)

Maria del Mar Delgado-Serrano

2017-03-01

Full Text Available This Special Feature gathers the results of five research projects funded by the 7th Research Framework Program of the European Union and aims to identify successful cases of community-based management of environmental challenges in Latin America. The funding scheme, Research for the benefit of Civil Society Organizations, fostered innovative research approaches between civil society and research organizations. More than 20 field sites have been explored, and issues such as trade-offs between conservation and development, scientific versus local knowledge, social learning, ecosystem services, community owned solutions, scaling-up and scaling-out strategies, the influence of context and actors in effective environmental management and governance, and the conflicts of interests around natural resources have been addressed. Based on our experiences as project coordinators, in this editorial we reflect on some of the important lessons gained for research praxis and impact, focusing on knowledge of governance models and their scaling-out and scaling-up, and on methods and tools to enable action research at the science-civil society interface. The results highlight the richness of community-based management experiences that exist in Latin America and the diversity of approaches to encourage the sustainable community-based management of environmental challenges.

Quality management: does it pay off?

NARCIS (Netherlands)

van den Heuvel, J.; Bogers, A.J.J.C.; Does, R.J.M.M.; van Dijk, S.L.; Berg, M.

2006-01-01

Health care today is facing serious quality problems while costs are exploding. Quality management therefore becomes a major strategic challenge. In this article, we go through the strategy deployment and quality management process of the Red Cross Hospital in the Netherlands. Growth, efficiency

Pediatric pleural empyema: one of the management challenges in children of Democratic Republic of Congo.

Science.gov (United States)

Simbi, Kibwe Alphonse; Kazadi, Valentin; Aissi, Louis-Marie; Katsuva, François Mbahewaka; Luboya, Numbi Oscar; Tshilolo, Léon; Zanardo, Vincenzo

2017-06-23

Empyema is a serious complication characterized by purulent exudate and bacteria in the pleural space, which may progress to necrosis, cavitations or fistulas in the thoracic cavity. It remains a major challenge throughout low-income countries. Objectives were to emphasize the role of basic medical and radiologic approach and to resolve a severe lung complication when facilities are inadequate. A five-year-old female was referred with distress respiratory to the Emergency Unit of Monkole, a large public-private missionary hospital in Kinshasa, Congo. Chest X-ray showed a massive empyema that was resolved by immediate drainage and antibiotiocs. Results were rapid improvement and discharge after 3 weeks. A classic medical and imaging approach is a winning return in low-income countries. According to the British Thoracic Society guidelines, pleural effusion with compromising respiratory function can be managed by drainage and antibiotics.

Management Challenges for DevOps Adoption within UK SMEs

OpenAIRE

Jones, Stephen; Noppen, Joost; Lettice, Fiona

2016-01-01

The DevOps phenomenon is gathering pace as more UK organisations seek to leverage the benefits it can potentially bring to software engineering functions. However substantial organisational change is inherent to adopting DevOps, especially where there are prior and established methods. As part of a wider piece of doctoral research investigating the management challenges of DevOps adoption, we present early findings of a six month qualitative diary study following the adoption of DevOps within...

Pneumonia: challenges in the definition, diagnosis, and management of disease.

Science.gov (United States)

Ottosen, Julie; Evans, Heather

2014-12-01

Defining health care-associated pneumonia, which includes both hospital-acquired pneumonia (HAP) and ventilator-associated pneumonia (VAP), is problematic and controversial. Aspiration pneumonia is often included as a subtype of HAP but may be related to community-acquired aspiration events. Scoring systems exist and new surveillance guidelines have been implemented to make early recognition of pneumonia more precise and objective. Management and prevention should follow recommendations, including early empirical therapy, targeted therapy, and limited duration of treatment. Patients with trauma present a challenge to the diagnosis and management of pneumonia, because of increased risk for aspiration and underlying chest and pulmonary injury. Copyright © 2014 Elsevier Inc. All rights reserved.

The portfolio method as management support for patients with major depression.

Science.gov (United States)

Nunstedt, Håkan; Nilsson, Kerstin; Skärsäter, Ingela

2014-06-01

To describe how patients with major depression in psychiatric outpatient care use the portfolio method and whether the method helps the patients to understand their depression. Major depressive disorder is an increasing problem in society. Learning about one's depression has been demonstrated to be important for recovery. If the goal is better understanding and management of depression, learning must proceed on the patient's own terms, based on the patient's previous understanding of their depression. Learning must be aligned with patient needs if it is to result in meaningful and useful understanding. Each patient's portfolio consisted of a binder. Inside the binder, there was a register with predetermined flaps and questions. The patients were asked to work with the questions in the sections that built the content in the portfolio. Individual interviews with patients (n = 5) suffering from major depression according to Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition (DSM-IV) (American Psychiatric Association 1994) were repeatedly conducted between April 2008 and August 2009 in two psychiatric outpatient clinics in western Sweden. Data were analysed using latent content analysis. The results showed that the portfolio was used by patients as a management strategy for processing and analysis of their situation and that a portfolio's structure affects its usability. The patients use the portfolio for reflection on and confirmation of their progress, to create structure in their situation, as a management strategy for remembering situations and providing reminders of upcoming activities. Using a clearly structured care portfolio can enable participation and patient learning and help patients understand their depression. The portfolio method could provide a tool in psychiatric nursing that may facilitate patient understanding and increase self-efficacy. © 2013 John Wiley & Sons Ltd.

Overview of the critical disaster management challenges faced during Van 2011 earthquakes.

Science.gov (United States)

Tolon, Mert; Yazgan, Ufuk; Ural, Derin N; Goss, Kay C

2014-01-01

On October 23, 2011, a M7.2 earthquake caused damage in a widespread area in the Van province located in eastern Turkey. This strong earthquake was followed by a M5.7 earthquake on November 9, 2011. This sequence of damaging earthquakes led to 644 fatalities. The management during and after these earthquake disaster imposed many critical challenges. In this article, an overview of these challenges is presented based on the observations by the authors in the aftermath of this disaster. This article presents the characteristics of 2011 Van earthquakes. Afterward, the key information related to the four main phases (ie, preparedness, mitigation, response, and recovery) of the disaster in Van is presented. The potential strategies that can be taken to improve the disaster management practice are identified, and a set of recommendations are proposed to improve the existing situation.

Colorectal cancer: complexities and challenges in managed care.

Science.gov (United States)

Minkoff, Neil B

2007-08-01

Managed care weighs advances and associated costs to determine whether the combination of longer life at sometimes significantly increased cost represents value. The price of treatment is only 1 factor. To review treatment decision processes for oncologic agents in managed care environments. Price can be exceptionally high for individuals. But if the population size is low, the per-member-per-month (PMPM) impact can be almost negligible, unlike treatments that have moderate costs but are used ubiquitously. Cancer therapies have, for the most part, escaped managed care's notice. For 2007, the national Cancer Institute projects that antineoplastic agents will consume almost a quarter of the overall drug spend. The Medicare population is a unique concern with regard to cancer. Traditionally, Medicare reimbursement of chemotherapeutic agents was based on average wholesale price (AWP) discounting, not the oncologist's purchasing cost. This allowed oncologists to use reimbursement for infusions to support their medical practices. The proposed plan of the Center for Medicare & Medicaid Services (CMS) to use average sales price (ASP) plus 6% to reimburse for drugs used in the office setting leads to significant problems. Pharmacy and therapeutics committees will also face challenges: fewer data are available for some agents because they have become available through the U.S. Food and drug administration's Fast Track, Priority review, or accelerated approval processes. Oncology disease management programs must reach out to patients and not necessarily deal with oncology issues directly, but address tangential issues that impact care, especially depression and pain management.

Integrated sulphur management : gas, oil sands, reclamation and the challenges of fluctuating demand

International Nuclear Information System (INIS)

Pineau, R.

2009-01-01

International Commodities Export Corporation is a privately held company that provides fully integrated service offerings to add maximum value in designing, building, owning, and operating sulphur assets. The company also offers in-house, engineering, procurement and project management, as well as supply management, transportation and distribution services. It also has expertise in marine transportation. This presentation discussed integrated sulphur management, with particular focus on gas, oil sands, reclamation and the challenges of fluctuating demand. The presentation provided an overview of the sulphur market and oil sands sulphur. Key considerations for oil sands producers were also presented. The challenges of fluctuating demand include price and volume considerations; logistics; geography and distance to market; export/offshore versus domestic/United States; seasonal considerations; and an inelastic sulphur market. The presentation concluded with a status update of ICEC's initiative and the advantages of Prince Rupert, an economically viable export infrastructure to producers without onsite forming facilities. figs

Challenges of Solid Waste Disposal and Management in the City of ...

African Journals Online (AJOL)

The paper discusses the environmental challenges associated with solid waste disposal and management currently confronting the city of Masvingo in Zimbabwe. In addition to an extensive literature review, the study used the primary field survey method to gather data. A number of types and sources of solid waste in this ...

Breast Cancer in Low- and Middle-Income Countries: An Emerging and Challenging Epidemic

Directory of Open Access Journals (Sweden)

Arafat Tfayli

2010-01-01

Full Text Available Breast cancer is a major health care problem that affects more than one million women yearly. While it is traditionally thought of as a disease of the industrialized world, around 45% of breast cancer cases and 55% of breast cancer deaths occur in low and middle income countries. Managing breast cancer in low income countries poses a different set of challenges including access to screening, stage at presentation, adequacy of management and availability of therapeutic interventions. In this paper, we will review the challenges faced in the management of breast cancer in low and middle income countries.

Strategies in disability management. Corporate disability management programs implemented at the work site.

Science.gov (United States)

Kalina, C M

1999-10-30

Managers are challenged to demonstrate all programs as economically essential to the business, generating an appreciable return on investment. Further challenge exists to blend and integrate clinical and business objectives in program development. Disability management programs must be viewed as economically essential to the financial success of the business to assure management support for clinical interventions and return-to-work strategies essential for a successful program. This paper discusses a disability management program integrating clinical and business goals and objectives in return-to-work strategies to effect positive clinical, social-cultural, and business results. Clinical, educational, social, and economic challenges in the development, implementation, and continued management of a disability program at a large corporation with multiple global work sites are defined. Continued discussion addresses the effective clinical interventions and educational strategies utilized successfully within the workplace environment in response to each defined challenge. A multiple disciplinary team approach, clinical and business outcome measures, and quality assurance indicators are discussed as major program components. This article discusses a successful program approach focusing on business process and methodology. These parameters are used to link resources to strategy, developing a product for implementing and managing a program demonstrating economic value added through effective clinical medical case management.

HRM Challenges in the Age of Globalisation

Directory of Open Access Journals (Sweden)

Sugandha Agarwal

2018-01-01

Full Text Available Globalization has caused blurred international boundaries. On one hand, there is an open market for companies to seek talent on the other hand for employees a wide array of choices to work with, all because of globalization. But such types of open and globalized market exposes the firms to the challenges occurring in the prominent field of human resource. This paper is an attempt in understanding and analyzing the challenges existing and affecting the functioning of HRM while a company operates on global platform. The major encounters and worries of HR team, and the responses that HR managers need to make to such challenges with their increasing responsibilities in the globalized environment, have also been discussed in this paper. This is a communication and cross-sectional study based on descriptive arguments and analytical logic developed through the responses received from HR teams of companies belonging to different sectors. Effective leadership, managing diverse workforce, role of technology in HR functions like recruitment and selection, legal and political aspects, skill management, global mindset are some of the jostling issues encountered by human resource function in the retro of globalization.

Goals, challenges, and successes of managing fusion activated materials

International Nuclear Information System (INIS)

El-Guebaly, L.; Massaut, V.; Zucchetti, M.; Tobita, K.; Cadwallader, L.

2007-01-01

After decades of designing magnetic and inertial fusion power plants, it is timely to develop a new framework for managing the activated materials generated during plant operation and after decommissioning - a framework that takes into account the lessons learned from numerous international fusion and fission studies and the environmental, political, and present reality in the U.S., EU, and Japan. Since the inception of the fusion projects in the early 1970s, the majority of power plant designs have focused on the disposal of active materials in geological repositories as the main option for handling the replaceable and life-of-plant components, adopting the preferred fission waste management approach. It is becoming evident that future regulations for geological burial will be upgraded to assure tighter environmental controls. Along with the political difficulty of constructing new repositories worldwide, the current reality suggests reshaping all aspects of handling the continual stream of fusion active materials. There is a growing international effort in support of this new trend. Beginning in the mid 1990s and continuing to the present, fusion designs developed in Europe, U.S., and Japan have examined replacing the disposal option with more environmentally attractive approaches, redirecting their attention to recycling and clearance while continuing the development of materials with low activation potential. These options became more technically feasible in recent years with the development of radiation-hardened remote handling (RH) tools and the introduction of the clearance category for slightly radioactive materials by national and international nuclear agencies. We applied all scenarios to selected fusion studies. While recycling and clearance appeared technically attractive and judged, in some cases, a must requirement to control the radwaste stream, the disposal scheme emerged as the preferred option for specific components for several reasons, including

Challenges in comprehensive management of spinal cord injury in India and in the Asian Spinal Cord network region: findings of a survey of experts, patients and consumers.

Science.gov (United States)

Chhabra, H S; Sharma, S; Arora, M

2018-01-01

Online survey. To understand the prevailing scenario of the comprehensive management of spinal cord injuries (SCI) in India and in the Asian Spinal Cord Network (ASCoN) region, especially with a view to document the challenges faced and its impact. Indian Spinal Injuries Centre. A questionnaire was designed which covered various aspects of SCI management. Patients, consumers (spinal injured patients discharged since at least 1 year) and experts in SCI management from different parts of India and the ASCoN region were approached to complete the survey. Sixty patients, 66 consumers and 34 experts completed the survey. Difference of opinion was noticed among the three groups. Disposable Nelaton catheters were used by 57% consumers and 47% patients. For reusable catheter, 31% experts recommended processing with soap and running water and 45% recommended clean cotton cloth bag for storage. Pre-hospital care and community inclusion pose the biggest challenges in management of SCI. More than 75% of SCI faced problems of access and mobility in the community. Awareness about SCI, illiteracy and inadequate patient education are the most important factors hindering pre- and in-hospital care. Inadequate physical as well as vocational rehabilitation and financial barriers are thought to be the major factors hindering integration of spinal injured into mainstream society. Strong family support helped in rehabilitation. Our study brought out that SCI in India and ASCoN region face numerous challenges that affect access to almost all aspects of comprehensive management of SCI.

An operational centre for managing major chemical industrial accidents.

Science.gov (United States)

Kiranoudis, C T; Kourniotis, S P; Christolis, M; Markatos, N C; Zografos, K G; Giannouli, I M; Androutsopoulos, K N; Ziomas, I; Kosmidis, E; Simeonidis, P; Poupkou, N

2002-01-28

The most important characteristic of major chemical accidents, from a societal perspective, is their tendency to produce off-site effects. The extent and severity of the accident may significantly affect the population and the environment of the adjacent areas. Following an accident event, effort should be made to limit such effects. Management decisions should be based on rational and quantitative information based on the site specific circumstances and the possible consequences. To produce such information we have developed an operational centre for managing large-scale industrial accidents. Its architecture involves an integrated framework of geographical information system (GIS) and RDBMS technology systems equipped with interactive communication capabilities. The operational centre was developed for Windows 98 platforms, for the region of Thriasion Pedion of West Attica, where the concentration of industrial activity and storage of toxic chemical is immense within areas of high population density. An appropriate case study is given in order to illuminate the use and necessity of the operational centre.

Challenges in the management of chronic HBV infection in West Africa: The clinician's perspective.

Science.gov (United States)

Okonkwo, Uchenna C; Onyekwere, Charles A

2016-01-01

Hepatitis B infection has become a public health issue in recent years. Approximately 350 million of the world's population are chronically infected reaching endemic proportions in West Africa. Guidelines for treatment are continuously improving but are becoming more complex. To determine the challenges hepatologists experience in the management of patients with chronic hepatitis B. This was a cross-sectional descriptive study conducted among hepatologists in West Africa during a regional hepatitis conference in 2013. Forty-six hepatologists completed the questionnaire. When evaluating a patient for chronic hepatitis B, the preferred investigations were: LFT (100%); abdominal ultrasound (93.5%); HBeAg (93.5%); HBV DNA (78%); HBsAg measure (22%); HBV genotype (15.2%); and liver biopsy (34.8%). Most had their patients on nucleoside/nucleotide analogue but follow-up visits after 1 year were problematic. The majority of hepatologists had good intentions regarding the evaluation of their patients, but only a small percentage of patients are properly investigated. © The Author(s) 2014.

Innovation and construction management in Brazil: Challenges of companies in times of quality and productivity

Science.gov (United States)

Barbosa, A. A. R.; Vilnītis, M.

2017-10-01

Considering the efforts to optimize productivity and quality in the construction through the potential existing in the respective companies, this study presents an approach for identification, management and priorities of improvements actions at construction sites focusing status on productivity, added value and innovation in the socioeconomic context and scenario of construction industry in Brazil. Technological advances in recent years have made the Brazilian construction industry gradually incorporate technologies and forms of management, despite its traditionally conservative character. In current days, the innovations are pursued with the quest for greater quality, productivity, safety and customer satisfaction, which have been increasingly competitive and global. Construction in Brazil occupies an important role in the economy, directly contributing to GDP and acting on an extensive productive chain of suppliers, commercialization services and maintenance. The Brazilian construction sector has undergone major changes in recent years, facilitated by factors such as the resumption of public investments, the creation of laws that facilitate real estate, investments and funding of external resources, and the efforts of the Brazilian Quality and Productivity Program - PBQP H. However, the sector faces problems of a lack of skilled labour to meet the growth needs of the sector. There are still problems and challenges of quality and productivity that prevent full sector development. The aspects of nonconformity, low quality, high tax burden, outsourcing and informality of the workforce have not been adequately addressed and resolved. Through the use of indicators of productivity and growth, the challenges of the Brazilian construction industry are discussed and the possible paths for the sector that allow its full development and to reduce the distance between the Brazilian construction industry and that of the developed countries.

Clicking to Learn: A Case Study of Embedding Radio-Frequency Based Clickers in an Introductory Management Information Systems Course

Science.gov (United States)

Nelson, Matthew L.; Hauck, Roslin V.

2008-01-01

The challenges associated with teaching a core introductory management information systems (MIS) course are well known (large class sizes serving a majority of non-MIS majors, sustaining student interests, encouraging class participation, etc.). This study offers a mechanism towards managing these challenges through the use of a simple and…

Challenges and opportunities of health care supply chain management in the United States.

Science.gov (United States)

Elmuti, Dean; Khoury, Grace; Omran, Omar; Abou-Zaid, Ahmed S

2013-01-01

This article explores current supply chain management challenges and initiatives and identifies problems that affect supply chain management success in the U.S. health-care industry. In addition, it investigates the impact of health care supply chain management (SCM) initiatives on the overall organizational effectiveness. The attitudinal results, as well as the performance results presented in this study support the claim of health care proponents that the SCM allows organizations to reduce cost, improve quality, and reduce cycle time, and leads to high performance.

Myositis in the head and neck: challenges in diagnosis and management.

Science.gov (United States)

Ratansi, R; Fabbroni, G; Kanatas, A

2017-09-01

Myositis in the head and neck may present with non-specific symptoms, and radiographically may mimic malignancy. Multidisciplinary management is often essential, and we describe the challenges in an effort to raise awareness of the condition. Copyright © 2017 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

Major health service transformation and the public voice: conflict, challenge or complicity?

Science.gov (United States)

Martin, Graham P; Carter, Pam; Dent, Mike

2018-01-01

Objectives Calls for major reconfigurations of health services have been accompanied by recommendations that wide ranging stakeholders be involved. In particular, patients and the wider public are seen as critical contributors as both funders and beneficiaries of public health care. But public involvement is fraught with challenges, and little research has focused on involvement in the health service transformation initiatives. This paper examines the design and function of public involvement in reconfiguration of health services within the English NHS. Methods Qualitative data including interviews, observation and documents were collected in two health service 'transformation' programmes; interviews include involved public and professional participants. Data were analysed using parallel deductive and inductive approaches. Results Public involvement in the programmes was extensive but its terms of reference, and the individuals involved, were restricted by policy pressures and programme objectives. The degree to which participants descriptively or substantively represented the wider public was limited; participants sought to 'speak for' this public but their views on what was 'acceptable' and likely to influence decision-making led them to constrain their contributions. Conclusions Public involvement in two major service reconfiguration programmes in England was seen as important and functional, and could not be characterized as tokenistic. Yet involvement in these programmes fell short of normative ideals, and could inadvertently reduce, rather than enlarge, public influence on health service reconfiguration decisions.

The emergence of enterprise systems management: a challenge to the IS curriculum

DEFF Research Database (Denmark)

Møller, Charles; Kræmmergaard, Pernille; Rikhardsson, Pall M.

2006-01-01

This paper proposes four cornerstones of a future Information Systems (IS) curriculum. It analyses the challenges of the IS curriculum based on the development of enterprise systems, and further argues that the practice and the research into enterprise systems have progressed to a new stage...... resulting in the emergence of Enterprise Systems Management (ESM). ESM calls for new competences and consequently represents new challenges to the IS curriculum. The paper outlines potential teaching issues and discusses the impact on the IS curriculum. Finally the paper suggests ways of approaching...

Challenges in setting up quality control in diagnostic radiology ...

African Journals Online (AJOL)

Journal Home > Vol 24, No 4 (2015) >. Log in or ... Quality control (QC) on diagnostic radiology equipment form part of the fundamental requirements for the ... Inadequate cooperation by facilities management, lack of QC equipment and insufficient staff form the major challenges in setting up QC in the facilities under study.

Carcinoid tumors: Challenges and considerations during anesthetic management

Directory of Open Access Journals (Sweden)

Sukhminder Jit Singh Bajwa

2015-01-01

Full Text Available Carcinoid tumors are rare, slow-growing neoplasms of neuroendocrine tissues from enterochromaffin or kulchitsky cells, which have the potential to metastasize. The mediators released from these tumors when bypass the hepatic metabolism, can lead to the possible development of carcinoid syndrome. This is a life-threatening complication, which can lead to profound hemodynamic instability, especially in a peri-operative period, when the patient is exposed to various types of noxious stimuli. Off late, use of octreotide, a synthetic analog of somatostatin, has significantly reduced the peri-operative morbidity and mortality. The current review discusses the various anesthetic challenges and considerations during peri-operative management of carcinoid tumors.

Challenges Imposed by User's Mobility in Future HetNet: Offloading and Mobility Management

OpenAIRE

Mahbas, Ali

2017-01-01

The users' mobility imposes challenges to mobility management and, the offloading process, which hinder the conventional heterogeneous networks (HetNets) in meeting the huge data traffic requirements of the future. In this thesis, a trio-connectivity (TC), which includes a control-plane (C-plane), a user-plane (U-plane) and an indication-plane (I-plane), is proposed to tackle these challenges. Especially, the I-plane is created as an indicator to help the user equipment (UE) identify and...

Teaching supply management by connecting with industry: experiences, trade-offs and challenges

NARCIS (Netherlands)

Steenhuis, H.J.; de Bruijn, E.J.

2005-01-01

This paper describes an approach to teaching supply chain management that is very much integrated with local industry. More than half of the time, students were interacting with companies in company visits and small projects. The approach has many challenges but is considered useful by industry,

Safety risk management of underground engineering in China: Progress, challenges and strategies

Directory of Open Access Journals (Sweden)

Qihu Qian

2016-08-01

Full Text Available Underground construction in China is featured by large scale, high speed, long construction period, complex operation and frustrating situations regarding project safety. Various accidents have been reported from time to time, resulting in serious social impact and huge economic loss. This paper presents the main progress in the safety risk management of underground engineering in China over the last decade, i.e. (1 establishment of laws and regulations for safety risk management of underground engineering, (2 implementation of the safety risk management plan, (3 establishment of decision support system for risk management and early-warning based on information technology, and (4 strengthening the study on safety risk management, prediction and prevention. Based on the analysis of the typical accidents in China in the last decade, the new challenges in the safety risk management for underground engineering are identified as follows: (1 control of unsafe human behaviors; (2 technological innovation in safety risk management; and (3 design of safety risk management regulations. Finally, the strategies for safety risk management of underground engineering in China are proposed in six aspects, i.e. the safety risk management system and policy, law, administration, economy, education and technology.

Knowledge Management in Economic Downturn: Indian Scenario

Directory of Open Access Journals (Sweden)

D. Mehta

2011-10-01

Full Text Available Knowledge management is becoming an indispensable aspect of most of the modern business organizations. It is considered as a corporate cost savings process to augment performance capabilities with broader availability and utilization of major corporate knowledge assets. Knowledge management is the basis of all planning, all development and all progress ofan organization. It is one of the significant ingredients, which makes the accessibility of acceptance with understanding of learning. With recession encompassing the globe, theorganizations are passionately engaged in cost cutting practices to maintain profitability and competitiveness. When enterprises realize that developing and sharing knowledge is pivotal tosustain a cutting edge, the management can decide to place knowledge management high on their agenda- especially during economic turmoil. The Indian organizations have exceedingly done well during the economic turmoil. The present paper is an attempt to study knowledge management during recession in Indian scenario. Major challenges faced by the organizations are highlighted along with strategies to overcome such challenges are presented by the authors.Keywords: knowledge, knowledge management, recession, innovation, Indian scenario.

Applications of operant learning theory to the management of challenging behavior after traumatic brain injury.

Science.gov (United States)

Wood, Rodger Ll; Alderman, Nick

2011-01-01

For more than 3 decades, interventions derived from learning theory have been delivered within a neurobehavioral framework to manage challenging behavior after traumatic brain injury with the aim of promoting engagement in the rehabilitation process and ameliorating social handicap. Learning theory provides a conceptual structure that facilitates our ability to understand the relationship between challenging behavior and environmental contingencies, while accommodating the constraints upon learning imposed by impaired cognition. Interventions derived from operant learning theory have most frequently been described in the literature because this method of associational learning provides good evidence for the effectiveness of differential reinforcement methods. This article therefore examines the efficacy of applying operant learning theory to manage challenging behavior after TBI as well as some of the limitations of this approach. Future developments in the application of learning theory are also considered.

The challenge of perioperative pain management in opioid-tolerant patients

Science.gov (United States)

Coluzzi, Flaminia; Bifulco, Francesca; Cuomo, Arturo; Dauri, Mario; Leonardi, Claudio; Melotti, Rita Maria; Natoli, Silvia; Romualdi, Patrizia; Savoia, Gennaro; Corcione, Antonio

2017-01-01

The increasing number of opioid users among chronic pain patients, and opioid abusers among the general population, makes perioperative pain management challenging for health care professionals. Anesthesiologists, surgeons, and nurses should be familiar with some pharmacological phenomena which are typical of opioid users and abusers, such as tolerance, physical dependence, hyperalgesia, and addiction. Inadequate pain management is very common in these patients, due to common prejudices and fears. The target of preoperative evaluation is to identify comorbidities and risk factors and recognize signs and symptoms of opioid abuse and opioid withdrawal. Clinicians are encouraged to plan perioperative pain medications and to refer these patients to psychiatrists and addiction specialists for their evaluation. The aim of this review was to give practical suggestions for perioperative management of surgical opioid-tolerant patients, together with schemes of opioid conversion for chronic pain patients assuming oral or transdermal opioids, and patients under maintenance programs with methadone, buprenorphine, or naltrexone. PMID:28919771

Disaster Risk Management - The Kenyan Challenges

Science.gov (United States)

Nabutola, W.

2009-04-01

Keywords: natural disasters; man-made disasters; terrorist attacks; land slides; disaster policies and legislations; fire; earthquakes; hurricanes; soil erosion; disaster research policy; Preamble: "Risk does not begin and end on the floor of the New York Stock Exchange. The vastness of the subject matter is daunting. Risk touches on the most profound aspects of psychology, mathematics, statistics and history. The literature is monumental; each day's headlines bring many new items of interest. But I know we are not unique, everywhere in the world risks abound." "AGAINST THE GODS the remarkable story of risk" by Peter L. Bernstein, 1998 The real challenge is what can we, as a nation do to avert, prevent them, or in the unfortunate event that they occur, how can we mitigate their impact on the economy? Introductory remarks: Disaster in Kenya, as indeed anywhere else, is not one of those happenings we can wish away. It can strike anywhere any time. Some of it is man-made but most of it is natural. The natural are sometimes induced by man in one way or another. For example, when we harvest trees without replacing them, this diminishes the forest cover and can lead to soil erosion, whose advanced form is land slides. Either way disasters in their different forms and sizes present challenges to the way we live our lives or not, perhaps, even how we die. Disasters in our country have reached crisis stage. ‘In Chinese language, crisis means danger, but it also means opportunity' Les Brown, motivational speaker in "the power of a larger vision" Why I am interested Whereas Kenya experiences man made and natural disasters, there are more sinister challenges of the man-made variety. These loom on the horizon and, from time to time raise their ugly heads, taking many Kenyan lives in their wake, and property destroyed. These are post election violence and terrorist attacks, both related to politics, internal and external. In January 2008, soon after presidential and national

Disaster Risk Management - The Kenyan Challenge

Science.gov (United States)

Nabutola, W.; Scheer, S.

2009-04-01

Keywords: natural disasters; man-made disasters; terrorist attacks; land slides; disaster policies and legislations; fire; earthquakes; hurricanes; soil erosion; disaster research policy; Preamble: "Risk does not begin and end on the floor of the New York Stock Exchange. The vastness of the subject matter is daunting. Risk touches on the most profound aspects of psychology, mathematics, statistics and history. The literature is monumental; each day's headlines bring many new items of interest. But I know we are not unique, everywhere in the world risks abound." "AGAINST THE GODS the remarkable story of risk" by Peter L. Bernstein, 1998 The real challenge is what can we, as a nation do to avert, prevent them, or in the unfortunate event that they occur, how can we mitigate their impact on the economy? Introductory remarks: Disaster in Kenya, as indeed anywhere else, is not one of those happenings we can wish away. It can strike anywhere any time. Some of it is man-made but most of it is natural. The natural are sometimes induced by man in one way or another. For example, when we harvest trees without replacing them, this diminishes the forest cover and can lead to soil erosion, whose advanced form is land slides. Either way disasters in their different forms and sizes present challenges to the way we live our lives or not, perhaps, even how we die. Disasters in our country have reached crisis stage. ‘In Chinese language, crisis means danger, but it also means opportunity' Les Brown, motivational speaker in "the power of a larger vision" Why I am interested Whereas Kenya experiences man made and natural disasters, there are more sinister challenges of the man-made variety. These loom on the horizon and, from time to time raise their ugly heads, taking many Kenyan lives in their wake, and property destroyed. These are post election violence and terrorist attacks, both related to politics, internal and external. In January 2008, soon after presidential and national

Results From the 2014 National Wilderness Manager Survey

Science.gov (United States)

Ramesh Ghimire; Ken Cordell; Alan Watson; Chad Dawson; Gary T. Green

2015-01-01

A national survey of managers was developed to support interagency wilderness strategic planning. The focus was on major challenges, perceived needs for science and training, and accomplishments of 1995 Strategic Plan objectives. The survey was administered to managers at the four federal agencies with wilderness management responsibilities: the Bureau of Land...

Data and Workflow Management Challenges in Global Adjoint Tomography

Science.gov (United States)

Lei, W.; Ruan, Y.; Smith, J. A.; Modrak, R. T.; Orsvuran, R.; Krischer, L.; Chen, Y.; Balasubramanian, V.; Hill, J.; Turilli, M.; Bozdag, E.; Lefebvre, M. P.; Jha, S.; Tromp, J.

2017-12-01

It is crucial to take the complete physics of wave propagation into account in seismic tomography to further improve the resolution of tomographic images. The adjoint method is an efficient way of incorporating 3D wave simulations in seismic tomography. However, global adjoint tomography is computationally expensive, requiring thousands of wavefield simulations and massive data processing. Through our collaboration with the Oak Ridge National Laboratory (ORNL) computing group and an allocation on Titan, ORNL's GPU-accelerated supercomputer, we are now performing our global inversions by assimilating waveform data from over 1,000 earthquakes. The first challenge we encountered is dealing with the sheer amount of seismic data. Data processing based on conventional data formats and processing tools (such as SAC), which are not designed for parallel systems, becomes our major bottleneck. To facilitate the data processing procedures, we designed the Adaptive Seismic Data Format (ASDF) and developed a set of Python-based processing tools to replace legacy FORTRAN-based software. These tools greatly enhance reproducibility and accountability while taking full advantage of highly parallel system and showing superior scaling on modern computational platforms. The second challenge is that the data processing workflow contains more than 10 sub-procedures, making it delicate to handle and prone to human mistakes. To reduce human intervention as much as possible, we are developing a framework specifically designed for seismic inversion based on the state-of-the art workflow management research, specifically the Ensemble Toolkit (EnTK), in collaboration with the RADICAL team from Rutgers University. Using the initial developments of the EnTK, we are able to utilize the full computing power of the data processing cluster RHEA at ORNL while keeping human interaction to a minimum and greatly reducing the data processing time. Thanks to all the improvements, we are now able to

Preventing and managing challenging behaviour.

Science.gov (United States)

Hallett, Nutmeg

2018-02-21

Patients exhibiting challenging behaviour, which includes any non-verbal, verbal or physical behaviour, is a significant issue in healthcare settings. Preventing such behaviour and the harm it can cause is important for healthcare organisations and individuals, and involves following a public health model comprised of three tiers: primary, secondary and tertiary prevention. Primary prevention aims to reduce the risk of challenging behaviour occurring in the first instance; secondary prevention involves reducing the risk associated with imminent challenging behaviour and its potential escalation; and tertiary prevention focuses on minimising the physical and emotional harm caused by challenging behaviours, during and after an event. De-escalation should be the first-line response to challenging behaviour, and healthcare staff should use a range of techniques - maintaining safety, self-regulation, effective communication, and assessment and actions - to reduce the incidence of challenging behaviour. In some situations, physical interventions may be required to protect the safety of the individual, healthcare staff and other individuals involved, and healthcare staff should be aware of local policies and procedures for this. Following a serious incident, where there was potential or actual harm to patients and healthcare staff, healthcare organisations should use post-incident reviews to learn from the situation, while healthcare staff should be offered the opportunity for debriefing. Positive responses to challenging behaviour at an organisational and individual level can lead to improved work environments for healthcare staff and optimal patient care and outcomes. ©2018 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

Future industrial and municipal waste management in poland the polish challenge

International Nuclear Information System (INIS)

Nowakowskl, J.; Sorum, L.; Hustad, J.E.

1996-01-01

Poland now face a very interesting discussion on modern waste treatment methods, although the waste problems are very oil. This paper presents a total waste management view from the formation process to recycling, utilisation and land filling. The average municipal solid waste (MSW) annual per capita generation in poland is 250 kg per person, which is half of the waste amount generated in norway and one third of the amount in Usa. The present low per capita generation, large variations in MSW properties and an expected growth in the standard of living make the decisions regarding future polish waste management systems very important. Waste management must be handled carefully to prevent a rapid growth of waste generation - this is the p olish challenge , both mow and for the future. Three different possibilities for future waste management systems for rural areas, small cities and larger cities are discussed in the paper. 4 figs., 1 tab

The effects of hospital reforms on the management of public hospitals in Tanzania: Challenges and lessons learnt.

Science.gov (United States)

Shwekerela, Byera

2014-01-01

Although hospital reforms are being advocated internationally as part of a solution to hospital management problems in developing countries, studies have shown that they do give rise to some challenges. A study was undertaken that used in-depth interviews, focus group discussion and document review to examine hospital reforms. The article examines the effects of reforms on the management of Level II public hospitals in Tanzania and documents the related challenges and lessons Learnt. It is shown that hospital reforms have mixed effects in resource-strained hospitals, and that hospital reform actions may have replaced the bureaucratic inefficiencies associated with hospitals being managed from the central level (MoHSW) with the equally bureaucratic inefficiencies that characterize the management of these hospitals from a supposedly local level, the office of the Regional Administrative Secretary (RAS). Managing hospitals from this level seems to cause many hospital management problems to be left unattended.

Drivers and challenges for implementing ISO 14001 environmental management systems in an emerging Gulf Arab country.

Science.gov (United States)

Waxin, Marie-France; Knuteson, Sandra L; Bartholomew, Aaron

2017-11-13

Worldwide, ISO 14001 certification for organizations has become the norm, but the Arab world accounts for an insignificant portion of all the certified organizations. There is a dearth of research on environmental management systems (EMS) in Arab and emerging countries and in public organizations. The objectives of this research are to: (1) examine the key drivers and challenges related to implementation of ISO 14001 certified EMS in the United Arab Emirates, an emerging Arab country and (2) compare and contrast these drivers and challenges between private and public organizations. We adopt an explorative, qualitative methodology, using semi-structured interviews with environmental managers in 11 organizations (6 private and 5 public) from different industrial sectors. Drivers of EMS certification were mostly similar between private and public organizations, with some differences. Compliance with regulations and standards, and increasing environmental performance were the main drivers for ISO 14001 certification in both private and public organizations. Commitment to sustainability was more important for public organizations. Cost reduction, competitors, leadership commitment and customers' demands were shared drivers, but more stressed by private organizations. Local community and employees' pressures were reported by private organizations only. The challenges to ISO 14001 implementation were similar for private and public organizations. They were: a lack of qualified human resources, practical challenges associated with implementation, a lack of regulations, a lack of support from management, and high costs. Our findings have implications for managers, academics, consultants, and policy makers in the UAE and other emerging markets.

Psychosocial management of chronic pain in patients with rheumatoid arthritis: challenges and solutions.

Science.gov (United States)

Sharpe, Louise

2016-01-01

There are numerous reviews and meta-analyses that confirm that psychological therapy is efficacious for patients with rheumatoid arthritis (RA) in terms of managing pain. Therefore, the literature has moved on to answer additional questions: 1) What types of interventions are most strongly supported by the current evidence? 2) Do different patients benefit from different approaches? 3) When is it best to intervene? 4) What modalities are best for administering the intervention? 5) What model of care should we be proposing that will result in widespread implementation and will ensure access for patients with RA? This review concludes that cognitive behavioral therapy (CBT) is the most efficacious treatment for pain management in RA; however, there are indications that mindfulness may have particular benefits for patients with a history of depression. CBT is most effective when administered early in the course of the disease. However, there is at present little evidence to confirm whether or not psychosocial interventions are effective for patients with comorbid psychological disorders. One of the major challenges is ensuring access to effective interventions for patients, particularly early on in the course of the disease, with a view to preventing physical and psychological morbidity. A stepped-care model is proposed; however, we urgently need more, better-quality trials of minimal interventions, particularly in Internet-delivered CBT, which appears promising and may form the cornerstone of future stepped-care models for providing psychosocial care to patients with RA.

Air quality management: challenges and solutions in delivering air quality action plans

Energy Technology Data Exchange (ETDEWEB)

Beattie, C.I.; Longhurst, J.W.S.; Woodfield, N.K.

2000-07-01

The Air Quality Strategy for England, Scotland, Wales and Northern Ireland (DETR, 2001) has the aim of showing how improved local air quality in the UK may be delivered. Through a process of reviewing and assessing local air quality in both urban and rural localities, a clear picture is emerging of areas of the UK where air quality objectives are not likely to be met. The next challenge will be the identification of the required actions and new ways of working to achieve specific air quality objectives. The declaration of air quality management areas, where objectives are not predicted to be met by their target years, involves co-ordinated local action and collaborative working, which can only be effective with support across local authority departments and external stake holders. This paper provides a background to the relevant legislation underpinning, local air quality management and summarises the review and assessment process. It then comments on future directions in relation to the designation of Air Quality Management Areas and considers the requirements of action plans to deliver the goal of cleaner air in the UK. It is concluded that the UK has developed a highly sophisticated system of air quality management over a relatively short period of time, and with it has brought a new way of local authority working. The challenge of the next stage of the process is likely to be in implementing cost effective and proportional solutions to identified problems at the local level. (Author)

Bacterial disease management: challenges, experience, innovation and future prospects: Challenges in Bacterial Molecular Plant Pathology.

Science.gov (United States)

Sundin, George W; Castiblanco, Luisa F; Yuan, Xiaochen; Zeng, Quan; Yang, Ching-Hong

2016-12-01

Plant diseases caused by bacterial pathogens place major constraints on crop production and cause significant annual losses on a global scale. The attainment of consistent effective management of these diseases can be extremely difficult, and management potential is often affected by grower reliance on highly disease-susceptible cultivars because of consumer preferences, and by environmental conditions favouring pathogen development. New and emerging bacterial disease problems (e.g. zebra chip of potato) and established problems in new geographical regions (e.g. bacterial canker of kiwifruit in New Zealand) grab the headlines, but the list of bacterial disease problems with few effective management options is long. The ever-increasing global human population requires the continued stable production of a safe food supply with greater yields because of the shrinking areas of arable land. One major facet in the maintenance of the sustainability of crop production systems with predictable yields involves the identification and deployment of sustainable disease management solutions for bacterial diseases. In addition, the identification of novel management tactics has also come to the fore because of the increasing evolution of resistance to existing bactericides. A number of central research foci, involving basic research to identify critical pathogen targets for control, novel methodologies and methods of delivery, are emerging that will provide a strong basis for bacterial disease management into the future. Near-term solutions are desperately needed. Are there replacement materials for existing bactericides that can provide effective disease management under field conditions? Experience should inform the future. With prior knowledge of bactericide resistance issues evolving in pathogens, how will this affect the deployment of newer compounds and biological controls? Knowledge is critical. A comprehensive understanding of bacterial pathosystems is required to not

Challenges for Community-Based Forest Management in the KoloAla Site Manompana

Science.gov (United States)

Urech, Zora Lea; Sorg, Jean-Pierre; Felber, Hans Rudolph

2013-03-01

Following the IUCN 5th World Congress on Protected Areas in 2003, the then-President of Madagascar decided to increase the area of Madagascar's protected areas from 1.7 to 6 million ha. To combine the aims of protection and timber production, a new concept was developed through the establishment of community-based forest management (CBFM) sites, called KoloAla. However, experience shows that similar management transfers to communities in Madagascar have only been successful in a very few cases. We aimed to explore the success to be expected of this new approach in the particular case of the Manompana corridor at Madagascar's eastern coast. In a first step, the readiness of the corridor's resource users for CBFM has been analysed according to the seven resource users' attributes developed by Ostrom that predict an effective self-organized resource management. In a second step, we explored how KoloAla addresses known challenges of Madagascar's CBFM. Analyses lead in a rather sober conclusion. Although KoloAla attempts to address the goals of poverty alleviation, biodiversity conservation and timber production under a single umbrella, it does so in a rather non-innovative way. Challenges with regard to the state's environmental governance, agricultural inefficiency and thus deforestation remain unsolved.

Systemic challenges in bipolar disorder management: A patient-centered approach.

Science.gov (United States)

Nestsiarovich, Anastasiya; Hurwitz, Nathaniel G; Nelson, Stuart J; Crisanti, Annette S; Kerner, Berit; Kuntz, Matt J; Smith, Alicia N; Volesky, Emma; Schroeter, Quentin L; DeShaw, Jason L; Young, S Stanley; Obenchain, Robert L; Krall, Ronald L; Jordan, Kimmie; Fawcett, Jan; Tohen, Mauricio; Perkins, Douglas J; Lambert, Christophe G

2017-12-01

As part of a series of Patient-Centered Outcomes Research Institute-funded large-scale retrospective observational studies on bipolar disorder (BD) treatments and outcomes, we sought the input of patients with BD and their family members to develop research questions. We aimed to identify systemic root causes of patient-reported challenges with BD management in order to guide subsequent studies and initiatives. Three focus groups were conducted where patients and their family members (total n = 34) formulated questions around the central theme, "What do you wish you had known in advance or over the course of treatment for BD?" In an affinity mapping exercise, participants clustered their questions and ranked the resulting categories by importance. The research team and members of our patient partner advisory council further rated the questions by expected impact on patients. Using a Theory of Constraints systems thinking approach, several causal models of BD management challenges and their potential solution were developed with patients using the focus group data. A total of 369 research questions were mapped to 33 categories revealing 10 broad themes. The top priorities for patient stakeholders involved pharmacotherapy and treatment alternatives. Analysis of causal relationships underlying 47 patient concerns revealed two core conflicts: for patients, whether or not to take pharmacotherapy, and for mental health services, the dilemma of care quality vs quantity. To alleviate the core conflicts identified, BD management requires a coordinated multidisciplinary approach including: improved access to mental health services, objective diagnostics, sufficient provider visit time, evidence-based individualized treatment, and psychosocial support. © 2017 The Authors. Bipolar Disorders Published by John Wiley & Sons Ltd.

Activity-Based Management System Implementation in Higher Education Institution: Benefits and Challenges

Science.gov (United States)

Ismail, Noor Azizi

2010-01-01

Purpose: The purpose of this paper is to discuss how activity-based costing (ABC) technique can be applied in the context of higher education institutions. It also discusses the obstacles and challenges to the successful implementation of activity-based management (ABM) in the higher education environment. Design/methodology/approach: This paper…

The challenges of theatre workshop in Katsina-Ala and Oju Colleges ...

African Journals Online (AJOL)

The paper recommends more funding by the College management for Theatre Arts Department, motivation of theatre Lecturers handling theatre workshop and making Theatre Arts a double major course among others to avert these challenges. Keywords: Theatre, theatre workshop, college of education, training and ...

Challenges in the Successful Research Management of a Collaborative EU Project.

Science.gov (United States)

Zikos, Dimitrios; Diomidous, Marianna; Mantas, John

2012-03-01

Successful research management requirements include; equal teamwork and efficient coordination, in order to increase the impact of the research outcomes and provide added value knowledge. Aim of this paper is to discuss the strategies that have been followed during the RN4CAST study, the largest nursing multi-country research project ever conducted in Europe. The paper focuses on the core research strategies rather than on the administrative activities, which are inevitably also required for the success of a large scale research. This paper is an extension of a conference presentation in the International Conference of the European Federation for Medical Informatics (MIE) 2011 in Oslo, and was subsequently published in the Studies in Health Technology and Informatics book series (IOS Press) under the title "Research management: the case of RN4CAST." Management of a multicountry nursing survey requires the use of common data collection tools, applicable to every context, research protocols supporting the scope of the research, data models for multi-country analyses and global dissemination strategies. Challenges that may be faced during the implementation of the study include the individualized confrontation of obstacles during data collection, the coherence of national procedures (for example permissions for data collection) in European level, and the challenge to gain information of added value for the EU, by aggregating the national survey results through a powerful data analysis model. Communication strategies are also discussed.

Big data management challenges in health research-a literature review.

Science.gov (United States)

Wang, Xiaoming; Williams, Carolyn; Liu, Zhen Hua; Croghan, Joe

2017-08-07

Big data management for information centralization (i.e. making data of interest findable) and integration (i.e. making related data connectable) in health research is a defining challenge in biomedical informatics. While essential to create a foundation for knowledge discovery, optimized solutions to deliver high-quality and easy-to-use information resources are not thoroughly explored. In this review, we identify the gaps between current data management approaches and the need for new capacity to manage big data generated in advanced health research. Focusing on these unmet needs and well-recognized problems, we introduce state-of-the-art concepts, approaches and technologies for data management from computing academia and industry to explore improvement solutions. We explain the potential and significance of these advances for biomedical informatics. In addition, we discuss specific issues that have a great impact on technical solutions for developing the next generation of digital products (tools and data) to facilitate the raw-data-to-knowledge process in health research. Published by Oxford University Press 2017. This work is written by US Government employees and is in the public domain in the US.

Proven Techniques: The Use and Impact of Major Management Concepts in Community Colleges.

Science.gov (United States)

Deegan, William L.

1992-01-01

Describes a survey of community college presidents' use of and perception of the effectiveness of major management concepts related to planning, organization, budgeting/finance, staffing, and evaluation. Also summarizes presidents' perceptions of the problems facing them and their perspectives on the future. (DMM)

Interconnection Structures, Management and Routing Challenges in Cloud-Service Data Center Networks: A Survey

Directory of Open Access Journals (Sweden)

Ahmad Nahar Quttoum

2018-01-01

Full Text Available Today’s data center networks employ expensive networking equipments in associated structures that were not designed to meet the increasing requirements of the current large-scale data center services. Limitations that vary between reliability, resource utilization, and high costs are challenging. The era of cloud computing represents a promise to enable large-scale data centers. Computing platforms of such cloud service data centers consist of large number of commodity low-price servers that, with a theme of virtualization on top, can meet the performance of the expensive high-level servers at only a fraction of the price. Recently, the research in data center networks started to evolve rapidly. This opened the path for addressing many of its design and management challenges, these like scalability, reliability, bandwidth capacities, virtual machines’ migration, and cost. Bandwidth resource fragmentation limits the network agility, and leads to low utilization rates, not only for the bandwidth resources, but also for the servers that run the applications. With Traffic Engineering methods, managers of such networks can adapt for rapid changes in the network traffic among their servers, this can help to provide better resource utilization and lower costs. The market is going through exciting changes, and the need to run demanding-scale services drives the work toward cloud networks. These networks that are enabled by the notation of autonomic management, and the availability of commodity low-price network equipments. This work provides the readers with a survey that presents the management challenges, design and operational constraints of the cloud-service data center networks

Challenges of Collaborative Governance; An Organizational Disocurse Study of Public Managers' Struggles with Collaboration in the Daycare Area

DEFF Research Database (Denmark)

Plotnikof, Mie

2015-01-01

dynamics by asking: how are public managers challenged through discursive constructions of collaborative governance? Empirically, the dissertation is based on a multi-site ethnographic case study of two local governments’ efforts to co-create new quality-management methods within the daycare sector...... discourses, and c) design issues related to social dynamics and power relations. The study shows that public managers are challenged by the ways in which discursive constructions of collaborative governance create more and less (dis-)organized communicative practices concerning a shared problem. Thereby......This doctoral study explores problematics of managing and organizing collaborative governance from an organizational discourse perspective. Collaborative governance is a public management practice developing currently to engage stakeholders in co-creating potential solutions to complex public...

Regulatory instrument review: Management of aging of LWR [light water reactor] major safety-related components

International Nuclear Information System (INIS)

Werry, E.V.

1990-10-01

This report comprises Volume 1 of a review of US nuclear plant regulatory instruments to determine the amount and kind of information they contain on managing the aging of safety-related components in US nuclear power plants. The review was conducted for the US Nuclear Regulatory Commission (NRC) by the Pacific Northwest Laboratory (PNL) under the NRC Nuclear Plant Aging Research (NPAR) Program. Eight selected regulatory instruments, e.g., NRC Regulatory Guides and the Code of Federal Regulations, were reviewed for safety-related information on five selected components: reactor pressure vessels, steam generators, primary piping, pressurizers, and emergency diesel generators. Volume 2 will be concluded in FY 1991 and will also cover selected major safety-related components, e.g., pumps, valves and cables. The focus of the review was on 26 NPAR-defined safety-related aging issues, including examination, inspection, and maintenance and repair; excessive/harsh testing; and irradiation embrittlement. The major conclusion of the review is that safety-related regulatory instruments do provide implicit guidance for aging management, but include little explicit guidance. The major recommendation is that the instruments be revised or augmented to explicitly address the management of aging

The new challenges of end-of-life tyres management systems: A Spanish case study

Energy Technology Data Exchange (ETDEWEB)

Uruburu, Ángel, E-mail: angel.uruburu@upm.es [Industrial Management Department, Technical University of Madrid, C/José Gutiérrez Abascal, 2, 28006 Madrid (Spain); Ponce-Cueto, Eva, E-mail: eva.ponce@upm.es [Industrial Management Department, Technical University of Madrid, C/José Gutiérrez Abascal, 2, 28006 Madrid (Spain); Center for Transportation and Logistics, Massachusetts Institute of Technology, Cambridge, MA (United States); Cobo-Benita, José Ramón, E-mail: joseramon.cobo@upm.es [Industrial Management Department, Technical University of Madrid, C/José Gutiérrez Abascal, 2, 28006 Madrid (Spain); Ordieres-Meré, Joaquín, E-mail: j.ordieres@upm.es [Industrial Management Department, Technical University of Madrid, C/José Gutiérrez Abascal, 2, 28006 Madrid (Spain)

2013-03-15

Highlights: ► Impact of the implementation of the Directive 2008/98/EC in Spain for end-of-life tyres. ► Characterization of the reverse supply chain for collecting, recovering, and treating end-of-life tyres. ► Identification of challenges to be coped and issues to be covered. ► Potential new applications for end-of-life tyres and development of new management related strategies. - Abstract: Directive 2008/98/EC released by the European Union represents a significant step forward in all relevant aspects of waste management. Under the already established, extended produced responsibility (EPR) principle, new policies have been enunciated to continuously achieve better overall environmental performance of key products throughout their life phases. This paper discusses how the directive is being articulated in Spain by the main integrated management system (IMS) for end-of-life (EOL) tyres since its creation in 2006. Focusing on the IMS technological, economic and legal aspects, the study provides a global perspective and evaluation of how the IMS is facing the current issues to resolve, the new challenges that have appeared and the management vision for the coming years.

The new challenges of end-of-life tyres management systems: A Spanish case study

International Nuclear Information System (INIS)

Uruburu, Ángel; Ponce-Cueto, Eva; Cobo-Benita, José Ramón; Ordieres-Meré, Joaquín

2013-01-01

Highlights: ► Impact of the implementation of the Directive 2008/98/EC in Spain for end-of-life tyres. ► Characterization of the reverse supply chain for collecting, recovering, and treating end-of-life tyres. ► Identification of challenges to be coped and issues to be covered. ► Potential new applications for end-of-life tyres and development of new management related strategies. - Abstract: Directive 2008/98/EC released by the European Union represents a significant step forward in all relevant aspects of waste management. Under the already established, extended produced responsibility (EPR) principle, new policies have been enunciated to continuously achieve better overall environmental performance of key products throughout their life phases. This paper discusses how the directive is being articulated in Spain by the main integrated management system (IMS) for end-of-life (EOL) tyres since its creation in 2006. Focusing on the IMS technological, economic and legal aspects, the study provides a global perspective and evaluation of how the IMS is facing the current issues to resolve, the new challenges that have appeared and the management vision for the coming years

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

Science.gov (United States)

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

2016-07-01

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

URBAN SOLID WASTE MANAGEMENT IN CAXIAS DO SUL/BRAZIL: PRACTICES AND CHALLENGES

Directory of Open Access Journals (Sweden)

Matheus Poletto

2016-01-01

Full Text Available Solid waste management is becoming a challenge for the cities’ authorities in developing countries mainly due to the rapid economic growth and population increasing. In cities of the developing world, the informal sector plays an important role in the management of urban solid waste. This work examines the participation of scavengers in an integrated municipal solid waste management system. The paper is based on direct field observations, interviews with scavengers and characterization of the urban solid waste generated in Caxias do Sul. The partnership between municipal government and local scavengers were also evaluated as well as the contribution of the scavengers in the urban solid waste management system. The study reveals that it is necessary to realize a campaign for improving the waste segregation at source. The infrastructure of the scavengers associations need to be improved and finally the scavengers need to be more deeply involved in the policies associated with the urban solid waste management system adopted in the city.

Managing large energy and mineral resources (EMR) projects in challenging environments

Science.gov (United States)

Chanmeka, Arpamart

The viability of energy mineral resources (EMR) construction projects is contingent upon the state of the world economic climate. Oil sands projects in Alberta, Canada exemplify large EMR projects that are highly sensitive to fluctuations in the world market. Alberta EMR projects are constrained by high fixed production costs and are also widely recognized as one of the most challenging construction projects to successfully deliver due to impacts from extreme weather conditions, remote locations and issues with labor availability amongst others. As indicated in many studies, these hardships strain the industry's ability to execute work efficiently, resulting in declining productivity and mounting cost and schedule overruns. Therefore, to enhance the competitiveness of Alberta EMR projects, project teams are targeting effective management strategies to enhance project performance and productivity by countering the uniquely challenging environment in Alberta. The main purpose of this research is to develop industry wide benchmarking tailored to the specific constraints and challenges of Alberta. Results support quantitative assessments and identify the root causes of project performance and ineffective field productivity problems in the heavy industry sector capital projects. Customized metrics produced from the data collected through a web-based survey instrument were used to quantitatively assess project performance in the following dimensions: cost, schedule, change, rework, safety, engineering and construction productivity and construction practices. The system enables the industry to measure project performance more accurately, get meaningful comparisons, while establishing credible norms specific to Alberta projects. Data analysis to identify the root cause of performance problems was conducted. The analysis of Alberta projects substantiated lessons of previous studies to create an improved awareness of the abilities of Alberta-based companies to manage their

Home Health Care (HHC) Managers Perceptions About Challenges and Obstacles that Hinder HHC Services in Jordan

Science.gov (United States)

Ajlouni, Musa T.; Dawani, Hania; Diab, Salah M.

2015-01-01

Home care aims at supporting people with various degrees of dependency to remain at home rather than use residential, long-term, or institutional-based nursing care. Demographic, epidemiological, social, and cultural trends in Jordan as in other countries are changing the traditional patterns of care with growing emphasis on home care. The purpose of this study is to highlight the most common challenges related to home health care (HHC) services in Jordan as perceived by the managers of HHC agencies. Methods: a descriptive qualitative design that depends on focus group discussions has been used to collect data from a sample of 18 managers who met the selection criteria and who are willing to participate, the study found that, the main challenges of HHC services as perceived by managers were: shortage of female staff, lack of governance and regulation, poor management, unethical practices, lack of referral systems, and low accessibility of the poor and less privileged as HHC services are not included in health insurance schemes, it concludes also that the home health care industry in Jordan is facing many challenges and problems that may have negative effects on the effectiveness, efficiency, equity and quality of services and should be addressed by health policy makers. PMID:25946949

Challenges in Fibromyalgia Management: A Study of Anxiety, Depression, and Motivation Using Distance Learning and Social Networking

Science.gov (United States)

Caines, Matthew J.

2010-01-01

Patients with fibromyalgia have difficulty managing symptoms (e.g., fatigue, chronic pain). The challenges in fibromyalgia management may vary from patient to patient, from painful physical exercise to pharmaceutical side-effects. Since the management of fibromyalgia greatly varies, there seems to be an individualist or personal component to…

Pediatric hearing aid use: parent-reported challenges.

Science.gov (United States)

Muñoz, Karen; Olson, Whitney A; Twohig, Michael P; Preston, Elizabeth; Blaiser, Kristina; White, Karl R

2015-01-01

The aim of this study was to investigate parent-reported challenges related to hearing aid management and parental psychosocial characteristics during the first 3 years of the child's life. Using a cross-sectional survey design, surveys were distributed to parents of children with hearing loss via state Early Intervention programs in Utah and Indiana. Packets contained one family demographic form and two sets of three questionnaires to obtain responses from mothers and fathers separately: the Parent Hearing Aid Management Inventory explored parent access to information, parent confidence in performing skills, expectations, communication with the audiologist, and hearing aid use challenges. The Acceptance and Action Questionnaire measured psychological flexibility, experiential avoidance, and internal thought processes that can affect problem-solving ability and decrease an individual's ability to take value-based actions. The Patient Health Questionnaire identified symptoms of depression. Thirty-seven families completed questionnaires (35 mothers and 20 fathers). Most responses were parents of toddlers (M = 22 months) who had been wearing binaural hearing aids for an average of 15 months. Both mothers and fathers reported that even though the amount of information they received was overwhelming, most (84%) preferred to have all the information at the beginning, rather than to receive it over an extended time period. Parents reported an array of challenges related to hearing aid management, with the majority related to daily management, hearing aid use, and emotional adjustment. Sixty-six percent of parents reported an audiologist taught them how to complete a listening check using a stethoscope, however, only one-third reported doing a daily hearing aid listening check. Both mothers and fathers reported a wide range of variability in their confidence in performing activities related to hearing aid management, and most reported minimal confidence in their ability to

Challenges in integrating the concept of ecosystem services and values in landscape planning, management and decision making

NARCIS (Netherlands)

Groot, de R.S.; Alkemade, J.R.M.; Braat, L.; Hein, L.G.; Willemen, L.L.J.M.

2010-01-01

Despite the growing body of literature on ecosystem services, still many challenges remain to structurally integrate ecosystem services in landscape planning, management and design. This paper therefore aims to provide an overview of the challenges involved in applying ecosystem service assessment

Nordic hydrogen energy foresight - challenges of managing the interactive process

DEFF Research Database (Denmark)

Eerola, A.; Loikkanen, T.; Koljonen, T.

2005-01-01

The paper discusses the managerial challenges of the Nordic Hydrogen Energy Foresight, a joint effort of the five Nordic countries (Denmark, Finland, Iceland, Norway, Sweden). Interaction between research, industry and government, and combination ofjudgmental and formal procedures, were essential...... of the project in the light of a dynamic model ofshared knowledge creation. In particular, the ways in which the design and the methodological tools facilitated the process and its management are discussed. Some suggestions for forthcoming foresight exercises are also presented....

Biologically Based Methods for Pest Management in Agriculture under Changing Climates: Challenges and Future Directions.

Science.gov (United States)

Chidawanyika, Frank; Mudavanhu, Pride; Nyamukondiwa, Casper

2012-11-09

The current changes in global climatic regimes present a significant societal challenge, affecting in all likelihood insect physiology, biochemistry, biogeography and population dynamics. With the increasing resistance of many insect pest species to chemical insecticides and an increasing organic food market, pest control strategies are slowly shifting towards more sustainable, ecologically sound and economically viable options. Biologically based pest management strategies present such opportunities through predation or parasitism of pests and plant direct or indirect defense mechanisms that can all be important components of sustainable integrated pest management programs. Inevitably, the efficacy of biological control systems is highly dependent on natural enemy-prey interactions, which will likely be modified by changing climates. Therefore, knowledge of how insect pests and their natural enemies respond to climate variation is of fundamental importance in understanding biological insect pest management under global climate change. Here, we discuss biological control, its challenges under climate change scenarios and how increased global temperatures will require adaptive management strategies to cope with changing status of insects and their natural enemies.

Biologically Based Methods for Pest Management in Agriculture under Changing Climates: Challenges and Future Directions

Directory of Open Access Journals (Sweden)

Casper Nyamukondiwa

2012-11-01

Full Text Available The current changes in global climatic regimes present a significant societal challenge, affecting in all likelihood insect physiology, biochemistry, biogeography and population dynamics. With the increasing resistance of many insect pest species to chemical insecticides and an increasing organic food market, pest control strategies are slowly shifting towards more sustainable, ecologically sound and economically viable options. Biologically based pest management strategies present such opportunities through predation or parasitism of pests and plant direct or indirect defense mechanisms that can all be important components of sustainable integrated pest management programs. Inevitably, the efficacy of biological control systems is highly dependent on natural enemy-prey interactions, which will likely be modified by changing climates. Therefore, knowledge of how insect pests and their natural enemies respond to climate variation is of fundamental importance in understanding biological insect pest management under global climate change. Here, we discuss biological control, its challenges under climate change scenarios and how increased global temperatures will require adaptive management strategies to cope with changing status of insects and their natural enemies.

Major customer accounts - strategic alliances for the future

International Nuclear Information System (INIS)

Shields, R.G.; Ricker, S.M.

1990-01-01

As electric utilities look to the future, they are forecasting a need for increased power supply capacity to meet load requirements. But rather than focus solely on the construction of new generating capacity, many utilities facing supply shortages have sought to develop and apply peak shaving and load shifting techniques. They commonly evaluate both new generation and demand side management (DSM) as alternative options in an integrated, least-cost planning approach. Demand side management poses new challenges for utilities because for demand side management to be successful, the product needs to be sold to customers. Gone are the days when a utility simply had to market a single product - electricity. Today, supply planning and marketing organizations need to form an integrated approach to furthering a company's DSM objectives and to bring marketing concepts to this process. This paper does not attempt to argue the pros and cons of demand side management, nor to identify the right DSM alternatives. Rather, the authors focus on issues utilities must address in implementing DSM: (1) value and means of forming strategic alliances with major utility customers if a utility is going to be able to perform in an increasingly competitive environment in the future; (2) critical success factors for an effective DSM program targeted at major utility customers; and (3) necessity of applying key marketing principles to DSM program design and implementation

The tale of two stories: Challenges and innovations in breast cancer management.

Science.gov (United States)

Henry-Tillman, Ronda S

2018-06-01

The keynote address The Tale of Two Stories: Challenges and Innovations in Breast Cancer Management presented on March 19-20, 2017 at the celebratory Festschrift Lecture in honor of the great Dr. LaSalle Leffall's on behalf of his impact and contributions to the field of Breast cancer science and treatment as a leader, surgeon, and mentor. This presentation and follow up opinion paper in the field of Breast Disease highlights the challenges that have baffled us and the innovations that have changed and translated into outcomes and those that have not. Where do they parallel and what are the gaps? Copyright © 2018. Published by Elsevier Inc.

Solid waste management in Kolkata, India: Practices and challenges

International Nuclear Information System (INIS)

Hazra, Tumpa; Goel, Sudha

2009-01-01

This paper presents an overview of current solid waste management (SWM) practices in Kolkata, India and suggests solutions to some of the major problems. More than 2920 ton/d of solid waste are generated in the Kolkata Municipal Corporation (KMC) area and the budget allocation for 2007-2008 was Rs. 1590 million (US$40 million), which amounts to Rs. 265/cap-y (US$6.7/cap-d) on SWM. This expenditure is insufficient to provide adequate SWM services. Major deficiencies were found in all elements of SWM. Despite 70% of the SWM budget being allocated for collection, collection efficiency is around 60-70% for the registered residents and less than 20% for unregistered residents (slum dwellers). The collection process is deficient in terms of manpower and vehicle availability. Bin capacity provided is adequate but locations were found to be inappropriate, thus contributing to the inefficiency of the system. At this time, no treatment is provided to the waste and waste is dumped on open land at Dhapa after collection. Lack of suitable facilities (equipment and infrastructure) and underestimates of waste generation rates, inadequate management and technical skills, improper bin collection, and route planning are responsible for poor collection and transportation of municipal solid wastes

Challenge of improving postoperative pain management: case studies of three acute pain services in the UK National Health Service.

Science.gov (United States)

Powell, A E; Davies, H T O; Bannister, J; Macrae, W A

2009-06-01

Previous national survey research has shown significant deficits in routine postoperative pain management in the UK. This study used an organizational change perspective to explore in detail the organizational challenges faced by three acute pain services in improving postoperative pain management. Case studies were conducted comprising documentary review and semi-structured interviews (71) with anaesthetists, surgeons, nurses, other health professionals, and managers working in and around three broadly typical acute pain services. Although the precise details differed to some degree, the three acute pain services all faced the same broad range of inter-related challenges identified in the organizational change literature (i.e. structural, political, cultural, educational, emotional, and physical/technological challenges). The services were largely isolated from wider organizational objectives and activities and struggled to engage other health professionals in improving postoperative pain management against a background of limited resources, turbulent organizational change, and inter- and intra-professional politics. Despite considerable efforts they struggled to address these challenges effectively. The literature on organizational change and quality improvement in health care suggests that it is only by addressing the multiple challenges in a comprehensive way across all levels of the organization and health-care system that sustained improvements in patient care can be secured. This helps to explain why the hard work and commitment of acute pain services over the years have not always resulted in significant improvements in routine postoperative pain management for all surgical patients. Using this literature and adopting a whole-organization quality improvement approach tailored to local circumstances may produce a step-change in the quality of routine postoperative pain management.

Challenges facing air management for fuel cell systems

Energy Technology Data Exchange (ETDEWEB)

Davis, P.B. [Department of Energy (United States); Sutton, R. [Argonne National Lab. (United States); Wagner, F.W. [Energetics Incorporated (United States)

2000-07-01

The U.S. Department of Energy (DOE) and the U.S. automotive industry are working cooperatively under the auspices of the Partnership for a New Generation of Vehicles (PNGV) to develop a six-passenger automobile that can achieve up to 80 mpg. while meeting customer needs and all safety and emission requirements. These partners are continuing to invest heavily in the research and development of polymer electrolyte membrane (PEM) fuel cells as a clean and efficient energy conversion system for the PNGV. A critical challenge facing fuel cell systems for the PNGV is the development of efficient, compact, cost-effective air management systems. The U.S. Department of Energy has been exploring several compressor/expander options for pressurized fuel cell systems, including scroll, toroidal intersecting vane, turbine, twin screw, and piston technologies. Each of these technologies has strengths and weaknesses regarding efficiency, pressure ratio over turndown, size and weight, and cost. This paper will present data from the U.S. Department of Energy's research and development efforts on air management systems and will discusses recent program developments resulting from an independent peer review evaluation. (author)

Challenges of diabetes management in immigrant Korean Americans.

Science.gov (United States)

Nam, Soohyun; Song, Hee-Jung; Park, So-Youn; Song, Youngshin

2013-01-01

To examine challenges in diabetes self-management among Korean Americans to guide clinicians in providing culturally appropriate and population-targeted diabetes care. Five focus groups with 23 Korean Americans with type 2 diabetes, 30 to 75 years of age, were conducted. Open-ended questions were presented focusing on previous experiences in living with diabetes; digital recordings were transcribed verbatim; transcripts were coded and themes were identified. Most participants were reluctant to disclose diabetes because of social stigma and said that they did not know much about diabetes and its complications. Diabetes self-management is not always a top priority for Korean Americans over other family obligations or financial stability in their busy immigration lives. Many Korean Americans experience conflicts with family members in managing diabetes or would not request support from family members for their diabetes care. Traditional women's roles and demanding immigration life seem to leave women particularly vulnerable to a lack of self-care. Lack of English proficiency limits access to mainstream health care. Providing diabetes education at the community level is important to raise public awareness of diabetes and to eliminate social stigma. To facilitate family support for individuals with type 2 diabetes, it is appropriate to include the entire family in diabetes educational programs and to promote individual family members' health in the context of maintaining their role within the family. Future efforts should be made with full implementation of language services in various clinical encounters and diabetes education.

Fault Management Architectures and the Challenges of Providing Software Assurance

Science.gov (United States)

Savarino, Shirley; Fitz, Rhonda; Fesq, Lorraine; Whitman, Gerek

2015-01-01

The satellite systems Fault Management (FM) is focused on safety, the preservation of assets, and maintaining the desired functionality of the system. How FM is implemented varies among missions. Common to most is system complexity due to a need to establish a multi-dimensional structure across hardware, software and operations. This structure is necessary to identify and respond to system faults, mitigate technical risks and ensure operational continuity. These architecture, implementation and software assurance efforts increase with mission complexity. Because FM is a systems engineering discipline with a distributed implementation, providing efficient and effective verification and validation (VV) is challenging. A breakout session at the 2012 NASA Independent Verification Validation (IVV) Annual Workshop titled VV of Fault Management: Challenges and Successes exposed these issues in terms of VV for a representative set of architectures. NASA's IVV is funded by NASA's Software Assurance Research Program (SARP) in partnership with NASA's Jet Propulsion Laboratory (JPL) to extend the work performed at the Workshop session. NASA IVV will extract FM architectures across the IVV portfolio and evaluate the data set for robustness, assess visibility for validation and test, and define software assurance methods that could be applied to the various architectures and designs. This work focuses efforts on FM architectures from critical and complex projects within NASA. The identification of particular FM architectures, visibility, and associated VVIVV techniques provides a data set that can enable higher assurance that a satellite system will adequately detect and respond to adverse conditions. Ultimately, results from this activity will be incorporated into the NASA Fault Management Handbook providing dissemination across NASA, other agencies and the satellite community. This paper discusses the approach taken to perform the evaluations and preliminary findings from the

Managing Costs and Medical Information

Science.gov (United States)

People with cancer may face major financial challenges and need help dealing with the high costs of care. Cancer treatment can be very expensive, even when you have insurance. Learn ways to manage medical information, paperwork, bills, and other records.

ANAESTHETIC CHALLENGES IN THE MANAGEMENT OF PEDIATRIC ENCEPHALOCOELE REPAIR: RETROSPECTIVE CASE SERIES

Directory of Open Access Journals (Sweden)

Ravindra Giri

2015-02-01

Full Text Available INTRODUCTION: Encephalocele is the protrusion of the cranial contents beyond the normal confines of the skull through a defect in the calvarium and is far less common than spinal dysraphism. 1 Anaesthetic challenges in management of occipital meningoencephalocele include securing the airway with intubation in lateral position, intraoperative prone position and its associated complications, careful securing of the endotracheal tube and accurate assessment of blood loss. These babies also have associated congenital anomalie s, gastrointestinal malrotation, renal anomalies, cardiac malformations and tracheoesophageal fistula, making anaesthetic management even more difficult. Meticulous anaesthetic management is crucial for early repair of encephalocoele to prevent any sequel. 2 METHODS: To identify the anaesthetic challenges, perioperative and postoperative complications during encephalocele repair, 20 cases were studied retrospectively from 2012 to 2014 at Department of Anaesthesia , Department of Neurosurgery, MR Medical College, Gulbarga. RESULTS: 20 cases of encephalocoele repair were undertaken during the study period. Out of these 12 (60% were male and 8(40% female. Age range was 1 day to 6 years. Most common type of encephalocele was occipital 12(60%, which posed a difficulty during positioning & intubation, followed by occipito - cervical 4(20%, Parietal 2(10%, Fronto - nasal 1(5% & Fronto - naso - ethmoidal 1(5%. Most of the patients were extubated successfully on table, only one patient required post - operative ventilator support for a day. Peri - operative complications included bronchospasm (15%, followed by hypotension, tachycardia, laryngospasm, hypoxia, accidental extubation (10% each & bradycardia, endobronchial intubation (5%. CONCLUSION: Children with Encephalocoele are prone to have peri - operative complications which can be managed by meticulous anaesthetic managenement. 3 Early surgical management of encephalocoele is not

Application of Customer Relationship Management Systems in Business: Challenges and Opportunities

OpenAIRE

K. Liagkouras; K. Metaxiotis

2014-01-01

Customer relationship management (CRM) systems in business are a reality of the contemporary business world for the last decade or so. Still, there are grey areas regarding the successful implementation and operation of CRM systems in business. This paper, through the systematic study of the CRM implementation paradigm, attempts to identify the most important challenges and opportunities that the CRM systems face in a rapidly changing business world.

Management of Inflammatory Bowel Disease in the Elderly Patient: Challenges and Opportunities.

Science.gov (United States)

Ananthakrishnan, Ashwin N; Donaldson, Tamara; Lasch, Karen; Yajnik, Vijay

2017-06-01

The population of older patients with inflammatory bowel disease (IBD) continues to grow, partly reflecting the aging global population in general. The debilitating effects of IBD compound age-related decrements in health and functional capacity, and make the medical management of older patients with Crohn's disease and ulcerative colitis distinctly challenging to clinicians. Here, we review the recent literature describing the pharmacologic management of IBD in this population, with focus on the safety, tolerability, and efficacy of common treatment options, such as steroids, immunomodulators, tumor necrosis factor-α antagonists, and integrin antagonists; surgical interventions in older patients are also discussed. Few studies have systematically and prospectively evaluated the clinical challenges in the medical management of IBD in this patient population, leaving a limited evidence base to which clinicians can turn to for guidance. Treatment patterns may thus be suboptimal. For example, prolonged steroid use in the elderly was found to be common, causing significant morbidity from side effects in a particularly vulnerable population. Finally, within the context of a limited evidence base, we discuss common treatment scenarios to define the parameters within which physicians can individualize care for older patients with IBD. Overall, older patients with IBD are at higher risk of adverse events and less treatment responsiveness compared with younger patients, underscoring the need for future studies to fully characterize appropriate treatment courses for this population.

The ımpact of benefıts and servıces on manager engagement and manager retentıon ın tourısm ındustry: Enhanced by the effect of management level

OpenAIRE

ALDATMAZ, Ipek; AYKAÇ, Cansu; DICLE, Ülkü

2017-01-01

Manager engagement and retention are vital to the success and organizational performance of many service sector organisations. Maintaining manager retention is a major challenge that many hotel enterprises face today. It is critical that organizations give greater importance to manager engagement, motivation and retention and therefore establish an efficient benefits and services strategy for retaining these core managers for the persistence and achievement of the organization...

Type 1 diabetes: Awareness, management and challenges: Current scenario in India

Directory of Open Access Journals (Sweden)

K M Prasanna Kumar

2015-01-01

Full Text Available Type 1 diabetes mellitus (T1DM has a wide presence in children and has a high mortality rates. The disease, if left unmanaged, poses various challenges to the patient and healthcare providers, including development of diabetic complications and thus decreasing the life expectancy of the affected child. The challenges of T1DM include awareness of the disease that is very poor among the general public and also in parents of T1DM children along with the health care professionals. The challenge of lack of awareness of T1DM can be met by increasing public awareness programs, conducting workshops for diabetes educators regarding T1DM in children, newsletters, CMEs, online courses, and by structured teaching modules for diabetes educators. Diagnosis of T1DM was a challenge a few decades ago but the situation has improved today with diagnostic tests and facilities, made available even in villages. Investigation facilities and infrastructure, however, are very poor at the primary care level, especially in rural areas. Insulin availability, acceptability, and affordability are also major problems, compounded by the various types of insulin that are available in the market with a varied price range. But effective use of insulin remains a matter of utmost importance.

Type 1 diabetes: Awareness, management and challenges: Current scenario in India

Science.gov (United States)

Kumar, K.M. Prasanna; Saboo, Banshi; Rao, P.V.; Sarda, Archana; Viswanathan, Vijay; Kalra, Sanjay; Sethi, Bipin; Shah, Nalini; Srikanta, S.S.; Jain, Sunil M; Raghupathy, P.; Shukla, Rishi; Jhingan, Ashok; Chowdhury, Subhankar; Jabbar, P.K.; Kanungo, Alok; Joshi, Rajesh; Kumar, Surendra; Tandon, Nikhil; Khadilkar, Vaman; Chadha, Manoj

2015-01-01

Type 1 diabetes mellitus (T1DM) has a wide presence in children and has a high mortality rates. The disease, if left unmanaged, poses various challenges to the patient and healthcare providers, including development of diabetic complications and thus decreasing the life expectancy of the affected child. The challenges of T1DM include awareness of the disease that is very poor among the general public and also in parents of T1DM children along with the health care professionals. The challenge of lack of awareness of T1DM can be met by increasing public awareness programs, conducting workshops for diabetes educators regarding T1DM in children, newsletters, CMEs, online courses, and by structured teaching modules for diabetes educators. Diagnosis of T1DM was a challenge a few decades ago but the situation has improved today with diagnostic tests and facilities, made available even in villages. Investigation facilities and infrastructure, however, are very poor at the primary care level, especially in rural areas. Insulin availability, acceptability, and affordability are also major problems, compounded by the various types of insulin that are available in the market with a varied price range. But effective use of insulin remains a matter of utmost importance. PMID:25941655

Understanding and Managing Process Interaction in IS Development Projects

DEFF Research Database (Denmark)

Bygstad, Bendik; Nielsen, Peter Axel

2012-01-01

Software-based information systems must be developed and implemented as a part of business change. This is a major challenge, since business change and the development of software-based information systems usually are performed in separate processes. Thus, there is a need to understand and manage...... critical events in the case, what led to the events, and what the consequences are. We discuss the implications for information systems research and in particular we discuss the contribution to project management of iterative and incremental software development.......Software-based information systems must be developed and implemented as a part of business change. This is a major challenge, since business change and the development of software-based information systems usually are performed in separate processes. Thus, there is a need to understand and manage...

Major Change in the Quality Management of the Qualitative Market Research

OpenAIRE

Balan, Carmen

2009-01-01

The goal of the present article is to explore a major change in the quality management of a distinct category of services, respectively the qualitative research. The essence of the change consists in the creation of an international standard aiming to increase the quality and professionalism of the market, opinion and social research, also including the qualitative research. The approach is entirely focused on the services provided by companies specialized in this field to all the organizatio...

Human Factors in the Management of Production

DEFF Research Database (Denmark)

Jensen, Per Langå; Alting, Leo

2006-01-01

The ‘Human factor’ is a major issue when optimizing manufacturing systems. The development in recommendations on how to handle this factor in the management of production reflects the change in dominating challenges faced by production in society. Presently, industrial societies are meeting new...... challenges. Qualitative interviews with Danish stakeholders in the education of engineers (BA & MA) confirm the picture given in international literature. Therefore, the didactics concerning the ‘human factor’ in the curriculum on production management has to reflect these changes. This paper concludes...

Prospects and future of conservative management of beta thalassemia major in a developing country

International Nuclear Information System (INIS)

Rahman, M.; Lodhi, Y.

2004-01-01

Objective: To assess the efficacy, prospects and future of conservative management of beta thalassemia major patients in a developing country. Design: Patients registered at IHBTS were studied over a period of three years. They consented to being managed on moderate transfusion regimen, aiming to maintain a pre-transfusion haemoglobin(Hgb) level of 9.0 plus minus 1.0 g per dL. We studied their transfusion requirements, status for transfusion transmitted infections (TTls), serum ferritin levels and complications developing as a result of iron overload. Subjects: Initially all registered patients were included in this study. Sporadic patients as well as dropouts occurring due to any reason, (patients concurrently seeking treatment at other centres as well, or complying poorly to advised chelation therapy) were excluded from the study. The data presented here conforms to a cohort of 60 regular patients who adhered best to our selection criteria. Main Outcome Measures: 1) The study highlights the deficiencies and problems of conservative management for beta thalassemia major. 2) The major impact of our study is the message that conservative management in a poor country, like ours, is a no-win situation. 3) There is an urgent need to immediately start a prevention programme. Results: In the younger patients, blood consumption even on the moderate transfusion regimen is 120ml/kg/year, however with ascending age the consumption increases to 240ml/kg/year. A substantive number of the patients are either Hep C (35%) or Hep B (1.7%) positive. There are no HIV positive patients. Serum ferritin levels vary widely and could not be controlled due to poor compliance to chelation. 50% of the patients developed one or other complications of iron overload. The cost of treatment depending on the quality of care, is tremendous and beyond the reach of the common man. Conclusions: Conservative management may be the best alternative and at times the only hope for patients in our country

Imagined Communities, Contested Watersheds: Challenges to Integrated Water Resources Management in Agricultural Areas

Science.gov (United States)

Ferreyra, Cecilia; de Loe, Rob C.; Kreutzwiser, Reid D.

2008-01-01

Integrated water resources management is one of the major bottom-up alternatives that emerged during the 1980s in North America as part of the trend towards more holistic and participatory styles of environmental governance. It aims to protect surface and groundwater resources by focusing on the integrated and collaborative management of land and…

Global Expansion of International Branch Campuses: Managerial and Leadership Challenges

Science.gov (United States)

Lane, Jason E.

2011-01-01

In this chapter, the author outlines the growth of international branch campuses (IBCs) over the past fifty years and discusses some of the major management and leadership challenges associated with creating and sustaining IBCs. Part one of the chapter provides a discussion of the global expansion of IBCs. The second part focuses on the…

Challenges in the management of haemophilia on transition from adolescence to adulthood.

Science.gov (United States)

Brand, Brigitte; Dunn, Spencer; Kulkarni, Roshni

2015-12-01

Patients with haemophilia undergo many transitions during their lives, but the period between adolescence and adulthood is particularly challenging. During this time, the patient must deal with all of the typical biological, social and emotional changes associated with this phase of life, whilst at the same time, adapting his lifestyle to the needs of his condition, transferring from paediatric to adult services and, most importantly, accepting increasing (and ultimately full) responsibility for managing his condition. Parents may also find their diminishing role equally challenging. Perhaps not surprisingly, given the challenges that adolescents face, treatment adherence during this time is generally low, which can lead to recurrent joint bleeds, chronic pain and reduced quality of life. To address the challenges, it is critical that a transition programme is put in place that meets the needs of not only the patient, but also his parents and healthcare providers. Key elements of the plan are a multidisciplinary approach, early planning, patient education and appropriate follow-up. A successful programme will equip all parties with the skills to deal with the challenges of transition from adolescence to adulthood, ensuring that the benefits of treatment in childhood are maintained, thus optimising health outcomes and quality of life. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Allogeneic stem cell transplantation for thalassemia major in India

Directory of Open Access Journals (Sweden)

Vikram Mathews

2017-12-01

Full Text Available Allogeneic stem cell transplantation (allo-SCT is the only currently available curative treatment for thalassemia major. Since it was first done in 1981, several thousand patients have benefited from it and it is now possible to offer this treatment in different parts of the world with good results. With better risk stratification and supportive care, the results of allo-SCT are now very good even in high risk patients who have significant iron overload related organ dysfunction. The improvements have mainly been in the conditioning strategies with less toxic myeloablation and management of the complications of SCT. However, several challenges remain. Transplant related complications still cause significant morbidity and mortality. There is data to show that the results of transplantation as best if done in well transfused and chelated patients <7 years of age. As only a third of the patients will have a matched related donor, there is need for investigating SCT with alternative donors. Experience with SCT for thalassemia major from matched unrelated donors or haplo-identical donors is still limited but needs further exploration. Adequate management needs to be provided post-SCT for all pre-existing complications particularly iron chelation to prevent further organ dysfunction. Systematic follow-up is needed to measure long term outcomes. The biggest challenges in India are the cost of this treatment and access to centres capable of providing this treatment. With greater support from the government, health insurance and philanthropic programs, there has been a rapid increase in the number of SCTs for thalassemia major in India. The number centres providing this treatment are also increasing making this curative treatment more widely available in India.

Aging management of major LWR components with nondestructive evaluation

International Nuclear Information System (INIS)

Shah, V.N.; MacDonald, P.E.; Akers, D.W.; Sellers, C.; Murty, K.L.; Miraglia, P.Q.; Mathew, M.D.; Haggag, F.M.

1997-01-01

Nondestructive evaluation of material damage can contribute to continued safe, reliable, and economical operation of nuclear power plants through their current and renewed license period. The aging mechanisms active in the major light water reactor components are radiation embrittlement, thermal aging, stress corrosion cracking, flow-accelerated corrosion, and fatigue, which reduce fracture toughness, structural strength, or fatigue resistance of the components and challenge structural integrity of the pressure boundary. This paper reviews four nondestructive evaluation methods with the potential for in situ assessment of damage caused by these mechanisms: stress-strain microprobe for determining mechanical properties of reactor pressure vessel and cast stainless materials, magnetic methods for estimating thermal aging damage in cast stainless steel, positron annihilation measurements for estimating early fatigue damage in reactor coolant system piping, and ultrasonic guided wave technique for detecting cracks and wall thinning in tubes and pipes and corrosion damage to embedded portion of metal containments

Occlusal Caries: Biological Approach for Its Diagnosis and Management

DEFF Research Database (Denmark)

Christina Carvalho, Joana; Dige, Irene; Machiulskiene, Vita

2016-01-01

The management of occlusal caries still remains a major challenge for researchers as well as for general practitioners. The present paper reviews and discusses the most up-to-date knowledge and evidence of the biological principles guiding diagnosis, risk assessment, and management of the caries...

PROJECT MANAGEMENT CONSIDERED IN A 2014 PERSPECTIVE

OpenAIRE

GRAPA ADELINA-ROXANA; SOARE ALICE-MAGDALENA

2014-01-01

Project Management has come of age, yet multiple surveys and reports confirm the fact that the majority of projects are challenged. Given the more demanding and strict financial constraints associated with the current fiscal climate, project management is regarded as a tool that can deliver more with less. The literature on Project Management shows that, in spite of advancement in Project Management processes, tools and systems, project success has not significantly improved. T...

Managing Service Quality within the Knowledge-Based Economy: Opportunities and Challenges

OpenAIRE

Ion Plumb; Andreea Zamfir

2009-01-01

The knowledge-based economy, along with the impact of information society technologies, presents the service organizations and their customers with many potential opportunities as well as challenges. Therefore, this study explores how the knowledge-based economy could influence the quality management of service organizations. The study reveals that the actors within the service sector have vast new opportunities in terms of communication and value co-creation, but in the same time, the requir...

Climate Change and Risk Management Challenges in the Arctic

DEFF Research Database (Denmark)

Jakobsen, Uffe

Climate change or global warming results in melting ice in the Arctic, both inland and sea ice. This opens up opportunities of natural ressource extraction and possibilities of new shipping routes, that opens up opportunities for increased maritime activities. However, with these opportunies come...... also the challenges of increased maritime activities that result in several risks in the Arctic such as the risk of pollution and the risks of accidents, which produce a need for preparedness towards oil spill and towards search and rescue (SAR) and institutions for SAR. Since the Arctic is such a huge...... possibilies of transborder risk management and partnership building....

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

Preparation is essential to cope with the challenge of providing optimal care when there is a sudden, unexpected surge of casualties due to a disaster or major incident. By definition, the requirements of such cases exceed the standard care facilities of hospitals in qualitative or quantitative respects and interfere with the care of regular patients. To meet the growing demands to be prepared for disasters, a permanent facility to provide structured, prepared relief in such situations was developed. A permanent but reserved Major Incident Hospital (MIH) has been developed through cooperation between a large academic medical institution, a trauma center, a military hospital, and the National Poison Information Centre (NVIC). The infrastructure, organization, support systems, training and systematic working methods of the MIH are designed to create order in a chaotic, unexpected situation and to optimize care and logistics in any possible scenario. Focus points are: patient flow and triage, registration, communication, evaluation and training. Research and the literature are used to identify characteristic pitfalls due to the chaos associated with and the unexpected nature of disasters, and to adapt our organization. At the MIH, the exceptional has become the core business, and preparation for disaster and large-scale emergency care is a daily occupation. An Emergency Response Protocol enables admittance to the normally dormant hospital of up to 100 (in exceptional cases even 300) patients after a start-up time of only 15 min. The Patient Barcode Registration System (PBR) with EAN codes guarantees quick and adequate registration of patient data in order to facilitate good medical coordination and follow-up during a major incident. The fact that the hospital is strictly reserved for this type of care guarantees availability and minimizes impact on normal care. When it is not being used during a major incident, there is time to address training and research

76 FR 71465 - Defense Federal Acquisition Regulation Supplement: Management of Manufacturing Risk in Major...

Science.gov (United States)

2011-11-18

... Government procurement. Mary Overstreet, Editor, Defense Acquisition Regulations System. Interim Rule Adopted... Federal Acquisition Regulation Supplement: Management of Manufacturing Risk in Major Defense Acquisition...). ACTION: Final rule. SUMMARY: DoD is adopting as final, without change, an interim rule amending the...

Educational challenges and requirements for managing leg ulcers in the community.

LENUS (Irish Health Repository)

Martin, Fiona

2014-06-01

The significant impact of leg ulcers upon quality of life and disease burden cannot be overemphasised, with the financial and economic impact from an individual, local and national perspective being widely acknowledged. This article attempts to highlight issues relating to education in leg ulcer management while identifying some current and emerging challenges faced in this area by professionals. With regard to education, formal training and perception of professionals, the provision of more specialised and focused training, increased use of patient-related outcome measures and the concept of knowledge brokering have been identified as important aspects in the planning and further development of education. Issues in the domains of community nursing, technology, pain management, nursing diagnosis, availability of research and recurrence were also highlighted.

Challenges in Clinical Management of Radiation-Induced Illnesses in Exploration Spaceflight

Science.gov (United States)

Blue, Rebecca; Chancellor, Jeffery; Suresh, Rahul; Carnell, Lisa; Reyes, David; Nowadly, Craig; Antonsen, Erik

2018-01-01

Historical solar particle events (SPEs) provide context for some understanding of acute radiation exposure risk to astronauts traveling outside of low Earth orbit. Modeling of potential doses delivered to exploration crewmembers anticipates limited radiation-induced health impacts, including prodromal symptoms of nausea, emesis, and fatigue, but suggests that more severe clinical manifestations are unlikely. Recent large animal-model research in space-analogs closely mimicking SPEs has identified coagulopathic events independent of the hematopoietic sequelae of higher radiation doses, similar in manifestation to disseminated intravascular coagulation (DIC). We explored the challenges of clinical management of radiation-related clinical manifestations, using currently accepted modeling techniques and anticipated physiological sequelae, to identify medical capabilities needed to successfully manage SPE-induced radiation illnesses during exploration spaceflight.

Demography management and challenges of alternating shift work; Demographiemanagement und Herausforderungen der Wechselschicht

Energy Technology Data Exchange (ETDEWEB)

Franzkowiak, Matthias [Arbeitsmedizin Rheinisches Revier, RWE Power AG, Bergheim (Germany); Schmitz, Michael [Personalcontrolling/-strategie, RWE Power AG, Essen (Germany); Feldhaus, Christian [Arbeitsmedizin/Betriebliches Gesundheitsmanagement, RWE Power AG, Essen (Germany)

2009-07-01

RWE Power has launched a comprehensive process to develop strategies for future demography management. A special focus is on the challenges which result from the age structure of the workforce in connection with alternating shift work. A comprehensive catalogue of measures was developed which is currently being implemented. Among other things, it includes programmes for the employees on issues like health and ergonomics or optimisation of existing shift systems. Several follow-up projects are also included. The measures presented in this paper are meant to help in responding proactively to future demographic trends and the resulting challenges. (orig.)

Challenges in Doctoral Research Project Management: A Comparative Study

Directory of Open Access Journals (Sweden)

Reuven Katz

2016-03-01

Full Text Available This paper presents quantitative results of a comparative study evaluating the management skills of doctoral candidates working toward a PhD and additional information related to their lifestyles. We conducted a survey among enrolled doctoral candidates at five universities in Israel and three technological universities in Western Europe. 1013 Israeli candidates and 457 Western European candidates replied to our survey. In our analysis, we compared the answers of Israeli Science and Engineering candidates to those of Social Sciences and Humanities candidates; in addition, we compared the answers of Israeli Science and Engineering students to their Western European peers. Our analysis focused on finding significant patterns by comparing these groups of students. In order to identify such patterns, we analyzed each question using the Pearson chi-square test. The current study’s main finding is that the majority of candidates, regardless of their chosen academic field or the region where they study, have no training or expertise in managing a doctoral research project. Based on these findings, we suggest that all doctoral candidates be taught basic research-project management. We believe that such training will provide them with a powerful tool for better managing their research as they advance towards successful completion of their doctorate.

Stress in crisis managers: evidence from self-report and psychophysiological assessments.

Science.gov (United States)

Janka, A; Adler, C; Fischer, L; Perakakis, P; Guerra, P; Duschek, S

2015-12-01

Directing disaster operations represents a major professional challenge. Despite its importance to health and professional performance, research on stress in crisis management remains scarce. The present study aimed to investigate self-reported stress and psychophysiological stress responses in crisis managers. For this purpose, 30 crisis managers were compared with 30 managers from other disciplines, in terms of self-reported stress, health status and psychophysiological reactivity to crisis-related and non-specific visual and acoustic aversive stimuli and cognitive challenge. Crisis managers reported lower stress levels, a more positive strain-recuperation-balance, greater social resources, reduced physical symptoms, as well as more physical exercise and less alcohol consumption. They exhibited diminished electrodermal and heart rate responses to crisis-related and non-specific stressors. The results indicate reduced stress and physical complaints, diminished psychophysiological stress reactivity, and a healthier life-style in crisis managers. Improved stress resistance may limit vulnerability to stress-related performance decline and facilitate preparedness for major incidents.

Radioactive waste management in Canada: progress and challenges 15 years after the policy framework