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Sample records for programmable clock manager

  1. Programmable Clock Waveform Generation for CCD Readout

    Energy Technology Data Exchange (ETDEWEB)

    Vicente, J. de; Castilla, J.; Martinez, G.; Marin, J.

    2006-07-01

    Charge transfer efficiency in CCDs is closely related to the clock waveform. In this paper, an experimental framework to explore different FPGA based clock waveform generator designs is described. Two alternative design approaches for controlling the rise/fall edge times and pulse width of the CCD clock signal have been implemented: level-control and time-control. Both approaches provide similar characteristics regarding the edge linearity and noise. Nevertheless, dissimilarities have been found with respect to the area and frequency range of application. Thus, while the time-control approach consumes less area, the level control approach provides a wider range of clock frequencies since it does not suffer capacitor discharge effect. (Author) 8 refs.

  2. The European Programme Manager

    DEFF Research Database (Denmark)

    Larson, Anne; Bergman, E.; Ehlers, S.

    The publication is a result of a cooperation between organisations in six European countries with the aim to develop a common European education for programme managers. It contains of a description of the different elements of the education together with a number of case-studies from the counties...

  3. Multiphase clock generators with controlled clock impulse width for programmable high order rotator SC FIR filters realized in 0.35 μm CMOS technology

    Science.gov (United States)

    Dlugosz, Rafal; Pawlowski, Pawel; Dabrowski, Adam

    2005-06-01

    Complexity of clock generator is one of the most important parameters in the design and optimization of switched-capacitor (SC) finite impulse response (FIR) filters. There are different SC FIR filter architectures. Some of them need a simple clock generator but the others require a quite complicated multiphase clock system. In the latter case an external clock system (i.e., outside the integrated circuit) is unrealistic because of a great number of the required external pins. We have implemented various SC FIR filter architectures together with complex internal clock generators in the CMOS 0.8 μm and 0.35 μm technologies. One of the most important problems in the design process was the optimization of waveforms and widths of the clock impulses. SC FIR filters are very sensitive to parameters of clock systems. Thus the clock generators must be designed very precisely. We demonstrate results of the design of the 64-phase clock generator for a programmable rotator SC FIR filter. In our approach the width of the clock impulses is controlled by two external signals. This is a very convenient solution, because optimization of the clock impulses, which was difficult in other approaches, is currently much easier. The internal clock generator area is ca. 0.15 mm2 in the CMOS 0.35 μm technology, i.e., only 7 % of the entire SC FIR filter chip area.

  4. Management and Communication programme

    CERN Multimedia

    Nathalie Dumeaux

    2005-01-01

    We are pleased to announce the launch of three new courses in the Management and Communication programme: 1.     Managing Time (Open to all Staff Members) The objectives are: To enhance your personal effectiveness through better organisation skills To acquire ways of making the most of your time through improved work habits To reduce stress For the description of this course, please see:  http://humanresources.web.cern.ch/humanresources/external/training/MANCO/P9798/S8E_e.asp 2.     Service Orientation (Open to all Staff Members working in a service-related function) The objectives are: To understand the key elements in an effective client/service provider relationship To develop a client focused approach to providing services For the description of this course, please see:  http://humanresources.web.cern.ch/humanresources/external/training/MANCO/P9798/serv_e.asp 3.   Introduction to Leadership (Open to Staff in Career Paths E & above, including newly appointed supervisors and Sect...

  5. Management and Communication programme

    CERN Multimedia

    Nathalie Dumeaux

    2005-01-01

    We are pleased to announce the launch of three new courses in the Management and Communication programme: 1.     Managing Time (Open to all Staff Members) The objectives are: To enhance your personal effectiveness through better organisation skills To acquire ways of making the most of your time through improved work habits To reduce stress For the description of this course, please see:  http://humanresources.web.cern.ch/humanresources/external/training/MANCO/P9798/S8E_e.asp 2.     Service Orientation (Open to all Staff Members working in a service-related function) The objectives are: To understand the key elements in an effective client/service provider relationship To develop a client focused approach to providing services For the description of this course, please see:  http://humanresources.web.cern.ch/humanresources/external/training/MANCO/P9798/serv_e.asp 3.   Introduction to Leadership (Open to Staff in Career Paths E & above, including newly appointed supervisors and Secti...

  6. Energy Management Programmes for Industry

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-09-05

    The IEA Policy Pathway publications provide details on how to implement specific recommendations drawn from the IEA 25 Energy Efficiency Policy Recommendations. This Policy Pathway, jointly produced by the International Energy Agency and the Institute for Industrial Productivity, develops the critical steps for policy makers implementing energy management programmes for industry. Optimising energy use in industry is essential to improve industrial competitiveness and achieve wider societal goals such as energy security, economic recovery and development, climate change mitigation and environmental protection. While there is significant potential to decrease energy consumption in this sector, opportunities to improve energy efficiency are still under-exploited. Energy management programmes have shown to be instrumental in addressing many of the barriers that inhibit wide-scale uptake of energy management in industry. The Policy Pathway builds on lessons learned from country experiences and provides actionable guidance on how to plan and design, implement, evaluate and monitor energy management programmes for industry.

  7. Management & communication programme

    CERN Multimedia

    Nathalie Dumeaux

    2006-01-01

    Calendar of courses for September to December 2006 Please check our Web site to find out the number of places available, which may vary. Management Curriculum 2nd semester 2006 Titres Dates Langue Quality Management 18, 19 September Bilingual Managing Teams 19, 20, 21 September English Communiquer efficacement - résidentiel 20, 21, 22 septembre Bilingue Personal Awareness & Impact 26, 27, 28 September Bilingual Introduction to Leadership 4, 5, 6 October Bilingue IProject Scheduling & Costing 12, 13 October English CDP-SL part 1 17, 18, 19 October English Personal Awareness & Impact 23, 24 October Bilingual Communicating to Convince 23, 24, 25 October Bilingual CDP-GL part 2 25, 26, 27 October English CDP-GL part 1 22, 23, 24 November Bilingual Risk Management 20, 21 December Bilingual Communication curriculum 2nd semester 2006 Titres Dates Langue Techniques d'exposé et de présentation 18, 19 septembre + 16 octobre Français Communi...

  8. CLOCK gene is implicated in weight reduction in obese patients participating in a dietary programme based on the Mediterranean diet.

    Science.gov (United States)

    Garaulet, M; Corbalán, M D; Madrid, J A; Morales, E; Baraza, J C; Lee, Y C; Ordovas, J M

    2010-03-01

    The success of obesity therapy is dependent on the genetic background of the patient. Circadian Locomotor Output Cycles Kaput (CLOCK), one of the transcription factors from the positive limb of the molecular clock, is involved in metabolic alterations. To investigate whether five candidate polymorphisms from CLOCK were associated with anthropometric, metabolic measures and weight loss in response to a behavioural weight reduction programme based on the Mediterranean diet. Five hundred overweight/obese subjects, aged 20-65 years, who attended outpatient clinics specializing in obesity, were studied. Anthropometric, biochemical and dietary intake variables were analysed. Effectiveness of the programme and weight loss progression during 28 weeks of treatment was assessed. Four of five CLOCK SNPs selected were significantly associated with obesity variables (PCLOCK was associated with obesity at baseline and also affected weight loss. Patients with the variant allele (G) lost significantly less weight i(P=0.008) compared with wild type. Repeated measures analysis showed that weight loss over time was significantly different between rs1801260 CLOCK variations (P=0.038). Carriers of the G allele displayed greater difficulty in losing weight than non-carriers. In this particular polymorphism, the frequency of short-time sleepers (CLOCK polymorphisms were also associated with significant differences in total plasma cholesterol at the completion of dietary treatment (PCLOCK gene polymorphisms and obesity. CLOCK rs1801260 SNP may predict the outcome of body weight reduction strategies based on low-energy diets.

  9. Auditing emergency management programmes: Measuring leading indicators of programme performance.

    Science.gov (United States)

    Tomsic, Heather

    Emergency Management Programmes benefit from review and measurement against established criteria. By measuring current vs required programme elements for their actual currency, completeness and effectiveness, the resulting timely reports of achievements and documentation of identified gaps can effectively be used to rationally support prioritised improvement. Audits, with their detailed, triangulated and objectively weighted processes, are the ultimate approach in terms of programme content measurement. Although Emergency Management is often presented as a wholly separate operational mechanism, distinct and functionally different from the organisation's usual management structure, this characterisation is only completely accurate while managing an emergency itself. Otherwise, an organisation's Emergency Management Programme is embedded within that organisation and dependent upon it. Therefore, the organisation's culture and structure of management, accountability and measurement must be engaged for the programme to exist, much less improve. A wise and successful Emergency Management Coordinator does not let the separate and distinct nature of managing an emergency obscure their realisation of the need for an organisation to understand and manage all of the other programme components as part of its regular business practices. This includes its measurement. Not all organisations are sufficiently large or capable of supporting the use of an audit. This paper proposes that alternate, less formal, yet effective mechanisms can be explored, as long as they reflect and support organisational management norms, including a process of relatively informal measurement focused on the organisation's own perception of key Emergency Management Programme performance indicators.

  10. Managing the Operations-Strategy Interface through Programme Management

    DEFF Research Database (Denmark)

    Meulengracht Jensen, Peter; Johansen, John; Wæhrens, Brian Vejrum

    2011-01-01

    This paper explores how one company with globally distributed operations, strive to manage the operations-strategy interface through programme management. The paper focuses on how the organizational context affects the programme configuration and raises a number of propositions as to how programmes...

  11. System-wide power management control via clock distribution network

    Science.gov (United States)

    Coteus, Paul W.; Gara, Alan; Gooding, Thomas M.; Haring, Rudolf A.; Kopcsay, Gerard V.; Liebsch, Thomas A.; Reed, Don D.

    2015-05-19

    An apparatus, method and computer program product for automatically controlling power dissipation of a parallel computing system that includes a plurality of processors. A computing device issues a command to the parallel computing system. A clock pulse-width modulator encodes the command in a system clock signal to be distributed to the plurality of processors. The plurality of processors in the parallel computing system receive the system clock signal including the encoded command, and adjusts power dissipation according to the encoded command.

  12. Policy Pathways: Energy Management Programmes for Industry

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-09-06

    The IEA Policy Pathway publications provide details on how to implement specific recommendations drawn from the IEA 25 Energy Efficiency Policy Recommendations. This Policy Pathway, jointly produced by the International Energy Agency and the Institute for Industrial Productivity, develops the critical steps for policy makers implementing energy management programmes for industry. Optimising energy use in industry is essential to improve industrial competitiveness and achieve wider societal goals such as energy security, economic recovery and development, climate change mitigation and environmental protection.While there is significant potential to decrease energy consumption in this sector, opportunities to improve energy efficiency are still under-exploited. Energy management programmes have shown to be instrumental in addressing many of the barriers that inhibit wide-scale uptake of energy management in industry. The Policy Pathway builds on lessons learned from country experiences and provides actionable guidance on how to plan and design, implement, evaluate and monitor energy management programmes for industry.

  13. Indian programme on radioactive waste management

    Indian Academy of Sciences (India)

    Abstract. The primary objective of radioactive waste management is protection of human health, environment and future generation. This article describes, briefly, the Indian programme on management of different radioactive wastes arising in the entire nuclear fuel cycle adhering to this objective.

  14. CERN Management & Communication Training programme

    CERN Multimedia

    2007-01-01

    Calendrier des cours prévus de septembre à décembre 2007
Calendar of courses for September to December 2007 Please check our Web site to find out the number of places available which may vary. Veuillez consulter notre site Web pour connaître le nombre de places disponibles qui peut varier. Management Curriculum / curriculum Management Personal Awareness & Impact (English) 10, 11, 12 September, (full) Managing by Project (English) 9, 10 October (2 places disponibles) Personal Awareness & Impact (English) 15, 16, 17 October, (full) Introduction to Leadership (English) 17, 18, 19 October, (full) Quality Management (Bilingual) 18, 19 October (10 places available) Managing Teams (English) 13, 14, 15 November (full) Communicating Effectively – residential (Bilingual) 20, 21, 22 November (full) Risk Management (English) 13, 14 December (6 places available) Communication Curriculum / curriculum communication Stress Management (English) 25, 26 September (6 places...

  15. CERN Management & Communication Training programme

    CERN Multimedia

    2007-01-01

    Calendrier des cours prévus de septembre à décembre 2007 Calendar of courses for September to December 2007 Please check our Web site to find out the number of places available which may vary. Veuillez consulter notre site Web pour connaître le nombre de places disponibles qui peut varier.   Management Curriculum / curriculum Management NEW COURSE - Dealing with Conflict, 5 & 12 October (6 places available) Managing by Project (English) 9, 10 October (Full) Personal Awareness & Impact (English) 15, 16, 17 October\t(Full) Introduction to Leadership (English) 17, 18, 19 October\t(Full) Managing Teams (English) 13, 14, 15 November (1 place available) Communicating Effectively – residential (Bilingual) 20, 21, 22 November (Full) Risk Management (English) 13, 14 December (6 places available) Core Development Package for new Supervisors and Section leaders (MARS exercice) - 
Session to be scheduled from November 2007 to January 2008 &...

  16. CERN Management & Communication Training programme

    CERN Multimedia

    2007-01-01

    Calendrier des cours prévus de septembre à décembre 2007 Calendar of courses for September to December 2007 Please check our Web site to find out the number of places available which may vary. Veuillez consulter notre site Web pour connaître le nombre de places disponibles qui peut varier. Management Curriculum / curriculum Management Managing by Project (English)\t9, 10 October (Full) Personal Awareness & Impact (English)\t15, 16, 17 October, (Full) Introduction to Leadership (English)\t17, 18, 19 October, (Full) Managing Teams (English)\t13, 14, 15 November\t(1 place available)) Communicating Effectively – residential (Bilingual)\t20, 21, 22 November (Full) Risk Management (English)\t13, 14 December (6 places available) Core Development Package for new Supervisors and Section leaders (MARS exercice) Session to be scheduled from November 2007 to January 2008 Communication Curriculum / curriculum communication Stress Management (English)\t25, 26 September (4 p...

  17. CERN Management & Communication Training programme

    CERN Multimedia

    HR Department

    2009-01-01

    Timetable of courses from October to December 2009 Please check our Web site to find out the number of places available, which may vary. Management Curriculum Communicating Leadership - 2 October, 29 October + 1 December - (full) CDP-SL for new supervisors, part 1 - 5, 6, 7 October - (2 places available) Introduction to Leadership - 7, 8, 9 October - (4 places available) Voice your Leadership - 13, 14 October - (full) Managing Teams - 10, 11, 12 November - (7 places available) Risk Management - 17, 18 November - (6 places available) Dealing with Conflict - 20, 27 November - (5 places available) CDP pour nouveaux superviseurs, part 1 - 30 novembre, 1, 2 décembre - (4 places disponibles) Communication Curriculum Making presentations - 14, 15 October + 9 November - (Full) Communiquer efficacement dans votre équipe - 19, 20 octobre - (7 places disponibles) Gestion du stress - 20, 21 octobre - (8 places disponibles) Communiquer efficacement - 21, 22 octobre + 9, 10 novemb...

  18. CERN Management & Communication Training programme

    CERN Multimedia

    HR Department

    2009-01-01

    Timetable of courses from February to June 2009 Please check our Web site to find out the number of places available, which may vary. Management Curriculum Core Development Package for new Supervisors and Section leaders (3 + 2 days) 3, 4, 5 February (part 1) + 13, 14 May 2009 (part 2)\t(full) Core Development Package for Group Leaders (part 2) 24, 25, 26 February (full) Communicating Effectively – Residential\t23, 24, 25 March (2 places available) Quality Management\t25, 26 March (10 places available) Introduction to Leadership\t1, 2, 3 April (3 places available) Personal Awareness & Impact\t5, 6, 7 May (full) 3, 4, 5 June (places available) Dealing with conflict / Gestion des conflits\t5 + 12 June (8 places available) (Session in English or in French) Managing Teams\t9, 10, 11 June (4 places available) Communication Curriculum Managing stress\t23, 24 February (6 places available) Negotiating Effectively\t3, 4 March (2 places available) Négociation efficace\t17, 18 mars (6 places d...

  19. CERN Management & Communication Training programme

    CERN Multimedia

    HR Department

    2009-01-01

    Calendar of courses for February to June 2009 Please check our Web site to find out the number of places available which may vary. Management Curriculum Core Development Package for new Supervisors and Section leaders (3 + 2 days) 3, 4, 5 February (part 1) + 13, 14 May 2009 (part 2) (full) Core Development Package for Group Leaders (part 2) 24, 25, 26 February (full) Communicating Effectively – Residential\t23, 24, 25 March (2 places available) Quality Management 25, 26 March (10 places available) Introduction to Leadership 1, 2, 3 April (3 places available) Personal Awareness & Impact 5, 6, 7 May (full) 3, 4, 5 June (places available) Dealing with conflict / Gestion des conflits\t5 + 12 June (8 places available) (Session in English or in French) Managing Teams\t9, 10, 11 June (4 places available) Communication Curriculum Managing stress\t23, 24 February (6 places available) Negotiating Effectively\t3, 4 March (2 places available) Négociation efficace\t17, 18 mar...

  20. CERN Management & Communication Training programme

    CERN Multimedia

    HR Department

    2009-01-01

    Timetable of courses from September to December 2009 Please check our Web site to find out the number of places available, which may vary. Management Curriculum Project Scheduling & Costing\t3, 4 September (full) Communicating Effectively – Residential\t15, 16, 17 September (5 places available) Personal Awareness & Impact – Follow-up\t17, 18 September (2 places available) Project Management\t22, 23 September (full) Personal Awareness & Impact\t22, 23, 24 September (full) Introduction to Leadership\t7, 8, 9 October (full) Managing Teams\t10, 11, 12 November (full) Communication Curriculum Managing Time\t22 September + 27 October + 18 November (8 places available) Making presentations\t14, 15 October + 9 November (Full) Communiquer efficacement dans votre équipe\t19, 20 octobre (2 places disponibles) Communiquer efficacement\t21, 22 octobre + 9, 10 novembre (1 place disponible) Techniques d’exposé et de présentations\t10, 11 novembre + 8 décembre (1...

  1. CERN Management & Communication Training programme

    CERN Multimedia

    HR Department

    2009-01-01

    Timetable of courses from September to December 2009 Please check our Web site to find out the number of places available, which may vary. Management Curriculum Project Scheduling & Costing\t3, 4 September (2 places available) Communicating Effectively – Residential\t15, 16, 17 September (6 places available) Personal Awareness & Impact – Follow-up\t17, 18 September (full) Project Management\t22, 23 September (full) Personal Awareness & Impact\t22, 23, 24 September (full) Introduction to Leadership\t7, 8, 9 October (full) Managing Teams\t10, 11, 12 November (full) Communication Curriculum Managing Time\t22 September + 27 October + 18 November (3 places available) Making presentations\t14, 15 October + 9 November (Full) Communiquer efficacement dans votre équipe\t19, 20 octobre (complet) Communiquer efficacement\t21, 22 octobre + 9, 10 novembre (complet) Techniques d’exposé et de présentations\t10, 11 novembre + 8 décembre (1 place disponible) Serv...

  2. CERN Management & Communication Training programme

    CERN Multimedia

    HR Department

    2009-01-01

    Timetable of courses from September to December 2009 Please check our web site to find out the number of places available, which may vary. Management Curriculum Project Scheduling & Costing\t3, 4 September (2 places available) Communicating Effectively – Residential\t15, 16, 17 September (6 places available) Personal Awareness & Impact – Follow-up\t17, 18 September (full) Project Management\t22, 23 September (full) Personal Awareness & Impact\t22, 23, 24 September (full) Introduction to Leadership\t7, 8, 9 October (full) Managing Teams\t10, 11, 12 November (full) Communication Curriculum Managing Time\t22 September + 27 October + 18 November (3 places available) Making presentations\t14, 15 October + 9 November (Full) Communiquer efficacement dans votre équipe\t19, 20 octobre (complet) Communiquer efficacement\t21, 22 octobre + 9, 10 novembre (complet) Techniques d’exposé et de présentations\t10, 11 novembre + 8 décembre (1 place disponible) Service Orientation/Orienta...

  3. CERN Management & Communication Training programme

    CERN Multimedia

    HR Department

    2009-01-01

    Timetable of courses from November to December 2009 Please check our Web site to find out the number of places available, which may vary. Management Curriculum Managing Teams\t10, 11, 12 November (4 places available) CDP pour nouveaux superviseurs, part 1\t30 novembre, 1, 2 décembre (2 places disponibles) Managing by Project\t1, 2 December (full) Communication Curriculum Techniques d’exposé et de présentations\t10, 11 novembre + 8 décembre (complet) Managing Stress\t10, 11 November (6 places available) Communicating Effectively\t11, 12 November + 8, 9 December (4 places available) Orientation service\t12, 13 novembre (5 places disponibles) Gestion du stress\t17, 18 novembre (6 places disponibles) Animer ou participer à une réunion de travail\t9, 10, 11 décembre (3 places disponibles) If you are interested in attending any of the above course sessions, please talk to your supervisor and/or your DTO, and apply electronically via EDH from the course description p...

  4. CERN Management & Communication Training programme

    CERN Multimedia

    HR Department

    2009-01-01

    Timetable of courses from February to June 2009 Please check our Web site to find out the number of places available, which may vary. Management Curriculum Communicating Effectively – Residential\t23, 24, 25 March (Full) Quality Management\t25, 26 March\t(6 places available) Introduction to Leadership\t1, 2, 3 April (2 places available) Personal Awareness & Impact\t5, 6, 7 May (full) 3, 4, 5 June (1 place available) Dealing with conflict / Gestion des conflits\t5 + 12 June (3 places available) (Session in English or in French) Managing Teams\t9, 10, 11 June (3 places available) Communication Curriculum Negotiating Effectively\t3, 4 March (Full) Communiquer efficacement dans votre équipe\t26, 27 mars (4 places disponibles) Gestion de temps\t27 avril + 27 mai + 23 juin (9 places disponibles) Communiquer efficacement\t27, 28 avril + 26, 27 mai (4 places disponibles) Service Orientation\t28, 29 April (6 places available) Communicating Effectively in your Team\t29, 30 April (7 places available) Nég...

  5. CERN Management & Communication Training programme

    CERN Multimedia

    HR Department

    2008-01-01

    Calendar of courses for October to December 2008 Please check our Web site to find out the number of places available which may vary. Management Curriculum Introduction to Leadership\t15, 16, 17 October (Full) Personal Awareness & Impact\t22, 23, 24 October (full) Core Development Package for Group Leaders (part 2)\t11, 12, 13 November (full) Risk Management\t13, 14 November (5 places available) Managing Teams\t18, 19, 20 November (2 places available) Communicating to Convince\t19, 20 November (5 places available) Core Development Package for new Supervisors and Section leaders (3 + 2 days) 25, 26, 27 November (part 1) + 3, 4 March 2009 (part 2) (full) Core Development Package pour nouveaux superviseurs et chefs de section (3 + 2 jours) 9, 10, 11 décembre (partie 1) + 21, 22 avril 2009 (partie 2) (full) Communication Curriculum Communicating Effectively\t21, 22 October + 27, 28 November (4 places available)\tCommuniquer efficacement\t23, 24 octobre + 2...

  6. CERN Management & Communication Training programme

    CERN Multimedia

    HR Department

    2009-01-01

    Timetable of courses from February to June 2009 Please check our Web site to find out the number of places available, which may vary. Management Curriculum Personal Awareness & Impact\t5, 6, 7 May (2 places available) 3, 4, 5 June (full) Quality Management\t12, 13 May (6 places available) Dealing with conflict / Gestion des conflits (Session in English or in French)\t5 + 12 June (2 places available) Managing Teams\t9, 10, 11 June (2 places available) Personal Awareness & Impact – Follow-up\t30 June + 1 July (6 places available) Communicating to Convince\t22, 23 June (7 places available) Communication Curriculum Négociation efficace\t5, 6 mai (3 places disponibles) Gestion de temps\t27 mai + 23 juin + 7 juillet (3 places disponibles) Making presentations\t13, 14 May + 11 June (Full) Writing of Successful FP7 Proposals\t26 May (20 places available) Communicating Effectively\t8, 29 May + 22, 23 June (2 places available) If you are interested in attending any of the above course sessio...

  7. CERN Management & Communication Training programme

    CERN Multimedia

    HR Department

    2009-01-01

    Timetable of courses from February to June 2009 Please check our Web site to find out the number of places available, which may vary. Management Curriculum Communicating Effectively – Residential\t23, 24, 25 March (Full) Introduction to Leadership\t1, 2, 3 April (1 place available) Personal Awareness & Impact\t5, 6, 7 May (full) 3, 4, 5 June (full) Dealing with conflict / Gestion des conflits (Session in English or in French)\t5 + 12 June (2 places available) Managing Teams\t9, 10, 11 June (3 places available) Communication Curriculum Communiquer efficacement dans votre équipe\t26, 27 mars\t(5 places disponibles) Gestion de temps\t27 avril + 27 mai + 23 juin (7 places disponibles) Communiquer efficacement\t27, 28 avril + 26, 27 mai (3 places disponibles) Service Orientation\t28, 29 April (5 places available) Communicating Effectively in your Team\t29, 30 April (7 places available) Négociation efficace\t5, 6 mai (6 places disponibles) Animer ou participer à un...

  8. CERN Management & Communication Training programme

    CERN Multimedia

    HR Department

    2009-01-01

    Timetable of courses from February to June 2009 Please check our Web site to find out the number of places available, which may vary. Management Curriculum Communicating Effectively – Residential\t23, 24, 25 March (Full) Introduction to Leadership\t1, 2, 3 April (1 place available) Personal Awareness & Impact\t5, 6, 7 May (full) 3, 4, 5 June (1 place available) Dealing with conflict / Gestion des conflits (Session in English or in French)\t5 + 12 June (3 places available) Managing Teams\t9, 10, 11 June (3 places available) Communication Curriculum Communiquer efficacement dans votre équipe\t26, 27 mars\t(4 places disponibles) Gestion de temps\t27 avril + 27 mai + 23 juin (8 places disponibles) Communiquer efficacement\t27, 28 avril + 26, 27 mai (3 places disponibles) Service Orientation\t28, 29 April (6 places available) Communicating Effectively in your Team\t29, 30 April (7 places available) Négociation efficace\t5, 6 mai (6 places disponibles) Animer ou par...

  9. CERN Management & Communication Training programme

    CERN Multimedia

    HR Department

    2009-01-01

    Timetable of courses from February to June 2009 Please check our Web site to find out the number of places available, which may vary. Management Curriculum Communicating Effectively – Residential\t23, 24, 25 March (Full) Introduction to Leadership\t1, 2, 3 April (1 place available) Personal Awareness & Impact\t5, 6, 7 May (full) 3, 4, 5 June (full) Dealing with conflict / Gestion des conflits (Session in English or in French)\t5 + 12 June (2 places available) Managing Teams\t9, 10, 11 June (3 places available) Communication Curriculum Communiquer efficacement dans votre équipe\t26, 27 mars\t(5 places disponibles) Gestion de temps\t27 avril + 27 mai + 23 juin (7 places disponibles) Communiquer efficacement\t27, 28 avril + 26, 27 mai (3 places disponibles) Service Orientation\t28, 29 April (5 places available) Communicating Effectively in your Team\t29, 30 April (7 places available) Négociation efficace\t5, 6 mai (6 places disponibles) Animer ou participer à une réunion de travail/Chairing ...

  10. CERN Management & Communication Training programme

    CERN Multimedia

    2007-01-01

    Calendar of courses for November to December 2007Calendrier des cours prévus de novembre à décembre 2007 Please check our Web site to find out the number of places available which may vary.Veuillez consulter notre site Web pour connaître le nombre de places disponibles qui peut varier. Managing Teams (English) 13, 14, 15 November (Full) Communicating effectively - residential (Bilingual) 20, 21, 22 November (Full) FP7 Training - How to Negotiate and Administer Framework 7 Grant Agreements (English) 21 November (7 places available) Core Development Package for new Supervisors and Section leaders (MARS exercise) (English) 20, 21, 22 November (Full) Core Development Package for new Supervisors and Section leaders (MARS exercise) (français) 5, 6, 7 décembre (2 places disponibles) Core Development Pac...

  11. CERN Management & Communication Training programme

    CERN Multimedia

    2007-01-01

    Calendar of courses for November to December 2007Calendrier des cours prévus de novembre à décembre 2007 Please check our Web site to find out the number of places available which may vary.Veuillez consulter notre site Web pour connaître le nombre de places disponibles qui peut varier. Managing Teams (English) 13, 14, 15 November (Full) Communicating effectively - residential (Bilingual) 20, 21, 22 November (Full) FP7 Training - How to Negotiate and Administer Framework 7 Grant Agreements (English) 21 November (12 places available) Core Development Package for new Supervisors and Section leaders (MARS exercise) (English) 20, 21, 22 November (Full) Core Development Package for new Supervisors and Section leaders (MARS exercise) (français) 5, 6, 7 décembre (4 places disponibles) Core Development Pa...

  12. Self-management education programmes for osteoarthritis.

    Science.gov (United States)

    Kroon, Féline P B; van der Burg, Lennart R A; Buchbinder, Rachelle; Osborne, Richard H; Johnston, Renea V; Pitt, Veronica

    2014-01-15

    Self-management education programmes are complex interventions specifically targeted at patient education and behaviour modification. They are designed to encourage people with chronic disease to take an active self-management role to supplement medical care and improve outcomes. To assess the effectiveness of self-management education programmes for people with osteoarthritis. The Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, PyscINFO, SCOPUS and the World Health Organization (WHO) International Clinical Trial Registry Platform were searched, without language restriction, on 17 January 2013. We checked references of reviews and included trials to identify additional studies. Randomised controlled trials of self-management education programmes in people with osteoarthritis were included. Studies with participants receiving passive recipients of care and studies comparing one type of programme versus another were excluded. In addition to standard methods we extracted components of the self-management interventions using the eight domains of the Health Education Impact Questionnaire (heiQ), and contextual and participant characteristics using PROGRESS-Plus and the Health Literacy Questionnaire (HLQ). Outcomes included self-management of osteoarthritis, participant's positive and active engagement in life, pain, global symptom score, self-reported function, quality of life and withdrawals (including dropouts and those lost to follow-up). We assessed the quality of the body of evidence for these outcomes using the GRADE approach. We included twenty-nine studies (6,753 participants) that compared self-management education programmes to attention control (five studies), usual care (17 studies), information alone (four studies) or another intervention (seven studies). Although heterogeneous, most interventions included elements of skill and technique acquisition (94%), health-directed activity (85%) and self-monitoring and insight (79

  13. CLOCK gene is implicated in weight reduction in obese patients participating in a dietary programme based on the Mediterranean diet

    Science.gov (United States)

    Introduction: The success of obesity therapy is dependent on the genetic background of the patient. Circadian Locomotor Output Cycles Kaput (CLOCK), one of the transcription factors from the positive limb of the molecular clock, is involved in metabolic alterations. Objective: To investigate whethe...

  14. Ineffective programme management on the delivery of health ...

    African Journals Online (AJOL)

    Ineffective programme management on the delivery of health infrastructure projects: A case of the Northern Cape. Peer reviewed and revised. Abstract. Programme management remains a challenging management practice in the Northern Cape. Department of Health (NCDoH), particularly when a health facility project has ...

  15. programme

    African Journals Online (AJOL)

    Aid for AIDS (AfA) is a disease management programme (DIVIPI available to beneficiaries and employees of contracted medical funds and ... the challenges alluded to in the first article, including late enrolment and the measurement of survival, especially in patients with ... I the HIV prevalence and incidence (new infections].

  16. Remote management and programmable automata; Telegestion et automate programmable

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    This document is the proceedings of the meeting organized by the French association of refrigeration (AFF) during the ELEC 2000 exhibition about the measurement, recording, data transmission, automation, diagnosis and management of refrigeration systems. An example of the energy saving made in a supermarket context thanks to the operation control of a refrigerating machinery is presented. (J.S.)

  17. Ineffective programme management on the delivery of health ...

    African Journals Online (AJOL)

    Programme management remains a challenging management practice in the Northern Cape Department of Health (NCDoH), particularly when a health facility project has to integrate the components of construction management and operations management in order to attain the benefits of strategic importance.

  18. Managing nutritional programmes in developing countries.

    Science.gov (United States)

    Sheikholeslam, R; Abdollahi, Z; Haghighi, F N

    2004-11-01

    Improving community nutrition in developing countries requires a detailed epidemiological picture of the prevalent nutritional problems in different regions and age groups. This makes it possible to identify priorities, sensitize policy-makers, establish political commitment and design appropriate community programmes for income generation and education for the best use of food resources. Experiences acquired from community-based nutritional programmes show that ownership of a programme by the community and using a tailor-made approach are essential factors in the successful implementation of programmes. A multifaceted approach is needed, involving a range of sectors-agriculture, commerce, education and health--and commitment at all levels from government to communities and individuals.

  19. A novel power-efficient high-speed clock management unit using quantum-dot cellular automata

    Science.gov (United States)

    Abutaleb, M. M.

    2017-04-01

    Quantum-dot cellular automata (QCA) is one of the most attractive alternatives for complementary metal-oxide semiconductor technology. The QCA widely supports a new paradigm in the field of nanotechnology that has the potential for high density, low power, and high speed. The clock manager is an essential building block in the new microwave and radio frequency integrated circuits. This paper describes a novel QCA-based clock management unit (CMU) that provides innovative clocking capabilities. The proposed CMU is achieved by utilizing edge-triggered D-type flip-flops (D-FFs) in the design of frequency synthesizer and phase splitter. Edge-triggered D-FF structures proposed in this paper have the successful QCA implementation and simulation with the least complexity and power dissipation as compared to earlier structures. The frequency synthesizer is used to generate new clock frequencies from the reference clock frequency based on a combination of power-of-two frequency dividers. The phase splitter is integrated with the frequency synthesizer to generate four clock signals that are 90o out of phase with each other. This paper demonstrates that the proposed QCA CMU structure has a superior performance. Furthermore, the proposed CMU is straightforwardly scalable due to the use of modular component architecture.

  20. A novel power-efficient high-speed clock management unit using quantum-dot cellular automata

    Energy Technology Data Exchange (ETDEWEB)

    Abutaleb, M. M., E-mail: mustafa-abotaleb@h-eng.helwan.edu.eg [Helwan University, Department of Electronics, Communications and Computer Engineering (Egypt)

    2017-04-15

    Quantum-dot cellular automata (QCA) is one of the most attractive alternatives for complementary metal-oxide semiconductor technology. The QCA widely supports a new paradigm in the field of nanotechnology that has the potential for high density, low power, and high speed. The clock manager is an essential building block in the new microwave and radio frequency integrated circuits. This paper describes a novel QCA-based clock management unit (CMU) that provides innovative clocking capabilities. The proposed CMU is achieved by utilizing edge-triggered D-type flip-flops (D-FFs) in the design of frequency synthesizer and phase splitter. Edge-triggered D-FF structures proposed in this paper have the successful QCA implementation and simulation with the least complexity and power dissipation as compared to earlier structures. The frequency synthesizer is used to generate new clock frequencies from the reference clock frequency based on a combination of power-of-two frequency dividers. The phase splitter is integrated with the frequency synthesizer to generate four clock signals that are 90{sup o} out of phase with each other. This paper demonstrates that the proposed QCA CMU structure has a superior performance. Furthermore, the proposed CMU is straightforwardly scalable due to the use of modular component architecture.

  1. Management training programmes: the influence of managerial ...

    African Journals Online (AJOL)

    The findings of the study revealed that managerial status had significantly influenced learning effectiveness. Also, old managers learn more than the young manager on psychological issues, such as stress management, workers motivation and career development. Male managers were found to be more responsive to ...

  2. Financial aspects of veterinary herd health management programmes.

    Science.gov (United States)

    Ifende, V I; Derks, M; Hooijer, G A; Hogeveen, H

    2014-09-06

    Veterinary herd health management (VHHM) programmes have been shown to be economically effective in the past. However, no current information is available on costs and benefits of these programmes. This study compared economics and farm performance between participants and non-participants in VHHM programmes in 1013 dairy farms with over 40 cows. Milk Production Registration (MPR) data and a questionnaire concerning VHHM were used. Based on the level of participation in VHHM (as indicated in the questionnaire), costs of the programmes were calculated using a normative model. The economic value of the production effects was similarly calculated using normative modelling based on MPR data. Participants in VHHM had a better performance with regard to production, but not with regard to reproduction. Over 90 per cent of the VHHM participants were visited at least once every six weeks and most participants discussed at least three topics. In most farms, the veterinarian did the pregnancy checks as part of the VHHM programmes. There was a benefit to cost ratio of about five per cow per year for VHHM participants, and a mean difference in net returns of €30 per cow per year after adjusting for the cost of the programme. This portrays that participation in a VHHM programme is cost-efficient. There is, however, much unexplained variation in the net returns, possibly due to diverse approaches by veterinarians towards VHHM or by other factors not included in this analysis, like nutritional quality or management abilities of the farmer. British Veterinary Association.

  3. Page 1 Management of the Indian space programme 299 major ...

    Indian Academy of Sciences (India)

    tenure, or due to the better programme management systems? Or the better promotion avenues for ST personnel in ISRO'? Or due to availability of progressive and flexible administrative, financial and purchase rules in ISRo? Or, if a combination of these, in what proportion? An analysis of the Schedule management of the ...

  4. Guide to Effective Purchasing. Operational Management Programme.

    Science.gov (United States)

    Frediani, Pam

    This manual is intended to help create and sustain good relations between purchasers and suppliers of foods and related products. It is designed to guide anyone involved in the purchasing function: purchasing officers and managers in medium and large establishments, food and beverage managers, catering managers, chefs, caterers, restaurateurs,…

  5. TEACHING METHODS IN MBA AND LIFELONG LEARNING PROGRAMMES FOR MANAGERS

    Directory of Open Access Journals (Sweden)

    Jarošová, Eva

    2017-09-01

    Full Text Available Teaching methods in MBA and Lifelong Learning Programmes (LLP for managers should be topically relevant in terms of content as well as the teaching methods used. In terms of the content, the integral part of MBA and Lifelong Learning Programmes for managers should be the development of participants’ leadership competencies and their understanding of current leadership concepts. The teaching methods in educational programmes for managers as adult learners should correspond to the strategy of learner-centred teaching that focuses on the participants’ learning process and their active involvement in class. The focus on the participants’ learning process also raises questions about whether the programme’s participants perceive the teaching methods used as useful and relevant for their development as leaders. The paper presents the results of the analysis of the responses to these questions in a sample of 54 Czech participants in the MBA programme and of lifelong learning programmes at the University of Economics, Prague. The data was acquired based on written or electronically submitted questionnaires. The data was analysed in relation to the usefulness of the teaching methods for understanding the concepts of leadership, leadership skills development as well as respondents’ personal growth. The results show that the respondents most valued the methods that enabled them to get feedback, activated them throughout the programme and got them involved in discussions with others in class. Implications for managerial education practices are discussed.

  6. Final report. The Watercourse Management Programme; Sluttrapport. Vassdragsdriftprogrammet

    Energy Technology Data Exchange (ETDEWEB)

    Skarboevik, Eva; Berg, Gry; Faugli, Per Einar

    1997-10-01

    In Norway, there was a need to provide quick answers to questions related to the management and use of river systems. To this end, the Norwegian Water Resources and Energy Administration (NVE) in 1988-1994 conducted the research and development programme described in this report. In the mid-eighties, river management came into focus. The importance of coordination, multi-use planning and multi-use assessments was constantly being stressed and the natural environment, recreation and health were incorporated into the decision-making processes. The programme has contributed to the Norwegian section of the UNESCO project Flow Regimes from International Experimental and Network Data (FRIEND). 4 figs., 1 tab.

  7. A Task Focused Management Development Programme.

    Science.gov (United States)

    Owen, Martin

    1993-01-01

    Describes a management-development program aimed at developing managerial skills and responsibilities across the whole staff of a Welsh secondary school. Explains the reasons for possible antipathy to this inservice training topic. The project used teachers' current managerial tasks so that teachers, in conjunction with self-study materials, could…

  8. Management of Adult Education Programme in Abia State, Nigeria ...

    African Journals Online (AJOL)

    Adult Education is the instruction or controlled experiences for the mature person so that he/she may attain social, economic, cultural, political or technical competence or individual development. The importance of management in adult education programme cannot be over emphasized because of the vital role it plays in ...

  9. Developing a national programme of flood risk management measures: Moldova

    Directory of Open Access Journals (Sweden)

    Ramsbottom David

    2016-01-01

    Full Text Available A Technical Assistance project funded by the European Investment Bank has been undertaken to develop a programme of flood risk management measures for Moldova that will address the main shortcomings in the present flood management system, and provide the basis for long-term improvement. Areas of significant flood risk were identified using national hydraulic and flood risk modelling, and flood hazard and flood risk maps were then prepared for these high risk areas. The flood risk was calculated using 12 indicators representing social, economic and environmental impacts of flooding. Indicator values were combined to provide overall estimates of flood risk. Strategic approaches to flood risk management were identified for each river basin using a multi-criteria analysis. Measures were then identified to achieve the strategic approaches. A programme of measures covering a 20-year period was developed together with a more detailed Short-Term Investment Plan covering the first seven years of the programme. Arrangements are now being made to implement the programme. The technical achievements of the project included national hydrological and hydraulic modelling covering 12,000 km of river, the development of 2-dimensional channel and floodplain hydraulic models from a range of topographic and bathymetric data, and an integrated flood risk assessment that takes account of both economic and non-monetary impacts.

  10. Discussion forum: management of population education programmes.

    Science.gov (United States)

    1984-01-01

    This discussion adopts a relatively simple management process, which consists of the elements of planning, organization, direction, and control, as the basis for analyzing management activities of population education programs. Each of these elements is analyzed in the context of programming, implementing, and evaluating country programs in population education. The planning process that applies well to population education is that of working out a scheme, a method of design for the attainment of an objective. This involves identifying what is to be done, when, and how; defining objectives; choosing from alternatives; and making a plan of action and communication. A few country programs in population education in Asia are lagging behind the realization of project objectives in part because the organizational scheme has been taken for granted. Specific problem areas include: facilities, equipment, and staff; grouping component jobs; structure of authority; methods and procedures; and selection and training of staff. Despite these problem areas, it is believed that the organization of population education could be enhanced if the following 2 aspects are taken care of: dividing labor and allocationg workloads to individuals as well as groups of individuals; and establishing lines of communication, influence, and authority among individuals and groups of individuals handling allotted work loads to ensure the coordination of their activities in relation to give objective. The soundness of a population education program hinges on efficiency, effectiveness, and continuity. Direction includes motivation, supervision, and coordination, all of which are applicalbe to population education. Direction consists of setting a detailed time and cost framework, initiating and providing leadership in carrying out plans by making decisiions, issuing specific instructions, and guilding, motivating, and supervising. Control consists of evaluation of performance compared to plan

  11. Chronic disease management programmes for adults with asthma.

    Science.gov (United States)

    Peytremann-Bridevaux, Isabelle; Arditi, Chantal; Gex, Grégoire; Bridevaux, Pierre-Olivier; Burnand, Bernard

    2015-05-27

    The burden of asthma on patients and healthcare systems is substantial. Interventions have been developed to overcome difficulties in asthma management. These include chronic disease management programmes, which are more than simple patient education, encompassing a set of coherent interventions that centre on the patients' needs, encouraging the co-ordination and integration of health services provided by a variety of healthcare professionals, and emphasising patient self-management as well as patient education. To evaluate the effectiveness of chronic disease management programmes for adults with asthma. Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Effective Practice and Organisation of Care (EPOC) Group Specialised Register, MEDLINE (MEDLINE In-Process and Other Non-Indexed Citations), EMBASE, CINAHL, and PsycINFO were searched up to June 2014. We also handsearched selected journals from 2000 to 2012 and scanned reference lists of relevant reviews. We included individual or cluster-randomised controlled trials, non-randomised controlled trials, and controlled before-after studies comparing chronic disease management programmes with usual care in adults over 16 years of age with a diagnosis of asthma. The chronic disease management programmes had to satisfy at least the following five criteria: an organisational component targeting patients; an organisational component targeting healthcare professionals or the healthcare system, or both; patient education or self-management support, or both; active involvement of two or more healthcare professionals in patient care; a minimum duration of three months. After an initial screen of the titles, two review authors working independently assessed the studies for eligibility and study quality; they also extracted the data. We contacted authors to obtain missing information and additional data, where necessary. We pooled results using the random-effects model and reported the pooled mean or

  12. Appendix: Data management and data archive for the HYREX Programme

    Directory of Open Access Journals (Sweden)

    A. M. Roberts

    2000-01-01

    Full Text Available Since the mid 1980s, changes in political imperatives plus technological changes in computer hardware and software have heightened the awareness of the economic value and importance of quality datasets to scientific research. The Natural Environment Research Council’s (NERC interdisciplinary Thematic and Special Topic Programmes have highlighted the need for a coherent data management policy to provide and preserve these quality datasets for posterity. The Hydrological Radar EXperiment (HYREX Special Topic Programme brought together multi-disciplinary researchers from UK public sector laboratories and universities. In this paper, the HYREX data management strategy, its problems and its solutions are discussed. The HYREX data archive, situated at NERC’s British Atmospheric Data Centre, is described. Keywords: radar, data, archive, web, storm, flood

  13. Disease management programme for diabetes mellitus in Nepal.

    Science.gov (United States)

    Dulal, R K; Karki, S

    2009-01-01

    The prevalence of diabetes in elderly is being out-numbered and continuously rising. Individuals expect miracles from their health care providers as everything is curable in the eyes of the patient. Disease Management Programme for diabetes mellitus is sensible from the medical and economic point of view since it organizes care in multidisciplinary, multicomponent, proactive approach focusing on the whole course of a disease, using evidence-based standards of care that reduce health care costs and hospital stay. In Nepal, health care professionals today need to be aware that the patients are more and more aware about their disease and technology and their increased awareness demand innovative services. Authenticated data used for the purpose of projection were drawn purely from urban or rural hospital-based. To estimate the prevalence of diabetes mellitus (DM), the data in pairs (i.e. prevalence and year) were fed into IDL - an inbuilt mathematical software program for best-fit regression. Literatures on DM prevalence and Disease Management Programme were examined. The overall projection for the DM prevalence in Nepal suggests that the prevalence of diagnosed DM will be 12.73%, 15.11% and 17.49% in 2010, 2015 and 2020 respectively. Diabetes disease management programme appeared to be helpful in reduction of health care costs and hospital stay. If the attributing factor for DM remains as it is today, many new cases of DM will be added each year. There is a need of effective disease management programme in the country. The increased level of awareness among the patients demands innovative services in future.

  14. Effective Management Tools in Implementing Operational Programme Administrative Capacity Development

    Directory of Open Access Journals (Sweden)

    Carmen – Elena DOBROTĂ

    2015-12-01

    Full Text Available Public administration in Romania and the administrative capacity of the central and local government has undergone a significant progress since 2007. The development of the administrative capacity deals with a set of structural and process changes that allow governments to improve the formulation and implementation of policies in order to achieve enhanced results. Identifying, developing and using management tools for a proper implementation of an operational programme dedicated to consolidate a performing public administration it was a challenging task, taking into account the types of interventions within Operational Programme Administrative Capacity Development 2007 – 2013 and the continuous changes in the economic and social environment in Romania and Europe. The aim of this article is to provide a short description of the approach used by the Managing Authority for OPACD within the performance management of the structural funds in Romania between 2008 and 2014. The paper offers a broad image of the way in which evaluations (ad-hoc, intermediate and performance were used in different stages of OP implementation as a tool of management.

  15. Developing Researching Managers and Relevant Research--The "Executive Research Programme"

    Science.gov (United States)

    Werr, Andreas; Strannegård, Lars

    2014-01-01

    The current paper argues for bridging the "relevance gap" in management research and education by creating educational programmes that bring together experienced managers and management researchers. In the "Executive Research Programme" discussed in this paper, managers were paired up with researchers to conduct a collaborative…

  16. Impact of an occupation-based self-management programme on chronic disease management.

    LENUS (Irish Health Repository)

    O'Toole, Lynn

    2013-02-01

    There is a need for the development and evaluation of occupational therapy interventions enabling participation and contributing to self-management for individuals with multiple chronic conditions. This pilot study aimed to assess the feasibility and potential impact of an occupation-based self-management programme for community living individuals with multiple chronic conditions.

  17. Management of Industrial Processes with Programmable Logic Controller

    Directory of Open Access Journals (Sweden)

    Marius Tufoi

    2009-10-01

    Full Text Available In a modern economy, automation (the control is primarily to raise the competitiveness of a product, either directly through price or quality, or indirectly through the improvement of working conditions of staff productive. The control of industrial processes involves the management of dynamic systems that have continuous states. These systems are described by differential equations and, in general, analog inputs and outputs. Management of these systems is achieved, in general, with classical automation, by automation or with analog computers which contains modules with input / output analog performance. If states, inputs and outputs of a system can be modeled using binary variables, then these systems can be driven with Programmable Logic Controller.

  18. Chronic Disease Management Programmes: an adequate response to patients' needs?

    Science.gov (United States)

    Rijken, Mieke; Bekkema, Nienke; Boeckxstaens, Pauline; Schellevis, François G; De Maeseneer, Jan M; Groenewegen, Peter P

    2014-10-01

    Inspired by American examples, several European countries are now developing disease management programmes (DMPs) to improve the quality of care for patients with chronic diseases. Recently, questions have been raised whether the disease management approach is appropriate to respond to patient-defined needs. In this article we consider the responsiveness of current European DMPs to patients' needs defined in terms of multimorbidity, functional and participation problems, and self-management. Information about existing DMPs was derived from a survey among country-experts. In addition, we made use of international scientific literature. Most European DMPs do not have a solid answer yet to the problem of multimorbidity. Methods of linking DMPs, building extra modules to deal with the most prevalent comorbidities and integration of case management principles are introduced. Rehabilitation, psychosocial and reintegration support are not included in all DMPs, and the involvement of the social environment of the patient is uncommon. Interventions tailored to the needs of specific social or cultural patient groups are mostly not available. Few DMPs provide access to individualized patient information to strengthen self-management, including active engagement in decision making. To further improve the responsiveness of DMPs to patients' needs, we suggest to monitor 'patient relevant outcomes' that might be based on the ICF-model. To address the needs of patients with multimorbidity, we propose a generic comprehensive model, embedded in primary care. A goal-oriented approach provides the opportunity to prioritize goals that really matter to patients. © 2012 John Wiley & Sons Ltd.

  19. Randomized controlled trial of a lay-facilitated angina management programme

    OpenAIRE

    Furze, Gill; Cox, Helen; Morton, Veronica; Chuang, Ling-Hsiang; Lewin, Robert JP; Nelson, Pauline; Carty, Richard; Norris, Heather; Patel, Nicky; Elton, Peter

    2012-01-01

    Aims This article reports a randomized controlled trial of lay-facilitated angina management (registered trial acronym: LAMP). Background Previously, a nurse-facilitated angina programme was shown to reduce angina while increasing physical activity, however most people with angina do not receive a cardiac rehabilitation or self-management programme. Lay people are increasingly being trained to facilitate self-management programmes. Design A randomized controlled trial comparing a lay-facilita...

  20. [Health locus of control of patients in disease management programmes].

    Science.gov (United States)

    Schnee, M; Grikscheit, F

    2013-06-01

    Health locus of control beliefs plays a major role in improving self-management skills of the chronically ill - a main goal in disease management programmes (DMP). This study aims at characterising participants in disease management regarding their health locus of control. Data are based on 4 cross-sectional postal surveys between spring and autumn of 2006 and 2007 within the Health Care Monitor of the Bertelsmann Foundation. Among the 6 285 respondents, 1 266 are chronically ill and not enrolled in a DMP and 327 are participating in a DMP. A high internal locus of control (HLC) occurs significantly less often in DMP patients than in normal chronically ill patients (and healthy people) controlling for age, gender and social class. With increasing age, a high internal locus of control is also significantly less likely. When comparing healthy people, the chronically ill and the DMP participants a social gradient of a high internal locus of control belief can be observed. The weaker internal and higher doctor-related external locus of control of DMP participants should be carefully observed by the physician when trying to strengthen the patients' self-management skills. Evaluators of DMP should take into account the different baselines of DMP patients and relevant control groups and incorporate these differences into the evaluation. © Georg Thieme Verlag KG Stuttgart · New York.

  1. A Masters Programme in Telecommunications Management--Demand-Based Curriculum Design

    Science.gov (United States)

    Gharaibeh, Khaled M.; Kaylani, Hazem; Murphy, Noel; Brennan, Conor; Itradat, Awni; Al-Bataineh, Mohammed; Aloqlah, Mohammed; Salhieh, Loay; Altarazi, Safwan; Rawashdeh, Nathir; del Carmen Bas Cerdá, María; Conchado Peiró, Andrea; Al-Zoubi, Asem; Harb, Bassam; Bany Salameh, Haythem

    2015-01-01

    This paper presents a curriculum design approach for a Masters Programme in Telecommunications Management based on demand data obtained from surveying the needs of potential students of the proposed programme. Through online surveys disseminated at telecom companies in Jordan, it was possible to measure the demand for such a programme and to…

  2. Improving Educational Objectives of the Industrial and Management Systems Engineering Programme at Kuwait University

    Science.gov (United States)

    Aldowaisan, Tariq; Allahverdi, Ali

    2016-01-01

    This paper describes the process of developing programme educational objectives (PEOs) for the Industrial and Management Systems Engineering programme at Kuwait University, and the process of deployment of these PEOs. Input of the four constituents of the programme, faculty, students, alumni, and employers, is incorporated in the development and…

  3. Health Management Information System in Leprosy Control Programme.

    Science.gov (United States)

    Yellapurkar, M V

    1984-01-01

    Health Management Information System was introduced methodically and enforced with ruthless punctuality in Maharashtra State from April 1981. It has paid excellent dividends so far as the implementation of the National Leprosy Control Programme is concerned. Key indicators have been fixed for new case detection, bacteriological examination, regularity of treatment and screening of old patients for activity status. Monitoring of these activities is done regularly and a feed back is provided. Marks are assigned for each kidney indicator and ranking is done based on the achievement of targets by each district, Municipal Corporation, Health Circle etc., every month. The same procedure is adopted at Primary Health Centre and even lower level. This has introduced a spirit of competition and generated a desire to better one's own performance by identifying and removing deficiencies. Maximum assistance is being derived from the Primary Health Care and use is being made of Multi Purpose Workers, Community Health Volunteers and other anciliary agencies in case finding and case holding programmes. The improvement in performance in respect of all key indicators during 1981-82 has been between 40 and 60 percent over the performance during 1980-81.

  4. Towards flexible programmes in higher professional education: An operations-management approach.

    NARCIS (Netherlands)

    Schellekens, Ad

    2007-01-01

    Schellekens, A. (2004). Towards flexible programmes in higher professional education: An operations-management approach. Unpublished doctoral dissertation, Open University of the Netherlands, The Netherlands.

  5. Evaluating disease management programme effectiveness: an introduction to instrumental variables.

    Science.gov (United States)

    Linden, Ariel; Adams, John L

    2006-04-01

    This paper introduces the concept of instrumental variables (IVs) as a means of providing an unbiased estimate of treatment effects in evaluating disease management (DM) programme effectiveness. Model development is described using zip codes as the IV. Three diabetes DM outcomes were evaluated: annual diabetes costs, emergency department (ED) visits and hospital days. Both ordinary least squares (OLS) and IV estimates showed a significant treatment effect for diabetes costs (P = 0.011) but neither model produced a significant treatment effect for ED visits. However, the IV estimate showed a significant treatment effect for hospital days (P = 0.006) whereas the OLS model did not. These results illustrate the utility of IV estimation when the OLS model is sensitive to the confounding effect of hidden bias.

  6. Decamp Clock Board Firmware

    Energy Technology Data Exchange (ETDEWEB)

    Vicente, J. de; Castilla, J.; Martinez, G.

    2007-09-27

    Decamp (Dark Energy Survey Camera) is a new instrument designed to explore the universe aiming to reveal the nature of Dark Energy. The camera consists of 72 CCDs and 520 Mpixels. The readout electronics of DECam is based on the Monsoon system. Monsoon is a new image acquisition system developed by the NOAO (National Optical Astronomical Observatory) for the new generation of astronomical cameras. The Monsoon system uses three types of boards inserted in a Eurocard format based crate: master control board, acquisition board and clock board. The direct use of the Monsoon system for DECam readout electronics requires nine crates mainly due to the high number of clock boards needed. Unfortunately, the available space for DECam electronics is constrained to four crates at maximum. The major drawback to achieve such desired compaction degree resides in the clock board signal density. This document describes the changes performed at CIEMAT on the programmable logic of the Monsoon clock board aiming to meet such restricted space constraints. (Author) 5 refs.

  7. The management of cardiovascular disease in the Netherlands: analysis of different programmes

    OpenAIRE

    Jane M. Cramm; Apostolos Tsiachristas; Bethany H Walters; Samantha A Adams; Roland Bal; Robbert Huijsman; Maureen P.M.H. Rutten-Van Mölken; Anna P Nieboer

    2013-01-01

    Background: Disease management programmes are increasingly used to improve the efficacy and effectiveness of chronic care delivery.But, disease management programme development and implementation is a complex undertaking that requires effective decision-making.Choices made in the earliest phases of programme development are crucial, as they ultimately impact costs, outcomes and sustainability.Methods: To increase our understanding of the choices that primary healthcare practices face when imp...

  8. Evaluation of a communication and stress management training programme for infertile couples

    DEFF Research Database (Denmark)

    Schmidt, Lone; Tjørnhøj-Thomsen, Tine; Boivin, Jackey

    2005-01-01

    This study evaluates a patient education programme focussed on improving communication and stress management skills among couples in fertility treatment.......This study evaluates a patient education programme focussed on improving communication and stress management skills among couples in fertility treatment....

  9. Cost Analysis of Chronic Disease Self-Management Programmes Being Delivered in South Florida

    Science.gov (United States)

    Page, Timothy F.; Palmer, Richard C.

    2014-01-01

    Background: Chronic disease accounts for the majority of healthcare costs. The Chronic Disease Self-Management Programme (CDSMP) has been shown to be effective in reducing the burden of chronic disease. Objectives: The objective of this study was to measure the cost of delivering the Chronic Disease Self-Management Programme (CDSMP) in order to…

  10. The Management of innovation: Lessons from a Danish Development Programme

    DEFF Research Database (Denmark)

    Clausen, Lennie

    1997-01-01

    The paper reports from an ongoing Danish development programme entitled "Process and Product Development in the Building Industry". The programme is a joint initiatvie, initiated by the Ministry of Housing and Building and the Ministry of Busines and Industry. In a competition in 1994 four consor...

  11. The management of cardiovascular disease in the Netherlands: analysis of different programmes

    Directory of Open Access Journals (Sweden)

    Jane M. Cramm

    2013-08-01

    Full Text Available Background: Disease management programmes are increasingly used to improve the efficacy and effectiveness of chronic care delivery.But, disease management programme development and implementation is a complex undertaking that requires effective decision-making.Choices made in the earliest phases of programme development are crucial, as they ultimately impact costs, outcomes and sustainability. Methods: To increase our understanding of the choices that primary healthcare practices face when implementing such programmes and to stimulate successful implementation and sustainability, we compared the early implementation of eight cardiovascular disease management programmes initiated and managed by healthcare practices in various regions of the Netherlands. Using a mixed-methods design, we identified differences in and challenges to programme implementation in terms of context, patient characteristics, disease management level, healthcare utilisation costs, development costs and health-related quality of life. Results: Shifting to a multidisciplinary, patient-centred care pathway approach to disease management is demanding for organisations, professionals and patients, and is especially vulnerable when sustainable change is the goal. Funding is an important barrier to sustainable implementation of cardiovascular disease management programmes, although development costs of the individual programmes varied considerably in relation to the length of the development period. The large number of professionals involved in combination with duration of programme development was the largest cost drivers. While Information and Communication Technology systems to support the new care pathways did not directly contribute to higher costs, delays in implementation indirectly did. Conclusions: Developing and implementing cardiovascular disease management programmes is time-consuming and challenging. Multidisciplinary, patient-centred care demands multifaceted changes

  12. The management of cardiovascular disease in the Netherlands: analysis of different programmes.

    Science.gov (United States)

    Cramm, Jane M; Tsiachristas, Apostolos; Walters, Bethany H; Adams, Samantha A; Bal, Roland; Huijsman, Robbert; Rutten-Van Mölken, Maureen P M H; Nieboer, Anna P

    2013-01-01

    Disease management programmes are increasingly used to improve the efficacy and effectiveness of chronic care delivery. But, disease management programme development and implementation is a complex undertaking that requires effective decision-making. Choices made in the earliest phases of programme development are crucial, as they ultimately impact costs, outcomes and sustainability. To increase our understanding of the choices that primary healthcare practices face when implementing such programmes and to stimulate successful implementation and sustainability, we compared the early implementation of eight cardiovascular disease management programmes initiated and managed by healthcare practices in various regions of the Netherlands. Using a mixed-methods design, we identified differences in and challenges to programme implementation in terms of context, patient characteristics, disease management level, healthcare utilisation costs, development costs and health-related quality of life. Shifting to a multidisciplinary, patient-centred care pathway approach to disease management is demanding for organisations, professionals and patients, and is especially vulnerable when sustainable change is the goal. Funding is an important barrier to sustainable implementation of cardiovascular disease management programmes, although development costs of the individual programmes varied considerably in relation to the length of the development period. The large number of professionals involved in combination with duration of programme development was the largest cost drivers. While Information and Communication Technology systems to support the new care pathways did not directly contribute to higher costs, delays in implementation indirectly did. Developing and implementing cardiovascular disease management programmes is time-consuming and challenging. Multidisciplinary, patient-centred care demands multifaceted changes in routine care. As care pathways become more complex, they

  13. The management of cardiovascular disease in the Netherlands: analysis of different programmes

    Directory of Open Access Journals (Sweden)

    Jane M. Cramm

    2013-08-01

    Full Text Available Background: Disease management programmes are increasingly used to improve the efficacy and effectiveness of chronic care delivery.But, disease management programme development and implementation is a complex undertaking that requires effective decision-making.Choices made in the earliest phases of programme development are crucial, as they ultimately impact costs, outcomes and sustainability.Methods: To increase our understanding of the choices that primary healthcare practices face when implementing such programmes and to stimulate successful implementation and sustainability, we compared the early implementation of eight cardiovascular disease management programmes initiated and managed by healthcare practices in various regions of the Netherlands. Using a mixed-methods design, we identified differences in and challenges to programme implementation in terms of context, patient characteristics, disease management level, healthcare utilisation costs, development costs and health-related quality of life.Results: Shifting to a multidisciplinary, patient-centred care pathway approach to disease management is demanding for organisations, professionals and patients, and is especially vulnerable when sustainable change is the goal. Funding is an important barrier to sustainable implementation of cardiovascular disease management programmes, although development costs of the individual programmes varied considerably in relation to the length of the development period. The large number of professionals involved in combination with duration of programme development was the largest cost drivers. While Information and Communication Technology systems to support the new care pathways did not directly contribute to higher costs, delays in implementation indirectly did.Conclusions: Developing and implementing cardiovascular disease management programmes is time-consuming and challenging. Multidisciplinary, patient-centred care demands multifaceted changes in

  14. The management of cardiovascular disease in the Netherlands: analysis of different programmes

    Science.gov (United States)

    Cramm, Jane M.; Tsiachristas, Apostolos; Walters, Bethany H.; Adams, Samantha A.; Bal, Roland; Huijsman, Robbert; Rutten-Van Mölken, Maureen P.M.H.; Nieboer, Anna P.

    2013-01-01

    Background Disease management programmes are increasingly used to improve the efficacy and effectiveness of chronic care delivery. But, disease management programme development and implementation is a complex undertaking that requires effective decision-making. Choices made in the earliest phases of programme development are crucial, as they ultimately impact costs, outcomes and sustainability. Methods To increase our understanding of the choices that primary healthcare practices face when implementing such programmes and to stimulate successful implementation and sustainability, we compared the early implementation of eight cardiovascular disease management programmes initiated and managed by healthcare practices in various regions of the Netherlands. Using a mixed-methods design, we identified differences in and challenges to programme implementation in terms of context, patient characteristics, disease management level, healthcare utilisation costs, development costs and health-related quality of life. Results Shifting to a multidisciplinary, patient-centred care pathway approach to disease management is demanding for organisations, professionals and patients, and is especially vulnerable when sustainable change is the goal. Funding is an important barrier to sustainable implementation of cardiovascular disease management programmes, although development costs of the individual programmes varied considerably in relation to the length of the development period. The large number of professionals involved in combination with duration of programme development was the largest cost drivers. While Information and Communication Technology systems to support the new care pathways did not directly contribute to higher costs, delays in implementation indirectly did. Conclusions Developing and implementing cardiovascular disease management programmes is time-consuming and challenging. Multidisciplinary, patient-centred care demands multifaceted changes in routine care. As

  15. [Essential issues for project management and quality control in the national schistosomiasis control programme of China].

    Science.gov (United States)

    Zhou, Xiao-Nong; Li, Shi-Zhu

    2012-08-01

    Based on theoretic management and quality control of the project, this paper summarizes the 3 major management modes in the national schistosomiasis control programme of China, and the health system management mechanisms under the guidance of national legislation, national programme and national standard and regulation. It is revealed that scientific assessment and assurance of the quality of each control programme is one of the highlighted concerns in the management mode of schistosomiasis control in China after a case study on mollusciciding project. Therefore, it is recommended that the actions, including management of every step in the project management of schistosomiasis control, formulation of operation procedure for each control programme and standardization of the working flow for professional staff, are not only a prerequistite to achievment-based evaluation, but also the key to ensure the quality of every control intervention and present the actual control effect.

  16. POST GRADUATE PROGRAMME IN DIETETICS &FOOD SERVICE MANAGEMENT (MSCDFSM PROGRAMME of IGNOU: Access through the Lucknow Regional Centre

    Directory of Open Access Journals (Sweden)

    J. S. DOROTHY

    2014-10-01

    Full Text Available Indira Gandhi National Open University (IGNOU which was established initially as a Single mode Distance Teaching Institution (DTI in the year 1985 opened its campus to face-to-face education in the year 2008 and thus now is a Dual mode Distance Teaching Institution (DTI. The Post Graduate Programme (Master of Science in Dietetics and Food Service Management (MScDFSM Programme of IGNOU offered through the Distance Learning Mode from the year 2005 has been the boon in developing human resources involved in Nutrition and Dietetics services and also serves as a mode for continuing education among the professionals on-the-job. Accessibility to the programme is independent of the qualification earned at the Bachelor’s level as at IGNOU flexibility of the qualification is ensured for fulfilling the eligibility criteria into the MScDFSM Programme so that the diverse needs of the aspirants are accommodated at entry level itself. The Programme is unique in that it has compulsory Dissertation and Internship besides the Theory and Practical Courses. The Self-Study is enriched by the Teacher inbuilt Self-instructional Study Materials coupled with compulsory submission of the Tutor Marked Assignments (TMA which phase learning and initiate the didactic communication between the Academic Counsellor (who facilitate the Academic Transactions at the field level functionary - the Learner Support Centre and the Learner. The MSc DFSM Programme of IGNOU, as the distance learning programme offered by the School of Continuing Education (SOCE of IGNOU in the Indian Sub-Continent only. This paper discusses how the MScDFSM Programme of IGNOU is contributing to the staff development of in-service Nutritionists and Dietitians through the distance education/learning mode in Lucknow (Uttar Pradesh, North India Regional Centre. This paper also highlights the Institutions, which served as the Learner Support Centres from the year 2005 (when the programme was launched till 2011

  17. Navigating the Turbulent Waters of Academia: The Leadership Role of Programme Managers

    Science.gov (United States)

    Vilkinas, Tricia; Cartan, Greg

    2015-01-01

    The focus of our paper is the leadership role of programme managers in the higher education sector. In particular, we highlight the complex and paradoxical nature of the programme leader's role, and provide an insight into leadership in this challenging and dynamic environment. We identify cognitive and behavioural complexity as necessary…

  18. Teacher Education Programmes and Their Contribution to Student Teacher Efficacy in Classroom Management and Pupil Engagement

    Science.gov (United States)

    Christophersen, Knut A.; Elstad, Eyvind; Turmo, Are; Solhaug, Trond

    2016-01-01

    This study focuses on how different educational programmes contribute to student teachers efficacy for classroom management and their abilities to provide learning opportunities and good classroom outcomes. Data were gathered from 491 student teachers attending different teacher education programmes in Norway and analysed via structural equation…

  19. Cost-Effectiveness of a Community-Based Exercise Programme in COPD Self-Management

    NARCIS (Netherlands)

    Zwerink, Marlies; Effing, Tanja; Kerstjens, Huib A. M.; van der Valk, Paul; Brusse-Keizer, Marjolein; van der Palen, Job

    2016-01-01

    Introduction: Information regarding cost-effectiveness of community-based exercise programmes in COPD is scarce. Therefore, we have investigated whether a community-based exercise programme is a cost-effective component of self-management for patients with COPD after 2 years of follow-up. Methods:

  20. Continuous Improvement in the Industrial and Management Systems Engineering Programme at Kuwait University

    Science.gov (United States)

    Aldowaisan, Tariq; Allahverdi, Ali

    2016-01-01

    This paper describes the process employed by the Industrial and Management Systems Engineering programme at Kuwait University to continuously improve the programme. Using a continuous improvement framework, the paper demonstrates how various qualitative and quantitative analyses methods, such as hypothesis testing and control charts, have been…

  1. Managing high-risk patients: the Mass General care management programme

    Directory of Open Access Journals (Sweden)

    Dennis L Kodner

    2015-09-01

    Full Text Available The Massachusetts General Care Management Program (Mass General CMP or CMP was designed as a federally supported demonstration to test the impact of intensive, practice-based care management on high-cost Medicare fee-for-service (FFS beneficiaries—primarily older persons—with multiple hospitalisations and multiple chronic conditions. The Massachusetts General Care Management Program operated over a 6-year period in two phases (3 years each. It started during the first phase at Massachusetts General Hospital, a major academic medical centre in Boston, Massachusetts in collaboration with Massachusetts General Physicians Organisation. During the second phase, the programme expanded to two more affiliated sites in and around the Boston area, including a community hospital, as well as incorporated several modifications primarily focused on the management of transitions to post-acute care in skilled nursing facilities. At the close of the demonstration in July 2012, Mass General Massachusetts General Care Management Program became a component of a new Pioneer accountable care organisation (ACO. The Massachusetts General Care Management Program is focused on individuals meeting defined eligibility criteria who are offered care that is integrated by a case manager embedded in a primary care practice. The demonstration project showed substantial cost savings compared to fee-for-service patients served in the traditional Medicare system but no impact on hospital readmissions. The Massachusetts General Care Management Program does not rest upon a “whole systems” approach to integrated care. It is an excellent example of how an innovative care co-ordination programme can be implemented in an existing health-care organisation without making fundamental changes in its underlying structure or the way in which direct patient care services are paid for. The accountable care organisation version of the Massachusetts General Care Management Program

  2. IMHE-Info. OECD Programme on Institutional Management in Higher Education, July 2006

    Science.gov (United States)

    Lafon, Valerie, Ed.

    2006-01-01

    IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: Higher Education: Quality, Equity and Efficiency. IMHE News, publications of interest and upcoming events are included.

  3. IMHE-Info. OECD Programme on Institutional Management in Higher Education, December 2006

    Science.gov (United States)

    OECD Publishing (NJ1), 2006

    2006-01-01

    IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: Governance on the Agenda. IMHE News, publications of interest and upcoming events are included.

  4. Individual health management - a comprehensive lifestyle counselling programme for health promotion, disease prevention and patient education

    OpenAIRE

    Melchart, Dieter; Eustachi, Axel; Wellenhofer-Li, Yanqing; Doerfler, Wolfgang; Bohnes, Evelin

    2016-01-01

    BACKGROUND Epidemiological data shows globally increasing numbers of obesity and stress-related diseases. In this article, a comprehensive medical lifestyle modification programme - called Individual Health Management (IHM) - is described in detail and discussed as a promising tool to individually manage and reverse such negative health trends in patients. METHODS The IHM programme is based on a blended learning concept. It comprises a 12-week basic training phase, followed by a 9-month maint...

  5. Randomized controlled trial of a lay-facilitated angina management programme.

    Science.gov (United States)

    Furze, Gill; Cox, Helen; Morton, Veronica; Chuang, Ling-Hsiang; Lewin, Robert J P; Nelson, Pauline; Carty, Richard; Norris, Heather; Patel, Nicky; Elton, Peter

    2012-10-01

    This article reports a randomized controlled trial of lay-facilitated angina management (registered trial acronym: LAMP). Previously, a nurse-facilitated angina programme was shown to reduce angina while increasing physical activity, however most people with angina do not receive a cardiac rehabilitation or self-management programme. Lay people are increasingly being trained to facilitate self-management programmes. A randomized controlled trial comparing a lay-facilitated angina management programme with routine care from an angina nurse specialist. Participants with new stable angina were randomized to the angina management programme (intervention: 70 participants) or advice from an angina nurse specialist (control: 72 participants). Primary outcome was angina frequency at 6 months; secondary outcomes at 3 and 6 months included: risk factors, physical functioning, anxiety, depression, angina misconceptions and cost utility. Follow-up was complete in March 2009. Analysis was by intention-to-treat; blind to group allocation. There was no important difference in angina frequency at 6 months. Secondary outcomes, assessed by either linear or logistic regression models, demonstrated important differences favouring the intervention group, at 3 months for: Anxiety, angina misconceptions and for exercise report; and at 6 months for: anxiety; depression; and angina misconceptions. The intervention was considered cost-effective. The angina management programme produced some superior benefits when compared to advice from a specialist nurse. © 2012 Blackwell Publishing Ltd.

  6. Talent Management Programmes at British, American and Canadian Universities: Comparative Study

    Science.gov (United States)

    Boichenko, Maryna

    2015-01-01

    The article deals with the peculiarities of talent management programmes implementation at the top British, American and Canadian universities. The essence of the main concepts of research--talent and talent management--has been revealed. Talent management is referred to as the systematic attraction, identification, development, engagement,…

  7. Critical pedagogy in a health service management development programme: can "critically thinking" managers change the NHS management culture?

    Science.gov (United States)

    Sambrook, Sally

    2009-01-01

    Management development programmes available to NHS managers focus on a performance orientation and sustain a culture of managerial and medical domination. This paper aims to question whether it is possible to consider NHS management development from a critical (empowerment culture) perspective. Features of the critical management studies approach (CMS) are identified. A new MSc is evaluated against these characteristics, examining the teaching and learning processes and students' perceptions of the programme. The aim is to develop critical thinkers who can return to their organizations and challenge existing power structures and practices to change local cultures and enhance health services. Empirical research employed anonymous student questionnaires and a focus group. Student evaluations suggest the MSc can deliver a critical pedagogy and help managers understand issues of power and empowerment, challenge dominant cultures, innovate and effect small, local changes in the NHS culture. There is a need to continue evaluating the programme and include other stakeholders. Longitudinal research should assess the impact of the managers' changed values, attitudes and behaviours on colleagues, clients and the local cultures. The paper identifies some of the tensions of developing "critical" health service managers, and the problems they encounter back in the "uncritical" NHS context, as well as some of the challenges in "facilitating" a critical curriculum. It questions the ethics of developing (or not) a critical perspective in a local context unfamiliar with CMS. Management development in the NHS largely ignores critical pedagogy. This paper makes a small and unique contribution to understanding how developing "critically thinking" managers can challenge the dominant culture. However, the limitations of such a small-scale study and ethical implications are noted.

  8. Employees' perceptions of the Aid-for-AIDS disease-management programme, South Africa.

    Science.gov (United States)

    Rothberg, Alan; Van Huyssteen, Karen

    2008-11-01

    It is estimated that 18-20% of South Africa's more than 5 million HIV-positive individuals are formally employed. Disease management programmes for these employees vary in scope and sophistication, with services provided by the employer, or third-party specialist disease managers, or through medical aid schemes. This study surveyed 215 HIV-positive employees in two organisations contracted to the Aid for AIDS (AfA) disease management programme through their in-house medical aid schemes. The two organisations differed in their overall approach to HIV and AIDS: one mainly relies on on-site access to voluntary counselling and testing (VCT) and AfA's management of registered HIV-positive employees, while the other has invested in and actively developed a comprehensive programme that also extends to families and the community as well as links employees to the AfA programme. Responses received from 28 of the 215 employees surveyed indicate that fear of disclosure of one's HIV status and of stigmatisation are reasons for late registration with the AfA programme or non-utilisation of other available support programmes. Respondents mentioned that confidence in the employer's ability to maintain confidentiality was also an issue. Respondents' important suggestions for change included: a) on-site educational and awareness programmes for management personnel and staff in order to reduce HIV discrimination and stigmatisation; b) information directed at HIV-positive employees publicising the benefits and effectiveness of medical treatment; c) support groups for HIV-positive employees; and d) management personnel to engage with HIV-infected employees who are willing to take an active role in staff education and the development of workplace policies and programmes.

  9. Talent Management Programmes at British, American and Canadian Universities: Comparative Study

    Directory of Open Access Journals (Sweden)

    Boichenko Maryna

    2015-12-01

    Full Text Available The article deals with the peculiarities of talent management programmes implementation at the top British, American and Canadian universities. The essence of the main concepts of research - talent and talent management - has been revealed. Talent management is referred to as the systematic attraction, identification, development, engagement, retention and deployment of those individuals who are of particular value to an organization, either in view of their “high potential” for the future or because they are fulfilling business/ operation-critical roles. The factors that drive the development of talent management at the universities have been defined. The benefits that can be obtained as a result of talent management programmes implementation in higher education institutions have been pointed out. The differences in talent management programmes implementation at the universities of Great Britain, the USA and Canada have been found out. These differences depend mainly on the human resources policy of the institution represented in its strategic plan. It has been concluded that most top British and American higher education institutions run talent development programmes, but the target categories and forms of their implementation greatly differ. Canadian universities in the human resources policy focus on professional development of staff and faculty, but do not have special talent management programmes. Progressive conceptual ideas of foreign experience that can be used in practice of Ukrainian universities have been considered.

  10. Patient level cost of diabetes self-management education programmes: an international evaluation

    Science.gov (United States)

    Doyle, Gerardine; O'Donnell, Shane; Quigley, Etáin; Cullen, Kate; Gibney, Sarah; Levin-Zamir, Diane; Ganahl, Kristin; Müller, Gabriele; Muller, Ingrid; Maindal, Helle Terkildsen; Chang, Wushou Peter; Van Den Broucke, Stephan

    2017-01-01

    Objectives The objective of this study was to examine the value of time-driven activity-based costing (TDABC) in understanding the process and costs of delivering diabetes self-management education (DSME) programmes in a multicountry comparative study. Setting Outpatient settings in five European countries (Austria, Denmark, Germany, Ireland, UK) and two countries outside Europe, Taiwan and Israel. Participants Providers of DSME programmes across participating countries (N=16) including healthcare professionals, administrators and patients taking part in DSME programmes. Primary and secondary measures Primary measure: time spent by providers in the delivery of DSME and resources consumed in order to compute programme costs. Secondary measures: self-report measures of behavioural self-management and diabetes disease/health-related outcomes. Results We found significant variation in costs and the processes of how DSME programmes are provided across and within countries. Variations in costs were driven by a combination of price variances, mix of personnel skill and efficiency variances. Higher cost programmes were not found to have achieved better relative outcomes. The findings highlight the value of TDABC in calculating a patient level cost and potential of the methodology to identify process improvements in guiding the optimal allocation of scarce resources in diabetes care, in particular for DSME that is often underfunded. Conclusions This study is the first to measure programme costs using estimates of the actual resources used to educate patients about managing their medical condition and is the first study to map such costs to self-reported behavioural and disease outcomes. The results of this study will inform clinicians, managers and policy makers seeking to enhance the delivery of DSME programmes. The findings highlight the benefits of adopting a TDABC approach to understanding the drivers of the cost of DSME programmes in a multicountry study to reveal

  11. Patient level cost of diabetes self-management education programmes: an international evaluation.

    Science.gov (United States)

    Doyle, Gerardine; O'Donnell, Shane; Quigley, Etáin; Cullen, Kate; Gibney, Sarah; Levin-Zamir, Diane; Ganahl, Kristin; Müller, Gabriele; Muller, Ingrid; Maindal, Helle Terkildsen; Chang, Wushou Peter; Van Den Broucke, Stephan

    2017-06-04

    The objective of this study was to examine the value of time-driven activity-based costing (TDABC) in understanding the process and costs of delivering diabetes self-management education (DSME) programmes in a multicountry comparative study. Outpatient settings in five European countries (Austria, Denmark, Germany, Ireland, UK) and two countries outside Europe, Taiwan and Israel. Providers of DSME programmes across participating countries (N=16) including healthcare professionals, administrators and patients taking part in DSME programmes. Primary measure: time spent by providers in the delivery of DSME and resources consumed in order to compute programme costs. Secondary measures: self-report measures of behavioural self-management and diabetes disease/health-related outcomes. We found significant variation in costs and the processes of how DSME programmes are provided across and within countries. Variations in costs were driven by a combination of price variances, mix of personnel skill and efficiency variances. Higher cost programmes were not found to have achieved better relative outcomes. The findings highlight the value of TDABC in calculating a patient level cost and potential of the methodology to identify process improvements in guiding the optimal allocation of scarce resources in diabetes care, in particular for DSME that is often underfunded. This study is the first to measure programme costs using estimates of the actual resources used to educate patients about managing their medical condition and is the first study to map such costs to self-reported behavioural and disease outcomes. The results of this study will inform clinicians, managers and policy makers seeking to enhance the delivery of DSME programmes. The findings highlight the benefits of adopting a TDABC approach to understanding the drivers of the cost of DSME programmes in a multicountry study to reveal opportunities to bend the cost curve for DSME. © Article author(s) (or their employer

  12. Malaria control through municipalities in the Philippines: struggling with the mandate of decentralized health programme management.

    Science.gov (United States)

    Espino, Fe; Beltran, Maylene; Carisma, Brian

    2004-01-01

    This is a study on the management of the decentralized malaria control programme in Maharlika, Lipunan, a municipality in rural Philippines. The theoretical assumption is that the malaria control programme must be viewed as a system and that success of reform in malaria control depends upon the understanding of management issues by municipal officials. Through interviews, and documents and archival reviews, a framework for describing the dynamics of municipal management of the malaria control programme was developed. The overall finding was that the administrative management system was not functioning optimally: (a) planning and budgeting systems are not helpful; (b) malaria data do not inform planning; and (c) local financial resources are not utilized for malaria control. The underlying causes were: the absence of a clear statement from national offices regarding decentralization of health services, and the management processes, as stipulated in the Local Government Code, were not responsive to the needs of the municipality.

  13. Application of a theoretical framework to foster a cardiac-diabetes self-management programme.

    Science.gov (United States)

    Wu, C-J Jo; Chang, A M

    2014-09-01

    This paper analyses and illustrates the application of Bandura's self-efficacy construct to an innovative self-management programme for patients with both type 2 diabetes and coronary heart disease. Using theory as a framework for any health intervention provides a solid and valid foundation for aspects of planning and delivering such an intervention; however, it is reported that many health behaviour intervention programmes are not based upon theory and are consequently limited in their applicability to different populations. The cardiac-diabetes self-management programme has been specifically developed for patients with dual conditions with the strategies for delivering the programme based upon Bandura's self-efficacy theory. This patient group is at greater risk of negative health outcomes than that with a single chronic condition and therefore requires appropriate intervention programmes with solid theoretical foundations that can address the complexity of care required. The cardiac-diabetes self-management programme has been developed incorporating theory, evidence and practical strategies. This paper provides explicit knowledge of the theoretical basis and components of a cardiac-diabetes self-management programme. Such detail enhances the ability to replicate or adopt the intervention in similar or differing populations and/or cultural contexts as it provides in-depth understanding of each element within the intervention. Knowledge of the concepts alone is not sufficient to deliver a successful health programme. Supporting patients to master skills of self-care is essential in order for patients to successfully manage two complex, chronic illnesses. Valuable information has been provided to close the theory-practice gap for more consistent health outcomes, engaging with patients for promoting holistic care within organizational and cultural contexts. © 2014 International Council of Nurses.

  14. Evaluating disease management programme effectiveness: an introduction to the regression discontinuity design.

    Science.gov (United States)

    Linden, Ariel; Adams, John L; Roberts, Nancy

    2006-04-01

    Although disease management (DM) has been in existence for over a decade, there is still much uncertainty as to its effectiveness in improving health status and reducing medical cost. The main reason is that most programme evaluations typically follow weak observational study designs that are subject to bias, most notably selection bias and regression to the mean. The regression discontinuity (RD) design may be the best alternative to randomized studies for evaluating DM programme effectiveness. The most crucial element of the RD design is its use of a 'cut-off' score on a pre-test measure to determine assignment to intervention or control. A valuable feature of this technique is that the pre-test measure does not have to be the same as the outcome measure, thus maximizing the programme's ability to use research-based practice guidelines, survey instruments and other tools to identify those individuals in greatest need of the programme intervention. Similarly, the cut-off score can be based on clinical understanding of the disease process, empirically derived, or resource-based. In the RD design, programme effectiveness is determined by a change in the pre-post relationship at the cut-off point. While the RD design is uniquely suitable for DM programme evaluation, its success will depend, in large part, on fundamental changes being made in the way DM programmes identify and assign individuals to the programme intervention.

  15. Evaluation of the UCL diabetes self-management programme (UCL-DSMP): a randomized controlled trial.

    Science.gov (United States)

    Steed, Liz; Lankester, Jill; Barnard, Maria; Earle, Ken; Hurel, Stephen; Newman, Stanton

    2005-03-01

    Self-management has been described as the cornerstone of care for diabetes. Many self-management studies are limited by poor methodology and poor descriptions of the intervention. The current study developed a theoretically based self-management programme for patients with type 2 diabetes, which was evaluated via a randomized controlled trial. At immediate post-intervention and three-month follow-up the intervention group showed significant improvement relative to controls on self-management behaviours, quality of life and illness beliefs. A trend towards improved HbA1c was also observed. Documentation in a manual and development of a training programme for facilitators ensures the programme is replicable.

  16. The effect of a leadership support programme on care home managers.

    Science.gov (United States)

    Penney, Sarah; Ryan, Assumpta

    2018-01-29

    To explore the effect of the My Home Life 12-month leadership support programme on care home managers' leadership skills and professional development, and their relationships with staff, residents and relatives. A qualitative study of 15 care home managers was undertaken, using focus groups to explore the study's aims and objectives. Data were analysed using Colaizzi's phenomenological method. The leadership support programme enabled managers to develop their leadership skills, which had a positive effect for them and for their relationships with staff, residents and relatives. Conclusion Participation in the programme enabled managers to make real practice development improvements with meaningful effect for residents. ©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.

  17. Development of a self-managed loaded exercise programme for rotator cuff tendinopathy.

    Science.gov (United States)

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

    2013-12-01

    This paper describes a self-managed loaded exercise programme which has been designed to address the pain and disability associated with rotator cuff tendinopathy. The intervention has been developed with reference to current self-management theory and with reference to the emerging benefit of loaded exercise for tendinopathy. This self-managed loaded exercise programme is being evaluated within the mixed methods SELF study (ISRCTN 84709751) which includes a pragmatic randomised controlled trial conducted within the UK National Health Service. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

  18. MANAGEMENT & COMMUNICATION: Programme of Seminars September to December 2003

    CERN Multimedia

    2003-01-01

    If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. MANAGEMENT & COMMUNICATION Nathalie Dumeaux tel. 78144 management.communication@cern.ch Situation : 13.10.2003 Dates Days Places Available Bilingual seminars Interpersonal Communication (Module 1-CM) 21, 22, 23 October 3 non* Managing a CERN unit - to be a Manager (Module 2) 28, 29 October 2 non Quality Management 10, 11, 12 November 3 oui Managing a CERN unit - to be a Manager (Module 3) 11, 12 November 2 non Risk Management 11, 12 December 2 oui Seminars In English Communicating Effectively (first part) 12, 13 November & 4...

  19. Postgraduate Programmes on Environmental Water Resources Engineering and Management in Greek Universities

    Science.gov (United States)

    Latinopoulos, Pericles; Angelidis, Panagiotis

    2014-01-01

    The management of complex water problems is nowadays being practised through new ways and approaches. Therefore, water engineers, planners and managers should be appropriately educated through modern undergraduate curricula and by well-designed postgraduate specialisation programmes. Within this framework, a study of the specific characteristics…

  20. University Lawyers: A Study of Legal Risk, Risk Management and Role in Work Integrated Learning Programmes

    Science.gov (United States)

    Cameron, Craig; Klopper, Christopher

    2015-01-01

    Work integrated learning (WIL) is in growing demand by multiple stakeholders within the higher education sector in Australia. There are significant and distinct legal risks to universities associated with WIL programmes. University lawyers, along with WIL administrators and university management, are responsible for managing legal risk. This…

  1. Management & Communication - Programme of Seminars September to December 2003

    CERN Multimedia

    Nathalie Dumeaux

    2003-01-01

    Situation : 23.09.2003 Dates Days Available Séminaires bilingues/Bilingual seminars Managing a CERN unit - to be a Manager/ Gérer une unité au CERN - Etre Manager (Module 1) 7, 8, 9, 10 octobre 3 non Communication interpersonnelle/ Interpersonal Communication (Module 1-CM) 21, 22, 23 octobre 3 non Managing a CERN unit - to be a Manager/ Gérer une unité au CERN - Etre Manager (Module 2) 28, 29 octobre 2 non Gestion de la qualité/Quality Management 10, 11, 12 novembre 3 oui Managing a CERN unit - to be a Manager/ Gérer une unité au CERN - Etre Manager (Module 3) 11, 12 novembre 2 non Gestion des risques /Risk Management 11, 12 décembre 2 oui Seminars In English Communicating Effectively (first part) 12, 13 November 4 yes Communicating Effectively (second part) 11, 12 December Communicating effectively in your team 19, 20 November 2 no Performance Appraisal Training MAPS 26, 27, 28 November 3 yes Managing by Project 3, 4 December 3 n...

  2. Internal Clock Drift Estimation in Computer Clusters

    Directory of Open Access Journals (Sweden)

    Hicham Marouani

    2008-01-01

    Full Text Available Most computers have several high-resolution timing sources, from the programmable interrupt timer to the cycle counter. Yet, even at a precision of one cycle in ten millions, clocks may drift significantly in a single second at a clock frequency of several GHz. When tracing the low-level system events in computer clusters, such as packet sending or reception, each computer system records its own events using an internal clock. In order to properly understand the global system behavior and performance, as reported by the events recorded on each computer, it is important to estimate precisely the clock differences and drift between the different computers in the system. This article studies the clock precision and stability of several computer systems, with different architectures. It also studies the typical network delay characteristics, since time synchronization algorithms rely on the exchange of network packets and are dependent on the symmetry of the delays. A very precise clock, based on the atomic time provided by the GPS satellite network, was used as a reference to measure clock drifts and network delays. The results obtained are of immediate use to all applications which depend on computer clocks or network time synchronization accuracy.

  3. The central role of national programme management for the achievement of malaria elimination: a cross case-study analysis of nine malaria programmes.

    Science.gov (United States)

    Smith Gueye, Cara; Newby, Gretchen; Tulloch, Jim; Slutsker, Laurence; Tanner, Marcel; Gosling, Roland D

    2016-09-22

    A malaria eradication goal has been proposed, at the same time as a new global strategy and implementation framework. Countries are considering the strategies and tools that will enable progress towards malaria goals. The eliminating malaria case-study series reports were reviewed to identify successful programme management components using a cross-case study analytic approach. Nine out of ten case-study reports were included in the analysis (Bhutan, Cape Verde, Malaysia, Mauritius, Namibia, Philippines, Sri Lanka, Turkey, Turkmenistan). A conceptual framework for malaria elimination programme management was developed and data were extracted and synthesized. Findings were reviewed at a consultative workshop, which led to a revision of the framework and further data extraction and synthesis. Success factors of implementation, programme choices and changes, and enabling factors were distilled. Decentralized programmes enhanced engagement in malaria elimination by sub-national units and communities. Integration of the malaria programme into other health services was also common. Decentralization and integration were often challenging due to the skill and experience levels of newly tasked staff. Accountability for programme impact was not clarified for most programmes. Motivation of work force was a key factor in maintaining programme quality but there were few clear, detailed strategies provided. Different incentive schemes targeted various stakeholders. Training and supervision, although not well described, were prioritized by most programmes. Multi-sectoral collaboration helped some programmes share information, build strategies and interventions and achieve a higher quality of implementation. In most cases programme action was spurred by malaria outbreaks or a new elimination goal with strong leadership. Some programmes showed high capacity for flexibility through introduction of new strategies and tools. Several case-studies described methods for monitoring

  4. [Clocks, Behavior, and Cognition].

    Science.gov (United States)

    Futamura, Akinori; Shiromaru, Azusa; Kuroda, Takeshi; Honma, Motoyasu; Kinno, Ryuta; Ono, Kenjiro; Kawamura, Mitsuru

    2017-06-01

    The nerve center responsible for controlling our circadian rhythm is located in a cluster of cells known as the suprachiasmatic nucleus in the hypothalamus. Various physiological functions such as sleep, arousal, blood pressure, body temperature, and hormone secretion are regulated in a 24-hour rhythm by this circuit. Somatic cells of other organs have a peripheral clock gene and by synchronizing the rhythm of the central and peripheral clocks, it is possible to live a healthy life. Due to aging and degenerative disease, circadian rhythm gradually collapses. Factors that can contribute to this include reduced expression of the time gene associated with photo stimulation, a reduction in neurotransmitter levels, and reduced melatonin production. Biological clocks play an important role in our emotions, cognitive function, and behavior. Sleep disorders and metabolic disease related to the circadian rhythm affect metabolic and endocrine activities via the autonomic nervous system and the intestinal bacterial flora. Shift work disorder is associated with insomnia and excessive drowsiness as individuals often work during their sleeping hours. Now time management is placed at the center of our society, and it is important to evaluate the medical risk of engaging in shift work. In frontotemporal dementia (FTD), the stereotypical behaviors may be associated with time. In some patients, multiple timed behaviors occupy a considerable part of the patient's daily life. Stereotypical behaviors in FTD are often considered in contrast to obsessive-compulsive disease (OCD). Studies of OCD have found a close correlation between clinical symptoms, cognitive function, and brain function.

  5. Medical care of type 2 diabetes in German disease management programmes: a population-based evaluation.

    Science.gov (United States)

    Stark, Reneé G; Schunk, Michaela V; Meisinger, Christine; Rathmann, Wolfgang; Leidl, Reiner; Holle, Rolf

    2011-05-01

    Type 2 diabetes disease management programmes (DDMPs) are offered by German social health insurance to promote healthcare consistent with evidence-based medical guidelines. The aim of this study was to compare healthcare quality and medical endpoints between diabetes management programme participants and patients receiving usual care designated as controls. All patients with type 2 diabetes (age range: 36-81) in a cross-sectional survey of a cohort study, performed by the Cooperative Health Research in the Region of Augsburg, received a self-administered questionnaire regarding their diabetes care. Physical examination and laboratory tests were also performed. The analysis only included patients with social health insurance and whose participation status in a diabetes disease management program was validated by the primary physician (n = 166). Regression analyses, adjusting for age, sex, education, diabetes duration, baseline waist circumference and clustering regarding primary physician were conducted. Evaluation of healthcare processes showed that those in diabetes disease management programmes (n = 89) reported medical examination of eyes and feet and medical advice regarding diet [odds ratio (OR): 2.39] and physical activity (OR: 2.87) more frequently, received anti-diabetic medications (OR: 3.77) and diabetes education more often (OR: 2.66) than controls. Both groups had satisfactory HbA(1c) control but poor low-density lipoprotein cholesterol control. Blood pressure goals (diabetes disease management programmes (OR: 2.21). German diabetes disease management programmes are associated with improved healthcare processes and blood pressure control. Low-density lipoprotein cholesterol control must be improved for all patients with diabetes. Further research will be required to assess the long-term effects of this diabetes disease management programme. Copyright © 2011 John Wiley & Sons, Ltd.

  6. Document remote management and programmable controllers for the refrigeration and air conditioning; Dossier Telegestion et automates programmables en froid et conditionnement d'air

    Energy Technology Data Exchange (ETDEWEB)

    Anon; Clodic, D.; Loyer, J.C.; Fayolle, F.; Bigot, G.; Palandre, L.

    2001-02-01

    This document presents four papers on technic of remote management and programmable controllers in the domain of the refrigeration and the air conditioning: the management of a refrigerating installation, the refrigerating chain control, the floating high pressure management and the assistance of the fuzzy logic to optimize the defrost of installation. (A.L.B.)

  7. Publicly administrated nuclear waste management research programme 1994-1996. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Vuori, S. [ed.] [VTT Energy, Espoo (Finland)

    1997-09-01

    The main objective of the JYT-programme has been to provide the authorities with independent information and research results relevant for the safety of nuclear waste management. The main emphasis in this research programme has been devoted to the final disposal of spent fuel. The whole area of the research programme has been subdivided into following main topic areas: (1) bedrock structure and stability, rock investigation methods and characteristics and flow of ground water, (2) release of radionuclides from a repository and subsequent transport in the bedrock, (3) performance and safety assessment of repositories and other phases of nuclear waste management, (4) natural analogue studies, (5) waste management technology and costs and (6) socio political and other societal issues and environmental impact assessment.

  8. Evaluation of programme for energy management in buildings; Evaluering av program for energiledelse i bygg

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-07-01

    Enova SF needed to evaluate the programmes for energy management for greater and smaller building owners. The question was: What has been the impact of the Buildings Network and the energy management programmes for greater and smaller building owners on energy conservation and economic life , and are the programmes operated efficiently? The buildings which participated in the Buildings Network in 1996 - 2002 had an average reduction of the energy consumption of about 7 per cent, which is somewhat less than the supposed potential of 10 per cent. There is some uncertainty in this calculation and the true figure is probably 1 or 2 per cent higher. Whether this energy conservation tendency has continued after Enova took over the responsibility for the programme in 2002 is too early to measure. It is very probable that the public support to the projects has triggered off the saving, that is, there has been few free riders. After 2002, Enova has made the programme more efficient and the cost per building has been halved in the period 2001 - 2003. But some of the original infrastructure of the programme has been discontinued.

  9. Contract Management Monitoring And Evaluation Of Ghana School Feeding Programme At Atwima Kwanwoma District

    Directory of Open Access Journals (Sweden)

    Andrews Osei Mensah

    2015-08-01

    Full Text Available Ghana School Feeding Programme was introduced at Atwima Kwanwoma District and other parts of the country in 2008 to alleviate hunger and to provide good nutrition for pupils in the public basic schools. Caterers were given contract to provide food to the school pupils on every school-going day under Ghana school feeding programme. Some years have lapsed and there is the need to look back and evaluate this programme taking into consideration the award and management of those contracts. The study also examined how the programme is monitored and evaluated. Data was collected from 80 respondents comprising 29 school pupils and 51 other actors through the use of questionnaire and interview guide It was realised that caterers who are well experience in catering services were awarded contracts based on their past experience and financial abilities through submission of their certificates but not necessarily through bidding. The main component of managing the caterers contract included monitoring payment of debt and problems solving as well as supervision through visiting the schools on quarterly basis. The programme has helped to increase enrolment and retaining pupils in school. It was found out that food giving to the pupils was not served on time not regularly bases and was not sufficient to the pupils as well. The health component of the programme has not been successful as expected. It is recommended that fruits and variety of foods need to be introduced together with de-worming the pupils.

  10. Information systems for administration, clinical documentation and quality assurance in an Austrian disease management programme.

    Science.gov (United States)

    Beck, Peter; Truskaller, Thomas; Rakovac, Ivo; Bruner, Fritz; Zanettin, Dominik; Pieber, Thomas R

    2009-01-01

    5.9% of the Austrian population is affected by diabetes mellitus. Disease Management is a structured treatment approach that is suitable for application to the diabetes mellitus area and often is supported by information technology. This article describes the information systems developed and implemented in the Austrian disease management programme for type 2 diabetes. Several workflows for administration as well as for clinical documentation have been implemented utilizing the Austrian e-Health infrastructure. De-identified clinical data is available for creating feedback reports for providers and programme evaluation.

  11. Management & Communication: Programme of Seminars September to December 2004

    CERN Multimedia

    Nathalie Dumeaux

    2004-01-01

    Situation : 13.07.2004 Bilingual seminars Dates Days Places Available Project Management 13, 14, 15 September 3 oui Introduction to Management 20, 21, 22 September 3 oui Managing by project 28, 29 September 2 oui Project Management Case study 8 October 1 oui Communication Techniques - 1 20, 21, 22 October 3 oui Quality Management 8, 9 November 2 oui Risk Management 6, 7 December 2 oui Seminars in English Communicating effectively 20 September, 1 october + 2, 3 November 4 yes Communicating effectively in your team 14, 15 October 2 yes Séminaires en Français Communiquer efficacement 21, 22 septembre + 12, 13 octobre 4 oui Techniques d'exposé et de présentation 27, 28 septembre + 18 octobre 3 oui Animer ou participer à une réunion de travail 15, 16, 17 novembre 3 oui * If you are interested in a seminar where there are no places available, please fill in an application form and we will contact you as soon as a new session is organised. MANAGEMENT & COMMUNICA...

  12. Social awareness programmes in waste management and recycling

    CSIR Research Space (South Africa)

    Oelofse, Suzanna HH

    2013-05-01

    Full Text Available www.csir.co.zaSlide 14 N e v e r r e c y c l e A l w a y s r e c y c l e a l l Reasons why South Africans don’t recycle © CSIR 2013 www.csir.co.zaSlide 15 © CSIR 2013 www.csir.co.zaSlide 16... management and recycling Presentation by Dr Suzan Oelofse Research Group Leader: Waste Management for Development Operating Unit: Natural Resources and the Environment Background Waste Act, 2008 adopted the waste management hierarchy © CSIR 2013...

  13. ClockWork: a Real-Time Feasibility Analysis Tool

    NARCIS (Netherlands)

    Jansen, P.G.; Hanssen, F.T.Y.; Mullender, Sape J.

    ClockWork shows that we can improve the flexibility and efficiency of real-time kernels. We do this by proposing methods for scheduling based on so-called Real-Time Transactions. ClockWork uses Real-Time Transactions which allow scheduling decisions to be taken by the system. A programmer does not

  14. Many-soliton bound states in dispersion-managed optical fiber: Possibility of fiber-optic transmission of three bits per clock period

    Science.gov (United States)

    Boudjemâa, Abdelâali

    2017-10-01

    We study the stability and the dynamics of many-soliton molecules in dispersion-managed (DM) optical fibers with focus on five-and seven-soliton molecules by analytical and numerical means. In particular we calculate the binding force, pulse durations and equilibrium separations using a variational approach. Predicted pulse shapes are in good agreement with those found by numerical simulations of the underlying nonlinear Schrödinger equation. Within limitations, soliton molecules with up to seven solitons possibly allow to encode three bits of data per clock period.

  15. Interpreting Financial Results. Financial Management Module. Operational Management Programme. Increasing Opportunities for Supervisors and Managers.

    Science.gov (United States)

    Adamson, Jan; And Others

    One of a series of three self-instructional units, these materials are aimed at helping British hotel and catering managers improve profits and/or reduce costs in their areas of responsibility. Following an introduction and a paragraph on how to use the unit, section 1 covers how to use management information. The section includes these trainee…

  16. Management & Communication: Programme of Seminars January to March 2004

    CERN Multimedia

    2004-01-01

    If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an "application for training" form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. MANAGEMENT & COMMUNICATION Nathalie Dumeaux tel. 78144 management.communication@cern.ch Situation : 20.01.2004 DatesDaysPlaces Available** Bilingual seminars Communication Techniques-1/Techniques de communication-1 16, 17, 18 March 3 non Project Management/Gestion de projet 17, 18, 19 March 3 oui Seminars in English Communicating effectively 22, 23 January & 19, 20 February 4 yes Performance Appraisal MAPS 4, 5, 6 February 3 yes Performance Appraisal -MAPS 11, 12, 13 February 3 yes Séminaires en Français Formation à l'entreti...

  17. Management & communication: Programme of Seminars October to December 2004

    CERN Multimedia

    Nathalie Dumeaux

    2004-01-01

    If you wish to participate in one of the following courses, please discuss with your supervisor and apply electronically directly from the course description pages that can be found on the Web at: http://www.cern.ch/Training/ or fill in an 'application for training' form available from your Divisional Secretariat or from your DTO (Divisional Training Officer). Applications will be accepted in the order of their receipt. Situation : 11.10.2004 Bilingual seminar Dates Days Places available Communication Techniques - 1 20, 21, 22 October 3 oui Quality Management 8, 9 November 2 oui Risk Management 6, 7 December 2 oui Project Management - Case Study 22 November 1 oui Seminars in English Communicating effectively in your team 14, 15 October 2 yes Performance Appraisal - MAPS 24, 25, 26 November 3 yes Performance Appraisal - MAPS 8, 9, 10 December 3 yes Séminaires en Français Appréciation des performances - MAPS 1, 2, 3 d&eacut...

  18. A Necessary Evil: The Experiences of Managers Implementing Downsizing Programmes

    Science.gov (United States)

    Noronha, Ernesto; D'Cruz, Premilla

    2006-01-01

    This paper presents the findings of a phenomenological study, which describes the experiences of human resource (HR) managers implementing a downsizing program in a steel manufacturing organization in India. Data were collected through conversational interviews. Following van Manens sententious analytic approach, the core theme of a necessary…

  19. RD and D-Programme 2004. Programme for research, development and demonstration of methods for the management and disposal of nuclear waste, including social science research

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2004-09-01

    SKB (the Swedish Nuclear Fuel and Waste Management Co), which is owned by the companies that operate the Swedish nuclear power plants, has been assigned the task of managing and disposing of the spent nuclear fuel from the reactors. The Nuclear Activities Act requires a programme of comprehensive research and development and other measures that are needed to manage and dispose of nuclear waste in a safe manner and to decommission and dismantle the nuclear power plants. SKB is now presenting RD and D-Programme 2004 in fulfilment of this requirement. The programme describes SKB's plans for the period 2005-2010. The period of immediate concern is 2005-2007. The level of detail for the three subsequent years is naturally lower.The programme provides a basis for designing systems for safe management and disposal of the radioactive waste from the nuclear power plants. SKB's plan is to implement deep disposal of the spent fuel in accordance with the KBS-3 method. In the RD and D-Programme we describe our activities and planning for this line of action and the work that is being conducted on alternative methods. Review of the programme can contribute valuable outside viewpoints. The regulatory authorities and the Government can clarify how they look upon different parts of the programme and stipulate guidelines for the future. Municipalities and other stakeholders can, after studying the programme, offer their viewpoints to SKB, the regulatory authorities or the Government.The goal for the period up to the end of 2008 is to be able to submit permit applications for the encapsulation plant and the deep repository. This RD and D-Programme therefore differs from the preceding ones in that it concentrates on questions relating to technology development for these facilities. The programmes for safety assessment and research on the long-term processes that take place in the deep repository are then linked together with the programmes for technology development. Another

  20. Process evaluation of a tailored intervention programme of cardiovascular risk management in general practices

    NARCIS (Netherlands)

    Huntink, E.; Wensing, M.; Timmers, I.M.; Lieshout, J. van

    2016-01-01

    BACKGROUND: A tailored implementation programme to improve cardiovascular risk management (CVRM) in general practice had little impact on outcomes. The questions in this process evaluation concerned (1) impact on counselling skills and CVRM knowledge of practice nurses, (2) their use of the various

  1. Monitoring and Evaluation of an Early Childhood Development Programme: Implications for Leadership and Management

    Science.gov (United States)

    Hodgson, Sarah; Papatheodorou, Theodora; James, Mary

    2014-01-01

    The article aims to discuss preliminary findings from a participatory monitoring and evaluation (M&E) framework, used in a community-based early childhood development (ECD) programme in KwaZulu-Natal South Africa, and their implications for leadership and management. The purposes of the M&E were for LETCEE, the implementing organization,…

  2. IMHE-Info. OECD Programme on Institutional Management in Higher Education, July 2007

    Science.gov (United States)

    Lafon, Valerie, Ed.

    2007-01-01

    IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: (1) Giving Knowledge for Free; The Emergence of Open Educational Resources; and (2) Education at a Glance 2007. IMHE News, publications of interest and upcoming events are included. (Contains 1 figure and 1 table.)

  3. IMHE-Info. OECD Programme on Institutional Management in Higher Education, December 2007

    Science.gov (United States)

    OECD Publishing (NJ1), 2007

    2007-01-01

    IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: (1) How Do Rankings Impact on Higher Education?; and (2) OECD International Assessment of Higher Education Outcomes. IMHE News, publications of interest and upcoming events are included.

  4. IMHE-Info. OECD Programme on Institutional Management in Higher Education, April 2007

    Science.gov (United States)

    Lafon, Valerie, Ed.

    2007-01-01

    IMHE-Info is the newsletter published by the Institutional Management in Higher Education (IMHE) programme. This issue includes: (1) Regional Engagement: The Future for Higher Education?; and (2) Notes from Australia. IMHE News, publications of interest and upcoming events are included.

  5. Chinese Postgraduate Choices When Considering a UK Business and Management Programme

    Science.gov (United States)

    Manns, Yihan; Swift, Jonathan

    2016-01-01

    This research investigated Chinese students' decision making processes for enrolling on a postgraduate taught business and management programme in a UK university, based on structured interviews, followed by a survey of just over 450 respondents. The validity and reliability of the research instrument were assessed prior to issuing the survey.…

  6. Individual Health Management - A Comprehensive Lifestyle Counselling Programme for Health Promotion, Disease Prevention and Patient Education.

    Science.gov (United States)

    Melchart, Dieter; Eustachi, Axel; Wellenhofer-Li, Yanqing; Doerfler, Wolfgang; Bohnes, Evelin

    2016-01-01

    Epidemiological data shows globally increasing numbers of obesity and stress-related diseases. In this article, a comprehensive medical lifestyle modification programme - called Individual Health Management (IHM) - is described in detail and discussed as a promising tool to individually manage and reverse such negative health trends in patients. The IHM programme is based on a blended learning concept. It comprises a 12-week basic training phase, followed by a 9-month maintenance phase, and includes the following key features: 1) web-based and physician-led health screenings; 2) a structured 12-week basic training with a core curriculum providing tuition in behavioural self-management strategies for weight loss and stress reduction; 3) weekly supervised group sessions during the core curriculum; 4) tailoring of materials, strategies and lifestyle goals; 5) continuous self-monitoring and feedback of the achieved progress; 6) regular contact with physicians or health professionals based on either face-to-face or distant lifestyle counselling; 7) recurrent one-day health seminars to ensure the sustainability of obtained results. IHM is a multi-component lifestyle intervention programme to increase physical activity, to reduce calorie intake and to practice both self and stress management. Individual care, group support and a tailored web-based programme blend to achieve the desired goals. A randomised control study to evaluate IHM's effects on weight control is currently being conducted. © 2016 S. Karger GmbH, Freiburg.

  7. An Innovative Supply Chain Management Programme Structure: Broadening the SCM Skill Set

    Science.gov (United States)

    Okongwu, Uche

    2007-01-01

    This paper proposes a matrix structure for training Supply Chain Management (SCM) professionals. It is an innovative programme structure that combines two approaches: cross-border and inter-organisational. It enables the students to comprehend complex and specific business environments and to understand the diverse nature of SCM systems in both…

  8. Factors in the implementation of a sustainable knowledge management programme

    OpenAIRE

    Dayan, Rony

    2006-01-01

    Purpose Knowledge Management (KM) is by now a recognized term, increasingly accepted in the corporate community. This research contributes a better understanding of its implementation by providing a list a factors, which though each seems self-evident, their combination, and the experience acquired in applying them would support practitioners applying KM, and constitute a stepping stone for researchers for deepening the knowledge about it. Research context Israel Aircr...

  9. Towards Developing an Initial Programme Theory: Programme Designers and Managers Assumptions on the Antiretroviral Treatment Adherence Club Programme in Primary Health Care Facilities in the Metropolitan Area of Western Cape Province, South Africa

    Science.gov (United States)

    Mukumbang, Ferdinand C.; van Belle, Sara; Marchal, Bruno; van Wyk, Brian

    2016-01-01

    Background The antiretroviral adherence club intervention was rolled out in primary health care facilities in the Western Cape province of South Africa to relieve clinic congestion, and improve retention in care, and treatment adherence in the face of growing patient loads. We adopted the realist evaluation approach to evaluate what aspects of antiretroviral club intervention works, for what sections of the patient population, and under which community and health systems contexts, to inform guidelines for scaling up of the intervention. In this article, we report on a step towards the development of a programme theory—the assumptions of programme designers and health service managers with regard to how and why the adherence club intervention is expected to achieve its goals and perceptions on how it has done so (or not). Methods We adopted an exploratory qualitative research design. We conducted a document review of 12 documents on the design and implementation of the adherence club intervention, and key informant interviews with 12 purposively selected programme designers and managers. Thematic content analysis was used to identify themes attributed to the programme actors, context, mechanisms, and outcomes. Using the context-mechanism-outcome configurational tool, we provided an explanatory focus of how the adherence club intervention is roll-out and works guided by the realist perspective. Results We classified the assumptions of the adherence club designers and managers into the rollout, implementation, and utilisation of the adherence club programme, constructed around the providers, management/operational staff, and patients, respectively. Two rival theories were identified at the patient-perspective level. We used these perspectives to develop an initial programme theory of the adherence club intervention, which will be tested in a later phase. Conclusion The perspectives of the programme designers and managers provided an important step towards developing

  10. Lego clocks : building a clock from parts

    NARCIS (Netherlands)

    Brunner, Michael; Simons, Mirre J. P.; Merrow, Martha

    2008-01-01

    A new finding opens up speculation that the molecular mechanism of circadian clocks in Synechococcus elongatus is composed of multiple oscillator systems (Kitayama and colleagues, this issue, pp. 1513-1521), as has been described in many eukaryotic clock model systems. However, an alternative

  11. Getting the Right Staff. Personnel Management Module. Operational Management Programme. Increasing Opportunities for Supervisors and Managers.

    Science.gov (United States)

    Goddard, Tessa; Murray, Jennifer

    This self-instructional unit for supervisors and managers in the British hotel and catering industry contains information on all the important stages in the process of recruiting staff. The document begins with an introduction and advice on how to use the unit. Five sections cover the following topics: (1) the cost of employment; (2) planning for…

  12. Staff Retention. Personnel Management Module. Operational Management Programme. Increasing Opportunities for Supervisors and Managers.

    Science.gov (United States)

    Murray, Jennifer

    This self-instructional unit for supervisors and managers in the British hotel and catering industry is based on the view that problems in staff recruitment and retention are directly linked to the level of job satisfaction. The document begins with an introduction and advice on how to use the unit. Five sections cover the following topics: (1)…

  13. Knowledge management systems in support of an induction programme: An action research approach

    Directory of Open Access Journals (Sweden)

    Murali Raman

    2013-12-01

    Full Text Available Higher education institutions are in the knowledge business since they are involved in knowledge creation, dissemination and learning. However, not many higher education institutions get the most benefit out of managing their knowledge. Most of these institutions are so busy delivering knowledge that they fail to capture the best practices in their knowledge delivery. The induction programme for new lecturers is therefore very important to improve the quality of teaching. In teaching, lecturers might be the subject matter experts but could lack knowledge related to teaching, such as theories of teaching and learning, classroom organization and management, development of curriculum and course content, and professionalism. This paper examines if knowledge management systems (KMS can support the induction programmes for new lecturers in an academic setting at the Bina Nusantara University in Indonesia. Action research is used as the underlying methodology. Specifically, a 5-step canonical action research was used to conduct the study. Our findings post intervention suggests that most lecturers understand the importance of the induction programme and the lecturers have positive attitudes towards the implementation of KMS to support the induction programme.

  14. Establishing an independent mobile health programme for chronic disease self-management support in Bolivia

    Directory of Open Access Journals (Sweden)

    John D Piette

    2014-08-01

    Full Text Available Background: Mobile health (m-health work in low and middle-income countries (LMICs mainly consists of pilot programmes with an unclear path to scaling and dissemination. We describe the deployment and testing of an m-health platform for non-communicable disease (NCD self-management support in Bolivia. Methods: 364 primary care patients in La Paz with diabetes or hypertension completed surveys about their use of mobile phones, health and access to care. 165 of those patients then participated in a 12-week demonstration of automated telephone monitoring and self-management support. Weekly Interactive Voice Response (IVR calls were made from a platform established at a university in La Paz, under the direction of the regional health ministry. Results: 37% of survey respondents spoke indigenous languages at home, and 38% had six or fewer years of education. 82% had a mobile phone; half (45% used text messaging with a standard phone, and 9% had a smartphone. Smartphones were least common among patients who were older, spoke indigenous languages, or had less education. IVR programme participants completed 1007 self-management support calls, with an overall response rate of 51%. IVR call completion was lower among older adults, but was not related to patients’ ethnicity, health status or healthcare access. IVR health and self-care reports were consistent with information reported during baseline interviews. Patients’ likelihood of reporting excellent, very good, or good health (versus fair or poor health via IVR increased during programme participation, and was associated with better medication adherence. Patients completing follow-up interviews were satisfied with the programme, with 19/20 (95% reporting that they would recommend it to a friend. Conclusions: By collaborating with LMICs, m-health programmes can be transferred from higher-resource centres to LMICs and implemented in ways that improve access to self-management support among people

  15. Designing financial-incentive programmes for return of medical service in underserved areas: seven management functions

    Directory of Open Access Journals (Sweden)

    Bärnighausen Till

    2009-06-01

    Full Text Available Abstract In many countries worldwide, health worker shortages are one of the main constraints in achieving population health goals. Financial-incentive programmes for return of service, whereby participants receive payments in return for a commitment to practise for a period of time in a medically underserved area, can alleviate local and regional health worker shortages through a number of mechanisms. First, they can redirect the flow of those health workers who would have been educated without financial incentives from well-served to underserved areas. Second, they can add health workers to the pool of workers who would have been educated without financial incentives and place them in underserved areas. Third, financial-incentive programmes may improve the retention in underserved areas of those health workers who participate in a programme, but who would have worked in an underserved area without any financial incentives. Fourth, the programmes may increase the retention of all health workers in underserved areas by reducing the strength of some of the reasons why health workers leave such areas, including social isolation, lack of contact with colleagues, lack of support from medical specialists and heavy workload. We draw on studies of financial-incentive programmes and other initiatives with similar objectives to discuss seven management functions that are essential for the long-term success of financial-incentive programmes: financing (programmes may benefit from innovative donor financing schemes, such as endowment funds, international financing facilities or compensation payments; promotion (programmes should use tested communication channels in order to reach secondary school graduates and health workers; selection (programmes may use selection criteria to ensure programme success and to achieve supplementary policy goals; placement (programmes should match participants to areas in order to maximize participant satisfaction and

  16. Designing financial-incentive programmes for return of medical service in underserved areas: seven management functions.

    Science.gov (United States)

    Bärnighausen, Till; Bloom, David E

    2009-06-26

    In many countries worldwide, health worker shortages are one of the main constraints in achieving population health goals. Financial-incentive programmes for return of service, whereby participants receive payments in return for a commitment to practise for a period of time in a medically underserved area, can alleviate local and regional health worker shortages through a number of mechanisms. First, they can redirect the flow of those health workers who would have been educated without financial incentives from well-served to underserved areas. Second, they can add health workers to the pool of workers who would have been educated without financial incentives and place them in underserved areas. Third, financial-incentive programmes may improve the retention in underserved areas of those health workers who participate in a programme, but who would have worked in an underserved area without any financial incentives. Fourth, the programmes may increase the retention of all health workers in underserved areas by reducing the strength of some of the reasons why health workers leave such areas, including social isolation, lack of contact with colleagues, lack of support from medical specialists and heavy workload. We draw on studies of financial-incentive programmes and other initiatives with similar objectives to discuss seven management functions that are essential for the long-term success of financial-incentive programmes: financing (programmes may benefit from innovative donor financing schemes, such as endowment funds, international financing facilities or compensation payments); promotion (programmes should use tested communication channels in order to reach secondary school graduates and health workers); selection (programmes may use selection criteria to ensure programme success and to achieve supplementary policy goals); placement (programmes should match participants to areas in order to maximize participant satisfaction and retention); support (programmes

  17. Views of commissioners, managers and healthcare professionals on the NHS Health Check programme: a systematic review.

    Science.gov (United States)

    Mills, Katie; Harte, Emma; Martin, Adam; MacLure, Calum; Griffin, Simon J; Mant, Jonathan; Meads, Catherine; Saunders, Catherine L; Walter, Fiona M; Usher-Smith, Juliet A

    2017-11-15

    To synthesise data concerning the views of commissioners, managers and healthcare professionals towards the National Health Service (NHS) Health Check programme in general and the challenges faced when implementing it in practice. A systematic review of surveys and interview studies with a descriptive analysis of quantitative data and thematic synthesis of qualitative data. An electronic literature search of MEDLINE, Embase, Health Management Information Consortium, Cumulative Index of Nursing and Allied Health Literature, Global Health, PsycInfo, Web of Science, OpenGrey, the Cochrane Library, NHS Evidence, Google Scholar, Google, ClinicalTrials.gov and the International Standard Randomised Controlled Trial Number registry from 1 January 1996 to 9 November 2016 with no language restriction and manual screening of reference lists of all included papers. Primary research reporting views of commissioners, managers or healthcare professionals on the NHS Health Check programme and its implementation in practice. Of 18 524 citations, 15 articles met the inclusion criteria. There was evidence from both quantitative and qualitative studies that some commissioners and general practice (GP) healthcare professionals were enthusiastic about the programme, whereas others raised concerns around inequality of uptake, the evidence base and cost-effectiveness. In contrast, those working in pharmacies were all positive about programme benefits, citing opportunities for their business and staff. The main challenges to implementation were: difficulties with information technology and computer software, resistance to the programme from some GPs, the impact on workload and staffing, funding and training needs. Inadequate privacy was also a challenge in pharmacy and community settings, along with difficulty recruiting people eligible for Health Checks and poor public access to some venues. The success of the NHS Health Check Programme relies on engagement by those responsible for its

  18. Using intervention mapping to develop a family-based childhood weight management programme.

    Science.gov (United States)

    Pittson, Helen; Wallace, Louise

    2011-04-01

    To develop, implement and evaluate a family-based childhood weight management programme. Programme development utilized Bartholomew's Intervention Mapping framework. This six step structured approach provides planners with a framework that links determinants of health behaviours with performance objectives and strategies to be incorporated into programme design. Using this process a needs analysis and literature review were undertaken, a steering group formed, six focus groups (with a total of n = 47 pupils) were completed and six interviews took place with parents. The determinants were combined with relevant theories to develop the programme. Y W8? is a 12 week course for families with children aged 8-13 years designed to assist with weight management. Participants' height, weight and physical activity levels along with self-esteem scores for children are recorded pre- and post-intervention and at three, six and 12 month follow-up. This paper documents post-course results at 12 weeks. Preliminary results showed children (mean pre-BMI = 28.48 (±4.44), mean post-BMI = 27.48 (±4.45; P = Intervention mapping was a useful approach for developing a theory based intervention. Results suggest Y W8? improves the body mass index (BMI) of children and parents at 12 weeks. Further work, including a randomized controlled trial (RCT), will confirm this, investigate the longer-term effectiveness and determine how the effects are mediated by psychological processes.

  19. Weight outcomes audit in 1.3 million adults during their first 3 months' attendance in a commercial weight management programme

    National Research Council Canada - National Science Library

    Stubbs, R James; Morris, Liam; Pallister, Carolyn; Horgan, Graham; Lavin, Jacquie H

    2015-01-01

    .... Evidence suggests commercial weight management programmes help people manage their weight but there is little research examining those that pay to attend such programmes rather than being referred by primary care...

  20. Implementation and evaluation of a clinical data management programme in a primary care centre.

    LENUS (Irish Health Repository)

    Sweeney, J

    2014-11-01

    Electronic health records (EHR) support clinical management, administration, quality assurance, research, and service planning. The aim of this study was to evaluate a clinical data management programme to improve consistency, completeness and accuracy of EHR information in a large primary care centre with 10 General Practitioners (GPs). A Clinical Data Manager was appointed to implement a Data Management Strategy which involved coding consultations using ICPC-2 coding, tailored support and ongoing individualised feedback to clinicians. Over an eighteen month period there were improvements in engagement with and level of coding. Prior to implementation (August 2011) 4 of the 10 GPs engaged in regular coding and 69% of their consultation notes were coded. After 12 months, all 10 GPs and 6 nurses were ICPC-2 coding their consultations and monthly coding levels had increased to 98%. This structured Data Management Strategy provides a feasible sustainable way to improve information management in primary care.

  1. Management of the camera electronics programme for the World Space Observatory ultraviolet WUVS instrument

    Science.gov (United States)

    Patel, Gayatri; Clapp, Matthew; Salter, Mike; Waltham, Nick; Beardsley, Sarah

    2016-08-01

    World Space Observatory Ultraviolet (WSO-UV) is a major international collaboration led by Russia and will study the universe at ultraviolet wavelengths between 115 nm and 320 nm. The WSO Ultraviolet Spectrograph (WUVS) subsystem is led by a consortium of Russian institutes and consists of three spectrographs. RAL Space is contracted by e2v technologies Ltd to provide the CCD readout electronics for each of the three WUVS channels. The programme involves the design, manufacturing, assembly and testing of each Camera Electronics Box (CEB), its associated Interconnection Module (ICM), Electrical Ground Support Equipment (EGSE) and harness. An overview of the programme will be presented, from the initial design phase culminating in the development of an Engineering Model (EM) through qualification whereby an Engineering Qualification Model (EQM) will undergo environmental testing to characterize the performance of the CEB against the space environment, to the delivery of the Flight Models (FMs). The paper will discuss the challenges faced managing a large, dynamic project. This includes managing significant changes in fundamental requirements mid-programme as a result of external political issues which forced a complete re-design of an existing CEB with extensive space heritage but containing many ITAR controlled electronic components to a new, more efficient solution, free of ITAR controlled parts. The methodology and processes used to ensure the demanding schedule is maintained through each stage of the project will be presented including an insight into planning, decision-making, communication, risk management, and resource management; all essential to the continued success of the programme.

  2. Educational and intervention programmes for gestational diabetes mellitus (GDM) management: An integrative review.

    Science.gov (United States)

    Carolan-OIah, Mary C

    2016-01-01

    Gestational diabetes mellitus (GDM) is a serious pregnancy disorder, which is linked to stillbirth, birth damage and later development of type 2 diabetes. Rates of GDM have increased dramatically in the past 20 years, related to obesity, sedentary lifestyles and ethnicity. The aim of this integrative review was to identify and to critically review existing self-management programmes for GDM. A search for studies published between 2000 and 2013 was conducted on: PubMed, CINAHL, Medline, OvidSP, ProQuest, SCOPUS and Wiley online library. GDM search terms included gestational diabetes mellitus; GDM, pregnancy diabetes. Search terms for self-management programmes, included educational programmes; lifestyle intervention; exercise, diet, weight management in pregnancy; life-style interventions. Fifty papers were located in the search, and 12 were included in the review. Interventions fell into three main groups: (1) dietary and exercise interventions; (2) self-monitoring of blood glucose levels; and (3) counselling/behavioural interventions. This review found that although interventions varied in approach, most were successful in reducing insulin requirements; in reducing rates of macrosomia and hypertensive disorders, and in improving levels of knowledge and pregnancy outcomes. Only one study found that the intervention did not contribute some positive outcome. Interventions that include adopting a low glycemic index diet and increasing levels of activity appear to be successful at reducing maternal blood glucose levels and reducing insulin requirements during pregnancy. Reducing maternal blood glucose levels, in turn, is associated with a reduction of macrosomia and maternal weight gain.

  3. Practical implementation of optimal management strategies in conservation programmes: a mate selection method

    Directory of Open Access Journals (Sweden)

    Fernández, J.

    2001-12-01

    Full Text Available The maintenance of genetic diversity is, from a genetic point of view, a key objective of conservation programmes. The selection of individuals contributing offspring and the decision of the mating scheme are the steps on which managers can control genetic diversity, specially on ‘ex situ’ programmes. Previous studies have shown that the optimal management strategy is to look for the parents’ contributions that yield minimum group coancestry (overall probability of identity by descent in the population and, then, to arrange mating couples following minimum pairwise coancestry. However, physiological constraints make it necessary to account for mating restrictions when deciding the contributions and, therefore, these should be implemented in a single step along with the mating plan. In the present paper, a single-step method is proposed to optimise the management of a conservation programme when restrictions on the mating scheme exist. The performance of the method is tested by computer simulation. The strategy turns out to be as efficient as the two-step method, regarding both the genetic diversity preserved and the fitness of the population.

  4. Self management programmes for quality of life in people with stroke.

    Science.gov (United States)

    Fryer, Caroline E; Luker, Julie A; McDonnell, Michelle N; Hillier, Susan L

    2016-08-22

    Stroke results from an acute lack of blood supply to the brain and becomes a chronic health condition for millions of survivors around the world. Self management can offer stroke survivors a pathway to promote their recovery. Self management programmes for people with stroke can include specific education about the stroke and likely effects but essentially, also focusses on skills training to encourage people to take an active part in their management. Such skills training can include problem-solving, goal-setting, decision-making, and coping skills. To assess the effects of self management interventions on the quality of life of adults with stroke who are living in the community, compared with inactive or active (usual care) control interventions. We searched the following databases from inception to April 2016: the Cochrane Stroke Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE, CINAHL, PsycINFO, SCOPUS, Web of Science, OTSeeker, OT Search, PEDro, REHABDATA, and DARE. We also searched the following trial registries: ClinicalTrials.gov, Stroke Trials Registry, Current Controlled Trials, World Health Organization, and Australian New Zealand Clinical Trials Registry. We included randomised controlled trials of adults with stroke living in the community who received self management interventions. These interventions included more than one component of self management or targeted more than a single domain of change, or both. Interventions were compared with either an inactive control (waiting list or usual care) or active control (alternate intervention such as education only). Measured outcomes included changes in quality of life, self efficacy, activity or participation levels, impairments, health service usage, health behaviours (such as medication adherence or lifestyle behaviours), cost, participant satisfaction, or adverse events. Two review authors independently extracted prespecified data from all included

  5. An Empirical Comparative Investigation of Operations Management Programmes: Demand, Content and Entrance Criteria within the Context of Internationalization

    Science.gov (United States)

    Wang, Chengbo; Chen, Xuezhong; Edgar, David; Zhao, Yang

    2013-01-01

    In higher education institutes (HEIs), Operations Management programmes (OMPs) are among those programmes attracting a substantial amount of international student enrollment. With the current situation that the government is reducing its funding input, the UK HEIs' financial balance relies more than before on the international students who pay…

  6. Economic evaluation of a diabetes disease management programme with a central role for the diabetes nurse specialist

    NARCIS (Netherlands)

    Steuten, Lotte Maria Gertruda; Bruijsten, M.W.A.M.; Vrijhoef, H.J.M.

    2007-01-01

    Background: In the region of Maastricht, The Netherlands, a disease management programme (DMP) for patients with diabetes mellitus was implemented. The programme aims to improve quality of care within existing budgets. To achieve this, diabetes nurse specialists (DNSs) were given a central role

  7. Self-management programmes in temporomandibular disorders: results from an international Delphi process.

    Science.gov (United States)

    Durham, J; Al-Baghdadi, M; Baad-Hansen, L; Breckons, M; Goulet, J P; Lobbezoo, F; List, T; Michelotti, A; Nixdorf, D R; Peck, C C; Raphael, K; Schiffman, E; Steele, J G; Story, W; Ohrbach, R

    2016-12-01

    Self-management (SM) programmes are commonly used for initial treatment of patients with temporomandibular disorders (TMD). The programmes described in the literature, however, vary widely with no consistency in terminology used, components of care or their definitions. The aims of this study were therefore to construct an operationalised definition of self-management appropriate for the treatment of patients with TMD, identify the components of that self-management currently being used and create sufficiently clear and non-overlapping standardised definitions for each of those components. A four-round Delphi process with eleven international experts in the field of TMD was conducted to achieve these aims. In the first round, the participants agreed upon six principal concepts of self-management. In the remaining three rounds, consensus was achieved upon the definition and the six components of self-management. The main components identified and agreed upon by the participants to constitute the core of a SM programme for TMD were as follows: education; jaw exercises; massage; thermal therapy; dietary advice and nutrition; and parafunctional behaviour identification, monitoring and avoidance. This Delphi process has established the principal concepts of self-management, and a standardised definition has been agreed with the following components for use in clinical practice: education; self-exercise; self-massage; thermal therapy; dietary advice and nutrition; and parafunctional behaviour identification, monitoring and avoidance. The consensus-derived concepts, definitions and components of SM offer a starting point for further research to advance the evidence base for, and clinical utility of, TMD SM. © 2016 John Wiley & Sons Ltd.

  8. Patient experiences of a bariatric group programme for managing obesity: A qualitative interview study.

    Science.gov (United States)

    Tarrant, Mark; Khan, Sammyh S; Farrow, Claire V; Shah, Pooja; Daly, Mark; Kos, Katarina

    2017-02-01

    People with obesity experience a range of physical and psychological ill-health outcomes. This study examined patients' experiences of a group-based programme for the management of morbid obesity delivered within the UK National Health Service. The focus of the study was on the emerging dynamic of the group and patients' perceptions of its impact on health outcomes. A qualitative interview study was conducted and involved patients recruited from a Tier 3 bariatric service in South West England. Verbatim transcripts were analysed using thematic analysis. Twenty patients (12 females) with a BMI ≥ 35 kg/m2 participated in a semi-structured one-to-one interview. Participants had been registered with the bariatric service for at least 6 months. None of the participants had had bariatric surgery. Most participants felt that they had benefited from participating in the group programme and talked about the group as a resource for lifestyle change. Participants' narratives centred on the emergence of a sense of self based upon their participation in the group: establishing psychological connections to other patients, or shared social identity, was regarded as a key mechanism through which the programme's educational material was accessed, and underpinned the experience of social support within the group. Through interaction with other patients, involving the sharing of personal experiences and challenges, participants came to experience their weight 'problem' through a collective lens that they felt empowered them to initiate and sustain individual lifestyle change. Bariatric care groups have the potential to support lifestyle change and weight loss and may help address the psychological needs of patients. Nurturing a sense of shared social identity amongst patients with morbid obesity should be a core aim of the care pathway and may provide the foundation for successful translation of dietetic content in group programmes. Statement of contribution What is already

  9. Identification of the factors associated with outcomes in a Condition Management Programme

    Directory of Open Access Journals (Sweden)

    Demou Evangelia

    2012-10-01

    Full Text Available Abstract Background A requirement of the Government’s Pathways to Work (PtW agenda was to introduce a Condition Management Programme (CMP. The aim of the present study was to identify the differences between those who engaged and made progress in this telephone-based biopsychosocial intervention, in terms of their health, and those who did not and to determine the client and practitioner characteristics and programme elements associated with success in a programme aimed at improving health. Methods Data were obtained from the CMP electronic spreadsheets and clients paper-based case records. CMP standard practice was that questionnaires were administered during the pre- and post-assessment phases over the telephone. Each client’s record contains their socio-demographic data, their primary health condition, as well as the pre- and post-intervention scores of the health assessment tool administered. Univariate and multivariate statistical analysis was used to investigate the relationships between the database variables. Clients were included in the study if their records were available for analysis from July 2006 to December 2007. Results On average there were 112 referrals per month, totalling 2016 referrals during the evaluation period. The majority (62.8% of clients had a mental-health condition. Successful completion of the programme was 28.5% (575 “completers”; 144 “discharges”. Several factors, such as age, health condition, mode of contact, and practitioner characteristics, were significant determinants of participation and completion of the programme. The results showed that completion of the CMP was associated with a better mental-health status, by reducing the number of clients that were either anxious, depressed or both, before undertaking the programme, from 74% to 32.5%. Conclusions Our findings showed that an individual's characteristics are associated with success in the programme, defined as completing the intervention

  10. Can Joint Forest Management Programme Sustain Rural Life: A Livelihood Analysis from Community-based Forest Management Groups

    OpenAIRE

    Das, Nimai

    2009-01-01

    This empirical study assesses the impact of community-based initiative under gender sensitive joint forest management (JFM) programme on sustainable rural livelihoods (SRL) across the socio-economic groups of forest fringe community based on JFM and non-JFM villages. The study suggests that strong livelihood sustainability criteria within the SRL framework meets for all marginal landholding and landless categories of households, which live below poverty line and that are almost dependent on f...

  11. Executing A Customer Relationship Management Programme In An Emerging Market: An Empirical Approach

    Directory of Open Access Journals (Sweden)

    Akinyele Samuel

    2013-05-01

    Full Text Available Retail financial services in all markets, including emerging markets, are undergoing major transaction, driven by change, deregulation and customer sophistication. Customer service and specifically relationship management in particular, are crucial to attaining a sustainable competitive advantage in the marketplace. The execution of a one- to- one programme within an emerging economy is the focus of this paper, specifically in the financial services environment. The steps in the execution of customer relationship management (CRM as proposed by Peppers, Rogers and Dorf (1999b are examined and the effect on customer service in an emerging market is investigated. The findings indicates that there are positive associations with these steps and customer service.

  12. Development of Verbal Expressive Skills Management Programme (VESMP for Patients with Brocas Aphasia

    Directory of Open Access Journals (Sweden)

    Humaira Shamim

    2017-06-01

    Full Text Available Introduction: Disorders of communication, including aphasia (mainly post stroke caused by the left hemisphere brain damage, is a major community health issue. The prevalence of aphasia after stroke is 25% in Pakistan in which Broca’s aphasia is predominant in stroke patients who have anterior lesion in the frontal lobe of the left hemispheres. The verbal expressive skills management programme (VESMP is the software which developed augmented management for patients to enhance verbal expressive skills for patients with severe Broca’s aphasia from different geographic areas. Moreover, the software increases the independencies which are not observed in other traditional techniques. This study is the pathway for maintaining and improving the functional life of patients. Objectives: The main objective was to develop the verbal expressive skills management programme (VESMP to enhance verbal expressive skills of patients with severe Broca’s aphasia. Methodology: Initially a pilot study with eight cases is carried out. The nonprobability purposive sampling technique was used to recruit the patients with severe aphasia who received therapy through VESMP programme on their smart phones. It contains seven domains: spontaneous speech, comprehension, naming, reading, writing, imitation, and automated speech. The programme was developed in Urdu language and its content was selected from grade three Urdu Punjab text books. The program was then updated with the help of guidance and feedback received from five experts of the relevant field. The patients scoring is recorded for each domain on basis of correct responses. The study was conducted in YUSRA general hospital and Pakistan Railway Hospital, Rawalpindi. The study includes patients that are 40+ years old, and have three months of post stroke with diagnosis of chronic Broca’s Aphasias, patients with severe cognitive impairment were excluded from the study. The pre-and post score was recorded for each

  13. Flexible clock systems : Adjusting the temporal programme

    NARCIS (Netherlands)

    van der Veen, Daan R.; Riede, Sjaak J.; Heideman, Paul D.; Hau, Michaela; van der Vinne, Vincent; Hut, Roelof A.

    2017-01-01

    Under natural conditions, many aspects of the abiotic and biotic environment vary with time of day, season or even era, while these conditions are typically kept constant in laboratory settings. The timing information contained within the environment serves as critical timing cues for the internal

  14. Professional commitment to changing chronic illness care: results from disease management programmes.

    Science.gov (United States)

    Lemmens, Karin; Strating, Mathilde; Huijsman, Robbert; Nieboer, Anna

    2009-08-01

    The aim of this exploratory study was to investigate to what extent primary care professionals are able to change their systems for delivering care to chronic obstructive pulmonary disease (COPD) patients and what professional and organizational factors are associated with the degree of process implementation. Quasi-experimental design with 1 year follow-up after intervention. Three regional COPD management programmes in the Netherlands, in which general practices cooperated with regional hospitals. All participating primary care professionals (n = 52). COPD management programme. Professional commitment, organizational context and degree of process implementation. Professionals significantly changed their systems for delivering care to COPD patients, namely self-management support, decision support, delivery system design and clinical information systems. Associations were found between organizational factors, professional commitment and changes in processes of care. Group culture and professional commitment appeared to be, to a moderate degree, predictors of process implementation. COPD management was effective; all processes improved significantly. Moreover, theoretically expected associations between organizational context and professional factors with the implementation of COPD management were indeed confirmed to some extent. Group culture and professional commitment are important facilitators.

  15. Physician empowerment programme; a unique workshop for physician-managers of community clinics.

    Science.gov (United States)

    Maza, Yafit; Shechter, Efrat; Pur Eizenberg, Neta; Segev, Efrat Gortler; Flugelman, Moshe Y

    2016-10-14

    The physician manager role in the health care system is invaluable as they serve as role models and quality setters. The requirements from physician managers have become more demanding and the role less prestigious; yet burnout and its prevention in this group have received little attention. Physician leadership development programmes have generally dealt directly with skill and knowledge acquisition. The aim of this research was to evaluate an intensive workshop designed to modify attitudes and improve skills of physician-managers of community clinics, through focus on personal well-being and empowerment. Two hundred fifty six physicians affiliated with Clalit Health Services, the largest health maintenance organization in Israel, participated in 16 IMPACT courses during the years 2013-2015. The programme comprised five full days during a two-week period, including an overnight and follow-up meetings three and six weeks later. Theoretical knowledge, experiential learning, practical tools, deep personal exercises, and simulations were conveyed through individual and group work. Topics included: models of self-awareness, outcome thinking, determining a personal and organizational vision, and creating a personal approach to leadership. At the end of each course, and by email at 6 or more months after completion of the course, participants were asked to anonymously respond to closed questions (on a scale of 1-6) and an open question. Mean scores for the contribution of IMPACT to participants' role of physician manager were 5.3 at the end of the course, and 4.7 at 6 or more months later. Mean scores at 6 or more months were 5.0 regarding the contribution of the programme to personal development, 4.4 regarding satisfaction in the role of physician manager, and 4.6 regarding their coping with managerial dilemmas. A workshop that focused on personal growth and self-awareness increased physicians' job satisfaction and their sense of managerial capability, coping with

  16. GPS Composite Clock Analysis

    OpenAIRE

    Wright, James R.

    2008-01-01

    The GPS composite clock defines GPS time, the timescale used today in GPS operations. GPS time is illuminated by examination of its role in the complete estimation and control problem relative to UTC/TAI. The phase of each GPS clock is unobservable from GPS pseudorange measurements, and the mean phase of the GPS clock ensemble (GPS time) is unobservable. A new and useful observability definition is presented, together with new observability theorems, to demonstrate explicitly that GPS time is...

  17. Do weight management programmes delivered at professional football clubs attract and engage high risk men? A mixed-methods study

    National Research Council Canada - National Science Library

    Hunt, Kate; Gray, Cindy M; Maclean, Alice; Smillie, Susan; Bunn, Christopher; Wyke, Sally

    2014-01-01

    .... Football Fans in Training (FFIT), a men-only weight management programme delivered to groups of men at top professional football clubs, encourages men to lose weight by working with, not against, cultural ideals of masculinity...

  18. Evaluation of a large scale implementation of disease management programmes in various Dutch regions: A study protocol

    NARCIS (Netherlands)

    K.M.M. Lemmens (Karin); M.P.M.H. Rutten-van Mölken (Maureen); J.M. Cramm (Jane); R. Huijsman (Robbert); R.A. Bal (Roland); A.P. Nieboer (Anna)

    2011-01-01

    textabstractBackground. Disease management programmes (DMPs) have been developed to improve effectiveness and economic efficiency within chronic care delivery by combining patient-related, professional-directed, and organisational interventions. The benefits of DMPs within different settings,

  19. Nuclear waste management programme 1999 for the Loviisa and Olkiluoto nuclear power plants; Olkiluodon ja Loviisan voimalaitosten ydinjaetehuollon ohjelma 1999

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-09-01

    A joint company Posiva Oy founded by nuclear energy producing Teollisuuden Voima Oy (TVO) and Imatran Voima Oy (IVO) coordinates the research work of the companies on nuclear waste management in Finland. in Posiva`s Nuclear Waste Management Programme 1999, an account of the nuclear waste management measures of TVO and IVO is given as required by the sections 74 and 75 of the Finnish Nuclear Energy Degree. At first, nuclear waste management situation and the programme of activities are reported. The nuclear waste management research for the year 1999 and more generally for the years 1999-2003 is presented 3 refs.

  20. [The relevance of a patient education programme for self-management of home peritoneal dialysis].

    Science.gov (United States)

    Ugonia, Andrea Piercarlo; Villa, Mauro

    2013-01-01

    Nursing care is an essential part of the management of patients undergoing home peritoneal dialysis. The institution of an educational pathway facilitates ease and safety of self-management of peritoneal dialysis (PD) procedures. The aim of this study was to evaluate the relevance of a nurse-guided training programme for PD patients. A questionnaire regarding quality of life was administered to patients undergoing PD at the Cardinal Massaia Hospital in Asti, Italy. The EQ-5D questionnaire was used with the adjunct of some study- specific questions. Prior research of relevant Pubmed references had also been performed. Our data confirm other works in the literature emphasising the central role of nurses during educational processes involving PD patients. The quality of life of these patients improved notably when compared to controls who had not followed an education programme. In fact, a higher average quality of life was reported by patients enrolled in our study when compared to that found in other studies. Nurses involved in our PD educational programme follow international guideline sources. Patient education is a fundamental and on-going part of the process of nursing care and contributes to the well-being, safety, independence and compliance of patients undergoing PD at home.

  1. Gathering Evidence of Benefits: A Structured Approach from the Jisc Managing Research Data Programme

    Directory of Open Access Journals (Sweden)

    Laura Molloy

    2013-11-01

    Full Text Available The work of the Jisc Managing Research Data programme is – along with the rest of the UK higher education sector – taking place in an environment of increasing pressure on research funding. In order to justify the investment made by Jisc in this activity – and to help make the case more widely for the value of investing time and money in research data management – individual projects and the programme as a whole must be able to clearly express the resultant benefits to the host institutions and to the broader sector. This paper describes a structured approach to the measurement and description of benefits provided by the work of these projects for the benefit of funders, institutions and researchers. We outline the context of the programme and its work; discuss the drivers and challenges of gathering evidence of benefits; specify benefits as distinct from aims and outputs; present emerging findings and the types of metrics and other evidence which projects have provided; explain the value of gathering evidence in a structured way to demonstrate benefits generated by work in this field; and share lessons learned from progress to date.

  2. Precision Clock Evaluation Facility

    Data.gov (United States)

    Federal Laboratory Consortium — FUNCTION: Tests and evaluates high-precision atomic clocks for spacecraft, ground, and mobile applications. Supports performance evaluation, environmental testing,...

  3. Process evaluation of a tailored intervention programme of cardiovascular risk management in general practices.

    Science.gov (United States)

    Huntink, E; Wensing, M; Timmers, I M; van Lieshout, J

    2016-12-15

    A tailored implementation programme to improve cardiovascular risk management (CVRM) in general practice had little impact on outcomes. The questions in this process evaluation concerned (1) impact on counselling skills and CVRM knowledge of practice nurses, (2) their use of the various components of the intervention programme and adoption of recommended practices and (3) patients' perceptions of counselling for CVRM. A mixed-methods process evaluation was conducted. We assessed practice nurses' motivational interviewing skills on audio-taped consultations using Motivational Interviewing Treatment Integrity (MITI). They also completed a clinical knowledge test. Both practice nurses and patients reported on their experiences in a written questionnaire and interviews. A multilevel regression analysis and an independent sample t test were used to examine motivational interviewing skills and CVRM knowledge. Framework analysis was applied to analyse qualitative data. Data from 34 general practices were available, 19 intervention practices and 14 control practices. No improvements were measured on motivational interviewing skills in both groups. There appeared to be better knowledge of CVRM in the control group. On average half of the practice nurses indicated that they adopted the recommended interventions, but stated that they did not necessarily record this in patients' medical files. The tailored programme was perceived as too large. Time, follow-up support and reminders were felt to be lacking. About 20% of patients in the intervention group visited the general practice during the intervention period, yet only a small number of these patients were referred to recommended options. The tailored programme was only partly used by practice nurses and had little impact on either their clinical knowledge and communication skills or on patient reported healthcare. If the assumed logical model of change is valid, a more intensive programme is needed to have an impact on CVRM

  4. Evaluation of the feasibility of a school-based asthma management programme in Taiwan.

    Science.gov (United States)

    Maa, Suh-Hwa; Chang, Yue-Cune; Chou, Chun-Liang; Ho, Shu-Chuan; Sheng, Te-Fang; Macdonald, Karen; Wang, Yanping; Shen, Yu-Ming; Abraham, Ivo

    2010-09-01

    To investigate the feasibility of a school-based asthma management programme for middle school children. Asthma rates are increasing among school-aged children. Successful asthma treatment in children depends in part on clear communication and effective education. This feasibility study employed a one-group only longitudinal design with four time points over 18 months. Nineteen female and twelve male (n = 31) seventh-grade children with asthma (13 SD 0·71 years) were identified using a six-stage asthma case-finding approach. Teachers and school staff were trained in the principles and methods of the proposed school-based asthma management programme. An individualised guided asthma self-management programme was developed for each child by a clinical team at a major academic medical centre. We assisted teachers in implementing the school programme; building a support network and monitoring children's activities. Outcome measures included lung function tests (at 0, six, 12 and 18 months), disease-related symptoms, psychosocial status and impact of asthma on learning (at 0 and 18 months). School provided data on academic achievement and school absences at 0, six, 12 and 18 months. Significant improvements were noted at six, 12 and 18 months on forced vital capacity (FVC)% of predicted (p = 0·001, 0·015, 0·015, respectively), forced expiratory volume in one second (FEV(1) )% of predicted (p = 0·001, 0·006, 0·088, respectively) and FEV(1) /FVC% of predicted (p = 0·001, 0·015, 0·099, respectively). There was a trend towards improved asthma symptoms (p = 0·050) and a significant decrease in positive perception of curriculum (p = 0·017) at 18 months after adjustment for covariates. This programme was associated with respiratory benefits on physiological asthma markers commonly, with a trend for symptom control. Academic and psychosocial outcomes are subject of further inquiry. School-based asthma management holds promise as a feasible clinical option for middle

  5. Using a Voltage Domain Programmable Technique for Low-Power Management Cell-Based Design

    Directory of Open Access Journals (Sweden)

    Ching-Hwa Cheng

    2011-09-01

    Full Text Available The Multi-voltage technique is an effective way to reduce power consumption. In the proposed cell-based voltage domain programmable (VDP technique, the high and low voltages applied to logic gates are programmable. The flexible voltage domain reassignment allows the chip performance and power consumption to be dynamically adjusted. In the proposed technique, the power switches possess the feature of flexible programming after chip manufacturing. This VDP method does not use an external voltage regulator to regulate the supply voltage level from outside of the chip but can be easily integrated within the design. This novel technique is proven by use of a video decoder test chip, which shows 55% and 61% power reductions compared to conventional single-Vdd and low-voltage designs, respectively. This power-aware performance adjusting mechanism shows great power reduction with a good power-performance management mechanism.

  6. Implementing case-based teaching strategies in a decentralised nursing management programme in South Africa.

    Science.gov (United States)

    Nkosi, Zethu; Pillay, Padmini; Nokes, Kathleen M

    2013-01-01

    Case-based education has a long history in the disciplines of education, business, law and the health professions. Research suggests that students who learn via a case-based method have advanced critical thinking skills and a greater ability for application of knowledge in practice. In medical education, case-based methodology is widely used to facilitate knowledge transfer from theoretical knowledge to application in patient care. Nursing education has also adopted case-based methodology to enhance learner outcomes and critical thinking. The objectives of the study was to describe a decentralised nursing management education programme located in Durban, South Africa and describe the perceptions of nursing faculty facilitators regarding implementation of this teaching method. Data was collected through the use of one-on-one interviews and also focus groups amongst the fifteen facilitators who were using a case-based curriculum to teach the programme content. The average facilitator was female, between 41 and 50 years of age, working part-time, educated with a baccalaureate degree, working as a professional nurse for between 11 and 20 years; slightly more than half had worked as a facilitator for three or more years. The facilitators identified themes related to the student learners, the learning environment, and strengths and challenges of using facilitation to teach the content through cases. Decentralised nursing management educational programmes can meet the needs of nurses who are located in remote areas which are characterised by poor transportation patterns and limited resources and have great need for quality healthcare services. Nursing faculty facilitators need knowledgeable and accessible contact with centrally based full-time nursing faculty in order to promote high quality educational programmes.

  7. Implementing case-based teaching strategies in a decentralised nursing management programme in South Africa

    Directory of Open Access Journals (Sweden)

    Zethu Nkosi

    2013-01-01

    Full Text Available Background: Case-based education has a long history in the disciplines of education, business, law and the health professions. Research suggests that students who learn via acase-based method have advanced critical thinking skills and a greater ability for application of knowledge in practice. In medical education, case-based methodology is widely used to facilitate knowledge transfer from theoretical knowledge to application in patient care. Nursing education has also adopted case-based methodology to enhance learner outcomes and critical thinking.Objectives: The objectives of the study was to describe a decentralised nursing management education programme located in Durban, South Africa and describe the perceptions of nursing faculty facilitators regarding implementation of this teaching method.Method: Data was collected through the use of one-on-one interviews and also focus groups amongst the fifteen facilitators who were using a case-based curriculum to teach the programme content. The average facilitator was female, between 41 and 50 years of age,working part-time, educated with a baccalaureate degree, working as a professional nurse for between 11 and 20 years; slightly more than half had worked as a facilitator for three or more years.Results: The facilitators identified themes related to the student learners, the learning environment, and strengths and challenges of using facilitation to teach the content through cases. Decentralised nursing management educational programmes can meet the needs of nurses who are located in remote areas which are characterised by poor transportation patterns and limited resources and have great need for quality healthcare services.Conclusion: Nursing faculty facilitators need knowledgeable and accessible contact with centrally based full-time nursing faculty in order to promote high quality educational programmes.

  8. Implementing case-based teaching strategies in a decentralised nursing management programme in South Africa

    Directory of Open Access Journals (Sweden)

    Zethu Nkosi

    2013-11-01

    Full Text Available Background: Case-based education has a long history in the disciplines of education, business, law and the health professions. Research suggests that students who learn via a case-based method have advanced critical thinking skills and a greater ability for application of knowledge in practice. In medical education, case-based methodology is widely used to facilitate knowledge transfer from theoretical knowledge to application in patient care. Nursing education has also adopted case-based methodology to enhance learner outcomes and critical thinking.Objectives: The objectives of the study was to describe a decentralised nursing management education programme located in Durban, South Africa and describe the perceptions of nursing faculty facilitators regarding implementation of this teaching method.Method: Data was collected through the use of one-on-one interviews and also focus groups amongst the fifteen facilitators who were using a case-based curriculum to teach the programme content. The average facilitator was female, between 41 and 50 years of age, working part-time, educated with a baccalaureate degree, working as a professional nurse for between 11 and 20 years; slightly more than half had worked as a facilitator for three or more years.Results: The facilitators identified themes related to the student learners, the learning environment, and strengths and challenges of using facilitation to teach the content through cases. Decentralised nursing management educational programmes can meet the needs of nurses who are located in remote areas which are characterised by poor transportation patterns and limited resources and have great need for quality healthcare services.Conclusion: Nursing faculty facilitators need knowledgeable and accessible contact with centrally based full-time nursing faculty in order to promote high quality educational programmes.

  9. A disease management programme for patients with diabetes mellitus is associated with improved quality of care within existing budgets

    NARCIS (Netherlands)

    Steuten, Lotte Maria Gertruda; Vrijhoef, H.J.M.; Landewe-Cleuren, S.; Schaper, N.; van Merode, G.G.; Spreeuwenberg, C.

    2007-01-01

    Aim  To assess the impact of a disease management programme for patients with diabetes mellitus (Type 1 and Type 2) on cost-effectiveness, quality of life and patient self-management. By organizing care in accordance with the principles of disease management, it is aimed to increase quality of care

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

    Directory of Open Access Journals (Sweden)

    R. Parker

    2009-02-01

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

  11. Meddling in the KBS Programme and Swedish Success in Nuclear Waste Management

    Energy Technology Data Exchange (ETDEWEB)

    Elam, Mark (Univ. of Goeteborg, Goeteborg (Sweden)), e-mail: mark.elam@sts.gu.se; Sundqvist, Goeran (Univ. of Oslo, Oslo (Norway))

    2010-09-15

    In this paper the intention is to analyse and re/describe the qualities that underlie the current fame and good standing of Swedish nuclear waste management (the so-called KBS Programme). Inspired by work in the actor-network theory tradition, we want to argue that the success of the KBS Programme can be best accounted for with reference to qualities which are the reverse of those you might otherwise expect. While you might imagine its good name to be ascribable to the constancy, solidity and singularity of the solution being advanced, we want to argue that it is rather the infidelity, fluidity and heterogeneity of this solution that can best account for the leading position of Swedish nuclear waste management today. In fact, we wish to assert that it is through the effacement of the inherent importance of the latter set of qualities, that the KBS Programme has been able to promote a vision of itself as successfully imbued with the former set. The enduring template for Swedish nuclear waste management was established in 1977 through the Nuclear Stipulation Act. This gave rise to the cultivation of a new expertise within the Swedish nuclear industry of demonstrating indubitable solutions to nuclear waste problems close at hand. Thus, while it may appear that the KBS Programme has always been about the conception, and step by step implementation of a completely coherent and largely unvarying approach to the geological disposal of nuclear waste, this can be seen as effacing another reality. Bringing this other reality back into view, we see that for the KBS Programme, attaining the goal of the geological disposal of nuclear waste has never been as important as maintaining the ability to demonstrate its attainability. The KBS Programme is firstly a long-running programme in the material semiotics of nuclear fuel safety and the production of palpable signs of the accomplishment of geological disposal close at hand. This production of palpable signs has extended to the

  12. Clocked combustor can array

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Won-Wook; McMahan, Kevin Weston; Srinivasan, Shiva Kumar

    2017-01-17

    The present application provides a clocked combustor can array for coherence reduction in a gas turbine engine. The clocked combustor can array may include a number of combustor cans positioned in a circumferential array. A first set of the combustor cans may have a first orientation and a second set of the combustor cans may have a second orientation.

  13. Biological Clocks & Circadian Rhythms

    Science.gov (United States)

    Robertson, Laura; Jones, M. Gail

    2009-01-01

    The study of biological clocks and circadian rhythms is an excellent way to address the inquiry strand in the National Science Education Standards (NSES) (NRC 1996). Students can study these everyday phenomena by designing experiments, gathering and analyzing data, and generating new experiments. As students explore biological clocks and circadian…

  14. Optical Clocks in Space

    NARCIS (Netherlands)

    Schiller, S.; Görlitz, A.; Nevsky, A.; Koelemeij, J. C J; Wicht, A.; Gill, K.P.; Klein, H. A.; Margolis, H. S.; Mileti, G.; Sterr, U.; Riehle, F.; Peik, E.; Tamm, Chr; Ertmer, W.; Rasel, E.; van der Klein, M; Salomon, C.; Tino, G. M.; Lemonde, P.; Holzwarth, R.; Hänsch, T. W.

    The performance of optical clocks has strongly progressed in recent years, and accuracies and instabilities of 1 part in 1018 are expected in the near future. The operation of optical clocks in space provides new scientific and technological opportunities. In particular, an earth-orbiting satellite

  15. PARP Around the Clock

    OpenAIRE

    Kumar, Vivek; Takahashi, Joseph S.

    2010-01-01

    Cells possess internal ~24-hour or circadian clocks that synchronize physiological processes with daily cycles of light and nutrient availability. In this issue, Asher et al. (2010) find that PARP-1 (Poly(ADP-ribose) polymerase-1) modifies components of the clock machinery in response to feeding, providing a mechanism for how metabolic rhythms coordinate with circadian rhythms.

  16. Egyptian "Star Clocks"

    Science.gov (United States)

    Symons, Sarah

    Diagonal, transit, and Ramesside star clocks are tables of astronomical information occasionally found in ancient Egyptian temples, tombs, and papyri. The tables represent the motions of selected stars (decans and hour stars) throughout the Egyptian civil year. Analysis of star clocks leads to greater understanding of ancient Egyptian constellations, ritual astronomical activities, observational practices, and pharaonic chronology.

  17. Post Graduate Programme in Dietetics & Food Service Management (MSCDFSM) Programme of IGNOU: Access through the Lucknow Regional Centre

    Science.gov (United States)

    Dorothy, J. S.; Kumar, Ashwini

    2014-01-01

    Indira Gandhi National Open University (IGNOU) which was established initially as a Single mode Distance Teaching Institution (DTI) in the year 1985 opened its campus to face-to-face education in the year 2008 and thus now is a Dual mode Distance Teaching Institution (DTI). The Post Graduate Programme (Master of Science) in Dietetics and Food…

  18. Circadian clocks: Not your grandfather's clock.

    Science.gov (United States)

    Turek, Fred W

    2016-11-25

    The last 20 years have seen the rapid evolution of our understanding of the molecular genes and networks that enable almost all forms of life to generate 24-hour-or circadian-rhythms. One finding has been particularly exciting: that the molecular circadian clock resides in almost all of the cells of the body and that the clock regulates the timing of many cellular and signaling pathways associated with multiple disease states. Such advances represent a new frontier for medicine: circadian medicine. Copyright © 2016, American Association for the Advancement of Science.

  19. Development of the learning programme management and evaluation scale for the South African skills development context

    Directory of Open Access Journals (Sweden)

    Maelekanyo C. Tshilongamulenzhe

    2013-01-01

    Full Text Available Research purpose: The present study developed and tested the construct validity and reliability of the learning programme management and evaluation (LPME scale.Motivation for the study: The LPME scale was developed to measure and enhance the effectiveness of the management and evaluation of occupational learning programmes in the South African skills development context. Currently no such instrument exists in the South African skills development context; hence there is a need for it.Research design, approach and method: This study followed a quantitative, non-experimental, cross-sectional design using primary data. The LPME scale was administered to a sample of 652 skills development practitioners and learners or apprentices drawn from six organisations representing at least five economic sectors in South Africa. Data were analysed using SPSS and Rasch modelling to test the validity and reliability of the new scale.Main findings: The findings show that the LPME scale is a valid and reliable 11-dimensional measure comprising 81 items.Practical/managerial implications: In view of the seriousness of the skills shortage challenge facing South Africa, this study provides a solid base upon which skills development practitioners can effectively manage and evaluate occupational learning programmes. Furthermore, the newly developed LPME scale provides a basis for further human resource development research in the quest for a solution to the skills shortage challenge.Contribution/value-add: This study contributes by developing a new scale and testing its validity and reliability. As a valid and reliable measure, the LPME scale can be applied with confidence in various South African workplaces.

  20. Implementing a hypertension management programme in a rural area: local approaches and experiences from Ba-Vi district, Vietnam

    Directory of Open Access Journals (Sweden)

    Nguyen Viet

    2011-05-01

    Full Text Available Abstract Background Costly efforts have been invested to control and prevent cardiovascular diseases (CVD and their risk factors but the ideal solutions for low resource settings remain unclear. This paper aims at summarising our approaches to implementing a programme on hypertension management in a rural commune of Vietnam. Methods In a rural commune, a programme has been implemented since 2006 to manage hypertensive people at the commune health station and to deliver health education on CVD risk factors to the entire community. An initial cross-sectional survey was used to screen for hypertensives who might enter the management programme. During 17 months of implementation, other people with hypertension were also followed up and treated. Data were collected from all individual medical records, including demographic factors, behavioural CVD risk factors, blood pressure levels, and number of check-ups. These data were analysed to identify factors relating to adherence to the management programme. Results Both top-down and bottom-up approaches were applied to implement a hypertension management programme. The programme was able to run independently at the commune health station after 17 months. During the implementation phase, 497 people were followed up with an overall regular follow-up of 65.6% and a dropout of 14.3%. Severity of hypertension and effectiveness of treatment were the main factors influencing the decision of people to adhere to the management programme, while being female, having several behavioural CVD risk factors or a history of chronic disease were the predictors for deviating from the programme. Conclusion Our model showed the feasibility, applicability and future potential of a community-based model of comprehensive hypertension care in a low resource context using both top-down and bottom-up approaches to engage all involved partners. This success also highlighted the important roles of both local authorities and a cardiac

  1. The development and implementation of the Chronic Care Management Programme in Counties Manukau.

    Science.gov (United States)

    Wellingham, John; Tracey, Jocelyn; Rea, Harold; Gribben, Barry

    2003-02-21

    To develop an effective and efficient process for the seamless delivery of care for targeted patients with specific chronic diseases. To reduce inexplicable variation and maximise use of available resources by implementing evidence-based care processes. To develop a programme that is acceptable and applicable to the Counties Manukau region. A model for the management of people with chronic diseases was developed. Model components and potential interventions were piloted. For each disease project, a return on investment was calculated and external evaluation was undertaken. The initial model was subsequently modified and individual disease projects aligned to it. The final Chronic Care Management model, agreed in September 2001, described a single common process. Key components were the targeting of high risk patients, organisation of cost effective interventions into a system of care, and an integrated care server acting as a data warehouse with a rules engine, providing flags and reminders. Return on investment analysis suggested potential savings for each disease component from $277 to $980 per person per annum. For selected chronic diseases, introduction of an integrated chronic care management programme, based on internationally accepted best practice processes and interventions can make significant savings, reducing morbidity and improving the efficiency of health delivery in the Counties Manukau region.

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

    Science.gov (United States)

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

    2010-12-01

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

  3. Managing the deteriorating nursing home resident after the introduction of a hospital avoidance programme: a nursing perspective.

    Science.gov (United States)

    O'Neill, Barbara J; Dwyer, Trudy; Reid-Searl, Kerry; Parkinson, Lynne

    2017-06-01

    Hospital avoidance programmes aim to reduce the number of emergency transfers from nursing homes to hospitals and facilitate early discharge for hospitalised residents. Nursing staff are at the forefront of these efforts, yet little is known about how the programmes affect them and their management of the deteriorating resident. This information is needed to inform hospital avoidance programmes and better understand their work. To examine nursing home nursing staff perceptions regarding their management of the deteriorating resident after the introduction of a hospital avoidance programme. A thematic analysis was conducted of focus group data collected from nursing staff 14 to 15 months after the introduction of a pilot hospital avoidance programme at an Australian nursing home. The programme was well received and filled a gap in nursing staff management of residents with deteriorating health by providing structure and support. Staff were more confident and focused on this area of their work. Nursing assistants felt more integrated into the system and were supported and learning from nurses. Workload remained heavy and there was a shift in how time was allocated, but nursing staff preferred to keep residents at the facility. Nursing staff welcomed the programme and benefitted from its implementation. However, strategies must be explored to accommodate the staffing needs associated with providing emergency and subacute care in the nursing home setting. © 2016 Nordic College of Caring Science.

  4. Training, supervision and quality of care in selected integrated community case management (iCCM programmes: A scoping review of programmatic evidence

    Directory of Open Access Journals (Sweden)

    Xavier Bosch–Capblanch

    2014-11-01

    Full Text Available To describe the training, supervision and quality of care components of integrated Community Case Management (iCCM programmes and to draw lessons learned from existing evaluations of those programmes

  5. The changing student profile at Service, Hospitality and Tourism Management Programme in Denmark

    DEFF Research Database (Denmark)

    Hammershøy, Anna

    2014-01-01

    of a short-cycle higher education programme in Hospitality and Tourist management in Denmark. The findings indicate that the international students (originating from countries of East Central Europe and the Baltics) demonstrate more passive classroom behaviour and experience more challenges in implementing......Using Hofstede’s cultural dimensions (Power Distance and Uncertainty Avoidance) as a theoretical foundation, this paper presents a two-phase qualitative research which aims to identify the reasons of different classroom and study behaviours of international and Danish students in the context...... be offered to new international students....

  6. RDandD Programme 2007. Programme for research, development and demonstration of methods for the management and disposal of nuclear waste

    Energy Technology Data Exchange (ETDEWEB)

    2007-09-15

    The programme describes in general terms the planned measures and the facilities that are needed for the task, with a focus on the plans for the period 2008-2013. The period of immediate concern is 2008-2010. The level of detail for the three subsequent years is naturally lower. The programme provides a basis for designing systems to manage and dispose of the radioactive waste from the nuclear power plants. SKB intends to dispose of the spent nuclear fuel in accordance with the KBS-3 method. In the RDandD Programme we describe our activities and the planning for it. We also deal with societal research and other methods for disposal of spent nuclear fuel. The planning for low- and intermediate-level waste, as well as for the societal research, is presented in separate parts. The upcoming review of the programme can contribute valuable outside viewpoints. The regulatory authorities and the Government can clarify how they view different parts of the activity. Municipalities and other stakeholders can, after studying the programme, offer their viewpoints to SKB, the regulatory authorities or the Government. The most important milestone during the coming three-year period is to submit applications under the Nuclear Activities Act for the final repository for spent nuclear fuel and under the Environmental Code for the final repository system. RDandD programme 2007 therefore focuses on the technology development that is needed to realize the final repository for spent nuclear fuel. The site investigations in Forsmark and Laxemar will be concluded in 2007. The work of compiling the applications for the final repository is under way. In contrast to the immediately preceding programmes, RDandD Programme 2007 therefore also contains a summary of the site investigation phase and a look ahead at the steps that remain before the final repository can be put into operation. RDandD Programme 2007 consists of six parts: Part I SKB's plan of action; Part II Final repository for

  7. A management programme for suspected heart failure in primary care in cooperation with specialists in cardiology.

    Science.gov (United States)

    Mejhert, Märit; Kahan, Thomas

    2015-03-01

    The diagnosis of new onset congestive heart failure (CHF) is often difficult as symptoms and signs are non-specific. Proper diagnostic investigations and treatments are underused in primary care. To describe a management programme for patients with suspected CHF in primary care in cooperation with specialists in cardiology. Prospective study of 102 consecutive primary care patients with suspected new onset CHF referred to an easily accessible hospital-based cardiology outpatient clinic management programme. Following clinical examination, ECG, echocardiography, blood chemistry including NT-proBNP, and assessment of NYHA class and quality of life (EQ5D), patients with a confirmed diagnosis of CHF were prescribed medication with advice on titration and target doses. Trained CHF nurses gave Information on CHF and provided follow up. Half (47%) of the referred patients had the diagnosis of CHF confirmed. Low NT-proBNP values (CHF group was 86% ACE-inhibitors/angiotensin receptor blockers, 61% ß-blocking agents, and 81% diuretics (P CHF in primary care, with referral to a hospital-based specialist team, can be applied successfully.

  8. Evaluation of the impact of intervention programmes on education organisations: Application to a Quality Management System.

    Science.gov (United States)

    Fernández-Díaz, Mª Jose; Rodríguez-Mantilla, Jesús Miguel; Jover-Olmeda, Gonzalo

    2017-08-01

    This paper analyses the importance of evaluating the various components of the programmes or actions carried out by education organisations. It highlights the need to assess the impact of the intervention on the organisation and consider how changes are consolidated over time in interaction with the context. We propose an impact evaluation model and as an example have chosen the implementation of Quality Management Systems in schools. The paper analyses the results obtained in 40 schools in three regions (Spanish Autonomous Communities) with varying levels of implementation. The results show overall impact on these education centres as the teachers and management teams of the centres perceive it. This impact is more evident in some of the dimensions considered in the study than in others. The results also confirm the differences between regional contexts. Copyright © 2017 Elsevier Ltd. All rights reserved.

  9. Optical clocks and relativity.

    Science.gov (United States)

    Chou, C W; Hume, D B; Rosenband, T; Wineland, D J

    2010-09-24

    Observers in relative motion or at different gravitational potentials measure disparate clock rates. These predictions of relativity have previously been observed with atomic clocks at high velocities and with large changes in elevation. We observed time dilation from relative speeds of less than 10 meters per second by comparing two optical atomic clocks connected by a 75-meter length of optical fiber. We can now also detect time dilation due to a change in height near Earth's surface of less than 1 meter. This technique may be extended to the field of geodesy, with applications in geophysics and hydrology as well as in space-based tests of fundamental physics.

  10. Ottawa Panel Evidence-Based Clinical Practice Guidelines for Patient Education Programmes in the Management of Osteoarthritis

    Science.gov (United States)

    Health Education Journal, 2011

    2011-01-01

    Objective: The purpose of this study was to develop guidelines and recommendations on patient education programmes of any type, targeted specially to individuals with OA and which were designed to improve the clinical effectiveness of managing OA. Methods: The Ottawa Methods Group contacted specialized organizations that focus on management for…

  11. Food and Beverage Management: An Introduction. Food and Beverage Management Module. Operational Management Programme. Increasing Opportunities for Supervisors and Managers.

    Science.gov (United States)

    Jones, Peter

    This self-instructional unit for supervisors and managers in the British hotel and catering industry is designed to prepare them for the more detailed units in this series, including those on food and beverage control, production, and provision. The document begins with advice on how to use the unit. Three sections cover the following topics: (1)…

  12. Evaluation of a self-management programme for patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Turner, Ap; Anderson, Jk; Wallace, Lm; Kennedy-Williams, P

    2014-06-30

    Self-management is becoming an important part of treatment for patients with chronic obstructive pulmonary disease (COPD). We conducted a longitudinal survey of patients with COPD who attended a 7-week group-based lay and clinician co-delivered COPD self-management programme (SMP)to see whether they became more activated, enjoyed better health status, and quality of life, were less psychologically distressed and improved their self-management abilities. The main analysis was a per-protocol analysis (N = 131), which included only patients who attended ≥5 SMP sessions and who returned a 6-month follow-up questionnaires. Changes in the mean values of the patient outcomes were compared over time using paired t tests and general linear model for repeated measures. Patient activation significantly improved 6 months after the SMP (p management abilities (self-monitoring and insight p = 0.03), constructive attitude shift (p = 0.04), skills and technique acquisition, (p management abilities. © The Author(s) 2014.

  13. The Dutch programme on soil ecology of arable farming systems : farm management monitoring programme and general results

    NARCIS (Netherlands)

    Lebbink, G.; Faassen, van H.G.; Ouwerkerk, van C.; Brussaard, L.

    1994-01-01

    A comparison was made between conventional farm management (CONV) and integrated farm management (INT) on a calcareous silty clay loam soil, with a crop rotation of winter wheat, sugar beet, spring barley and potatoes. Both types of management were started at two levels of soil organic matter, 2.2%

  14. Effectiveness of a peer-led self-management programme for people with schizophrenia: protocol for a randomized controlled trial.

    Science.gov (United States)

    Chan, Sally Wai Chi; Li, Ziqiang; Klainin-Yobas, Piyanee; Ting, Steven; Chan, Moon Fai; Eu, Pui-Wai

    2014-06-01

    To determine the effectiveness of a peer-led self-management programme for people with schizophrenia in reducing psychotic symptom severity, hospital readmission and psychiatric consultation and in enhancing cognition, empowerment, functioning level, medication adherence, perceived recovery, quality of life and social support. Several self-management programmes have been developed to empower patients with severe mental illness in achieving recovery. Research suggests that peer-led self-management programmes have positive effects on patient recovery. However, the existing evidence is inconclusive, due to a lack of credible evidence and long-term follow-up evaluations. A stratified randomized controlled trial will be conducted at six community mental health rehabilitation centres A sample of 242 adults with schizophrenia will be recruited. A peer-led self-management programme, comprising six 2-hour sessions, will be implemented in the intervention group and a standard rehabilitation programme in the control group. Outcomes will be measured at baseline, postintervention and at the 6- and 12-month follow-ups. The measures will include cognition, empowerment, functioning level, medication adherence, perceived recovery, quality of life, social support, symptom severity, hospital readmission and psychiatric consultation. A mixed effects model will be used to analyse the results. Semi-structured interviews will be conducted to explore the peer-trainers' and participants' perspectives on the programme. Research Ethics Committee approval was obtained in December 2011 and funding was obtained in January 2012. This study will provide evidence on the effectiveness of a peer-led self-management programme for patient recovery. It will identify a clinically useful and potentially effective intervention that incorporates empowerment concept. © 2013 John Wiley & Sons Ltd.

  15. The PREVENT research programme--a novel research programme to identify and manage midlife risk for dementia: the conceptual framework.

    Science.gov (United States)

    Ritchie, Craig W; Wells, Katie; Ritchie, Karen

    2013-12-01

    It is clear that the neurodegenerative disease processes which cause dementias are initiated many years before the onset of symptoms. In people with mild cognitive impairment there is already good evidence available to suggest that many of the key pathologies are well established. The PREVENT research programme seeks to understand the origin point and sequence of pathological changes which lead to dementia. It also aims to determine what clinical, environmental and genetic factors increase (or decrease) the risk of these changes initiating and developing. From this data we will be able to develop risk models that can be applied both in clinical practice and research which illustrate the chances a given individual has of developing clinical symptoms of neurodegenerative disease. Once these risks are identified and the sequence of pathological events are characterized; interventions to remove risk or reduce the impact of a risk can be undertaken, as can studies of agents which specifically target the earliest or most up-stream pathological processes. This paper provides the conceptual framework for the PREVENT programme and other similar studies interrogating people in midlife with a view to providing empirical evidence to inform intervention studies and better clinical practice.

  16. An isokinetic eccentric programme for the management of chronic lateral epicondylar tendinopathy.

    Science.gov (United States)

    Croisier, Jean-Louis; Foidart-Dessalle, Marguerite; Tinant, France; Crielaard, Jean-Michel; Forthomme, Bénédicte

    2007-04-01

    Lateral epicondylitis represents a frequent overuse injury. In spite of many conservative treatment procedures, prolonged symptoms and relapse are frequently observed. To compare the outcome of patients performing an isokinetic eccentric training with that of age-, gender-, activity-matched patients receiving a non-strengthening classical rehabilitation. Ninety-two patients with unilateral chronic lateral epicondylar tendinopathy (mean duration of symptoms 8+/-3 months) were assigned either to a control group (n = 46) or to an eccentrically trained group (n = 46). The control group underwent a passive standardised rehabilitation programme that excluded strengthening exercises. In addition to this programme, the trained group also performed eccentric exercises based on the repetitive lengthening of the active musculo-tendinous unit. The latter exercises started with submaximal contraction intensity and slow speed movement. Modalities were progressively intensified (increase in intensity contraction and speed movement) over a long period of treatment. Programme effectiveness was assessed through pain score evaluation, a disability questionnaire, muscle strength measurement and ultrasonographic examination. Compared to the non-strengthening control group, the following observations were made in the eccentrically trained group: (1) a significantly more marked reduction of pain intensity, mainly after one month of treatment; (2) an absence of strength deficit on the involved side through bilateral comparison for the forearm supinator and wrist extensor muscles; (3) an improvement of the tendon image as demonstrated by decreasing thickness and a recovered homogenous tendon structure; and (4) a more marked improvement in disability status during occupational, spare time and sports activities. These results highlight the relevance of implementing isokinetic adapted eccentric training in the management of chronic lateral epicondylar tendinopathy.

  17. Effectiveness of a tinnitus management programme: a 2-year follow-up study

    Directory of Open Access Journals (Sweden)

    Sørensen Jan

    2009-06-01

    Full Text Available Abstract Background Tinnitus impairs the possibility of leading a normal life in 0.5–1% of the population. While neither medical nor surgical treatment appears effective, counselling may offer some relief. An intervention combining counselling and hearing devices is offered to clients referred to the Centre for Help Aids and Communication (CHC in southern Denmark. The aims of this exploratory study were to examine i the characteristics of CHC's clients and their tinnitus, ii the effectiveness of the treatment, and iii whether particular client groups benefit more than others. Methods One hundred new clients presenting with tinnitus completed the Tinnitus Handicap Inventory (THI three times – before their first consultation, after one month and after 1–2 years. The scores were tested for significant differences over time using tests for paired data. Logistic regression was used to examine factors associated with a clinically important difference (i.e. THI score improvement of at least 20 points. Results At final follow-up, total THI score was significantly lower than baseline, i.e. 29.8 (CI 25.5–34.2 vs. 37.2 (CI 33.1–37.2, p Conclusion The tinnitus management programme appeared to provide significant benefit to many clients at a relatively low cost. It would be useful to conduct a randomised controlled study comparing the current programme with alternative forms of combination counselling/sound therapy approaches.

  18. Increasing leadership capacity for HIV/AIDS programmes by strengthening public health epidemiology and management training in Zimbabwe

    Directory of Open Access Journals (Sweden)

    Hader Shannon L

    2009-08-01

    Full Text Available Abstract Background Increased funding for global human immunodeficiency virus prevention and control in developing countries has created both a challenge and an opportunity for achieving long-term global health goals. This paper describes a programme in Zimbabwe aimed at responding more effectively to the HIV/AIDS epidemic by reinforcing a critical competence-based training institution and producing public health leaders. Methods The programme used new HIV/AIDS programme-specific funds to build on the assets of a local education institution to strengthen and expand the general public health leadership capacity in Zimbabwe, simultaneously ensuring that they were trained in HIV interventions. Results The programme increased both numbers of graduates and retention of faculty. The expanded HIV/AIDS curriculum was associated with a substantial increase in trainee projects related to HIV. The increased number of public health professionals has led to a number of practically trained persons working in public health leadership positions in the ministry, including in HIV/AIDS programmes. Conclusion Investment of a modest proportion of new HIV/AIDS resources in targeted public health leadership training programmes can assist in building capacity to lead and manage national HIV and other public health programmes.

  19. Increasing leadership capacity for HIV/AIDS programmes by strengthening public health epidemiology and management training in Zimbabwe

    Science.gov (United States)

    Jones, Donna S; Tshimanga, Mufuta; Woelk, Godfrey; Nsubuga, Peter; Sunderland, Nadine L; Hader, Shannon L; St Louis, Michael E

    2009-01-01

    Background Increased funding for global human immunodeficiency virus prevention and control in developing countries has created both a challenge and an opportunity for achieving long-term global health goals. This paper describes a programme in Zimbabwe aimed at responding more effectively to the HIV/AIDS epidemic by reinforcing a critical competence-based training institution and producing public health leaders. Methods The programme used new HIV/AIDS programme-specific funds to build on the assets of a local education institution to strengthen and expand the general public health leadership capacity in Zimbabwe, simultaneously ensuring that they were trained in HIV interventions. Results The programme increased both numbers of graduates and retention of faculty. The expanded HIV/AIDS curriculum was associated with a substantial increase in trainee projects related to HIV. The increased number of public health professionals has led to a number of practically trained persons working in public health leadership positions in the ministry, including in HIV/AIDS programmes. Conclusion Investment of a modest proportion of new HIV/AIDS resources in targeted public health leadership training programmes can assist in building capacity to lead and manage national HIV and other public health programmes. PMID:19664268

  20. Nurse- and peer-led self-management programme for patients with an implantable cardioverter defibrillator; a feasibility study

    Directory of Open Access Journals (Sweden)

    van Eijk Jacques

    2007-09-01

    Full Text Available Abstract Background The prevalence of cardiovascular disease is increasing. Improved treatment options increase survival after an acute myocardial infarction or sudden cardiac arrest, although patients often have difficulty adjusting and regaining control in daily life. In particular, patients who received an implantable cardioverter defibrillator (ICD experience physical and psychological problems. Interventions to enhance perceived control and acceptance of the device are therefore necessary. This paper describes a small-scale study to explore the feasibility and the possible benefits of a structured nurse- and peer-led self-management programme ('Chronic Disease Self-Management Program' – CDSMP among ICD patients. Methods Ten male ICD patients (mean age = 65.5 years participated in a group programme, consisting of six sessions, led by a team consisting of a nurse specialist and a patient with cardiovascular disease. Programme feasibility was evaluated among patients and leaders by measuring performance of the intervention according to protocol, attendance and adherence of the participating ICD patients, and patients' and leaders' opinions about the programme. In addition, before and directly after attending the intervention, programme benefits (e.g. perceived control, symptoms of anxiety and depression, and quality of life were assessed. Results The programme was conducted largely according to protocol. Eight patients attended at least four sessions, and adherence ranged from good to very good. On average, the patients reported to have benefited very much from the programme, which they gave an overall report mark of 8.4. The leaders considered the programme feasible as well. Furthermore, improvements were identified for general self-efficacy expectancies, symptoms of anxiety, physical functioning, social functioning, role limitations due to physical problems, and pain. Conclusion This study suggests that a self-management programme led by a

  1. Importance of strategic management in the implementation of private medicine retailer programmes: case studies from three districts in Kenya

    Directory of Open Access Journals (Sweden)

    Marsh Vicki

    2010-07-01

    Full Text Available Abstract Background The home-management of malaria strategy seeks to improve prompt and effective anti-malarial drug use through the informal sector, with a potential channel being the Private Medicine Retailers (PMRs. Previous evaluations of PMR programmes focused on their impact on retailer knowledge and practices, with limited evidence about the influence of implementation processes on the impacts at scale. This paper examines how the implementation processes of three PMR programmes in Kenya, each scaled up within a district, contributed to the outcomes observed. These were a Ministry of Health programme in Kwale district; and two programmes supported by non-governmental organizations in collaboration with government in Kisii Central and Bungoma districts. Methods The research methods included 24 focus group discussions with clients and PMRs, 19 in-depth interviews with implementing actors, document review and a diary of events. The data were analysed using the combination of a broad policy analysis framework and more specific scaling up/diffusion of innovations frameworks. Results The Kisii programme, a case study of successful implementation, was underpinned by good relationships between district health managers and a “resource team”, supported by a memorandum of understanding which enabled successful implementation. It had flexible budgetary and decision making processes which were responsive to local contexts, and took account of local socio-economic activities. In contrast, the Kwale programme, which had implementation challenges, was characterised by a complex funding process, with lengthy timelines, that was tied to the government financial management system which constrained implementation Although there was a flexible funding system in Bungoma, a perceived lack of transparency in fund management, inadequate management of inter-organisational relationships, and inability to adapt and respond to changing circumstances led to

  2. Importance of strategic management in the implementation of private medicine retailer programmes: case studies from three districts in Kenya.

    Science.gov (United States)

    Abuya, Timothy; Amin, Abdinasir; Molyneux, Sassy; Akhwale, Willis; Marsh, Vicki; Gilson, Lucy

    2010-07-02

    The home-management of malaria strategy seeks to improve prompt and effective anti-malarial drug use through the informal sector, with a potential channel being the Private Medicine Retailers (PMRs). Previous evaluations of PMR programmes focused on their impact on retailer knowledge and practices, with limited evidence about the influence of implementation processes on the impacts at scale. This paper examines how the implementation processes of three PMR programmes in Kenya, each scaled up within a district, contributed to the outcomes observed. These were a Ministry of Health programme in Kwale district; and two programmes supported by non-governmental organizations in collaboration with government in Kisii Central and Bungoma districts. The research methods included 24 focus group discussions with clients and PMRs, 19 in-depth interviews with implementing actors, document review and a diary of events. The data were analysed using the combination of a broad policy analysis framework and more specific scaling up/diffusion of innovations frameworks. The Kisii programme, a case study of successful implementation, was underpinned by good relationships between district health managers and a "resource team", supported by a memorandum of understanding which enabled successful implementation. It had flexible budgetary and decision making processes which were responsive to local contexts, and took account of local socio-economic activities. In contrast, the Kwale programme, which had implementation challenges, was characterised by a complex funding process, with lengthy timelines, that was tied to the government financial management system which constrained implementation Although there was a flexible funding system in Bungoma, a perceived lack of transparency in fund management, inadequate management of inter-organisational relationships, and inability to adapt and respond to changing circumstances led to implementation difficulties. For effective scaling up of PMR

  3. Can we reduce preventable heart failure readmissions in patients enrolled in a Disease Management Programme?

    LENUS (Irish Health Repository)

    Phelan, D

    2012-02-01

    BACKGROUND: Disease Management Programmes (DMPs) are successful in reducing hospital readmissions in heart failure (HF). However, there remain a number of patients enrolled in a DMP who are readmitted with HF. The primary aim of the study was to determine the proportion of preventable readmissions (PR). The secondary aim was to recognise patient characteristics which would identify certain patients at risk of having a PR. METHODS: A retrospective chart search was performed on patients readmitted over a 1-year period. RESULTS: 38.5% of readmissions were classified as PR. None of these patients made prior contact with the DMP. Admission levels of BNP, potassium, urea and creatinine were significantly lower in the PR group. CONCLUSION: DMP have proven benefits in reducing hospital readmission nonetheless a significant proportion of these readmissions are preventable. Further work is required to prospectively analyse why these patients fail to contact the DMP.

  4. A haemophilia disease management programme targeting cost and utilization of specialty pharmaceuticals.

    Science.gov (United States)

    Duncan, N; Roberson, C; Lail, A; Donfield, S; Shapiro, A

    2014-07-01

    The high cost of clotting factor concentrate (CFC) used to treat haemophilia and von Willebrand disease (VWD) attracts health plans' attention for cost management strategies such as disease management programmes (DMPs). In 2004, Indiana's high risk insurance health plan, the Indiana Comprehensive Health Insurance Association, in partnership with the Indiana Hemophilia and Thrombosis Center developed and implemented a DMP for beneficiaries with bleeding disorders. This report evaluates the effectiveness of the DMP 5 years post implementation, with specific emphasis on the cost of CFC and other medical expenditures by severity of disease. A pre/post analysis was used. The main evaluation measures were total cost, total outpatient CFC IU dispensed and adjusted total outpatient CFC cost. Summary statistics and mean and median plots were calculated. Overall, 1000 non-parametric bootstrap replicates were created and percentile confidence limits for 95% confidence intervals (CI) are reported. Mean emergency department (ED) visits and mean and median duration of hospitalizations are also reported. The DMP was associated with a significant decrease in mean annualized total cost including decreased CFC utilization and cost in most years in the overall group, and specifically in patients with severe haemophilia. Patients with mild and moderate haemophilia contributed little to overall programme expenditures. This specialty health care provider-administered DMP exemplifies the success of targeted interventions developed and implemented through a health care facility expert in the disease state to curb the cost of specialty pharmaceuticals in conditions when their expenditures represent a significant portion of total annual costs of care. © 2014 John Wiley & Sons Ltd.

  5. IMPACT OF MANAGERIAL SKILLS LEARNT THROUGH MA EDUCATIONAL PLANNING MANAGEMENT PROGRAMME OF AIOU ON THE PERFORMANCE OF INSTITUTIONAL HEADS

    Directory of Open Access Journals (Sweden)

    Muhammad Asif CHUADHRY

    2012-04-01

    Full Text Available Management provides formal coordination in an organization for achieving pre-determined goals. The educational manager particulary performs his duties by using different planning and management techniques. These techniques are equally important for the manager of other sectors. The present study was focused on the impact of managerial skills learnt through MA EPM programme on the performance of the heads. Following were the objectives of the study .to assess the contribution of the programme towards the learning of the heads of educational institutions. Ø To identify the managerial skills and competencies of Educational Managers and heads trained through EPPSL Department of the Allama Iqbal Open University. Ø (ii To evaluate the effectiveness of the programme and its impact on the skills of the MA EPM graduates. Ø (iii To analyze the performance of EPM graduates working as heads in their respective institutions.A questionnaire for graduates was developed for those working as institutional heads in Rawalpindi and Islamabad. There were 58 educational institutionl heads who have their master degree in EPM .The data obtained was organized, tabulated, and analyzed by using descriptive statistics means of percentage method in numbers of tables in order to find out the impact of the skills of the MA EPM programme. The finding and conclusions of the data indicated that the impact of the skills on their performance. Majority of the heads were agreed that the programme was beneficial for them. It was recommended on the basis of the conclusions that the selection of the resource person should be on merit; quality of books might be improved; and there should be a separate course for educational budgeting. It was also recommended that this programme should be compulsory for the institutional heads. There might be upgradation of the course.

  6. A cluster randomised control trial of a multi-component weight management programme for adults with intellectual disabilities and obesity.

    Science.gov (United States)

    Harris, Leanne; Hankey, Catherine; Jones, Nathalie; Pert, Carol; Murray, Heather; Tobin, Janet; Boyle, Susan; Melville, Craig

    2017-08-01

    There have been few published controlled studies of multi-component weight management programmes that include an energy deficit diet (EDD), for adults with intellectual disabilities and obesity. The objective of this study was to conduct a single-blind, cluster randomised controlled trial comparing a multi-component weight management programme to a health education programme. Participants were randomised to either TAKE 5, which included an EDD or Waist Winners Too (WWToo), based on health education principles. Outcomes measured at baseline, 6 months (after a weight loss phase) and 12 months (after a 6-month weight maintenance phase), by a researcher blinded to treatment allocation, included: weight; BMI; waist circumference; physical activity; sedentary behaviour and health-related quality of life. The recruitment strategy was effective with fifty participants successfully recruited. Both programmes were acceptable to adults with intellectual disabilities, evidenced by high retention rates (90 %). Exploratory efficacy analysis revealed that at 12 months there was a trend for more participants in TAKE 5 (50·0 %) to achieve a clinically important weight loss of 5-10 %, in comparison to WWToo (20·8 %) (OR 3·76; 95 % CI 0·92, 15·30; 0·064). This study found that a multi-component weight management programme that included an EDD, is feasible and an acceptable approach to weight loss when tailored to meet the needs of adults with intellectual disabilities and obesity.

  7. Outcomes of a community-based weight management programme for morbidly obese populations.

    Science.gov (United States)

    Nield, L; Kelly, S

    2016-12-01

    Morbid obesity is an ongoing concern worldwide. There is a paucity of research reporting primary care outcomes focussed on complex and morbidly obese populations. The National Institute for Health and Care Excellence (NICE) recommends a specialist, multidisciplinary weight management team for the successful management of such populations. This is the first service evaluation reporting both primary (weight change) and secondary [body mass index (BMI), waist circumference, physical activity levels, fruit and vegetable intake, Rosenberg self-esteem score] outcomes in these patients. The present study comprised a prospective observational study of a cohort data set for patients (n = 288) attending their 3-month and 6-month (n = 115) assessment appointments at a specialist community weight management programme. Patients had a mean (SD) initial BMI of 45.5 (6.6) kg m - ²; 66% were females. Over 80% of patients attending the service lost some weight by 3 months. Average absolute weight loss was 4.11 (4.95) kg at 3 months and 6.30 (8.41) kg at 6 months, equating to 3.28% (3.82%) and 4.90% (6.26%), respectively, demonstrating a statistically significant weight change at both time points (P physical activity levels, fruit and vegetable consumption, and self-esteem levels (P < 0.001). This service was successful in aiding weight loss in morbidly obese populations. The findings of the present study support the view that weight-loss targets of 3% are realistic. © 2016 The British Dietetic Association Ltd.

  8. Certified Integral Programme Management for R&D European Projects in Marine Sciences

    Science.gov (United States)

    Castro, Ayoze; Hildebrandt, silvia; Quevedo, Eduardo; Meme, Simone; Loustau, Josefina; Hernandez-Brito, Joaquin; Llinás, Octavio

    2017-04-01

    The Oceanic Platform of the Canary Islands (PLOCAN) is a multipurpose service centre with novel land-based and sea-based infrastructures to support research, technology development an innovation in the marine and maritime sectors. Its mission is to promote long-term observation and sustainability of the ocean, providing a cost-effective combination of services, such as observatories, test site, base for underwater vehicles, training and innovation hub. PLOCAN has been actively participating in the European Commission Blue Growth strategy to support sustainable growth in the marine and maritime sectors as a whole. As a result, during the period 2014-2016, there has been a particularly high increase in the number of projects in execution in the organization. In order to successfully manage this situation, the development of a robust, effective and certified programme management system has turned out to be essential. To do so, an integral management methodology was specifically created and has successfully passed the ISO 9001:2008 certification in 2016.

  9. Effectiveness of self-management programmes in diabetes management: A systematic review.

    Science.gov (United States)

    Vas, Aldrin; Devi, Elsa Sanatombi; Vidyasagar, Sudha; Acharya, Raviraja; Rau, Nileshwar Radhakrishna; George, Anice; Jose, Tessy; Nayak, Baby

    2017-10-01

    Diabetes is a major noncommunicable disease, which is increasing, and approximately 415 million people are affected around the globe. Since diabetes is a lifelong disease, patients require better understanding and knowledge of the condition to become self-reliant in making diabetes-related decisions. This systematic review was performed to assess the effectiveness of diabetes self-management programs in people with type 2 diabetes. A comprehensive literature search was undertaken to identify all published English language articles through EBSCO discovery services in the following electronic database: Science Direct, CINAHL Plus with Full Text, MEDLINE, and Access Medicine. Studies were published from January 2000 to October 2015. The initial search retrieved 37 566 studies and based on the inclusion criteria, 14 studies were selected for review. Of 14 studies, most findings favoured diabetes self-management. But the overall effectiveness of individual interventions was not conclusive. A wide variety of interventions was used including diabetes education as a major component in self-management programs. Interventions used varied strategies in differing composition, and further work is needed to find out the effectiveness of individual interventions. © 2017 John Wiley & Sons Australia, Ltd.

  10. Higher Education Curriculum for Sustainability: Course Contents Analyses of Purchasing and Supply Management Programme of Polytechnics in Ghana

    Science.gov (United States)

    Etse, Daniel; Ingley, Coral

    2016-01-01

    Purpose: The purpose of this study is to determine the degree of attention to and the nature of sustainability issues in the curriculum of the Higher National Diploma (HND) Purchasing and Supply Management programme of Ghana. Design/Methodology/Approach: Documentary research is the approach used to analyse the curriculum document for the programme…

  11. Impact of parental weight status on a school-based weight management programme designed for Mexican-American children

    Science.gov (United States)

    While overweight and obese children are more likely to have overweight or obese parents, less is known about the effect of parental weight status on children's success in weight management programmes. This study was a secondary data analysis of a randomized controlled trial and investigated the impa...

  12. Diabetes rehabilitation : Effects of a Multidisciplinary Intensive Education Programme for diabetic patients with prolonged self-management difficulties

    NARCIS (Netherlands)

    Keers, JC; Links, TP; Bouma, J; Scholten-Jaegers, SMHJ; Gans, ROB; Sanderman, R

    This study aimed to determine effects of a Multidisciplinary Intensive Education Programme (MIEP) based on the empowerment approach for diabetic patients with prolonged self-management difficulties. In 89 participants, glycaemic control (HbA1c), health related quality of life (HR-QoL) and indicators

  13. A cluster of avian malaria cases in a kiwi management programme.

    Science.gov (United States)

    Banda, M E; Howe, L; Gartrell, B D; McInnes, K; Hunter, S; French, N P

    2013-05-01

    To describe a temporal cluster of avian malaria (Plasmodium spp.) at an Operation Nest Egg™ (ONE) site in Rotorua which caused mortality in a juvenile kiwi and had high population prevalence in brown kiwi (Apteryx mantelli). A 70-day-old wild-born captive brown kiwi was submitted for post-mortem examination to Massey University Wildlife Health Centre. Post-mortem examination and histopathology were used to determine the cause of death. Plasmodium specific PCR analysis was subsequently conducted on tissue samples and 108 individual blood samples from living kiwi from five ONE breeding sites and two rowi kiwi crèches. Positive PCR products were sequenced to identify the Plasmodium spp. isolated. Where possible, blood smear microscopic examination was used to determine the level of parasitaemia in the infected kiwi. Plasmodium spp. was detected in the kiwi which died and it showed histopathological evidence of disseminated protozoal infection. A high prevalence of Plasmodium was found in blood samples from kiwi concurrently residing at ONE Rotorua by blood smear microscopy (22/32, 68%) and PCR (25/32, 78%). All kiwi with positive blood smears had only a low level of peripheral parasitaemia at the time of sampling. However, 0/17 additional kiwi sampled at Rotorua 3 weeks after the juvenile's death, 0/23 Rotorua juveniles sampled 1 year later and 0/59 kiwi from the five other locations were positive for Plasmodium by these methods. Sequencing analysis revealed a cosmopolitan Plasmodium (Huffia) elongatum lineage in all positive birds. This is the first description of an avian malaria (Plasmodium spp.) infection associated with mortality and a high population prevalence in brown kiwi at a ONE site in the 20 years of the programme. The study suggests that this level of infection in a population of kiwi was unusual and provides evidence in support of continued vigilance of disease risks associated with this and other conservation management programmes involving wildlife

  14. Testing measurement invariance of the Learning Programme Management and Evaluation scale across academic achievement

    Directory of Open Access Journals (Sweden)

    Maelekanyo C. Mulaudzi

    2016-02-01

    Full Text Available Orientation: Measurement invariance is one of the most precarious aspects of the scale development process without which the interpretation of research findings on population subgroups may be ambiguous and even invalid. Besides tests for validity and reliability, measurement invariance represents the hallmark for psychometric compliance of a new measuring instrument and provides the basis for inference of research findings across a range of relevant population sub-groups.Research purpose: This study tested the measurement invariance of a Learning Programme Management and Evaluation (LPME scale across levels of academic achievement.Motivation for the study: It is important for any researcher involved in new scale development to ensure that the measurement instrument and its underlying constructs have proper structural alignment and that they both have the same level of meaning and significance across comparable heterogeneous groups.Research design, approach and method: A quantitative, non-experimental, cross-sectional survey design was used, and data were obtained from 369 participants who were selected from three public sector organisations using a probabilistic simple random sampling technique. The Statistical Package for Social Sciences and Analysis of Moment Structures software (versions 21.0.0 were used to analyse the data.Main findings: The findings show that all the four invariance models tested have achieved acceptable goodness-of-fit indices. Furthermore, the findings show that the factorial structure of the LPME scale and the meaning of its underlying constructs are invariant across different levels of academic achievement for human resource development (HRD practitioners and learners or apprentices involved in occupational learning programmes.Practical implications: The findings of this study suggest practical implications for HRD scholars as they are enabled to make informed decisional balance comparisons involving educational

  15. Market competition and price of disease management programmes: an observational study.

    Science.gov (United States)

    van Dijk, Christel E; Venema, Bob; de Jong, Judith D; de Bakker, Dinny H

    2014-10-30

    Managed competition was introduced into the health care system in several countries including the Netherlands, although effects of competition of both providers and health insurers on the price of health care are inconclusive. We investigated the association between competition of both providers (care groups) and health insurers and the price of disease management programmes (DMPs). Data from 76 DMP contractual agreements for type II diabetes mellitus in 2008, 2009 and 2010 were used to analyse the association between market competition and the price of DMPs. Market competition was calculated per municipal health services region (GGD). Insurer market competition was measured by the Herfindahl-Hirschman Index (HHI), care group competition by the number of care groups and the care group market share of GPs. The effect of competition was cross-sectionally studied with linear regression analyses. Insurer market concentration (HHI) and care group market share were not associated with the price of DMPs. The number of care groups in a GGD region was associated with a lower price (-€4.68; 95% CI: -8.36 - -1.00). The mean difference in the price of DMPs between health insurers was €58. The price of DMPs seems to be more dependent on the particular health insurer than on market conditions. For competition among health insurers and provider groups to develop, preconditions such as selective contracting and option for patient to change provider should be in place.

  16. The nurse manager as a transformational leader in implementing a cervical cancer screening programme in primary health care clinics

    OpenAIRE

    2014-01-01

    M.Cur. (Nursing Management) Transformational leadership involves the creation of a motivating climate that enhances growth, development, commitment, goal achievement and enjoyment which encourages behaviour based on a set of shared values (Price, 2006:124). In this study transformational leadership referred to concepts of motivation, and change management with regard to the implementation of the Cervical Cancer Screening Programme in a PRe setting. During support visits in Ekurhuleni Healt...

  17. 'Getting the balance between encouragement and taking over': reflections on using a new stroke self-management programme.

    Science.gov (United States)

    Jones, Fiona; Livingstone, Elizabeth; Hawkes, Louise

    2013-06-01

    This paper presents findings from a study which aimed to explore contextual, personal and professional factors in applying training in the use of a new stroke self-management programme. Practitioners completed in-depth case reflections as part of their two-day training in the Bridges stroke self-management programme (SSMP). The study utilized a qualitative approach to explore the understanding and meaning participants gave to their experiences of using the SSMP. Data from case reflections were analysed using a thematic content analysis. Data from 60 case reflections were included in the analysis. Several themes were prominent including: timing, belief in the concept of self-management, congruence with goal setting, balance of power and subtleties and sensitivities of using the SSMP. The use of in-depth case reflections enabled a personal awareness of the complexities of supporting self-management after stroke. Participants reflected on their communication styles and interactions and how they influence the development of self-management skills in individuals post-stroke. Case reflections offered an opportunity for participants who had received training in the use of an SSMP to explore their experiences of using the programme with individuals post-stroke. This enabled personal reflection on learning and facilitated a wider discussion on the professional and organizational context concerning integration of a self-management programme into stroke rehabilitation. The paradox between professionals having a role as 'experts' and the subtle changes in practice towards a more collaborative therapeutic relationship to support self-management needs further exploration. Physiotherapists were required to make a change in their practice from traditional, educational, hands on approaches to one which gave more prominence to facilitating an individual's problem solving, collaborative goal setting and decision-making post-stroke. This study highlights a number of issues relevant to

  18. The modern molecular clock.

    Science.gov (United States)

    Bromham, Lindell; Penny, David

    2003-03-01

    The discovery of the molecular clock--a relatively constant rate of molecular evolution--provided an insight into the mechanisms of molecular evolution, and created one of the most useful new tools in biology. The unexpected constancy of rate was explained by assuming that most changes to genes are effectively neutral. Theory predicts several sources of variation in the rate of molecular evolution. However, even an approximate clock allows time estimates of events in evolutionary history, which provides a method for testing a wide range of biological hypotheses ranging from the origins of the animal kingdom to the emergence of new viral epidemics.

  19. The Effects and Costs of a Group-Based Education Programme for Self-Management of Patients with Type 2 Diabetes. A Community-Based Study

    Science.gov (United States)

    Molsted, Stig; Tribler, Jane; Poulsen, Peter B.; Snorgaard, Ole

    2012-01-01

    The worldwide epidemic of Type 2 diabetes necessitates evidence-based self-management education programmes. The purpose of this study was to investigate the effects and costs of an empowerment-based structured diabetes self-management education programme in an unselected group of patients with Type 2 diabetes. Seven hundred and two patients…

  20. Cost-utility analysis of a pharmacy-led self-management programme for patients with COPD.

    Science.gov (United States)

    Khdour, Maher R; Agus, Ashley M; Kidney, Joseph C; Smyth, Bronagh M; McElnay, James C; Elnay, James C; Crealey, Grainne E

    2011-08-01

    To undertake a cost-utility analysis (CUA) of a pharmacy-led self-management programme for Chronic Obstructive Pulmonary Disease (COPD). A single outpatient COPD clinic at the Mater Hospital, Belfast, Northern Ireland between. CUA alongside a randomised control trial. The economic analysis used data from 127 COPD patients aged over 45 years, with an FEV1 of 30-80% of the predicted normal value. Participants received either a pharmacy-led education and self-management programme, or usual care. One year costs were estimated from the perspective of the National Health Service and Personal Social Services and quality-adjusted life years (QALYs) were calculated based on responses to the EQ-5D at baseline, 6 and 12 months. Cost per QALY gained. The mean differences in costs and effects between the self-management and education programme and usual care were -£671.59 (95 CI%: -£1,584.73 to -£68.14) and 0.065 (95% CI; 0.000-0.128). Thus the intervention was the dominant strategy as it was both less costly and more effective than usual care. The probability of the intervention being cost-effective was 95% at a threshold of £20,000/QALY gained. Sensitivity analyses indicated that conclusions were robust to variations in most of the key parameters. The self-management and education programme was found to be highly cost-effective compared to usual care. Further research is required to establish what aspects of self-management and education programmes have the greatest impact on cost-effectiveness.

  1. Assessing the Food Safety Attitudes and Awareness of Managers of School Feeding Programmes in Mpumalanga, South Africa.

    Science.gov (United States)

    Sibanyoni, J J; Tabit, F T

    2017-08-01

    The managers of school feeding programmes are responsible for ensuring the safety of the food which is provided to schoolchildren, but very few studies have been conducted on the food safety knowledge and awareness of these managers. The objective of this study is to evaluate the food safety attitudes and awareness of managers of the National School Nutrition Programme (NSNP) in schools in Mpumalanga, a province of South Africa. A cross-sectional survey study was conducted in which questionnaires were used to collect data from 300 NSNP food service managers. The majority of schools offering NSNP meals were located in informal settlements and most were found to lack basic resources such as electricity (power supplies to the food preparation facility) and potable tap water in their kitchens. No school was found to have implemented the hazard analysis and critical control points (HACCP) programme, and only a few staff had received food safety training. Food safety implementation is worst in informal schools in rural areas due to limited resources and infrastructure. The NSNP food service managers in some schools-especially those located in rural settlements-were found to have little knowledge and awareness of HACCP. These results indicate an urgent need to provide NSNP managers with food safety training and resources (potable water supplies, electricity, dedicated food preparation facilities), particularly in schools in rural settlements.

  2. Task 9. Deployment of photovoltaic technologies: co-operation with developing countries. The role of quality management, hardware certification and accredited training in PV programmes in developing countries

    Energy Technology Data Exchange (ETDEWEB)

    Fitzgerald, M. C. [Institute for Sustainable Power, Highlands Ranch, CO (United States); Oldach, R.; Bates, J. [IT Power Ltd, The Manor house, Chineham (United Kingdom)

    2003-09-15

    This report for the International Energy Agency (IEA) made by Task 9 of the Photovoltaic Power Systems (PVPS) programme takes a look at the role of quality management, hardware certification and accredited training in PV programmes in developing countries. The objective of this document is to provide assistance to those project developers that are interested in implementing or improving support programmes for the deployment of PV systems for rural electrification. It is to enable them to address and implement quality assurance measures, with an emphasis on management, technical and training issues and other factors that should be considered for the sustainable implementation of rural electrification programmes. It is considered important that quality also addresses the socio-economic and the socio-technical aspects of a programme concept. The authors summarise that, for a PV programme, there are three important areas of quality control to be implemented: quality management, technical standards and quality of training.

  3. An information system to manage the rollout of the antiretroviral treatment programme in the Free State

    Directory of Open Access Journals (Sweden)

    J.E. Kotzé

    2010-09-01

    Full Text Available The Acquired Immune Deficiency Syndrome epidemic, caused by the Human Immunodeficiency Virus, is a global crisis which threatens development gains, economies, and societies. Within sub-Saharan Africa, where the epidemic began the earliest and the HIV prevalence is the highest, African countries have death rates not seen before. In South Africa the epidemic has a devastating impact which creates profound suffering on individuals and their families, and the impact on the socio-economic level is of great concern. The eradication of HIV/AIDS represents one of humanity’s greatest challenges, which requires co-operation and comprehensive collaboration between many different role players. In this endeavour clinical information plays a major role. To combat the effect of the disease, the Free State Department of Health started with the provisioning of antiretroviral therapy in the public health sector. The objective of this paper was to address the challenges they faced in order to develop and implement an information system to manage the rollout of antiretroviral treatment effectively. They started with a paper-based system to collect vital information. It was followed by a palm computer project that was initiated to electronically capture the data collected by the paper-based system. This system was then replaced by a comprehensive Hospital and Clinic Information System which was acquired and customised for the antiretroviral data collection process. Research partners developed a standalone antiretroviral data warehouse for collecting information associated with the monitoring and evaluation of the Free State antiretroviral and HIV/ AIDS treatment programme. The data warehouse successfully produced several management information reports to the antiretroviral management team. A need was identified to design a comprehensive antiretroviral data warehouse that will integrate data from several operational sources which are all associated with HIV/AIDS.

  4. An information system to manage the rollout of the antiretroviral treatment programme in the Free State.

    Science.gov (United States)

    Kotzé, J E; McDonald, T

    2010-06-01

    The Acquired Immune Deficiency Syndrome epidemic, caused by the Human Immunodeficiency Virus, is a global crisis which threatens development gains, economies, and societies. Within sub-Saharan Africa, where the epidemic began the earliest and the HIV prevalence is the highest, African countries have death rates not seen before. In South Africa the epidemic has a devastating impact which creates profound suffering on individuals and their families, and the impact on the socio-economic level is of great concern. The eradication of HIV/AIDS represents one of humanity's greatest challenges, which requires co-operation and comprehensive collaboration between many different role players. In this endeavour clinical information plays a major role. To combat the effect of the disease, the Free State Department of Health started with the provisioning of antiretroviral therapy in the public health sector. The objective of this paper was to address the challenges they faced in order to develop and implement an information system to manage the rollout of antiretroviral treatment effectively. They started with a paper-based system to collect vital information. It was followed by a palm computer project that was initiated to electronically capture the data collected by the paper-based system. This system was then replaced by a comprehensive Hospital and Clinic Information System which was acquired and customised for the antiretroviral data collection process. Research partners developed a standalone antiretroviral data warehouse for collecting information associated with the monitoring and evaluation of the Free State antiretroviral and HIV/ AIDS treatment programme. The data warehouse successfully produced several management information reports to the antiretroviral management team. A need was identified to design a comprehensive antiretroviral data warehouse that will integrate data from several operational sources which are all associated with HIV/AIDS.

  5. Effectiveness of an online fatigue self-management programme for people with chronic neurological conditions: a randomized controlled trial.

    Science.gov (United States)

    Ghahari, Setareh; Leigh Packer, Tanya; Passmore, Anne Elizabeth

    2010-08-01

    To evaluate an online fatigue self-management programme in a sample of adults with chronic neurological conditions. Randomized controlled trial. Online fatigue self-management programme delivered across Australia. Ninety-five people with fatigue secondary to multiple sclerosis, Parkinson's disease or post-polio syndrome. An online fatigue self-management programme, an information-only fatigue self-management programme and a control group. Groups were compared at pre test, post test and at three months on primary outcomes using the Fatigue Impact Scale, Activity Card Sort and Personal Wellbeing Index. With the exception of the Personal Wellbeing Index at post test (F = 3.519; P =0.034) and the Physical Subscale of the Fatigue Impact Scale at follow-up (F = 3.473; P =0.035) there were no significant differences between the three groups on primary outcomes. Post-hoc testing showed the differences to be between the information-only and control groups (P = 0.036 and P = 0.030 respectively). Improvement in the information-only group was unexpected but appears to be similar to results of other online interventions. The fatigue self-management and information-only groups performed better than the control on some secondary outcome measures. Low power in the analysis may have contributed to the findings. Repeated-measures ANCOVA showed that the fatigue self-management and the information-only groups improved over time on the Fatigue Impact Scale and the Activity Card Sort (P<0.05). The control group showed no improvements over time. Although the fatigue self-management group improved over time, results did not demonstrate additional benefit in most outcome measures when compared with the control group.

  6. Where does the Albumin go? Human Albumin Solution usage following the implementation of a demand management programme.

    Science.gov (United States)

    Yazdani, M S; Retter, A; Maggs, T; Li, P; Robson, M G; Reid, C; Holmes, P; Garood, T; Robinson, S E

    2017-06-01

    To outline the Guy's and St Thomas' NHS Foundation Trust (GSTFT) and Evelina London Children's Hospital (ELCH) demand management plan for human albumin solution (HAS) and usage. There is no UK-wide guidance governing the use of HAS. A severe shortage in 2015 prompted a Trust demand management programme. Indications were categorised according to locally agreed colour code and ASFA categories. Following the implementation of the demand management programme, a 6-month audit of HAS usage was completed. A total of 1303.1 L of HAS was used in 1139 infusions; 737 infusions were 20% HAS, accounting for 175.7 L (13.5%) in 181 patients. Indications for 20% HAS were red in 53.9% (94.7 L), blue in 26.5% (46.5 L) and grey in 19.6% (34.5 L). The remaining 1127.4 L (86.5%) infused were of 4.5 and 5 % HAS. A total of 1102.3 L (97.8%) was used for plasma exchange, 941.4 L (85.4%) ASFA category I, 93.7 L (8.5%) category II, 25.5 L (2.3%) category IV and 41.7 L (3.8%) for indications not specified according to ASFA; 25.1 L (2.2%) were used for a grey indication (volume resuscitation for hypovolaemia). The demand management programme provides surveillance of indications and retrospective verification of appropriate use. The majority of HAS indications were appropriate. Plasma exchange accounted for 84.6% of HAS usage and will be the focus of further demand management strategies. The demand management programme whilst aiming to promote best transfusion practice also ensures a tool to manage future shortages according to indication and available supply. © 2017 British Blood Transfusion Society.

  7. Health-related quality of life in patients undergoing peritoneal dialysis: effects of a nurse-led case management programme.

    Science.gov (United States)

    Chow, Susan Ka Yee; Wong, Frances K Y

    2010-08-01

    This paper is a report of an examination of the effectiveness of a nurse-led case management programme in improving the quality of life of peritoneal dialysis patients in Hong Kong. Patients with end-stage renal failure need integrated health care to maintain a desirable quality of life. Studies suggest that transitional care using a nurse case management model has a positive effect for patients suffering from chronic diseases, but the results have not been conclusive. Eighty-five patients participated in the study in 2005, 43 in the study group and 42 in the control group. Patients in the control group received routine hospital discharge services. Study group patients received a comprehensive education programme prior to discharge and standardized, 6-week nurse-initiated telephone follow-up. Kidney disease quality of life was measured for each patient at three time intervals: before the intervention, at completion of the 6-week intervention and 6 weeks after completion of the programme. Repeated measures analysis of variance, general linear model was carried out. Statistically significant within-group effects were found for symptoms/problems, effects of kidney disease, sleep, role-physical, pain, emotional wellbeing and social function. Statistically significant interaction effects were demonstrated for staff encouragement, patient satisfaction, sleep and social function. The nurse-led case management programme can be applied effectively to patients receiving peritoneal dialysis. The new model of care is particularly useful for enhancing patients' wellbeing in the transition from hospital to home.

  8. Cryptochromes and Biological Clocks

    Indian Academy of Sciences (India)

    Home; Journals; Resonance – Journal of Science Education; Volume 7; Issue 9. Cryptochromes and Biological Clocks. V R Bhagwat. General Article Volume 7 Issue 9 September 2002 pp 36-48. Fulltext. Click here to view fulltext PDF. Permanent link: http://www.ias.ac.in/article/fulltext/reso/007/09/0036-0048. Keywords.

  9. Current Status of the United Kingdom Programme for Long-Term Radioactive Waste Management

    Energy Technology Data Exchange (ETDEWEB)

    Murray, C. H.; Hooper, A. J.; Mathieson, J.

    2002-02-27

    In 1997, the UK programme for the deep disposal of radioactive waste was ''stopped dead in its tracks'' with the refusal by the Secretary of State for the Environment to allow Nirex to go ahead with its plans for an underground Rock Characterisation Facility at Sellafield in north-west England. Since that time a House of Lords' Select Committee has held an inquiry into what went wrong and what the way ahead should be. In addition, Nirex and the nuclear industry players have also been analyzing the past with a view to learning from the experience in taking things forward. In Nirex's view this is essentially an ethical issue; the waste exists and we should deal with it in this generation. Three areas need to be better addressed if a successful program of management of the nation's radioactive waste is to be achieved: the process of how policy development and implementation can be achieved; the structure of the nuclear industry and its relationship to the waste management organization; and the behavior of the players in their interaction with stakeholders. All three are underpinned by the need for transparency. In recognition that developing a policy for managing radioactive waste has to be achieved with the support of all stakeholders, the Government instigated a consultation exercise in September 2001. The initial phase of this initiative is essentially a consultation about consultation and is intended to decide on how the next stages of a six year policy development program should be addressed. In addition to this exercise, the Government is undertaking a fundamental review of the structuring of the United Kingdom Atomic Energy Authority (UKAEA) and British Nuclear Fuels plc (BNFL). They are both shareholders in Nirex and in November 2001 the Government announced the setting up of a Liabilities Management Authority (LMA) to manage the long-term nuclear liabilities that are publicly owned, particularly through those organizations

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

    Science.gov (United States)

    Loop, Carole

    2013-01-01

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

  11. Clock drawing: analysis in a retirement community.

    Science.gov (United States)

    Paganini-Hill, A; Clark, L J; Henderson, V W; Birge, S J

    2001-07-01

    measured variable had a significant effect. Cognitively impaired individuals were more likely to be female and older. After adjusting for age and gender, they were also more likely to be hypertensive and to have taken blood pressure medication and less likely to be college graduates, have glaucoma or arthritis, and to have taken vitamin supplements. The clock-drawing task is an appealing measure of cognitive function for large epidemiological studies because it is a simple, self-administered test that is easily adapted to mail surveys and correlates with more-detailed and more-time-consuming cognitive screens. Although it is relatively free of influence by language, cultural, or ethnic factors, our study shows that even in a highly educated population, clock drawing is influenced by educational level and other known risk factors for Alzheimer's disease. Thus a clock-drawing task may help predict cognitive frailty and future disability in older people. Such determination can direct high-risk individuals to earlier diagnosis, potential therapies, and better management.

  12. Impact of parental weight status on a school-based weight management programme designed for Mexican-American children.

    Science.gov (United States)

    Moreno, J P; Johnston, C A; Hernandez, D C; LeNoble, J; Papaioannou, M A; Foreyt, J P

    2016-10-01

    While overweight and obese children are more likely to have overweight or obese parents, less is known about the effect of parental weight status on children's success in weight management programmes. This study was a secondary data analysis of a randomized controlled trial and investigated the impact of having zero, one or two obese parents on children's success in a school-based weight management programme. Sixty-one Mexican-American children participated in a 24-week school-based weight management intervention which took place in 2005-2006. Children's heights and weights were measured at baseline, 3, 6 and 12 months. Parental weight status was assessed at baseline. Repeated measures anova and ancova were conducted to compare changes in children's weight within and between groups, respectively. Within-group comparisons revealed that the intervention led to significant decreases in standardized body mass index (zBMI) for children with zero (F = 23.16, P school-based weight management programme appears to be most efficacious for children with one or no obese parents compared to children with two obese parents. These results demonstrate the need to consider parental weight status when engaging in childhood weight management efforts. © 2015 World Obesity.

  13. Resolving a double standard for risk management of thalidomide: an evaluation of two different risk management programmes in Japan.

    Science.gov (United States)

    Ooba, Nobuhiro; Sato, Tsugumichi; Watanabe, Hikaru; Kubota, Kiyoshi

    2010-01-01

    Thalidomide, once withdrawn because of its teratogenicity, has now been re-launched worldwide. In Japan, thalidomide has been imported by individual doctors since around the year 2000. In October 2008, it was approved for the treatment of multiple myeloma (MM) by the Ministry of Health, Labour and Welfare (MHLW) on the condition that the manufacturer implemented a risk management programme termed the Thalidomide Education and Risk Management System (TERMS). It is likely that the imports of thalidomide will be used off-label to treat diseases other than MM. Thus, the MHLW is also planning to introduce a web-based registration system, referred to as the Safety Management System for Unapproved Drugs (SMUD), for thalidomide imported by individual doctors. To evaluate the difference between TERMS and SMUD and establish a way to resolve the 'double standard' for risk management of thalidomide treatment in Japan. The fraction of patients with disorders other than MM was estimated by the volume of annual imports obtained from the MHLW and records of the imports for patients with MM, other oncological diseases (ODs) and non-ODs in 2007 through a major supplier covering 63% of the total imported thalidomide. The information for TERMS was obtained from web pages of the manufacturer and the MHLW. The components of TERMS were compared with those in SMUD. Provided that the distribution of the indication for thalidomide (MM) in 2007, estimated from the records of imports through the major supplier, is representative of the entire nation, it is estimated that on average 866 patients, including 851 (98.3%) with MM, are using thalidomide on any one day. However, if the major supplier's imports, which account for 63% of the total imports, are not representative of the nation as a whole, possibly only half of the patients treated with thalidomide in Japan have MM. This would be the case in a scenario where the remaining 37% of imports are exclusively used to treat disorders other than

  14. The benefits of using a heart failure management programme in Swedish primary healthcare.

    Science.gov (United States)

    Agvall, Björn; Alehagen, Urban; Dahlström, Ulf

    2013-02-01

    Heart failure (HF) is a common condition with which high mortality, morbidity, and poor quality of life are associated. It has previously been shown that use of HF management programmes (HFMPs) in HF clinics can be beneficial. The purpose of this study was to evaluate if the use of HFMPs also has beneficial effects on HF patients in primary healthcare (PHC). This is a randomized, prospective, open-label study including 160 patients from five PHC centres with systolic HF and a mean age of 75 years (standard deviation 7.8). In the intervention group, an intensive follow-up was performed by HF nurses and physicians providing information and education about HF and the optimization of HF treatment according to recognized guidelines. There was a significant improvement of composite endpoints in the intervention group. Significantly more patients with reduced N-terminal pro brain natriuretic peptide (P = 0.012), improved cardiac function (P = 0.03), fewer healthcare contacts (P = 0.04), and fewer emergency room visits and admittances (P = 0.0002 and P = 0.03, respectively) could be seen in the intervention group when compared with the control group. The use of a HFMP in a PHC setting was found to have beneficial effects in terms of reducing the number of healthcare contacts and hospital admissions, and improving cardiac function in patients with systolic HF, even if the result should be interpreted with caution. It can therefore be recommended that HFMPs should be used in PHC.

  15. Social embeddedness in an online weight management programme is linked to greater weight loss.

    Science.gov (United States)

    Poncela-Casasnovas, Julia; Spring, Bonnie; McClary, Daniel; Moller, Arlen C; Mukogo, Rufaro; Pellegrini, Christine A; Coons, Michael J; Davidson, Miriam; Mukherjee, Satyam; Nunes Amaral, Luis A

    2015-03-06

    The obesity epidemic is heightening chronic disease risk globally. Online weight management (OWM) communities could potentially promote weight loss among large numbers of people at low cost. Because little is known about the impact of these online communities, we examined the relationship between individual and social network variables, and weight loss in a large, international OWM programme. We studied the online activity and weight change of 22,419 members of an OWM system during a six-month period, focusing especially on the 2033 members with at least one friend within the community. Using Heckman's sample-selection procedure to account for potential selection bias and data censoring, we found that initial body mass index, adherence to self-monitoring and social networking were significantly correlated with weight loss. Remarkably, greater embeddedness in the network was the variable with the highest statistical significance in our model for weight loss. Average per cent weight loss at six months increased in a graded manner from 4.1% for non-networked members, to 5.2% for those with a few (two to nine) friends, to 6.8% for those connected to the giant component of the network, to 8.3% for those with high social embeddedness. Social networking within an OWM community, and particularly when highly embedded, may offer a potent, scalable way to curb the obesity epidemic and other disorders that could benefit from behavioural changes. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  16. The importance of a multi-disciplinary perspective and patient activation programmes in MS management.

    Science.gov (United States)

    Feys, Peter; Giovannoni, Gavin; Dijsselbloem, Nathalie; Centonze, Diego; Eelen, Piet; Lykke Andersen, Stine

    2016-08-01

    Multiple sclerosis (MS) is a progressive disease associated with a large variety of symptoms and changing patients' needs during the disease course. In order to provide appropriate care in every disease stage and let patients live their lives to the full, a multi-disciplinary approach and patient activation is needed. To summarise the multi-disciplinary perspective of MS, with focus on the organisation of a multi-disciplinary care team and possibilities to support patient activation. This review reflects the content of the presentations, audience polling results and discussions on the multi-disciplinary perspective of MS during the second Pan-European MS Multi-stakeholder Colloquium. In many countries, the neurologist with or without the support of an MS nurse is responsible for the long-term care of MS patients. When needed, they should refer to other (non-)medical specialists. However, the patient should be empowered as well to manage his/her disease and to implement a physically active lifestyle in order to improve treatment outcomes and quality of life. To create equal access to care for MS patients across Europe, evidence-based standards of care, symptom self-monitoring tools and educational programmes for patients and healthcare professionals including non-medical treatment strategies should be developed at the European level. © The Author(s), 2016.

  17. Perceptions of the impact of an advanced training programme on the management skills of health professionals in Gauteng, South Africa

    Directory of Open Access Journals (Sweden)

    J Mutyabule

    2017-10-01

    Full Text Available Background. South Africa’s health sector spans the private and the public sectors. Within the sectors, health managers take on strategic leadership roles without formal training in management or leadership – a trend more common in the public sector than the private sector. Health managers are selected based on their clinical skills rather than their leadership or management skills. Objective. To compare self-rated competencies in management and leadership before and after training of the participants; to assess participants’ experience of the training programme; and to evaluate the management and leadership skills of the participants after training. Methods. A cross-sectional, descriptive analytical method and 360° interviewing were used in this study. Participants were evaluated ~18 months after completion of the training programme. A 360° evaluation (360° E of six of the 12 leadership/management competencies was done with the supervisors, colleagues, and subordinates of the participants. Results. All participants rated themselves as improved in 12 managerial and leadership competencies. The 360° E affirmed five of these competencies as improved, with the ability to create and implement a marketing plan rating poorly. Conclusion. Training in management leads to improvement in both leadership and managerial skills of health professionals.

  18. A programmable motion phantom for quality assurance of motion management in radiotherapy.

    Science.gov (United States)

    Dunn, L; Kron, T; Johnston, P N; McDermott, L N; Taylor, M L; Callahan, J; Franich, R D

    2012-03-01

    A commercially available motion phantom (QUASAR, Modus Medical) was modified for programmable motion control with the aim of reproducing patient respiratory motion in one dimension in both the anterior-posterior and superior-inferior directions, as well as, providing controllable breath-hold and sinusoidal patterns for the testing of radiotherapy gating systems. In order to simulate realistic patient motion, the DC motor was replaced by a stepper motor. A separate 'chest-wall' motion platform was also designed to accommodate a variety of surrogate marker systems. The platform employs a second stepper motor that allows for the decoupling of the chest-wall and insert motion. The platform's accuracy was tested by replicating patient traces recorded with the Varian real-time position management (RPM) system and comparing the motion platform's recorded motion trace with the original patient data. Six lung cancer patient traces recorded with the RPM system were uploaded to the motion platform's in-house control software and subsequently replicated through the phantom motion platform. The phantom's motion profile was recorded with the RPM system and compared to the original patient data. Sinusoidal and breath-hold patterns were simulated with the motion platform and recorded with the RPM system to verify the systems potential for routine quality assurance of commercial radiotherapy gating systems. There was good correlation between replicated and actual patient data (P 0.003). Mean differences between the location of maxima in replicated and patient data-sets for six patients amounted to 0.034 cm with the corresponding minima mean equal to 0.010 cm. The upgraded motion phantom was found to replicate patient motion accurately as well as provide useful test patterns to aid in the quality assurance of motion management methods and technologies.

  19. Do weight management programmes delivered at professional football clubs attract and engage high risk men? A mixed-methods study.

    Science.gov (United States)

    Hunt, Kate; Gray, Cindy M; Maclean, Alice; Smillie, Susan; Bunn, Christopher; Wyke, Sally

    2014-01-21

    The prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes. Developing weight management programmes which are appealing and acceptable to men is a public health priority. Football Fans in Training (FFIT), a men-only weight management programme delivered to groups of men at top professional football clubs, encourages men to lose weight by working with, not against, cultural ideals of masculinity. To inform further development of interventions in football club settings, the current study explored who is attracted to FFIT and why overweight/obese men choose to take part. A mixed-methods study analysing baseline data on 747 men aged 35-65 years with BMI ≥ 28 kg/m2 who were participants in a randomised controlled trial of FFIT, and data from 13 focus group discussions with 63 men who had attended the programme. Objectively-measured mean body mass index was 35.3 kg/m2 (sd 4.9). Overall over 90% of participants were at very high or extremely high risk of future ill-health. Around three-quarters of participants in all age groups were at 'very high' risk of type 2 diabetes, hypertension and cardiovascular disease (72%, 73% and 80% of men aged 35-44, 45-54 and 55-64 years respectively). A further 21%, 16% and 13% were at 'extremely high' risk. Qualitative data revealed that the powerful 'draw' of the football club attracted men otherwise reluctant to attend existing weight management programmes. The location and style of delivery of early FFIT sessions fostered team spirit; men appreciated being with others 'like them' and the opportunity to undertake weight management in circumstances that enhanced physical and symbolic proximity to something they valued highly, the football club. The delivery of a weight management intervention via professional football clubs attracted men at high risk of ill-health. The setting enabled men to join a weight management programme in

  20. Do weight management programmes delivered at professional football clubs attract and engage high risk men? A mixed-methods study

    Science.gov (United States)

    2014-01-01

    Background The prevalence of obesity in men in the UK is amongst the highest in Europe but men are less likely than women to use existing weight loss programmes. Developing weight management programmes which are appealing and acceptable to men is a public health priority. Football Fans in Training (FFIT), a men-only weight management programme delivered to groups of men at top professional football clubs, encourages men to lose weight by working with, not against, cultural ideals of masculinity. To inform further development of interventions in football club settings, the current study explored who is attracted to FFIT and why overweight/obese men choose to take part. Methods A mixed-methods study analysing baseline data on 747 men aged 35–65 years with BMI ≥ 28 kg/m2 who were participants in a randomised controlled trial of FFIT, and data from 13 focus group discussions with 63 men who had attended the programme. Results Objectively-measured mean body mass index was 35.3 kg/m2 (sd 4.9). Overall over 90% of participants were at very high or extremely high risk of future ill-health. Around three-quarters of participants in all age groups were at ‘very high’ risk of type 2 diabetes, hypertension and cardiovascular disease (72%, 73% and 80% of men aged 35–44, 45–54 and 55–64 years respectively). A further 21%, 16% and 13% were at ‘extremely high’ risk. Qualitative data revealed that the powerful ‘draw’ of the football club attracted men otherwise reluctant to attend existing weight management programmes. The location and style of delivery of early FFIT sessions fostered team spirit; men appreciated being with others ‘like them’ and the opportunity to undertake weight management in circumstances that enhanced physical and symbolic proximity to something they valued highly, the football club. Conclusions The delivery of a weight management intervention via professional football clubs attracted men at high risk of ill-health. The setting

  1. Help for heroes? Evaluating a case management programme for ex-service personnel in the United Kingdom.

    Science.gov (United States)

    Warren, Jon; Garthwaite, Kayleigh; Bambra, Clare

    2015-01-01

    There is increasing recognition of the health and social needs of ex-service personnel, but the UK evidence base on interventions is small. This article presents the findings from an evaluation of a vocational case management programme co-funded by the National Health Service (NHS) to prevent ill health among ex-service personnel. Qualitative, semi-structured interviews with 15 ex-service personnel were conducted. Five interviews with case management staff were also undertaken. Data were transcribed, thematically coded and analysed using NVivo. Ex-service personnel valued the service and consistently highlighted 'being listened to', 'being made to feel valued by programme staff', 'having their problems taken seriously' and 'being treated as an individual' as the most valuable aspects of the programme. Respondents particularly valued the personal support that case managers provided and the environment in which the service was delivered. Case management is a viable way in which the military, health professionals and support services can provide ongoing support for ex-service personnel in transitioning successfully to civilian life. © Royal Society for Public Health 2014.

  2. Using intervention mapping (IM to develop a self-management programme for employees with a chronic disease in the Netherlands

    Directory of Open Access Journals (Sweden)

    Heerkens Yvonne F

    2010-06-01

    Full Text Available Abstract Background Employees with a chronic disease often encounter problems at work because of their chronic disease. The current paper describes the development of a self-management programme based on the Chronic Disease Self-Management programme (CDSMP of Stanford University to help employees with a chronic somatic disease cope with these problems at work. The objective of this article is to present the systematic development and content of this programme. Methods The method of intervention mapping (Bartholomew 2006 was used to tailor the original CDSMP for employees with a chronic somatic disease. This paper describes the process of adjusting the CDSMP for this target group. A needs assessment has been carried out by a literature review and qualitative focus groups with employees with a chronic disease and involved health professionals. On the basis of the needs assessment, the relevant determinants of self-management behaviour at work have been identified for the target population and the objectives of the training have been formulated. Furthermore, techniques have been chosen to influence self-management and the determinants of behaviour and a programme plan has been developed. Results The intervention was designed to address general personal factors such as lifestyle, disease-related factors (for example coping with the disease and work-related personal factors (such as self-efficacy at work. The course consists of six sessions of each two and a half hour and intents to increase the self management and empowerment of employees with a chronic somatic disease. Conclusion Intervention mapping has been found to be a useful tool for tailoring in a systematic way the original CDSMP for employees with a chronic somatic disease. It might be valuable to use IM for the development or adjusting of interventions in occupational health care.

  3. Using intervention mapping (IM) to develop a self-management programme for employees with a chronic disease in the Netherlands.

    Science.gov (United States)

    Detaille, Sarah I; van der Gulden, Joost W J; Engels, Josephine A; Heerkens, Yvonne F; van Dijk, Frank J H

    2010-06-21

    Employees with a chronic disease often encounter problems at work because of their chronic disease. The current paper describes the development of a self-management programme based on the Chronic Disease Self-Management programme (CDSMP) of Stanford University to help employees with a chronic somatic disease cope with these problems at work. The objective of this article is to present the systematic development and content of this programme. The method of intervention mapping (Bartholomew 2006) was used to tailor the original CDSMP for employees with a chronic somatic disease. This paper describes the process of adjusting the CDSMP for this target group. A needs assessment has been carried out by a literature review and qualitative focus groups with employees with a chronic disease and involved health professionals. On the basis of the needs assessment, the relevant determinants of self-management behaviour at work have been identified for the target population and the objectives of the training have been formulated. Furthermore, techniques have been chosen to influence self-management and the determinants of behaviour and a programme plan has been developed. The intervention was designed to address general personal factors such as lifestyle, disease-related factors (for example coping with the disease) and work-related personal factors (such as self-efficacy at work). The course consists of six sessions of each two and a half hour and intents to increase the self management and empowerment of employees with a chronic somatic disease. Intervention mapping has been found to be a useful tool for tailoring in a systematic way the original CDSMP for employees with a chronic somatic disease. It might be valuable to use IM for the development or adjusting of interventions in occupational health care.

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

    Directory of Open Access Journals (Sweden)

    Horan Sheila

    2011-01-01

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

  5. RDandD Programme 2010. Programme for research, development and demonstration of methods for the management and disposal of nuclear waste

    Energy Technology Data Exchange (ETDEWEB)

    2010-09-15

    RDandD Programme 2010 presents SKB's plans for research, development and demonstration during the period 2011-2016. SKB's activities are divided into two main areas: the programme for low- and intermediate-level waste (the LILW Programme) and the Nuclear Fuel Programme. Operation of the existing facilities takes place within the Operational Process. RDandD Programme 2010 consists of five parts: Part I Overall plan of action Part II The LILW Programme Part III The Nuclear Fuel Programme Part IV Research for assessment of long-term safety Part V Social science research RDandD Programme 2007 was mainly focused on development of technology to realize the final repository for spent nuclear fuel. The efforts described were aimed at gaining a greater knowledge of long-term safety and compiling technical supporting documentation for applications under the Nuclear Activities Act for the final repository for spent nuclear fuel and under the Environmental Code for the final repository system. Many important results from these efforts are reported in this programme. The integrated account of the results will be presented in applications submitted in early 2011. The regulatory review of RDandD Programme 2007 and its supplement called for clarifications of plans and programmes for the final repository for short-lived radioactive waste, SFR, and the final repository for long-lived waste, SFL. This RDandD Programme describes these plans more clearly

  6. Exploring the role of self‐management programmes in caring for people from culturally and linguistically diverse backgrounds in Melbourne, Australia

    OpenAIRE

    Walker, Christine; Weeks, Amanda; McAvoy, Brian; Demetriou, Elsa

    2005-01-01

    Background  Chronic disease self‐management programmes are now an important adjunct to the treatment and care of Australians with chronic illnesses. Most programmes are delivered in English and cater for ‘Anglo’ views of health and illness. The Peer‐Led Self‐Management of Chronic Illness Project was funded by the National Health and Medical Research Council (NHMRC) to test the hypothesis that the Stanford University Chronic Disease Self‐Management Program would improve health outcomes for peo...

  7. Leader-Member Exchange Theory: A Driver for Open and Distance Learning (Odl) Quality Programme Management at the Zimbabwe Open University

    OpenAIRE

    Tichaona Mapolisa; Primrose Kurasha

    2013-01-01

    The current study is a qualitative case study which explores the degree to which the Leader-Member Exchange (LMX) theory could be a driver for quality ODL programme Management in the Department of Education at the Zimbabwe Open University. It conveniently sample 24 out of 27 members of the Department of Education comprising six Programme Leaders, one Chairperson and 17 Regional Programme Co-ordinators in the year 2010. Research participants responded to an in-depth questionnaire. The study fo...

  8. Training Vietnamese diabetes specialists in facilitation methods as part of a train-the-trainer programme in diabetes management

    DEFF Research Database (Denmark)

    Bjerre-Christensen, Ulla; Persson, Frederik; Noctor, Eoin

    2018-01-01

    Type 2 diabetes is an important issue in Vietnam, with a doubling in prevalence to 5.4% of the population from 2002 to 2012. Upskilling general practitioners and internal medicine physicians to provide comprehensive, evidence-based diabetes treatment is a key step in addressing this emerging...... challenge. The Vietnamese Association of Diabetes and Endocrinology and Steno Diabetes Center, with Ministry of Health support, deliver a train-the-trainer programme to build diabetes treatment capacity. In this model, an annual 2-day course is delivered to a group of endocrinologists (the ’trainers......’). These doctors then form the faculty for a national training programme on evidence-based diabetes management for general practitioners and internal medicine physicians. In addition to diabetes management topics, various pedagogical methods, with an emphasis on participant interaction, sharing a constructivist...

  9. Implementation of a mentored professional development programme in laboratory leadership and management in the Middle East and North Africa.

    Science.gov (United States)

    Perrone, L A; Confer, D; Scott, E; Livingston, L; Bradburn, C; McGee, A; Furtwangler, T; Downer, A; Mokdad, A H; Flandin, J F; Shotorbani, S; Asghar, H; Tolbah, H E; Ahmed, H J; Alwan, A; Martin, R

    2017-02-01

    Laboratories need leaders who can effectively utilize the laboratories' resources, maximize the laboratories'capacity to detect disease, and advocate for laboratories in a fluctuating health care environment. To address this need, the University of Washington, USA, created the Certificate Program in Laboratory Leadership and Management in partnership with WHO Regional Office for the Eastern Mediterranean, and implemented it with 17 participants and 11 mentors from clinical and public health laboratories in 10 countries (Egypt, Iraq, Jordan, Lebanon, Morocco, Oman, Pakistan, Qatar, Saudi Arabia, and Yemen) in 2014. Designed to teach leadership and management skills to laboratory supervisors, the programme enabled participants to improve laboratory testing quality and operations. The programme was successful overall, with 80% of participants completing it and making impactful changes in their laboratories. This success is encouraging and could serve as a model to further strengthen laboratory capacity in the Region.

  10. Evaluation of a nurse-led disease management programme for chronic kidney disease: a randomized controlled trial.

    Science.gov (United States)

    Wong, Frances Kam Yuet; Chow, Susan Ka Yee; Chan, Tony Moon Fai

    2010-03-01

    Patients with end stage renal failure require dialysis and strict adherence to treatment plans to sustain life. However, non-adherence is a common and serious problem among patients with chronic kidney disease. There is a scarcity of studies in examining the effects of disease management programmes on patients with chronic kidney disease. This paper examines whether the study group receiving the disease management programme have better improvement than the control group, comparing outcomes at baseline (O1), at 7 weeks at the completion of the programme (O2) and at 13 weeks (O3). This is a randomized controlled trial. The outcome measures were non-adherence in diet, fluid, dialysis and medication, quality of life, satisfaction, symptom control, complication control and health service utilisation. There was no significant difference between the control and study group for the baseline measures, except for sleep. Significant differences (pcontrol and study group at O2 in the outcome measures of diet degree non-adherence, sleep, symptom, staff encouragement, overall health and satisfaction. Sustained effects at O3 were noted in the outcome measures of continuous ambulatory peritoneal dialysis (CAPD) non-adherence degree, sleep, symptom, and effect of kidney disease. Many studies exploring chronic disease management have neglected the group with end stage renal failure and this study fills this gap. This study has employed an innovative model of skill mix using specialist and general nurses and demonstrated patient improvement in diet non-adherence, CAPD non-adherence, aspects of quality of life and satisfaction with care. Redesigning chronic disease management programmes helps to optimize the use of different levels of skills and resources to bring about positive outcomes. Copyright 2009 Elsevier Ltd. All rights reserved.

  11. Management of Emergency Peace Education Programmes for Boko Haram Internally Displaced Persons in Yola Refugee Camp of Adamawa State Nigeria

    OpenAIRE

    Kabiru Mohammed Badau; Olowoselu Abdulrasheed

    2015-01-01

    Education is a fundamental right of children even under emergency situations. The purpose of this study was to asses, access resources, curriculum activities, coordination of capacity building in managing emergency peace education programmes for Boko Haram internally displaced persons in Yola Refugee Camp of Adamawa State. Data was collected using teachers assessment of emergency peace Education for Internally Displaced Persons questionnaire (TAEPEIDPQ) consisting of twenty (20) items. The fi...

  12. The role of intrinsic motivation in a group of low vision patients participating in a self-management programme to enhance self-efficacy and quality of life.

    Science.gov (United States)

    Tay, Kay Chai Peter; Drury, Vicki Blair; Mackey, Sandra

    2014-02-01

    Self-management programmes have previously been found to decrease health problems, enhance quality of life and increase independence. However, there is no literature that examines the influence of the participants' intrinsic motivation on the outcomes of such programmes. This study examined the role of intrinsic motivation in a pilot low vision self-management programme to enhance self-efficacy and quality of life of the programme participants. A positive association was observed between the female participants' perceived choice and perceived competence, two underlying dimensions of the Intrinsic Motivation Inventory. In addition, a positive correlation was observed between the younger participants' perceived competence and the change in their quality of life. The findings provide some support for consideration of participants' intrinsic motivation in the development of effective self-management programmes. © 2013 Wiley Publishing Asia Pty Ltd.

  13. Evaluation of a self-management programme for congestive heart failure patients: design of a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    van Eijk Jacques

    2006-07-01

    Full Text Available Abstract Background Congestive heart failure (CHF has a substantial impact on care utilisation and quality of life. It is crucial for patients to cope with CHF adequately, if they are to live an acceptable life. Self-management may play an important role in this regard. Previous studies have shown the effectiveness of the 'Chronic Disease Self-Management Program' (CDSMP, a group-based cognitive behavioural programme for patients with various chronic conditions. However, the programme's effectiveness has not yet been studied specifically among CHF patients. This paper presents the design of a randomised controlled trial to evaluate the effects of the CDSMP on psychosocial attributes, health behaviour, quality of life, and health care utilisation of CHF patients. Methods/Design The programme is being evaluated in a two-group randomised controlled trial. Patients were eligible if they had been diagnosed with CHF and experienced slight to marked limitation of physical activity. They were selected from the Heart Failure and/or Cardiology Outpatient Clinics of six hospitals. Eligible patients underwent a baseline assessment and were subsequently allocated to the intervention or control group. Patients allocated to the intervention group were invited to attend the self-management programme consisting of six weekly sessions, led by a CHF nurse specialist and a CHF patient. Those allocated to the control group received care as usual. Follow-up measurements are being carried out immediately after the intervention period, and six and twelve months after the start of the intervention. An effect evaluation and a process evaluation are being conducted. The primary outcomes of the effect evaluation are self-efficacy expectancies, perceived control, and cognitive symptom management. The secondary outcome measures are smoking and drinking behaviour, Body Mass Index (BMI, physical activity level, self-care behaviour, health-related quality of life, perceived

  14. Evaluating collaborative planning methods supporting programme-based planning in natural resource management.

    Science.gov (United States)

    Vacik, Harald; Kurttila, Mikko; Hujala, Teppo; Khadka, Chiranjeewee; Haara, Arto; Pykäläinen, Jouni; Honkakoski, Päivi; Wolfslehner, Bernhard; Tikkanen, Jukka

    2014-11-01

    Programme-based Planning of Natural Resources (PBPNR) is an evolving planning frame for solving complex land use, environmental and forest management problems within hierarchically administrated funding and decision-making schemes. PBPNR acknowledges that an effective planning process requires the combined consideration of environmental, technological, economic and socio-political factors. To reach acceptability, commitment and operability, PBPNR processes need to foster collaboration and learning. For this study, an analysis of 43 collaborative planning methods was conducted to examine their potential to be applied within PBPNR. We present the approach of screening the applicability of methods for specific needs that may occur in PBPNR. The approach is based on a list of key criteria for the phases of a collaborative planning process: problem identification, problem modelling and problem solving. The features of each method were qualitatively assessed and peer-reviewed by a team of experts. Most of the methods are able to deal with qualitative data, support processes to increase transparency in planning and capture the preferences of the participating stakeholders. They also produce understandable results for the three phases. Contrarily, many methods do not offer features to handle uncertainty, nor do they satisfactorily stimulate creativity and innovation in the planning process. The results show that the overall applicability of the reviewed methods for the three planning phases varies according to a cluster analysis basing on the capabilities of the methods. Methods such as "Planning for Real", "Open Space" and "A'WOT" seem to be particularly promising for a broad range of planning situations. Copyright © 2014 Elsevier Ltd. All rights reserved.

  15. The development of an evidence-based physical self-management rehabilitation programme for cancer survivors

    NARCIS (Netherlands)

    van Weert, Ellen; Hoekstra-Weebers, Josette E. H. M.; May, Anne M.; Korstjens, Irene; Ros, Wynand J. G.; van der Schans, Cees P.

    Objective: This paper describes the development of a physical training programme for cancer patients. Four related but conceptually and empirically distinct physical problems are described: decreased aerobic capacity, decreased muscle strength, fatigue and impaired role physical functioning. The

  16. Designing financial-incentive programmes for return of medical service in underserved areas: seven management functions

    National Research Council Canada - National Science Library

    Bärnighausen, Till; Bloom, David E

    2009-01-01

    .... Financial-incentive programmes for return of service, whereby participants receive payments in return for a commitment to practise for a period of time in a medically underserved area, can alleviate...

  17. Food and Beverage Provision. Food and Beverage Management Module. Operational Management Programme. Increasing Opportunities for Supervisors and Managers.

    Science.gov (United States)

    Jones, Peter

    This self-instructional unit for supervisors and managers in the British hotel and catering industry is intended to consolidate work covered in a 1-day course. The unit covers the essential elements in the final stage of supplying food and drink--the point at which these items are served and sold to the customer. The document begins with an…

  18. Light and the human circadian clock.

    Science.gov (United States)

    Roenneberg, Till; Kantermann, Thomas; Juda, Myriam; Vetter, Céline; Allebrandt, Karla V

    2013-01-01

    The circadian clock can only reliably fulfil its function if it is stably entrained. Most clocks use the light-dark cycle as environmental signal (zeitgeber) for this active synchronisation. How we think about clock function and entrainment has been strongly influenced by the early concepts of the field's pioneers, and the astonishing finding that circadian rhythms continue a self-sustained oscillation in constant conditions has become central to our understanding of entrainment.Here, we argue that we have to rethink these initial circadian dogmas to fully understand the circadian programme and how it entrains. Light is also the prominent zeitgeber for the human clock, as has been shown experimentally in the laboratory and in large-scale epidemiological studies in real life, and we hypothesise that social zeitgebers act through light entrainment via behavioural feedback loops (zeitnehmer). We show that human entrainment can be investigated in detail outside of the laboratory, by using the many 'experimental' conditions provided by the real world, such as daylight savings time, the 'forced synchrony' imposed by the introduction of time zones, or the fact that humans increasingly create their own light environment. The conditions of human entrainment have changed drastically over the past 100 years and have led to an increasing discrepancy between biological and social time (social jetlag). The increasing evidence that social jetlag has detrimental consequences for health suggests that shift-work is only an extreme form of circadian misalignment, and that the majority of the population in the industrialised world suffers from a similarly 'forced synchrony'.

  19. Monitoring for the management of disease risk in animal translocation programmes

    Science.gov (United States)

    Nichols, James D.; Hollmen, Tuula E.; Grand, James B.

    2017-01-01

    Monitoring is best viewed as a component of some larger programme focused on science or conservation. The value of monitoring is determined by the extent to which it informs the parent process. Animal translocation programmes are typically designed to augment or establish viable animal populations without changing the local community in any detrimental way. Such programmes seek to minimize disease risk to local wild animals, to translocated animals, and in some cases to humans. Disease monitoring can inform translocation decisions by (1) providing information for state-dependent decisions, (2) assessing progress towards programme objectives, and (3) permitting learning in order to make better decisions in the future. Here we discuss specific decisions that can be informed by both pre-release and post-release disease monitoring programmes. We specify state variables and vital rates needed to inform these decisions. We then discuss monitoring data and analytic methods that can be used to estimate these state variables and vital rates. Our discussion is necessarily general, but hopefully provides a basis for tailoring disease monitoring approaches to specific translocation programmes.

  20. A programme to increase appropriate usage of benzathine penicillin for management of streptococcal pharyngitis and rheumatic heart disease in Zambia.

    Science.gov (United States)

    Long, Aidan; Lungu, Joyce Chipili; Machila, Elizabeth; Schwaninger, Sherri; Spector, Jonathan; Tadmor, Brigitta; Fishman, Mark; Mayosi, Bongani M; Musuku, John

    Rheumatic heart disease is highly prevalent and associated with substantial morbidity and mortality in many resource-poor areas of the world, including sub-Saharan Africa. Primary and secondary prophylaxis with penicillin has been shown to significantly improve outcomes and is recognised to be the standard of care, with intra-muscular benzathine penicillin G recommended as the preferred agent by many technical experts. However, ensuring compliance with therapy has proven to be challenging. As part of a public-private partnership initiative in Zambia, we conducted an educational and access-to-medicine programme aimed at increasing appropriate use of benzathine penicillin for the prevention and management of rheumatic heart disease, according to national guidelines. The programme was informed early on by identification of potential barriers to the administration of injectable penicillin, which included concern by health workers about allergic events. We describe this programme and report initial signs of success, as indicated by increased use of benzathine penicillin. We propose that a similar approach may have benefits in rheumatic heart disease programmes in other endemic regions.

  1. Effects of self-management support programmes on activities of daily living of older adults: A systematic review.

    Science.gov (United States)

    van Het Bolscher-Niehuis, Marian J T; den Ouden, Marjolein E M; de Vocht, Hilde M; Francke, Anneke L

    2016-09-01

    The ability of older adults to carry out activities of daily living and to adapt and to manage their own life decreases due to deterioration of their physical and cognitive condition. Nurses and other health care professionals should support the self-management ability of older adults to prevent activities of daily living dependence and increase the ability to adapt and to self-manage the consequences of living with a chronic condition. To gain insight into the evidence of the effects of self-management support programmes on the activities of daily living of older adults living at home. A systematic literature review of original research publications. Searches were performed in PubMed, CINAHL, PsychInfo, EMBASE and the Cochrane Central Register of Controlled Trials (in February 2016). No limitations were applied regarding date of publication, language or country. Publications were eligible for this review on condition that they described a self-management support programme directed at adults of on average 65 years or older, and living in the community; used a randomized control group design; and presented information about the effects on activities of daily living. The methodological quality of the included studies was independently assessed by the authors using the quality criteria for reviews of the Cochrane Effective Practice and Organisation of Care Review Group. A best evidence synthesis was performed using guidelines provided by the Cochrane Collaboration Back Review Group. A total of 6246 potentially relevant references were found. After screening the references, 12 studies with a randomized controlled trial design were included. The methodological assessment of the 12 studies indicated variations in the risk of bias from low (n=1) to unclear (n=3) and high (n=8). Although there was considerable variation in study population, intervention characteristics and measurement instruments used, most studies (n=11) showed effects of self-management support

  2. Evaluation of nurses' changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care: a qualitative study

    National Research Council Canada - National Science Library

    Roets-Merken, L.M; Vernooij-Dassen, M.J.F.J; Zuidema, S.U; Dees, M.K; Hermsen, P.G; Kempen, G.I; Graff, M.J.L

    2016-01-01

    OBJECTIVES: To gain insights into the process of nurses' changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care, and into the...

  3. Exploring strategies used following a group-based fatigue management programme for people with multiple sclerosis (FACETS) via the Fatigue Management Strategies Questionnaire (FMSQ).

    Science.gov (United States)

    Thomas, S; Kersten, P; Thomas, P W; Slingsby, V; Nock, A; Jones, R; Davies Smith, A; Galvin, K T; Baker, R; Hillier, C

    2015-10-20

    To explore cross-sectional patterns of use of fatigue management strategies in people with multiple sclerosis (MS) who had attended a group-based fatigue management programme, Fatigue: Applying Cognitive behavioural and Energy effectiveness Techniques to lifeStyle ('FACETS'). In a multicentre randomised controlled trial (RCT) the FACETS programme was shown to reduce fatigue severity and improve self-efficacy and quality of life. A questionnaire substudy within a RCT involving the self-completed Fatigue Management Strategies Questionnaire (FMSQ). The FMSQ includes: (1) closed questions about the use and helpfulness of fatigue management strategies taught in FACETS and (2) open items about changes to lifestyle, attitudes or expectations, barriers or difficulties encountered and helpful strategies not covered in FACETS. All had a clinical diagnosis of MS, significant fatigue, were ambulatory and had attended at least 4 of 6 scheduled FACETS sessions. Participants (n=72) were posted the FMSQ with a prepaid return envelope 4 months after the end of the FACETS programme. 82% (59/72) of participants returned the FMSQ. The fatigue management strategies most frequently used since attending FACETS were prioritisation (80%), pacing (78%), saying no to others (78%), grading tasks (75%) and challenging unhelpful thoughts (71%). Adding in those participants who were already using the respective strategies prior to FACETS, the three most used strategies at 4 months were prioritisation (55/59), grading (54/59) and pacing (53/58). Free-text comments illustrated the complex interplay between attitudes/expectations, behaviours, emotions and the environment. Issues related to expectations featured strongly in participants' comments. Expectations (from self and others) were both facilitators and barriers to effective fatigue management. Individuals' comments highlighted the complex, multifaceted nature of fatigue management. Revising expectations and a greater acceptance of fatigue

  4. Implementing care programmes for frail older people: a project management perspective.

    Science.gov (United States)

    Bindels, Jill; Cox, Karen; Abma, Tineke A; van Schayck, Onno C P; Widdershoven, Guy

    2015-01-01

    To examine the issues that influenced the implementation of programmes designed to identify and support frail older people in the community in the Netherlands. Qualitative research methods were used to investigate the perspectives of project leaders, project members and members of the steering committee responsible for the implementation of the programmes. Interviews were conducted in 2009 (n = 10) and in 2012 (n = 13) and a focus group was organised in 2012 (n = 5). The interviews revealed that the implementation was influenced by the extent and quality of collaboration between organisations, adaptation to existing structures, future funding for the programmes and project leadership. A good relationship between participating organisations and professionals is required for successful implementation. A lack of clear project leadership and structural funding hampers the implementation of complex programmes in primary care settings. The findings of this study are useful for organisations and professionals who are planning to implement complex programmes. Identifying barriers concerning institutional collaboration, adaptation to existing structures, leadership and continuation of financial support at an early stage of the implementation process can support practitioners in overcoming them. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  5. Patient perspectives of Condition Management Programmes as a route to better health, well-being and employability.

    Science.gov (United States)

    Joyce, K E; Smith, K E; Henderson, G; Greig, G; Bambra, C

    2010-02-01

    Condition Management Programmes (CMPs), delivered through primary care settings, have been identified as possible vehicles to facilitate return to work for individuals with chronic health problems. There is little research, however, which examines how such programmes are received by patients. To explore patients' experiences of CMPs in terms of health, well-being and employability. Four focus groups and nine semi-structured interviews were conducted in order to capture patients' (n = 25) perceptions and experiences regarding participation in one of five different CMPs: Cardiac Rehabilitation, Counselling, Lower Back Pain Services, Smoking Cessation and a GP Exercise Referral Programme. Experiences of the CMPs were generally positive. Respondents reported improved health behaviours (specifically better diets and increased exercise), positive psychosocial outcomes (including increased self-esteem, confidence and social support) and in some cases, return to work. However, concerns were expressed about the shortness of interventions and their accessibility. Although condition management appears to have been well received by participants, the findings also illustrate that there is no 'one size fits all' template for CMPs. Rather, interventions should be adapted to take account of the dynamics of specific conditions, the context in which the intervention is based and the characteristics of the individuals involved.

  6. Evaluation of the impact of a Herd Health and Production Management programme in organic dairy cattle farms: a process evaluation approach.

    Science.gov (United States)

    Duval, J E; Bareille, N; Madouasse, A; de Joybert, M; Sjöström, K; Emanuelson, U; Bonnet-Beaugrand, F; Fourichon, C

    2017-11-06

    Animal health planning activities are not always providing a satisfactory positive impact on herd health and welfare. Moreover, evaluating the impact of advisory programmes is complex due to multiple interacting elements that influence its outcome. Therefore, measuring solely health outcomes is not sufficient: the whole process of the implementation and use of such programmes should be evaluated. In order to evaluate the impact of an intervention with a Herd Health and Production Management (HHPM) programme a process evaluation framework was designed and used. The intervention involved 20 organic dairy cattle farmers and their advisors, in both France and Sweden. In both countries 20 organic dairy farms were selected as control herds. The evaluation of the HHPM programme was based on: (a) the compliance to the programme; (b) the programme's functions influencing herd health management practices and stimulating dialogue between farmers and advisors; (c) its effectiveness in terms of improving herd health compared with control farms. Complete compliance to the programme was fulfilled by 21 out of 40 farmers-advisors. Results from a questionnaire showed that the programme functioned as intended (e.g. by allowing early identification of herd health problems), stimulated change in farmers' herd health management practices and farmer-advisor dialogue. Even though the majority of the users perceived that the programme contributed to herd health improvements, no significant differences in health outcomes were found when compared with control farms 12 months after the start of the intervention. The programme allowed creating an environment promoting the exchange of information between farmers and advisors, necessary to define pertinent advice in a farm-specific situation. Future research should aim at improving methods for the evaluation of the effect of advisory programmes, by identifying early indicators for effective advice and developing methods to evaluate the quality

  7. A programme to facilitate quality patient care in a case management environment

    OpenAIRE

    2014-01-01

    D.Cur. (Nursing Management) A health maintenance organisation (HMO) that implements managed care is the health care service provider for a mine group. Case management is an integral part of managed care. Case management in a managed care setting within this mine group should be to the holistic benefit of both the client/patient and the service provider. Within the case management environment, nurse case managers (CMs) and their counterparts (professional nurses) should provide and facilita...

  8. Effectiveness of a diabetes education and self management programme (DESMOND) for people with newly diagnosed type 2 diabetes mellitus

    DEFF Research Database (Denmark)

    Khunti, Kamlesh; Gray, Laura J.; Skinner, Timothy

    2012-01-01

    lipid levels, smoking status, physical activity, quality of life, beliefs about illness, depression, emotional impact of diabetes, and drug use at three years. Results: HbA1c levels at three years had decreased in both groups. After adjusting for baseline and cluster the difference was not significant...... scores and quality of life did not differ at three years. Conclusion: A single programme for people with newly diagnosed type 2 diabetes mellitus showed no difference in biomedical or lifestyle outcomes at three years although there were sustained improvements in some illness beliefs. Trial registration......Objective: To measure whether the benefits of a single education and self management structured programme for people with newly diagnosed type 2 diabetes mellitus are sustained at three years. Design: Three year follow-up of a multicentre cluster randomised controlled trial in primary care...

  9. A Light Clock Satisfying the Clock Hypothesis of Special Relativity

    Science.gov (United States)

    West, Joseph

    2007-01-01

    The design of the FMEL, a floor-mirrored Einstein-Langevin "light clock", is introduced. The clock provides a physically intuitive manner to calculate and visualize the time dilation effects for a spatially extended set of observers (an accelerated "frame") undergoing unidirectional acceleration or observers on a rotating cylinder of constant…

  10. An efficacy study of a combined parent and teacher management training programme for children with ADHD.

    Science.gov (United States)

    Ostberg, Monica; Rydell, Ann-Margret

    2012-04-01

    Several parent training programmes and behavioural teacher training programmes built on learning theory have been developed for problem prevention and treatment of attention-deficit/hyperactivity disorder (ADHD) and/or oppositional defiant disorder (ODD) during the last few decades. Group format has often been used for parent training but single-subject designs are more common in teacher training. More studies have focussed on pre-school children than on older children, and a minority have been conducted in public mental health settings. This study aimed to evaluate a combined parent and teacher manual-based group training programme for children with ADHD conducted by the staff at a child and adolescent psychiatric clinic in Sweden. The intervention was a modified version of Barkley's programme. Children were randomized to an Intervention or a Control group. Sixty-one parents and 68 teachers answered questions about ADHD and ODD symptoms, and about behavioural problems when the study started and at a 3-month follow-up. RESULTS showed that the intervention resulted in a reduction of the number of children who met DSM-IV criteria for ADHD and/or ODD. Effects were more pronounced in the home setting than in the school setting, and were further accentuated when both parents and teachers of the same child took part in the intervention. Teachers with more problematic classroom situations benefited most from the intervention. The programme, "Strategies in Everyday Life", has, in a regular clinical setting, demonstrated promising effects on children's disruptive behaviour, and a clinical implication was to recommend involving both parents and teachers in the programme.

  11. Understanding the drivers of interprofessional collaborative practice among HIV primary care providers and case managers in HIV care programmes.

    Science.gov (United States)

    Mavronicolas, Heather A; Laraque, Fabienne; Shankar, Arti; Campbell, Claudia

    2017-05-01

    Care coordination programmes are an important aspect of HIV management whose success depends largely on HIV primary care provider (PCP) and case manager collaboration. Factors influencing collaboration among HIV PCPs and case managers remain to be studied. The study objective was to test an existing theoretical model of interprofessional collaborative practice and determine which factors play the most important role in facilitating collaboration. A self-administered, anonymous mail survey was sent to HIV PCPs and case managers in New York City. An adapted survey instrument elicited information on demographic, contextual, and perceived social exchange (trustworthiness, role specification, and relationship initiation) characteristics. The dependent variable, perceived interprofessional practice, was constructed from a validated scale. A sequential block wise regression model specifying variable entry order examined the relative importance of each group of factors and of individual variables. The analysis showed that social exchange factors were the dominant drivers of collaboration. Relationship initiation was the most important predictor of interprofessional collaboration. Additional influential factors included organisational leadership support of collaboration, practice settings, and frequency of interprofessional meetings. Addressing factors influencing collaboration among providers will help public health programmes optimally design their structural, hiring, and training strategies to foster effective social exchanges and promote collaborative working relationships.

  12. Analysis list: CLOCK [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available CLOCK Blood,Digestive tract + hg19 http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/target/CLOCK....1.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/target/CLOCK.5.tsv http://dbarchive.biosc...iencedbc.jp/kyushu-u/hg19/target/CLOCK.10.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/colo/CLOCK.Blo...od.tsv,http://dbarchive.biosciencedbc.jp/kyushu-u/hg19/colo/CLOCK.Digestive_tract

  13. [Self-management programme for leg ulcer patients: increased physical activity and fewer wound days

    NARCIS (Netherlands)

    Heinen, M.M.; Borm, G.F.; Vleuten, C.J. van der; Evers, A.W.; Oostendorp, R.A.B.; Achterberg, T. van

    2012-01-01

    OBJECTIVE: To investigate the effectiveness of the Lively Legs programme on patient adherence to compression therapy, walking behaviour and leg exercising, as well as on leg ulcer recurrence. DESIGN: Randomized controlled trial (ClinicalTrials.gov identifier: NCT00184873). METHOD: A total of 184

  14. Changing Times: A Changing Public Sector May Require Changes to Public Management Education Programmes

    Science.gov (United States)

    Oldfield, Chrissie

    2017-01-01

    It is becoming apparent that the environment in which Executive Masters in Public Administration programmes operate has changed dramatically in the wake of economic crisis and subsequent cuts in public spending. Changes in the funding of public sector organisations has been compounded by a broader "crisis" in the wider public sector…

  15. Study protocol: a mixed methods feasibility study for a loaded self-managed exercise programme for patellofemoral pain.

    Science.gov (United States)

    Smith, Benjamin E; Hendrick, Paul; Bateman, Marcus; Moffatt, Fiona; Rathleff, Michael Skovdal; Selfe, James; Smith, Toby O; Logan, Pip

    2018-01-01

    Patellofemoral pain (PFP) is one of the most common forms of knee pain in adults under the age of 40, with a prevalence of 23% in the general population. The long-term prognosis is poor, with only one third of people pain-free 1 year after diagnosis. The biomedical model of pain in relation to persistent PFP has recently been called into question. It has been suggested that interventions for chronic musculoskeletal conditions should consider alternative mechanisms of action, beyond muscles and joints. Modern treatment therapies should consider desensitising strategies, with exercises that target movements and activities patients find fearful and painful. High-quality research on exercise prescription in relation to pain mechanisms, not directed at specific tissue pathology, and dose response clearly warrants further investigation. Our primary aim is to establish the feasibility and acceptability of conducting a definitive RCT which will evaluate the clinical and cost-effectiveness of a loaded self-managed exercise programme for people with patellofemoral pain. This is a single-centred, multiphase, sequential, mixed-methods trial that will evaluate the feasibility of running a definitive large-scale randomised controlled trial of a loaded self-managed exercise programme versus usual physiotherapy. Initially, 8-10 participants with a minimum 3-month history of PFP will be recruited from an NHS physiotherapy waiting list and interviewed. Participants will be invited to discuss perceived barriers and facilitators to exercise engagement, and the meaning and impact of PFP. Then, 60 participants will be recruited in the same manner for the main phase of the feasibility trial. A web-based service will randomise patients to a loaded self-managed exercise programme or usual physiotherapy. The loaded self-managed exercise programme is aimed at addressing lower limb knee and hip weakness and is positioned within a framework of reducing fear/avoidance with an emphasis on self-management

  16. Implementing and managing self-management skills training within primary care organisations: a national survey of the expert patients programme within its pilot phase

    Directory of Open Access Journals (Sweden)

    Rogers Anne

    2006-02-01

    Full Text Available Abstract A key element of the United Kingdom (UK health policy reform in relation to chronic disease management is the introduction of a national programme seeking to promote self-care from within the National Health Service (NHS. The mainstay of the Expert Patients Programme (EPP is a six-week training course that provides the opportunity for anyone with a long-term condition to develop new skills to manage their condition better on a day-to-day basis. The course forms part of the NHS self-care support programme, is administered by Primary Care Trusts (PCTs and delivered by people who have personal experience of living with a long-term condition. The NHS' official Expert Patients Programme website presently states that, "Pilot EPP courses began at 26 NHS PCT sites across England in May 2002, and by May 2004 approximately 300 PCTs had either actively implemented pilot courses or had committed to joining. The majority of PCTs are now coming to the end of the pilot phase, with many implementing plans to make EPP sustainable for the long-term." The NHS website heralds the pilot "a success." A national, postal survey of PCT EPP Leads was undertaken in order to examine both the evolvement of EPP during its pilot stage and future plans for the programme. A questionnaire was sent out to the 299 PCTs known to have committed to the EPP pilot, and an excellent 100% response rate was obtained over a 3-month period (April-July 2005. One marker of success of the Expert Patients Programme implementation is the actual running of courses by the Primary Care Trusts. This paper explores the extent to which the implementation of the pilot can indeed be viewed as a "success," primarily in terms of the number of courses run, and considers the extent to which PCTs have carried out all that they were committed to do. Findings suggest that the more time an EPP Lead dedicates to the Programme, the more likely it is that EPP has run successfully in the past, and the more

  17. PHARAO space atomic clock: new developments on the laser source

    Science.gov (United States)

    Saccoccio, Muriel; Loesel, Jacques; Coatantiec, Claude; Simon, Eric; Laurent, Philippe; Lemonde, Pierre; Maksimovic, I.; Abgrall, M.

    2017-11-01

    The PHARAO project purpose is to open the way for a new atomic clock generation in space, where laser cooling techniques and microgravity allow high frequency stability and accuracy. The French space agency, CNES is funding and managing the clock construction. The French SYRTE and LKB laboratories are scientific and technical advisers for the clock requirements and the follow-up of subsystem development in industrial companies. EADS SODERN is developing two main subsystems of the PHARAO clock: the Laser Source and the Cesium Tube where atoms are cooled, launched, selected and detected by laser beams. The Laser Source includes an optical bench and electronic devices to generate the laser beams required. This paper describes PHARAO and the role laser beams play in its principle of operation. Then we present the Laser Source design, the technologies involved, and the status of development. Lastly, we focus of a key equipment to reach the performances expected, which is the Extended Cavity Laser Diode.

  18. Dementia behaviour management programme at home: impact of a palliative care approach on care managers and professional caregivers of home care services.

    Science.gov (United States)

    Nakanishi, Miharu; Endo, Kaori; Hirooka, Kayo; Nakashima, Taeko; Morimoto, Yuko; Granvik, Eva; Minthon, Lennart; Nägga, Katarina; Nishida, Atsushi

    2017-05-29

    Care managers and professional caregivers of home care services are sometimes unaware of the psychosocial approaches to the challenging behaviour of dementia. Therefore, we developed a Behaviour Analytics & Support Enhancement (BASE) programme. We investigated the effects of the programme on the attitudes towards dementia care among professionals. Forty-six participants in Japan received training in August 2016. The ongoing monitoring and assessment system was introduced to the participants for repeated measures of challenging behaviour. A 1-day follow-up meeting for debriefing was also performed after two months. A baseline and follow-up questionnaire survey was administered to the participating caregivers using a Japanese version of the Approaches to Dementia Questionnaire (ADQ) and the Zarit Burden Interview (ZBI). A significant improvement was observed in the total ADQ score among the participating caregivers from baseline to follow-up assessment. There was no significant difference between the baseline and follow-up assessment in the ZBI scores. In the follow-up meeting, several participants reported challenges and suggested solutions in facilitating a discussion on an action plan among professionals from various organizations. The implementation of the programme resulted in enhanced attitudes towards dementia care among the participants without an increased burden of care. Future studies should examine the programme's effectiveness on the challenging behaviour of persons with dementia.

  19. Effectiveness of online and face-to-face fatigue self-management programmes for adults with neurological conditions.

    Science.gov (United States)

    Ghahari, Setareh; Packer, Tanya

    2012-01-01

    To evaluate effectiveness of a face-to-face and an online fatigue self-management programme and to compare these to two control groups (information-only and no-intervention) in a sample of adults (n = 115) with neurological conditions reporting extreme fatigue. Non-equivalent pre-test post-test control group design using the Fatigue Impact Scale, Personal Wellbeing Index and Activity Card Sort as primary outcome measures. Participants in the two intervention groups and the information-only group showed clinically significant improvements in fatigue over time (p < 0.05). When compared to the no-intervention group, face-to-face participants showed significantly greater improvement in overall and cognitive fatigue, while participants in the online group showed significant improvement in self-efficacy and stress. Participation in either the online or face-to-face programme appears to result in improved self-management, however, with different potency depending on outcomes. The improvement in the online information only group further complicates the understanding of the results. With few other comparisons of online and face-to-face self-management protocols available, further research is needed to understand differential impacts which may be related to the delivery format, the rural versus urban split of participants or other unknown factors.

  20. Radioactive waste management and public participation in the EU. Lessons learnt from the EURATOM research framework programmes

    Energy Technology Data Exchange (ETDEWEB)

    Ferraro, Gianluca [European Commission, Joint Research Centre, Petten (Netherlands); Martell, Meritxell [Merience SCP, Barcelona (Spain)

    2015-12-15

    Since 2000, the EURATOM Framework Programmes have dedicated political attention and economic support to public participation in radioactive waste management (RWM). Although a one-fit-all solution for a participatory RWM does not exist, the diversity that characterizes the European Union (EU) offers a relevant pool of knowledge and experience. The Joint Research Centre has used the knowledge and experience cumulated by relevant EURATOM projects to define a list of general principles for a more participatory approach to RWM. The principles explained in this article can ultimately work as indications for the changes and strategic actions that are needed for a better RWM in the EU.

  1. Exploring the use of social network analysis to measure communication between disease programme and district managers at sub-national level in South Africa.

    Science.gov (United States)

    Kawonga, Mary; Blaauw, Duane; Fonn, Sharon

    2015-06-01

    With increasing interest in maximising synergies between disease control programmes (DCP) and general health services (GHS), methods are needed to measure interactions between DCP and GHS actors. In South Africa, administrative integration reforms make GHS managers at decentralised level (district managers) responsible for the oversight of DCP operations within districts, with DCP managers (programme managers) providing specialist support. The reforms necessitate interdependence, but these actors work together ineffectively. Communication is crucial for joint working, but no research to assess communication between these actors has been done. This study explores the use of social network analysis (SNA) to measure the extent to which programme and district managers in South Africa communicate, using HIV monitoring and evaluation (M&E) as an exemplar. Data were collected from fifty one managers in two provinces during 2010-2011, to measure: a) one-on-one task-related communication - talking about the collation (verification, reporting) and use of HIV data for monitoring HIV interventions; and b) group communication through co-participating in management committees where HIV data are used for monitoring HIV interventions in districts. SNA measures were computed to describe actor centrality, network density (cohesion), and communication within and between respective manager groups. Block modelling was applied to identify management committees that connect respective manager groups. Results show HIV programme managers located at higher level communicated largely amongst themselves as a group (homophily), seldom talked to the district managers to whom they are supposed to provide specialist HIV M&E support, and rarely participated with them in management committees. This research demonstrates the utility of SNA as a tool for measuring the extent of communication between DCP and GHS actors at sub-national level. Actions are needed to bridge observed communication gaps in

  2. Outcomes of a Community-Based Paediatric Weight Management Programme in an Irish Midlands Setting

    LENUS (Irish Health Repository)

    Bennett, AE

    2018-02-01

    Ongoing investigation is needed into feasible approaches which reduce excess weight in childhood. This study aimed to assess the effectiveness of an adapted version of the Scottish Childhood Overweight Treatment Trial (SCOTT) in an Irish primary care setting. Families were offered monthly dietitian-led sessions for six months. These sessions targeted dietary habits, family meals, screen time and exercise. Of the 95 children (mean age 7.6 years) referred, 90.5% (n86) were obese and 9.5% (n9) were overweight. Fifty-one (53.7%) families opted into the programme from referral, and 18 completed the programme (64.7% attrition). Statistically significant reductions in body mass index (BMI) were observed between sessions one and six (25.7±4.2kg\\/m2 and 25.3±4.8kg\\/m2, respectively, p<0.01). BMI z-score modestly decreased by 0.2 (p=0.01). Despite these reductions, issues with programme referral, attrition and long-term effectiveness were evident. Further investigation into strategies which reduce paediatric overweight is warranted.

  3. Improving malaria treatment and prevention in India by aiding district managers to manage their programmes with local information: a trial assessing the impact of Lot Quality Assurance Sampling on programme outcomes.

    Science.gov (United States)

    Valadez, Joseph J; Devkota, Baburam; Pradhan, Madan Mohan; Meherda, Pramod; Sonal, G S; Dhariwal, Akshay; Davis, Rosemary

    2014-10-01

    This paper reports the first trial of Lot Quality Assurance Sampling (LQAS) assessing associations between access to LQAS data and subsequent improvements in district programming. This trial concerns India's approach to addressing an increase in malaria-attributable deaths by training community health workers to diagnose, treat and prevent malaria, while using LQAS to monitor sub-district performance and make programme improvements. The Ministry of Health introduced LQAS into four matched high malaria burden districts (Annual Parasite Incidence >5) (N > 5 million). In each sub-district, we sampled four populations in three 6-monthly surveys: households, children <5 years, people with fever in the last 2 weeks and community health workers. In three districts, trained local staff collected, analysed and used data for programme management; in one control district, non-local staff collected data and did not disseminate results. For eight indicators, we calculated the change in proportion from survey one to three and used a Difference-in-Differences test to compare the relative change between intervention and control districts. Coverage increased from survey one to three for 24 of 32 comparisons. Difference-in-Differences tests revealed that intervention districts exhibited significantly greater change in four of six vertical strategies (insecticide treated bed-nets and indoor residual spraying), one of six treatment-seeking behaviours and four of 12 health worker capacity indicators. The control district displayed greater improvement than two intervention districts for one health worker capacity indicator. One district with poor management did not improve. In this study, LQAS results appeared to support district managers to increase coverage in underperforming areas, especially for vertical strategies in the presence of diligent managers. © 2014 The Authors. Tropical Medicine & International Health published by John Wiley & Sons Ltd.

  4. Patient participation during and after a self-management programme in primary healthcare - The experience of patients with chronic obstructive pulmonary disease or chronic heart failure.

    Science.gov (United States)

    Luhr, Kristina; Holmefur, Marie; Theander, Kersti; Eldh, Ann Catrine

    2017-12-26

    Patient participation is facilitated by patients' ability to take responsibility for and engage in health issues. Yet, there is limited research as to the promotion of these aspects of patient participation in long-term healthcare interactions. This paper describes patient participation as experienced by patients with chronic obstructive pulmonary disease (COPD) or chronic heart failure (CHF); the aim was to describe if and how a self-management programme in primary healthcare influenced patient participation. Patients who had participated in a self-management programme were interviewed in nine focus groups (36 patients). Data was analysed using qualitative content analysis. Patients described equality in personal interactions, opportunities to share and discuss, and a willingness to share and learn to facilitate patient participation in a self-management programme. Consequently, patient participation was promoted by a match between the individuals' personal traits and the context. Features facilitating patient participation by means of sharing and assimilating knowledge and insights should be included in self-management programmes and in the care for patients with COPD and CHF. A self-management programme can complement regular primary care regarding enhanced understanding of one's disease and support patient participation and the patient's own resources in self-management. Copyright © 2017. Published by Elsevier B.V.

  5. Evaluation of a large scale implementation of disease management programmes in various Dutch regions: a study protocol.

    Science.gov (United States)

    Lemmens, Karin M M; Rutten-Van Mölken, Maureen P M H; Cramm, Jane M; Huijsman, Robbert; Bal, Roland A; Nieboer, Anna P

    2011-01-10

    Disease management programmes (DMPs) have been developed to improve effectiveness and economic efficiency within chronic care delivery by combining patient-related, professional-directed, and organisational interventions. The benefits of DMPs within different settings, patient groups, and versions remain unclear. In this article we propose a protocol to evaluate a range of current DMPs by capturing them in a single conceptual framework, employing comparable structure, process, and outcome measures, and combining qualitative and quantitative research methods. To assess DMP effectiveness a practical clinical trial will be conducted. Twenty-two disease management experiments will be studied in various Dutch regions consisting of a variety of collaborations between organisations and/or professionals. Patient cohorts include those with cardiovascular diseases, chronic obstructive pulmonary disease, diabetes, stroke, depression, psychotic diseases, and eating disorders. Our methodological approach combines qualitative and quantitative research methods to enable a comprehensive evaluation of complex programmes. Process indicators will be collected from health care providers' data registries and measured via physician and staff questionnaires. Patient questionnaires include health care experiences, health care utilisation, and quality of life. Qualitative data will be gathered by means of interviews and document analysis for an in depth description of project interventions and the contexts in which DMPs are embedded, and an ethnographic process evaluation in five DMPs. Such a design will provide insight into ongoing DMPs and demonstrate which elements of the intervention are potentially (cost)-effective for which patient populations. It will also enable sound comparison of the results of the different programmes. The study will lead to a better understanding of (1) the mechanisms of disease management, (2) the feasibility, and cost-effectiveness of a disease management

  6. Evaluation of a large scale implementation of disease management programmes in various Dutch regions: a study protocol

    Directory of Open Access Journals (Sweden)

    Bal Roland A

    2011-01-01

    Full Text Available Abstract Background Disease management programmes (DMPs have been developed to improve effectiveness and economic efficiency within chronic care delivery by combining patient-related, professional-directed, and organisational interventions. The benefits of DMPs within different settings, patient groups, and versions remain unclear. In this article we propose a protocol to evaluate a range of current DMPs by capturing them in a single conceptual framework, employing comparable structure, process, and outcome measures, and combining qualitative and quantitative research methods. Methods To assess DMP effectiveness a practical clinical trial will be conducted. Twenty-two disease management experiments will be studied in various Dutch regions consisting of a variety of collaborations between organisations and/or professionals. Patient cohorts include those with cardiovascular diseases, chronic obstructive pulmonary disease, diabetes, stroke, depression, psychotic diseases, and eating disorders. Our methodological approach combines qualitative and quantitative research methods to enable a comprehensive evaluation of complex programmes. Process indicators will be collected from health care providers' data registries and measured via physician and staff questionnaires. Patient questionnaires include health care experiences, health care utilisation, and quality of life. Qualitative data will be gathered by means of interviews and document analysis for an in depth description of project interventions and the contexts in which DMPs are embedded, and an ethnographic process evaluation in five DMPs. Such a design will provide insight into ongoing DMPs and demonstrate which elements of the intervention are potentially (cost-effective for which patient populations. It will also enable sound comparison of the results of the different programmes. Discussion The study will lead to a better understanding of (1 the mechanisms of disease management, (2 the

  7. CO{sub 2}MPARE. CO2 Model for Operational Programme Assessment in EU Regions. Improved carbon management with EU Regional Policy. Final Report

    Energy Technology Data Exchange (ETDEWEB)

    Hekkenberg, M. [ECN Policy Studies, Amsterdam (Netherlands); Schram, J. [Energies Demain, Montreuil Sous Bois (France); Amerighi, O. [Italian National Agency for New Technologies, Energy and Sustainable Economic Development ENEA, Rome (Italy); Keppo, I. [University College London UCL, London (United Kingdom); Papagianni, S. [Centre for Renewable Energy Sources and Saving CRES, Pikermi Attiki (Greece); Ten Donkelaar, M. [ENVIROS, Prague (Czech Republic)

    2013-03-15

    The CO2MPARE model supports national and regional authorities in making balanced decisions for their investment portfolio under their regional development programmes, in particular under their Operational Programmes of EU Regional Policy. The EU's climate objectives require that investments across the EU are channeled towards low-carbon development. The carbon impacts of investments should therefore be seriously considered in the decision making process of regional development programmes. The CO2MPARE model informs national and regional authorities on the impacts that the investments under various Operational Programmes can have in terms of CO2 emissions. Knowing which investments lead either to additional emissions or rather to emission reductions, and what the overall impact of a programme is, represents the first step towards investment decisions that have decarbonisation co-benefits. CO2MPARE estimates the combined carbon impact of all activities that take place under a programme, and provides insights into the relative contributions of the different themes. Through its high aggregation level, it allows comparison of investment scenarios rather than individual projects. As such, it aims to support informed decisions on investment strategies rather than project investment decisions. In doing so, it also helps to build and develop a 'carbon culture' within the authorities directly or indirectly in charge of managing Regional Policy Operational Programmes. The model is primarily aimed at Operational Programmes co-financed by the European Regional Development Fund (ERDF)

  8. Physiological links of circadian clock and biological clock of aging

    Directory of Open Access Journals (Sweden)

    Fang Liu

    2017-01-01

    Full Text Available ABSTRACT Circadian rhythms orchestrate biochemical and physiological processes in living organisms to respond the day/night cycle. In mammals, nearly all cells hold self-sustained circadian clocks meanwhile couple the intrinsic rhythms to systemic changes in a hierarchical manner. The suprachiasmatic nucleus (SCN of the hypothalamus functions as the master pacemaker to initiate daily synchronization according to the photoperiod, in turn determines the phase of peripheral cellular clocks through a variety of signaling relays, including endocrine rhythms and metabolic cycles. With aging, circadian desynchrony occurs at the expense of peripheral metabolic pathologies and central neurodegenerative disorders with sleep symptoms, and genetic ablation of circadian genes in model organisms resembled the aging-related features. Notably, a number of studies have linked longevity nutrient sensing pathways in modulating circadian clocks. Therapeutic strategies that bridge the nutrient sensing pathways and circadian clock might be rational designs to defy aging.

  9. Acceleration effects on atomic clocks

    CERN Document Server

    Dahia, F

    2014-01-01

    We consider a free massive particle inside a box which is dragged by Rindler observers. Admitting that the particle obeys the Klein-Gordon equation, we find the frequencies of the stationary states of this system. Transitions between the stationary states are employed to set a standard frequency for a toy atomic clock. Comparing the energy spectrum of the accelerated system with the energy spectrum of an identical system in an inertial frame, we determine the influence of the instantaneous acceleration on the rate of atomic clocks. We argue that our result does not violate the clock hypothesis.

  10. Developing skills and competence of employees of the Kujawsko-Pomorskie regional operational programme managing body – research findings

    Directory of Open Access Journals (Sweden)

    Małgorzata Michalcewicz-Kaniowska

    2011-01-01

    Full Text Available In the contemporary world it is the employees or the human capital of any company who are responsible for effective management and caring for the future of their business. Organisations change all the time which means that continual staff training should be provided. The purpose of the research was to evaluate the training policy of the managing body of the Kujawsko-Pomorskie Regional Operational Programme (IZ RPO WK-P and its employees’ development potential. The research participants preferred mentoring (47%, coaching (27% and briefing (26% techniques. They also benefited from a range of educational techniques such as training courses, post-graduate studies etc. and a wide choice of subjects. Thus, it is necessary to conduct periodic research on training requirements, focusing on subjects and training techniques.

  11. Brain clocks for morning and evening behaviour

    Indian Academy of Sciences (India)

    Unknown

    228 taneously synthesized transcripts of a clock gene, mPer1, in one of the two lobes, and transcripts of another clock gene,. Bmal1, in the other, suggesting antiphasic nature of the two bilaterally symmetric SCN lobes. Further, it was ... resolution of clock cell targeting. The authors developed. Figure 1. Clock neurons in the ...

  12. Simulating Future GPS Clock Scenarios with Two Composite Clock Algorithms

    Science.gov (United States)

    2010-11-01

    Alexandria, Virginia), pp. 223-242. [8] C. A. Greenhall, 2007, “A Kalman filter clock ensemble algorithm that admits measurement noise,” Metrologia ...43, S311-S321. [9] J. A. Davis, C. A. Greenhall, and P. W. Stacey, 2005, “A Kalman filter clock algorithm for use in the presence of flicker frequency modulation noise,” Metrologia , 42, 1-10.

  13. The Effect of Peer-Led Self-Management Education Programmes for Adolescents with Asthma: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Zhong, Connie S.; Melendez-Torres, G. J.

    2017-01-01

    Background: Adolescents with asthma face unique challenges due to hormonal changes, psychosocial development and healthcare transition. Peer-led self-management programmes may increase treatment adherence and social adjustment by addressing these challenges. The purpose of this study was to assess whether peer-led self-management programmes…

  14. Professional Education Programme for Land Management and Land Administration in Cambodia

    Science.gov (United States)

    Setha, Vung; Mund, Jan-Peter

    2008-01-01

    Land management and land administration are defined as a system of planning, management and administration methods and techniques that aims to integrate ecological with social, economic and legal principles in the management of land for urban and rural development purposes. The main objective is to meet changing and developing human needs, while…

  15. Diabetes structured self-management education programmes: a narrative review and current innovations

    NARCIS (Netherlands)

    Chatterjee, Sudesna; Davies, Melanie J.; Heller, Simon; Speight, Jane; Snoek, Frank J.; Khunti, Kamlesh

    2017-01-01

    Both type 1 and type 2 diabetes are associated with long-term complications that can be prevented or delayed by intensive glycaemic management. People who are empowered and skilled to self-manage their diabetes have improved health outcomes. Over the past 20 years, diabetes self-management education

  16. PERICLES: a knowledge management programme applied to solar data from International Space Station-Columbus

    Science.gov (United States)

    Muller, Christian; PERICLES Consortium

    2017-06-01

    The FP-7 (Framework Programme 7 of the European Union) PERICLES project addresses the life-cycle of large and complex data sets to cater for the evolution of context of data sets and user communities, including groups unanticipated when the data was created. Semantics of data sets are thus also expected to evolve and the project includes elements which could address the reuse of data sets at periods where the data providers and even their institutions are not available any more. This paper presents the PERICLES science case with the example of the SOLAR (SOLAR monitoring observatory) payload on International Space Station-Columbus.

  17. A qualitative study of patients' experiences of participating in SPACE for COPD: a Self-management Programme of Activity, Coping and Education

    Directory of Open Access Journals (Sweden)

    Lindsay D. Apps

    2017-10-01

    Full Text Available The aim of this study was to understand experiences of participation in a supported self-management programme for chronic obstructive pulmonary disease (COPD. There is a wealth of clinical trials examining the outcomes of self-management interventions for individuals with COPD, but current understanding regarding patients' perspectives of such complex interventions is limited. Further insight may help to tailor self-management interventions and maximise patient engagement. Semi-structured interviews were conducted with individuals participating in a self-management programme, SPACE for COPD. Interviews took place at 6 weeks and 6 months following the programme. Data were analysed at each time point using inductive thematic analysis, and subsequently re-examined together. 40 interviews were undertaken and four themes emerged from the analysis: perceptions of the programme; lifestyle changes; social support; and disrupting factors and barriers to maintaining routines. SPACE for COPD was acceptable to participants in this study. The importance of education and social support was emphasised at both time points studied, but there were challenges such as comorbidities, ill health of family members and limited maintenance of exercise behaviours over the longer term. Further consideration of the role of carers and partners may help to improve adherence to self-management programmes once healthcare professional support has stopped.

  18. A qualitative study of patients' experiences of participating in SPACE for COPD: a Self-management Programme of Activity, Coping and Education.

    Science.gov (United States)

    Apps, Lindsay D; Harrison, Samantha L; Mitchell, Katy E; Williams, Johanna E A; Hudson, Nicky; Singh, Sally J

    2017-10-01

    The aim of this study was to understand experiences of participation in a supported self-management programme for chronic obstructive pulmonary disease (COPD). There is a wealth of clinical trials examining the outcomes of self-management interventions for individuals with COPD, but current understanding regarding patients' perspectives of such complex interventions is limited. Further insight may help to tailor self-management interventions and maximise patient engagement. Semi-structured interviews were conducted with individuals participating in a self-management programme, SPACE for COPD. Interviews took place at 6 weeks and 6 months following the programme. Data were analysed at each time point using inductive thematic analysis, and subsequently re-examined together. 40 interviews were undertaken and four themes emerged from the analysis: perceptions of the programme; lifestyle changes; social support; and disrupting factors and barriers to maintaining routines. SPACE for COPD was acceptable to participants in this study. The importance of education and social support was emphasised at both time points studied, but there were challenges such as comorbidities, ill health of family members and limited maintenance of exercise behaviours over the longer term. Further consideration of the role of carers and partners may help to improve adherence to self-management programmes once healthcare professional support has stopped.

  19. Cost-effectiveness of a disease management programme for secondary prevention of coronary heart disease and heart failure in primary care.

    Science.gov (United States)

    Turner, D A; Paul, S; Stone, M A; Juarez-Garcia, A; Squire, I; Khunti, K

    2008-12-01

    To determine if a disease management programme for patients with coronary heart disease and heart failure represents an efficient use of health services resources. We carried out an economic evaluation alongside a cluster randomised control trial of 1163 patients with coronary heart disease and chronic heart failure in 20 primary care practices in the United Kingdom. Practices were randomised to either a control group, where patients received standard general practice care, or an intervention group where patients had access to a specialist nurse-led disease management programme. We estimated costs in both groups for coronary heart disease-related resource use. The main outcome measure used in the economic evaluation was quality adjusted life years (QALY) measured using the EuroQol. The disease management programme was associated with an increase in the QALY measured of 0.03 per year and an increase in the total NHS costs of 425 pounds (540 euros), of this only 83 pounds was directly associated with the provision of the nurse clinics. The clinics generated additional QALY at an incremental cost of 13 pounds 158 per QALY compared to the control group. The use of a nurse-led disease management programme is associated with increased costs in other coronary heart disease-related services as well as for the costs of the clinics. They are also associated with improvements in health. Even in the short term these disease management programmes may represent a cost-effective service, as additional QALY are generated at an acceptable extra cost.

  20. Knowledge and perceptions of national and provincial tuberculosis control programme managers in Pakistan about the WHO Stop TB strategy: a qualitative study.

    Science.gov (United States)

    Khan, Wasiq Mehmood; Smith, Helen; Qadeer, Ejaz; Hassounah, Sondus

    2016-01-01

    To understand how national and provincial tuberculosis programme managers in Pakistan perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. National and provincial tuberculosis programme managers play an important role in effective implementation of the Stop TB strategy. A qualitative interview study was conducted with 10 national and provincial tuberculosis programme managers to understand how they perceive and engage with the Stop TB strategy, its strengths, weaknesses and their experience in its implementation. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). National and provincial tuberculosis programme managers in Pakistan. Managers were selected purposively; 10 managers were interviewed (six national staff and four from provincial level). National and provincial tuberculosis programmes in Pakistan. 1. Knowledge and perceptions of national and provincial tuberculosis programme managers about the Stop TB strategy 2. Progress in implementing the strategy in Pakistan 3. Significant success factors 4. Significant implementation challenges 5. Lessons learnt to scale up successful implementation. The managers reported that most progress had been made in extending DOTS, health systems strengthening, public -private mixed interventions, MDR-TB care and TB/HIV care. The four factors that contributed significantly to progress were the availability of DOTS services, the public-private partnership approach, comprehensive guidance for TB control and government and donor commitment to TB control. This study identified three main challenges as perceived by national and provincial tuberculosis programme managers in terms of implementing the Stop TB strategy: 1. Inadequate political commitment, 2. Issue pertaining to prioritisation of certain components in the TB strategy over others due to external influences and 3. Limitations in the overall

  1. Rationale and methods of the multicenter randomised trial of a heart failure management programme among geriatric patients (HF-Geriatrics

    Directory of Open Access Journals (Sweden)

    Casado Jose

    2011-08-01

    Full Text Available Abstract Background Disease management programmes (DMPs have been shown to reduce hospital readmissions and mortality in adults with heart failure (HF, but their effectiveness in elderly patients or in those with major comorbidity is unknown. The Multicenter Randomised Trial of a Heart Failure Management Programme among Geriatric Patients (HF-Geriatrics assesses the effectiveness of a DMP in elderly patients with HF and major comorbidity. Methods/Design Clinical trial in 700 patients aged ≥ 75 years admitted with a primary diagnosis of HF in the acute care unit of eight geriatric services in Spain. Each patient should meet at least one of the following comorbidty criteria: Charlson index ≥ 3, dependence in ≥ 2 activities of daily living, treatment with ≥ 5 drugs, active treatment for ≥ 3 diseases, recent emergency hospitalization, severe visual or hearing loss, cognitive impairment, Parkinson's disease, diabetes mellitus, chronic obstructive pulmonary disease (COPD, anaemia, or constitutional syndrome. Half of the patients will be randomly assigned to a 1-year DMP led by a case manager and the other half to usual care. The DMP consists of an educational programme for patients and caregivers on the management of HF, COPD (knowledge of the disease, smoking cessation, immunizations, use of inhaled medication, recognition of exacerbations, diabetes (knowledge of the disease, symptoms of hyperglycaemia and hypoglycaemia, self-adjustment of insulin, foot care and depression (knowledge of the disease, diagnosis and treatment. It also includes close monitoring of the symptoms of decompensation and optimisation of treatment compliance. The main outcome variables are quality of life, hospital readmissions, and overall mortality during a 12-month follow-up. Discussion The physiological changes, lower life expectancy, comorbidity and low health literacy associated with aging may influence the effectiveness of DMPs in HF. The HF-Geriatrics study

  2. Effectiveness of a patient self-management programme for breast cancer as a chronic illness: a non-randomised controlled clinical trial.

    Science.gov (United States)

    Loh, Siew Yim; Packer, Tanya; Chinna, Karuthan; Quek, Kia Fatt

    2013-09-01

    Patient self-management enables living with a chronic disease effectively. This study examines the effectiveness of a 4-week self-management programme to enable self-management of the numerous after-effects and with breast cancer as a chronic disease. Upon ethical approval, 147 multiethnic survivors (stages I-III breast cancer) received either a 4-week self-management intervention (n = 68) or usual care (n = 78) on a controlled clinical trial in a medical centre. The facilitator-led group intervention provides self-management support and skills for managing the medical, emotional and role tasks. Survivors completed the pre- and post-intervention measures on quality of life, distress and participation inventory. Multiple analyses of covariance (adjusted for baseline measures) showed significant differences between groups [F(6, 129) = 2.26, p = 0.04 at post-test and F(6, 129) = 4.090, p management intervention enhance the QOL of women with breast cancer, by enabling them to better self-manage the numerous medical, emotional and role tasks. Further randomised trials are warranted. Survivors receiving self-management programme report improved HRQL compared with those on usual care. Although time can attenuate the participation limitation and distress of survivors, self-management programmes could help to increase patients' self-efficacy for better self-management.

  3. Einstein's Clocks and Langevin's Twins

    CERN Document Server

    Weinstein, Galina

    2012-01-01

    In 1905 Einstein presented the Clock Paradox and in 1911 Paul Langevin expanded Einstein's result to human observers, the "Twin Paradox." I will explain the crucial difference between Einstein and Langevin. Einstein did not present the so-called "Twin Paradox." Later Einstein continued to speak about the clock paradox. Einstein might not have been interested in the question: what happens to the observers themselves. The reason for this could be the following; Einstein dealt with measurement procedures, clocks and measuring rods. Einstein's observers were measuring time with these clocks and measuring rods. Einstein might not have been interested in so-called biology of the observers, whether these observers were getting older, younger, or whether they have gone any other changes; these changes appeared to be out of the scope of his "Principle of relativity" or kinematics. The processes and changes occurring within observers seemed to be good for philosophical discussions. Later writers criticized Einstein's c...

  4. Payday, ponchos, and promotions: a qualitative analysis of perspectives from non-governmental organization programme managers on community health worker motivation and incentives.

    Science.gov (United States)

    B-Lajoie, Marie-Renée; Hulme, Jennifer; Johnson, Kirsten

    2014-12-05

    Community health workers (CHWs) have been central to broadening the access and coverage of preventative and curative health services worldwide. Much has been debated about how to best remunerate and incentivize this workforce, varying from volunteers to full time workers. Policy bodies, including the WHO and USAID, now advocate for regular stipends. This qualitative study examines the perspective of health programme managers from 16 international non-governmental organizations (NGOs) who directly oversee programmes in resource-limited settings. It aimed to explore institutional guidelines and approaches to designing CHW incentives, and inquire about how NGO managers are adapting their approaches to working with CHWs in this shifting political and funding climate. Second, it meant to understand the position of stakeholders who design and manage non-governmental organization-run CHW programmes on what they consider priorities to boost CHW motivation. Individuals were recruited using typical case sampling through chain referral at the semi-annual CORE Group meeting in the spring of 2012. Semi-structured interviews were guided by a peer reviewed tool. Two reviewers analyzed the transcripts for thematic saturation. Six key factors influenced programme manager decision-making: National-level government policy, donor practice, implicit organizational approaches, programmatic, cultural, and community contexts, experiences and values of managers, and the nature of the work asked of CHWs. Programme managers strongly relied on national government to provide clear guidance on CHW incentives schemes. Perspectives on remuneration varied greatly, from fears that it is unsustainable, to the view that it is a basic human right, and a mechanism to achieve greater gender equity. Programme managers were interested in exploring career paths and innovative financing schemes for CHWs, such as endowment funds or material sales, to heighten local ownership and sustainability of programmes

  5. Association of risky alcohol consumption and accreditation in the 'Good Sports' alcohol management programme.

    Science.gov (United States)

    Rowland, Bosco; Allen, Felicity; Toumbourou, John W

    2012-08-01

    Involvement in community sports clubs is often associated with high levels of risky alcohol consumption; however, developing prevention-focused interventions in these settings can be complex. We examined the association of reduced risky alcohol consumption with the implementation of the Good Sports Programme (GSP)--a programme that accredits clubs in three stages, on the basis of their implementation of alcohol-related harm reduction strategies. Using a cross section of football and cricket clubs, consumption was compared between clubs accredited at level 1, 2 or 3 of the GSP and clubs not accredited (92 clubs; 1924 individuals). Drinking above Australian guidelines for short-term risk (more than four standard drinks) on the last playing day prior to the survey and drinking at the club over the last 12 months at average levels exceeding short- and long-term risk (more than two standard drinks) guidelines were also examined. Multilevel modelling indicated that higher accreditation stage (0, 1, 2, 3) was associated with a 0.79 reduction in the odds of risky consumption on the playing day; a 0.85 reduction in the odds for short-term risky drinking, and a 0.86 reduction in long-term risky drinking. The findings suggest that higher accreditation in the GSP is associated with reduced rates of risky alcohol use at a population level.

  6. Biological clocks in theory and experiments

    OpenAIRE

    Millar Andrew J

    2005-01-01

    Eukaryotes and some prokaryotes have adapted to the 24 h day/night cycle by evolving circadian clocks. The circadian clock now controls 24-hour rhythms in very many aspects of metabolism, physiology and behaviour. Day-length (photoperiod) measurement depends on the circadian clock, so the 24 h clock mechanism also governs seasonal rhythms, such as reproduction. In the model plant species, Arabidopsis thaliana, the clock controls the expression of about 10% of genes, and this proportion is sim...

  7. Analysis list: Clock [Chip-atlas[Archive

    Lifescience Database Archive (English)

    Full Text Available Clock Liver + mm9 http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/target/Clock.1.tsv... http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/target/Clock.5.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/target/Clock....10.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/colo/Clock.Liver.tsv http://dbarchive.biosciencedbc.jp/kyushu-u/mm9/colo/Liver.gml ...

  8. Stochastic models for atomic clocks

    Science.gov (United States)

    Barnes, J. A.; Jones, R. H.; Tryon, P. V.; Allan, D. W.

    1983-01-01

    For the atomic clocks used in the National Bureau of Standards Time Scales, an adequate model is the superposition of white FM, random walk FM, and linear frequency drift for times longer than about one minute. The model was tested on several clocks using maximum likelihood techniques for parameter estimation and the residuals were acceptably random. Conventional diagnostics indicate that additional model elements contribute no significant improvement to the model even at the expense of the added model complexity.

  9. Evaluation of a group based cognitive behavioural therapy programme for menstrual pain management in young women with intellectual disabilities: protocol for a mixed methods controlled clinical trial.

    Science.gov (United States)

    Kennedy, Susan; O'Higgins, Siobhan; Sarma, Kiran; Willig, Carla; McGuire, Brian E

    2014-09-08

    Menstrual pain which is severe enough to impact on daily activities is very common amongst menstruating females. Research suggests that menstrual pain which impacts on daily functioning may be even more prevalent amongst those with intellectual disabilities. Despite this, little research attention has focused on pain management programmes for those with intellectual disabilities.The aims of this pilot study were to develop and evaluate a theory-based cognitive behavioural therapy (CBT) programme for menstrual pain management in young women with intellectual disabilities. The study utilised a mixed methods controlled clinical trial to evaluate elements from a CBT programme called Feeling Better (McGuire & McManus, 2010). The Feeling Better programme is a modular, manualised intervention designed for people with an intellectual disability and their carers. The programme was delivered to 36 young women aged 12-30 years who have a Mild-Moderate Intellectual Disability, split between two conditions. The treatment group received the Feeling Better intervention and the control group received treatment as usual. To evaluate the effectiveness of the programme, measures were taken of key pain variables including impact, knowledge, self-efficacy and coping. Process evaluation was conducted to examine which elements of the programme were most successful in promoting change. Participants in the intervention group were expected to report the use of a greater number of coping strategies and have greater knowledge of pain management strategies following participation in the intervention and at three month follow-up, when compared to control group participants. A significant advantage of the study was the use of mixed methods and inclusion of process evaluation to determine which elements of a cognitive behavioural therapy programme work best for individuals with intellectual disabilities. Current Controlled Trials ISRCTN75567759.

  10. Effectiveness of a tinnitus management programme: a 2-year follow-up

    DEFF Research Database (Denmark)

    Gudex, Claire

    2009-01-01

    BACKGROUND: Tinnitus impairs the possibility of leading a normal life in 0.5-1% of the population. While neither medical nor surgical treatment appears effective, counselling may offer some relief. An intervention combining counselling and hearing devices is offered to clients referred...... to the Centre for Help Aids and Communication (CHC) in southern Denmark. The aims of this exploratory study were to examine i) the characteristics of CHC's clients and their tinnitus, ii) the effectiveness of the treatment, and iii) whether particular client groups benefit more than others. METHODS: One hundred...... significant benefit to many clients at a relatively low cost. It would be useful to conduct a randomised controlled study comparing the current programme with alternative forms of combination counselling/sound therapy approaches....

  11. Management of neonatal hydrocephalus: feasibility of use and safety of two programmable (Sophy and Polaris) valves.

    Science.gov (United States)

    Martínez-Lage, Juan F; Almagro, María-José; Del Rincón, Isabel Sanchez; Pérez-Espejo, Miguel A; Piqueras, Claudio; Alfaro, Raúl; Ros de San Pedro, Javier

    2008-05-01

    Neonates represent a unique group of pediatric patients with special peculiarities. Hydrocephalus valves have not always been designed to meet the requirements of these small children. Few series have addressed the problem of cerebrospinal fluid shunting in newborn babies. We aimed (1) to evaluate the feasibility of the use of two programmable valves (Sophy and Polaris) in hydrocephalic neonates and (2) to ascertain complications and safety issues arising from their use. We performed a prospective study of 100 consecutive preterm and term babies (Polaris) can be safely used for treatment of neonatal hydrocephalus, introducing some technical modifications. (2) Both valves are comparable to other shunts with regard to indications, performance, and safety. (3) The possibility of modifying their working pressure seems to constitute their main advantage. Prevention of late overdrainage syndromes with these valves needs a longer follow-up.

  12. Psychosocial predictors and moderators of weight management programme outcomes in ethnically diverse obese youth.

    Science.gov (United States)

    Taylor, J H; Xu, Y; Li, F; Shaw, M; Dziura, J; Caprio, S; Tamborlane, W V; Nowicka, P; Savoye, M

    2016-07-07

    An important area of research in childhood obesity is the identification of factors that predict or moderate the responses to obesity intervention programmes, yet few studies have examined the impact of self-esteem and family functioning on obesity treatment outcomes. We sought to determine whether baseline self-esteem and family functioning predicted or moderated childhood obesity intervention outcomes at 6 months. From 2009 to 2011, seventy-five 10-16 year old, racially/ethnically diverse obese youths with abnormal glucose tolerance were randomized to 6 months of an intensive family-based obesity lifestyle intervention (Bright Bodies) or routine outpatient Clinic Care. We examined youth self-concept, parent-rated family functioning and 6-month outcomes (youths' glucose tolerance, weight, body mass index and percent fat). We set the significance threshold as P ≤ 0.05 for moderator and predictor analyzes. Having poor family functioning and self-concept scores indicating high anxiety and low self-esteem at baseline predicted poor 6-month outcomes overall (Bright Bodies and Clinic Care groups combined). Additionally, baseline self-esteem and family functioning moderated treatment effects such that Bright Bodies outperformed Clinic Care in youths with low self-esteem and poorly functioning families, whereas youths with high self-esteem and high-functioning families did similarly well with either intervention. Our findings suggest intensive family-based lifestyle programmes are particularly beneficial for youth with low self-esteem and poorly functioning families. © 2016 World Obesity Federation.

  13. Resource-stratified implementation of a community-based breast cancer management programme in Peru.

    Science.gov (United States)

    Duggan, Catherine; Dvaladze, Allison L; Tsu, Vivien; Jeronimo, Jose; Constant, Tara K Hayes; Romanoff, Anya; Scheel, John R; Patel, Shilpen; Gralow, Julie R; Anderson, Benjamin O

    2017-10-01

    Breast cancer incidence and mortality rates continue to rise in Peru, with related deaths projected to increase from 1208 in 2012, to 2054 in 2030. Despite improvements in national cancer control plans, various barriers to positive breast cancer outcomes remain. Multiorganisational stakeholder collaboration is needed for the development of functional, sustainable early diagnosis, treatment and supportive care programmes with the potential to achieve measurable outcomes. In 2011, PATH, the Peruvian Ministry of Health, the National Cancer Institute in Lima, and the Regional Cancer Institute in Trujillo collaborated to establish the Community-based Program for Breast Health, the aim of which was to improve breast health-care delivery in Peru. A four-step, resource-stratified implementation strategy was used to establish an effective community-based triage programme and a practical early diagnosis scheme within existing multilevel health-care infrastructure. The phased implementation model was initially developed by the Breast Cancer Initiative 2·5: a group of health and non-governmental organisations who collaborate to improve breast cancer outcomes. To date, the Community-based Program for Breast Health has successfully implemented steps 1, 2, and 3 of the Breast Cancer Initiative 2·5 model in Peru, with reports of increased awareness of breast cancer among women, improved capacity for early diagnosis among health workers, and the creation of stronger and more functional linkages between the primary levels (ie, local or community) and higher levels (ie, district, region, and national) of health care. The Community-based Program for Breast Health is a successful example of stakeholder and collaborator involvement-both internal and external to Peru-in the design and implementation of resource-appropriate interventions to increase breast health-care capacity in a middle-income Latin American country. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Effects of self-management support programmes on activities of daily living of older adults.

    NARCIS (Netherlands)

    Bolscher-Niehuis, M.J.T. van het; Bergsma, A.; Vocht, H.M. de; Ouden, M.E.M. den; Francke, A.L.

    2016-01-01

    Background: The ability of older adults to carry out activities of daily living (ADL) and to adapt and to manage their own life decreases due to deterioration of their physical and cognitive condition. Nurses and other health care professionals should support the self-management ability of older

  15. Production objectives and management strategies of livestock keepers in south-east Kenya: implications for a breeding programme.

    Science.gov (United States)

    Mwacharo, J M; Drucker, A G

    2005-11-01

    A survey of pastoralist and agropastoralist households in south-east Kenya was conducted to determine their production objectives and management strategies in order to optimize and extend a breeding programme for indigenous small East African Shorthorn Zebu cattle. The reasons for keeping cattle and the breed/trait preferences identified reflect the multiple objectives of the livestock keepers, with both adaptive traits and productive/reproductive traits rated as important. Although the Maasai and Kamba zebu (M&KZ) breeds were ranked highly with regard to adaptive traits, the population is considered to have been in decline over recent years. In order to promote the conservation and sustainable use of the M&KZ cattle, the formation of an open nucleus breeding scheme is recommended. In particular, such a scheme would be able to address several existing constraints (e.g. individual herds are very small and communal use of pastures/water makes controlled mating difficult). Such interventions would require the full participation of the livestock keepers, as well as ensuring that a holistic approach to species and breed attributes is taken into account in setting breeding goals, such that the full array of contributions that livestock make to livelihoods and the genetic characteristics related to these contributions are fully incorporated into the programme.

  16. Improving the management of non-ST elevation acute coronary syndromes: systematic evaluation of a quality improvement programme European QUality Improvement Programme for Acute Coronary Syndrome: The EQUIP-ACS project protocol and design

    Directory of Open Access Journals (Sweden)

    Bardaji Alfredo

    2010-01-01

    Full Text Available Abstract Background Acute coronary syndromes, including myocardial infarction and unstable angina, are important causes of premature mortality, morbidity and hospital admissions. Acute coronary syndromes consume large amounts of health care resources, and have a major negative economic and social impact through days lost at work, support for disability, and coping with the psychological consequences of illness. Several registries have shown that evidence based treatments are under-utilised in this patient population, particularly in high-risk patients. There is evidence that systematic educational programmes can lead to improvement in the management of these patients. Since application of the results of important clinical trials and expert clinical guidelines into clinical practice leads to improved patient care and outcomes, we propose to test a quality improvement programme in a general group of hospitals in Europe. Methods/Design This will be a multi-centre cluster-randomised study in 5 European countries: France, Spain, Poland, Italy and the UK. Thirty eight hospitals will be randomised to receive a quality improvement programme or no quality improvement programme. Centres will enter data for all eligible non-ST segment elevation acute coronary syndrome patients admitted to their hospital for a period of approximately 10 months onto the study database and the sample size is estimated at 2,000-4,000 patients. The primary outcome is a composite of eight measures to assess aggregate potential for improvement in the management and treatment of this patient population (risk stratification, early coronary angiography, anticoagulation, beta-blockers, statins, ACE-inhibitors, clopidogrel as a loading dose and at discharge. After the quality improvement programme, each of the eight measures will be compared between the two groups, correcting for cluster effect. Discussion If we can demonstrate important improvements in the quality of patient care as

  17. Physician empowerment programme; a unique workshop for physician-managers of community clinics

    National Research Council Canada - National Science Library

    Maza, Yafit; Shechter, Efrat; Pur Eizenberg, Neta; Segev, Efrat Gortler; Flugelman, Moshe Y

    2016-01-01

    .... The aim of this research was to evaluate an intensive workshop designed to modify attitudes and improve skills of physician-managers of community clinics, through focus on personal well-being and empowerment...

  18. CSIR NYENDA programme: traffic management R&D capacity building - balancing the opportunities and constraints

    CSIR Research Space (South Africa)

    Labuschagne, FJJ

    2009-07-01

    Full Text Available (SATC, 2008). NyendaWeb harnesses Intelligent Transport Systems (ITS) in its various forms of implementation and is developed as an open source instrument to facilitate improved collaboration among transport researchers, managers and operations...

  19. The role of programme evaluation in organisational decision-making about management and leadership development

    OpenAIRE

    Voller, Shirine

    2010-01-01

    A number of models of evaluation exist in the education and training domain, yet most are rarely cited in studies of the effectiveness of management and leadership development. Given the vast sums of money that continue to be invested by organisations in management development, we must assume that organisations are perceiving value and that this is identified, in the main, through processes other than formal evaluation. Relatively little attention has been paid to how organisat...

  20. Institutional evolution of a community-based programme for malaria control through larval source management in Dar es Salaam, United Republic of Tanzania

    Science.gov (United States)

    2014-01-01

    Background Community-based service delivery is vital to the effectiveness, affordability and sustainability of vector control generally, and to labour-intensive larval source management (LSM) programmes in particular. Case description The institutional evolution of a city-level, community-based LSM programme over 14 years in urban Dar es Salaam, Tanzania, illustrates how operational research projects can contribute to public health governance and to the establishment of sustainable service delivery programmes. Implementation, management and governance of this LSM programme is framed within a nested set of spatially-defined relationships between mosquitoes, residents, government and research institutions that build upward from neighbourhood to city and national scales. Discussion and evaluation The clear hierarchical structure associated with vertical, centralized management of decentralized, community-based service delivery, as well as increasingly clear differentiation of partner roles and responsibilities across several spatial scales, contributed to the evolution and subsequent growth of the programme. Conclusions The UMCP was based on the principle of an integrated operational research project that evolved over time as the City Council gradually took more responsibility for management. The central role of Dar es Salaam’s City Council in coordinating LSM implementation enabled that flexibility; the institutionalization of management and planning in local administrative structures enhanced community-mobilization and funding possibilities at national and international levels. Ultimately, the high degree of program ownership by the City Council and three municipalities, coupled with catalytic donor funding and technical support from expert overseas partners have enabled establishment of a sustainable, internally-funded programme implemented by the National Ministry of Health and Social Welfare and supported by national research and training institutes. PMID

  1. Barriers and facilitators to the implementation of a community-based, multidisciplinary, family-focused childhood weight management programme in Ireland: a qualitative study.

    Science.gov (United States)

    Kelleher, Emily; Harrington, Janas M; Shiely, Frances; Perry, Ivan J; McHugh, Sheena M

    2017-08-28

    To explore the barriers and facilitators experienced by those implementing a government-funded, community-based childhood weight management programme. Qualitative using semistructured interviews. Two geographical regions in the south and west of Ireland. 29 national-level and local-level stakeholders responsible for implementing the programme, including professionals from dietetics, psychology, public health nursing, physiotherapy, health promotion and administration. Framework analysis was used to identify barriers and facilitators, which were mapped onto six levels of factors influencing implementation outlined by Grol and Wensing: the innovation, the individual professional, the patient, the social context, the organisational context and the external environment. Most barriers occurred at the level of the organisational context. For all stakeholders, barriers arose due to the multidisciplinary nature of the programme, including the lack of role clarity and added complexity of working in different locations. Health professionals' low-perceived self-efficacy in approaching the subject of weight with parents and parental resistance to hearing about their child's weight status were barriers to programme implementation at the individual professional and patient levels, respectively. The main facilitators of implementation, occurring at the level of the health professional, included stakeholders' recognition of the need for a weight management programme and personal interest in the area of childhood obesity. Having a local lead and supportive colleagues were further implementation drivers. This study highlights the complexities associated with implementing a multidisciplinary childhood weight management programme, particularly translating such a programme to a community setting. Our results suggest the assignment of clear roles and responsibilities, the provision of sufficient practical training and resources, and organisational support play pivotal roles in

  2. Reduced Voltage Scaling in Clock Distribution Networks

    Directory of Open Access Journals (Sweden)

    Khader Mohammad

    2009-01-01

    Full Text Available We propose a novel circuit technique to generate a reduced voltage swing (RVS signals for active power reduction on main buses and clocks. This is achieved without performance degradation, without extra power supply requirement, and with minimum area overhead. The technique stops the discharge path on the net that is swinging low at a certain voltage value. It reduces active power on the target net by as much as 33% compared to traditional full swing signaling. The logic 0 voltage value is programmable through control bits. If desired, the reduced-swing mode can also be disabled. The approach assumes that the logic 0 voltage value is always less than the threshold voltage of the nMOS receivers, which eliminate the need of the low to high voltage translation. The reduced noise margin and the increased leakage on the receiver transistors using this approach have been addressed through the selective usage of multithreshold voltage (MTV devices and the programmability of the low voltage value.

  3. Atomic clock ensemble in space

    Science.gov (United States)

    Cacciapuoti, L.; Salomon, C.

    2011-12-01

    Atomic Clock Ensemble in Space (ACES) is a mission using high-performance clocks and links to test fundamental laws of physics in space. Operated in the microgravity environment of the International Space Station, the ACES clocks, PHARAO and SHM, will generate a frequency reference reaching instability and inaccuracy at the 1 · 10-16 level. A link in the microwave domain (MWL) and an optical link (ELT) will make the ACES clock signal available to ground laboratories equipped with atomic clocks. Space-to-ground and ground-to-ground comparisons of atomic frequency standards will be used to test Einstein's theory of general relativity including a precision measurement of the gravitational red-shift, a search for time variations of fundamental constants, and Lorentz Invariance tests. Applications in geodesy, optical time transfer, and ranging will also be supported. ACES has now reached an advanced technology maturity, with engineering models completed and successfully tested and flight hardware under development. This paper presents the ACES mission concept and the status of its main instruments.

  4. Circadian clocks, epigenetics, and cancer

    KAUST Repository

    Masri, Selma

    2015-01-01

    The interplay between circadian rhythm and cancer has been suggested for more than a decade based on the observations that shift work and cancer incidence are linked. Accumulating evidence implicates the circadian clock in cancer survival and proliferation pathways. At the molecular level, multiple control mechanisms have been proposed to link circadian transcription and cell-cycle control to tumorigenesis.The circadian gating of the cell cycle and subsequent control of cell proliferation is an area of active investigation. Moreover, the circadian clock is a transcriptional system that is intricately regulated at the epigenetic level. Interestingly, the epigenetic landscape at the level of histone modifications, DNA methylation, and small regulatory RNAs are differentially controlled in cancer cells. This concept raises the possibility that epigenetic control is a common thread linking the clock with cancer, though little scientific evidence is known to date.This review focuses on the link between circadian clock and cancer, and speculates on the possible connections at the epigenetic level that could further link the circadian clock to tumor initiation or progression.

  5. Sound Clocks and Sonic Relativity

    Science.gov (United States)

    Todd, Scott L.; Menicucci, Nicolas C.

    2017-10-01

    Sound propagation within certain non-relativistic condensed matter models obeys a relativistic wave equation despite such systems admitting entirely non-relativistic descriptions. A natural question that arises upon consideration of this is, "do devices exist that will experience the relativity in these systems?" We describe a thought experiment in which `acoustic observers' possess devices called sound clocks that can be connected to form chains. Careful investigation shows that appropriately constructed chains of stationary and moving sound clocks are perceived by observers on the other chain as undergoing the relativistic phenomena of length contraction and time dilation by the Lorentz factor, γ , with c the speed of sound. Sound clocks within moving chains actually tick less frequently than stationary ones and must be separated by a shorter distance than when stationary to satisfy simultaneity conditions. Stationary sound clocks appear to be length contracted and time dilated to moving observers due to their misunderstanding of their own state of motion with respect to the laboratory. Observers restricted to using sound clocks describe a universe kinematically consistent with the theory of special relativity, despite the preferred frame of their universe in the laboratory. Such devices show promise in further probing analogue relativity models, for example in investigating phenomena that require careful consideration of the proper time elapsed for observers.

  6. The effects and costs of a group-based education programme for self-management of patients with Type 2 diabetes. A community-based study

    DEFF Research Database (Denmark)

    Mølsted, Stig; Tribler, Jane; Poulsen, Peter B.

    2012-01-01

    The worldwide epidemic of Type 2 diabetes necessitates evidence-based self-management education programmes. The purpose of this study was to investigate the effects and costs of an empowerment-based structured diabetes self-management education programme in an unselected group of patients with Type...... 2 diabetes. Seven hundred and two patients undergoing treatment by general practitioners (GPs) were included. The education comprised three modules over a 12-month period. It was based on the empowerment philosophy. The education followed a written curriculum, and the educators were given special...... training in its use. Glycemic control (HbA1c) was found to improve from 7.34 ± 1.34 to 6.88 ± 1.09%, P education programme. Moreover, significant improvements were found in terms of fasting blood glucose, blood...

  7. Donor Hemovigilance Programme in managing Blood Transfusion Needs: Complications of Whole Blood Donation

    Directory of Open Access Journals (Sweden)

    S Mangwana

    2013-10-01

    Full Text Available Background: Hemovigilance like quality systems and audits have become an integral part of Blood Transfusion Services in the developed countries and has contributed greatly to its development. Hemovigilance begins with donors and must enable the collection of information on reactions occurring during the donation of blood, selections of donors and to prevent such incidents. The aim of study was to help identify the trends of adverse events , occurring in blood donors at a tertiary-care hospital, to recommend best practices to improve donor care and safety Materials and Methods: This record-based study was conducted on all adverse events related to allogenic whole blood donations performed over 24 months. All whole blood donations were analyzed. All adverse events occurring during or at the end of the donation were noted using a standardized format and analyzed determining significance at p<0.05. Results: Overall rate was 0.3% with vasovagal reactions constituting 82%, and 18% mild syncopal reactions (p<0.001. Immediate vasovagal reaction with injury was very rare (0.007%. Vasovagal reactions showed a significant association with young age, female gender, first time donation status. Mean age of persons recording adverse effects was 30.23 ± 7.49 years as compared to those without adverse effects, 31.14 ± 8.56 years. Conclusion: Donor safety is an essential perquisite to increase voluntary blood donation. AE analysis helps in identifying the blood donors at risk of AE, applying appropriate motivational strategies, predonation counseling, care during and after donation, developing guidelines and hemovigilance programme in countries with limited resources. DOI: http://dx.doi.org/10.3126/jpn.v3i6.8993   Journal of Pathology of Nepal (2013 Vol. 3, 459-463

  8. Market competition and price of disease management programmes : An observational study

    NARCIS (Netherlands)

    van Dijk, Christel E.; Venema, Bob; de Jong, Judith D.; de Bakker, Dinny H.

    2014-01-01

    Background Managed competition was introduced into the health care system in several countries including the Netherlands, although effects of competition of both providers and health insurers on the price of health care are inconclusive. We investigated the association between competition of both

  9. Market competition and price of disease management programmes: an observational study.

    NARCIS (Netherlands)

    Dijk, C.E. van; Venema, B.; Jong, J.D. de; Bakker, D.H. de

    2014-01-01

    Background: Managed competition was introduced into the health care system in several countries including the Netherlands, although effects of competition of both providers and health insurers on the price of health care are inconclusive. We investigated the association between competition of both

  10. Accuracy of Interviewers and Students in Identifying the Personality Characteristics of Personnel Managers and Computer Programmers.

    Science.gov (United States)

    Paunonen, Sampo V.; Jackson, Douglas N.

    1987-01-01

    Discusses the employment interview as a method of studying the personality characteristics of job applicants. Describes two studies that indicated a substantial degree of agreement and accuracy in the conceptions held by students and by professional employment interviewers regarding the personality characteristics of personnel managers and…

  11. Lean programm as a method of managing lean changes in the company

    Directory of Open Access Journals (Sweden)

    Suetina Tatiana Aleksandrovna

    2012-12-01

    Full Text Available This article is about methods and ways of providing changes on enterprices which introduce instruments of lean production. The main accent is how to use metodology of the project management by providing lean-changes. Lean program is proposed as a program of strategic developement of enterprices.

  12. Reasons for Aggressive Classroom Management and Directions for Change through Teachers' Professional Development Programmes

    Science.gov (United States)

    Romi, Shlomo; Salkovsky, Merav; Lewis, Ramon

    2016-01-01

    This investigation was designed to determine whether there are significant relationships between the reasons teachers provide for aggressive classroom management techniques and the type of professional education created to help them reduce their reliance on such techniques. The study reports data from a survey of 192 Australian teachers showing…

  13. Management of heart failure in primary care (the IMPROVEMENT of Heart Failure Programme) : an international survey

    NARCIS (Netherlands)

    Cleland, JGF; Cohen-Solal, A; Aguilar, JC; Dietz, R; Eastaugh, J; Follath, F; Freemantle, N; Gavazzi, A; van Gilst, WH; Hobbs, FDR; Korewicki, J; Madeira, HC; Preda, [No Value; Swedberg, K; Widimsky, J

    2002-01-01

    Background Heart failure is a prevalent condition that is generally treated in primary care. The aim of this study was to assess how primary-care physicians think that heart failure should be managed, how they implement their knowledge, and whether differences exist in practice between countries.

  14. Developing a Leadership Programme for School Leaders: An NPQH Assessment Centre Manager Reflects.

    Science.gov (United States)

    Collarbone, Patricia

    1998-01-01

    Examines development and implementation of Britain's National Professional Qualification for Headship (NPQH) initiative, particularly the needs-assessment process, from an assessment center manager's perspective. Despite the pace, changing context, and inadequate resources, this initiative has ensured that principals will have more systematic…

  15. Evaluating the Impact of Career Management Skills Module and Internship Programme within a University Business School

    Science.gov (United States)

    Taylor, Antony Richard; Hooley, Tristram

    2014-01-01

    This study evaluates the impact of an intervention on business school graduates' employability comprising of a curriculum-based career management skills (CMS) module and an industrial placement year. The study uses data from the destinations of leavers of higher education survey to examine the employability of different groups within the cohort…

  16. The Role of Senior Management in Developing and Achieving a Successful Enterprise Education Programme?

    Science.gov (United States)

    Lee, Kerry; Hebaishi, Ghada; Hope, John

    2015-01-01

    Purpose: The New Zealand Ministry of Education identified that teachers need to be confident they have the support of their school management team before they embrace twenty-first century teaching and learning in enterprise education (Ministry of Education, 2013b). The purpose of this paper is to outline an interpretive case study which…

  17. Measuring management's perspective of data quality in Pakistan's Tuberculosis control programme: a test-based approach to identify data quality dimensions.

    Science.gov (United States)

    Ali, Syed Mustafa; Anjum, Naveed; Kamel Boulos, Maged N; Ishaq, Muhammad; Aamir, Javariya; Haider, Ghulam Rasool

    2018-01-16

    Data quality is core theme of programme's performance assessment and many organizations do not have any data quality improvement strategy, wherein data quality dimensions and data quality assessment framework are important constituents. As there is limited published research about the data quality specifics that are relevant to the context of Pakistan's Tuberculosis control programme, this study aims at identifying the applicable data quality dimensions by using the 'fitness-for-purpose' perspective. Forty-two respondents pooled a total of 473 years of professional experience, out of which 223 years (47%) were in TB control related programmes. Based on the responses against 11 practical cases, adopted from the routine recording and reporting system of Pakistan's TB control programme (real identities of patient were masked), completeness, accuracy, consistency, vagueness, uniqueness and timeliness are the applicable data quality dimensions relevant to the programme's context, i.e. work settings and field of practice. Based on a 'fitness-for-purpose' approach to data quality, this study used a test-based approach to measure management's perspective and identified data quality dimensions pertinent to the programme and country specific requirements. Implementation of a data quality improvement strategy and achieving enhanced data quality would greatly help organizations in promoting data use for informed decision making.

  18. A 4-year Follow-up Evaluation Of A Pharmacist-managed Smoking Cessation Programme With Emphasis On Effectiveness Of Different Treatment Modalities

    Directory of Open Access Journals (Sweden)

    Phaik Yuan Poh

    2016-10-01

    Patient participation in a pharmacist-managed SCC was associated with significantly improved abstinence rates at 6- and 12-months following programme completion. The use of pharmacotherapy was significantly associated with overall abstinence rates at 6-months’ follow-up with varenicline appearing as the most effective smoking cessation aid.

  19. The effectiveness of aerobic training, cognitive behavioural therapy, and energy conservation management in treating MS-related fatigue: The design of the TREFAMS-ACE programme

    NARCIS (Netherlands)

    H. Beckerman (Heleen); L.J.M. Blikman (Lyan); M. Heine (Martin); A. Malekzadeh (Arjan); C.E. Teunissen (Charlotte); J.B.J. Bussmann (Hans); G. Kwakkel (Gert); J. van Meeteren (Jetty); V. de Groot (Vincent)

    2013-01-01

    textabstractBackground: TREFAMS is an acronym for TReating FAtigue in Multiple Sclerosis, while ACE refers to the rehabilitation treatment methods under study, that is, Aerobic training, Cognitive behavioural therapy, and Energy conservation management. The TREFAMS-ACE research programme consists of

  20. The effectiveness of aerobic training, cognitive behavioural therapy, and energy conservation management in treating MS-related fatigue: the design of the TREFAMS-ACE programme

    NARCIS (Netherlands)

    Beckerman, H.; Blikman, L.J.; Heine, M.; Malekzadeh, A.; Teunissen, C.E.; Bussmann, J.B.; Kwakkel, G.; Meeteren, J. van; Groot, V. de; Jong, B.A. de; Knoop, H.; Bleijenberg, G.

    2013-01-01

    BACKGROUND: TREFAMS is an acronym for TReating FAtigue in Multiple Sclerosis, while ACE refers to the rehabilitation treatment methods under study, that is, Aerobic training, Cognitive behavioural therapy, and Energy conservation management. The TREFAMS-ACE research programme consists of four

  1. Evaluation of nurses' changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care: a qualitative study

    NARCIS (Netherlands)

    Roets-Merken, L.M.; Vernooij-Dassen, M.J.F.J.; Zuidema, S.U.; Dees, M.K.; Hermsen, P.G.; Kempen, G.I.; Graff, M.J.L.

    2016-01-01

    OBJECTIVES: To gain insights into the process of nurses' changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care, and into the factors that contributed to these changes in their perceptions. DESIGN: Qualitative study

  2. Evaluation of nurses' changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care : a qualitative study

    NARCIS (Netherlands)

    Roets-Merken, Lieve M.; Vernooij-Dassen, Myrra J. F. J.; Zuidema, Sytse U.; Dees, Marianne K.; Hermsen, Pieter G. J. M.; Kempen, Gertrudis I. J. M.; Graff, Maud J. L.

    2016-01-01

    Objectives: To gain insights into the process of nurses' changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care, and into the factors that contributed to these changes in their perceptions. Design: Qualitative study

  3. A Mixed-Methods Evaluation of the Longer-Term Implementation and Utility of a Teacher Classroom Management Training Programme in Irish Primary Schools

    Science.gov (United States)

    Leckey, Yvonne; Hyland, Lynda; Hickey, Gráinne; Lodge, Anne; Kelly, Paul; Bywater, Tracey; Comiskey, Catherine; Donnelly, Michael; McGilloway, Sinéad

    2016-01-01

    Inappropriate, aggressive and disruptive behaviour in the classroom can be detrimental to child and teacher well-being. This study involved a longer-term evaluation of the "Incredible Years Teacher [Classroom Management]" programme (IYTP) undertaken mainly within disadvantaged schools in south-west Ireland. The IYTP is designed to…

  4. Exploring the Effects of a Universal Classroom Management Training Programme on Teacher and Child Behaviour: A Group Randomised Controlled Trial and Cost Analysis

    Science.gov (United States)

    Hickey, Grainne; McGilloway, Sinead; Hyland, Lynda; Leckey, Yvonne; Kelly, Paul; Bywater, Tracey; Comiskey, Catherine; Lodge, Anne; Donnelly, Michael; O'Neill, Donal

    2017-01-01

    Teachers frequently struggle to cope with conduct problems in the classroom. The aim of this study was to assess the effectiveness of the Incredible Years Teacher Classroom Management Training Programme for improving teacher competencies and child adjustment. The study involved a group randomised controlled trial which included 22 teachers and 217…

  5. Nurses' experiences of managing patient deterioration following a post-registration education programme: A critical incident analysis study.

    Science.gov (United States)

    Butler, Clare

    2017-10-13

    The aim of this study was to explore nurses' experiences assessing and managing deteriorating patients in practice following completion of a relevant post-registration education programme. Recognising the increasing acuity of ward patients, nurses are faced with patients who are at an increased risk of deterioration. Patients who are acutely ill or deteriorating often exhibit periods of physiological deterioration; however there is evidence illustrating that these clinical changes are frequently missed, misinterpreted or mismanaged in practice. In order to prepare nurses to competently assess and manage the deteriorating patient, education as a care initiative is offered to develop the knowledge and skills required. A qualitative study using critical incident analysis was conducted to acquire narrative data from nurses, describing their clinical practice experiences of patient deterioration. Thematic analysis was used to analyse the data. Findings revealed improvements in nurses' abilities to recognise patient deterioration, greater application of the evidence base and an increase in confidence and assertiveness. There was some evidence of applying the knowledge and skills learned, however equally some nurses indicated that they remained ill-prepared to apply the skills in practice. Crown Copyright © 2017. Published by Elsevier Ltd. All rights reserved.

  6. An analysis of the management of youth football development programmes established in the Gauteng province

    OpenAIRE

    2013-01-01

    M. Phil. (Sport Management) Youth football development has developed into an important, integral part of professional football world-wide. Countries such as Spain, Brazil and the Netherlands have proven that an investment in youth football development has resulted in them becoming the world’s best football playing countries as ranked by International Football Association (FIFA). The investment in youth football development by these countries has resulted in sustained football success. The ...

  7. Personal competencies from the perspective of human resource management and the business programmes of higher education

    OpenAIRE

    Erika Varga; Ildikó Budavári-Takács; Helga Boda-Kinga; Ilona Bárdos

    2015-01-01

    Our paper is centred on the research problem whether competencies are really essential as they play a significant role in human resource management and also enhance competitiveness. It wishes to highlight what competencies (can) enhance the success of employees and their competitiveness in the labour market together with certain personality traits that have a powerful impact on decision making mechanisms. An answer is also sought to the question of how competencies have been transformed and ...

  8. Clock, Circadian Rhythms, and Breast Cancer

    National Research Council Canada - National Science Library

    Hill, Steven M

    2004-01-01

    .... Work involving circadian clock genes and cell cycle components suggests not only an association between the two time-keeping systems, but also regulation of the cell cycle by the circadian clock...

  9. Cost implications of self-management education intervention programmes in arthritis.

    Science.gov (United States)

    Brady, Teresa J

    2012-10-01

    The purpose of this review is to examine cost implications, including cost-effectiveness analyses, cost-savings calculated from health-care utilisation and intervention delivery costs of arthritis-related self-management education (SME) interventions. Literature searches, covering 1980-March 2012, using arthritis, self-management and cost-related terms, identified 487 articles; abstracts were reviewed to identify those with cost information. Three formal cost-effectiveness analyses emerged; results were equivocal but analyses done from the societal perspective, including out-of-pocket and other indirect costs, were more promising. Eight studies of individual, group and telephone-delivered SME calculated cost-savings based on health-care utilisation changes. These studies had variable results but the costs-savings extrapolation methods are questionable. Meta-analyses of health-care utilisation changes in two specific SME interventions demonstrated only one significant result at 6 months, which did not persist at 12 months. Eleven studies reported intervention delivery costs ranging from $35 to $740 per participant; the variability is likely due to costing methods and differences in delivery mode. Economic analysis in arthritis-related SME is in its infancy; more robust economic evaluations are required to reach sound conclusions. The most common form of analysis used changes in health-care utilisation as a proxy for cost-savings; the results are less than compelling. However, other value metrics, including the value of SME as part of health systems' self-management support efforts, to population health (from improved self-efficacy, psychological well-being and physical activity), and to igniting patient activation, are all important to consider. Published by Elsevier Ltd.

  10. Light and the human circadian clock

    NARCIS (Netherlands)

    Roenneberg, Till; Kantermann, Thomas; Juda, Myriam; Vetter, Céline; Allebrandt, Karla V

    2013-01-01

    The circadian clock can only reliably fulfil its function if it is stably entrained. Most clocks use the light-dark cycle as environmental signal (zeitgeber) for this active synchronisation. How we think about clock function and entrainment has been strongly influenced by the early concepts of the

  11. A managed multidisciplinary programme on multi-resistant Klebsiella pneumoniae in a Danish university hospital.

    Science.gov (United States)

    Andersen, Stig Ejdrup; Knudsen, Jenny Dahl

    2013-11-01

    Bacteria-producing extended spectrum β-lactamase (ESBL) enzymes are resistant to commonly used antimicrobials. In 2008, routine monitoring revealed a clonal hospital outbreak of ESBL-producing Klebsiella pneumoniae (ESBL-KP). At a 510-bed Danish university hospital, a multidisciplinary change project inspired by Kotter's Eight Steps of Change was designed. In addition to revision of antimicrobial guidelines and restriction of selected antimicrobials, the complex, managed, multi-faceted intervention comprised training and education, enhanced isolation precautions, and a series of actions to improve the infection control measures and standardise procedures across the hospital. A prospective interrupted time series design was used to analyse data collected at hospital level from January 2008 through December 2011. Though overall antimicrobial consumption remained unaffected, the intervention led to intended, immediate and sustained reduction in the use of cefuroxime, and an increase in the use of ertapenem, piperacillin/tazobactam and β-lactamase sensitive penicillin. Moreover, a postintervention reduction in the rate of ESBL-KP in diagnostic samples and in the incidence of ESBL-KP infections was observed. The intervention may also have reduced the need for isolation precautions and may have shortened each isolation period. The results indicate that an immediate and sustained change in the antimicrobial consumption and a decreasing rate of ESBL-KP are achievable through the application of a managed, multi-faceted intervention that does not require ongoing antibiotic stewardship.

  12. Real Time GPS- Satellite Clock Estimation Development of a RTIGS Web Service

    Science.gov (United States)

    Opitz, M.; Weber, R.; Caissy, M.

    2006-12-01

    Since 3 years the IGS (International GNSS Service) Real-Time Working Group disseminates via Internet raw observation data of a subset of stations of the IGS network. This observation data can be used to establish a real-time integrity monitoring of the IGS predicted orbits (Ultra Rapid (IGU-) Orbits) and clocks, according to the recommendations of the IGS Workshop 2004 in Bern. The Institute for "Geodesy and Geophysics" of the TU-Vienna develops in cooperation with the IGS Real-Time Working Group the software "RTR- Control", which currently provides a real-time integrity monitoring of predicted IGU Clock Corrections to GPS Time. Our poster presents the results of a prototype version which is in operation since August this year. Besides RTR-Control allows for the comparison of pseudoranges measured at any permanent station in the global network with theoretical pseudoranges calculated on basis of the IGU- orbits. Thus, the programme can diagnose incorrectly predicted satellite orbits and clocks as well as detect multi-path distorted pseudoranges in real- time. RTR- Control calculates every 15 seconds Satellite Clock Corrections with respect to the most recent IGU- clocks (updated in a 6 hours interval). The clock estimations are referenced to a stable station clock (H-maser) with a small offset to GPS- time. This real-time Satellite Clocks are corrected for individual outliers and modelling errors. The most recent GPS- Satellite Clock Corrections (updated every 60 seconds) are published in Real Time via the Internet. The user group interested in a rigorous integrity monitoring comprises on the one hand the components of IGS itself to qualify the issued orbital data and on the other hand all users of the IGS Ultra Rapid Products (e.g. for PPP in Real Time).

  13. Biological clocks: riding the tides.

    Science.gov (United States)

    de la Iglesia, Horacio O; Johnson, Carl Hirschie

    2013-10-21

    Animals with habitats in the intertidal zone often display biological rhythms that coordinate with both the tidal and the daily environmental cycles. Two recent studies show that the molecular components of the biological clocks mediating tidal rhythms are likely different from the phylogenetically conserved components that mediate circadian (daily) rhythms. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. <=ryptochromes and Biological Clocks -36 ...

    Indian Academy of Sciences (India)

    eyes (reptiles), pineal gland and deep brain photoreceptors. In mammals, all existing evidence indicates that photoreceptors. Figure 1. The anatomy of for both vision and the circadian clock are located in the eye. vision. A. Section through eye showing the location of light sensitive layer, the retina. B. The histological.

  15. Perspectives on the Nutritional Management of Metabolic Syndrome in Asia: People, Practice and Programmes

    Directory of Open Access Journals (Sweden)

    Phing Chee Huei

    2017-03-01

    Full Text Available Numerous Asian countries have a high prevalence of metabolic syndrome, also associated with cardiovascular disease and diabetes mellitus. Healthcare expenditure varies among Asian countries, and is influenced by poverty factor and large populations. The effect of metabolic syndrome on nutritional management in Asia demonstrates the essential for clinicians to equalize the needs for higher standards of dietetics practice; as they execute optimal care processes with the aim of improving outcomes, alongside setting of workforce limitations, inadequate expertise in metabolic syndrome nutrition practice, as well as ethnic diversity among Asians. This paper presents some aspects of dietetics practice and the possibility that an alteration in practice is mandatory if dietitians are to play an active role in preventing or decelerating the evolution of the metabolic syndrome.

  16. Coverage of community-based management of severe acute malnutrition programmes in twenty-one countries, 2012-2013.

    Science.gov (United States)

    Rogers, Eleanor; Myatt, Mark; Woodhead, Sophie; Guerrero, Saul; Alvarez, Jose Luis

    2015-01-01

    This paper reviews coverage data from programmes treating severe acute malnutrition (SAM) collected between July 2012 and June 2013. This is a descriptive study of coverage levels and barriers to coverage collected by coverage assessments of community-based SAM treatment programmes in 21 countries that were supported by the Coverage Monitoring Network. Data from 44 coverage assessments are reviewed. These assessments analyse malnourished populations from 6 to 59 months old to understand the accessibility and coverage of services for treatment of acute malnutrition. The majority of assessments are from sub-Saharan Africa. Most of the programmes (33 of 44) failed to meet context-specific internationally agreed minimum standards for coverage. The mean level of estimated coverage achieved by the programmes in this analysis was 38.3%. The most frequently reported barriers to access were lack of awareness of malnutrition, lack of awareness of the programme, high opportunity costs, inter-programme interface problems, and previous rejection. This study shows that coverage of CMAM is lower than previous analyses of early CTC programmes; therefore reducing programme impact. Barriers to access need to be addressed in order to start improving coverage by paying greater attention to certain activities such as community sensitisation. As barriers are interconnected focusing on specific activities, such as decentralising services to satellite sites, is likely to increase significantly utilisation of nutrition services. Programmes need to ensure that barriers are continuously monitored to ensure timely removal and increased coverage.

  17. Evaluation of nurses’ changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care: a qualitative study

    Science.gov (United States)

    Roets-Merken, Lieve M; Vernooij-Dassen, Myrra J F J; Zuidema, Sytse U; Dees, Marianne K; Hermsen, Pieter G J M; Kempen, Gertrudis I J M; Graff, Maud J L

    2016-01-01

    Objectives To gain insights into the process of nurses’ changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care, and into the factors that contributed to these changes in their perceptions. Design Qualitative study alongside a cluster randomised controlled trial. Setting 17 long-term care homes spread across the Netherlands. Participants 34 licensed practical nurses supporting 54 dual sensory impaired older adults. Intervention A 5-month training programme designed to enable nurses to support the self-management of dual sensory impaired older adults in long-term care. Primary outcomes Nurses’ perceptions on relevance and feasibility of the self-management programme collected from nurses’ semistructured coaching diaries over the 5-month training and intervention period, as well as from trainers’ reports. Results Nurses’ initial negative perceptions on relevance and feasibility of the intervention changed to positive as nurses better understood the concept of autonomy. Through interactions with older adults and by self-evaluations of the effect of their behaviour, nurses discovered that their usual care conflicted with client autonomy. From that moment, nurses felt encouraged to adapt their behaviour to the older adults’ autonomy needs. However, nurses’ initial unfamiliarity with conversation techniques required a longer exploration period than planned. Once client autonomy was understood, nurses recommended expanding the intervention as a generic approach to all their clients, whether dual sensory impaired or not. Conclusions Longitudinal data collection enabled exploration of nurses’ changes in perceptions when moving towards self-management support. The training programme stimulated nurses to go beyond ‘protocol thinking’, discovering client autonomy and exploring the need for their own behavioural adaptations. Educational programmes for practical nurses should offer

  18. Personal competencies from the perspective of human resource management and the business programmes of higher education

    Directory of Open Access Journals (Sweden)

    Erika Varga

    2015-12-01

    Full Text Available Our paper is centred on the research problem whether competencies are really essential as they play a significant role in human resource management and also enhance competitiveness. It wishes to highlight what competencies (can enhance the success of employees and their competitiveness in the labour market together with certain personality traits that have a powerful impact on decision making mechanisms. An answer is also sought to the question of how competencies have been transformed and how their role was appreciated and re-evaluated. To this end, we applied both primary and secondary research with qualitative (focus group interviews and quantitative (standardised questionnaires phases. One of our further objectives was to create and test a competency structure tailored to the Hungarian labour market situation on the basis of the professional literature and our research. Based on the literature review we have supposed that it is not practical to talk about competencies in general, rather the adequate competency profile and portfolio has to be reviewed in a certain job or profession. As a conclusion, our research has underlined the importance of competencies in the labour market and justified their existence mostly in selection. Both parties, i.e. the employers and employees have pointed out the significance of developing them in training and practice and see competencies as a factor of future growth. Furthermore, they regard the role that competencies play indispensable in improving the dialogue between the labour market and education.

  19. Demand generation and social mobilisation for integrated community case management (iCCM and child health: Lessons learned from successful programmes in Niger and Mozambique

    Directory of Open Access Journals (Sweden)

    Alyssa B Sharkey

    2014-11-01

    Full Text Available We present the approaches used in and outcomes resulting from integrated community case management (iCCM programmes in Niger and Mozambique with a strong focus on demand generation and social mobilisation. We use a case study approach to describe the programme and contextual elements of the Niger and Mozambique programmes. Awareness and utilisation of iCCM services and key family practices increased following the implementation of the Niger and Mozambique iCCM and child survival programmes, as did care–seeking within 24 hours and care–seeking from appropriate, trained providers in Mozambique. These approaches incorporated interpersonal communication activities and community empowerment/participation for collective change, partnerships and networks among key stakeholder groups within communities, media campaigns and advocacy efforts with local and national leaders. iCCM programmes that train and equip community health workers and successfully engage and empower community members to adopt new behaviours, have appropriate expectations and to trust community health workers’ ability to assess and treat illnesses can lead to improved care–seeking and utilisation, and community ownership for iCCM.

  20. Interference of GSM mobile phones with communication between Cardiac Rhythm Management devices and programmers: A combined in vivo and in vitro study.

    Science.gov (United States)

    Huang, Dong; Dong, Zhi-Feng; Chen, Yan; Wang, Fa-Bin; Wei, Zhi; Zhao, Wen-Bin; Li, Shuai; Liu, Ming-Ya; Zhu, Wei; Wei, Meng; Li, Jing-Bo

    2015-07-01

    To investigate interference, and how to avoid it, by high-frequency electromagnetic fields (EMFs) of Global System for Mobile Communications (GSM) mobile phone with communication between cardiac rhythm management devices (CRMs) and programmers, a combined in vivo and in vitro testing was conducted. During in vivo testing, GSM mobile phones interfered with CRM-programmer communication in 33 of 65 subjects tested (50.8%). Losing ventricle sensing was representative in this study. In terms of clinical symptoms, only 4 subjects (0.6%) felt dizzy during testing. CRM-programmer communication recovered upon termination of mobile phone communication. During in vitro testing, electromagnetic interference by high-frequency (700-950 MHz) EMFs reproducibly occurred in duplicate testing in 18 of 20 CRMs (90%). During each interference, the pacing pulse signal on the programmer would suddenly disappear while the synchronous signal was normal on the amplifier-oscilloscope. Simulation analysis showed that interference by radiofrequency emitting devices with CRM-programmer communication may be attributed to factors including materials, excitation source distance, and implant depth. Results suggested that patients implanted with CRMs should not be restricted from using GSM mobile phones; however, CRMs should be kept away from high-frequency EMFs of GSM mobile phone during programming. © 2015 Wiley Periodicals, Inc.

  1. Negotiating reform at an arm's length from the state: Disease Management Programmes and the introduction of clinical standards in Germany.

    Science.gov (United States)

    Burau, Viola

    2009-07-01

    Studies of German health policy often highlight institutional constraints to reform. However, based on a case study of the introduction of clinical standards as part of the Disease Management Programmes for chronic illnesses, this article suggests that negotiating reform at an arm's length from the state can also lead to governance change, although the strengthening of hierarchy is not as prominent as that in some of the countries studied in this special issue. As such, the case of Germany offers interesting insights into the politics of governance change that occur in the shadow, but largely without the direct involvement of the state, which is typical of a corporatist health-care state. In this respect, the analysis identifies three leverages for change. First, the change in medical governance explicitly builds on earlier reforms and gives the reform alliance a competitive edge. Second, the organisations of the joint self-administration, as a more or less open ally of the state, play an influential role throughout the reform process. Importantly and third, this is complemented by the state steering at a distance.

  2. The impact of an immunization programme administered through the Growth Monitoring Programme Plus as an alternative way of implementing Integrated Management of Childhood Illnesses in urban-slum areas of Lusaka, Zambia.

    Science.gov (United States)

    Igarashi, Kumiko; Sasaki, Satoshi; Fujino, Yasuyuki; Tanabe, Naohito; Muleya, Clara Mbwili; Tambatamba, Bushimbwa; Suzuki, Hiroshi

    2010-09-01

    A time-lag study design was used to examine the effects of an immunization programme implemented through an integrated community-based child health approach called the Growth Monitoring Programme Plus (GMP+) in peri-urban areas of Lusaka, Zambia. The immunization coverage and sociodemographic data of eligible children and households were obtained from three repeated surveys in two intervention areas. Logistic regression analysis was performed to explore the factors affecting immunization coverage. For assessing the timeliness of immunization, a Computerised Immunization Coverage Calculation System (CICCS) was used. Full immunization coverage significantly increased in both the primary intervention (Pattendance to GMP+ sessions played a significant role in the improvement of immunization coverage (P<0.001 for the final survey in the primary intervention area), whereas other sociodemographic characteristics of the child and caretaker were not associated with immunization coverage. Analysis of the timeliness of three doses of diphtheria, pertussis and tetanus DPT3 immunization by CICCS showed that coverage in the primary intervention area had significantly improved compared to the lagged intervention area. Our study indicated that immunization coverage was improved effectively with the intervention of the GMP+ as a model of an integrated immunization programme for child health in line with the Integrated Management of Childhood Illnesses (IMCI) and the Global Immunization Vision and Strategy (GIVS). Copyright 2010 Royal Society of Tropical Medicine and Hygiene. Published by Elsevier Ltd. All rights reserved.

  3. Programmable Cadence Timer

    Science.gov (United States)

    Hall, William A.; Gilbert, John

    1990-01-01

    Electronic metronome paces users through wide range of exercise routines. Conceptual programmable cadence timer provides rhythmic aural and visual cues. Timer automatically changes cadence according to program entered by the user. It also functions as clock, stopwatch, or alarm. Modular pacer operated as single unit or as two units. With audiovisual module moved away from base module, user concentrates on exercise cues without distraction from information appearing on the liquid-crystal display. Variety of uses in rehabilitative medicine, experimental medicine, sports, and gymnastics. Used in intermittent positive-pressure breathing treatment, in which patient must rhythmically inhale and retain medication delivered under positive pressure; and in incentive spirometer treatment, in which patient must inhale maximally at regular intervals.

  4. KEY ASPECTS OF MANAGING AN INNOVATION PROJECT IN THE EU FRAMEWORK PROGRAMME HORIZON 2020

    Directory of Open Access Journals (Sweden)

    Siniša M. Arsić

    2015-01-01

    Full Text Available The program EU Horizon 2020 (ec.europa.eu is the largest source of resources for all legal entities from Europe, with the budget of 80 billion €. It is possible to use donations from the EU for various proposals and themes, from the 91 calls for projects, with subjects differing from sustainable transport to the innovation support of the SME sector. A group of Serbian authors decided to enter into somewhat of an ambitious endeavour (authors had individual experience on projects, they decided to send a project proposal in the framework of the „SME Instrument“ call, which is directed to inovation support project in the SME sector. The projects that are proposed for the financing by the EU Horizon 2020 program, are in the group of complex and very specific projects, so the authors presented the review of key aspects of projects that are engaged in realization of the inovation process that starts with a certain idea on paper, and ends with a verified product which is placed on the competitive EU market. The special chapter of this paper deals with the sinergy of the inovation project explorers, which must answer to the multidisciplinarity of research problems. The possibilities are examined in the research of the technical-technological sciences, by using organizational-informatic tools, developed for the needs of managing projects. The main use of this work for readers are illuminating of numerous unknown technical details regarding the proposal itself, and the process of connecting with the project partners, because the large number of proposals quits off right at the beginning. Then contribution is reflected in the fact that the paper signifies a sort of basis for a knowledge base, which can be served to higher education institutions and economy to focus a part of their intentions on lifting their own capacity for the struggle with the massive competition of EU that is expected in years and decades to come.

  5. Circadian clock, cell cycle and cancer

    Directory of Open Access Journals (Sweden)

    Cansu Özbayer

    2011-12-01

    Full Text Available There are a few rhythms of our daily lives that we are under the influence. One of them is characterized by predictable changes over a 24-hour timescale called circadian clock. This cellular clock is coordinated by the suprachiasmatic nucleus in the anterior hypothalamus. The clock consist of an autoregulatory transcription-translation feedback loop compose of four genes/proteins; BMAL1, Clock, Cyrptochrome, and Period. BMAL 1 and Clock are transcriptional factors and Period and Cyrptochrome are their targets. Period and Cyrptochrome dimerize in the cytoplasm to enter the nucleus where they inhibit Clock/BMAL activity.It has been demonstrate that circadian clock plays an important role cellular proliferation, DNA damage and repair mechanisms, checkpoints, apoptosis and cancer.

  6. Automatic control of clock duty cycle

    Science.gov (United States)

    Feng, Xiaoxin (Inventor); Roper, Weston (Inventor); Seefeldt, James D. (Inventor)

    2010-01-01

    In general, this disclosure is directed to a duty cycle correction (DCC) circuit that adjusts a falling edge of a clock signal to achieve a desired duty cycle. In some examples, the DCC circuit may generate a pulse in response to a falling edge of an input clock signal, delay the pulse based on a control voltage, adjust the falling edge of the input clock signal based on the delayed pulse to produce an output clock signal, and adjust the control voltage based on the difference between a duty cycle of the output clock signal and a desired duty cycle. Since the DCC circuit adjusts the falling edge of the clock cycle to achieve a desired duty cycle, the DCC may be incorporated into existing PLL control loops that adjust the rising edge of a clock signal without interfering with the operation of such PLL control loops.

  7. Effectiveness of a multidisciplinary risk assessment and management programme-diabetes mellitus (RAMP-DM) on patient-reported outcomes.

    Science.gov (United States)

    Wan, Eric Yuk Fai; Fung, Colman Siu Cheung; Wong, Carlos King Ho; Choi, Edmond Pui Hang; Jiao, Fang Fang; Chan, Anca Ka Chun; Chan, Karina Hiu Yen; Lam, Cindy Lo Kuen

    2017-02-01

    Little is known about how the patient-reported outcomes is influenced by multidisciplinary-risk-assessment-and-management-programme for patients with diabetes mellitus (RAMP-DM). This paper aims to evaluate the effectiveness of RAMP-DM on patient-reported outcomes. This was a prospective longitudinal study on 1039 diabetes mellitus patients (714/325 RAMP-DM/non-RAMP-DM) managed in primary care setting. 536 and 402 RAMP-DM participants, and 237 and 187 non-RAMP-DM participants were followed up at 12 and 24 months with completed survey, respectively. Patient-reported outcomes included health-related quality of life, change in global health condition and patient enablement measured by Short Form-12 Health Survey version-2 (SF-12v2), Global Rating Scale, Patient Enablement Instrument respectively. The effects of RAMP-DM on patient-reported outcomes were evaluated by mixed effect models. Subgroup analysis was performed by stratifying haemoglobin A1c (HbA1c) (optimal HbA1c DM with suboptimal HbA1c was associated with greater improvement in SF-12v2 physical component summary score at 12-month (coefficient:3.80; P-value DM participants. However, there was no significant difference in patient-reported outcomes between RAMP-DM and non-RAMP-DM participants with optimal HbA1c. Participation in RAMP-DM is effective in improving physical component of HRQOL, Global Rating Scale and patient enablement among diabetes mellitus patients with suboptimal HbA1c, but not in those with optimal HbA1c. Patients with sub-optimal diabetes mellitus control should be the priority target population for RAMP-DM. This observational study design may have potential bias in the characteristics between groups, and randomized clinical trial is needed to confirm the results.

  8. Review: Towards the agroecological management of ruminants, pigs and poultry through the development of sustainable breeding programmes. II. Breeding strategies.

    Science.gov (United States)

    Phocas, F; Belloc, C; Bidanel, J; Delaby, L; Dourmad, J Y; Dumont, B; Ezanno, P; Fortun-Lamothe, L; Foucras, G; Frappat, B; González-García, E; Hazard, D; Larzul, C; Lubac, S; Mignon-Grasteau, S; Moreno, C R; Tixier-Boichard, M; Brochard, M

    2016-11-01

    Agroecology uses ecological processes and local resources rather than chemical inputs to develop productive and resilient livestock and crop production systems. In this context, breeding innovations are necessary to obtain animals that are both productive and adapted to a broad range of local contexts and diversity of systems. Breeding strategies to promote agroecological systems are similar for different animal species. However, current practices differ regarding the breeding of ruminants, pigs and poultry. Ruminant breeding is still an open system where farmers continue to choose their own breeds and strategies. Conversely, pig and poultry breeding is more or less the exclusive domain of international breeding companies which supply farmers with hybrid animals. Innovations in breeding strategies must therefore be adapted to the different species. In developed countries, reorienting current breeding programmes seems to be more effective than developing programmes dedicated to agroecological systems that will struggle to be really effective because of the small size of the populations currently concerned by such systems. Particular attention needs to be paid to determining the respective usefulness of cross-breeding v. straight breeding strategies of well-adapted local breeds. While cross-breeding may offer some immediate benefits in terms of improving certain traits that enable the animals to adapt well to local environmental conditions, it may be difficult to sustain these benefits in the longer term and could also induce an important loss of genetic diversity if the initial pure-bred populations are no longer produced. As well as supporting the value of within-breed diversity, we must preserve between-breed diversity in order to maintain numerous options for adaptation to a variety of production environments and contexts. This may involve specific public policies to maintain and characterize local breeds (in terms of both phenotypes and genotypes), which could

  9. Demographic profile, clinical characteristics, motivations and weight loss outcomes of patients in a nonsurgical weight management programme.

    Science.gov (United States)

    Tan, Woei Jen Michelle; Wong, Tack Keong Michael

    2014-03-01

    Weight management programmes (WMPs) can help overweight individuals lose weight, and thus prevent complications associated with obesity. Herein, we describe the demographic profile, clinical characteristics, motivations and expectations, and outcomes of patients enrolled in a nonsurgical WMP. This was a retrospective study of consecutive patients with a body mass index (BMI) of > 23 kg/m2 enrolled in the four-month WMP at the Health For Life Clinic, Alexandra Hospital, Singapore, between 1 and 31 August 2009. Demographic data, medical history and source of referral were recorded. Details on personal motivations and weight loss goals were obtained from the completed self-administered questionnaires of the WMP participants. Weight, waist circumference, fat percentage and BMI were measured at the start and end of the WMP. A weight loss of ≥ 5% was deemed as a successful outcome. A total of 58 patients (mean age 37.2 years) were included in our study. Of these 58 patients, 58.6% were of Chinese ethnicity and 55.2% were male. Many patients (32.8%) attributed their weight gain to work- or study-related stress, and a minority to poor eating habits (12.1%) or a lack of exercise (10.3%). Patients' motivations included a desire for better health (53.4%) and better fitness (15.5%). However, only 53.4% patients scored their motivation as high (i.e. a score of > 7). The mean expected weight loss was 9.9 kg at 4 months, and 14.1 kg at 12 months. Among the 40 patients (69.0%) who completed the programme, the mean percentage weight loss was 1.8 ± 4.3%. A weight loss of ≥ 5% was achieved by 8 (13.8%) patients. Although the patients in our study cohort were young and educated, only a portion of them appeared to be highly motivated to lose weight, despite joining the WMP. There is a need for patients to be guided on how to set realistic weight loss goals.

  10. Outcomes of a nurse-managed service for stable HIV-positive patients in a large South African public sector antiretroviral therapy programme.

    Science.gov (United States)

    Grimsrud, Anna; Kaplan, Richard; Bekker, Linda-Gail; Myer, Landon

    2014-09-01

    Models of care utilizing task shifting and decentralization are needed to support growing ART programmes. We compared patient outcomes between a doctor-managed clinic and a nurse-managed down-referral site in Cape Town, South Africa. Analysis included all adults who initiated ART between 2002 and 2011 within a large public sector ART service. Stable patients were eligible for down-referral. Outcomes [mortality, loss to follow-up (LTFU), virologic failure] were compared under different models of care using proportional hazards models with time-dependent covariates. Five thousand seven hundred and forty-six patients initiated ART and over 5 years 41% (n = 2341) were down-referred; the median time on ART before down-referral was 1.6 years (interquartile range, 0.9-2.6). The nurse-managed down-referral site reported lower crude rates of mortality, LTFU and virologic failure compared with the doctor-managed clinic. After adjustment, there was no difference in the risk of mortality or virologic failure by model of care. However, patients who were down-referred were more likely to be LTFU than those retained at the doctor-managed site (adjusted hazard ratio, 1.36; 95% CI, 1.09-1.69). Increased levels of LTFU in the nurse-managed vs. doctor-managed service were observed in subgroups of male patients, those with advanced disease at initiation and those who started ART in the early years of the programme. Reorganization of ART maintenance by down-referral to nurse-managed services is associated with programme outcomes similar to those achieved using doctor-driven primary care services. Further research is necessary to identify optimal models of care to support long-term retention of patients on ART in resource-limited settings. © 2014 John Wiley & Sons Ltd.

  11. Circadian clocks and neurodegenerative diseases: time to aggregate?

    Science.gov (United States)

    Hastings, Michael H; Goedert, Michel

    2013-10-01

    The major neurodegenerative diseases are characterised by a disabling loss of the daily pattern of sleep and wakefulness, which may be reflective of a compromise to the underlying circadian clock that times the sleep cycle. At a molecular level, the canonical property of neurodegenerative diseases is aberrant aggregation of otherwise soluble neuronal proteins. They can thus be viewed as disturbances of proteostasis, raising the question whether the two features - altered daily rhythms and molecular aggregation - are related. Recent discoveries have highlighted the fundamental contribution of circadian clocks to the correct ordering of daily cellular metabolic cycles, imposing on peripheral organs such as the liver a strict programme that alternates between anabolic and catabolic states. The discovery that circadian mechanisms are active in local brain regions suggests that they may impinge upon physiological and pathological elements that influence pro-neurodegenerative aggregation. This review explores how introducing the dimension of circadian time and the circadian clock might refine the analysis of aberrant aggregation, thus expanding our perspective on the cell biology common to neurodegenerative diseases. Copyright © 2013 The Authors. Published by Elsevier Ltd.. All rights reserved.

  12. From national to regional plans – the Integrated Drought Management Programme of the Global Water Partnership for Central and Eastern Europe

    Directory of Open Access Journals (Sweden)

    Sabina Bokal

    2014-06-01

    Full Text Available In the past few decades it has become evident that the countries of Central and Eastern Europe (CEE are affected by droughts which are becoming more and more lasting and severe. The region׳s vulnerability to this natural hazard alerted the public, governments, and operational agencies to the many socio-economic problems accompanying water shortage and to the need for drought mitigation measures. In addition, climate change amplifies the frequency and severity of droughts in the region. In this context, the CEE region of the Global Water Partnership (GWP recently launched the regional Integrated Drought Management Programme (IDMP as part of the global joint World Meteorological Organization (WMO/GWP IDMP. The purpose of this paper is to present the work plan of the GWP CEE IDM Programme which is being implemented in the years 2013–2015. The planning process for this Programme carried out in 2012 included national and regional reviews of existing drought risks, policies and strategies. The programme inception phase was summarized in October 2012 by a regional workshop organized jointly by GWP and WMO, with the participation of representatives of the United Nations Convention to Combat Desertification (UNCCD Secretariat, the Drought Management Centre for Southeastern Europe (DMCSEE, the EU Joint Research Centre, the United Nations Economic Commission for Europe (UNECE and the European Drought Centre. The Programme was launched in February 2013 and involves more than 40 organizations from 9 CEE countries. The basic four elements of the Programme include policy advice, demonstration projects, capacity building knowledge management and regional cooperation (from national to regional plans. The major output, building upon national initiatives, shall be a coordinated regional framework for drought monitoring, early warning, prediction and management, accompanied by a set of guidelines and tools for the development of regional, national and local

  13. Tectonic blocks and molecular clocks

    OpenAIRE

    De Baets, Kenneth; Antonelli, Alex; Donoghue, Philip

    2016-01-01

    Evolutionary timescales have mainly used fossils for calibrating molecular clocks, though fossils only really provide minimum clade age constraints. In their place, phylogenetic trees can be calibrated by precisely dated geological events that have shaped biogeography. However, tectonic episodes are protracted, their role in vicariance is rarely justified, the biogeography of living clades and their antecedents may differ, and the impact of such events is contingent on ecology. Biogeographic ...

  14. Inertial Frames and Clock Rates

    CERN Document Server

    Kak, Subhash

    2012-01-01

    This article revisits the historiography of the problem of inertial frames. Specifically, the case of the twins in the clock paradox is considered to see that some resolutions implicitly assume inertiality for the non-accelerating twin. If inertial frames are explicitly identified by motion with respect to the large scale structure of the universe, it makes it possible to consider the relative inertiality of different frames.

  15. Spouses’ involvement in older patients’ fast-track programmes during total hip replacement using case management intervention. A study protocol of the SICAM-trial

    DEFF Research Database (Denmark)

    Berthelsen, Connie Bøttcher; Kristensson, Jimmie

    2015-01-01

    status, nutrition, pain, depression and healthcare consumptions; and for spouses: caregiver satisfaction and difficulties and anxiety. Conclusion The intervention will give further evidence on the need for relatives’ participation in the patients’ fast-track programmes and the results will contribute...... and subsequently include the intervention group to avoid contamination of the control group. A case manager will be recruited to perform the case management intervention. Data will be collected from both groups at baseline, 2 weeks and 3 months after surgery. Outcome measures for patients include: functional...... to education of the health professionals in their need to include relatives in fast-track programmes. The study was funded by the Novo Nordisk Foundation and the Regional Health Scientific Foundation of Sealand....

  16. Motivation programmes of organizations

    OpenAIRE

    Pízová, Tereza

    2008-01-01

    The Bachelor Thesis "'Motivation Programmes of Organizations" focuses on an extremely important area within personnel management. Employee motivation is crucial to the effective operation of businesses. Motivation programmes assist in increasing and maintaining employee motivation and demonstrate an organization's interest in its employees. This piece is on one hand concerned with theoretical foundations of motivation, describing theories and concepts important to the area of human behaviour ...

  17. Entanglement of quantum clocks through gravity.

    Science.gov (United States)

    Castro Ruiz, Esteban; Giacomini, Flaminia; Brukner, Časlav

    2017-03-21

    In general relativity, the picture of space-time assigns an ideal clock to each world line. Being ideal, gravitational effects due to these clocks are ignored and the flow of time according to one clock is not affected by the presence of clocks along nearby world lines. However, if time is defined operationally, as a pointer position of a physical clock that obeys the principles of general relativity and quantum mechanics, such a picture is, at most, a convenient fiction. Specifically, we show that the general relativistic mass-energy equivalence implies gravitational interaction between the clocks, whereas the quantum mechanical superposition of energy eigenstates leads to a nonfixed metric background. Based only on the assumption that both principles hold in this situation, we show that the clocks necessarily get entangled through time dilation effect, which eventually leads to a loss of coherence of a single clock. Hence, the time as measured by a single clock is not well defined. However, the general relativistic notion of time is recovered in the classical limit of clocks.

  18. Replacing Concrete with Natural and Social Engineering: Learning the Lessons of Stakeholder Engagement from South West Water's Upland Catchment Management Programme

    Science.gov (United States)

    Smith, David; Grand-Clement, Emile; Brazier, Richard

    2014-05-01

    Replacing Concrete with Natural and Social Engineering: Learning the Lessons of Stakeholder Engagement from South West Water's Upland Catchment Management Programme Smith, D., Grand-Clement, E., Anderson, K., Luscombe, D., G, N., Bratis, Brazier, R.E Peatlands in the South West of the British Isles have been extensively drained for agricultural reclamation and peat cutting. The improvement in food production resulting from this management practice has never clearly been observed. Instead, we are now faced with several detrimental consequences on a whole suite of ecosystem services, such as the delivery of water, water quality, biodiversity and carbon storage. Alongside the direct environmental implications, poor water quality is increasing water treatment costs and will drive significant future investment. As a result, water companies now need to find appropriate solutions to varying water levels and decreasing water quality through catchment management. The Mires Project, the catchment management programme used by South West Water (SWW) is working with a wide range of stakeholders to restore the hydrological functioning of peatlands, and the ecosystem services they provide. This programme is driven by overarching legal requirements (i.e. the water framework directive, Natura 2000), future climate change predictions, corporate responsibility and commercial needs. Post-restoration scientific monitoring is at the heart of the project improving of our understanding of the eco-hydrological and chemical process driving changes in management practice. The challenges faced from the involvement of a wide range of stakeholders will be explored, focusing on the benefits from stakeholder involvement in catchment management and hydrological research, but also considering the difficulties to be overcome. SWW is working with private land-owners, government agencies, local and national park Authorities, community and single interest groups and research institutions to achieve its

  19. Hanle Detection for Optical Clocks

    Directory of Open Access Journals (Sweden)

    Xiaogang Zhang

    2015-01-01

    Full Text Available Considering the strong inhomogeneous spatial polarization and intensity distribution of spontaneous decay fluorescence due to the Hanle effect, we propose and demonstrate a universe Hanle detection configuration of electron-shelving method for optical clocks. Experimental results from Ca atomic beam optical frequency standard with electron-shelving method show that a designed Hanle detection geometry with optimized magnetic field direction, detection laser beam propagation and polarization direction, and detector position can improve the fluorescence collection rate by more than one order of magnitude comparing with that of inefficient geometry. With the fixed 423 nm fluorescence, the improved 657 nm optical frequency standard signal intensity is presented. The potential application of the Hanle detection geometry designed for facilitating the fluorescence collection for optical lattice clock with a limited solid angle of the fluorescence collection has been discussed. The Hanle detection geometry is also effective for ion detection in ion optical clock and quantum information experiments. Besides, a cylinder fluorescence collection structure is designed to increase the solid angle of the fluorescence collection in Ca atomic beam optical frequency standard.

  20. Circadian clock components in the rat neocortex

    DEFF Research Database (Denmark)

    Rath, Martin Fredensborg; Rohde, Kristian; Fahrenkrug, Jan

    2013-01-01

    The circadian master clock of the mammalian brain resides in the suprachiasmatic nucleus (SCN) of the hypothalamus. At the molecular level, the clock of the SCN is driven by a transcriptional/posttranslational autoregulatory network with clock gene products as core elements. Recent investigations...... in the rat neocortex. Among these, Per1, Per2, Per3, Cry1, Bmal1, Nr1d1 and Dbp were found to exhibit daily rhythms. The amplitude of circadian oscillation in neocortical clock gene expression was damped and the peak delayed as compared with the SCN. Lesions of the SCN revealed that rhythmic clock gene...... expression in the neocortex is dependent on the SCN. In situ hybridization and immunohistochemistry showed that products of the canonical clock gene Per2 are located in perikarya throughout all areas of the neocortex. These findings show that local circadian oscillators driven by the SCN reside within...

  1. Genetically Blocking the Zebrafish Pineal Clock Affects Circadian Behavior

    National Research Council Canada - National Science Library

    Ben-Moshe Livne, Zohar; Alon, Shahar; Vallone, Daniela; Bayleyen, Yared; Tovin, Adi; Shainer, Inbal; Nisembaum, Laura G; Aviram, Idit; Smadja-Storz, Sima; Fuentes, Michael; Falcón, Jack; Eisenberg, Eli; Klein, David C; Burgess, Harold A; Foulkes, Nicholas S; Gothilf, Yoav

    2016-01-01

    ... its synchronization with the solar day [2]. At the heart of the molecular clock in vertebrates are daily oscillations in the expression and function of evolutionarily conserved clock genes and their protein products, including CLOCK and BMAL, which form heterodimers that activate the transcription of clock and clock-controlled genes (CCGs) via E-box enhan...

  2. RD and D-Programme 2001. Programme for research, development and demonstration of methods for the management and disposal of nuclear waste

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2001-09-01

    An overall goal for SKB is to start the initial operation of a deep repository for spent fuel in 2015. This presumes that site investigations have been commenced at the beginning of 2002 and that the different phases have been executed without major changes. The encapsulation plant should be ready to start roughly one year before the deep repository is finished. Spent fuel is the waste that is to be isolated in the deep repository. Various processes will with time alter the conditions in the fuel and in the voids of the canister. Many of these process only occur if the isolation of the canister is breached and water enters the canister. Radiolysis of water is an example of such a process, which can in turn influence the chemical conditions in the canister. Water in the canister can also cause corrosion of the fuel's cladding tubes. If water comes into contact with the fuel it can lead to dissolution of radionuclides. Dissolved radionuclides can diffuse in the water and thereby escape from a damaged canister. Fuel dissolution is a priority area in RDandD Programme 2001. Large resources are being devoted to studies of copper corrosion and stress corrosion cracking in the copper canister. SKB will also investigate the long-term safety of a canister type with a slightly thinner shell but a heavier-duty insert. The buffer of bentonite clay is supposed to protect the canister mechanically against minor rock movements. It is also supposed to retard solute transport. The initial evolution of the buffer is studied in the Aespoe HRL and by means of models. The long-term evolution of the backfill is controlled by largely the same processes as in the buffer. The backfill is more sensitive to saline water than the more compacted buffer. Several processes in the geosphere are important for the safety assessment, such as groundwater flow, earthquakes, microbial processes and matrix diffusion. The models for groundwater flow will be further refined in order to handle the

  3. The Square Light Clock and Special Relativity

    Science.gov (United States)

    Galli, J. Ronald; Amiri, Farhang

    2012-01-01

    A thought experiment that includes a square light clock is similar to the traditional vertical light beam and mirror clock, except it is made up of four mirrors placed at a 45[degree] angle at each corner of a square of length L[subscript 0], shown in Fig. 1. Here we have shown the events as measured in the rest frame of the square light clock. By…

  4. A pilot evaluation on a stress management programme using a combined approach of cognitive behavioural therapy (CBT) and complementary and alternative medicine (CAM) for elementary school teachers.

    Science.gov (United States)

    Tsang, Hector W H; Cheung, W M; Chan, Alan H L; Fung, Kelvin M T; Leung, Ada Y; Au, Doreen W H

    2015-02-01

    The aim of this study is to explore the efficacy of implementing a stress management programme based on a combined approach using cognitive behavioural therapy and complementary and alternative medicine for elementary school teachers who experienced mild level of stress, anxiety and/or depressive symptoms in Hong Kong. A 12-h programme involving cognitive behavioural therapy, self-management, relaxation techniques (diaphragmatic breathing and progressive muscle relaxation), mindful exercises (qigong and yoga), aromatherapy and acupressure was conducted. A quasi-experimental design was used to compare the intervention groups (n = 47) with the wait-list control groups (n = 46). The primary outcome measures were depression, anxiety and stress. Results indicated that the intervention group had significant reduction in depression [(F = 3.93; degrees of freedom (df) = 2.90; p = 0.023)], anxiety (F = 3.37; df = 2.90; p = 0.039) and stress (F = 3.63; df = 2.89; p = 0.031) when compared with the control group. Participants in both groups demonstrated lowered level of salivary cortisol at the post-assessment. The pilot results provided preliminary support to the multi-component stress management programme in relieving affective symptoms of teachers. The programme may be considered as an initial strategy to empower teachers with the abilities to cope with their affective symptoms. Further evaluation using a better designed randomized study with a larger sample size is warranted. (word: 198; max.: 200). © 2013 John Wiley & Sons, Ltd.

  5. Randomised controlled trial of a web-based programme in sustaining best practice alcohol management practices at community sports clubs: a study protocol.

    Science.gov (United States)

    McFadyen, Tameka; Wolfenden, Luke; Kingsland, Melanie; Tindall, Jennifer; Rowland, Bosco; Sherker, Shauna; Gillham, Karen; Heaton, Rachael; Clinton-McHarg, Tara; Lecathelinais, Christophe; Brooke, Daisy; Wiggers, John

    2018-01-23

    Community-based interventions have been found to effectively increase the implementation of alcohol management practices and reduce excessive alcohol use and alcohol-related harm at sports clubs. However, once implementation support ceases there may be a reduction in such intervention effects. Thus, ongoing contribution to improving the health of the community is diminished; sustaining practice implementation is a key determinant to address this. One possible solution to the strategic and logistical challenges of sustainability involves the use of the web. The primary aim of this study is to assess the effectiveness of a web-based programme in sustaining the implementation of alcohol management practices by community football clubs. The secondary aim is to assess the effectiveness of the programme in preventing excessive alcohol consumption and alcohol-related harm among members of community football clubs. The study will employ a repeat randomised controlled trial design and be conducted in regional and metropolitan areas within two states of Australia. Community level football clubs who are currently accredited with an existing alcohol management programme ('Good Sports') and implementing at least 10 of the 13 core alcohol management practices (eg, not serving alcohol to sustainability programme or a 'minimal contact' programme. The primary outcome measures are the proportion of football clubs implementing ≥10 of the 13 required alcohol management practices and the mean number of those practices being implemented at 3-year follow-up. Secondary outcomes include: the proportion of club members who report risky drinking at their club, the Alcohol Use Disorder Identification Test (AUDIT) score and mean AUDIT score of club members. Outcome data will be collected via observation at the club during a 1-day visit to a home game, conducted by trained research assistants at baseline and follow-up. The study was approved by The University of Newcastle Human Research

  6. Circadian clock genes, ovarian development and diapause

    Directory of Open Access Journals (Sweden)

    Bradshaw William E

    2010-09-01

    Full Text Available Abstract Insects, like most organisms, have an internal circadian clock that oscillates with a daily rhythmicity, and a timing mechanism that mediates seasonal events, including diapause. In research published in BMC Biology, Ikeno et al. show that downregulation of the circadian clock genes period and cycle affects expression of ovarian diapause in the insect Riptortus pedestris. They interpret these important results as support for Erwin Bünning's (1936 hypothesis that the circadian clock constitutes the basis of photoperiodism. However, their observations could also be the result of pleiotropic effects of the individual clock genes. See research article http://www.biomedcentral.com/1741-7007/8/116

  7. Transcriptional architecture of the mammalian circadian clock.

    Science.gov (United States)

    Takahashi, Joseph S

    2017-03-01

    Circadian clocks are endogenous oscillators that control 24-hour physiological and behavioural processes in organisms. These cell-autonomous clocks are composed of a transcription-translation-based autoregulatory feedback loop. With the development of next-generation sequencing approaches, biochemical and genomic insights into circadian function have recently come into focus. Genome-wide analyses of the clock transcriptional feedback loop have revealed a global circadian regulation of processes such as transcription factor occupancy, RNA polymerase II recruitment and initiation, nascent transcription, and chromatin remodelling. The genomic targets of circadian clocks are pervasive and are intimately linked to the regulation of metabolism, cell growth and physiology.

  8. Calm child programme.

    Science.gov (United States)

    Gobrial, Ereny; Raghavan, Raghu

    2017-01-01

    Children with autism spectrum disorder (ASD) and intellectual disabilities (IDs) are more vulnerable to experiencing anxiety disorders. Parental involvement in intervention is crucial for successful management of the interventions in the population of people with ASDs. This article describes the design and evaluation of parenting programme for anxiety disorders in children and young people with ASD and ID. In phase 1 semi-structured interviews were conducted to explore management strategies for anxiety at home and in school settings. A total of 34 participants (14 parents, 20 teachers) participated in the interviews. A Delphi process was conducted with health professionals to develop consensus on appropriate anxiety interventions. In phase 2 the intervention programme was implemented by seven parents who also participated in focus group to evaluate the developed programme. A parental programme, calm child programme (CCP), was developed, implemented and evaluated. The evaluations show significant decrease in children's anxiety as a result of implementing the programme. This study contributes further evidence to parental involvement in interventions for children and young people with ASD and IDs. The CCP is a useful and cost-effective approach in enabling parents to provide anxiety interventions in a home setting.

  9. On Thursday 14 September 2006, members of CERN Management welcomed recently-recruited staff members and fellows at the trimester session of the Induction Programme (photographed here with Enrico CHIAVERI, Department HR).

    CERN Multimedia

    Maximilien Brice

    2006-01-01

    On Thursday 14 September 2006, members of CERN Management welcomed recently-recruited staff members and fellows at the trimester session of the Induction Programme (photographed here with Enrico CHIAVERI, Department HR).

  10. Challenges in Clock Synchronization for On-Site Coding Digital Beamformer

    Directory of Open Access Journals (Sweden)

    Satheesh Bojja Venkatakrishnan

    2017-01-01

    Full Text Available Typical radio frequency (RF digital beamformers can be highly complex. In addition to a suitable antenna array, they require numerous receiver chains, demodulators, data converter arrays, and digital signal processors. To recover and reconstruct the received signal, synchronization is required since the analog-to-digital converters (ADCs, digital-to-analog converters (DACs, field programmable gate arrays (FPGAs, and local oscillators are all clocked at different frequencies. In this article, we present a clock synchronization topology for a multichannel on-site coding receiver (OSCR using the FPGA as a master clock to drive all RF blocks. This approach reduces synchronization errors by a factor of 8, when compared to conventional digital beamformer.

  11. Evaluation of nurses' changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care: a qualitative study.

    Science.gov (United States)

    Roets-Merken, Lieve M; Vernooij-Dassen, Myrra J F J; Zuidema, Sytse U; Dees, Marianne K; Hermsen, Pieter G J M; Kempen, Gertrudis I J M; Graff, Maud J L

    2016-11-17

    To gain insights into the process of nurses' changing perceptions when trained to implement a self-management programme for dual sensory impaired older adults in long-term care, and into the factors that contributed to these changes in their perceptions. Qualitative study alongside a cluster randomised controlled trial. 17 long-term care homes spread across the Netherlands. 34 licensed practical nurses supporting 54 dual sensory impaired older adults. A 5-month training programme designed to enable nurses to support the self-management of dual sensory impaired older adults in long-term care. Nurses' perceptions on relevance and feasibility of the self-management programme collected from nurses' semistructured coaching diaries over the 5-month training and intervention period, as well as from trainers' reports. Nurses' initial negative perceptions on relevance and feasibility of the intervention changed to positive as nurses better understood the concept of autonomy. Through interactions with older adults and by self-evaluations of the effect of their behaviour, nurses discovered that their usual care conflicted with client autonomy. From that moment, nurses felt encouraged to adapt their behaviour to the older adults' autonomy needs. However, nurses' initial unfamiliarity with conversation techniques required a longer exploration period than planned. Once client autonomy was understood, nurses recommended expanding the intervention as a generic approach to all their clients, whether dual sensory impaired or not. Longitudinal data collection enabled exploration of nurses' changes in perceptions when moving towards self-management support. The training programme stimulated nurses to go beyond 'protocol thinking', discovering client autonomy and exploring the need for their own behavioural adaptations. Educational programmes for practical nurses should offer more longitudinal coaching of autonomy supportive conversational skills. Intervention programming should

  12. The effect of an active implementation of a disease management programme for chronic obstructive pulmonary disease on healthcare utilization - a cluster-randomised controlled trial

    Science.gov (United States)

    2013-01-01

    Background The growing population living with chronic conditions calls for efficient healthcare-planning and effective care. Implementing disease-management-programmes is one option for responding to this demand. Knowledge is scarce about the effect of implementation processes and their effect on patients; only few studies have reported the effectiveness of disease-management-programmes targeting patients with chronic obstructive pulmonary disease (COPD). The objective of this paper was to determine the effect on healthcare-utilization of an active implementation model for a disease-management-programme for patients with one of the major multimorbidity diseases, COPD. Methods The standard implementation of a new disease-management-programme for COPD was ongoing during the study-period from November 2008 to November 2010 in the Central Denmark Region. We wanted to test a strategy using Breakthrough Series, academic detailing and lists of patients with COPD. It targeted GPs and three hospitals serving approx. 60,000 inhabitants aged 35 or older and included interventions directed at professionals, organisations and patients. The study was a non-blinded block- and cluster-randomised controlled trial with GP-practices as the unit of randomisation. In Ringkoebing-Skjern Municipality, Denmark, 16 GP-practices involving 38 GPs were randomised to either the intervention-group or the control-group. A comparable neighbouring municipality acted as an external-control-group which included nine GP-practices with 25 GPs. An algorithm based on health-registry-data on lung-related contacts to the healthcare-system identified 2,736 patients who were alive at the end of the study-period. The population included in this study counted 1,372 (69.2%) patients who responded to the baseline questionnaire and confirmed their COPD diagnosis; 458 (33.4%) patients were from the intervention-group, 376 (27.4%) from the control-group and 538(39.2%) from the external-control-group. The primary

  13. The effect of an active implementation of a disease management programme for chronic obstructive pulmonary disease on healthcare utilization--a cluster-randomised controlled trial.

    Science.gov (United States)

    Smidth, Margrethe; Christensen, Morten Bondo; Fenger-Grøn, Morten; Olesen, Frede; Vedsted, Peter

    2013-10-03

    The growing population living with chronic conditions calls for efficient healthcare-planning and effective care. Implementing disease-management-programmes is one option for responding to this demand. Knowledge is scarce about the effect of implementation processes and their effect on patients; only few studies have reported the effectiveness of disease-management-programmes targeting patients with chronic obstructive pulmonary disease (COPD). The objective of this paper was to determine the effect on healthcare-utilization of an active implementation model for a disease-management-programme for patients with one of the major multimorbidity diseases, COPD. The standard implementation of a new disease-management-programme for COPD was ongoing during the study-period from November 2008 to November 2010 in the Central Denmark Region. We wanted to test a strategy using Breakthrough Series, academic detailing and lists of patients with COPD. It targeted GPs and three hospitals serving approx. 60,000 inhabitants aged 35 or older and included interventions directed at professionals, organisations and patients. The study was a non-blinded block- and cluster-randomised controlled trial with GP-practices as the unit of randomisation. In Ringkoebing-Skjern Municipality, Denmark, 16 GP-practices involving 38 GPs were randomised to either the intervention-group or the control-group. A comparable neighbouring municipality acted as an external-control-group which included nine GP-practices with 25 GPs. An algorithm based on health-registry-data on lung-related contacts to the healthcare-system identified 2,736 patients who were alive at the end of the study-period. The population included in this study counted 1,372 (69.2%) patients who responded to the baseline questionnaire and confirmed their COPD diagnosis; 458 (33.4%) patients were from the intervention-group, 376 (27.4%) from the control-group and 538(39.2%) from the external-control-group. The primary outcome was

  14. Innovative project management on the basis of programme-and-target approach for energy saving in the construction complex

    Science.gov (United States)

    Mottaeva, Angela

    2017-10-01

    Article is devoted to the consideration of the existing approaches to energy saving. According to the author’s opinion,the system approach is not enough for the achievement of the goal of the increase in energy efficiency and economy of energy, which is quite relevant for the world scientific community today, when the mankind has reached the certain power and ecological threshold. The author reasons the need of programme-and-target approach to energy saving and the increase in energy efficiency of buildings. The problems of the energy saving in current conditions are revealed. The provisional algorithm of the programme-and-target approach to energy efficiency. The expected results from introduction of the programme-and-target approach are presented in the article.

  15. High Performance Clocks and Gravity Field Determination

    Science.gov (United States)

    Müller, J.; Dirkx, D.; Kopeikin, S. M.; Lion, G.; Panet, I.; Petit, G.; Visser, P. N. A. M.

    2018-02-01

    Time measured by an ideal clock crucially depends on the gravitational potential and velocity of the clock according to general relativity. Technological advances in manufacturing high-precision atomic clocks have rapidly improved their accuracy and stability over the last decade that approached the level of 10^{-18}. This notable achievement along with the direct sensitivity of clocks to the strength of the gravitational field make them practically important for various geodetic applications that are addressed in the present paper. Based on a fully relativistic description of the background gravitational physics, we discuss the impact of those highly-precise clocks on the realization of reference frames and time scales used in geodesy. We discuss the current definitions of basic geodetic concepts and come to the conclusion that the advances in clocks and other metrological technologies will soon require the re-definition of time scales or, at least, clarification to ensure their continuity and consistent use in practice. The relative frequency shift between two clocks is directly related to the difference in the values of the gravity potential at the points of clock's localization. According to general relativity the relative accuracy of clocks in 10^{-18} is equivalent to measuring the gravitational red shift effect between two clocks with the height difference amounting to 1 cm. This makes the clocks an indispensable tool in high-precision geodesy in addition to laser ranging and space geodetic techniques. We show how clock measurements can provide geopotential numbers for the realization of gravity-field-related height systems and can resolve discrepancies in classically-determined height systems as well as between national height systems. Another application of clocks is the direct use of observed potential differences for the improved recovery of regional gravity field solutions. Finally, clock measurements for space-borne gravimetry are analyzed along with

  16. The effectiveness of the Austrian disease management programme for type 2 diabetes: a cluster-randomised controlled trial

    Directory of Open Access Journals (Sweden)

    Klima Gert

    2010-11-01

    Full Text Available Abstract Background Disease management programmes (DMPs are costly and impose additional work load on general practitioners (GPs. Data on their effectiveness are inconclusive. We therefore conducted a cluster-randomised controlled trial to evaluate the effectiveness of the Austrian DMP for diabetes mellitus type 2 on HbA1c and quality of care for adult patients in primary care. Methods All GPs of Salzburg-province were invited to participate. After cluster-randomisation by district, all patients with diabetes type 2 were recruited consecutively from 7-11/2007. The DMP, consisting mainly of physician and patient education, standardised documentation and agreement on therapeutic goals, was implemented in the intervention group while the control group received usual care. We aimed to show superiority of the intervention regarding metabolic control and process quality. The primary outcome measure was a change in HbA1c after one year. Secondary outcomes were days in the hospital, blood pressure, lipids, body mass index (BMI, enrolment in patient education and regular guideline-adherent examination. Blinding was not possible. Results 92 physicians recruited 1489 patients (649 intervention, 840 control. After 401 ± 47 days, 590 intervention-patients and 754 controls had complete data. In the intention to treat analysis (ITT of all 1489 patients, HbA1c decreased 0.41% in the intervention group and 0.28% in controls. The difference of -0.13% (95% CI -0.24; -0.02 was significant at p = 0.026. Significance was lost in mixed models adjusted for baseline value and cluster-effects (adjusted mean difference -0.03 (95% CI -0.15; 0.09, p = 0.607. Of the secondary outcome measures, BMI and cholesterol were significantly reduced in the intervention group compared to controls in ITT after adjustments (-0.53 kg/m²; 95% CI -1.03;-0.02; p = 0.014 and -0.10 mmol/l; 95% CI -0.21; -0.003; p = 0.043. Additionally, more patients received patient education (49.5% vs. 20

  17. Gigabit Ethernet Asynchronous Clock Compensation FIFO

    Science.gov (United States)

    Duhachek, Jeff

    2012-01-01

    Clock compensation for Gigabit Ethernet is necessary because the clock recovered from the 1.25 Gb/s serial data stream has the potential to be 200 ppm slower or faster than the system clock. The serial data is converted to 10-bit parallel data at a 125 MHz rate on a clock recovered from the serial data stream. This recovered data needs to be processed by a system clock that is also running at a nominal rate of 125 MHz, but not synchronous to the recovered clock. To cross clock domains, an asynchronous FIFO (first-in-first-out) is used, with the write pointer (wprt) in the recovered clock domain and the read pointer (rptr) in the system clock domain. Because the clocks are generated from separate sources, there is potential for FIFO overflow or underflow. Clock compensation in Gigabit Ethernet is possible by taking advantage of the protocol data stream features. There are two distinct data streams that occur in Gigabit Ethernet where identical data is transmitted for a period of time. The first is configuration, which happens during auto-negotiation. The second is idle, which occurs at the end of auto-negotiation and between every packet. The identical data in the FIFO can be repeated by decrementing the read pointer, thus compensating for a FIFO that is draining too fast. The identical data in the FIFO can also be skipped by incrementing the read pointer, which compensates for a FIFO draining too slowly. The unique and novel features of this FIFO are that it works in both the idle stream and the configuration streams. The increment or decrement of the read pointer is different in the idle and compensation streams to preserve disparity. Another unique feature is that the read pointer to write pointer difference range changes between compensation and idle to minimize FIFO latency during packet transmission.

  18. Evaluation of the quality of care of a multi-disciplinary Risk Factor Assessment and Management Programme for Hypertension (RAMP-HT).

    Science.gov (United States)

    Yu, Esther Yee Tak; Wan, Eric Yuk Fai; Chan, Karina Hiu Yen; Wong, Carlos King Ho; Kwok, Ruby Lai Ping; Fong, Daniel Yee Tak; Lam, Cindy Lo Kuen

    2015-06-19

    There is some evidence to support a risk-stratified, multi-disciplinary approach to manage patients with hypertension in primary care. The aim of this study is to evaluate the quality of care (QOC) of a multi-disciplinary Risk Assessment and Management Programme for Hypertension (RAMP-HT) for hypertensive patients in busy government-funded primary care clinics in Hong Kong. The objectives are to develop an evidence-based, structured and comprehensive evaluation framework on quality of care, to enhance the QOC of the RAMP-HT through an audit spiral of two evaluation cycles and to determine the effectiveness of the programme in reducing cardiovascular disease (CVD) risk. A longitudinal study is conducted using the Action Learning and Audit Spiral methodologies to measure whether pre-set target standards of care intended by the RAMP-HT are achieved. A structured evaluation framework on the quality of structure, process and outcomes of care has been developed based on the programme objectives and literature review in collaboration with the programme workgroup and health service providers. Each participating clinic is invited to complete a structure of care evaluation questionnaire in each evaluation cycle. The data of all patients who have enrolled into the RAMP-HT in the pre-defined evaluation periods are used for the evaluation of the process and outcomes of care in each evaluation cycle. For evaluation of the effectiveness of RAMP-HT, the primary outcomes including blood pressure (both systolic and diastolic), low-density lipoprotein cholesterol and estimated 10-year CVD risk of RAMP-HT participants are compared to those of hypertensive patients in usual care without RAMP-HT. The QOC and effectiveness of the RAMP-HT in improving clinical and patient-reported outcomes for patients with hypertension in normal primary care will be determined. Possible areas for quality enhancement and standards of good practice will be established to inform service planning and policy

  19. The Impact of Self-Criticism and Self-Reassurance on Weight-Related Affect and Well-Being in Participants of a Commercial Weight Management Programme

    Directory of Open Access Journals (Sweden)

    Cristiana Duarte

    2017-04-01

    Full Text Available Objective: Certain psychological and emotional factors can undermine attempts at weight management. Previously we have found that shame and self-criticism were significantly associated with disinhibition and perceived hunger in 2,236 participants of a weight management programme. This effect was fully mediated through weight-related negative affect. The present study examined the impact of self-criticism and self-reassurance on well-being and whether it was mediated by weight-related affect in the same population. Methods: Participants completed an online survey of measures of self-criticism and self-reassurance, and negative and positive affect associated with weight and well-being. Results: Path analysis suggested that self-criticism was significantly associated with decreased well-being, both directly and indirectly, mediated by increased negative and decreased positive weight-related affect. Self-reassurance had a stronger association with increased well-being by predicting lower negative and increased positive weight-related affect. All effects were significant at p Conclusion: Self-criticism and self-reassurance were related to well-being in participants attempting to manage their weight, both directly and through their impact on weight-related affect. The positive association between self-reassurance and well-being was stronger than the negative association between self-criticism and well-being. Supporting the development of self-reassuring competencies in weight management programmes may improve weight-related affect and well-being.

  20. A programmable associative memory for track finding

    Energy Technology Data Exchange (ETDEWEB)

    Bardi, A.; Belforte, S.; Donati, S.; Galeotti, S.; Giannetti, P.; Morsani, F.; Passuello, D.; Spinella, F. [Istituto Nazionale di Fisica Nucleare, Pisa (Italy); Cerri, A.; Punzi, G.; Ristori, L. [Scuola Normale Superiore, Piazza dei Cavalieri 7, 56100 Pisa (Italy); Dell`Orso, M.; Meschi, E. [Dipartimento di Fisica, Universita di Pisa, Piazza Torricelli 2, 56100 Pisa (Italy); Leger, A.; Speer, T.; Wu, X. [Departement de Physique Nucleaire et Corpusculaire, Universite de Geneve, 24 Quai Ernest-Ansermet, CH-1211 Geneve (Switzerland)

    1998-08-21

    We present a device, based on the concept of associative memory for pattern recognition, dedicated to on-line track finding in high-energy physics experiments. A large pattern bank, describing all possible tracks, can be organized into field programmable gate arrays where all patterns are compared in parallel to data coming from the detector during readout. Patterns, recognized among 2{sup 66} possible combinations, are output in a few 30 MHz clock cycles. Programmability results in a flexible, simple architecture and it allows to keep up smoothly with technology improvements. (orig.) 4 refs.

  1. Arabidopsis circadian clock and photoperiodism: time to think about location

    OpenAIRE

    Imaizumi, Takato

    2009-01-01

    Plants possess a circadian clock that enables them to coordinate internal biological events with external daily changes. Recent studies in Arabidopsis revealed that tissue specific clock components exist and that the clock network architecture also varies within different organs. These findings indicate that the makeup of circadian clock(s) within a plant is quite variable. Plants utilize the circadian clock to measure day-length changes for regulating seasonal responses, such as flowering. T...

  2. Tectonic blocks and molecular clocks

    Science.gov (United States)

    2016-01-01

    Evolutionary timescales have mainly used fossils for calibrating molecular clocks, though fossils only really provide minimum clade age constraints. In their place, phylogenetic trees can be calibrated by precisely dated geological events that have shaped biogeography. However, tectonic episodes are protracted, their role in vicariance is rarely justified, the biogeography of living clades and their antecedents may differ, and the impact of such events is contingent on ecology. Biogeographic calibrations are no panacea for the shortcomings of fossil calibrations, but their associated uncertainties can be accommodated. We provide examples of how biogeographic calibrations based on geological data can be established for the fragmentation of the Pangaean supercontinent: (i) for the uplift of the Isthmus of Panama, (ii) the separation of New Zealand from Gondwana, and (iii) for the opening of the Atlantic Ocean. Biogeographic and fossil calibrations are complementary, not competing, approaches to constraining molecular clock analyses, providing alternative constraints on the age of clades that are vital to avoiding circularity in investigating the role of biogeographic mechanisms in shaping modern biodiversity. This article is part of the themed issue ‘Dating species divergences using rocks and clocks’. PMID:27325840

  3. A clock synchronization skeleton based on RTAI

    NARCIS (Netherlands)

    Huang, Y.; Visser, P.M.; Broenink, Johannes F.

    2006-01-01

    This paper presents a clock synchronization skeleton based on RTAI (Real Time Application Interface). The skeleton is a thin layer that provides unified but extendible interfaces to the underlying operating system, the synchronization algorithms and the upper level applications in need of clock

  4. Could Atomic clocks be affected by neutrinos?

    CERN Document Server

    Hanafi, Hanaa

    2016-01-01

    An atomic clock is a clock device that uses an electronic transition frequency of the electromagnetic spectrum of atoms as a frequency standard in order to derive a time standard since time is the reciprocal of frequency. If the electronic transition frequencies are in an "optical region", we are talking in this case about optical atomic clocks. If they are in an "microwave region" these atomic clocks are made of the metallic element cesium so they are called Cesium atomic clocks. Atomic clocks are the most accurate time and frequency standards known despite the different perturbations that can affect them, a lot of researches were made in this domain to show how the transitions can be different for different type of perturbations..Since atomic clocks are very sensitive devices, based on coherent states (A coherent state tends to loose coherence after interacting). One question can arise (from a lot of questions) which is why cosmic neutrinos are not affecting these clocks? The answer to this question requir...

  5. Global synchronization of parallel processors using clock pulse width modulation

    Science.gov (United States)

    Chen, Dong; Ellavsky, Matthew R.; Franke, Ross L.; Gara, Alan; Gooding, Thomas M.; Haring, Rudolf A.; Jeanson, Mark J.; Kopcsay, Gerard V.; Liebsch, Thomas A.; Littrell, Daniel; Ohmacht, Martin; Reed, Don D.; Schenck, Brandon E.; Swetz, Richard A.

    2013-04-02

    A circuit generates a global clock signal with a pulse width modification to synchronize processors in a parallel computing system. The circuit may include a hardware module and a clock splitter. The hardware module may generate a clock signal and performs a pulse width modification on the clock signal. The pulse width modification changes a pulse width within a clock period in the clock signal. The clock splitter may distribute the pulse width modified clock signal to a plurality of processors in the parallel computing system.

  6. Effects of a Short Teacher Training Programme on the Management of Children's Sexual Behaviours: A Pilot Study

    Science.gov (United States)

    Charnaud, Jean-Paul; Turner, William

    2015-01-01

    This small-scale quasi-experimental study set out to examine the effects of a brief training programme aiming to develop primary school teachers' knowledge, attitudes and confidence in recognising and responding to children who display sexual behaviours. Data on prevalence of sexual behaviours observed by teachers in the study, their level of…

  7. Selection of Postgraduate Students in a South African Management Programme: How Effective Is the General Reasoning Test?

    Science.gov (United States)

    Abrahams, Fatima; Friedrich, Christian; Tredoux, Nanette

    2012-01-01

    South African higher education institutions are experiencing challenges regarding access, redress and the successful completion of programmes in an environment where there are still imbalances in the schooling system. Tools are needed that will assist with the process of selecting students. The aim of this study is to determine whether a test…

  8. A Self-Management Programme of Activity Coping and Education - SPACE for COPD(C) - in primary care: The protocol for a pragmatic trial.

    Science.gov (United States)

    Bourne, Claire LA; Kanabar, Pratiksha; Mitchell, Katy; Schreder, Sally; Houchen-Wolloff, Linzy; Bankart, M John G; Apps, Lindsay; Hewitt, Stacey; Harvey-Dunstan, Theresa; Singh, Sally J

    2017-07-10

    National guidance for chronic obstructive pulmonary disease (COPD) suggests that self-management support be provided for patients. Our institution has developed a standardised, manual-based, supported self-management programme: Self-Management Programme of Activity Coping and Education (SPACE for COPD(C)). SPACE was previously piloted on a 1-2-1 basis, delivered by researchers, to individuals with COPD. Discussions with stakeholders highlighted considerable interest in delivering the SPACE for COPD(C) intervention as a group-based self-management programme facilitated by healthcare professionals (HCPs) in primary care settings. The study aims are to explore the feasibility, acceptability and efficacy for the intervention to be delivered and supported by HCPs and to examine whether group-based delivery of SPACE for COPD(C), with sustained support, improves patient outcomes following the SPACE for COPD(C) intervention. A prospective, multi-site, single-blinded randomised controlled trial (RCT) will be conducted, with follow-up at 6 and 9 months. Participants will be randomly assigned to either the control group (usual care) or intervention group (a six-session, group-based SPACE for COPD(C)self-management programme delivered over 5 months). The primary outcome is change in COPD assessment test at 6 months.A discussion session will be conducted with HCPs who deliver the intervention to discuss and gain insight into any potential facilitators/barriers to implementing the intervention in practice. Furthermore, we will conduct semi-structured focus groups with intervention participants to understand feasibility and acceptability. All qualitative data will be analysed thematically. The project has received a favourable opinion from South Hampshire B Research Ethics Committee, REC reference: 14/SC/1169 and full R&D approval from the University Hospitals of Leicester NHS Trust: 152408.Study results will be disseminated through appropriate peer-reviewed journals, national

  9. Laser controlled atom source for optical clocks

    Science.gov (United States)

    Kock, Ole; He, Wei; Świerad, Dariusz; Smith, Lyndsie; Hughes, Joshua; Bongs, Kai; Singh, Yeshpal

    2016-11-01

    Precision timekeeping has been a driving force in innovation, from defining agricultural seasons to atomic clocks enabling satellite navigation, broadband communication and high-speed trading. We are on the verge of a revolution in atomic timekeeping, where optical clocks promise an over thousand-fold improvement in stability and accuracy. However, complex setups and sensitivity to thermal radiation pose limitations to progress. Here we report on an atom source for a strontium optical lattice clock which circumvents these limitations. We demonstrate fast (sub 100 ms), cold and controlled emission of strontium atomic vapours from bulk strontium oxide irradiated by a simple low power diode laser. Our results demonstrate that millions of strontium atoms from the vapour can be captured in a magneto-optical trap (MOT). Our method enables over an order of magnitude reduction in scale of the apparatus. Future applications range from satellite clocks testing general relativity to portable clocks for inertial navigation systems and relativistic geodesy.

  10. The ozone-iodine-chlorate clock reaction.

    Directory of Open Access Journals (Sweden)

    Rafaela T P Sant'Anna

    Full Text Available This work presents a new clock reaction based on ozone, iodine, and chlorate that differs from the known chlorate-iodine clock reaction because it does not require UV light. The induction period for this new clock reaction depends inversely on the initial concentrations of ozone, chlorate, and perchloric acid but is independent of the initial iodine concentration. The proposed mechanism considers the reaction of ozone and iodide to form HOI, which is a key species for producing non-linear autocatalytic behavior. The novelty of this system lies in the presence of ozone, whose participation has never been observed in complex systems such as clock or oscillating reactions. Thus, the autocatalysis demonstrated in this new clock reaction should open the possibility for a new family of oscillating reactions.

  11. Cost and Precision of Brownian Clocks

    CERN Document Server

    Barato, Andre C

    2016-01-01

    Brownian clocks are biomolecular networks that can count time. A paradigmatic example are proteins that go through a cycle thus regulating some oscillatory behaviour in a living system. Typically, such a cycle requires free energy often provided by ATP hydrolysis. We investigate the relation between the precision of such a clock and its thermodynamic costs. For clocks driven by a constant thermodynamic force, a given precision requires a minimal cost that diverges as the uncertainty of the clock vanishes. In marked contrast, we show that a clock driven by a periodic variation of an external protocol can achieve arbitrary precision at arbitrarily low cost. This result constitutes a fundamental difference between processes driven by a fixed thermodynamic force and those driven periodically. As a main technical tool, we map a periodically driven system with a deterministic protocol to one subject to an external protocol that changes in stochastic time intervals, which simplifies calculations significantly. In th...

  12. The Impact of Shame, Self-Criticism and Social Rank on Eating Behaviours in Overweight and Obese Women Participating in a Weight Management Programme

    Science.gov (United States)

    Duarte, Cristiana; Matos, Marcela; Stubbs, R. James; Gale, Corinne; Morris, Liam; Gouveia, Jose Pinto; Gilbert, Paul

    2017-01-01

    Recent research has suggested that obesity is a stigmatised condition. Concerns with personal inferiority (social rank), shame and self-criticism may impact on weight management behaviours. The current study examined associations between social comparison (shame, self-criticism), negative affect and eating behaviours in women attending a community based weight management programme focused on behaviour change. 2,236 participants of the programme completed an online survey using measures of shame, self-criticism, social comparison, and weight-related affect, which were adapted to specifically address eating behaviour, weight and body shape perceptions. Correlation analyses showed that shame, self-criticism and social comparison were associated with negative affect. All of these variables were related to eating regulation and weight control (p < 0.001). Path analysis revealed that the association of shame, hated-self, and low self-reassurance on disinhibition and susceptibility to hunger was fully mediated by weight-related negative affect, even when controlling for the effect of depressive symptoms (p < 0.050 to p < 0.010). In addition, feelings of inadequacy and unfavourable social comparisons were associated with higher disinhibition and susceptibility to hunger, partially mediated through weight-related negative affect (p = 0.001). These variables were negatively associated with extent of weight loss during programme attendance prior to the survey, while self-reassurance and positive social comparisons were positively associated with the extent of weight loss prior to the survey (p < .050). Shame, self-criticism, and perceptions of inferiority may play a significant role in self-regulation of eating behaviour in overweight people trying to manage their weight. PMID:28107449

  13. The Impact of Shame, Self-Criticism and Social Rank on Eating Behaviours in Overweight and Obese Women Participating in a Weight Management Programme.

    Science.gov (United States)

    Duarte, Cristiana; Matos, Marcela; Stubbs, R James; Gale, Corinne; Morris, Liam; Gouveia, Jose Pinto; Gilbert, Paul

    2017-01-01

    Recent research has suggested that obesity is a stigmatised condition. Concerns with personal inferiority (social rank), shame and self-criticism may impact on weight management behaviours. The current study examined associations between social comparison (shame, self-criticism), negative affect and eating behaviours in women attending a community based weight management programme focused on behaviour change. 2,236 participants of the programme completed an online survey using measures of shame, self-criticism, social comparison, and weight-related affect, which were adapted to specifically address eating behaviour, weight and body shape perceptions. Correlation analyses showed that shame, self-criticism and social comparison were associated with negative affect. All of these variables were related to eating regulation and weight control (p shame, hated-self, and low self-reassurance on disinhibition and susceptibility to hunger was fully mediated by weight-related negative affect, even when controlling for the effect of depressive symptoms (p Shame, self-criticism, and perceptions of inferiority may play a significant role in self-regulation of eating behaviour in overweight people trying to manage their weight.

  14. A review of behaviour change theories and techniques used in group based self-management programmes for chronic low back pain and arthritis.

    Science.gov (United States)

    Keogh, Alison; Tully, Mark A; Matthews, James; Hurley, Deirdre A

    2015-12-01

    Medical Research Council (MRC) guidelines recommend applying theory within complex interventions to explain how behaviour change occurs. Guidelines endorse self-management of chronic low back pain (CLBP) and osteoarthritis (OA), but evidence for its effectiveness is weak. This literature review aimed to determine the use of behaviour change theory and techniques within randomised controlled trials of group-based self-management programmes for chronic musculoskeletal pain, specifically CLBP and OA. A two-phase search strategy of electronic databases was used to identify systematic reviews and studies relevant to this area. Articles were coded for their use of behaviour change theory, and the number of behaviour change techniques (BCTs) was identified using a 93-item taxonomy, Taxonomy (v1). 25 articles of 22 studies met the inclusion criteria, of which only three reported having based their intervention on theory, and all used Social Cognitive Theory. A total of 33 BCTs were coded across all articles with the most commonly identified techniques being 'instruction on how to perform the behaviour', 'demonstration of the behaviour', 'behavioural practice', 'credible source', 'graded tasks' and 'body changes'. Results demonstrate that theoretically driven research within group based self-management programmes for chronic musculoskeletal pain is lacking, or is poorly reported. Future research that follows recommended guidelines regarding the use of theory in study design and reporting is warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. An economic evaluation of a self-management programme of activity, coping and education for patients with chronic obstructive pulmonary disease.

    Science.gov (United States)

    Dritsaki, Melina; Johnson-Warrington, Vicki; Mitchell, Katy; Singh, Sally; Rees, Karen

    2016-02-01

    The aim was to undertake a cost-utility analysis of a self-management programme of activity, coping and education (SPACE) for chronic obstructive pulmonary disease (COPD). The analysis was conducted alongside a six-month randomized controlled trial in 30 primary care settings. The economic analysis used data from 184 patients with confirmed diagnosis of COPD, forced expiratory volume in one second/forced vital capacity ratio manual (SPACE for COPD) and consultation or usual care. Six-month costs were estimated from the National Health Service and Personal Social Services perspective and quality-adjusted life years (QALYs) were calculated based on patient responses at baseline and six months.The mean difference in costs between usual care and SPACE FOR COPD programme was -£27.18 (95% confidence interval (CI); -£122.59 to £68.25) while mean difference in QALYs was -0.10 (95% CI; -0.17 to -0.02). The results suggest that the intervention is more costly and more effective than usual care. The probability of the intervention being cost-effective was 97% at a threshold of £20,000/QALY gained. We conclude that the SPACE FOR COPD programme is cost-effective compared to usual care. © The Author(s) 2015.

  16. (ARV) treatment training programme

    African Journals Online (AJOL)

    Winnie

    successful ARV programme requires that all components of a functional management system be put in place for effective and efficient functioning.This would include logistics, human resources, financial planning, and monitoring and ..... which service recipients were surveyed on the quality of service delivery noted above.

  17. Evaluation of a multicomponent programme for the management of musculoskeletal pain and depression in primary care: a cluster-randomised clinical trial (the DROP study).

    Science.gov (United States)

    Aragonès, Enric; López-Cortacans, Germán; Caballero, Antonia; Piñol, Josep Ll; Sánchez-Rodríguez, Elisabet; Rambla, Concepció; Tomé-Pires, Catarina; Miró, Jordi

    2016-03-16

    Chronic musculoskeletal pain and depression are very common in primary care patients. Furthermore, they often appear as comorbid conditions, resulting in additive effect on adverse health outcomes. On the basis of previous studies, we hypothesise that depression and chronic musculoskeletal pain may benefit from an integrated management programme at primary care level. We expect positive effects on both physical and psychological distress of patients. To determine whether a new programme for an integrated approach to chronic musculoskeletal pain and depression leads to better outcomes than usual care. Cluster-randomised controlled trial involving two arms: a) control arm (usual care); and b) intervention arm, where patients participate in a programme for an integrated approach to the pain-depression dyad. Primary care centres in the province of Tarragona, Catalonia, Spain, Participants: We will recruit 330 patients aged 18-80 with moderate or severe musculoskeletal pain (Brief Pain Inventory, average pain subscale ≥5) for at least 3 months, and with criteria for major depression (DSM-IV). A multicomponent programme according to the chronic care model. The main components are care management, optimised antidepressant treatment, and a psychoeducational group action. Blind measurements: The patients will be monitored through blind telephone interviews held at 0, 3, 6 and 12 months. Severity of pain and depressive symptoms, pain and depression treatment response rates, and depression remission rates. The outcomes will be analysed on an intent-to-treat basis and the analysis units will be the individual patients. This analysis will consider the effect of the study design on any potential lack of independence between observations made within the same cluster. The protocol was approved by the Research Ethics Committee of the Jordi Gol Primary Care Research Institute (IDIAP), Barcelona, (P14/142). This project strengthens and improves treatment approaches for a major

  18. Circadian clocks are designed optimally

    CERN Document Server

    Hasegawa, Yoshihiko

    2014-01-01

    Circadian rhythms are acquired through evolution to increase the chances for survival by synchronizing to the daylight cycle. Reliable synchronization is realized through two trade-off properties: regularity to keep time precisely, and entrainability to synchronize the internal time with daylight. Since both properties have been tuned through natural selection, their adaptation can be formalized in the framework of mathematical optimization. By using a succinct model, we found that simultaneous optimization of regularity and entrainability entails inherent features of the circadian mechanism irrespective of model details. At the behavioral level we discovered the existence of a dead zone, a time during which light pulses neither advance nor delay the clock. At the molecular level we demonstrate the role-sharing of two light inputs, phase advance and delay, as is well observed in mammals. We also reproduce the results of phase-controlling experiments and predict molecular elements responsible for the clockwork...

  19. Fostering critical thinking in an under-graduate public management programme : an investigation on the role of integrated assessments

    OpenAIRE

    2015-01-01

    M.Ed. (Curriculum Policy Evaluation) Critical thinking is an essential component and graduate attribute addressed within higher education. Students in higher education institutions are expected to possess and display certain levels of critical thinking skills. They, therefore, are expected upon completion of their programmes in higher education, among others, to demonstrate personal and process competencies, and capacity to effectively interact in the world of work, as well as in a continu...

  20. The circadian clock regulates inflammatory arthritis.

    Science.gov (United States)

    Hand, Laura E; Hopwood, Thomas W; Dickson, Suzanna H; Walker, Amy L; Loudon, Andrew S I; Ray, David W; Bechtold, David A; Gibbs, Julie E

    2016-11-01

    There is strong diurnal variation in the symptoms and severity of chronic inflammatory diseases, such as rheumatoid arthritis. In addition, disruption of the circadian clock is an aggravating factor associated with a range of human inflammatory diseases. To investigate mechanistic links between the biological clock and pathways underlying inflammatory arthritis, mice were administered collagen (or saline as a control) to induce arthritis. The treatment provoked an inflammatory response within the limbs, which showed robust daily variation in paw swelling and inflammatory cytokine expression. Inflammatory markers were significantly repressed during the dark phase. Further work demonstrated an active molecular clock within the inflamed limbs and highlighted the resident inflammatory cells, fibroblast-like synoviocytes (FLSs), as a potential source of the rhythmic inflammatory signal. Exposure of mice to constant light disrupted the clock in peripheral tissues, causing loss of the nighttime repression of local inflammation. Finally, the results show that the core clock proteins cryptochrome (CRY) 1 and 2 repressed inflammation within the FLSs, and provide novel evidence that a CRY activator has anti-inflammatory properties in human cells. We conclude that under chronic inflammatory conditions, the clock actively represses inflammatory pathways during the dark phase. This interaction has exciting potential as a therapeutic avenue for treatment of inflammatory disease.-Hand, L. E., Hopwood, T. W., Dickson, S. H., Walker, A. L., Loudon, A. S. I., Ray, D. W., Bechtold, D. A., Gibbs, J. E. The circadian clock regulates inflammatory arthritis. © The Author(s).

  1. Time clock requirements for hospital physicians.

    Science.gov (United States)

    Shapira, Chen; Vilnai-Yavetz, Iris; Rafaeli, Anat; Zemel, Moran

    2016-06-01

    An agreement negotiated following a doctors' strike in 2011 introduced a requirement that physicians in Israel's public hospitals clock in and out when starting and leaving work. The press reported strong negative reactions to this policy and predicted doctors deserting hospitals en masse. This study examines physicians' reactions toward the clock-in/clock-out policy 6 months after its implementation, and assesses the relationship between these reactions and aspects of their employment context. 676 physicians in 42 hospitals responded to a survey assessing doctor's reactions toward the clock, hospital policy makers, and aspects of their work. Reactions to the clock were generally negative. Sense of calling correlated positively with negative reactions to the clock, and the latter correlated positively with quit intentions. However, overall, respondents reported a high sense of calling and low quit intentions. We suggest that sense of calling buffers and protects physicians from quit intentions. Differences in reactions to the clock were associated with different employment characteristics, but sense of calling did not vary by hospital size or type or by physicians' specialty. The findings offer insights into how physicians' working environment affects their reactions to regulatory interventions, and highlight medical professionalism as buffering reactions to unpopular regulatory policies. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  2. Perceptions of the impact of an advanced training programme on the management skills of health professionals in Gauteng, South Africa

    OpenAIRE

    J Mutyabule; Senkubuge, F.; Cameron, D.; Pillay, V; P. Petrucka

    2017-01-01

    Background. South Africa’s health sector spans the private and the public sectors. Within the sectors, health managers take on strategic leadership roles without formal training in management or leadership – a trend more common in the public sector than the private sector. Health managers are selected based on their clinical skills rather than their leadership or management skills. Objective. To compare self-rated competencies in management and leadership before and after training of the p...

  3. Molecular Architecture of the Mammalian Circadian Clock

    Science.gov (United States)

    Partch, Carrie L.; Green, Carla B.; Takahashi, Joseph S.

    2013-01-01

    Circadian clocks coordinate physiology and behavior with the 24-hour solar day to provide temporal homeostasis with the external environment. The molecular clocks that drive these intrinsic rhythmic changes are based on interlocked transcription/translation feedback loops that integrate with diverse environmental and metabolic stimuli to generate internal 24-hour timing. In this review we highlight recent advances in our understanding of the core molecular clock and how it utilizes diverse transcriptional and post-transcriptional mechanisms to impart temporal control onto mammalian physiology. Understanding the way in which biological rhythms are generated throughout the body may provide avenues for temporally-directed therapeutics to improve health and prevent disease. PMID:23916625

  4. Transcripts from the Circadian Clock: Telling Time and Season

    NARCIS (Netherlands)

    K. Brand (Karl)

    2011-01-01

    textabstractWe all know it when we wake mere moments before an alarm clock is scheduled to wake us: our body clock made the alarm clock redundant. This phenomenon is driven by an endogenous timer known as the biological, or circadian clock. Each revolution of the Earth about its own axis produces

  5. Automatic Clock and Time Signal System of the Astronomical Agency in East Asia Area

    Directory of Open Access Journals (Sweden)

    Yong Sam Lee

    2009-09-01

    Full Text Available We analysed the old automatic clock and time signal system that was used by the national astronomical agency in East Asian Area. Jagyeongnu is a kind of water clock that was operated by the flowing water in Joseon Dynasty. Seowoongwan managed the water clock so as to keep the standard time system in the dynasty from the 16th year (1434 of King Sejong's reign. In 1438 the Okru that was invented in the period. Such kind of clock system already was used in China, which was Shui yun i hsiang t'ai (? in 1092. During the period Joseon Dynasty, China and Japan had been kept the time system that one day is divided into 12 shin (?2? or 100 gak (?. However detailed part of the system had a little difference among the three countries. Though the whole system of water clock in Joseon had manufactured on the basis of Chinese, it had been gradually developed by own method and idea. In this study we show the historical records of the standard time keeping system in East Asian history. And then we can inform materials on the structure and functional devises for the purpose of new restoration models about the automatic clock and time system.

  6. Clock Drawing in Spatial Neglect: A Comprehensive Analysis of Clock Perimeter, Placement, and Accuracy

    Science.gov (United States)

    Chen, Peii; Goedert, Kelly M.

    2012-01-01

    Clock drawings produced by right-brain-damaged (RBD) individuals with spatial neglect often contain an abundance of empty space on the left while numbers and hands are placed on the right. However, the clock perimeter is rarely compromised in neglect patients’ drawings. By analyzing clock drawings produced by 71 RBD and 40 healthy adults, this study investigated whether the geometric characteristics of the clock perimeter reveal novel insights to understanding spatial neglect. Neglect participants drew smaller clocks than either healthy or non-neglect RBD participants. While healthy participants’ clock perimeter was close to circular, RBD participants drew radially extended ellipses. The mechanisms for these phenomena were investigated by examining the relation between clock-drawing characteristics and performance on six subtests of the Behavioral Inattention Test (BIT). The findings indicated that the clock shape was independent of any BIT subtest or the drawing placement on the test sheet and that the clock size was significantly predicted by one BIT subtest: the poorer the figure and shape copying, the smaller the clock perimeter. Further analyses revealed that in all participants, clocks decreased in size as they were placed farther from the center of the paper. However, even when neglect participants placed their clocks towards the center of the page, they were smaller than those produced by healthy or non-neglect RBD participants. These results suggest a neglect-specific reduction in the subjectively available workspace for graphic production from memory, consistent with the hypothesis that neglect patients are impaired in the ability to enlarge the attentional aperture. PMID:22390278

  7. OPTIMAL, an occupational therapy led self-management support programme for people with multimorbidity in primary care: a randomized controlled trial.

    Science.gov (United States)

    Garvey, Jess; Connolly, Deirdre; Boland, Fiona; Smith, Susan M

    2015-05-12

    We investigated the effectiveness of an occupational therapy led self-management support programme, OPTIMAL, designed to address the challenges of living with multiple chronic conditions or multimorbidity in a primary care setting. Pragmatic feasibility randomised controlled trial including fifty participants with multimorbidity recruited from family practice and primary care settings. OPTIMAL is a six-week community-based programme, led by occupational therapy facilitators and focuses on problems associated with managing multimorbidity. The primary outcome was frequency of activity participation. Secondary outcomes included self-perception of, satisfaction with and ability to perform daily activities, independence in activities of daily living, anxiety and depression, self-efficacy, health-related quality of life, self-management support, healthcare utilisation and individualised goal attainment. Outcomes were collected within two weeks of intervention completion. There was a significant improvement in frequency of activity participation, measured using the Frenchay Activities Index, for the intervention group compared to the control group (Adjusted Mean Difference at follow up 4.22. 95% Confidence Interval 1.59-6.85). There were also significant improvements in perceptions of activity performance and satisfaction, self-efficacy, independence in daily activities and quality of life. Additionally, the intervention group demonstrated significantly higher levels of goal achievement, following the intervention. No significant differences were found between the two groups in anxiety, depression, self-management scores or healthcare utilisation. OPTIMAL significantly improved frequency of activity participation, self-efficacy and quality of life for patients with multimorbidity. Further work is required to test the sustainability of these effects over time but this study indicates that it is a promising intervention that can be delivered in primary care and community

  8. The NKS-B Programme for Nordic cooperation on nuclear and radiological emergency preparedness, including measurement strategies, radioecology and waste management

    DEFF Research Database (Denmark)

    Andersson, Kasper Grann; Leino, Kaisu; Magnússon, Sigurður M.

    2014-01-01

    The NKS platform for Nordic cooperation and competence maintenance in nuclear and radiological safety comprises two parallel programmes: the NKS-R programme on nuclear reactor safety and the NKS-B programme on emergency preparedness. This paper introduces the NKS-B programme and its current...

  9. The Mechanics of Mechanical Watches and Clocks

    CERN Document Server

    Du, Ruxu

    2013-01-01

    "The Mechanics of Mechanical Watches and Clocks" presents historical views and mathematical models of mechanical watches and clocks. Although now over six hundred years old, mechanical watches and clocks are still popular luxury items that fascinate many people around the world. However few have examined the theory of how they work as presented in this book. The illustrations and computer animations are unique and have never been published before. It will be of significant interest to researchers in mechanical engineering, watchmakers and clockmakers, as well as people who have an engineering background and are interested in mechanical watches and clocks. It will also inspire people in other fields of science and technology, such as mechanical engineering and electronics engineering, to advance their designs. Professor Ruxu Du works at the Chinese University of Hong Kong, China. Assistant Professor Longhan Xie works at the South China University of Technology, China.

  10. CDDIS_GNSS_products_clocks_final

    Data.gov (United States)

    National Aeronautics and Space Administration — Satellite and receiver clock products derived from analysis of Global Navigation Satellite System (GNSS) data. These products are the generated by analysis centers...

  11. CDDIS_GNSS_products_clocks_rapid

    Data.gov (United States)

    National Aeronautics and Space Administration — Satellite and receiver clock products derived from analysis of Global Navigation Satellite System (GNSS) data. These products are the generated by analysis centers...

  12. Mini Review: Circadian Clocks, Stress and Immunity

    Directory of Open Access Journals (Sweden)

    Rebecca eDumbell

    2016-05-01

    Full Text Available In mammals, molecular circadian clocks are present in most cells of the body, and this circadian network plays an important role in synchronizing physiological processes and behaviors to the appropriate time of day. The hypothalamic-pituitary-adrenal endocrine axis regulates the response to acute and chronic stress, acting through its final effectors – glucocorticoids – released from the adrenal cortex. Glucocorticoid secretion, characterized by its circadian rhythm, has an important role in synchronizing peripheral clocks and rhythms downstream of the master circadian pacemaker in the suprachiasmatic nucleus. Finally, glucocorticoids are powerfully anti-inflammatory, and recent work has implicated the circadian clock in various aspects and cells of the immune system, suggesting a tight interplay of stress and circadian systems in the regulation of immunity. This mini-review summarizes our current understanding of the role of the circadian clock network in both, the HPA axis and the immune system, and discusses their interactions.

  13. Cellular Reprogramming–Turning the Clock Back

    Indian Academy of Sciences (India)

    Cellular Reprogramming - Turning the Clock Back - Nobel Prize in Physiology or Medicine, 2012. Deepa Subramanyam ... Keywords. Embryonic stem cells; pluripotency; reprogramming; differentiation; Nobel Prize 2012. ... National Centre for Cell Science University of Pune Campus Ganeshkhind Pune 411 007, India.

  14. Draper Clock-Synchronization Protocol in SAL

    Data.gov (United States)

    National Aeronautics and Space Administration — In 1973, Daly, Hpokins, and McKenna (from Draper Lab.) presented a fault-tolerant digital clocking system at the FTCS conference. This is probably one of the first...

  15. Cell-permeable Circadian Clock Proteins

    National Research Council Canada - National Science Library

    Johnson, Carl

    2002-01-01

    .... These 'biological clocks' are important to human physiology. For example, psychiatric and medical studies have shown that circadian rhythmicity is involved in some forms of depressive illness, 'jet lag', drug tolerance/efficacy, memory, and insomnia...

  16. Entrainment of the Neurospora circadian clock

    NARCIS (Netherlands)

    Merrow, M; Boesl, C; Ricken, J; Messerschmitt, M; Goedel, M; Roenneberg, T

    2006-01-01

    Neurospora crassa has been systematically investigated for circadian entrainment behavior. Many aspects of synchronization can be investigated in this simple, cellular system, ranging from systematic entrainment and drivenness to masking. Clock gene expression during entrainment and entrainment

  17. Photoemission delay: The White Rabbit's clock

    Science.gov (United States)

    Calegari, Francesca

    2017-03-01

    Without a very precise timer one can never catch up with the electron released in photoemission. Attosecond streaking spectroscopy allows such a chronometer clock to be set to zero and reveals the role of electron correlations.

  18. Avian Circadian Organization: A Chorus of Clocks

    Science.gov (United States)

    Cassone, Vincent M

    2013-01-01

    In birds, biological clock function pervades all aspects of biology, controlling daily changes in sleep: wake, visual function, song, migratory patterns and orientation, as well as seasonal patterns of reproduction, song and migration. The molecular bases for circadian clocks are highly conserved, and it is likely the avian molecular mechanisms are similar to those expressed in mammals, including humans. The central pacemakers in the avian pineal gland, retinae and SCN dynamically interact to maintain stable phase relationships and then influence downstream rhythms through entrainment of peripheral oscillators in the brain controlling behavior and peripheral tissues. Birds represent an excellent model for the role played by biological clocks in human neurobiology; unlike most rodent models, they are diurnal, they exhibit cognitively complex social interactions, and their circadian clocks are more sensitive to the hormone melatonin than are those of nocturnal rodents. PMID:24157655

  19. Supporting self-management after attending a structured education programme: a qualitative longitudinal investigation of type 1 diabetes patients' experiences and views.

    Science.gov (United States)

    Rankin, David; Cooke, Debbie D; Elliott, Jackie; Heller, Simon R; Lawton, Julia

    2012-08-14

    Structured education programmes for patients with diabetes and other chronic conditions are being widely adopted. However, follow-up studies suggest that course graduates may struggle to sustain the self-care practices taught on their courses over time. This study explored the support needs of patients with type 1 diabetes after attending a structured education programme promoting an empowerment approach and training in use of flexible intensive insulin therapy, a regimen now widely advocated and used to manage this condition. The objective was to inform future support offered to course graduates. Repeat, in-depth interviews with 30 type 1 diabetes patients after attending Dose Adjustment for Normal Eating (DAFNE) courses in the UK, and six and 12 months later. Data were analysed using an inductive, thematic approach. While the flexible intensive insulin treatment approach taught on DAFNE courses was seen as a logical and effective way of managing one's diabetes, it was also considered more technically complex than other insulin regimens. To sustain effective disease self-management using flexible intensive insulin treatment over time, patients often expected, and needed, on-going input and support from health care professionals trained in the approach. This included: help determining insulin dose adjustments; reassurance; and, opportunities to trouble-shoot issues of concern. While some benefits were identified to receiving follow-up support in a group setting, most patients stated a preference or need for tailored and individualised support from appropriately-trained clinicians, accessible on an 'as and when needed' basis. Our findings highlight potential limitations to group-based forms of follow-up support for sustaining diabetes self-management. To maintain the clinical benefits of structured education for patients with type 1 diabetes over time, course graduates may benefit from and prefer ongoing, one-to-one support from health care professionals trained

  20. Biological clocks and the practice of psychiatry

    OpenAIRE

    Schulz, Pierre

    2007-01-01

    Endogenous biological clocks enable living species to acquire some independence in relation to time. They improve the efficiency of biological systems, by allowing them to anticipate future constraints on major physyological systems and cell energy metabolism. The temporal organization of a giwen biological function can be impaired in its coordination with astronomical time or with other biological function. There are also external conditions that influence biological clocks. This temporal or...

  1. Cesium Atomic Fountain Clocks at NMIJ

    Science.gov (United States)

    2010-11-01

    Wynands and S. Weyers, 2005, “Atomic fountain clocks,” Metrologia , 42, S64-S79. [2] M. Takamoto, F. L. Hong, R. Higashi, et al., 2005, “An optical...beam of laser-cooled cesium atoms,” Physical Review, A 60, R4241-R4244. [13] V. Gerginov, N. Nemitz, S. Weyers, et al., 2010, “Uncertainty evaluation of the caesium fountain clock PTB-CSF2,” Metrologia , 47, 65-79.

  2. Reduced Kalman Filters for Clock Ensembles

    Science.gov (United States)

    Greenhall, Charles A.

    2011-01-01

    This paper summarizes the author's work ontimescales based on Kalman filters that act upon the clock comparisons. The natural Kalman timescale algorithm tends to optimize long-term timescale stability at the expense of short-term stability. By subjecting each post-measurement error covariance matrix to a non-transparent reduction operation, one obtains corrected clocks with improved short-term stability and little sacrifice of long-term stability.

  3. Clock gene variation in Tachycineta swallows

    Science.gov (United States)

    Dor, Roi; Cooper, Caren B; Lovette, Irby J; Massoni, Viviana; Bulit, Flor; Liljesthrom, Marcela; Winkler, David W

    2012-01-01

    Many animals use photoperiod cues to synchronize reproduction with environmental conditions and thereby improve their reproductive success. The circadian clock, which creates endogenous behavioral and physiological rhythms typically entrained to photoperiod, is well characterized at the molecular level. Recent work provided evidence for an association between Clock poly-Q length polymorphism and latitude and, within a population, an association with the date of laying and the length of the incubation period. Despite relatively high overall breeding synchrony, the timing of clutch initiation has a large impact on the fitness of swallows in the genus Tachycineta. We compared length polymorphism in the Clock poly-Q region among five populations from five different Tachycineta species that breed across a hemisphere-wide latitudinal gradient (Fig. 1). Clock poly-Q variation was not associated with latitude; however, there was an association between Clock poly-Q allele diversity and the degree of clutch size decline within breeding seasons. We did not find evidence for an association between Clock poly-Q variation and date of clutch initiation in for any of the five Tachycineta species, nor did we found a relationship between incubation duration and Clock genotype. Thus, there is no general association between latitude, breeding phenology, and Clock polymorphism in this clade of closely related birds. Figure 1 Photos of Tachycineta swallows that were used in this study: A) T. bicolor from Ithaca, New York, B) T. leucorrhoa from Chascomús, Argentina, C) T. albilinea from Hill Bank, Belize, D) T. meyeni from Puerto Varas, Chile, and E) T. thalassina from Mono Lake, California, Photographers: B: Valentina Ferretti; A, C-E: David Winkler. PMID:22408729

  4. Direct Laser Cooling Al{}^{+} Ion Optical Clocks

    Science.gov (United States)

    Zhang, Jie; Deng, Ke; Luo, Jun; Lu, Ze-Huang

    2017-05-01

    The Al {}+ ion optical clock is a very promising optical frequency standard candidate due to its extremely small black-body radiation shift. It has been successfully demonstrated with the indirect cooled, quantum-logic-based spectroscopy technique. Its accuracy is limited by second-order Doppler shift, and its stability is limited by the number of ions that can be probed in quantum logic processing. We propose a direct laser cooling scheme of Al {}+ ion optical clocks where both the stability and accuracy of the clocks are greatly improved. In the proposed scheme, two Al {}+ traps are utilized. The first trap is used to trap a large number of Al {}+ ions to improve the stability of the clock laser, while the second trap is used to trap a single Al {}+ ion to provide the ultimate accuracy. Both traps are cooled with a continuous wave 167 nm laser. The expected clock laser stability can reach 9.0× {10}-17/\\sqrt{τ }. For the second trap, in addition to 167 nm laser Doppler cooling, a second stage pulsed 234 nm two-photon cooling laser is utilized to further improve the accuracy of the clock laser. The total systematic uncertainty can be reduced to about 1× {10}-18. The proposed Al {}+ ion optical clock has the potential to become the most accurate and stable optical clock. Supported by the National Basic Research Program of China under Grant No 2012CB821300, the National Natural Science Foundation of China under Grant Nos 91336213, 11304109, 91536116 and 11174095, and the Program for New Century Excellent Talents by the Ministry of Education under Grant No NCET-11-0176.

  5. Clock Genes Control Cortical Critical Period Timing

    OpenAIRE

    Kobayashi, Yohei; Ye, Zhanlei; Hensch, Takao K.

    2015-01-01

    Circadian rhythms control a variety of physiological processes, but whether they may also time brain development remains largely unknown. Here, we show that circadian clock genes control the onset of critical period plasticity in the neocortex. Within visual cortex of Clock-deficient mice, the emergence of circadian gene expression was dampened, and the maturation of inhibitory parvalbumin (PV)-cell networks slowed. Loss of visual acuity in response to brief monocular deprivation was concomit...

  6. Do Caucasian and Asian clocks tick differently?

    Directory of Open Access Journals (Sweden)

    A.A. Barbosa

    Full Text Available The Period 3 and Clock genes are important components of the mammalian molecular circadian system. Studies have shown association between polymorphisms in these clock genes and circadian phenotypes in different populations. Nevertheless, differences in the pattern of allele frequency and genotyping distribution are systematically observed in studies with different ethnic groups. To investigate and compare the pattern of distribution in a sample of Asian and Caucasian populations living in Brazil, we evaluated two well-studied polymorphisms in the clock genes: a variable number of tandem repeats (VNTR in PER3 and a single nucleotide polymorphism (SNP in CLOCK. The aim of this investigation was to search for clues about human evolutionary processes related to circadian rhythms. We selected 109 Asian and 135 Caucasian descendants. The frequencies of the shorter allele (4 repeats in the PER3 gene and the T allele in the CLOCK gene among Asians (0.86 and 0.84, respectively were significantly higher than among Caucasians (0.69 and 0.71, respectively. Our results directly confirmed the different distribution of these polymorphisms between the Asian and Caucasian ethnic groups. Given the genetic differences found between groups, two points became evident: first, ethnic variations may have implications for the interpretation of results in circadian rhythm association studies, and second, the question may be raised about which evolutionary conditions shaped these genetic clock variations.

  7. Do Caucasian and Asian clocks tick differently?

    Science.gov (United States)

    Barbosa, A A; Pedrazzoli, M; Koike, B D V; Tufik, S

    2010-01-01

    The Period 3 and Clock genes are important components of the mammalian molecular circadian system. Studies have shown association between polymorphisms in these clock genes and circadian phenotypes in different populations. Nevertheless, differences in the pattern of allele frequency and genotyping distribution are systematically observed in studies with different ethnic groups. To investigate and compare the pattern of distribution in a sample of Asian and Caucasian populations living in Brazil, we evaluated two well-studied polymorphisms in the clock genes: a variable number of tandem repeats (VNTR) in PER3 and a single nucleotide polymorphism (SNP) in CLOCK. The aim of this investigation was to search for clues about human evolutionary processes related to circadian rhythms. We selected 109 Asian and 135 Caucasian descendants. The frequencies of the shorter allele (4 repeats) in the PER3 gene and the T allele in the CLOCK gene among Asians (0.86 and 0.84, respectively) were significantly higher than among Caucasians (0.69 and 0.71, respectively). Our results directly confirmed the different distribution of these polymorphisms between the Asian and Caucasian ethnic groups. Given the genetic differences found between groups, two points became evident: first, ethnic variations may have implications for the interpretation of results in circadian rhythm association studies, and second, the question may be raised about which evolutionary conditions shaped these genetic clock variations.

  8. Cost and Precision of Brownian Clocks

    Directory of Open Access Journals (Sweden)

    Andre C. Barato

    2016-12-01

    Full Text Available Brownian clocks are biomolecular networks that can count time. A paradigmatic example are proteins that go through a cycle, thus regulating some oscillatory behavior in a living system. Typically, such a cycle requires free energy often provided by ATP hydrolysis. We investigate the relation between the precision of such a clock and its thermodynamic costs. For clocks driven by a constant thermodynamic force, a given precision requires a minimal cost that diverges as the uncertainty of the clock vanishes. In marked contrast, we show that a clock driven by a periodic variation of an external protocol can achieve arbitrary precision at arbitrarily low cost. This result constitutes a fundamental difference between processes driven by a fixed thermodynamic force and those driven periodically. As a main technical tool, we map a periodically driven system with a deterministic protocol to one subject to an external protocol that changes in stochastic time intervals, which simplifies calculations significantly. In the nonequilibrium steady state of the resulting bipartite Markov process, the uncertainty of the clock can be deduced from the calculable dispersion of a corresponding current.

  9. Cost and Precision of Brownian Clocks

    Science.gov (United States)

    Barato, Andre C.; Seifert, Udo

    2016-10-01

    Brownian clocks are biomolecular networks that can count time. A paradigmatic example are proteins that go through a cycle, thus regulating some oscillatory behavior in a living system. Typically, such a cycle requires free energy often provided by ATP hydrolysis. We investigate the relation between the precision of such a clock and its thermodynamic costs. For clocks driven by a constant thermodynamic force, a given precision requires a minimal cost that diverges as the uncertainty of the clock vanishes. In marked contrast, we show that a clock driven by a periodic variation of an external protocol can achieve arbitrary precision at arbitrarily low cost. This result constitutes a fundamental difference between processes driven by a fixed thermodynamic force and those driven periodically. As a main technical tool, we map a periodically driven system with a deterministic protocol to one subject to an external protocol that changes in stochastic time intervals, which simplifies calculations significantly. In the nonequilibrium steady state of the resulting bipartite Markov process, the uncertainty of the clock can be deduced from the calculable dispersion of a corresponding current.

  10. Network features of the mammalian circadian clock.

    Directory of Open Access Journals (Sweden)

    Julie E Baggs

    2009-03-01

    Full Text Available The mammalian circadian clock is a cell-autonomous system that drives oscillations in behavior and physiology in anticipation of daily environmental change. To assess the robustness of a human molecular clock, we systematically depleted known clock components and observed that circadian oscillations are maintained over a wide range of disruptions. We developed a novel strategy termed Gene Dosage Network Analysis (GDNA in which small interfering RNA (siRNA-induced dose-dependent changes in gene expression were used to build gene association networks consistent with known biochemical constraints. The use of multiple doses powered the analysis to uncover several novel network features of the circadian clock, including proportional responses and signal propagation through interacting genetic modules. We also observed several examples where a gene is up-regulated following knockdown of its paralog, suggesting the clock network utilizes active compensatory mechanisms rather than simple redundancy to confer robustness and maintain function. We propose that these network features act in concert as a genetic buffering system to maintain clock function in the face of genetic and environmental perturbation.

  11. Do Caucasian and Asian clocks tick differently?

    Directory of Open Access Journals (Sweden)

    A.A. Barbosa

    2010-01-01

    Full Text Available The Period 3 and Clock genes are important components of the mammalian molecular circadian system. Studies have shown association between polymorphisms in these clock genes and circadian phenotypes in different populations. Nevertheless, differences in the pattern of allele frequency and genotyping distribution are systematically observed in studies with different ethnic groups. To investigate and compare the pattern of distribution in a sample of Asian and Caucasian populations living in Brazil, we evaluated two well-studied polymorphisms in the clock genes: a variable number of tandem repeats (VNTR in PER3 and a single nucleotide polymorphism (SNP in CLOCK. The aim of this investigation was to search for clues about human evolutionary processes related to circadian rhythms. We selected 109 Asian and 135 Caucasian descendants. The frequencies of the shorter allele (4 repeats in the PER3 gene and the T allele in the CLOCK gene among Asians (0.86 and 0.84, respectively were significantly higher than among Caucasians (0.69 and 0.71, respectively. Our results directly confirmed the different distribution of these polymorphisms between the Asian and Caucasian ethnic groups. Given the genetic differences found between groups, two points became evident: first, ethnic variations may have implications for the interpretation of results in circadian rhythm association studies, and second, the question may be raised about which evolutionary conditions shaped these genetic clock variations.

  12. Clock genes control cortical critical period timing.

    Science.gov (United States)

    Kobayashi, Yohei; Ye, Zhanlei; Hensch, Takao K

    2015-04-08

    Circadian rhythms control a variety of physiological processes, but whether they may also time brain development remains largely unknown. Here, we show that circadian clock genes control the onset of critical period plasticity in the neocortex. Within visual cortex of Clock-deficient mice, the emergence of circadian gene expression was dampened, and the maturation of inhibitory parvalbumin (PV) cell networks slowed. Loss of visual acuity in response to brief monocular deprivation was concomitantly delayed and rescued by direct enhancement of GABAergic transmission. Conditional deletion of Clock or Bmal1 only within PV cells recapitulated the results of total Clock-deficient mice. Unique downstream gene sets controlling synaptic events and cellular homeostasis for proper maturation and maintenance were found to be mis-regulated by Clock deletion specifically within PV cells. These data demonstrate a developmental role for circadian clock genes outside the suprachiasmatic nucleus, which may contribute mis-timed brain plasticity in associated mental disorders. Copyright © 2015 Elsevier Inc. All rights reserved.

  13. Modeling the mammalian circadian clock

    Science.gov (United States)

    Jolley, Craig; Ueda, Hiroki

    2012-02-01

    In biology, important processes often depend on a temporal schedule. The 24-hour periodicity of solar illumination caused by the earth's rotation has consequences for environmental factors such as temperature and humidity as well as ecological factors such as the presence of food, predators, or potential mates. As a result, many organisms have evolved to develop a circadian clock that allows them to anticipate these environmental changes in the absence of direct temporal cues. In recent years, extensive efforts have been made to deconstruct the biological clockwork from various organisms, develop mathematical models of circadian function, and construct synthetic analogues to test our understanding. My present work has two major foci. First, we have used regulatory principles revealed by recent experimental work to construct a model of the core genetic oscillator of the mammalian circadian system that captures key system-level behaviors. Second, we are exploring the possibility of a post-translational phosphorylation-based oscillator that is coupled to the core oscillator, conferring enhanced robustness and stability on the complete system. A simple model of this post-translational oscillator reveals key design constraints that must be satisfied by any such oscillator.

  14. [The methods within the evaluation of disease management programmes in control-group designs using the example of diabetes mellitus - a systematic literature review].

    Science.gov (United States)

    Drabik, A; Sawicki, P T; Müller, D; Passon, A; Stock, S

    2012-08-01

    Disease management programmes (DMPs) were implemented in Germany in 2002. Their evaluation is required by law. Beyond the mandatory evaluation, a growing number of published studies evaluate the DMP for diabetes mellitus type 2 in a control-group design. As patients opt into the programme on a voluntary basis it is necessary to adjust the inherent selection bias between groups. The aim of this study is to review published studies which evaluate the diabetes DMP using a control-group design with respect to the methods used. A systematic literature review of electronic databases (PUBMED, Cochrane Library, EMBASE, MEDPILOT) and a hand search of reference lists of the relevant publications was conducted to identify studies evaluating the DMP diabetes mellitus in a control-group design. 8 studies were included in the systematic literature review. 4 studies gathered retrospective claims data from sickness funds, one from physician's records, one study used prospective data from ambulatory care, and 2 studies were based on one patient survey. Methods used for adjustment of selection bias included exact matching, matching using propensity score methods, age-adjusted and sex-separated analysis, and adjustment in a regression model/analysis of covariance. One study did not apply adjustment methods. The intervention period ranged from 1 day to 4 years. Considered outcomes of studies (surrogate parameter, diabetes complications, mortality, quality of life, and claim data) depended on the database. In the evaluation of the DMP diabetes mellitus based on a control-group design neither the database nor the methods used for selection bias adjustment were consistent in the available studies. Effectiveness of DMPs cannot be judged based on this review due to heterogeneity of study designs. To allow for a comprehensive programme evaluation standardised minimum requirements for the evaluation of DMPs in the control group design are required. © Georg Thieme Verlag KG Stuttgart · New

  15. Practical assessment of the SWMM programme

    Science.gov (United States)

    Hlustik, P.

    2017-10-01

    The article describes the advantages and disadvantages of the SWMM programme user environment when working with it. The Storm Water Management Model (SWMM) is a programme developed by the U.S. EPA (United States Environmental Protection Agency). The SWMM programme is used worldwide to plan, analyse and design rainfall-runoff, combined and separate sanitary sewage systems and other drainage systems in urban areas [1]. The programme is freely available to download from the U.S. EPA website [2].

  16. Water management. A core task of the Wismut remediation programme; Kernaufgaben des langfristigen Wassermanagements an den saechsisch-thueringischen Wismut-Standorten

    Energy Technology Data Exchange (ETDEWEB)

    Paul, Michael; Meyer, Juergen; Jenk, Ulf; Kassahun, Andrea; Schramm, Andrea; Baacke, Delf; Forbrig, Norbert; Metschies, Thomas [Wismut GmbH, Chemnitz (Germany). Bereich Ingenieurwesen/Strahlenschutz

    2015-07-01

    Water management and conventional technical water treatment are by far the most cost-intensive long-term tasks of the Wismut remediation programme. Over the medium term, there is no viable alternative to the operation of active systems to catch and treat contaminated mine waters at the Ronneburg, Schlema, Koenigstein, Poehla, Seelingstaedt and Heimsdorf sites. Based on the status quo this paper outlines the key issues of the Wismut GmbH water management strategy over the medium and long term. lt is focused primarily on achieving protection goals for potentially impacted water bodies in the surroundings of Wismut sites and on optimising associated remediation expenditure as well as on creating the prerequisites for achieving low post-remedial care and maintenance or walk-away system status over the long term. The topic of this paper is the presentation of priority tasks related to future water management at Wismut sites in Saxony and Thuringia. The reflections are based on experiences and lessons learned and take into account current statutory management requirements referring to ground and surface water bodies affected by Wismut. The paper is based on a presentation made at the International Mining Symposium WISSYM 2015 on 2nd September 2015 in Bad Schlema, Germany.

  17. Teachers' Facility with Evidence-Based Classroom Management Practices: An Investigation of Teachers' Preparation Programmes and In-Service Conditions

    Science.gov (United States)

    Ficarra, Laura; Quinn, Kevin

    2014-01-01

    In the present investigation, teachers' self-reported knowledge and competency ratings for the evidence-based classroom management practices were analysed. Teachers also reflected on how they learned evidence-based classroom management practices. Results suggest that teachers working in schools that implement Positive Behavioural Interventions and…

  18. The clock in the cell : Entrainment of the circadian clock in Neurospora crassa

    NARCIS (Netherlands)

    Madeti Jyothi-Boesl, Cornelia

    2008-01-01

    Since reports of daily leaf movements 2000 years ago, a so-called circadian clock (‘circa diem’ meaning ‘about a day’) has been described in organisms from almost all phyla. The work presented in this thesis gives special emphasis on the circadian clock in the fungus Neurospora crassa, a rather

  19. The effectiveness of a multidisciplinary pain management programme managing chronic pain on pain perceptions, health-related quality of life and stages of change--A non-randomized controlled study.

    Science.gov (United States)

    Dysvik, Elin; Kvaløy, Jan Terje; Stokkeland, Ragnhild; Natvig, Gerd Karin

    2010-07-01

    Cognitive behavioural therapy (CBT) has been useful in the treatment of chronic pain conditions for many years. Given the increasing number of persons with chronic pain and associated psychosocial problems, the development and implementation of effective interventions based on CBT is warranted. The aim of this study is to evaluate the effects of a multidisciplinary pain management programme on health-related quality of life (HRQL), as measured by the Short Form Health Survey (SF-36), pain perception as measured by the Brief Pain Inventory (BPI), and readiness-to-change as measured by the Pain Stages of Change Questionnaire (PSOCQ). A pretest-post-test quasi-experimental design, with waiting list controls and baseline and post-test measures, was used. The study was conducted in the rehabilitation unit of a university hospital. Of 117 people suffering from chronic pain, 113 completed the 8-week multidisciplinary pain management programme. The patients were consecutive referrals. Inclusion criteria were: adults (18-67 years), pain lasting over 6 months, motivation and no ongoing litigation. Exclusion criteria were affected by major mental disorders or major medical conditions requiring treatment. The intervention was based on a cognitive behavioural approach. Therapeutic dialogues and training, combined with physical activity, were provided to a fixed plan, including homework. The programme has several features that directly address psychosocial aspects of chronic pain. Statistical and clinical significance are considered. The findings suggest that this programme has the potential to improve HRQL, reduce pain intensity and interference, and contribute to improvement in readiness-to-change. Statistically significant results are supplemented by results showing their clinical significance. Improvements in HRQL, pain-related disability, and readiness-to-change suggest that the vicious cycle of chronic pain may be alleviated by our programme. As we see it, effective

  20. Evaluation of an international educational programme for health care professionals on best practice in the management of a perinatal death: IMproving Perinatal mortality Review and Outcomes Via Education (IMPROVE).

    Science.gov (United States)

    Gardiner, Paul A; Kent, Alison L; Rodriguez, Viviana; Wojcieszek, Aleena M; Ellwood, David; Gordon, Adrienne; Wilson, Patricia A; Bond, Diana M; Charles, Adrian; Arbuckle, Susan; Gardener, Glenn J; Oats, Jeremy J; Erwich, Jan Jaap; Korteweg, Fleurisca J; Duc, T H Nguyen; Leisher, Susannah Hopkins; Kishore, Kamal; Silver, Robert M; Heazell, Alexander E; Storey, Claire; Flenady, Vicki

    2016-11-25

    Stillbirths and neonatal deaths are devastating events for both parents and clinicians and are global public health concerns. Careful clinical management after these deaths is required, including appropriate investigation and assessment to determine cause (s) to prevent future losses, and to improve bereavement care for families. An educational programme for health care professionals working in maternal and child health has been designed to address these needs according to the Perinatal Society of Australia and New Zealand Guideline for Perinatal Mortality: IMproving Perinatal mortality Review and Outcomes Via Education (IMPROVE). The programme has a major focus on stillbirth and is delivered as six interactive skills-based stations. We aimed to determine participants' pre- and post-programme knowledge of and confidence in the management of perinatal deaths, along with satisfaction with the programme. We also aimed to determine suitability for international use. The IMPROVE programme was delivered to health professionals in maternity hospitals in all seven Australian states and territories and modified for use internationally with piloting in Vietnam, Fiji, and the Netherlands (with the assistance of the International Stillbirth Alliance, ISA). Modifications were made to programme materials in consultation with local teams and included translation for the Vietnam programme. Participants completed pre- and post-programme evaluation questionnaires on knowledge and confidence on six key components of perinatal death management as well as a satisfaction questionnaire. Over the period May 2012 to May 2015, 30 IMPROVE workshops were conducted, including 26 with 758 participants in Australia and four with 136 participants internationally. Evaluations showed a significant improvement between pre- and post-programme knowledge and confidence in all six stations and overall, and a high degree of satisfaction in all settings. The IMPROVE programme has been well received in

  1. The Circadian Clock Mutation Promotes Intestinal Dysbiosis.

    Science.gov (United States)

    Voigt, Robin M; Summa, Keith C; Forsyth, Christopher B; Green, Stefan J; Engen, Phillip; Naqib, Ankur; Vitaterna, Martha H; Turek, Fred W; Keshavarzian, Ali

    2016-02-01

    Circadian rhythm disruption is a prevalent feature of modern day society that is associated with an increase in pro-inflammatory diseases, and there is a clear need for a better understanding of the mechanism(s) underlying this phenomenon. We have previously demonstrated that both environmental and genetic circadian rhythm disruption causes intestinal hyperpermeability and exacerbates alcohol-induced intestinal hyperpermeability and liver pathology. The intestinal microbiota can influence intestinal barrier integrity and impact immune system function; thus, in this study, we sought to determine whether genetic alteration of the core circadian clock gene, Clock, altered the intestinal microbiota community. Male Clock(Δ19) -mutant mice (mice homozygous for a dominant-negative-mutant allele) or littermate wild-type mice were fed 1 of 3 experimental diets: (i) a standard chow diet, (ii) an alcohol-containing diet, or (iii) an alcohol-control diet in which the alcohol calories were replaced with dextrose. Stool microbiota was assessed with 16S ribosomal RNA gene amplicon sequencing. The fecal microbial community of Clock-mutant mice had lower taxonomic diversity, relative to wild-type mice, and the Clock(Δ19) mutation was associated with intestinal dysbiosis when mice were fed either the alcohol-containing or the control diet. We found that alcohol consumption significantly altered the intestinal microbiota in both wild-type and Clock-mutant mice. Our data support a model by which circadian rhythm disruption by the Clock(Δ19) mutation perturbs normal intestinal microbial communities, and this trend was exacerbated in the context of a secondary dietary intestinal stressor. Copyright © 2016 by the Research Society on Alcoholism.

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

    Science.gov (United States)

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

    2013-01-01

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

  3. Programme driven music radio

    OpenAIRE

    Hayes, Conor; Cunningham, Padraig; Clerkin, Patrick; Grimaldi, Marco

    2002-01-01

    This paper describes the operation of and research behind a networked application for the delivery of personalised streams of music at Trinity College Dublin. Smart Radio is a web based client-server application that uses streaming audio technology and recommendation techniques to allow users build, manage and share music programmes. While it is generally acknowledged that music distribution over the web will dramatically change how the music industry operates, there are ...

  4. Technology Programme

    Energy Technology Data Exchange (ETDEWEB)

    Batistoni, Paola; De Marco, Francesco; Pieroni, Leonardo (ed.)

    2005-07-01

    The technology activities carried out by the Euratom-ENEA Association in the framework of the European Fusion Development Agreement concern the Next Step (International Thermonuclear Experimental Reactor - ITER), the Long-Term Programme (breeder blanket, materials, International Fusion Materials Irradiation Facility - IFMIF), Power Plant Conceptual Studies and Socio-Economic Studies. The Underlying Technology Programme was set up to complement the fusion activities as well to develop technologies with a wider range of interest. The Technology Programme mainly involves staff from the Frascati laboratories of the Fusion Technical and Scientific Unit and from the Brasimone laboratories of the Advanced Physics Technologies Unit. Other ENEA units also provide valuable contributions to the programme. ENEA is heavily engaged in component development/testing and in design and safety activities for the European Fusion Technology Programme. Although the work documented in the following covers a large range of topics that differ considerably because they concern the development of extremely complex systems, the high level of integration and coordination ensures the capability to cover the fusion system as a whole. In 2004 the most significant testing activities concerned the ITER primary beryllium-coated first wall. In the field of high-heat-flux components, an important achievement was the qualification of the process for depositing a copper liner on carbon fibre composite (CFC) hollow tiles. This new process, pre-brazed casting (PBC), allows the hot radial pressing (HRP) joining procedure to be used also for CFC-based armour monoblock divertor components. The PBC and HRP processes are candidates for the construction of the ITER divertor. In the materials field an important milestone was the commissioning of a new facility for chemical vapour infiltration/deposition, used for optimising silicon carbide composite (SiCf/SiC) components. Eight patents were deposited during 2004

  5. The Cardiomyopathy Registry of the EURObservational Research Programme of the European Society of Cardiology: baseline data and contemporary management of adult patients with cardiomyopathies.

    Science.gov (United States)

    Charron, Philippe; Elliott, Perry M; Gimeno, Juan R; Caforio, Alida L P; Kaski, Juan Pablo; Tavazzi, Luigi; Tendera, Michal; Maupain, Carole; Laroche, Cécile; Rubis, Pawel; Jurcut, Ruxandra; Calò, Leonardo; Heliö, Tiina M; Sinagra, Gianfranco; Zdravkovic, Marija; Kavoliuniene, Aušra; Felix, Stephan B; Grzybowski, Jacek; Losi, Maria-Angela; Asselbergs, Folkert W; García-Pinilla, José Manuel; Salazar-Mendiguchia, Joel; Mizia-Stec, Katarzyna; Maggioni, Aldo P

    2018-01-24

    The Cardiomyopathy Registry of the EURObservational Research Programme is a prospective, observational, and multinational registry of consecutive patients with four cardiomyopathy subtypes: hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), arrhythmogenic right ventricular cardiomyopathy (ARVC), and restrictive cardiomyopathy (RCM). We report the baseline characteristics and management of adults enrolled in the registry. A total of 3208 patients were enrolled by 69 centres in 18 countries [HCM (n = 1739); DCM (n = 1260); ARVC (n = 143); and RCM (n = 66)]. Differences between cardiomyopathy subtypes (P diagnosis, history of familial disease, history of sustained ventricular arrhythmia, use of magnetic resonance imaging or genetic testing, and implantation of defibrillators. When compared with probands, relatives had a lower age at diagnosis (P cardiomyopathies, the registry provides a platform for the evaluation of guideline implementation. Potential gaps with existing recommendations are discussed as well as some suggestions for improvement of health care provision in Europe.

  6. Efficacy of Tailored Physical Activity or Chronic Pain Self-Management Programme on return to work for sick-listed citizens

    DEFF Research Database (Denmark)

    Andersen, Lotte Nygaard; Juul-Kristensen, Birgit; Sørensen, Thomas Lund

    2015-01-01

    OBJECTIVES: The aim was to evaluate the efficacy of 'Tailored Physical Activity' (TPA) and a 'Chronic Pain Self-management Programme' (CPSMP) compared with a reference group (REF) on return to work after 3 months as sick-listed citizens with pain related to the back or the upper body. METHODS....... In contrast, no benefit of TPA and CPSMP was evident regarding work ability, kinesiophobia or physical capacity after 3 months of follow-up. CONCLUSIONS: The results suggest that TPA is a promising intervention to facilitate return to work and reduce pain among sick-listed citizens with pain related......: Using a randomised controlled trial design all participants (n= 141) received health guidance for 1.5 hours and were randomised to TPA, CPSMP or REF. Characteristics of participants were collected from a questionnaire. The primary endpoint was proportion of participants returned to work as registered...

  7. Delivering the diabetes education and self management for ongoing and newly diagnosed (DESMOND) programme for people with newly diagnosed type 2 diabetes

    DEFF Research Database (Denmark)

    Gillett, M.; Dallosso, H. M.; Dixon, S.

    2010-01-01

    data from a 12 month, multicentre, cluster randomised controlled trial and, using the Sheffield type 2 diabetes model, modelled long term outcomes in terms of use of therapies, incidence of complications, mortality, and associated effect on costs and health related quality of life. A further cost...... programme delivered in the community by two professional healthcare educators. Main outcome measures: Incremental costs and quality adjusted life years (QALYs) gained. Results: On the basis of the data in the trial, the estimated mean incremental lifetime cost per person receiving the DESMOND intervention......Objectives: To assess the long term clinical and cost effectiveness of the diabetes education and self management for ongoing and newly diagnosed (DESMOND) intervention compared with usual care in people with newly diagnosed type 2 diabetes. Design: We undertook a cost-utility analysis that used...

  8. Testing measurement invariance of the learning programme management and evaluation (LPME scale across gender using multi-group confirmatory factor analysis

    Directory of Open Access Journals (Sweden)

    Maelekanyo C. Tshilongamulenzhe

    2015-05-01

    Full Text Available The purpose of this study was to test measurement invariance of the LPME scale across gender using multi-group CFA. The LPME scale was developed to measure the effectiveness of management and evaluation practices pertaining to occupational learning programmes in the South African skills development context. A non-experimental cross-sectional survey was conducted with 389 human resource practitioners and apprentices/learners. The results indicate that the LPME scale is invariant between males and females at the levels of configural, metric and strong invariance. The number of factors/constructs, pattern of item factor loading, latent constructs variances and covariances, and the reliability of the LPME scale and its dimensions are equivalent between males and females

  9. Phase II randomised controlled trial of a 6-month self-managed community exercise programme for people with Parkinson's disease.

    Science.gov (United States)

    Collett, Johnny; Franssen, Marloes; Meaney, Andy; Wade, Derick; Izadi, Hooshang; Tims, Martin; Winward, Charlotte; Bogdanovic, Marko; Farmer, Andrew; Dawes, Helen

    2017-03-01

    Evidence for longer term exercise delivery for people with Parkinson's disease (PwP) is deficient. Evaluate safety and adherence to a minimally supported community exercise intervention and estimate effect sizes (ES). 2-arm parallel phase II randomised controlled trial with blind assessment. PwP able to walk ≥100 m and with no contraindication to exercise were recruited from the Thames valley, UK, and randomised (1:1) to intervention (exercise) or control (handwriting) groups, via a concealed computer-generated list. Groups received a 6-month, twice weekly programme. Exercise was undertaken in community facilities (30 min aerobic and 30 min resistance) and handwriting at home, both were delivered through workbooks with monthly support visits. Primary outcome was a 2 min walk, with motor symptoms (Movement Disorder Society Unified Parkinson's Disease Rating Scale, MDS-UPDRS III), fitness, health and well-being measured. Between December 2011 and August 2013, n=53 (n=54 analysed) were allocated to exercise and n=52 (n=51 analysed) to handwriting. N=37 adhered to the exercise, most attending ≥1 session/week. Aerobic exercise was performed in 99% of attended sessions and resistance in 95%. Attrition and adverse events (AEs) were similar between groups, no serious AEs (n=2 exercise, n=3 handwriting) were related, exercise group-related AEs (n=2) did not discontinue intervention. Largest effects were for motor symptoms (2 min walk ES=0.20 (95% CI -0.44 to 0.45) and MDS-UPDRS III ES=-0.30 (95% CI 0.07 to 0.54)) in favour of exercise over the 12-month follow-up period. Some small effects were observed in fitness and well-being measures (ES>0.1). PwP exercised safely and the possible long-term benefits observed support a substantive evaluation of this community programme. NCT01439022. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

  10. Circadian clock genes in Drosophila: recent developments.

    Science.gov (United States)

    Subramanian, P; Balamurugan, E; Suthakar, G

    2003-08-01

    Circadian rhythms provide a temporal framework to living organisms and are established in a majority of eukaryotes and in a few prokaryotes. The molecular mechanisms of circadian clock is constantly being investigated in Drosophila melanogaster. The core of the clock mechanism was described by a transcription-translation feedback loop model involving period (per), timeless (tim), dclock and cycle genes. However, recent research has identified multiple feedback loops controlling rhythm generation and expression. Novel mutations of timeless throw more light on the functions of per and tim products. Analysis of pdf neuropeptide gene (expressed in circadian pacemaker cells in Drosophila), indicate that PDF acts as the principal circadian transmitter and is involved in output pathways. The product of cryptochrome is known to function as a circadian photoreceptor as well as component of the circadian clock. This review focuses on the recent progress in the field of molecular rhythm research in the fruit fly. The gene(s) and the gene product(s) that are involved in the transmission of environmental information to the clock, as well as the timing signals from the clock outward to cellular functions are remain to be determined.

  11. Feasibility of an optical fiber clock

    Science.gov (United States)

    Ilinova, Ekaterina; Babb, James F.; Derevianko, Andrei

    2017-09-01

    We explore the feasibility of a fiber clock, i.e., a compact, high-precision, optical lattice atomic clock based on atoms trapped inside a hollow-core optical fiber. Such a setup offers an intriguing potential both for a substantially increased number of interrogated atoms (and thereby an improved clock stability) and for miniaturization. We evaluate the sensitivity of the 1S0-3P0 clock transition in Hg and other divalent atoms to the fiber inner core surface at nonzero temperatures. The Casimir-Polder interaction induced 1S0-3P0 transition frequency shift is calculated for the atom inside the hollow capillary as a function of atomic position, capillary material, and geometric parameters. For Hg atoms on the axis of a silica capillary with inner radius ≥15 μ m and optimally chosen thickness d ˜1 μ m , the atom-surface interaction induced 1S0-3P0 clock transition frequency shift can be kept on the level δ ν /νHg˜10-19 . We also estimate the atom loss and heating due to collisions with the buffer gas, lattice intensity noise induced heating, spontaneous photon scattering heating, and residual birefringence induced frequency shifts.

  12. Dating phylogenies with hybrid local molecular clocks.

    Directory of Open Access Journals (Sweden)

    Stéphane Aris-Brosou

    Full Text Available BACKGROUND: Because rates of evolution and species divergence times cannot be estimated directly from molecular data, all current dating methods require that specific assumptions be made before inferring any divergence time. These assumptions typically bear either on rates of molecular evolution (molecular clock hypothesis, local clocks models or on both rates and times (penalized likelihood, Bayesian methods. However, most of these assumptions can affect estimated dates, oftentimes because they underestimate large amounts of rate change. PRINCIPAL FINDINGS: A significant modification to a recently proposed ad hoc rate-smoothing algorithm is described, in which local molecular clocks are automatically placed on a phylogeny. This modification makes use of hybrid approaches that borrow from recent theoretical developments in microarray data analysis. An ad hoc integration of phylogenetic uncertainty under these local clock models is also described. The performance and accuracy of the new methods are evaluated by reanalyzing three published data sets. CONCLUSIONS: It is shown that the new maximum likelihood hybrid methods can perform better than penalized likelihood and almost as well as uncorrelated Bayesian models. However, the new methods still tend to underestimate the actual amount of rate change. This work demonstrates the difficulty of estimating divergence times using local molecular clocks.

  13. Advancing the application of systems thinking in health: realist evaluation of the Leadership Development Programme for district manager decision-making in Ghana.

    Science.gov (United States)

    Kwamie, Aku; van Dijk, Han; Agyepong, Irene Akua

    2014-06-16

    Although there is widespread agreement that strong district manager decision-making improves health systems, understanding about how the design and implementation of capacity-strengthening interventions work is limited. The Ghana Health Service has adopted the Leadership Development Programme (LDP) as one intervention to support the development of management and leadership within district teams. This paper seeks to address how and why the LDP 'works' when it is introduced into a district health system in Ghana, and whether or not it supports systems thinking in district teams. We undertook a realist evaluation to investigate the outcomes, contexts, and mechanisms of the intervention. Building on two working hypotheses developed from our earlier work, we developed an explanatory case study of one rural district in the Greater Accra Region of Ghana. Data collection included participant observation, document review, and semi-structured interviews with district managers prior to, during, and after the intervention. Working backwards from an in-depth analysis of the context and observed short- and medium-term outcomes, we drew a causal loop diagram to explain interactions between contexts, outcomes, and mechanisms. The LDP was a valuable experience for district managers and teams were able to attain short-term outcomes because the novel approach supported teamwork, initiative-building, and improved prioritisation. However, the LDP was not institutionalised in district teams and did not lead to increased systems thinking. This was related to the context of high uncertainty within the district, and hierarchical authority of the system, which triggered the LDP's underlying goal of organisational control. Consideration of organisational context is important when trying to sustain complex interventions, as it seems to influence the gap between short- and medium-term outcomes. More explicit focus on systems thinking principles that enable district managers to better cope with

  14. Supporting self-management after attending a structured education programme: a qualitative longitudinal investigation of type 1 diabetes patients’ experiences and views

    Directory of Open Access Journals (Sweden)

    Rankin David

    2012-08-01

    Full Text Available Abstract Background Structured education programmes for patients with diabetes and other chronic conditions are being widely adopted. However, follow-up studies suggest that course graduates may struggle to sustain the self-care practices taught on their courses over time. This study explored the support needs of patients with type 1 diabetes after attending a structured education programme promoting an empowerment approach and training in use of flexible intensive insulin therapy, a regimen now widely advocated and used to manage this condition. The objective was to inform future support offered to course graduates. Methods Repeat, in-depth interviews with 30 type 1 diabetes patients after attending Dose Adjustment for Normal Eating (DAFNE courses in the UK, and six and 12 months later. Data were analysed using an inductive, thematic approach. Results While the flexible intensive insulin treatment approach taught on DAFNE courses was seen as a logical and effective way of managing one’s diabetes, it was also considered more technically complex than other insulin regimens. To sustain effective disease self-management using flexible intensive insulin treatment over time, patients often expected, and needed, on-going input and support from health care professionals trained in the approach. This included: help determining insulin dose adjustments; reassurance; and, opportunities to trouble-shoot issues of concern. While some benefits were identified to receiving follow-up support in a group setting, most patients stated a preference or need for tailored and individualised support from appropriately-trained clinicians, accessible on an ‘as and when needed’ basis. Conclusions Our findings highlight potential limitations to group-based forms of follow-up support for sustaining diabetes self-management. To maintain the clinical benefits of structured education for patients with type 1 diabetes over time, course graduates may benefit from and

  15. The Roadmap from Quality Assurance in Programmes and Teaching towards Quality Development as a Strategic Instrument of University Management

    Directory of Open Access Journals (Sweden)

    Bianka Lichtenberger

    2013-12-01

    Full Text Available An inflation of publicly formulated expectations and requirements with regard to instruments and methods for preparing, securing and monitoring research and teaching quality as well as the quality of the management of higher education give the impression of an overload of quality management and thus a new “quality of bureaucracy”. Behind it appears at a first glance an in transparent and confusing puzzle of highly diverse procedures which are subsumed under the term quality management. The cause of this development can be seen in the context of the Bologna process and the Lisbon strategy, which has defined development and control of a high quality in teaching and research as a central success factor in the implementation of higher education policy reforms and as an organizational obligation for Higher Education Institutions.

  16. Design and Construction of a Talking Clock | Okosun | Journal of the ...

    African Journals Online (AJOL)

    Most of the time-measuring instruments which have been developed give information about time visually. This denies the visually impaired the ability to keep track of time and as such makes him unable to manage time. This paper presents a design and construction of a Talking Clock. The design incorporates both audio ...

  17. Evolutionary links between circadian clocks and photoperiodic diapause in insects.

    Science.gov (United States)

    Meuti, Megan E; Denlinger, David L

    2013-07-01

    In this article, we explore links between circadian clocks and the clock involved in photoperiodic regulation of diapause in insects. Classical resonance (Nanda-Hamner) and night interruption (Bünsow) experiments suggest a circadian basis for the diapause response in nearly all insects that have been studied. Neuroanatomical studies reveal physical connections between circadian clock cells and centers controlling the photoperiodic diapause response, and both mutations and knockdown of clock genes with RNA interference (RNAi) point to a connection between the clock genes and photoperiodic induction of diapause. We discuss the challenges of determining whether the clock, as a functioning module, or individual clock genes acting pleiotropically are responsible for the photoperiodic regulation of diapause, and how a stable, central circadian clock could be linked to plastic photoperiodic responses without compromising the clock's essential functions. Although we still lack an understanding of the exact mechanisms whereby insects measure day/night length, continued classical and neuroanatomical approaches, as well as forward and reverse genetic experiments, are highly complementary and should enable us to decipher the diverse ways in which circadian clocks have been involved in the evolution of photoperiodic induction of diapause in insects. The components of circadian clocks vary among insect species, and diapause appears to have evolved independently numerous times, thus, we anticipate that not all photoperiodic clocks of insects will interact with circadian clocks in the same fashion.

  18. Sugars, the clock and transition to flowering

    Directory of Open Access Journals (Sweden)

    Mohammad Reza eBolouri Moghaddam

    2013-02-01

    Full Text Available Sugars do not only act as source of energy, but they also act as signals in plants. This mini review summarizes the emerging links between sucrose-mediated signaling and the cellular networks involved in flowering time control and defense. Cross-talks with gibberellin (GA and jasmonate (JA signaling pathways are highlighted. The circadian clock fulfills a crucial role at the heart of cellular networks and the bilateral relation between sugar signaling and the clock is discussed. It is proposed that important factors controlling plant growth (DELLAs, PIFs, invertases and trehalose- 6-phosphate or T6P might fulfill central roles in the transition to flowering as well. The emerging concept of ‘sweet immunity’, modulated by the clock, might at least partly rely on a sucrose-specific signaling pathway that needs further exploration.

  19. A 5 Gb/s low area CDR for embedded clock serial links

    Science.gov (United States)

    You, Li; Junsheng, Lü; Yumei, Zhou; Jianzhong, Zhao; Yuhu, Chen; Feng, Zhang

    2015-02-01

    A multi-standard compatible clock and data recovery circuit (CDR) with a programmable equalizer and wide tracking range is presented. Considering the jitter performance, tracking range and chip area, the CDR employs a first-order digital loop filter, two 6-bit DACs and high linearity phase interpolators to achieve high phase resolution and low area. Meanwhile the tracking range is greater than ±2200 ppm, making this proposed CDR suitable for the embedded clock serial links. A test chip was fabricated in the 55 nm CMOS process. The measurements show that the test chip can achieve BER < 10-12 and meet the jitter tolerance specification. The test chip occupies 0.19 mm2 with a 0.0486 mm2 CDR core, which only consumes 30 mW from a 1.2 V supply at 5 Gb/s.

  20. The development and pilot testing of the Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease (SPACE for COPD

    Directory of Open Access Journals (Sweden)

    Apps LD

    2013-07-01

    Full Text Available Lindsay D Apps,1 Katy E Mitchell,1 Samantha L Harrison,1 Louise Sewell,1 Johanna E Williams,1 Hannah ML Young,1 Michael Steiner,1 Mike Morgan,1 Sally J Singh1,2 1National Institute of Health Research CLAHRC-LNR Pulmonary Rehabilitation Research Group, University Hospitals of Leicester NHS, Leicester, UK; 2Applied Research Centre, Health and Lifestyle Interventions, Coventry University, Coventry, UK Purpose: There is no independent standardized self-management approach available for chronic obstructive pulmonary disease (COPD. The aim of this project was to develop and test a novel self-management manual for individuals with COPD. Patients: Participants with a confirmed diagnosis of COPD were recruited from primary care. Methods: A novel self-management manual was developed with health care professionals and patients. Five focus groups were conducted with individuals with COPD (N = 24 during development to confirm and enhance the content of the prototype manual. The Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease (SPACE for COPD manual was developed as the focus of a comprehensive self-management approach facilitated by health care professionals. Preference for delivery was initial face-to-face consultation with telephone follow-up. The SPACE for COPD manual was piloted with 37 participants in primary care. Outcome measures included the Self-Report Chronic Respiratory Questionnaire, Incremental Shuttle Walk Test, and Endurance Shuttle Walking Test (ESWT; measurements were taken at baseline and 6 weeks. Results: The pilot study observed statistically significant improvements for the dyspnea domain of the Self-Report Chronic Respiratory Questionnaire and ESWT. Dyspnea showed a mean change of 0.67 (95% confidence interval 0.23–1.11, P = 0.005. ESWT score increased by 302.25 seconds (95% confidence interval 161.47–443.03, P < 0.001. Conclusion: This article describes the development and

  1. Susceptibility of Redundant Versus Singular Clock Domains Implemented in SRAM-Based FPGA TMR Designs

    Science.gov (United States)

    Berg, Melanie D.; LaBel, Kenneth A.; Pellish, Jonathan

    2016-01-01

    We present the challenges that arise when using redundant clock domains due to their clock-skew. Radiation data show that a singular clock domain (DTMR) provides an improved TMR methodology for SRAM-based FPGAs over redundant clocks.

  2. Sex differences in self-reported symptoms after aerobic exercise in non-injured athletes: implications for concussion management programmes.

    Science.gov (United States)

    Gaetz, M B; Iverson, G L

    2009-07-01

    After a concussion, when symptoms have decreased substantially at rest, it is recommended that athletes begin light aerobic exercise before progressing to sport specific exercise. The British Columbia Concussion Rehabilitation Programme (BC-CRP) uses a standardized cognitive and exercise test protocol designed to indicate when an athlete should progress to sport-specific exercise after a concussion. To document the effects of exercise on symptom reporting in healthy, uninjured, male and female amateur athletes. Quasi-experimental, pretest-post-test, nonequivalent groups design. Before the exercise protocol, 45 female and 30 male young amateur athletes completed computerized cognitive testing, symptom ratings and balance testing. The 15-minute cycle ergometry protocol, conducted at 90 revolutions/minute, was as follows: 0-2 minutes at 0 W tension, 2-5 minutes at 50 W, 5-8 minutes at 100 W, 8-11 minutes at 150 W and 11-14 minutes at 200 W tension followed by a 1-minute cooling-down period. After exercise, participants completed symptom ratings, balance testing and perceived exertion ratings. Self-reported symptoms were assessed using an abbreviated version of the Post-Concussion Scale. Significant increases in self-reported balance problems, numbness and tingling were seen for both genders after aerobic exercise. For women, emotional symptoms such as irritability, sadness, nervousness and feeling more emotional decreased significantly after aerobic exercise. Headache also decreased in the women, but no significant change was seen in the men. Sex differences exist for symptom reporting after aerobic exercise. Both genders report increases in somatic symptoms, but only women report decreases in emotional symptoms. The concept of being "asymptomatic" after exercise should be reconsidered to include expected mild increases and decreases in certain symptoms.

  3. Effective management of exposure keratopathy developed in intensive care units: the impact of an evidence based eye care education programme.

    Science.gov (United States)

    Demirel, Soner; Cumurcu, Tongabay; Fırat, Penpegül; Aydogan, Mustafa Said; Doğanay, Selim

    2014-02-01

    To assess the impact of eye care education on the incidence of corneal exposure in intensive care units (ICU). Approximately 300 ICU personnel were educated about eye care to reduce the incidence of corneal exposure. The patients were divided into two groups: pre-training (Group 1: Between February 1, 2011 and March 31, 2011 [2 months]) and post-training periods (Group 2: Between April 1, 2011 and April 1 2012 [1 year]). We compared the groups for keratopathy incidence to evaluate the efficacy of this education. The number of patients were 762 in Group 1 and 6196 in Group 2 (p = 0.335). Medians of patients followed in pre training ICU and post training ICU for each month were found to be 476 (interquartile range, 433-539) and 515 (interquartile range, 490-528). Exposure keratopathy was identified in 8 eyes of 6 patients (3 males and 3 females) in pre training ICU with the mean age of 27.6 ± 31.8 years and 5 eyes of 3 patients (1 male and 2 females) in post training ICU with the mean age of 41.3 ± 32.1 years. No significant difference was noticed between two groups in terms of the medians of patients followed in ICUs for each month (p=0.335). The time of hospitalisation in ICU when the patients were consulted for the first ocular assessment in pre training ICU and post training ICU were found to be 13 ± 8.7 days and 8 ± 1.7 days, respectively. After the training, the decrease in incidence of exposure keratopathy was found to be highly significant (p < 0.001). We observed a highly significant reduction in the incidence of corneal exposure, following the eye-care education programme. Copyright © 2013. Published by Elsevier Ltd.

  4. Enhanced self-efficacy after a self-management programme in pituitary disease: a randomized controlled trial

    NARCIS (Netherlands)

    Andela, C.D.; Repping-Wuts, H.; Stikkelbroeck, N.; Pronk, M.C.; Tiemensma, J.; Hermus, A.R.M.M.; Kaptein, A.A.; Pereira, A.M.; Kamminga, N.G.; Biermasz, N.R.

    2017-01-01

    CONTEXT: Patients with pituitary disease report impairments in Quality of Life (QoL) despite optimal biomedical care. Until now, the effects of a self-management intervention (SMI) addressing psychological and social issues for these patients and their partners have not been studied. OBJECTIVE: To

  5. GPs' role security and therapeutic commitment in managing alcohol problems: a randomised controlled trial of a tailored improvement programme

    NARCIS (Netherlands)

    Keurhorst, M.N.; Beurden, I. van; Anderson, P.D.; Heinen, M.M.; Akkermans, R.P.; Wensing, M.; Laurant, M.G.

    2014-01-01

    BACKGROUND: General practitioners with more positive role security and therapeutic commitment towards patients with hazardous or harmful alcohol consumption are more involved and manage more alcohol-related problems than others. In this study we evaluated the effects of our tailored multi-faceted

  6. Long Term Effects of a Staff Development Programme on Effective Instruction and Classroom Management for Teachers in Multigrade Classes.

    Science.gov (United States)

    Veenman, Simon; Raemaekers, Jan

    1995-01-01

    Presents the findings of a six-year staff development program for multigrade teachers. Discovers a significant increase in the time on task levels of the pupils and the instructional and classroom management skills of the teachers. Discusses the implications of, and problems with, the study. (MJP)

  7. Development of Feeling Better: A web-based pain management programme for children with chronic pain and their parents.

    Directory of Open Access Journals (Sweden)

    Angeline M Traynor

    2015-10-01

    Conclusions: It is feasible to create an evidence-based and theory driven online self-management intervention to support children with chronic pain and their parents. Service users can be involved in the design and conduct of research in a meaningful way. An exploratory trial to test the feasibility of acceptability of Feeling Better is underway.

  8. Home Management and Consumer Education in Rural Development Programmes: Latin America. Nutrition Information Documents Series No. 5.

    Science.gov (United States)

    United Nations Food and Agriculture Organization, Rome (Italy).

    The report represents a preliminary study of a three-month consultantship intended to review field experiences in selected Latin American countries for teaching rural families home management/consumer education concepts and to collect materials based on experiences. A detailed account is presented of the projects visited in Mexico, Argentina, and…

  9. Process Evaluation of "Learn Young, Learn Fair": A Stress Management Programme for 5th and 6th Graders

    Science.gov (United States)

    Kraag, Gerda; Van Breukelen, Gerard; Lamberts, Petra; Vugts, Odette; Kok, Gerjo; Fekkes, Minne; Abu-Saad, Huda Huijer

    2007-01-01

    This article describes the process evaluation of a stress management program called "Learn Young, Learn Fair" for 5th and 6th graders. Studies, reviews and meta-analyses of prevention programs report that a common limitation in studies is the restricted documentation of process factors that contribute to the success of interventions. Program…

  10. Sample-Clock Phase-Control Feedback

    Science.gov (United States)

    Quirk, Kevin J.; Gin, Jonathan W.; Nguyen, Danh H.; Nguyen, Huy

    2012-01-01

    To demodulate a communication signal, a receiver must recover and synchronize to the symbol timing of a received waveform. In a system that utilizes digital sampling, the fidelity of synchronization is limited by the time between the symbol boundary and closest sample time location. To reduce this error, one typically uses a sample clock in excess of the symbol rate in order to provide multiple samples per symbol, thereby lowering the error limit to a fraction of a symbol time. For systems with a large modulation bandwidth, the required sample clock rate is prohibitive due to current technological barriers and processing complexity. With precise control of the phase of the sample clock, one can sample the received signal at times arbitrarily close to the symbol boundary, thus obviating the need, from a synchronization perspective, for multiple samples per symbol. Sample-clock phase-control feedback was developed for use in the demodulation of an optical communication signal, where multi-GHz modulation bandwidths would require prohibitively large sample clock frequencies for rates in excess of the symbol rate. A custom mixedsignal (RF/digital) offset phase-locked loop circuit was developed to control the phase of the 6.4-GHz clock that samples the photon-counting detector output. The offset phase-locked loop is driven by a feedback mechanism that continuously corrects for variation in the symbol time due to motion between the transmitter and receiver as well as oscillator instability. This innovation will allow significant improvements in receiver throughput; for example, the throughput of a pulse-position modulation (PPM) with 16 slots can increase from 188 Mb/s to 1.5 Gb/s.

  11. Education of dietitian's in Brazil: Minimum clock hours of instruction for a bachelor's degree in nutrition

    Directory of Open Access Journals (Sweden)

    Maria Angélica Tavares de Medeiros

    2013-10-01

    Full Text Available This essay aims to debate the minimum clock hours of instruction necessary for obtaining a bachelor's degree in nutrition considering the challenges to educate health professionals. Official documents on the minimum clock hours of instruction required by undergraduate nutrition programs were analyzed to investigate compliance with the curriculum guidelines for the area, the law that regulates the profession of dietitian, and the necessary education for the Sistema Único de Saúde (Unified Health Care System. Compared with other health programs, nutrition presented the smallest increase in the minimum clock hours of instruction required for the degree. The changes that occurred in the epidemiological, demographic, and nutritional profile of the population and scientific advances require specific nutrition actions. Since Sistema Único de Saúde focuses on comprehensiveness in the three levels of care, on humanization, and on health care, the theoretical and methodological concepts given in undergraduate programs need to be improved for the dietitians education to meet the Sistema Único de Saúde needs. Incorporation of the knowledge needed for working with food and nutritional phenomena, including its social and cultural dimensions, management of public policies, quantity cooking, and food and nutritional surveillance requires a higher minimum clock hours of instruction. In conclusion, dietitians need a minimum clock hours of instruction of 4,000 to acquire a proper education, integrate into the university life, and coordinate interdisciplinary experiences of the triad teaching/research/extension.

  12. A theory evaluation of an induction programme

    Directory of Open Access Journals (Sweden)

    Kenrick Hendricks

    2012-07-01

    Full Text Available Orientation: An induction programme is commonly used to help new employees understand their job within the organisation. Research purpose: The main aim of this study was to examine whether or not the programme theory of an induction programme was plausible and would lead to the intended outcomes as described by the programme manager.Motivation for the study: Induction training is one of the most common training programmes in an organisation. However, there is little research to evaluate whether or not the activities of an induction programme will lead to the intended outcomes of such a programme.Research design, approach and method: This theory evaluation used a descriptive design. One hundred and thirteen employees of a media company completed a ten-item, five-point Likert scale which measured their perceptions of the programme’s outcome, identification with the organisation and intentions to stay with the organisation.Main findings: From this theory evaluation it was apparent that an induction programme based on an implausible programme theory could be problematic. An implausible programme theory affects the design of the programme activities and unsuitable activities may not deliver the desired outcomes.Practical/managerial implications: The intention of the evaluation is to guide human resource managers through a process of replacing an implausible programme theory with one that is plausible, and which ensures better alignment of programme activities and outcomes.Contribution/value-add: The evaluators showed how a plausible programme theory could improve programme design. This redesigned induction programme may lead to benefits, such as staff retention and company identification, rather than the vague assumption that it has been conforming to a legal obligation.

  13. Clock frequency estimation under spontaneous emission

    Science.gov (United States)

    Qin, Xi-Zhou; Huang, Jia-Hao; Zhong, Hong-Hua; Lee, Chaohong

    2018-02-01

    We investigate the quantum dynamics of a driven two-level system under spontaneous emission and its application in clock frequency estimation. By using the Lindblad equation to describe the system, we analytically obtain its exact solutions, which show three different regimes: Rabi oscillation, damped oscillation, and overdamped decay. From the analytical solutions, we explore how the spontaneous emission affects the clock frequency estimation. We find that under a moderate spontaneous emission rate, the transition frequency can still be inferred from the Rabi oscillation. Our results enable potential practical applications in frequency measurement and quantum control under decoherence.

  14. Clocking Scheme for Switched-Capacitor Circuits

    DEFF Research Database (Denmark)

    Steensgaard-Madsen, Jesper

    1998-01-01

    A novel clocking scheme for switched-capacitor (SC) circuits is presented. It can enhance the understanding of SC circuits and the errors caused by MOSFET (MOS) switches. Charge errors, and techniques to make SC circuits less sensitive to them are discussed.......A novel clocking scheme for switched-capacitor (SC) circuits is presented. It can enhance the understanding of SC circuits and the errors caused by MOSFET (MOS) switches. Charge errors, and techniques to make SC circuits less sensitive to them are discussed....

  15. A transportable optical clock for chronometric levelling

    Science.gov (United States)

    Lisdat, C.; Koller, S. B.; Grotti, J.; Vogt, S.; Al-Masoudi, A.; Dörscher, S.; Herbers, S.; Häfner, S.; Sterr, U.

    2016-12-01

    With their supreme accuracy and precision, optical clocks in combination with new methods of long-distance frequency transfer can be used to determine height differences by measuring the gravitational red shift between two clocks without accumulation of measurement errors, as in classical levelling. We are developing transportable optical clocks for this purpose that will also serve for the technology development regarding optical clocks in Space and for international comparisons between optical clocks that cannot be linked with sufficient accuracy otherwise.In this talk we will focus on the transportable strontium lattice clock that we are developing and its first evaluation. Presently, we achieve a fractional frequency instability of 3×10-17 after 1000 s averaging time, which is equivalent to a height resolution of 30 cm. The first uncertainty evaluation of the system yielded 7×10-17. We expect rapid improvements to an uncertainty of a few parts in 1017.The clock then placed within a car trailer, which requires compact and rugged lasers systems and physics package. Special care has been taken in the design of the ultra-frequency stable interrogation laser that has to achieve fractional frequency instabilities of considerably below 10-15. Typical laboratory constructions of the reference resonator system used to pre-stabilize the laser frequency are not compatible with the requirement of transportability.In an actual levelling campaign, this clock will be connected e.g. via a stabilized optical fibre link with another, stationary frequency standard. The measured gravitational red shift can be compared to the ones calculated from potential differences derived with state of the art geodetic data and models. A first campaign has been completed in cooperation with colleagues from the Italian and UK metrology institutes INRIM and NPL, respectively, and the Institut für Erdmessung (IfE), Leibniz University Hannover. We will discuss the status of the evaluation and

  16. Synthesizing genetic sequential logic circuit with clock pulse generator

    National Research Council Canada - National Science Library

    Chuang, Chia-Hua; Lin, Chun-Liang

    2014-01-01

    .... This paper presents a genetic sequential logic circuit with a clock pulse generator based on a synthesized genetic oscillator, which generates a consecutive clock signal whose frequency is an inverse...

  17. Modulation of circadian clocks by nutrients and food factors.

    Science.gov (United States)

    Oike, Hideaki

    2017-05-01

    Daily activity rhythms that are dominated by internal clocks are called circadian rhythms. A central clock is located in the suprachiasmatic nucleus of the hypothalamus, and peripheral clocks are located in most mammalian peripheral cells. The central clock is entrained by light/dark cycles, whereas peripheral clocks are entrained by feeding cycles. The effects of nutrients on the central and peripheral clocks have been investigated during the past decade and much interaction between them has come to light. For example, a high-fat diet prolongs the period of circadian behavior, a ketogenic diet advances the onset of locomotor activity rhythms, and a high-salt diet advances the phase of peripheral molecular clocks. Moreover, some food factors such as caffeine, nobiletin, and resveratrol, alter molecular and/or behavioral circadian rhythms. Here, we review nutrients and food factors that modulate mammalian circadian clocks from the cellular to the behavioral level.

  18. Breast cancer risk, nightwork, and circadian clock gene polymorphisms

    National Research Council Canada - National Science Library

    Truong, Thérèse; Liquet, Benoît; Menegaux, Florence; Plancoulaine, Sabine; Laurent-Puig, Pierre; Mulot, Claire; Cordina-Duverger, Emilie; Sanchez, Marie; Arveux, Patrick; Kerbrat, Pierre; Richardson, Sylvia; Guénel, Pascal

    2014-01-01

    ...) in 23 circadian clock genes. We also used a gene- and pathway-based approach to investigate the overall effect on breast cancer of circadian clock gene variants that might not be detected in analyses based on individual SNPs...

  19. Novel transcriptional networks regulated by CLOCK in human neurons.

    Science.gov (United States)

    Fontenot, Miles R; Berto, Stefano; Liu, Yuxiang; Werthmann, Gordon; Douglas, Connor; Usui, Noriyoshi; Gleason, Kelly; Tamminga, Carol A; Takahashi, Joseph S; Konopka, Genevieve

    2017-11-01

    The molecular mechanisms underlying human brain evolution are not fully understood; however, previous work suggested that expression of the transcription factor CLOCK in the human cortex might be relevant to human cognition and disease. In this study, we investigated this novel transcriptional role for CLOCK in human neurons by performing chromatin immunoprecipitation sequencing for endogenous CLOCK in adult neocortices and RNA sequencing following CLOCK knockdown in differentiated human neurons in vitro. These data suggested that CLOCK regulates the expression of genes involved in neuronal migration, and a functional assay showed that CLOCK knockdown increased neuronal migratory distance. Furthermore, dysregulation of CLOCK disrupts coexpressed networks of genes implicated in neuropsychiatric disorders, and the expression of these networks is driven by hub genes with human-specific patterns of expression. These data support a role for CLOCK-regulated transcriptional cascades involved in human brain evolution and function. © 2017 Fontenot et al.; Published by Cold Spring Harbor Laboratory Press.

  20. Pulsed optically pumped atomic clock with zero-dead-time

    Science.gov (United States)

    Lin, Haixiao; Lin, Jinda; Deng, Jianliao; Zhang, Song; Wang, Yuzhu

    2017-12-01

    By alternatively operating two pulsed optically pumped (POP) atomic clocks, the dead time in a single clock can be eliminated, and the local oscillator can be discriminated continuously. A POP atomic clock with a zero-dead-time (ZDT) method is then insensitive to the microwave phase noise. From τ = 0.01 to 1 s, the Allan deviation of the ZDT-POP clock is reduced as nearly τ-1, which is significantly faster than τ-1/2 of a conventional clock. During 1-40 s, the Allan deviation returns to τ-1/2. Moreover, the frequency stability of the ZDT-POP clock is improved by one order of magnitude compared with that of the conventional POP clock. We also analyze the main factors that limit the short-term frequency stability of the POP atomic clock.