What is felt temperature? Air conditioning with felt temperature in buildings and vehicles?; Was ist gefuehlte Temperatur? Klimaregelung mit gefuehlter Temperatur in Gebaeuden und Fahrzeugen

Energy Technology Data Exchange (ETDEWEB)

Eigel, Franz [Technology Marketing Support, St. Georgen (Germany); Rengshausen, Detlef [Vereta GmbH, Einbeck (Germany)

2010-11-15

The term 'felt temperature' reaches back to a long series of medical, empirical-sociological and meteorological studies accomplished world-wide for human temperature feeling. The consideration of the felt temperature at the regulation of refrigerators meets not only the comfort feeling of humans, but also saves cash money at the same time.

Structural and Psychological Empowerment Climates, Performance, and the Moderating Role of Shared Felt Accountability: A Managerial Perspective

Science.gov (United States)

Wallace, J. Craig; Johnson, Paul D.; Mathe, Kimberly; Paul, Jeff

2011-01-01

The authors proposed and tested a model in which data were collected from managers (n = 539) at 116 corporate-owned quick service restaurants to assess the structural and psychological empowerment process as moderated by shared-felt accountability on indices of performance from a managerial perspective. The authors found that empowering leadership…

High-Performance Vanadium Redox Flow Batteries with Graphite Felt Electrodes

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Trevor J. Davies

2018-01-01

Full Text Available A key objective in the development of vanadium redox flow batteries (VRFBs is the improvement of cell power density. At present, most commercially available VRFBs use graphite felt electrodes under relatively low compression. This results in a large cell ohmic resistance and limits the maximum power density. To date, the best performing VRFBs have used carbon paper electrodes, with high active area compression pressures, similar to that used in fuel cells. This article investigates the use of felt electrodes at similar compression pressures. Single cells are assembled using compression pressures of 0.2–7.5 bar and tested in a VRFB system. The highest cell compression pressure, combined with a thin Nafion membrane, achieved a peak power density of 669 mW cm−2 at a flow rate of 3.2 mL min−1 per cm2 of active area, more than double the previous best performance from a felt-VRFB. The results suggest that felt electrodes can compete with paper electrodes in terms of performance when under similar compression pressures, which should help guide electrode development and cell optimization in this important energy storage technology.

Genetic Causal Attribution of Epilepsy and its Implications for Felt Stigma

Science.gov (United States)

Sabatello, Maya; Phelan, Jo C.; Hesdorffer, Dale C.; Shostak, Sara; Goldsmith, Jeff; Sorge, Shawn T.; Winawer, Melodie R.; Chung, Wendy K.; Ottman, Ruth

2015-01-01

Summary Objective Research in other disorders suggests that genetic causal attribution of epilepsy might be associated with increased stigma. We investigated this hypothesis in a unique sample of families containing multiple individuals with epilepsy. Methods 181 people with epilepsy and 178 biological relatives without epilepsy completed a self-administered survey. In people with epilepsy, felt stigma was assessed through the Epilepsy Stigma Scale (ESS), scored 1 to 7 with higher scores indicating more stigma and >4 indicating some felt stigma. Felt stigma related to having epilepsy in the family was assessed through the Family Epilepsy Stigma Scale (FESS), created by replacing “epilepsy” with “epilepsy in my family” in each ESS item. Genetic attribution was assessed through participants’ perceptions of the (1) role of genetics in causing epilepsy in the family, (2) chance they had an epilepsy-related mutation, and (3) (in people with epilepsy) influence of genetics in causing their epilepsy. Results Among people with epilepsy, 22% met criteria for felt stigma (ESS score >4). Scores were increased among individuals who were aged ≥60 years, were unemployed, reported epilepsy-related discrimination, or had seizures within the last year or >100 seizures in their lifetime. Adjusting for other variables, ESS scores in people with epilepsy were significantly higher among those who perceived genetics played a “medium” or “big” role in causing epilepsy in the family than in others (3.4 vs. 2.7, p=0.025). Only 4% of relatives without epilepsy had felt stigma. Scores in relatives were unrelated to genetic attribution. Significance In these unusual families, predictors of felt stigma in individuals with epilepsy are similar to those in other studies, and stigma levels are low in relatives without epilepsy. Felt stigma may be increased in people with epilepsy who believe epilepsy in the family has a genetic cause, emphasizing the need for sensitive

Heat-treated stainless steel felt as scalable anode material for bioelectrochemical systems.

Science.gov (United States)

Guo, Kun; Soeriyadi, Alexander H; Feng, Huajun; Prévoteau, Antonin; Patil, Sunil A; Gooding, J Justin; Rabaey, Korneel

2015-11-01

This work reports a simple and scalable method to convert stainless steel (SS) felt into an effective anode for bioelectrochemical systems (BESs) by means of heat treatment. X-ray photoelectron spectroscopy and cyclic voltammetry elucidated that the heat treatment generated an iron oxide rich layer on the SS felt surface. The iron oxide layer dramatically enhanced the electroactive biofilm formation on SS felt surface in BESs. Consequently, the sustained current densities achieved on the treated electrodes (1 cm(2)) were around 1.5±0.13 mA/cm(2), which was seven times higher than the untreated electrodes (0.22±0.04 mA/cm(2)). To test the scalability of this material, the heat-treated SS felt was scaled up to 150 cm(2) and similar current density (1.5 mA/cm(2)) was achieved on the larger electrode. The low cost, straightforwardness of the treatment, high conductivity and high bioelectrocatalytic performance make heat-treated SS felt a scalable anodic material for BESs. Copyright © 2015 Elsevier Ltd. All rights reserved.

Felt power explains the link between position power and experienced emotions.

Science.gov (United States)

Bombari, Dario; Schmid Mast, Marianne; Bachmann, Manuel

2017-02-01

The approach/inhibition theory by Keltner, Gruenfeld, and Anderson (2003) predicts that powerful people should feel more positive and less negative emotions. To date, results of studies investigating this prediction are inconsistent. We fill this gap with four studies in which we investigated the role of different conceptualizations of power: felt power and position power. In Study 1, participants were made to feel more or less powerful and we tested how their felt power was related to different emotional states. In Studies 2, 3, and 4, participants were assigned to either a high or a low power role and engaged in an interaction with a virtual human, after which participants reported on how powerful they felt and the emotions they experienced during the interaction. We meta-analytically combined the results of the four studies and found that felt power was positively related to positive emotions (happiness and serenity) and negatively to negative emotions (fear, anger, and sadness), whereas position power did not show any significant overall relation with any of the emotional states. Importantly, felt power mediated the relationship between position power and emotion. In summary, we show that how powerful a person feels in a given social interaction is the driving force linking the person's position power to his or her emotional states. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

FeltRadio – Experiencing Community-generated WiFi Activities

DEFF Research Database (Denmark)

Fritsch, Jonas; Gronvall, Erik

2016-01-01

FeltRadio is a portable technology for sensing WiFi through sensorial augmentation and Electric Muscle Stimulation (EMS). The technology enables its wearer to sensorially engage with the radio waves and WiFi activities that have become an integrated part of our everyday lives. The sensorial...... engagement changes people’s experience of WiFi activities, and allows them to participate in wireless communication infrastructures in novel ways. This is both an immediately embodied activity as it is a new form of social awareness. In this paper, we briefly present the FeltRadio technology and show how...

Can painted glass felt or glass fibre cloth be used as vapour barrier?

DEFF Research Database (Denmark)

El-Khattam, Amira; Andersen, Mie Them; Hansen, Kurt Kielsgaard

2014-01-01

In most Nordic homes the interior surfaces of walls and ceilings have some kind of surface treatment for aesthetical reasons. The treatments can for example be glass felt or glass fibre cloth which are painted afterwards. To evaluate the hygrothermal performance of walls and ceilings...... treatments. The surface treatments were glass felt or glass fibre cloth with different types of paints or just paint. The paint types were acrylic paint and silicate paint. The results show that the paint type has high influence on the water vapour resistance while the underlay i.e. glass felt or glass fibre...... acrylic paint on glass felt or glass fibre cloth cannot be used instead of a vapour barrier....

Study on Ballistic Absorbing Energy Character of High Performance Polyethylene Needle Felt

Science.gov (United States)

Kailiang, Zhu; Jianqiao, Fu

2017-11-01

The ballistic performance of polyethylene needle felt is tested and the failure morphology after test is also observed. The results showed that when the non-dimensionally non-stressed fibers in polyethylene needles are subjected to high-speed projectile, secondary movement such as stretching and twisting occurs first. This secondary movement is very full, it is the main way of ballistic absorbing energy of the polyethylene needle felt which can avoid the polyethylene fiber short-term rapid heating-up and destroyed. Analysis results show that under normal temperature and humidity conditions, the V50 of 6-layer forded polyethylene needle felt sample is 250m/s. At (450 ± 50) m/s speed range of the target missile, the mean value of the penetrative specific energy absorption for 3-layer forded polyethylene needle felt anti-1.1g simulated projectiles (tapered column) reaches 24.1J·m2/kg.

Stretchable Conductive Composites from Cu-Ag Nanowire Felt.

Science.gov (United States)

Catenacci, Matthew J; Reyes, Christopher; Cruz, Mutya A; Wiley, Benjamin J

2018-04-24

Materials that retain a high conductivity under strain are essential for wearable electronics. This article describes a conductive, stretchable composite consisting of a Cu-Ag core-shell nanowire felt infiltrated with a silicone elastomer. This composite exhibits a retention of conductivity under strain that is superior to any composite with a conductivity greater than 1000 S cm -1 . This work also shows how the mechanical properties, conductivity, and deformation mechanism of the composite changes as a function of the stiffness of the silicone matrix. The retention of conductivity under strain was found to decrease as the Young's modulus of the matrix increased. This was attributed to void formation as a result of debonding between the nanowire felt and the elastomer. The nanowire composite was also patterned to create serpentine circuits with a stretchability of 300%.

Evaluation of Random Blinded Re-Checking of AFB Slides under Revised National Tuberculosis Control Programme in Solapur District

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Swapnil Vishnu Lale

2013-01-01

Full Text Available Background: One of the important components of revised national tuberculosis control programme is ‘Good quality diagnosis, primarily by sputum smear microscopy’. All efforts are made to ensure that the designated microscopy centers function at optimal level. The process of ‘Random Blinded Re-Checking’ (RBRCof Acid Fast Bacillus slides is built in the programme. Objectives: To study the relationship of different types of errors detected in RBRC with respect to time, place and cost. To study the stability and capability of the process of RBRC. Methods: Analysis of secondary data of external quality assessment of Solapur district since January 2006 is supplemented by direct implementation of the programme since April 2011 till date. Data analysis is done using statistical software Minitab version 16.Results: Since January 2006 to May 2012;42191 slides were re-checked in 77 RBRC sessions at District Tuberculosis Center, Solapur.Different types of 69 errors were detected. Onsite evaluation and panel testing did not show any discordance. Barshi and Mangalwedha Tuberculosis Units (TU showed significantly higher number of errors as compared to Karmala TU. (P<0.002 Weighted Pareto Chart revealed that the costliest form of errors is high false negatives and low false negatives. Conclusion:Detection of errors in RBRC sessions follows Poisson distribution. The process of RBRC is found to be in control and capable of achieving the desired target of detection of errors.

Integrating Felting in Elementary Science Classrooms to Facilitate Understanding of the Polar Auroras

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Brandy Terrill

2017-10-01

Full Text Available The Next Generation Science Standards (NGSS emphasize conceptual science instruction that draws on students’ ability to make observations, explain natural phenomena, and examine concept relationships. This paper explores integrating the arts, in the form of felting, in elementary science classrooms as a way for students to model and demonstrate understanding of the complex scientific processes that cause the polar auroras. The steps for creating felting, and using the felting artwork students create for assessing science learning, are described.

High efficiency of CO2-activated graphite felt as electrode for vanadium redox flow battery application

Science.gov (United States)

Chang, Yu-Chung; Chen, Jian-Yu; Kabtamu, Daniel Manaye; Lin, Guan-Yi; Hsu, Ning-Yih; Chou, Yi-Sin; Wei, Hwa-Jou; Wang, Chen-Hao

2017-10-01

A simple method for preparing CO2-activated graphite felt as an electrode in a vanadium redox flow battery (VRFB) was employed by the direct treatment in a CO2 atmosphere at a high temperature for a short period. The CO2-activated graphite felt demonstrates excellent electrochemical activity and reversibility. The VRFB using the CO2-activated graphite felts in the electrodes has coulombic, voltage, and energy efficiencies of 94.52%, 88.97%, and 84.15%, respectively, which is much higher than VRFBs using the electrodes of untreated graphite felt and N2-activated graphite felt. The efficiency enhancement was attributed to the higher number of oxygen-containing functional groups on the graphite felt that are formed during the CO2-activation, leading to improving the electrochemical behaviour of the resultant VRFB.

"Castor Oil" - The Culprit of Acute Hair Felting.

Science.gov (United States)

Maduri, V Ramya; Vedachalam, Ahalya; Kiruthika, S

2017-01-01

Acute hair felting is a rare disorder of scalp hair. In this condition, the hair becomes twisted, entangled as a hard stony mass resembling a bird's nest. Sudden hair matting has been reported earlier in the literature after vigorous use of chemical and herbal shampoos. Plica polonica is a patchy area of hair matting occurring in due course of time in neglected hair or underlying psychiatric illness. This case is interesting as the whole scalp hair matted immediately after using coconut oil and castor oil following washing. Growing long hair and taking oil bath are cultural and religious customs in South India. The high viscosity of castor oil and long hair had contributed to sudden felting of hair. This disorder of hair is irreversible and the hair should be cut off. Acute nature of this disorder will result in a serious psychological impact on the patient and the family.

The effects of surface modification on carbon felt electrodes for use in vanadium redox flow batteries

International Nuclear Information System (INIS)

Kim, Ki Jae; Kim, Young-Jun; Kim, Jae-Hun; Park, Min-Sik

2011-01-01

Highlights: ► We observed the physical and chemical changes on the surface of carbon felts after various surface modifications. ► The surface area and chemistry of functional groups formed on the surface of carbon felt are critical to determine the kinetics of the redox reactions of vanadium ions. ► By incorporation of the surface modifications into the electrode preparation, the electrochemical activity of carbon felts could be notably enhanced. - Abstract: The surface of carbon felt electrodes has been modified for improving energy efficiency of vanadium redox flow batteries. For comparative purposes, the effects of various surface modifications such as mild oxidation, plasma treatment, and gamma-ray irradiation on the electrochemical properties of carbon felt electrodes were investigated at optimized conditions. The cell energy efficiency was improved from 68 to 75% after the mild oxidation of the carbon felt at 500 °C for 5 h. This efficiency improvement could be attributed to the increased surface area of the carbon felt electrode and the formation of functional groups on its surface as a result of the modification. On the basis of various structural and electrochemical characterizations, a relationship between the surface nature and electrochemical activity of the carbon felt electrodes is discussed.

Investigation of Ir-modified carbon felt as the positive electrode of an all-vanadium redox flow battery

International Nuclear Information System (INIS)

Wang, W.H.; Wang, X.D.

2007-01-01

Porous graphite felts have been used as electrode materials for all-vanadium redox flow batteries due to their wide operating potential range, stability as both an anode and a cathode, and availability in high surface area. In this paper, the carbon felt was modified by pyrolysis of Ir reduced from H 2 IrCl 6 . ac impedance and steady-state polarization measurements showed that the Ir-modified materials have improved activity and lowered overpotential of the desired V(IV)/V(V) redox process. Ir-modification of carbon felt enhanced the electro-conductivity of electrode materials. The Ir-material, when coated on the graphite felt electrode surface, lowered the cell internal resistance. A test cell was assembled with the Ir-modified carbon felt as the activation layer of the positive electrode, the unmodified raw felt as the activation layer of the negative electrode. At an operating current density of 20 mA cm -2 , a voltage efficiency of 87.5% was achieved. The resistance of the cell using Ir-modified felt decreased 25% compared to the cell using non-modified felt

PROCEEDINGS OF RIKEN BNL RESEARCH CENTER WORKSHOP, VOLUME 72, RHIC SPIN COLLABORATION MEETINGS XXXI, XXXII, XXXIII

International Nuclear Information System (INIS)

OGAWA, A.

2005-01-01

The RIKEN BNL Research Center (RBRC) was established in April 1997 at Brookhaven National Laboratory. It is funded by the ''Rikagaku Kenkyusho'' (RIKEN, The Institute of Physical and Chemical Research) of Japan. The Center is dedicated to the study of strong interactions, including spin physics, lattice QCD, and RHIC physics through the nurturing of a new generation of young physicists. The RBRC has both a theory and experimental component. At present the theoretical group has 4 Fellows and 3 Research Associates as well as 11 RHIC Physics/University Fellows (academic year 2003-2004). To date there are approximately 30 graduates from the program of which 13 have attained tenure positions at major institutions worldwide. The experimental group is smaller and has 2 Fellows and 3 RHIC Physics/University Fellows and 3 Research Associates, and historically 6 individuals have attained permanent positions. Beginning in 2001 a new RIKEN Spin Program (RSP) category was implemented at RBRC. These appointments are joint positions of RBRC and RIKEN and include the following positions in theory and experiment: RSP Researchers, RSP Research Associates, and Young Researchers, who are mentored by senior RBRC Scientists. A number of RIKEN Jr. Research Associates and Visiting Scientists also contribute to the physics program at the Center. RBRC has an active workshop program on strong interaction physics with each workshop focused on a specific physics problem. Each workshop speaker is encouraged to select a few of the most important transparencies from his or her presentation, accompanied by a page of explanation. This material is collected at the end of the workshop by the organizer to form proceedings, which can therefore be available within a short time. To date there are seventy-two proceeding volumes available. The construction of a 0.6 teraflops parallel processor, dedicated to lattice QCD, begun at the Center on February 19, 1998, was completed on August 28, 1998 and is still

Factors associated with increased felt stigma among individuals with epilepsy.

Science.gov (United States)

Bautista, Ramon Edmundo D; Shapovalov, Denys; Shoraka, Ali Reza

2015-08-01

The aim of the study is to determine whether certain demographic, clinical, and psychosocial traits are associated with higher levels of felt stigma among persons with epilepsy (PWE) patients followed at a level 4 epilepsy center. We performed a direct survey of 182 consenting patients that included the Epilepsy Stigma Scale. On univariate analysis, higher levels of perceived stigma were associated with age, marital status, race, driving, work status, seizure etiology, Quality of Life in Epilepsy-10 (QOLIE-10) scores, and health literacy. Among coping reactions, the use of denial, behavioral disengagement and venting were also associated with higher degrees of felt stigma. Using multiple linear regression, being single, poorer QOLIE-10 scores, difficulties understanding written information, and the use of behavioral disengagement were independently associated with poorer scores on the Epilepsy Stigma Scale. Our study paints a compelling profile of a PWE who has greater perceived stigma. Programs that increase the level of social support, improve health literacy, and enhance quality of life may also help decrease the amount of felt stigma among PWE. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

Nettfrekvente elektromagnetiske felt og helseeffekter

Directory of Open Access Journals (Sweden)

Karl Gerhard Blaasaas

2009-10-01

Full Text Available I denne artikkelen oppsummeres epidemiologisk kunnskap om mulige helseeffekter etter eksponering for nettfrekvente (50/60 Hz elektromagnetiske felt. Vi har basert oss på et flertall av vitenskapelige arbeider publisert i perioden 2001-2004 og konklusjoner i rapporter og oversiktsartikler fra perioden før 2001. Det er ikke funnet noen etiologisk sammenheng mellom elektromagnetiske felt og kronisk sykdom. Man vet heller ikke sikkert hvilke egenskaper ved de elektromagnetiske feltene som eventuelt kan fremskaffe sykdom. Eventuell latenstid fra eksponering til sykdomsutvikling er også ukjent. Eksponering over 0,4 mT fra kraftlinjer ser ut til å kunne gi en dobling i risikoen for barneleukemi, og basert på metaanalyser kan ikke resultatene avvises som tilfeldige funn. Holdepunktene for en slik sammenheng er likevel begrenset. Ved vokseneksponering har man i enkeltstudier observert risikoøkninger for brystkreft, leukemi, hjernesvulst og amyotrofisk lateralsklerose. Det er også gjort isolerte funn av abort blant kvinner eksponert under graviditeten. For alle disse endepunktene er funnene allikevel ikke tilstrekkelige til å trekke sikre konklusjoner om sammenheng med eksponeringThis review is based on epidemiologic literature in the period 2001-2004 and conclusions in reports and review articles before 2001, regarding power frequency (50/60 Hz electromagnetic fields and health outcomes. Twotimes increased risks for childhood leukaemia have been observed among children exposed to magnetic fields above 0.4 mT from power lines, and based on meta-analyses these results can not be regarded as chance alone. The evidence for an association is however, still limited. Increased risks of breast cancer, leukaemia, braintumor and amyotrophic lateral sclerosis have been observed in isolated studies. Increased risk of spontaneousabortion among women exposed during pregnancy has also been reported. None of the observations for any ofthese endpoints are

Supercapacitor Electrode Based on Activated Carbon Wool Felt

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Ana Claudia Pina

2018-04-01

Full Text Available An electrical double-layer capacitor (EDLC is based on the physical adsorption/desorption of electrolyte ions onto the surface of electrodes. Due to its high surface area and other properties, such as electrochemical stability and high electrical conductivity, carbon materials are the most widely used materials for EDLC electrodes. In this work, we study an activated carbon felt obtained from sheep wool felt (ACF’f as a supercapacitor electrode. The ACF’f was characterized by elemental analysis, scanning electron microscopy (SEM, textural analysis, and X-ray photoelectron spectroscopy (XPS. The electrochemical behaviour of the ACF’f was tested in a two-electrode Swagelok®-type, using acidic and basic aqueous electrolytes. At low current densities, the maximum specific capacitance determined from the charge-discharge curves were 163 F·g−1 and 152 F·g−1, in acidic and basic electrolytes, respectively. The capacitance retention at higher current densities was better in acidic electrolyte while, for both electrolytes, the voltammogram of the sample presents a typical capacitive behaviour, being in accordance with the electrochemical results.

On the Matching of Seen and Felt Shape by Newly Sighted Subjects

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John Schwenkler

2012-04-01

Full Text Available How do we recognize identities between seen shapes and felt ones? Is this due to associative learning, or intrinsic connections these sensory modalities? We can address this question by testing the capacities of newly sighted subjects to match seen and felt shapes, but only if the subjects can see the objects well enough to form adequate visual representations of their shapes. In light of this, a recent study by R. Held and colleagues fails to demonstrate that their newly sighted subjects' inability to match seen and felt shape was due to a lack of intermodal connections rather than a purely visual deficit, as the subjects may not have been able visually to represent 3D shape in the perspective-invariant manner required for intermodal matching. However, the study could be modified in any of several ways to help avoid this problem.

HF/H2O2 treated graphite felt as the positive electrode for vanadium redox flow battery

Science.gov (United States)

He, Zhangxing; Jiang, Yingqiao; Meng, Wei; Jiang, Fengyun; Zhou, Huizhu; Li, Yuehua; Zhu, Jing; Wang, Ling; Dai, Lei

2017-11-01

In order to improve the electrochemical performance of the positive graphite felt electrode in vanadium flow redox battery, a novel method is developed to effectively modify the graphite felt by combination of etching of HF and oxidation of H2O2. After the etching of HF for the graphite felt at ambient temperature, abundant oxygen-containing functional groups were further introduced on the surface of graphite felt by hydrothermal treatment using H2O2 as oxidant. Benefiting from the surface etching and introduction of functional groups, mass transfer and electrode process can be improved significantly on the surface of graphite felt. VO2+/VO2+ redox reaction on the graphite felt modified by HF and H2O2 jointly (denote: GF-HF/H2O2) exhibits superior electrochemical kinetics in comparison with the graphite felt modified by single HF or H2O2 treatment. The cell using GF-HF/H2O2 as the positive electrode was assembled and its electrochemical properties were evaluated. The increase of energy efficiency of 4.1% for GF-HF/H2O2 at a current density of 50 mA cm-2 was obtained compared with the pristine graphite felt. The cell using GF-HF/H2O2 also demonstrated higher discharge capacity. Our study revealed that HF/H2O2 treatment is an efficient method to enhance the electrochemical performance of graphite felt, further improving the comprehensive energy storage performance of the vanadium flow redox battery.

Proceedings of RIKEN BNL Research Center Workshop: Thermal Photons and Dileptons in Heavy-Ion Collisions. Volume 119

Energy Technology Data Exchange (ETDEWEB)

David, G. [Brookhaven National Laboratory (BNL), Upton, NY (United States); Rapp, R. [Brookhaven National Laboratory (BNL), Upton, NY (United States); Ruan, L. [Brookhaven National Laboratory (BNL), Upton, NY (United States); Yee, H-U. [Brookhaven National Laboratory (BNL), Upton, NY (United States)

2014-09-11

The RIKEN BNL Research Center (RBRC) was established in April 1997 at Brookhaven National Laboratory. It is funded by the ''Rikagaku Kenkyusho'' (RIKEN, The Institute of Physical and Chemical Research) of Japan and the U. S. Department of Energy’s Office of Science. The RBRC is dedicated to the study of strong interactions, including spin physics, lattice QCD, and RHIC physics through the nurturing of a new generation of young physicists. The RBRC has theory, lattice gauge computing and experimental components. It is presently exploring the possibility of an astrophysics component being added to the program. The primary theme for this workshop related to sharing the latest experimental and theoretical developments in area of low transverse momentum (p_T) dielectron and photons. All the presentations given at the workshop are included in this proceedings, primarily as PowerPoint presentations.

Sound absorption enhancement of nonwoven felt by using coupled membrane - sonic crystal inclusion

Science.gov (United States)

Fitriani, M. C.; Yahya, I.; Harjana; Ubaidillah; Aditya, F.; Siregar, Y.; Moeliono, M.; Sulaksono, S.

2016-11-01

The experimental results from laboratory test on the sound absorption performance of nonwoven felt with an array thin tubes and sonic crystal inclusions reported in this paper. The nonwoven felt sample was produced by a local company with 15 mm in its thickness and 900 gsm. The 6.4 mm diameter plastic straw was used to construct the thin tubes array while the sonic crystal is arranged in a 4 × 4 lattice crystal formation. It made from a PVC cylinder with 17 mm and 50 mm in diameter and length respectively. All cylinders have two holes positioned on 10 mm and 25 mm from the base. The results show that both treatments, array of thin tube and sonic crystal inclusions are effectively increased the sound absorption coefficient of the nonwoven felt significantly especially in the low frequency range starting from 200Hz.

Electrochemical catalytic activity of tungsten trioxide- modified graphite felt toward VO2+/VO2+ redox reaction

International Nuclear Information System (INIS)

Shen, Yang; Xu, Hongfeng; Xu, Pengcheng; Wu, Xiaoxin; Dong, Yiming; Lu, Lu

2014-01-01

A novel graphite felt electrode modified with tungsten trioxide (WO 3 ) was developed to improve the electrochemical performance of graphite felt toward the VO 2 + /VO 2+ redox pair. WO 3 was prepared using a hydrothermal method, and the morphology of WO 3 structures was investigated by scanning electron microscopy (SEM) and X-ray diffraction (XRD). The electrochemical property of WO 3 -modified graphite felt toward VO 2 + /VO 2+ was carefully characterized using cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) measurements. The hydrogen-vanadium redox flow battery (H-VRFB) test indicates that single cells using 1.1 mg cm −2 WO 3 -modified graphite felt exhibited excellent performance at 70 mA cm −2 , and the corresponding coulombic, voltage, and energy efficiencies were 99.1%, 88.66% and 87.86%, respectively

Treatment of graphite felt by modified Hummers method for the positive electrode of vanadium redox flow battery

International Nuclear Information System (INIS)

Wu, Xiaoxin; Xu, Hongfeng; Shen, Yang; Xu, Pengcheng; Lu, Lu; Fu, Jie; Zhao, Hong

2014-01-01

A novel and highly effective treatment based on modified Hummers method was firstly used to improve the electrochemical activity of graphite felt as the positive electrode in all-vanadium redox flow battery (VRFB). The graphite felt was treated by the modified Hummers method and characterized by Fourier transform infrared spectroscopy and scanning electron microscopy. The electrochemical performance of the prepared electrode was evaluated through cyclic voltammetry and electrochemical impedance spectroscopy. Results show that graphite felt treated by modified Hummers method exhibits excellent electrocatalytic activity and reaction rate to vanadium redox couples. In our research, the hydrogen electrode and H 2 replaced the graphite felt and V 2+ /V 3+ couple in the negative side in the VRFB performance test. The coulombic, voltage, and energy efficiencies of the VRFB with the as-prepared electrodes at 50 mA cm −2 are 95.0%, 81.3%, and 77.2%, respectively. These values are much higher than those of the cell-assembled graphite felt electrodes that were conventionally and thermally treated. The graphite felt treated by the modified Hummers method carries more hydrophilic groups, such as–OH, on its defects, which is advantageous in facilitating the redox reaction of vanadium ions, thereby improving the operation efficiency of the vanadium redox flow battery

Electric and Hydraulic Properties of Carbon Felt Immersed in Different Dielectric Liquids.

Science.gov (United States)

Kossenko, Alexey; Lugovskoy, Svetlana; Averbukh, Moshe

2018-04-23

Electroconductive carbon felt (CF) material, having a permeable structure and significant electroconductive surface, is widely used for electrodes in numerous electrochemical applications such as redox flow batteries, fuel cells, electrochemical desalination apparatus, etc. The internal structure of CF is composed of different lengths of carbon filaments bonded together. This structure creates a large number of stochastically oriented and stochastically linked channels that have different lengths and cross sections. Therefore, the CF hydraulic permeability is similar to that of porous media and is determined by the internal empty volume and arrangement of carbon fibers. Its electroconductivity is ensured by the conductivity of the carbon filaments and by the electrical interconnections between fibers. Both of these properties (permeability and electrical conductivity) are extremely important for the efficient functioning of electrochemical devices. However, their influences counter each other during CF compressing. Increasing the stress on a felt element provides supplementary electrical contacts of carbon filaments, which lead to improved electrical conductivity. Thus, the active surface of the felt electrode is increased, which also boosts redox chemical reactions. On the other hand, compressed felt possesses reduced hydrodynamic permeability as a result of a diminished free volume of porous media and intrinsic channels. This causes increasing hydrodynamic expenditures of electrolyte pumping through electrodes and lessened cell (battery) efficiency. The designer of specific electrochemical systems has to take into account both of these properties when selecting the optimal construction for a cell. This article presents the results of measurements and novel approximating expressions of electrical and hydraulic characteristics of a CF during its compression. Since electrical conductivity plays a determining role in providing electrochemical reactions, it was

Electric and Hydraulic Properties of Carbon Felt Immersed in Different Dielectric Liquids

Directory of Open Access Journals (Sweden)

Alexey Kossenko

2018-04-01

Full Text Available Electroconductive carbon felt (CF material, having a permeable structure and significant electroconductive surface, is widely used for electrodes in numerous electrochemical applications such as redox flow batteries, fuel cells, electrochemical desalination apparatus, etc. The internal structure of CF is composed of different lengths of carbon filaments bonded together. This structure creates a large number of stochastically oriented and stochastically linked channels that have different lengths and cross sections. Therefore, the CF hydraulic permeability is similar to that of porous media and is determined by the internal empty volume and arrangement of carbon fibers. Its electroconductivity is ensured by the conductivity of the carbon filaments and by the electrical interconnections between fibers. Both of these properties (permeability and electrical conductivity are extremely important for the efficient functioning of electrochemical devices. However, their influences counter each other during CF compressing. Increasing the stress on a felt element provides supplementary electrical contacts of carbon filaments, which lead to improved electrical conductivity. Thus, the active surface of the felt electrode is increased, which also boosts redox chemical reactions. On the other hand, compressed felt possesses reduced hydrodynamic permeability as a result of a diminished free volume of porous media and intrinsic channels. This causes increasing hydrodynamic expenditures of electrolyte pumping through electrodes and lessened cell (battery efficiency. The designer of specific electrochemical systems has to take into account both of these properties when selecting the optimal construction for a cell. This article presents the results of measurements and novel approximating expressions of electrical and hydraulic characteristics of a CF during its compression. Since electrical conductivity plays a determining role in providing electrochemical

Investigations into the Anti-Felting Properties of Sputtered Wool Using Plasma Treatment

International Nuclear Information System (INIS)

Borghei, S. M.; Shahidi, S.; Ghoranneviss, M.; Abdolahi, Z.

2013-01-01

In this research the effects of mordant and plasma sputtering treatments on the crystallinity and morphological properties of wool fabrics were investigated. The felting behavior of the treated samples was also studied. We used madder as a natural dye and copper sulfate as a metal mordant. We also used copper as the electrode material in a DC magnetron plasma sputtering device. The anti-felting properties of the wool samples before and after dying was studied, and it was shown that the shrink resistance and anti-felting behavior of the wool had been significantly improved by the plasma sputtering treatment. In addition, the percentage of crystallinity and the size of the crystals were investigated using an X-ray diffractometer, and a scanning electron microscope was used for morphological analysis. The amount of copper particles on the surface of the mordanted and sputtered fabrics was studied using the energy dispersive X-ray (EDX) method, and the hydrophobic properties of the samples were examined using the water drop test. The results show that with plasma sputtering treatment, the hydrophobic properties of the surface of wool become super hydrophobic.

Electrochemical reduction of dilute chromate solutions on carbon felt electrodes

NARCIS (Netherlands)

Frenzel, Ines; Frenzel, I.; Holdik, Hans; Barmashenko, Vladimir; Stamatialis, Dimitrios; Wessling, Matthias

2006-01-01

Carbon felt is a potential material for electrochemical reduction of chromates. Very dilute solutions may be efficiently treated due to its large specific surface area and high porosity. In this work, the up-scaling of this technology is investigated using a new type of separated cell and

Felt Stigma in Injection Drug Users and Sex Workers: Focus Group Research with HIV-Risk Populations in Puerto Rico.

Science.gov (United States)

Jiménez, Julio; Puig, Marieva; Sala, Ana Cecilia; Ramos, Juan Carlos; Castro, Eida; Morales, Marangelie; Santiago, Lydia; Zorrilla, Carmen

Though many studies have conclusively linked felt stigma and HIV, few have focused on the experiences of rejection felt by members of such socially marginalized groups as intravenous drug users (IDU) and sex workers (SW). Using focus groups, our study explored these experiences in 34 individuals (17 male UDUs and 17 female SWs) at risk of becoming infected with HIV, the objective being to discover why they engaged in maladaptive behaviors as a way of coping with felt stigma. We used deductive and inductive analysis to codify the resulting data. Concepts associated with the word stigma, emotional reactions to felt stigma, and the impact of felt stigma on self-schema helped elucidate how the internalization of felt stigma can lead to negative affective states and self-destructive behaviors (e.g., drug use and syringe exchange). Results underline the importance of developing intervention models that reduce stigma as a means of HIV prevention in vulnerable populations.

Emotion felt by the listener and expressed by the music: literature review and theoretical perspectives

Science.gov (United States)

Schubert, Emery

2013-01-01

In his seminal paper, Gabrielsson (2002) distinguishes between emotion felt by the listener, here: “internal locus of emotion” (IL), and the emotion the music is expressing, here: “external locus of emotion” (EL). This paper tabulates 16 comparisons of felt versus expressed emotions in music published in the decade 2003–2012 consisting of 19 studies/experiments and provides some theoretical perspectives. The key findings were that (1) IL rating was frequently rated statistically the same or lower than the corresponding EL rating (e.g., lower felt happiness rating compared to the apparent happiness of the music), and that (2) self-select and preferred music had a smaller gap across the emotion loci than experimenter-selected and disliked music. These key findings were explained by an “inhibited” emotional contagion mechanism, where the otherwise matching felt emotion may have been attenuated by some other factor such as social context. Matching between EL and IL for loved and self-selected pieces was explained by the activation of “contagion” circuits. Physiological arousal, personality and age, as well as musical features (tempo, mode, putative emotions) also influenced perceived and felt emotion distinctions. A variety of data collection formats were identified, but mostly using rating items. In conclusion, a more systematic use of terminology appears desirable. Two broad categories, namely matched and unmatched, are proposed as being sufficient to capture the relationships between EL and IL, instead of four categories as suggested by Gabrielsson. PMID:24381565

Emotion felt by the listener and expressed by the music: literature review and theoretical perspectives.

Science.gov (United States)

Schubert, Emery

2013-12-17

In his seminal paper, Gabrielsson (2002) distinguishes between emotion felt by the listener, here: "internal locus of emotion" (IL), and the emotion the music is expressing, here: "external locus of emotion" (EL). This paper tabulates 16 comparisons of felt versus expressed emotions in music published in the decade 2003-2012 consisting of 19 studies/experiments and provides some theoretical perspectives. The key findings were that (1) IL rating was frequently rated statistically the same or lower than the corresponding EL rating (e.g., lower felt happiness rating compared to the apparent happiness of the music), and that (2) self-select and preferred music had a smaller gap across the emotion loci than experimenter-selected and disliked music. These key findings were explained by an "inhibited" emotional contagion mechanism, where the otherwise matching felt emotion may have been attenuated by some other factor such as social context. Matching between EL and IL for loved and self-selected pieces was explained by the activation of "contagion" circuits. Physiological arousal, personality and age, as well as musical features (tempo, mode, putative emotions) also influenced perceived and felt emotion distinctions. A variety of data collection formats were identified, but mostly using rating items. In conclusion, a more systematic use of terminology appears desirable. Two broad categories, namely matched and unmatched, are proposed as being sufficient to capture the relationships between EL and IL, instead of four categories as suggested by Gabrielsson.

Do People Agree on What Makes One Feel Loved? A Cognitive Psychometric Approach to the Consensus on Felt Love.

Science.gov (United States)

Oravecz, Zita; Muth, Chelsea; Vandekerckhove, Joachim

2016-01-01

This pragmatic study examines love as a mode of communication. Our focus is on the receiver side: what makes an individual feel loved and how felt love is defined through daily interactions. Our aim is to explore everyday life scenarios in which people might experience love, and to consider people's converging and diverging judgments about which scenarios indicate felt love. We apply a cognitive psychometric approach to quantify a receiver's ability to detect, understand, and know that they are loved. Through crowd-sourcing, we surveyed lay participants about whether various scenarios were indicators of felt love. We thus quantify these responses to make inference about consensus judgments of felt love, measure individual levels of agreement with consensus, and assess individual response styles. More specifically, we (1) derive consensus judgments on felt love; (2) describe its characteristics in qualitative and quantitative terms, (3) explore individual differences in both (a) participant agreement with consensus, and (b) participant judgment when uncertain about shared knowledge, and (4) test whether individual differences can be meaningfully linked to explanatory variables. Results indicate that people converge towards a shared cognitive model of felt love. Conversely, respondents showed heterogeneity in knowledge of consensus, and in dealing with uncertainty. We found that, when facing uncertainty, female respondents and people in relationships more frequently judge scenarios as indicators of felt love. Moreover, respondents from smaller households tend to know more about consensus judgments of felt love, while respondents from larger households are more willing to guess when unsure of consensus.

Proceedings of RIKEN BNL Research Center Workshop: The Approach to Equilibrium in Strongly Interacting Matter. Volume 118

Energy Technology Data Exchange (ETDEWEB)

Liao, J. [Brookhaven National Lab. (BNL), Upton, NY (United States); Venugopalan, R. [Brookhaven National Lab. (BNL), Upton, NY (United States); Berges, J. [Brookhaven National Lab. (BNL), Upton, NY (United States); Blaizot, J. -P. [Brookhaven National Lab. (BNL), Upton, NY (United States); Gelis, F. [Brookhaven National Lab. (BNL), Upton, NY (United States)

2014-04-09

The RIKEN BNL Research Center (RBRC) was established in April 1997 at Brookhaven National Laboratory*. It is funded by the ''Rikagaku Kenkyusho'' (RIKEN, The Institute of Physical and Chemical Research) of Japan and the U. S. Department of Energy’s Office of Science. The RBRC is dedicated to the study of strong interactions, including spin physics, lattice QCD, and RHIC physics through the nurturing of a new generation of young physicists. The RBRC has theory, lattice gauge computing and experimental components. It is presently exploring the possibility of an astrophysics component being added to the program. The purpose of this Workshop is to critically review the recent progress on the theory and phenomenology of early time dynamics in relativistic heavy ion collisions from RHIC to LHC energies, to examine the various approaches on thermalization and existing issues, and to formulate new research efforts for the future. Topics slated to be covered include Experimental evidence for equilibration/isotropization, comparison of various approaches, dependence on the initial conditions and couplings, and turbulent cascades and Bose-Einstein condensation.

Analysis of key factors influencing the evaporation performances of an oriented linear cutting copper fiber sintered felt

Science.gov (United States)

Pan, Minqiang; Zhong, Yujian

2018-01-01

Porous structure can effectively enhance the heat transfer efficiency. A kind of micro vaporizer using the oriented linear cutting copper fiber sintered felt is proposed in this work. Multiple long cutting copper fibers are firstly fabricated with a multi-tooth tool and then sintered together in parallel to form uniform thickness metal fiber sintered felts that provided a characteristic of oriented microchannels. The temperature rise response and thermal conversion efficiency are experimentally investigated to evaluate the influences of porosity, surface structure, feed flow rate and input power on the evaporation characteristics. It is indicated that the temperature rise response of water is mainly affected by input power and feed flow rate. High input power and low feed flow rate present better temperature rise response of water. Porosity rather than surface structure plays an important role in the temperature rise response of water at a relatively high input power. The thermal conversion efficiency is dominated by the input power and surface structure. The oriented linear cutting copper fiber sintered felts for three kinds of porosities show better thermal conversion efficiency than that of the oriented linear copper wire sintered felt when the input power is less than 115 W. All the sintered felts have almost the same performance of thermal conversion at a high input power.

Critical evaluation of quality assurance in laboratory diagnosis of tuberculosis in selected nearby microscopic centers under RNTCP

Directory of Open Access Journals (Sweden)

Anuradha

2013-08-01

Full Text Available Objective: RNTCP relies on sputum smear microscopy for diagnosis, categorization of patients for treatment and assessment of their program. Therefore, it is crucial that the smear microscopy services provided are of highest quality possible. The current study is undertaken to do on site evaluation and Random blinded rechecking (RBRC of slides at selected microscopic centers. Material & Methods: Five microscopic centers were selected for onsite evaluation and Random Blinded rechecking. Slides were collected monthly from the respective DMCs. A questionnaire was developed to assess the overall operational conditions at the DMCs and a checklist was prepared to record the observation during the visit. RBRC slides were read by two microbiologists independently and results were compared with RNTCP results. Slides were read before and after restaining the slides. Results: After the evaluation of checklist and questionnaire, it was found that 100% centers were following the charts for smear preparation, staining and grading with adequate stock supply. One out of 5 centers had maximum number of slides with poor quality of smear (16.7%, 8% uneven smear and 14% slides with improper thickness. There was 100% concordance when reading five positive and five negative smears. The mean time spent on microscopic examination was 4.4 minutes, compared with recommended time of 10 minutes. Out of 828 slides rechecked under RBRC one low false negative error was found. Conclusion: The evaluation of quality control practices was found satisfactory. The laboratory staff was able to incorporate simple quality control procedures for AFB microscopy into their routine practice, resulting in reliable service. Onsite evaluation and RBRC

SalanderMaps: A rapid overview about felt earthquakes through data mining of web-accesses

Science.gov (United States)

Kradolfer, Urs

2013-04-01

While seismological observatories detect and locate earthquakes based on measurements of the ground motion, they neither know a priori whether an earthquake has been felt by the public nor is it known, where it has been felt. Such information is usually gathered by evaluating feedback reported by the public through on-line forms on the web. However, after a felt earthquake in Switzerland, many people visit the webpages of the Swiss Seismological Service (SED) at the ETH Zurich and each such visit leaves traces in the logfiles on our web-servers. Data mining techniques, applied to these logfiles and mining publicly available data bases on the internet open possibilities to obtain previously unknown information about our virtual visitors. In order to provide precise information to authorities and the media, it would be desirable to rapidly know from which locations these web-accesses origin. The method 'Salander' (Seismic Activitiy Linked to Area codes - Nimble Detection of Earthquake Rumbles) will be introduced and it will be explained, how the IP-addresses (each computer or router directly connected to the internet has a unique IP-address; an example would be 129.132.53.5) of a sufficient amount of our virtual visitors were linked to their geographical area. This allows us to unprecedentedly quickly know whether and where an earthquake was felt in Switzerland. It will also be explained, why the method Salander is superior to commercial so-called geolocation products. The corresponding products of the Salander method, animated SalanderMaps, which are routinely generated after each earthquake with a magnitude of M>2 in Switzerland (http://www.seismo.ethz.ch/prod/salandermaps/, available after March 2013), demonstrate how the wavefield of earthquakes propagates through Switzerland and where it was felt. Often, such information is available within less than 60 seconds after origin time, and we always get a clear picture within already five minutes after origin time

Effect of NaX zeolite-modified graphite felts on hexavalent chromium removal in biocathode microbial fuel cells.

Science.gov (United States)

Wu, Xiayuan; Tong, Fei; Yong, Xiaoyu; Zhou, Jun; Zhang, Lixiong; Jia, Honghua; Wei, Ping

2016-05-05

Two kinds of NaX zeolite-modified graphite felts were used as biocathode electrodes in hexavalent chromium (Cr(VI))-reducing microbial fuel cells (MFCs). The one was fabricated through direct modification, and the other one processed by HNO3 pretreatment of graphite felt before modification. The results showed that two NaX zeolite-modified graphite felts are excellent bio-electrode materials for MFCs, and that a large NaX loading mass, obtained by HNO3 pretreatment (the HNO3-NaX electrode), leads to a superior performance. The HNO3-NaX electrode significantly improved the electricity generation and Cr(VI) removal of the MFC. The maximum Cr(VI) removal rate increased to 10.39±0.28 mg/L h, which was 8.2 times higher than that of the unmodified control. The improvement was ascribed to the strong affinity that NaX zeolite particles, present in large number on the graphite felt, have for microorganisms and Cr(VI) ions. Copyright © 2016 Elsevier B.V. All rights reserved.

Commercially Available Activated Carbon Fiber Felt Enables Efficient Solar Steam Generation.

Science.gov (United States)

Li, Haoran; He, Yurong; Hu, Yanwei; Wang, Xinzhi

2018-03-21

Sun-driven steam generation is now possible and has the potential to help meet future energy needs. Current technologies often use solar condensers to increase solar irradiance. More recently, a technology for solar steam generation that uses heated surface water and low optical concentration is reported. In this work, a commercially available activated carbon fiber felt is used to generate steam efficiently under one sun illumination. The evaporation rate and solar conversion efficiency reach 1.22 kg m -2 h -1 and 79.4%, respectively. The local temperature of the evaporator with a floating activated carbon fiber felt reaches 48 °C. Apart from the high absorptivity (about 94%) of the material, the evaporation performance is enhanced thanks to the well-developed pores for improved water supply and steam escape and the low thermal conductivity, which enables reduced bulk water temperature increase. This study helps to find a promising material for solar steam generation using a water evaporator that can be produced economically (∼6 $/m 2 ) with long-term stability.

Glucose oxidase-modified carbon-felt-reactor coupled with peroxidase-modified carbon-felt-detector for amperometric flow determination of glucose

International Nuclear Information System (INIS)

Wang Yue; Hasebe, Yasushi

2012-01-01

Glucose oxidase (GOx) and horseradish peroxidase (HRP) were covalently immobilized on a porous carbon-felt (CF) by using cyanuric chloride (CC) as a linking reagent. The resulting GOx-modified-CF (GOx-ccCF) was used as column-type enzyme reactor and placed on upstream of the HRP-ccCF-based H 2 O 2 flow-detector to fabricate amperometric flow-biosensor for glucose. Sensor setting conditions and the operational conditions were optimized, and the analytical performance characteristics of the resulting flow-biosensor were evaluated. The chemical modification of the GOx via CC was found to be effective to obtain larger catalytic activity as compared with the physical adsorption. Under the optimized conditions (i.e., volume ratio of the GOx-ccCF-reactor to the HRP-ccCF-detector is 1.0; applied potential is − 0.12 V vs. Ag/AgCl; carrier pH is 6.5; and carrier flow rate is 4.3 ml/min), highly selective and quite reproducible peak current responses toward glucose were obtained: the RSD for 30 consecutive injections of 3 mM glucose was 1.04%, and no serious interferences were observed for fructose, ethanol, uric acid, urea and tartaric acid for the amperometric measurements of glucose. The magnitude of the cathodic peak currents for glucose was linear up to 5 mM (sensitivity, 6.38 ± 0.32 μA/μM) with the limit detection of 9.4 μM (S/N = 3, noise level, 20 nA). The present GOx-ccCF-reactor and HRP-ccCF-detector-coupled flow-glucose biosensor was utilized for the determination of glucose in beverages and liquors, and the analytical results by the sensor were in fairly good agreement with those by the conventional spectrophotometry. - Highlights: ► Glucose oxidase (GOx) and peroxidase (HRP) were modified on carbon-felt. ► GOx-CF reactor and HRP-CF detector-coupled flow glucose biosensor was developed. ► This flow biosensor enabled the determination of glucose in beverages and liquors.

Glucose oxidase-modified carbon-felt-reactor coupled with peroxidase-modified carbon-felt-detector for amperometric flow determination of glucose

Energy Technology Data Exchange (ETDEWEB)

Wang Yue [School of Chemical Engineering, University of Science and Technology LiaoNing, 185 Qianshan Middle Road, High-tech Zone, Anshan, LiaoNing, 114501 (China); Hasebe, Yasushi, E-mail: hasebe@sit.ac.jp [Department of Life Science and Green Chemistry, Faculty of Engineering, Saitama Institute of Technology, 1690, Fusaiji, Fukaya, Saitama 369-0293 (Japan)

2012-04-01

Glucose oxidase (GOx) and horseradish peroxidase (HRP) were covalently immobilized on a porous carbon-felt (CF) by using cyanuric chloride (CC) as a linking reagent. The resulting GOx-modified-CF (GOx-ccCF) was used as column-type enzyme reactor and placed on upstream of the HRP-ccCF-based H{sub 2}O{sub 2} flow-detector to fabricate amperometric flow-biosensor for glucose. Sensor setting conditions and the operational conditions were optimized, and the analytical performance characteristics of the resulting flow-biosensor were evaluated. The chemical modification of the GOx via CC was found to be effective to obtain larger catalytic activity as compared with the physical adsorption. Under the optimized conditions (i.e., volume ratio of the GOx-ccCF-reactor to the HRP-ccCF-detector is 1.0; applied potential is - 0.12 V vs. Ag/AgCl; carrier pH is 6.5; and carrier flow rate is 4.3 ml/min), highly selective and quite reproducible peak current responses toward glucose were obtained: the RSD for 30 consecutive injections of 3 mM glucose was 1.04%, and no serious interferences were observed for fructose, ethanol, uric acid, urea and tartaric acid for the amperometric measurements of glucose. The magnitude of the cathodic peak currents for glucose was linear up to 5 mM (sensitivity, 6.38 {+-} 0.32 {mu}A/{mu}M) with the limit detection of 9.4 {mu}M (S/N = 3, noise level, 20 nA). The present GOx-ccCF-reactor and HRP-ccCF-detector-coupled flow-glucose biosensor was utilized for the determination of glucose in beverages and liquors, and the analytical results by the sensor were in fairly good agreement with those by the conventional spectrophotometry. - Highlights: Black-Right-Pointing-Pointer Glucose oxidase (GOx) and peroxidase (HRP) were modified on carbon-felt. Black-Right-Pointing-Pointer GOx-CF reactor and HRP-CF detector-coupled flow glucose biosensor was developed. Black-Right-Pointing-Pointer This flow biosensor enabled the determination of glucose in beverages and

Critical evaluation of quality assurance in laboratory diagnosis of tuberculosis in selected nearby microscopic centers under RNTCP

Directory of Open Access Journals (Sweden)

Anuradha

2013-01-01

Full Text Available Objective: RNTCP relies on sputum smear microscopy for diagnosis, categorization of patients for treatment and assessment of their program. Therefore, it is crucial that the smear microscopy services provided are of highest quality possible. The current study is undertaken to do on site evaluation and Random blinded rechecking (RBRC of slides at selected microscopic centers. Material & Methods: Five microscopic centers were selected for onsite evaluation and Random Blinded rechecking. Slides were collected monthly from the respective DMCs. A questionnaire was developed to assess the overall operational conditions at the DMCs and a checklist was prepared to record the observation during the visit. RBRC slides were read by two microbiologists independently and results were compared with RNTCP results. Slides were read before and after restaining the slides. Results: After the evaluation of checklist and questionnaire, it was found that 100% centers were following the charts for smear preparation, staining and grading with adequate stock supply. One out of 5 centers had maximum number of slides with poor quality of smear (16.7%, 8% uneven smear and 14% slides with improper thickness. There was 100% concordance when reading five positive and five negative smears. The mean time spent on microscopic examination was 4.4 minutes, compared with recommended time of 10 minutes. Out of 828 slides rechecked under RBRC one low false negative error was found. Conclusion: The evaluation of quality control practices was found satisfactory. The laboratory staff was able to incorporate simple quality control procedures for AFB microscopy into their routine practice, resulting in reliable service. Onsite evaluation and RBRC are viable measures of laboratory performance and both should be continued.

Identification of Material Parameters for the Simulation of Acoustic Absorption of Fouled Sintered Fiber Felts

Directory of Open Access Journals (Sweden)

Nicolas Lippitz

2016-08-01

Full Text Available As a reaction to the increasing noise pollution, caused by the expansion of airports close to residential areas, porous trailing edges are investigated to reduce the aeroacoustic noise produced by flow around the airframe. Besides mechanical and acoustical investigations of porous materials, the fouling behavior of promising materials is an important aspect to estimate the performance in long-term use. For this study, two sintered fiber felts were selected for a long-term fouling experiment where the development of the flow resistivity and accumulation of dirt was observed. Based on 3D structural characterizations obtained from X-ray tomography of the initial materials, acoustic models (Biot and Johnson–Champoux–Allard in the frame of the transfer matrix method were applied to the sintered fiber felts. Flow resistivity measurements and the measurements of the absorption coefficient in an impedance tube are the basis for a fouling model for sintered fiber felts. The contribution will conclude with recommendations concerning the modeling of pollution processes of porous materials.

ShakeMapple : tapping laptop motion sensors to map the felt extents of an earthquake

Science.gov (United States)

Bossu, Remy; McGilvary, Gary; Kamb, Linus

2010-05-01

There is a significant pool of untapped sensor resources available in portable computer embedded motion sensors. Included primarily to detect sudden strong motion in order to park the disk heads to prevent damage to the disks in the event of a fall or other severe motion, these sensors may also be tapped for other uses as well. We have developed a system that takes advantage of the Apple Macintosh laptops' embedded Sudden Motion Sensors to record earthquake strong motion data to rapidly build maps of where and to what extent an earthquake has been felt. After an earthquake, it is vital to understand the damage caused especially in urban environments as this is often the scene for large amounts of damage caused by earthquakes. Gathering as much information from these impacts to determine where the areas that are likely to be most effected, can aid in distributing emergency services effectively. The ShakeMapple system operates in the background, continuously saving the most recent data from the motion sensors. After an earthquake has occurred, the ShakeMapple system calculates the peak acceleration within a time window around the expected arrival and sends that to servers at the EMSC. A map plotting the felt responses is then generated and presented on the web. Because large-scale testing of such an application is inherently difficult, we propose to organize a broadly distributed "simulated event" test. The software will be available for download in April, after which we plan to organize a large-scale test by the summer. At a specified time, participating testers will be asked to create their own strong motion to be registered and submitted by the ShakeMapple client. From these responses, a felt map will be produced representing the broadly-felt effects of the simulated event.

Damage Behavior of Sintered Fiber Felts

Directory of Open Access Journals (Sweden)

Nicolas Lippitz

2015-04-01

Full Text Available The reduction of aircraft noise is important due to a rising number of flights and the growth of urban centers close to airports. During landing, a significant part of the noise is generated by flow around the airframe. To reduce that noise porous trailing edges are investigated. Ideally, the porous materials should to be structural materials as well. Therefore, the mechanical properties and damage behavior are of major interest. The aim of this study is to show the change of structure and the damage behavior of sintered fiber felts, which are promising materials for porous trailing edges, under tensile loading using a combination of tensile tests and three dimensional computed tomography scans. By stopping the tensile test after a defined stress or strain and scanning the sample, it is possible to correlate structural changes and the development of damage to certain features in the stress-strain curve and follow the damage process with a high spatial resolution. Finally, the correlation between material structure and mechanical behavior is demonstrated.

Trust in Supervisor and Job Engagement: Mediating Effects of Psychological Safety and Felt Obligation.

Science.gov (United States)

Basit, Ameer A

2017-11-17

In the social context of job engagement, the role of trust in supervisor in predicting engagement of employees has received attention in research. Very limited research, however, has investigated the mechanisms mediating this dynamic relationship. To address this important gap in knowledge, the aim of this study was to examine psychological safety and felt obligation as two psychological mechanisms mediating the effect of trust in supervisor on job engagement. Drawing from job engagement and social exchange theories, the mediating roles of psychological safety and felt obligation in the trust-engagement relationship were empirically investigated in the Malaysian context. Using self-report questionnaires, data were collected from 337 nurses employed in a public hospital located near Kuala Lumpur, Malaysia. Results fully supported the proposed serial multiple mediator model. Trust in supervisor was indirectly related to job engagement via psychological safety followed by felt obligation. This study provides empirical evidence that trust in supervisor makes employees feel psychologically safe to employ and express their selves in their job roles. This satisfaction of the psychological safety need is interpreted by employees as an important socioemotional benefit that, in turn, makes them feel obligated to pay back to their organization through their enhanced level of job engagement. Implications for theory and practice were discussed.

A high-performance carbon nanoparticle-decorated graphite felt electrode for vanadium redox flow batteries

International Nuclear Information System (INIS)

Wei, L.; Zhao, T.S.; Zhao, G.; An, L.; Zeng, L.

2016-01-01

Highlights: • Propose a carbon nanoparticle-decorated graphite felt electrode for VRFBs. • The energy efficiency is up to 84.8% at 100 mA cm"−"2. • The new electrode allows the peak power density to reach 508 mW cm"−"2. - Abstract: Increasing the performance of vanadium redox flow batteries (VRFBs), especially the energy efficiency and power density, is critically important to reduce the system cost to a level for widespread commercialization. Unlike conventional VRFBs with flow-through structure, in this work we create a VRFB featuring a flow-field structure with a carbon nanoparticle-decorated graphite felt electrode for the battery. This novel structure, exhibiting a significantly reduced ohmic loss through reducing electrode thickness, an increased surface area and improved electrocatalytic activity by coating carbon nanoparticles, allows the energy efficiency up to 84.8% at a current density of as high as 100 mA cm"−"2 and the peak power density to reach a value of 508 mW cm"−"2. In addition, it is demonstrated that the battery with this proposed structure exhibits a substantially improved rate capability and capacity retention as opposed to conventional flow-through structured battery with thick graphite felt electrodes.

Electrochemical disinfection of simulated ballast water on PbO2/graphite felt electrode

International Nuclear Information System (INIS)

Chen, Shuiping; Hu, Weidong; Hong, Jianxun; Sandoe, Steve

2016-01-01

A novel PbO 2 /graphite felt electrode was constructed by electrochemical deposition of PbO 2 on graphite felt and characterized by X-ray powder diffraction (XRD) and scanning electron microscopy (SEM) analysis. The prepared electrode is a viable technology for inactivation of Escherichia coli, Enterococcus faecalis, and Artemia salina as indicator organisms in simulated ballast water treatment, which meets the International Maritime Organization (IMO) Regulation D-2. The effects of contact time and current density on inactivation were investigated. An increase in current density generally had a beneficial effect on the inactivation of the three species. E.faecalis and A.salina were more resistant to electrochemical disinfection than E. coli. The complete disinfection of E.coli was achieved in <8 min at an applied current density of 253 A/m 2 . Complete inactivation of E. faecalis and A.salina was achieved at the same current density after 60 and 40 min of contact time, respectively. A. salina inactivation follows first-order kinetics. - Highlights: •A novel PbO 2 /graphite felt anode was developed for the electrochemical treatment of the simulated ballast water. •The technology meets the IMO D‐2 regulation and provides a high degree of removal of the microorganisms of ballast water without any additional chemical substances. •E.faecalis, E.coli, and A.salina cells in simulated ballast water were completely inactivated after 60, 8 and 40 min of contact time at 253 A/m 2 of current density, respectively.

Emotion felt by the listener and expressed by the music: a literature review and theoretical investigation

Directory of Open Access Journals (Sweden)

Emery eSchubert

2013-12-01

Full Text Available In his seminal paper, Gabrielsson (2002 distinguishes between emotion felt by the listener, here: ‘internal locus of emotion’ (IL, and the emotion the music is expressing, here: 'external locus emotion' (EL. This paper tabulates 16 such publications published in the decade 2003-2012 consisting of 19 studies/experiments and provides some theoretical perspectives. The key findings were that (1 IL ratings was frequently rated statistically the same or lower than the corresponding EL rating (e.g. lower felt happiness rating compared to the apparent happiness of the music, and that (2 self-select and preferred music had a smaller gap across the emotion loci than experimenter selected and disliked music. These key findings were explained by an ‘inhibited’ emotional contagion mechanism, where the otherwise matching felt emotion may have been attenuated by some other factor such as social context. Matching between EL and IL for loved and self-selected pieces was explained by the activation of ‘contagion’ circuits. Physiological arousal, personality and age, as well as musical features (tempo, mode, putative emotions were observed to influence perceived and felt emotion distinctions. A variety of data collection formats were identified, but mostly using continuous rating scales. In conclusion, a more systematic use of terminology appears desirable with respect to theory-building. Whether two broad categories, namely matched and unmatched, are sufficient to capture the relationships between EL and IL, instead of four categories as suggested by Gabrielsson, is subject to future research.

Subclinical depression in Urban Indian adolescents: Prevalence, felt needs, and correlates

OpenAIRE

Singhal, Meghna; Manjula, M.; Vijay Sagar, K. John

2016-01-01

Background: Subclinical depression in adolescents constitutes a risk factor for future clinical depression and hence warrants examination. However, there is a paucity of research that documents subclinical depression among adolescents in India. Objectives: (a) To investigate the prevalence of subclinical depression in urban school-going adolescents; (b) to investigate the problems and felt needs of these adolescents; (c) to examine depression-related variables; and (d) to examine the relation...

Influence of Fenton's reagent treatment on electrochemical properties of graphite felt for all vanadium redox flow battery

International Nuclear Information System (INIS)

Gao, Chao; Wang, NanFang; Peng, Sui; Liu, SuQin; Lei, Ying; Liang, XinXing; Zeng, ShanShan; Zi, HuiFang

2013-01-01

Highlights: ► Highly hydroxyl-functionalized graphite felt has been obtained through Fenton's reagent treatment. ► Fenton's reagent treatment involves only one step, works under ambient conditions and will never produce any toxic gas. ► The treated graphite felt exhibits superior electrochemical performance in comparison to the untreated one. -- Abstract: An environmental, economic and highly effective method for carbon fiber hydroxylated-functionalization based on Fenton's reagent treatment is used to improve the electrochemical activity of graphite felt (GF) as the positive electrode in all vanadium redox flow battery (VRFB). The effect of H 2 O 2 content in Fenton's reagent on the structure and electrochemical properties of GF is investigated. The scanning electron microscope (SEM) indicates that the surface of the treated GF is etched increasingly with the content of H 2 O 2 . The Fourier transformation infrared (FTIR) spectroscopy shows that the peak intensity of hydroxyl groups on the treated felt is increased with the H 2 O 2 concentration, which is further verified by X-ray photoelectron spectroscopy (XPS). Cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) show that the treated sample exhibits a higher electrochemical activity. A VRFB with the treated GF as electrodes exhibits higher coulombic, voltage and energy efficiency (98.8%, 75.1% and 74.2%) than that with the untreated GF (93.9%, 72.1% and 67.7%) at 60 mA cm −2 , and this method is even superior when compared with the reported methods

University Performance Management

DEFF Research Database (Denmark)

For the last two decades the Danish Universities have felt the impact of the international trend towards implementation of New Public Management. The results are seen in the implementation of new hierarchical governance structures and contractual governance system including market based quantitat......For the last two decades the Danish Universities have felt the impact of the international trend towards implementation of New Public Management. The results are seen in the implementation of new hierarchical governance structures and contractual governance system including market based...... quantitative measurement systems for resource allocation and performance evaluation. Compared to other countries the changes in performance measurements and governance of the Danish universities are radical and the Minister of Science heralded them as "the greatest change in university management since...... the founding of Copenhagen University in 1479". The changes took place with surprisingly little resistance from university scholars. The articles in this anthology investigate the origins and rationales for the silent managerial revolution at Danish Universities and the radical implications for the identity...

Thermal conductivity of carbon felts, insulating materials with a high anisotropy; Conductivite thermique des feutres de carbone, isolants a forte anisotropie

Energy Technology Data Exchange (ETDEWEB)

Danes, F.E.; Bardon, J.P. [Centre National de la Recherche Scientifique, 44 - Nantes (France). Lab. de Thermocinetique

1996-12-31

Because of their high temperature resistance, carbon felts are used as thermal insulating materials for high temperature applications. The aim of this paper is to present a model that allows to calculate the thermal conductivity of felt fibers taking into account their high anisotropy and the contact resistance of fibers generated by the 3-D constriction phenomena which develop in fibers around each contact point. The study is divided in two parts: the first part concerns the bibliographic study of the different anisotropies of fibers and felts, while the second part presents the proposed conductivity model. (J.S.) 12 refs.

Electrochemical removal of fluoride from water by PAOA-modified carbon felt electrodes in a continuous flow reactor.

Science.gov (United States)

Cui, Hao; Qian, Yan; An, Hao; Sun, Chencheng; Zhai, Jianping; Li, Qin

2012-08-01

A novel poly(aniline-co-o-aminophenol) (PAOA) modified carbon felt electrode reactor was designed and investigated for fluoride removal from aqueous solutions. This reactor design is innovative because it operates under a wider pH range because of coating with a copolymer PAOA ion exchange film. In addition, contaminant mass transfer from bulk solution to the electrode surface is enhanced by the porous carbon felt as an electron-conducting carrier material compared to other reactors. The electrically controlled anion exchange mechanism was investigated by X-ray photoelectron spectroscopy and cyclic voltammetry. The applicability of the reactor in the field was tested through a series of continuous flow experiments. When the flow rate and initial fluoride concentration were increased, the breakthrough curve became sharper, which lead to a decrease in the breakthrough time and the defluoridation capacity of the reactor. The terminal potential values largely influenced fluoride removal by the reactor and the optimal defluoridation efficiency was observed at around 1.2V. The breakthrough capacities were all >10mg/g over a wide pH range (pH 5-9) with an initial fluoride concentration of 10mg/L. Consecutive treatment-regeneration studies over a week (once each day) revealed that the PAOA-modified carbon felt electrode could be effectively regenerated for reuse. The PAOA-modified carbon felt electrode reactor is a promising system that could be made commercially available for fluoride removal from aqueous solutions in field applications. Copyright © 2012 Elsevier Ltd. All rights reserved.

Felt stigma and self-esteem among psychiatric hospital outdoor and community camp attending patients

Directory of Open Access Journals (Sweden)

Shantna Kumari

2014-01-01

Full Text Available Background: Self-stigma of people with mental illness is a major obstacle to recovery, limiting opportunities and undermining self-esteem. Aim: The aim of this study is to compare felt stigma and self-esteem in psychiatric patients receiving treatment from hospital outdoor clinic or from Community Outreach Program (COP. Materials and Methods: This cross-sectional study was conducted on psychiatric patients who were on outpatient treatment for at least 6 months, but had never been hospitalized. The study sample included 130 patients receiving outdoor treatment from a Psychiatric Hospital and a matched group of 140 patients receiving treatment from COP of the same hospital. Demographic and clinical details of the patients were recorded on a specially designed proforma. Modified felt stigma scale and Rosenberg self-esteem scale were used to assess stigma and self-esteem, respectively. Results: On the modified felt stigma scale, the mean (±standard deviation [SD] score of psychiatric hospital outpatients (31.89 ± 6.51 was significantly higher than the scores of patients attending COP (29.20 ± 6.80. On Rosenberg self-esteem scale, mean (±SD scores of patients with psychosis (17.98 ± 1.69 was significantly lower compared to scores of patients with epilepsy (21.83 ± 1.60. There was no significant correlation between stigma and self-esteem. Conclusion: As psychiatric hospital outpatients have significantly more self-stigma when compared to patients attending community outreach camps, the availability of more community outreach camps along with educating people about psychiatric illnesses may help in lowering stigma of psychiatric disorders.

Electrochemical disinfection of simulated ballast water on PbO2/graphite felt electrode.

Science.gov (United States)

Chen, Shuiping; Hu, Weidong; Hong, Jianxun; Sandoe, Steve

2016-04-15

A novel PbO2/graphite felt electrode was constructed by electrochemical deposition of PbO2 on graphite felt and characterized by X-ray powder diffraction (XRD) and scanning electron microscopy (SEM) analysis. The prepared electrode is a viable technology for inactivation of Escherichia coli, Enterococcus faecalis, and Artemia salina as indicator organisms in simulated ballast water treatment, which meets the International Maritime Organization (IMO) Regulation D-2. The effects of contact time and current density on inactivation were investigated. An increase in current density generally had a beneficial effect on the inactivation of the three species. E.faecalis and A.salina were more resistant to electrochemical disinfection than E. coli. The complete disinfection of E.coli was achieved in <8min at an applied current density of 253A/m(2). Complete inactivation of E. faecalis and A.salina was achieved at the same current density after 60 and 40min of contact time, respectively. A. salina inactivation follows first-order kinetics. Copyright © 2016 Elsevier Ltd. All rights reserved.

W18O49 nanowires assembled on carbon felt for application to supercapacitors

Science.gov (United States)

Jung, Jinjoo; Kim, Do Hyung

2018-03-01

For supercapacitor applications, W18O49 nanowires have been extensively grown on graphitic carbon felt using a facile solvothermal method. The diameter and length of the nanowires are about 7 and 300 nm, respectively. The nanowires consist of monoclinic W18O49 grown along the [010] direction, as shown by TEM and XRD analyses. The W18O49 nanowires, assembled on carbon felt, exhibit a high capacity of 588.33 F/g at a current density of 1 A/g together with an excellent cycle performance, and a low internal resistance during the electrochemical tests. This outstanding performance may originate from the three-dimensional porous nanostructure of these W18O49 nanowires, which leads to a reduction in the resistance and fast reaction kinetics due to the high specific surface area and electrolyte accessibility. Furthermore, sufficient oxygen deficiencies of the substoichiometric tungsten oxide can also contribute to the electrochemical activity, which can be confirmed by comparison of CV and EIS data with WO3 nanowires.

Numerical study of the effects of carbon felt electrode compression in all-vanadium redox flow batteries

International Nuclear Information System (INIS)

Oh, Kyeongmin; Won, Seongyeon; Ju, Hyunchul

2015-01-01

Highlights: • The effects of electrode compression on VRFB are examined. • The electronic conductivity is improved when the compression is increased. • The kinetic losses are similar regardless of the electrode compression level. • The vanadium distribution is more uniform within highly compressed electrode. - Abstract: The porous carbon felt electrode is one of the major components of all-vanadium redox flow batteries (VRFBs). These electrodes are necessarily compressed during stack assembly to prevent liquid electrolyte leakage and diminish the interfacial contact resistance among VRFB stack components. The porous structure and properties of carbon felt electrodes have a considerable influence on the electrochemical reactions, transport features, and cell performance. Thus, a numerical study was performed herein to investigate the effects of electrode compression on the charge and discharge behavior of VRFBs. A three-dimensional, transient VRFB model developed in a previous study was employed to simulate VRFBs under two degrees of electrode compression (10% vs. 20%). The effects of electrode compression were precisely evaluated by analysis of the solid/electrolyte potential profiles, transfer current density, and vanadium concentration distributions, as well as the overall charge and discharge performance. The model predictions highlight the beneficial impact of electrode compression; the electronic conductivity of the carbon felt electrode is the main parameter improved by electrode compression, leading to reduction in ohmic loss through the electrodes. In contrast, the kinetics of the redox reactions and transport of vanadium species are not significantly altered by the degree of electrode compression (10% to 20%). This study enhances the understanding of electrode compression effects and demonstrates that the present VRFB model is a valuable tool for determining the optimal design and compression of carbon felt electrodes in VRFBs.

Longitudinal Associations between Gender and Ethnic-Racial Identity Felt Pressure from Family and Peers and Self-Esteem among African American and Latino/a Youth.

Science.gov (United States)

Aoyagi, Keiko; Santos, Carlos E; Updegraff, Kimberly A

2018-01-01

Gender identity felt pressure is negatively associated with adjustment indices, including self-esteem, among children and early adolescents, and both gender and ethnic-racial identity felt pressure are negatively associated with self-esteem among young adults. This study explored the longitudinal associations between gender identity and ethnic-racial identity felt pressure from family and peers to behave in either gender or race/ethnic-accordant ways, and self-esteem among a sample of 750 (49.2% female) African American (n = 194) and Latino/a youth (n = 556) (M = 12.10 years, SD = .97 years). For African Americans, the results revealed significant negative longitudinal associations between (a) ethnic-racial identity felt pressure from family at Time 1 and self-esteem at Time 2 and (b) ethnic-racial identity felt pressure from peers at Time 1 and self-esteem at Time 2, controlling for self-esteem at Time 1. These associations were not found among Latinos/as, nor were associations found between gender identity felt pressure from peers or family and self-esteem. The findings are discussed by drawing on the gender identity and ethnic-racial identity literatures.

Effects of atmospheric air plasma treatment of graphite and carbon felt electrodes on the anodic current from Shewanella attached cells.

Science.gov (United States)

Epifanio, Monica; Inguva, Saikumar; Kitching, Michael; Mosnier, Jean-Paul; Marsili, Enrico

2015-12-01

The attachment of electrochemically active microorganisms (EAM) on an electrode is determined by both the chemistry and topography of the electrode surface. Pre-treatment of the electrode surface by atmospheric air plasma introduces hydrophilic functional groups, thereby increasing cell attachment and electroactivity in short-term experiments. In this study, we use graphite and carbon felt electrodes to grow the model EAM Shewanella loihica PV-4 at oxidative potential (0.2 V vs. Ag/AgCl). Cell attachment and electroactivity are measured through electrodynamic methods. Atmospheric air plasma pre-treatment increases cell attachment and current output at graphite electrodes by 25%, while it improves the electroactivity of the carbon felt electrodes by 450%. Air plasma pre-treatment decreased the coulombic efficiency on both carbon felt and graphite electrodes by 60% and 80%, respectively. Microbially produced flavins adsorb preferentially at the graphite electrode, and air plasma pre-treatment results in lower flavin adsorption at both graphite and carbon felt electrodes. Results show that air plasma pre-treatment is a feasible option to increase current output in bioelectrochemical systems. Copyright © 2015 Elsevier B.V. All rights reserved.

40 CFR 443.40 - Applicability; description of the linoleum and printed asphalt felt subcategory.

Science.gov (United States)

2010-07-01

... 40 Protection of Environment 29 2010-07-01 2010-07-01 false Applicability; description of the linoleum and printed asphalt felt subcategory. 443.40 Section 443.40 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) EFFLUENT GUIDELINES AND STANDARDS EFFLUENT LIMITATIONS GUIDELINES FOR EXISTING SOURCES AND STANDARDS OF PERFORMANC...

Adsorption of Remazol Black B dye on Activated Carbon Felt

Directory of Open Access Journals (Sweden)

Donnaperna Lucio

2008-11-01

Full Text Available The adsorption of Remazol Black B (anionic dye on a microporous activated carbon felt is investigated from its aqueous solution. The surface chemistry of activated carbon is studied using X-ray microanalysis, "Boehm" titrations and pH of PZC measurements which indicates that the surface oxygenated groups are mainly acidic in nature. The kinetics of Remazol Black B adsorption is observed to be pH dependent and governed by the diffusion of the dye molecules. The experimental data can be explained by "intra-particle diffusion model". For Remazol Black B, the Khan model is best suited to simulate the adsorption isotherms.

Development of Gender Typicality and Felt Pressure in European French and North African French Adolescents.

Science.gov (United States)

Hoffman, Adam J; Dumas, Florence; Loose, Florence; Smeding, Annique; Kurtz-Costes, Beth; Régner, Isabelle

2017-11-14

Trajectories of gender identity were examined from Grade 6 (M age  = 11.9 years) to Grade 9 in European French (n = 570) and North African French (n = 534) adolescents, and gender and ethnic group differences were assessed in these trajectories. In Grade 6, boys of both ethnic groups reported higher levels of gender typicality and felt pressure for gender conformity than girls. European French girls and boys and North African French girls reported decreasing gender typicality from Grade 6 to Grade 9, whereas North African French boys did not change. Felt pressure decreased among girls, did not change in European French boys, and increased in North African French boys. Ethnic and gender differences in gender identity development are discussed. © 2017 The Authors. Child Development © 2017 Society for Research in Child Development, Inc.

Nitrogen-Doped Carbon Nanotube/Graphite Felts as Advanced Electrode Materials for Vanadium Redox Flow Batteries.

Science.gov (United States)

Wang, Shuangyin; Zhao, Xinsheng; Cochell, Thomas; Manthiram, Arumugam

2012-08-16

Nitrogen-doped carbon nanotubes have been grown, for the first time, on graphite felt (N-CNT/GF) by a chemical vapor deposition approach and examined as an advanced electrode for vanadium redox flow batteries (VRFBs). The unique porous structure and nitrogen doping of N-CNT/GF with increased surface area enhances the battery performance significantly. The enriched porous structure of N-CNTs on graphite felt could potentially facilitate the diffusion of electrolyte, while the N-doping could significantly contribute to the enhanced electrode performance. Specifically, the N-doping (i) modifies the electronic properties of CNT and thereby alters the chemisorption characteristics of the vanadium ions, (ii) generates defect sites that are electrochemically more active, (iii) increases the oxygen species on CNT surface, which is a key factor influencing the VRFB performance, and (iv) makes the N-CNT electrochemically more accessible than the CNT.

GeoNet's `Felt Rapid': Collecting What Is Needed, When You Need It, No More, No Less. Rapid, Volumous Data For Response Versus Detailed, Precise Data For Research

Science.gov (United States)

Little, C. L.; McBride, S.; Balfour, N.

2016-12-01

New Zealand's geohazard monitoring agency, GeoNet, recently implemented `Felt Rapid': earthquake felt reporting that is quick and simple. GeoNet locates 20,000 earthquakes each year with hundreds of those reported as being felt. Starting in the late 1800s, the New Zealand public has become adept at completing felt reports but feedback since the Canterbury Earthquake Sequence suggested that traditional felt reporting was not meeting researchers' or the public's needs. GeoNet required something rapid, adaptable and robust. The solution was Felt Rapid, a mobile app and website where respondents simply pick from 6 cartoon images - representing Modified Mercalli Intensity (MMI) 3-8 - that best aligned to what they felt. For the last decade, felt reporting has been conducted via the GeoNet website, with additional targeted surveys after damaging earthquakes. The vast majority of the submitted felt reports were for earthquakes too small to cause damage, as these are by far the most frequent. Reports from small events are of little interest to researchers who are only concerned with damaging, MMI6 and above. However, we found that when damaging earthquakes did occur, such as Christchurch's M6.3, they were only sparsely reported (3,776 reports). Understandably, sitting at a computer and completing a lengthy online form wasn't a priority for people after a devastating earthquake. With Felt Rapid, reporting has to be completed within an hour of an earthquake, the use of GeoNet's automatically compiled felt reporting maps had evolved; their main purpose is immediate assessment of an earthquake's impact on populations, and is used by Civil Defence agencies. Reports are immediately displayed on an interactive map via the website and mobile app. With over 250,000 users this provides rapid and robust information regarding the experienced shaking. When a damaging earthquake occurs and researchers want to collect important and rare damaging felt reports, a separate in-depth survey

Career Paths in Sport Management

Science.gov (United States)

Schwab, Keri A.; Legg, Eric; Tanner, Preston; Timmerman, Danielle; Dustin, Daniel; Arthur-Banning, Skye G.

2015-01-01

Sport management alumni (N = 268) from five universities that offer undergraduate programs with an emphasis in sport management within departments of parks, recreation, and tourism were sampled via an electronic survey. The survey sought to learn where alumni were working, and how they felt about their career choice and undergraduate professional…

Knowledge and attitudes of pain management among nursing faculty.

Science.gov (United States)

Voshall, Barbara; Dunn, Karen S; Shelestak, Debra

2013-12-01

A descriptive correlational design was used in this study to examine nursing faculty knowledge and attitudes in pain management. Relationships between age, education level, pain management preparation, length of time practicing as a nurse, length of time teaching nursing, time teaching pain management in the classroom, taught pain guidelines in the classroom, and additional continuing education about pain management were explored. Ninety-six nursing faculty participated from 16 schools of nursing in one Midwestern U.S. region. Findings identified that most of the nursing faculty recalled being taught about pain management in their basic education, but less than one-half felt adequately prepared. Most respondents said that they taught pain management, yet fewer than one-half identified that they used specific pain management guidelines. Faculty demonstrated adequate knowledge of pain assessment, spiritual/cultural issues, and pathophysiology. Areas of weakness were found in medications, interventions, and addiction. Faculty that reported teaching pain management in the classroom and reported more continuing education missed fewer items. Older nursing faculty reported more years of practice, more years of teaching, and more continuing education in pain management than younger faculty. Younger nursing faculty remembered being taught pain management in nursing school and felt more adequately prepared than older nursing faculty. Faculty that reported practicing for longer periods of time felt less prepared in pain management than faculty who practiced for shorter periods of time. More continuing education in pain management may be needed for older nurses to meet the recommendations of the Institute of Medicines' report on relieving pain in the U.S. Copyright © 2013 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Power generation using an activated carbon fiber felt cathode in an upflow microbial fuel cell

KAUST Repository

Deng, Qian; Li, Xinyang; Zuo, Jiane.; Ling, Alison; Logan, Bruce E.

2010-01-01

An activated carbon fiber felt (ACFF) cathode lacking metal catalysts is used in an upflow microbial fuel cell (UMFC). The maximum power density with the ACFF cathode is 315 mW m-2, compared to lower values with cathodes made of plain carbon paper

Writing business communications. Are nurse managers prepared?

Science.gov (United States)

Spears, L A

1997-12-01

Based on interviews, this study indicates that writing business communications is a key task for nurse managers, affecting their professional success and power. However, most of the nurse managers interviewed felt they needed more education in business communications. Several ways of bringing this training to nursing students and practicing managers are suggested.

Carbon felt interlayer derived from rice paper and its synergistic encapsulation of polysulfides for lithium-sulfur batteries

Science.gov (United States)

Yang, Kai; Zhong, Lei; Guan, Ruiteng; Xiao, Min; Han, Dongmei; Wang, Shuanjin; Meng, Yuezhong

2018-05-01

Lithium-sulfur (Li-S) batteries have remarkably high theoretical specific capacity as promising candidates for next-generation energy storage. However, the "polysulfides shuttle" effect hampers its commercial application. Here, we use a kind of rice paper as a raw material to get inorganic oxides doping carbon felt by the facile carbonization method, and then modified by a simple coating process using poly (fluorenyl ether ketone) and Super P slurry. The special structure of the carbon felt derived from rice paper and its modified layer endow the final electronic conductive interlayer with inherent polysulfides absorbents and ion Coulombic repulsion functions, respectively, which show synergistic effect for trapping polysulfides. As an interlayer of Li-S batteries, the obtained carbon felt/poly (fluorenyl ether ketone)& Super P (CFSS) interlayer shows excellent electrochemical performance in improving specific capacity and decreasing polarization. The batteries with CFSS interlayer exhibit a high capacity of 837 mA h g-1 at 2.0 C and a high initial capacity of 1073.4 mA h g-1 and good capacity retention of 824.5 mA h g-1 after 500 cycles at 0.5 C. CFSS interlayer also shows excellent anti-self-discharge performance. Therefore, the simple and economical CFSS interlayer can be considered as a promising component for high performance Li-S batteries.

Solutions to Improve Educational Management Quality

OpenAIRE

Ramezan Jahanian; Masoomeh Motahari

2013-01-01

Nowadays, enhancing the quality in educational systems of different countries has gained especial importance and stand. Improving utilizing and increasing the quality in our country’s educational system is felt too. One of the utilizing factors in education system is to improve the educational management quality.In this article, effective factors in educational management quality and one of its improving solutions, thorough management quality, is analyzed.

Effective NiMn Nanoparticles-Functionalized Carbon Felt as an Effective Anode for Direct Urea Fuel Cells

Directory of Open Access Journals (Sweden)

Nasser A. M. Barakat

2018-05-01

Full Text Available The internal resistances of fuel cells strongly affect the generated power. Basically, in the fuel cell, the anode can be prepared by deposition of a film from the functional electrocatalyst on a proper gas diffusion layer. Accordingly, an interfacial resistance for the electron transport is created between the two layers. Electrocatalyst-functionalized gas diffusion layer (GDL can distinctly reduce the interfacial resistance between the catalyst layer and the GDL. In this study, NiMn nanoparticles-decorated carbon felt is introduced as functionalized GDL to be exploited as a ready-made anode in a direct urea fuel cell. The proposed treated GDL was prepared by calcination of nickel acetate/manganese acetate-loaded carbon felt under an argon atmosphere at 850 °C. The physiochemical characterizations confirmed complete reduction for the utilized precursors and deposition of pristine NiMn nanoparticles on the carbon felt fiber. In passive direct urea fuel cells, investigation the performance of the functionalized GDLs indicated that the composition of the metal nanoparticles has to be optimized as the GDL obtained from 40 wt % manganese acetate reveals the maximum generated power density; 36 mW/m2 at room temperature and 0.5 M urea solution. Moreover, the electrochemical measurements proved that low urea solution concentration is preferred as utilizing 0.5 M solution resulted into generating higher power compared to 1.0 and 2.0 M solution. Overall, this study opens a new avenue toward functionalization of the GDL as a novel strategy to overcome the interfacial resistance between the electrocatalyst and the GDL.

Power generation using an activated carbon fiber felt cathode in an upflow microbial fuel cell

KAUST Repository

Deng, Qian

2010-02-01

An activated carbon fiber felt (ACFF) cathode lacking metal catalysts is used in an upflow microbial fuel cell (UMFC). The maximum power density with the ACFF cathode is 315 mW m-2, compared to lower values with cathodes made of plain carbon paper (67 mW m-2), carbon felt (77 mW m-2), or platinum-coated carbon paper (124 mW m-2, 0.2 mg-Pt cm-2). The addition of platinum to the ACFF cathode (0.2 mg-Pt cm-2) increases the maximum power density to 391 mW m-2. Power production is further increased to 784 mW m-2 by increasing the cathode surface area and shaping it into a tubular form. With ACFF cutting into granules, the maximum power is 481 mW m-2 (0.5 cm granules), and 667 mW m-2 (1.0 cm granules). These results show that ACFF cathodes lacking metal catalysts can be used to substantially increase power production in UMFC compared to traditional materials lacking a precious metal catalyst. © 2009 Elsevier B.V.

Outstanding electrochemical performance of a graphene-modified graphite felt for vanadium redox flow battery application

Science.gov (United States)

González, Zoraida; Flox, Cristina; Blanco, Clara; Granda, Marcos; Morante, Juan R.; Menéndez, Rosa; Santamaría, Ricardo

2017-01-01

The development of more efficient electrode materials is essential to obtain vanadium redox flow batteries (VRFBs) with enhanced energy densities and to make these electrochemical energy storage devices more competitive. A graphene-modified graphite felt synthesized from a raw graphite felt and a graphene oxide water suspension by means of electrophoretic deposition (EPD) is investigated as a suitable electrode material in the positive side of a VRFB cell by means of cyclic voltammetry, impedance spectroscopy and charge/discharge experiments. The remarkably enhanced performance of the resultant hybrid material, in terms of electrochemical activity and kinetic reversibility towards the VO2+/VO2+, and mainly the markedly high energy efficiency of the VRFB cell (c.a. 95.8% at 25 mA cm-2) can be ascribed to the exceptional morphological and chemical characteristics of this tailored material. The 3D-architecture consisting of fibers interconnected by graphene-like sheets positively contributes to the proper development of the vanadium redox reactions and so represents a significant advance in the design of effective electrode materials.

Strategic issue diagnosis : the roles of organizational scanning, information processing structure of top management teams, and managers' cognitive complexity

OpenAIRE

Kuvaas, Bård

1998-01-01

Managers in organizations are continuously confronted by an array of ambiguous data and -vaguely felt stimuli which they must somehow order, explicate and imbue with meaning before they decide on how to respond. This study of -162 -members of organizations' top management teams employed a cross-level analysis to investigate how individual-, group- and organizational-level factors relate to how managers diagnose strategic issues. Findings show that managers' cognitive style, the...

Improvement of the Performance of Graphite Felt Electrodes for Vanadium-Redox-Flow-Batteries by Plasma Treatment

Directory of Open Access Journals (Sweden)

Eva-Maria Hammer

2014-02-01

Full Text Available In the frame of the present contribution oxidizing plasma pretreatment is used for the improvement of the electrocatalytic activity of graphite felt electrodes for Vanadium-Redox-Flow-Batteries (VRB. The influence of the working gas media on the catalytic activity and the surface morphology is demonstrated. The electrocatalytical properties of the graphite felt electrodes were examined by cyclic voltammetry and electrochemical impedance spectroscopy. The obtained results show that a significant improvement of the redox reaction kinetics can be achieved for all plasma modified samples using different working gasses (Ar, N2 and compressed air in an oxidizing environment. Nitrogen plasma treatment leads to the highest catalytical activities at the same operational conditions. Through a variation of the nitrogen plasma treatment duration a maximum performance at about 14 min cm-2 was observed, which is also represented by a minimum of 90 Ω in the charge transfer resistance obtained by EIS measurements. The morphology changes of the graphitized surface were followed using SEM.

PKU-RBRC Workshop on Transverse Spin

Energy Technology Data Exchange (ETDEWEB)

Avakian,H.; Bunce, G.; Yuan, F.

2008-06-30

Understanding the structure of the nucleon is a fundamental question in subatomic physics, and it has been under intensive investigation for the last several years. Modern research focuses in particular on the spin structure of the nucleon. Experimental and theoretical investigations worldwide over the last few decades have established that, contrary to nave quark model expectations, quarks carry only about 30% of the totd spin of the proton. The origin of the remaining spin is the key question in current hadronic physics and also the major driving forces for the current and future experiments, such as RHIC and CEBAF in US, JPARC in Japan, COMPASS at CERN in Europe, FAIR at GSI in Germany. Among these studies, the transverse-spin physics develops actively and rapidly in the last few years. Recent studies reveal that transverse-spin physics is closely related to many fundamental properties of the QCD dynamics such as the factorization, the non-trivial universality of the parton distribution and fragmentation functions. It was very timely to bring together the theorists and experimentalists in this field at this workshop to review and discuss the latest developments and future perspective in hadronic spin physics. This workshop was very success iu many aspects. First of all, it attracted almost every expert working in this field. We had more than eighty participants in total, among them 27 came from the US institutes, 13 from Europe, 3 from Korea, and 2 from Japan. The rest participants came from local institutes in China. Second, we arranged plenty physics presentations, and the program covers all recent progresses made in the last few years. In total, we had 47 physics presentations, and two round table discussions. The discussion sessions were especially very useful and very much appreciated by all participants. In addition, we also scheduled plenty time for discussion in each presentation, and the living discussions impressed and benefited all participants.

Performance evaluation of thermally treated graphite felt electrodes for vanadium redox flow battery and their four-point single cell characterization

Science.gov (United States)

Mazúr, P.; Mrlík, J.; Beneš, J.; Pocedič, J.; Vrána, J.; Dundálek, J.; Kosek, J.

2018-03-01

In our contribution we study the electrocatalytic effect of oxygen functionalization of thermally treated graphite felt on kinetics of electrode reactions of vanadium redox flow battery. Chemical and morphological changes of the felts are analysed by standard physico-chemical characterization techniques. A complex method four-point method is developed and employed for characterization of the felts in a laboratory single-cell. The method is based on electrochemical impedance spectroscopy and load curves measurements of positive and negative half-cells using platinum wire pseudo-reference electrodes. The distribution of ohmic and faradaic losses within a single-cell is evaluated for both symmetric and asymmetric electrode set-up with respect to the treatment conditions. Positive effect of oxygen functionalization is observed only for negative electrode, whereas kinetics of positive electrode reaction is almost unaffected by the treatment. This is in a contradiction to the results of typically employed cyclovoltammetric characterization which indicate that both electrodes are enhanced by the treatment to a similar extent. The developed four-point characterization method can be further used e.g., for the component screening and in-situ durability studies on single-cell scale redox flow batteries of various chemistries.

Electrocatalytic properties of N-doped graphite felt in electro-Fenton process and degradation mechanism of levofloxacin.

Science.gov (United States)

Liu, Xiaocheng; Yang, Danxing; Zhou, Yaoyu; Zhang, Jiachao; Luo, Lin; Meng, Sijun; Chen, Song; Tan, Mengjiao; Li, Zhicheng; Tang, Lin

2017-09-01

The degradation of antibiotic levofloxacin was investigated by dimensionally stable anode as well as modified cathode using low-cost chemical reagents of hydrazine hydrate and ethanol for electro-Fenton in an undivided cell at pH 3.0 under room temperature. Comparison of unmodified and modified cathode was performed. The apparent rate constant of levofloxacin decay was found to be 0.2883 min -1 for graphite felt-10 with the best performance at 200 mA, which is lower than graphite felt at 400 mA. The optimum modified cathode showed a significant improvement of complete mineralization of levofloxacin, reaching a 92% TOC removal at 200 mA for 480 min higher than unmodified one at twice the current. Surface physicochemical properties and morphology were investigated by scanning electron microscope, contact angle and X-ray photoelectron spectroscopy. The electrochemical characterization of hydrogen evolution reaction was adopted to clarify a possible pathway for the higher mineralization of levofloxacin, indicating a potential pilot-scale study to the pollution with the similar structure. Copyright © 2017 Elsevier Ltd. All rights reserved.

PROCEEDINGS OF RIKEN BNL RESEARCH CENTER WORKSHOP, VOLUME 65, RHIC SPIN COLLABORATION MEETINGS XXVII, XXVIII, and XXX

International Nuclear Information System (INIS)

OGAWA, A.

2004-01-01

The RIKEN BNL Research Center (RSRC) was established in April 1997 at Brookhaven National Laboratory. It is funded by the 'Rikagaku Kenkyusho' (RIKEN, The Institute of Physical and Chemical Research) of Japan. The Center is dedicated to the study of strong interactions, including spin physics, lattice QCD, and RHIC physics through the nurturing of a new generation of young physicists. The RBRC has both a theory and experimental component. At present the theoretical group has 4 Fellows and 3 Research Associates as well as 11 RHIC Physics/University Fellows (academic year 2003-2004). To date there are approximately 30 graduates from the program of which 13 have attained tenure positions at major institutions worldwide. The experimental group is smaller and has 2 Fellows and 3 RHIC Physics/University Fellows and 3 Research Associates, and historically 6 individuals have attained permanent positions. Beginning in 2001 a new RIKEN Spin Program (RSP) category was implemented at RBRC. These appointments are joint positions of RBRC and RIKEN and include the following positions in theory and experiment: RSP Researchers, RSP Research Associates, and Young Researchers, who are mentored by senior RBRC Scientists, A number of RIKEN Jr. Research Associates and Visiting Scientists also contribute to the physics program at the Center. RBRC has an active workshop program on strong interaction physics with each workshop focused on a specific physics problem. Each workshop speaker is encouraged to select a few of the most important transparencies from his or her presentation, accompanied by a page of explanation. This material is collected at the end of the workshop by the organizer to form proceedings, which can therefore be available within a short time. To date there are sixty nine proceedings volumes available. The construction of a 0.6 teraflops parallel processor, dedicated to lattice QCD, begun at the Center on February 19, 1998, was completed on August 28, 1998 and is still

Using Online Databases in Corporate Issues Management.

Science.gov (United States)

Thomsen, Steven R.

1995-01-01

Finds that corporate public relations practitioners felt they were able, using online database and information services, to intercept issues earlier in the "issue cycle" and thus enable their organizations to develop more "proactionary" or "catalytic" issues management repose strategies. (SR)

Effect of oxygen plasma treatment on the electrochemical performance of the rayon and polyacrylonitrile based carbon felt for the vanadium redox flow battery application

Science.gov (United States)

Dixon, D.; Babu, D. J.; Langner, J.; Bruns, M.; Pfaffmann, L.; Bhaskar, A.; Schneider, J. J.; Scheiba, F.; Ehrenberg, H.

2016-11-01

Oxygen plasma treatment was applied on commercially available graphite felt electrodes based on rayon (GFA) and polyacrylonitrile (GFD). The formation of functional groups on the surface of the felt was confirmed by X-ray photoelectron spectroscopy measurements. The BET studies of the plasma treated electrodes showed no significant increase in surface area for both the rayon as well as the PAN based felts. Both plasma treated electrodes showed significantly enhanced V3+/V2+ redox activity compared to the pristine electrodes. Since an increase of the surface area has been ruled out for plasma treated electrode the enhanced activity could be attributed to surface functional groups. Interestingly, plasma treated GFD felts showed less electrochemical activity towards V5+/V4+ compared to the pristine electrode. Nevertheless, an overall increase of the single cell performance was still observed as the negative electrode is known to be the performance limiting electrode. Thus, to a great extent the present work helps to preferentially understand the importance of functional groups on the electrochemical activity of negative and positive redox reaction. The study emphasizes the need of highly active electrodes especially at the negative electrode side as inactive electrodes can still facilitate hydrogen evolution and degrade the electrolyte in VRFBs.

Surface chemical changes of atmospheric pressure plasma treated rabbit fibres important for felting process

Energy Technology Data Exchange (ETDEWEB)

Štěpánová, Vlasta, E-mail: vstepanova@mail.muni.cz [Department of Physical Electronics, Faculty of Science Masaryk University, Kotlářská 2, 611 37 Brno (Czech Republic); Slavíček, Pavel; Stupavská, Monika; Jurmanová, Jana [Department of Physical Electronics, Faculty of Science Masaryk University, Kotlářská 2, 611 37 Brno (Czech Republic); Černák, Mirko [Department of Physical Electronics, Faculty of Science Masaryk University, Kotlářská 2, 611 37 Brno (Czech Republic); Department of Experimental Physics, Faculty of Mathematics, Physics and Informatics, Comenius University, Mlynská dolina F2, 842 48 Bratislava (Slovakia)

2015-11-15

Graphical abstract: - Highlights: • Rabbit fibres plasma treatment is an effective method for fibres modification. • Atmospheric pressure plasma treatment is able to affect fibres properties. • Surface changes on fibres after plasma treatment were analysed via SEM, ATR-FTIR, XPS. • Significant increase of fibres wettability after plasma treatment was observed. • Plasma treatment at atmospheric pressure can replace the chemical treatment of fibres. - Abstract: We introduce the atmospheric pressure plasma treatment as a suitable procedure for in-line industrial application of rabbit fibres pre-treatment. Changes of rabbit fibre properties due to the plasma treatment were studied in order to develop new technology of plasma-based treatment before felting. Diffuse Coplanar Surface Barrier Discharge (DCSBD) in ambient air at atmospheric pressure was used for plasma treatment. Scanning electron microscopy was used for determination of the fibres morphology before and after plasma treatment. X-ray photoelectron spectroscopy and attenuated total reflectance-Fourier transform infrared spectroscopy were used for evaluation of reactive groups. The concentration of carbon decreased and conversely the concentration of nitrogen and oxygen increased after plasma treatment. Aging effect of plasma treated fibres was also investigated. Using Washburn method the significant increase of fibres wettability was observed after plasma treatment. New approach of pre-treatment of fibres before felting using plasma was developed. Plasma treatment of fibres at atmospheric pressure can replace the chemical method which consists of application of strong acids on fibres.

It felt fluent, and I liked it: subjective feeling of fluency rather than objective fluency determines liking.

Science.gov (United States)

Forster, Michael; Leder, Helmut; Ansorge, Ulrich

2013-04-01

According to the processing-fluency explanation of aesthetics, more fluently processed stimuli are preferred (R. Reber, N. Schwarz, & P. Winkielman, 2004, Processing fluency and aesthetic pleasure: Is beauty in the perceiver's processing experience? Personality and Social Psychology Review, Vol. 8, pp. 364-382.). In this view, the subjective feeling of ease of processing is considered important, but this has not been directly tested in perceptual processing. In two experiments, we therefore objectively manipulated fluency (ease of processing) with subliminal perceptual priming (Study 1) and variations in presentation durations (Study 2). We assessed the impact of objective fluency on feelings of fluency and liking, as well as their interdependence. In line with the processing-fluency account, we found that objectively more fluent images were indeed judged as more fluent and were also liked more. Moreover, differences in liking were even stronger when data were analyzed according to felt fluency. These findings demonstrate that perceptual fluency is not only explicitly felt, it can also be reported and is an important determinant of liking. PsycINFO Database Record (c) 2013 APA, all rights reserved.

KOH etched graphite felt with improved wettability and activity for vanadium flow batteries

International Nuclear Information System (INIS)

Zhang, Zhengyang; Xi, Jingyu; Zhou, Haipeng; Qiu, Xinping

2016-01-01

Highlights: • GF electrode is activated by KOH etching method for VFB application. • The wettability and activity of eGF electrode towards VO 2+ /VO 2 + and V 2+ /V 3+ couples are improved. • VFB with eGF electrode can run stable at current densities range from 50 to 250 mA cm −2 . • Cycling test at current density of 150 mA cm −2 confirms the superior durability of eGF electrode. - Abstract: In this work, a simple and effective method to activate graphite felt (GF) electrode by using KOH as etching agent is studied for vanadium flow battery (VFB) application. The surface of GF is etched by KOH at 800 °C to generate micropores and attain oxygen-containing functional groups, resulting in greatly improved electrolyte accessibility. Surface morphology, oxygen distribution and microstructure of the KOH etched graphite felts (eGFs) are characterized by SEM, EDX, XPS, XRD and Raman techniques. Due to the abundant exposed edge carbon sites and oxygen-containing functional groups introduced by KOH activation, electrochemical activity of eGFs towards both VO 2+ /VO 2 + and V 2+ /V 3+ redox couples are remarkably improved comparing with GF. In particular, eGF-2 (mass ratio of KOH/GF = 1.25) exhibits the best electrochemical activity and VFB performance among all eGFs. Moreover, the VFB with eGF-2 electrode can run at current density up to 250 mA cm −2 with the energy efficiency of 64%. Long-term cycle life test at higher current density of 150 mA cm −2 confirms the outstanding stability of eGF-2 electrode.

Highly catalytic and stabilized titanium nitride nanowire array-decorated graphite felt electrodes for all vanadium redox flow batteries

Science.gov (United States)

Wei, L.; Zhao, T. S.; Zeng, L.; Zeng, Y. K.; Jiang, H. R.

2017-02-01

In this work, we prepare a highly catalytic and stabilized titanium nitride (TiN) nanowire array-decorated graphite felt electrode for all vanadium redox flow batteries (VRFBs). Free-standing TiN nanowires are synthesized by a two-step process, in which TiO2 nanowires are first grown onto the surface of graphite felt via a seed-assisted hydrothermal method and then converted to TiN through nitridation reaction. When applied to VRFBs, the prepared electrode enables the electrolyte utilization and energy efficiency to be 73.9% and 77.4% at a high current density of 300 mA cm-2, which are correspondingly 43.3% and 15.4% higher than that of battery assembled with a pristine electrode. More impressively, the present battery exhibits good stability and high capacity retention during the cycle test. The superior performance is ascribed to the significant improvement in the electrochemical kinetics and enlarged active sites toward V3+/V2+ redox reaction.

Highly active, bi-functional and metal-free B4C-nanoparticle-modified graphite felt electrodes for vanadium redox flow batteries

Science.gov (United States)

Jiang, H. R.; Shyy, W.; Wu, M. C.; Wei, L.; Zhao, T. S.

2017-10-01

The potential of B4C as a metal-free catalyst for vanadium redox reactions is investigated by first-principles calculations. Results show that the central carbon atom of B4C can act as a highly active reaction site for redox reactions, due primarily to the abundant unpaired electrons around it. The catalytic effect is then verified experimentally by cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) tests, both of which demonstrate that B4C nanoparticles can enhance the kinetics for both V2+/V3+ and VO2+/VO2+ redox reactions, indicating a bi-functional effect. The B4C-nanoparticle-modified graphite felt electrodes are finally prepared and tested in vanadium redox flow batteries (VRFBs). It is shown that the batteries with the prepared electrodes exhibit energy efficiencies of 88.9% and 80.0% at the current densities of 80 and 160 mA cm-2, which are 16.6% and 18.8% higher than those with the original graphite felt electrodes. With a further increase in current densities to 240 and 320 mA cm-2, the batteries can still maintain energy efficiencies of 72.0% and 63.8%, respectively. All these results show that the B4C-nanoparticle-modified graphite felt electrode outperforms existing metal-free catalyst modified electrodes, and thus can be promising electrodes for VRFBs.

"Brothers and Sisters": A Novel Way to Teach Human Resources Management.

Science.gov (United States)

Bumpus, Minnette

2000-01-01

The novel "Brothers and Sisters" by Bebe Moore Campbell was used in a management course to explore human resource management issues, concepts, and theories. The course included prereading and postreading surveys, lecture, book review, and examination. Most of the students (92%) felt the novel was an appropriate way to meet course…

Direct methanol fuel cell with extended reaction zone anode: PtRu and PtRuMo supported on graphite felt

Energy Technology Data Exchange (ETDEWEB)

Bauer, Alex; Gyenge, Elod L.; Oloman, Colin W. [Department of Chemical and Biological Engineering, The University of British Columbia, 2360 East Mall, Vancouver, BC (Canada)

2007-05-15

Pressed graphite felt (thickness {proportional_to}350 {mu}m) with electrodeposited PtRu (43 g m{sup -2}, 1.4:1 atomic ratio) or PtRuMo (52 g m{sup -2}, 1:1:0.3 atomic ratio) nanoparticle catalysts was investigated as an anode for direct methanol fuel cells. At temperatures above 333 K the fuel cell performance of the PtRuMo catalyst was superior compared to PtRu. The power density was 2200 W m{sup -2} with PtRuMo at 5500 A m{sup -2} and 353 K while under the same conditions PtRu yielded 1925 W m{sup -2}. However, the degradation rate of the Mo containing catalyst formulation was higher. Compared to conventional gas diffusion electrodes with comparable PtRu catalyst composition and load, the graphite felt anodes gave higher power densities mainly due to the extended reaction zone for methanol oxidation. (author)

Direct methanol fuel cell with extended reaction zone anode: PtRu and PtRuMo supported on graphite felt

Science.gov (United States)

Bauer, Alex; Gyenge, Előd L.; Oloman, Colin W.

Pressed graphite felt (thickness ∼350 μm) with electrodeposited PtRu (43 g m -2, 1.4:1 atomic ratio) or PtRuMo (52 g m -2, 1:1:0.3 atomic ratio) nanoparticle catalysts was investigated as an anode for direct methanol fuel cells. At temperatures above 333 K the fuel cell performance of the PtRuMo catalyst was superior compared to PtRu. The power density was 2200 W m -2 with PtRuMo at 5500 A m -2 and 353 K while under the same conditions PtRu yielded 1925 W m -2. However, the degradation rate of the Mo containing catalyst formulation was higher. Compared to conventional gas diffusion electrodes with comparable PtRu catalyst composition and load, the graphite felt anodes gave higher power densities mainly due to the extended reaction zone for methanol oxidation.

An Action Research Study Exploring How Education May Enhance Pain Management in Children.

Science.gov (United States)

Simons, Joan M.

2002-01-01

Focus groups (n=14) and a study day (n=10) on pain management for child patients were held for pediatric nurses. Participants felt they increased their knowledge of pharmacology and their confidence and assertiveness in the practice of pain management. (Contains 37 references.) (SK)

Delayed post-surgical sepsis from Teflon felt: The diagnostic value of CT scanning, and a reminder for theatre staff

Directory of Open Access Journals (Sweden)

D Emby

2011-05-01

Full Text Available We report on 2 patients with surgical site infections following the inadvertent use of Teflon felt for haemostasis in elective and emergency surgery. CT scanning was superior to plain radiography in demonstrating the foreign bodies to enable planning of further surgical treatment.

Decision making model and behavior of Iranian top managers

OpenAIRE

Aliakbar Farhangi; Seyed Reza Seyed Javadin; Majid balali; Seyed Badredin Ahmadi

2010-01-01

Aesthetics relates to felt meaning generated from sensory perceptions, and involves subjective,tacit knowledge rooted in feeling and emotion. We believe the aesthetics of management isimportant, but little understood, aspect of organizational life. We propose that followers use theiraesthetic senses in making these assessments.In this article we try to discover the role of aesthetic in management and then try to find out thestyle of about 130 industrial and governmental top managers in Iran u...

Microwave-assisted preparation of carbon nanofiber-functionalized graphite felts as electrodes for polymer-based redox-flow batteries

Science.gov (United States)

Schwenke, A. M.; Janoschka, T.; Stolze, C.; Martin, N.; Hoeppener, S.; Schubert, U. S.

2016-12-01

A simple and fast microwave-assisted protocol to functionalize commercially available graphite felts (GFs) with carbon nanofibers (CNFs) for the application as electrode materials in redox-flow batteries (RFB) is demonstrated. As catalyst for the CNF synthesis nickel acetate is applied and ethanol serves as the carbon source. By the in-situ growth of CNFs, the active surface of the electrodes is increased by a factor of 50, which is determined by the electrochemical double layer capacities of the obtained materials. Furthermore, the morphology of the CNF-coating is investigated by scanning electron microscopy. Subsequently, the functionalized electrodes are applied in a polymer-based redox-flow battery (pRFB) using a TEMPO- and a viologen polymer as active materials. Due to the increased surface area as compared to an untreated graphite felt electrode, the current rating is improved by about 45% at 80 mA cm-2 and, furthermore, a decrease in overpotentials is observed. Thus, using this microwave-assisted synthesis approach, CNF-functionalized composite electrodes are prepared with a very simple protocol suitable for real life applications and an improvement of the overall performance of the polymer-based redox-flow battery is demonstrated.

Electrocatalytic activity of cobalt phosphide-modified graphite felt toward VO2+/VO2+ redox reaction

Science.gov (United States)

Ge, Zhijun; Wang, Ling; He, Zhangxing; Li, Yuehua; Jiang, Yingqiao; Meng, Wei; Dai, Lei

2018-04-01

A novel strategy for improving the electro-catalytic properties of graphite felt (GF) electrode in vanadium redox flow battery (VRFB) is designed by depositing cobalt phosphide (CoP) onto GF surface. The CoP powder is synthesized by direct carbonization of Co-based zeolitic imidazolate framework (ZIF-67) followed by phosphidation. Cyclic voltammetry results confirm that the CoP-modified graphite felt (GF-CoP) electrode has excellent reversibility and electro-catalytic activity to the VO2+/VO2+ cathodic reaction compared with the pristine GF electrode. The cell using GF-CoP electrode shows apparently higher discharge capacity over that based on GF electrode. The cell using GF-CoP electrode has the capacity of 67.2 mA h at 100 mA cm-2, 32.7 mA h larger than that using GF electrode. Compared with cell using GF electrode, the voltage efficiency of the cell based on GF-CoP electrode increases by 5.9% and energy efficiency by 5.4% at a current density of 100 mA cm-2. The cell using GF-CoP electrode can reach 94.31% capacity retention after 50 cycles at a current density of 30 mA cm-2. The results show that the CoP can effectively promote the VO2+/VO2+ redox reaction, implying that metal phosphides are a new kind of potential catalytic materials for VRFB.

Personal knowledge management: the foundation of organisational knowledge management

Directory of Open Access Journals (Sweden)

Priti Jain

2011-01-01

Full Text Available The purpose of this small-scale study was to explore how people perceived Personal Knowledge Management (PKM, whether people were aware of the PKM concept, and how PKM can have an impact on organisational knowledge management and productivity. A questionnaire survey with quantitative and qualitative questions was used. The study revealed that a majority (63% of respondents were not aware of the PKM concept; 33% were aware, while 2% had a vague idea about it. Eighty three (83% felt that it was important to manage personal knowledge and that PKM could increase individual productivity and organisational performance. The major recommendations included creating awareness about PKM. It should be at the heart of each employee-development programme, alignment of personal and organisational goals and adequate facilities and training in PKM.

The value of usability testing for Internet-based adolescent self-management interventions: "Managing Hemophilia Online".

Science.gov (United States)

Breakey, Vicky R; Warias, Ashley V; Ignas, Danial M; White, Meghan; Blanchette, Victor S; Stinson, Jennifer N

2013-10-04

As adolescents with hemophilia approach adulthood, they are expected to assume responsibility for their disease management. A bilingual (English and French) Internet-based self-management program, "Teens Taking Charge: Managing Hemophilia Online," was developed to support adolescents with hemophilia in this transition. This study explored the usability of the website and resulted in refinement of the prototype. A purposive sample (n=18; age 13-18; mean age 15.5 years) was recruited from two tertiary care centers to assess the usability of the program in English and French. Qualitative observations using a "think aloud" usability testing method and semi-structured interviews were conducted in four iterative cycles, with changes to the prototype made as necessary following each cycle. This study was approved by research ethics boards at each site. Teens responded positively to the content and appearance of the website and felt that it was easy to navigate and understand. The multimedia components (videos, animations, quizzes) were felt to enrich the experience. Changes to the presentation of content and the website user-interface were made after the first, second and third cycles of testing in English. Cycle four did not result in any further changes. Overall, teens found the website to be easy to use. Usability testing identified end-user concerns that informed improvements to the program. Usability testing is a crucial step in the development of Internet-based self-management programs to ensure information is delivered in a manner that is accessible and understood by users.

Study on Sintering Mechanism of Stainless Steel Fiber Felts by X-ray Computed Tomography

Directory of Open Access Journals (Sweden)

Jun Ma

2016-01-01

Full Text Available The microstructure evolution of Fe-17 wt. % Cr-12 wt. % Ni-2 wt. % Mo stainless steel fiber felts during the fast sintering process was investigated by the synchrotron radiation X-ray computed tomography technique. The equation of dynamics of stable inter-fiber neck growth was established for the first time based on the geometry model of sintering joints of two fibers and Kucsynski’s two-sphere model. The specific evolutions of different kinds of sintering joints were observed in the three-dimensional images. The sintering mechanisms during sintering were proposed as plastic flow and grain boundary diffusion, the former leading to a quick growth of sintering joints.

Managers air thoughts on the top competitive issues

International Nuclear Information System (INIS)

Makansi, J.; Swanekamp, R.

1996-01-01

Over 100 powerplant managers and representatives from other industry segments exchanged ideas and opinions at Power magazine's Fifth Powerplant O and M Symposium, ''Managing the Powerplant in a Competitive Environment,'' held June 12--14 in Richmond, VA. Attendees may have represented both utility and independent power facilities, but it was clear from the dialogue that, regardless of ownership, most felt that their plants would have to operate as independent businesses, implicitly if not directly

Chemically modified graphite felt as an efficient cathode in electro-Fenton for p-nitrophenol degradation

International Nuclear Information System (INIS)

Zhou, Lei; Zhou, Minghua; Hu, Zhongxin; Bi, Zhaoheng; Serrano, K. Groenen

2014-01-01

Highlights: • Chemically modified graphite felt was prepared using ethanol and hydrazine hydrate as reagents. • Carbon nanoparticles with functional groups were deposited on the surface after modification. • The electrochemical activity for ORR and H 2 O 2 generation on the modified electrode was improved. • The cathode modification effictively improved the EF performance for pollutant degradation. - Abstract: A simple method with low-cost chemical reagents ethanol and hydrazine hydrate was used to modify graphite felt as the cathode for electro-Fenton (EF) application, using p-nitrophenol (p-Np) as the model pollutant. Characterized by scanning electron microscope, contact angle, Raman spectrum and X-ray photoelectron spectroscopy, the morphology and surface physicochemical properties after modification were observed considerably changed. After modification, some nanoparticles and oxygen and nitrogen-containing functional groups appeared on the cathode surface, which greatly improved the surface hydrophilic property and the electrocatalytic activity for oxygen reduction reaction. The effects led to the hydrogen peroxide accumulation on the modified cathode markedly increased to 175.8 mg L −1 , while that on the unmodified one was only 67.5 mg L −1 . p-Np of initial 50 mg L −1 could be completely removed by EF using the modified cathode, and the mineralization ratio reached 51.4%, more than 2 times of the pristine one. After 10 cycles, the mineralization ratio of the modified cathode was still above 45%, suggesting that the modification method can provide an effective approach to improve EF performance, and thus benefits to promote its environmental applications

Pancreatic fistula after laparoscopic splenectomy in patients with hypersplenism due to liver cirrhosis: effect of fibrin glue and polyglycolic acid felt on prophylaxis of postoperative complications.

Science.gov (United States)

Tsutsumi, Norifumi; Tomikawa, Morimasa; Akahoshi, Tomohiko; Kawanaka, Hirofumi; Ota, Mitsuhiko; Sakaguchi, Yoshihisa; Kusumoto, Tetsuya; Ikejiri, Koji; Hashizume, Makoto; Maehara, Yoshihiko

2016-11-01

This study aimed to determine the effect of fibrin glue and polyglycolic acid (PGA) felt on prevention of pancreatic fistula (PF) after laparoscopic splenectomy in patients with hypersplenism due to liver cirrhosis. Fifty consecutive patients were enrolled in this prospective study. Twenty-three patients underwent laparoscopic splenectomy with a fibrin sheet (fibrin sheet group). The sealing ability of each treatment was evaluated by an ex vivo pressure test model. Based on the results from ex vivo experiments, 27 patients received prophylaxis using fibrin glue and PGA felt (PGA with fibrin group). The primary endpoint was the incidence of PF. Significantly more (5, 22%) patients developed PF in the fibrin sheet group than in the PGA with fibrin group (0%, P = .037). Our new application of fibrin glue and PGA felt is an effective prophylactic procedure for preventing development of PF after laparoscopic splenectomy. Copyright © 2016 Elsevier Inc. All rights reserved.

A combined Surface Enhanced Raman Spectroscopy (SERS)/UV-vis approach for the investigation of dye content in commercial felt tip pens inks.

Science.gov (United States)

Saviello, Daniela; Trabace, Maddalena; Alyami, Abeer; Mirabile, Antonio; Giorgi, Rodorico; Baglioni, Piero; Iacopino, Daniela

2018-05-01

The development of protocols for the protection of the large patrimony of works of art created by felt tip pen media since the 1950's requires detailed knowledge of the main dyes constituting commercial ink mixtures. In this work Surface Enhanced Raman Scattering (SERS) and UV-vis spectroscopy were used for the first time for the systematic identification of dye composition in commercial felt tip pens. A large selection of pens comprising six colors of five different brands was analyzed. Intense SERS spectra were obtained for all colors, allowing identification of main dye constituents. Poinceau 4R and Eosin dyes were found to be the main constituents of red and pink colors; Rhodamine and Tartrazine were found in orange and yellow colors; Erioglaucine was found in green and blue colors. UV-vis analysis of the same inks was used to support SERS findings but also to unequivocally assign some uncertain dye identifications, especially for yellow and orange colors. The spectral data of all felt tip pens collected through this work were assembled in a database format. The data obtained through this systematic investigation constitute the basis for the assembly of larger reference databases that ultimately will support the development of conservation protocols for the long term preservation of modern art collections. Copyright © 2018 Elsevier B.V. All rights reserved.

Training future surgeons for management roles: the resident-surgeon-manager conference.

Science.gov (United States)

Hanna, Waël C; Mulder, David S; Fried, Gerald M; Elhilali, Mostafa; Khwaja, Kosar A

2012-10-01

OBJECTIVE To demonstrate that senior surgical residents would benefit from focused training by professionals with management expertise. Although managerial skills are recognized as necessary for the successful establishment of a surgical practice, they are not often emphasized in traditional surgical residency curricula. DESIGN Senior residents from all surgical subspecialties at McGill University were invited to participate in a 1-day management seminar. Precourse questionnaires aimed at evaluating the residents' perceptions of their own managerial knowledge and preparedness were circulated. The seminar was then given in the form of interactive lectures and case-based discussions. The questionnaires were readministered at the end of the course, along with an evaluation form. Precourse and postcourse data were compared using the Freeman-Halton extension of the Fisher exact test to determine statistical significance (P < .05). SETTING McGill University Health Centre in Montreal, Quebec, Canada. PARTICIPANTS A total of 43 senior residents. RESULTS Before the course, the majority of residents (27 of 43 [63%]) thought that management instruction only happened "from time to time" in their respective programs. After the course, 15 residents (35%) felt that management topics were "well addressed," and 19 (44%) felt that management topics have been "very well addressed" (P < .01). Residents noted a significant improvement in their ability to perform the following skills after the course: giving feedback, delegating duties, coping with stress, effective learning, and effective teaching. On the ensemble of all managerial skills combined, 26 residents (60%) rated their performance as "good" or "excellent" after the course vs only 21 (49%) before the course (P = .02). Residents also noted a statistically significant improvement in their ability to perform the managerial duties necessary for the establishment of a surgical practice. CONCLUSIONS Surgical residency programs

Japanese Adolescents' Disclosure and Information Management with Parents

Science.gov (United States)

Nucci, Larry; Smetana, Judith; Araki, Noriyuki; Nakaue, Masataka; Comer, Jessamy

2014-01-01

Adolescents' obligation to disclose and their actual disclosure about their activities to parents, justifications for nondisclosure, and strategies for information management were examined in different domains in 460 middle adolescents (M[subscript age] = 16.6 years) from working and middle-class families in Japan. Adolescents felt most obligated…

The sociology of big science | Public Lecture by Ulrike Felt | 15 July

CERN Multimedia

2014-01-01

"The sociology of big science" Public Lecture by Prof. Ulrike Felt Tuesday 15 July 2014 - 7.30 p.m. Globe of Science and Innovation Lecture in English, translated in French. Entrance free. Limited number of seats. Reservation essential: +41 22 767 76 76 or cern.reception@cern.ch What science for what kind of society? Reflecting the development of big science Without any doubt, CERN can be described as being among the most ambitious scientific enterprises ever undertaken. For 60 years, the Member States have not only invested considerable financial means into this institution, but have also supported the creation of a highly visionary research programme. And this has led to a change in the way science is done, as captured by the idea of "big science". Yet this naturally also raises a number of quite fundamental questions: How did the meaning of "doing science" change? What justifies societal engagement with and support for such a cost-intensive long-t...

Electrochemically assisted organosol method for Pt-Sn nanoparticle synthesis and in situ deposition on graphite felt support: Extended reaction zone anodes for direct ethanol fuel cells

Energy Technology Data Exchange (ETDEWEB)

Lycke, Derek R.; Gyenge, Elod L. [Department of Chemical and Biological Engineering, The University of British Columbia, 2360 East Mall, Vancouver, BC (Canada)

2007-03-20

Two electrochemically assisted variants of the Boenneman organosol method were developed for Pt-Sn nanoparticle synthesis and in situ deposition on graphite felt electrodes (e.g. thickness up to 2 mm). Tetraoctylammonium triethylhydroborate N(C{sub 8}H{sub 17}){sub 4}BH(C{sub 2}H{sub 5}){sub 3} was employed as colloid stabilizer and reductant dissolved in tetrahydrofuran (THF). The role of the electric field at a low deposition current density of 1.25 mA cm{sup -2} was mainly electrophoretic causing the migration and adsorption of N(C{sub 8}H{sub 17}){sub 4}BH(C{sub 2}H{sub 5}){sub 3} on the graphite felt surface where it reduced the PtCl{sub 2}-SnCl{sub 2} mixture. Faradaic electrodeposition was detected mostly for Sn. Typical Pt-Sn loadings were between 0.4 and 0.9 mg cm{sup -2} depending on the type of pre-deposition exposure of the graphite felt: surfactant-adsorption and metal-adsorption variant, respectively. The catalyst surface area and Pt:Sn surface area ratio was determined by anodic striping of an underpotential deposited Cu monolayer. The two deposition variants gave different catalyst surfaces: total area 233 and 76 cm{sup 2} mg{sup -1}, with Pt:Sn surface area ratio of 3.5:1 and 7.7:1 for surfactant and metal adsorption, respectively. Regarding electrocatalysis of ethanol oxidation, voltammetry and chronopotentiometry studies corroborated by direct ethanol fuel cell experiments using 0.5 M H{sub 2}SO{sub 4} as electrolyte, showed that due to a combination of higher catalyst load and Pt:Sn surface ratio, the graphite felt anodes prepared by the metal-adsorption variant gave better performance. The catalyzed graphite felt provided an extended reaction zone for ethanol electrooxidation and it gave higher catalyst mass specific peak power outputs compared to literature data obtained using gas diffusion anodes with carbon black supported Pt-Sn nanoparticles. (author)

Comparison of adsorption of Remazol Black B and Acidol Red on microporous activated carbon felt.

Science.gov (United States)

Donnaperna, L; Duclaux, L; Gadiou, R; Hirn, M-P; Merli, C; Pietrelli, L

2009-11-15

The adsorption of two anionic dyes, Remazol Black B (RB5) and Acidol Red 2BE-NW (AR42), onto a microporous activated carbon felt was investigated. The characterization of carbon surface chemistry by X-ray microanalysis, Boehm titrations, and pH-PZC measurements indicates that the surface oxygenated groups are mainly acidic. The rate of adsorption depends on the pH and the experimental data fit the intraparticle diffusion model. The pore size distribution obtained by DFT analysis shows that the mean pore size is close to 1nm, which indicates that a slow intraparticle diffusion process control the adsorption. The adsorption isotherms were measured for different pH values. The Khan and the Langmuir-Freundlich models lead to the best agreement with experimental data for RB5 and AR42, respectively. These isotherm simulations and the pH dependence of adsorption show that the adsorption capacity is mainly controlled by nondispersive electrostatic interactions for pH values below 4. The adsorption kinetics, the irreversibility of the process, and the influence of the pH indicate that the rate of adsorption in this microporous felt proceeds through two steps. The first one is fast and results from direct interaction of dye molecules with the external surface of the carbon material (which account for 10% of the whole surface area); in the second, slow step, the adsorption rate is controlled by the slow diffusion of dye molecules into the narrow micropores. The influence of temperature on the adsorption isotherms was studied and the thermodynamic parameters were obtained. They show that the process is spontaneous and exothermic.

PROCEEDINGS OF RIKEN BNL RESEARCH CENTER WORKSHOP, VOLUME 66

International Nuclear Information System (INIS)

OGAWA, A.

2005-01-01

The RIKEN BNL Research Center (RSRC) was established in April 1997 at Brookhaven National Laboratory. It is funded by the 'Rikagaku Kenkyusho (RIKEN, The Institute of Physical and Chemical Research) of Japan. The Center is dedicated to the study of strong interactions, including spin physics, lattice QCD, and RHIC physics through the nurturing of a new generation of young physicists. The RBRC has both a theory and experimental component. At present the theoretical group has 4 Fellows and 3 Research Associates as well as 11 RHIC Physics/University Fellows (academic year 2003-2004). To date there are approximately 30 graduates from the program of which 13 have attained tenure positions at major institutions worldwide. The experimental group is smaller and has 2 Fellows and 3 RHIC Physics/University Fellows and 3 Research Associates, and historically 6 individuals have attained permanent positions. Beginning in 2001 a new RIKEN Spin Program (RSP) category was implemented at RBRC. These appointments are joint positions of RBRC and RIKEN and include the following positions in theory and experiment: RSP Researchers, RSP Research Associates, and Young Researchers, who are mentored by senior RBRC Scientists, A number of RIKEN Jr. Research Associates and Visiting Scientists also contribute to the physics program at the Center. RBRC has an active workshop program on strong interaction physics with each workshop focused on a specific physics problem. Each workshop speaker is encouraged to select a few of the most important transparencies from his or her presentation, accompanied by a page of explanation. This material is collected at the end of the workshop by the organizer to form proceedings, which can therefore be available within a short time. To date there are sixty nine proceedings volumes available. The construction of a 0.6 teraflops parallel processor, dedicated to lattice QCD, begun at the Center on February 19, 1998, was completed on August 28, 1998 and is still

Tree breeding as a forest management supplement - economical, sociological, and ecological considerations

Science.gov (United States)

Gordon White

1973-01-01

To set the stage for my remarks, I would like to tell a story I recently heard. The top management of a large corporation has just ordered installed two IBM machines in the accounting department. Two middle-aged men - the office manager and his assistant - received the news with some misgivings. They felt that things were progressing well in their office; the...

The value of usability testing for Internet-based adolescent self-management interventions: “Managing Hemophilia Online”

Science.gov (United States)

2013-01-01

Background As adolescents with hemophilia approach adulthood, they are expected to assume responsibility for their disease management. A bilingual (English and French) Internet-based self-management program, “Teens Taking Charge: Managing Hemophilia Online,” was developed to support adolescents with hemophilia in this transition. This study explored the usability of the website and resulted in refinement of the prototype. Methods A purposive sample (n=18; age 13–18; mean age 15.5 years) was recruited from two tertiary care centers to assess the usability of the program in English and French. Qualitative observations using a “think aloud” usability testing method and semi-structured interviews were conducted in four iterative cycles, with changes to the prototype made as necessary following each cycle. This study was approved by research ethics boards at each site. Results Teens responded positively to the content and appearance of the website and felt that it was easy to navigate and understand. The multimedia components (videos, animations, quizzes) were felt to enrich the experience. Changes to the presentation of content and the website user-interface were made after the first, second and third cycles of testing in English. Cycle four did not result in any further changes. Conclusions Overall, teens found the website to be easy to use. Usability testing identified end-user concerns that informed improvements to the program. Usability testing is a crucial step in the development of Internet-based self-management programs to ensure information is delivered in a manner that is accessible and understood by users. PMID:24094082

The opinion of the general practitioner toward clinical management of patients with psychogenic nonepileptic seizures.

LENUS (Irish Health Repository)

O'Sullivan, S S

2012-02-03

OBJECTIVE: The purpose of this work was to assess the opinion of general practitioners (GPs) regarding the diagnosis of psychogenic nonepileptic seizures (PNES) and the role they feel they should play in the management of the disorder. METHODS: Patients with PNES were identified from hospital records. Seizure and patient characteristics were recorded. Their GPs were surveyed regarding their understanding of the diagnosis and ongoing management of PNES. RESULTS: Twenty-three patients were identified over a 3-year period as having been diagnosed with PNES. Sixty-five percent of GPs agreed with the diagnosis, and when asked to grade their understanding of the diagnosis (poor = 1, excellent = 10), the mean score was 5.7 (+\\/-SD 2.3). Thirty-five percent of GPs felt psychological input was of benefit to their patients. Fifty-two percent of GPs felt comfortable following up these patients, either with or without neurology outpatient services. CONCLUSIONS: PNES remains a difficult disease to manage. There is a high level of uncertainty regarding the optimum management of PNES among primary care physicians, for which further education is needed.

Copper nanoparticle-deposited graphite felt electrodes for all vanadium redox flow batteries

International Nuclear Information System (INIS)

Wei, L.; Zhao, T.S.; Zeng, L.; Zhou, X.L.; Zeng, Y.K.

2016-01-01

Highlights: • Copper nanoparticle is proposed as electrocatalyst for VRFBs for the first time. • Propose a binder-free copper nanoparticle decorated electrode. • The energy efficiency is up to 80.1% at 300 mA cm"−"2, enhancing more than 17%. • High stability and capacity retention are achieved by battery with copper catalyst. - Abstract: A copper nanoparticle deposited graphite felt electrode for all vanadium redox flow batteries (VRFBs) is developed and tested. It is found that the copper catalyst enables a significant improvement in the electrochemical kinetics of the V"3"+/V"2"+ redox reaction. The battery’s utilization of the electrolyte and energy efficiency are found to be as high as 83.7% and 80.1%, at a current density of 300 mA cm"−"2, which are 53.1% and 17.8% higher than those of the battery without the catalyst. Moreover, the present battery shows a good stability during the cycle test. The results suggest that the inexpensive copper nanoparticle catalyst without tedious preparation process offers a great promise for VRFB application.

Radioactive waste management in Canada: a bibliography of published literature

International Nuclear Information System (INIS)

Hawley, N.J.

1978-09-01

In view of the increased interest in the management of radioactive wastes, a need has been felt for a listing of Canadian publications in this field. Over one hundred AECL reports and other Canadian papers are included as well as a list of selected international conferences on the topic. (author)

Efficient oxidative dissolution of V2O3 by the in situ electro-generated reactive oxygen species on N-doped carbon felt electrodes

International Nuclear Information System (INIS)

Xue, Yudong; Wang, Yunting; Zheng, Shili; Sun, Zhi; Zhang, Yi; Jin, Wei

2017-01-01

Highlights: • Novel alkaline electro-Fenton-like was applied for V 2 O 3 oxidative dissolution. • N-doped carbon felt electrode was fabricated for the two-electron ORR. • ROS including ·OH and HO 2 − was in-situ generated from the electrochemical system. • A significant enhancement of V 2 O 3 dissolution was achieved due to the ROS. - Abstract: Oxidative dissolution is a critical step for the efficient remediation of heavy metal oxides in large-scale solid wastes. In the present study, a novel electro-oxidative dissolution process of V 2 O 3 to VO 4 3− is achieved by the in-situ generated reactive oxygen species on the N-doped carbon felt cathode in alkaline media. The electro-catalytic HO 2 − generation and hydrophilic behavior were significantly enhanced by the introduction of nitrogen-containing functional groups. Besides, the mechanism of electrochemical vanadium conversion is systematically illustrated, and a vanadium self-induced electro-Fenton-like reaction is proposed. By employing the radical quenching and ESR measurements, the contributions for V(III) dissolution is determined to be 43.5% by HO 2 − and 56.5% by hydroxyl radicals, respectively. It should be noted that the V 2 O 3 solid particles can be efficiently dissolved via adsorption-reaction scheme on the carbon felt electrode. This novel electrochemical strategy provides a promising solution for the heavy metal oxide treatment and further understanding for the in situ reactive oxygen species.

Electroadsorption desalination with carbon nanotube/PAN-based carbon fiber felt composites as electrodes.

Science.gov (United States)

Liu, Yang; Zhou, Junbo

2014-01-01

The chemical vapor deposition method is used to prepare CNT (carbon nanotube)/PCF (PAN-based carbon fiber felt) composite electrodes in this paper, with the surface morphology of CNT/PCF composites and electroadsorption desalination performance being studied. Results show such electrode materials with three-dimensional network nanostructures having a larger specific surface area and narrower micropore distribution, with a huge number of reactive groups covering the surface. Compared with PCF electrodes, CNT/PCF can allow for a higher adsorption and desorption rate but lower energy consumption; meanwhile, under the condition of the same voltage change, the CNT/PCF electrodes are provided with a better desalination effect. The study also found that the higher the original concentration of the solution, the greater the adsorption capacity and the lower the adsorption rate. At the same time, the higher the solution's pH, the better the desalting; the smaller the ions' radius, the greater the amount of adsorption.

Self-esteem and the quest for felt security: how perceived regard regulates attachment processes.

Science.gov (United States)

Murray, S L; Holmes, J G; Griffin, D W

2000-03-01

The authors proposed that personal feelings of self-esteem foster the level of confidence in a partner's regard critical for satisfying attachments. Dating and married couples described themselves, their partners, how they thought their partners saw them, and how they wanted their partners to see them on a variety of interpersonal qualities. The results revealed that low self-esteem individuals dramatically underestimated how positively their partners saw them. Such unwarranted and unwanted insecurities were associated with less generous perceptions of partners and lower relationship well-being. The converse was true for high self-esteem individuals. A longitudinal examination of the dating couples revealed that the vulnerabilities of lows were only exacerbated over time. A dependency regulation model is proposed, wherein felt security in a partner's perceived regard is suggested as a prime mechanism linking self-esteem to relational well-being.

Collaborative care management effectively promotes self-management: patient evaluation of care management for depression in primary care.

Science.gov (United States)

DeJesus, Ramona S; Howell, Lisa; Williams, Mark; Hathaway, Julie; Vickers, Kristin S

2014-03-01

Chronic disease management in the primary care setting increasingly involves self-management support from a nurse care manager. Prior research had shown patient acceptance and willingness to work with care managers. This survey study evaluated patient-perceived satisfaction with care management and patient opinions on the effectiveness of care management in promoting self-management. Qualitative and quantitative survey responses were collected from 125 patients (79% female; average age 46; 94% Caucasian) enrolled in care management for depression. Qualitative responses were coded with methods of content analysis by 2 independent analysts. Patients were satisfied with depression care management. Patients felt that care management improved their treatment above and beyond other aspects of their depression treatment (mean score, 6.7 [SD, 2]; 10 = Very much), increased their understanding of depression self-management (mean score, 7.2 [SD, 2]; 10 = Very much), and increased the frequency of self-management goal setting (mean score, 6.9 [SD, 3]; 10 = Very much). Predominant qualitative themes emphasized that patients value emotional, motivational, and relational aspects of the care manager relationship. Patients viewed care managers as caring and supportive, helpful in creating accountability for patients and knowledgeable in the area of depression care. Care managers empower patients to take on an active role in depression self-management. Some logistical challenges associated with a telephonic intervention are described. Care manager training should include communication and motivation strategies, specifically self-management education, as these strategies are valued by patients. Barriers to care management, such as scheduling telephone calls, should be addressed in future care management implementation and study.

Schizophrenia, violence, and case management: being supportive and overwhelmed.

Science.gov (United States)

Rice, Elizabeth I

2009-01-01

The aim of this study is to understand the experiences of case managers as they delivered care to women who were diagnosed with schizophrenia and live with histories of violence. Interpretive phenomenology. Providers valued their relationships with women, yet felt overwhelmed and frustrated with aspects of the case management role. Case managers at times blamed women for the violence in their lives and lacked clarity with regard to their role assisting women in recovery. The violence and poverty that is common for these women is a key factor that increased providers' alienation and confusion as to their role in the provision of care. The educational and supportive needs of case managers must be addressed to uphold recovery-oriented services.

Managing effective reform for Community Medicine subject: Vision to actions

Directory of Open Access Journals (Sweden)

Amiruddin Kadri

2017-12-01

Full Text Available Reforming Community Medicine discipline is the felt need amongst fraternities of Community Medicine but making effective change is the greatest challenge. It is uphill task and many big organizations failed in ushering the change without full thought to how to manage reform? With changing demand and role of the subject, Royal Colleges of Physicians of United Kingdom had tried to change Faculty of Public Health to Faculty of Community Medicine and then to Faculty of Public Health Medicine to manage the change but it failed (1. However, we need to learn from them and succeed in managing the change.

Effective time management – selected issues

Directory of Open Access Journals (Sweden)

Aneta Olejniczak

2013-03-01

Full Text Available Deliberations included in this article contain the basic issues related to the subject of time management. As we know, people who waste their time the most, most complain about the lack of the time. We should treat our time, time of our co-workers, and friends as a valuable, but limited wealth. Principles of effective time management can be applied in any scientific and research institutions, companies or corporations. The benefits of a good and effective time management will be felt not only by ourselves but also by our friends and family. Detailed formulation of objectives, identification and elimination of time wasters and postponing work on later (Procrastination, using methods of time management and systematic control will allow for efficient use of time. A good plan is the basis for optimal and meaningful use of time.

Consideration of pain felt by patients in the ICU.

Science.gov (United States)

Hasegawa, Ryuichi

2017-01-01

Patients in the ICU are often treated under extreme conditions, with the patient often fearful of losing his life or experiencing severe pain. As a result, high-quality pain management is required. However, response to pain is often inadequate due to continuous administration of sedatives, difficulties in communicating with intubated patients, and/or poor awareness of pain in patients not receiving surgery. Reports on difficulties in pain management in the ICU are many, but few consider the correlation between pain management and patient prognosis. Consequently, consideration on how to implement pain control activities in the ICU to improve patient prognosis is needed.

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

Science.gov (United States)

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

2017-02-01

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

Public perceptions of aspects of radioactive waste management

International Nuclear Information System (INIS)

1985-04-01

The paper concerns a study of peoples' attitude towards the siting of radioactive waste repositories, carried out by the University of Surrey, United Kingdom. The work has been commissioned by the Department of the Environment as part of its radioactive waste management research programme. The people taking part were asked to mark on a map of Great Britain places they felt radioactive waste repositories would be least objectionable. The degree to which people worried about the technology and the management of radioactive waste disposal was monitored. Questions were asked about storage, disposal and transportation aspects, and about present and future worries. (UK)

The Performance of a Direct Borohydride/Peroxide Fuel Cell Using Graphite Felts as Electrodes

Directory of Open Access Journals (Sweden)

Heng-Yi Lee

2017-08-01

Full Text Available A direct borohydride/peroxide fuel cell (DBPFC generates electrical power by recirculating liquid anolyte and catholyte between the stack and reservoirs, which is similar to the operation of flow batteries. To enhance the accessibility of the catalyst layer to the liquid anolyte/catholyte, graphite felts are employed as the porous diffusion layer of a single-cell DBPFC instead of carbon paper/cloth. The effects of the type of anode alkaline solution and operating conditions, including flow rate and temperature of the anolyte/catholyte, on DBPFC performance are investigated and discussed. The durability of the DBPFC is also evaluated by galvanostatic discharge at 0.1 A∙cm−2 for over 50 h. The results of this preliminary study show that a DBPFC with porous graphite electrodes can provide a maximum power density of 0.24 W∙cm−2 at 0.8 V. The performance of the DBPFC drops slightly after 50 h of operation; however, the discharge capacity shows no significant decrease.

UK National Survey of Practice Patterns of Fluid Volume Management in Haemodialysis Patients: A Need for Evidence.

Science.gov (United States)

Dasgupta, Indranil; Farrington, Ken; Davies, Simon J; Davenport, Andrew; Mitra, Sandip

2016-01-01

Fluid management in haemodialysis (HD) affects patient experience, morbidity and mortality. Standards for best practice are lacking. A national survey of the United Kingdom was undertaken to define prevalent practice. An online questionnaire was distributed to all UK renal centres. Forty-five of 74 centres (173 dialysis units), serving 62% (n = 14,697) of UK HD population responded. Seventy-eight per cent had no agreed policy for managing fluid balance in patients on HD; 44% did not assess fluid status routinely. Clinical assessment was the norm; 27% used bio-impedance-based device. To achieve a target-weight, 53% reduced weight as far as tolerated. Twenty-two per cent measured residual renal function (RRF). Ninety-one per cent had no policy for fluid overload. Sixty-four per cent restricted salt and water. Ninety-three per cent used diuretics in patients with RRF. Thirty-eight per cent felt management was adequate; 77% felt there was a need for better evidence. Ninety-one per cent would participate in a study addressing this. There is an urgent need for establishing an evidence base on the optimal approaches to fluid management. © 2016 S. Karger AG, Basel.

Attitudes toward Management of Sickle Cell Disease and Its Complications: A National Survey of Academic Family Physicians

Directory of Open Access Journals (Sweden)

Arch G. Mainous

2015-01-01

Full Text Available Objective. Sickle cell disease (SCD is a disease that requires a significant degree of medical intervention, and family physicians are one potential provider of care for patients who do not have access to specialists. The extent to which family physicians are comfortable with the treatment of and concerned about potential complications of SCD among their patients is unclear. Our purpose was to examine family physician’s attitudes toward SCD management. Methods. Data was collected as part of the Council of Academic Family Medicine Educational Research Alliance (CERA survey in the United States and Canada that targeted family physicians who were members of CERA-affiliated organizations. We examined attitudes regarding management of SCD. Results. Overall, 20.4% of respondents felt comfortable with treatment of SCD. There were significant differences in comfort level for treatment of SCD patients depending on whether or not physicians had patients who had SCD, as well as physicians who had more than 10% African American patients. Physicians also felt that clinical decision support (CDS tools would be useful for treatment (69.4% and avoiding complications (72.6% in managing SCD patients. Conclusions. Family physicians are generally uncomfortable with managing SCD patients and recognize the utility of CDS tools in managing patients.

Supply chain management practices in a leading manufacturing organization

OpenAIRE

2014-01-01

M.Com. (Logistics Management) Within the increasingly competitive global economic environment, organisations need to find ways of increasing their competitiveness. This trend has been felt strongly by South African manufacturing organisations as a result of the liberalization of the South African economy, particularly the relaxation of tariff and trade barriers, and the reduction in the cost of international trade leading to the importation of manufactured goods from both developed and eme...

Graphite felt modified with bismuth nanoparticles as negative electrode in a vanadium redox flow battery.

Science.gov (United States)

Suárez, David J; González, Zoraida; Blanco, Clara; Granda, Marcos; Menéndez, Rosa; Santamaría, Ricardo

2014-03-01

A graphite felt decorated with bismuth nanoparticles was studied as negative electrode in a vanadium redox flow battery (VRFB). The results confirm the excellent electrochemical performance of the bismuth modified electrode in terms of the reversibility of the V(3+) /V(2+) redox reactions and its long-term cycling performance. Moreover a mechanism that explains the role that Bi nanoparticles play in the redox reactions in this negative half-cell is proposed. Bi nanoparticles favor the formation of BiHx , an intermediate that reduces V(3+) to V(2+) and, therefore, inhibits the competitive irreversible reaction of hydrogen formation (responsible for the commonly observed loss of Coulombic efficiency of VRFBs). Thus, the total charge consumed during the cathodic sweep in this electrode is used to reduce V(3+) to V(2+) , resulting in a highly reversible and efficient process. © 2014 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

Embattled and embittered or empowered and evolving: nurse practitioner attitudes toward managed care.

Science.gov (United States)

Hayes, Eileen F

2007-03-01

To explore the attitudes of nurse practitioners (NPs) toward managed care and to identify the sources of negative attitudes and the factors that may ameliorate them. NPs, members of the Massachusetts Coalition of NPs, participated in in-depth interviews about the impact of managed care on their practice. The sources of NP negativity about managed care for many study participants lay in their not appreciating the importance of the business aspects of practice and the provider's role in controlling healthcare costs, reluctance to work with what they perceived as a rigid "system," and lack of support for them to navigate it. They felt pressured by productivity issues, time constraints, practice restrictions, and documentation demands associated with reimbursement. Those who sustained a more positive attitude were realistic about healthcare economics, were willing and able to negotiate the system, were creative and flexible, and felt empowered by knowledge of the business of practice. Some NPs, however, chose to work in practices where they did not feel as pressured as their counterparts in large, busy primary care practices. IMPLICATIONS FOR NP PRACTICE AND EDUCATION: Understanding experiences that have influenced NP attitudes regarding managed care may assist NP faculty to better prepare NP students for their future roles. NPs must be able to challenge, yet be part of, an evolving system that promotes cost-effective health care for everyone, which was what managed care originally was intended to do.

Effect of anode polarization on biofilm formation and electron transfer in Shewanella oneidensis/graphite felt microbial fuel cells.

Science.gov (United States)

Pinto, David; Coradin, Thibaud; Laberty-Robert, Christel

2018-04-01

In microbial fuel cells, electricity generation is assumed by bacterial degradation of low-grade organics generating electrons that are transferred to an electrode. The nature and efficiency of the electron transfer from the bacteria to the electrodes are determined by several chemical, physical and biological parameters. Specifically, the application of a specific potential at the bioanode has been shown to stimulate the formation of an electro-active biofilm, but the underlying mechanisms remain poorly understood. In this study, we have investigated the effect of an applied potential on the formation and electroactivity of biofilms established by Shewanella oneidensis bacteria on graphite felt electrodes in single- and double-chamber reactor configurations in oxic conditions. Using amperometry, cyclic voltammetry, and OCP/Power/Polarization curves techniques, we showed that a potential ranging between -0.3V and +0.5V (vs. Ag/AgCl/KCl sat.) and its converse application to a couple of electrodes leads to different electrochemical behaviors, anodic currents and biofilm architectures. For example, when the bacteria were confined in the anodic compartment of a double-chamber cell, a negative applied potential (-0.3V) at the bioanode favors a mediated electron transfer correlated with the progressive formation of a biofilm that fills the felt porosity and bridges the graphite fibers. In contrast, a positive applied potential (+0.3V) at the bioanode stimulates a direct electron transfer resulting in the fast-bacterial colonization of the fibers only. These results provide significant insight for the understanding of the complex bacteria-electrode interactions in microbial fuel cells. Copyright © 2017 Elsevier B.V. All rights reserved.

A pharmacy business management simulation exercise as a practical application of business management material and principles.

Science.gov (United States)

Rollins, Brent L; Gunturi, Rahul; Sullivan, Donald

2014-04-17

To implement a pharmacy business management simulation exercise as a practical application of business management material and principles and assess students' perceived value. As part of a pharmacy management and administration course, students made various calculations and management decisions in the global categories of hours of operation, inventory, pricing, and personnel. The students entered the data into simulation software and a realistic community pharmacy marketplace was modeled. Course topics included accounting, economics, finance, human resources, management, marketing, and leadership. An 18-item posttest survey was administered. Students' slightly to moderately agreed the pharmacy simulation program enhanced their knowledge and understanding, particularly of inventory management, cash flow statements, balance sheets, and income statements. Overall attitudes toward the pharmacy simulation program were also slightly positive and students also slightly agreed the pharmacy simulation program enhanced their learning of pharmacy business management. Inventory management was the only area in which students felt they had at least "some" exposure to the assessed business management topics during IPPEs/internship, while all other areas of experience ranged from "not at all" to "a little." The pharmacy simulation program is an effective active-learning exercise and enhanced students' knowledge and understanding of the business management topics covered.

Utilization of Dental Services in Public Health Center: Dental Attendance, Awareness and Felt Needs.

Science.gov (United States)

Pewa, Preksha; Garla, Bharath K; Dagli, Rushabh; Bhateja, Geetika Arora; Solanki, Jitendra

2015-10-01

In rural India, dental diseases occur due to many factors, which includes inadequate or improper use of fluoride and a lack of knowledge regarding oral health and oral hygiene, which prevent proper screening and dental care of oral diseases. The objective of the study was to evaluate the dental attendance, awareness and utilization of dental services in public health center. A cross-sectional study was conducted among 251 study subjects who were visiting dental outpatient department (OPD) of public health centre (PHC), Guda Bishnoi, and Jodhpur using a pretested proforma from month of July 2014 to October 2014. A pretested questionnaire was used to collect the data regarding socioeconomic status and demographic factors affecting the utilization of dental services. Pearson's Chi-square test and step-wise logistic regression were applied for the analysis. Statistically significant results were found in relation to age, educational status, socioeconomic status and gender with dental attendance, dental awareness and felt needs. p-value dental services, thereby increasing the oral health status of the population.

Coulometric determination of dissolved hydrogen with a multielectrolytic modified carbon felt electrode-based sensor.

Science.gov (United States)

Matsuura, Hiroaki; Yamawaki, Yosuke; Sasaki, Kosuke; Uchiyama, Shunichi

2013-06-01

A multielectrolytic modified carbon electrode (MEMCE) was fabricated by the electrolytic-oxidation/reduction processes. First, the functional groups containing nitrogen atoms such as amino group were introduced by the electrode oxidation of carbon felt electrode in an ammonium carbamate aqueous solution, and next, this electrode was electroreduced in sulfuric acid. The redox waves between hydrogen ion and hydrogen molecule at highly positive potential range appeared in the cyclic voltammogram obtained by MEMCE. A coulometric cell using MEMCE with a catalytic activity of electrooxidation of hydrogen molecule was constructed and was used for the measurement of dissolved hydrogen. The typical current vs. time curve was obtained by the repetitive measurement of the dissolved hydrogen. These curves indicated that the measurement of dissolved hydrogen was finished completely in a very short time (ca. 10 sec). A linear relationship was obtained between the electrical charge needed for the electrooxidation process of hydrogen molecule and dissolved hydrogen concentration. This indicates that the developed coulometric method can be used for the determination of the dissolved hydrogen concentration.

Procontarinia mangiferae (Felt (Diptera: Cecidomyiidae new pest of mango (Mangifera indica L. in Cuba

Directory of Open Access Journals (Sweden)

Jorge Luís Rodríguez Tapia

2018-01-01

Full Text Available The diptera grouped in the family Cecidomyiidae, are considered important pests in the crop of mango (Mangifera indica L.. In the period of 2013-15, prospections were carried out in patios and plantations of several localities of Cuba (Havana, Artemisa, Mayabeque, Ciego de Ávila and Santiago de Cuba, during the stages of vegetative and floral sprouting, to evaluate the presence of insects. Thirteen samplings were made and 25 young leaves and 10 floral shoots were collected per sample, for a total of 325 young leaves and 130 floral shoots in which the number of galls, larvae, pupae and adults of an agallero insect was determined. A total of 2 423 galls were found in young leaves, which represented an average of 7.5 guts per leaf. A total of 207 larvae, 60 pupae and 40 adults were counted among diptera males and females. The morphological characters of the collected insects allowed identifying Procontarinia mangiferae (Felt, belonging to the family Cecidomyiidae, as the cause of the galls in the young leaves and floral shoots in the mango areas sampled.

PHENIX Spinfest School 2009 at BNL

Energy Technology Data Exchange (ETDEWEB)

Foster,S.P.; Foster,S.; Seidl, R.; Goto, Y.; Okada, K.

2009-08-07

Since 2005, the PHENIX Spin Physics Working Group has set aside several weeks each summer for the purposes of training and integrating recent members of the working group as well as coordinating and making rapid progress on support tasks and data analysis. One week is dedicated to more formal didactic lectures by outside speakers. The location has so far alternated between BNL and the RIKEN campus in Wako, Japan, with support provided by RBRC and LANL.

Policy on manager involvement in work re-integration: managers' experiences in a Canadian setting.

Science.gov (United States)

Maiwald, Karin; Meershoek, Agnes; de Rijk, Angelique; Nijhuis, Frans J N

2014-01-01

In Canada and other countries, sickness absence among workers is a significant concern. Local return-to-work policies developed by both management and workers' representatives are preferred to tackle the problem. This article examines how managers perceive this local bipartite agreed upon return-to-work policy, wherein a social constructivist view on the policy process is taken. In-depth interviews were held with 10 managers on their experiences with execution of this policy in a Canadian healthcare organization. Interviews were transcribed verbatim and qualitative analyses were completed to gain deep insight into the managers' perspectives. Results show that the managers viewed themselves as a linchpin between the workplace and the worker. They did not feel heard by the other stakeholders, wrestled with worker's limitations, struggled getting plans adjusted and became overextended to meet return-to-work objectives. The study shows that the managers felt unable to meet the responsibilities the policy demanded and got less involved in the return-to-work process than this policy intended. RTW policy needs to balance on the one hand, flexibility to safeguard active involvement of managers and, on the other hand, strictness regarding taking responsibility by stakeholders, particularly the health care and re-integration professionals.

Effects of Message Framing on Influenza Vaccination: Understanding the Role of Risk Disclosure, Perceived Vaccine Efficacy, and Felt Ambivalence.

Science.gov (United States)

Kim, Sungsu; Pjesivac, Ivanka; Jin, Yan

2017-10-20

The current study examined the effects of framing in promotional health messages on intention to vaccinate against seasonal influenza virus. The findings of an experimental study (N = 86) indicated that exposure to both benefits and side effects of vaccination (gain-framed with risk disclosure message) led to lower intention to receive the flu vaccine. This relationship was mediated by both perceived vaccine efficacy and felt ambivalence in a serial order, revealing the underlying psychological mechanisms important for understanding health-related behaviors. Theoretical implications of constructing sub-framed messages are discussed and the concept of second-order framing is introduced.

Fabrication and Characteristics of Sintered Cutting Stainless Steel Fiber Felt with Internal Channels and an Al2O3 Coating

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Shufeng Huang

2018-03-01

Full Text Available A novel sintered cutting stainless steel fiber felt with internal channels (SCSSFFC composed of a stainless-steel fiber skeleton, three-dimensional interconnected porous structure and multiple circular microchannels is developed. SCSSFFC has a jagged and rough surface morphology and possesses a high specific surface area, which is approximately 2.4 times larger than that of the sintered bundle-drawing stainless steel fiber felt with internal channels (SBDSSFFC and is expected to enhance adhesive strength. The sol-gel and wet impregnation methods are adopted to prepare SCSSFFC with an Al2O3 coating (SCSSFFC/Al2O3. The adhesive strength of SCSSFFC/Al2O3 is investigated using ultrasonic vibration and thermal shock tests. The experimental results indicate that the weight loss rate of the Al2O3 coating has a 4.2% and 8.42% reduction compared with those of SBDSSFFCs based on ultrasonic vibration and thermal shock tests. In addition, the permeability of SCSSFFC/Al2O3 is investigated based on forced liquid flow tests. The experimental results show that the permeability and inertial coefficients of SCSSFFC/Al2O3 are mainly affected by the coating rate, porosity and open ratio; however, the internal microchannel diameter has little influence. It is also found that SCSSFFC/Al2O3 yields superior permeability, as well as inertial coefficients compared with those of other porous materials reported in the literature.

Explanation of the Rb-Rc discrepancy using new physics

International Nuclear Information System (INIS)

Bhattacharyya, G.; Branco, G.C.; Hou, W.

1996-01-01

The experimental values of R b and R c are the only data which do not seem to agree with standard model predictions. Although it is still premature to draw any definite conclusions, it is timely to look for new physics which could explain the excess in R b and deficit in R c . We investigate this problem in a simple extension of the standard model, where a charge +2/3 isosinglet quark is added to the standard spectrum. Upon the further introduction of an extra scalar doublet, one finds a solution with interesting consequences. copyright 1996 The American Physical Society

RESEARCH ON ROMANIAN MANAGER TRAINING IN PRE-UNIVERSITY EDUCATION

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Tuşa Ana

2013-06-01

Full Text Available Following the implementation of educational reform, school leadership has become very important. School principals have become managers and it was necessary a qualification process for them. The purpose of this study was to establish training needs and training school managers. The research instrument was a questionnaire applied to a number of 38 school managers of the eight regions of Romania. Analyzing data from the questionnaires respondents received, we found the following: • there is a clear idea of managerial tasks • school management issues are not fully known by the respondents. School education directors reported several problems such as: • Requiring high problems that have not been trained • The need for skills in areas such as accounting, administration, legal, information technology • Making teaching standard together with managerial activity A percentage of 62.70% of executives felt they were not sufficiently prepared for effective business management.

Experimental study of effective thermal conductivity of stainless steel fiber felt

International Nuclear Information System (INIS)

Li, W.Q.; Qu, Z.G.

2015-01-01

An experimental apparatus was designed to measure the effective thermal conductivity of porous stainless steel fiber felt under different operating pressures. The total effective thermal conductivity was studied by analyzing matrix heat conduction, air natural convection, and matrix thermal radiation at ambient pressure. The contribution of air natural convection was experimentally obtained by changing the ambient pressure to vacuum condition and the solid matrix heat conduction was evaluated using a theoretical model. The ratios of the three mechanisms to the total effective thermal conductivity were approximately 40%, 37.9%, and 22.1%, respectively. In addition, the effects of fiber diameter and porosity on the three mechanisms and on the total effective thermal conductivity were studied. The air natural convection was found to gradually intensify when the operating pressure increases from vacuum condition (15 Pa) to ambient pressure (1.0 × 10 5  Pa). With an increase in fiber diameter under fixed porosity, the solid matrix heat conduction remained unchanged, and air natural convection and thermal radiation decreased, thereby resulting in reduced effective thermal conductivity. With an increase in porosity under fixed fiber diameter, the air natural convection was almost unchanged, and solid matrix heat conduction and thermal radiation were reduced, thereby resulting in reduced effective thermal conductivity. - Highlights: • Matrix conduction, radiation and air convection were in the same order of magnitude. • Air natural convection was suppressed by reducing operating pressure. • Intensity of air convection was more sensitive to fiber diameter than porosity. • Surface area and permeability was comparable in air convection as fiber diameter fixed. • Interfacial area exerted dominant role in radiation and air convection as porosity fixed

Water-activated graphite felt as a high-performance electrode for vanadium redox flow batteries

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Kabtamu, Daniel Manaye; Chen, Jian-Yu; Chang, Yu-Chung; Wang, Chen-Hao

2017-02-01

A simple, green, novel, time-efficient, and potentially cost-effective water activation method was employed to enhance the electrochemical activity of graphite felt (GF) electrodes for vanadium redox flow batteries (VRFBs). The GF electrode prepared with a water vapor injection time of 5 min at 700 °C exhibits the highest electrochemical activity for the VO2+/VO2+ couple among all the tested electrodes. This is attributed to the small, controlled amount of water vapor that was introduced producing high contents of oxygen-containing functional groups, such as sbnd OH groups, on the surface of the GF fibers, which are known to be electrochemically active sites for vanadium redox reactions. Charge-discharge tests further confirm that only 5 min of GF water activation is required to improve the efficiency of the VRFB cell. The average coulombic efficiency, voltage efficiency, and energy efficiency are 95.06%, 87.42%, and 83.10%, respectively, at a current density of 50 mA cm-2. These voltage and energy efficiencies are determined to be considerably higher than those of VRFB cells assembled using heat-treated GF electrodes without water activation and pristine GF electrodes.

The Impact of the Nurse-Physician Professional Relationship on Nurses' Experience of Ethical Dilemmas in Effective Pain Management.

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Van Niekerk, Leesa Micole; Martin, Frances

2002-01-01

A survey of 1,015 Australian registered nurses found that those who felt adequately consulted by physicians were significantly more likely to initiate consultation. Nurses dissatisfied with their relationship with physicians were more likely to experience ethical conflicts related to pain management. Level of satisfaction with this relationship…

Surgeons’ and Emergency Physicians’ Perceptions of Trauma Management and Training

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Hemphill, Robin R

2009-08-01

Full Text Available Objective: The study objective was to determine whether surgeons and emergency medicine physicians (EMPs have differing opinions on trauma residency training and trauma management in clinical practice.Methods: A survey was mailed to 250 EMPs and 250 surgeons randomly selected.Results: Fifty percent of surgeons perceived that surgery exclusively managed trauma compared to 27% of EMPs. Surgeons were more likely to feel that only surgeons should manage trauma on presentation to the ED. However, only 60% of surgeons currently felt comfortable with caring for the trauma patient, compared to 84% of EMPs. Compared to EMPs, surgeons are less likely to feel that EMPs can initially manage the trauma patient (71% of surgeons vs. 92% of EMPs.Conclusion: EMPs are comfortable managing trauma while many surgeons do not feel comfortable with the complex trauma patient although the majority of surgeons responded that surgeons should manage the trauma.[WestJEM. 2009;10:144-149.

Negative workplace behaviours: an ethical dilemma for nurse managers.

Science.gov (United States)

Lindy, Cheryl; Schaefer, Florence

2010-04-01

To discover nurse managers' perception of negative workplace behaviours (bullying) encountered by staff on their unit. Background Negative workplace behaviour is a worldwide phenomenon happening in all types of work settings. Absent from the literature were studies specific to the nurse managers' perception on this topic. A phenomenological qualitative research methodology was used to gain insight into the perceptions of nurse managers about negative workplace behaviours that they have observed or addressed. Nurse Managers described their perceptions of, and experiences pertaining to, instances of negative workplace behaviour. Six themes emerged from the data analysis: 'that's just how she is', 'they just take it', 'a lot of things going on', 'old baggage', 'three sides to a story' and 'a management perspective'. Nurse Managers had observed, experienced and/or had received reports of negative workplace behaviours. While some felt comfortable addressing the behaviour, others experienced ethical dilemmas when trying to treat all fairly. The results of the present study provide guidance for nurse managers to address negative workplace behaviours occurring on their units.

Radioactive waste management alternatives

International Nuclear Information System (INIS)

Baranowski, F.P.

1976-01-01

The information in the US ERDA ''Technical Alternatives Document'' is summarized. The first two points show that waste treatment, interim storage and transportation technologies for all wastes are currently available. Third, an assessment of integrated waste management systems is needed. One such assessment will be provided in our expanded waste management environmental statement currently planned for release in about one year. Fourth, geologies expected to be suitable for final geologic storage are known. Fifth, repository system assessment methods, that is a means to determine and assess the acceptability of a terminal storage facility for nonretrievable storage, must and will be prepared. Sixth, alternatives to geologic storage are not now available. Seventh, waste quantities and characteristics are sensitive to technologies and fuel-cycle modes, and therefore an assessment of these technologies and modes is important. Eighth, and most important, it is felt that the LWR fuel cycle can be closed with current technologies

Values and attitudes of National Wildlife Refuge managers and biologists; Report to respondents

Science.gov (United States)

Brinson, Ayeisha A.; Benson, Delwin E.

2002-01-01

The issues affecting natural resource management, the society in which natural resource management occurs, natural resource agency personnel, and the publics they serve have changed in recent decades. Previous studies of Refuge professionals in the U.S. Fish and Wildlife Service (Service) have revealed that employees lack strong commitment to the current organizational structure, were frustrated with the lack of communication within the agency and felt there was a need for strong leadership (PEER 1998, 1999). These results prompted the authors to have further questions about refuge management in the Fish and Wildlife Service. What do employees value about their agency? Is there a difference in values between refuge managers and biologists and if so, what are those differences and what influences those differences?

A survey on the beliefs and knowledge of gout management in new medical graduates - New South Wales, Australia.

Science.gov (United States)

Terrill, Matthew; Riordan, John

2018-02-01

To assess the beliefs and knowledge of gout management in new medical graduates. A survey on gout management was sent to new medical graduates during their orientation week, New South Wales, Australia. Of 15 hospital networks, 11 agreed to participate. From these, 168 graduates responded (23.7% response rate). Most (81.1%) felt that gout was a serious disease, 51.2% answered that they had been taught adequately to manage acute gout, only 37.2% for chronic gout. In an acute gout flare, 63.4% answered they would continue urate lowering therapy and 67.2% were aware of first-line pharmacological management options; 28% answered the correct dosing regimen for colchicine. Chronic management was answered poorly. Only 42.0% stated they would titrate allopurinol dosing to a target urate level; 23.5% would check the urate level monthly. More than half, 56.8%, were aware that medical prophylaxis is indicated when initiating urate lowering therapy. Of this subgroup, 46.7% (25.9% overall) knew that non-steroidal anti-inflammatory drugs and colchicine were recommended and 28.4% (15.4% overall) answered the correct timeframe of use. Close to one-third (35.0%), were aware of febuxostat, probenecid and benzbromarone as second-line urate lowering therapy. The findings of this study suggest that new graduates' knowledge of gout management, especially chronic management, is suboptimal. Many felt their teaching on gout management inadequate; this is a potential target for intervention. Up to date university education which covers chronic management may lead to better clinical outcomes for this burdensome disease. © 2017 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Numancia: The lived past. The felt past

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Jimeno Martínez, Alfredo

2000-12-01

Full Text Available In this paper the principal components of the Management Plan of Numancia (Soria are exposed. Its aim is to integrate the different activities (research, conservation, diffusion and management that have been undertaken at this historic site. For their better understanding, some previous considerations are presented about the ''leisure culture ", tourism and Archaeology, as well as about the ideological use and the mental reconstruction of the past, having always the site of Numancia as a reference. Afterwards we expose the need of reconstructions made in situ as a means to offer a comprehensible and living past. Finally, these programs of work are evaluated in relation with the evolution of the number of visitors and the socioeconomic implications.

En este artículo se exponen los componentes del Plan Director de Numancia (Soria, que tiene como objetivo integrar el conjunto de actuaciones (investigación, conservación, difusión y gestión a realizar en este histórico yacimiento. Para entender mejor las actuaciones que se están realizando en la presentación didáctica y puesta en valor de Numancia, se hace previamente una serie de consideraciones sobre ocio cultural, turismo y Arqueología, uso ideológico y reconstrucción mental del pasado, teniendo a Numancia como referente. A continuación se expone la necesidad de presentar este yacimiento a través de reconstrucciones realizadas in situ, como fórmula para hacer el pasado comprensible y vivido. Finalmente se valoran estas intervenciones, atendiendo a la evolución del número de visitantes y a las implicaciones socioeconómicas.

Gas chromatographic-mass spectrometric determination of hydrophilic compounds in environmental water by solid-phase extraction with activated carbon fiber felt.

Science.gov (United States)

Kawata, K; Ibaraki, T; Tanabe, A; Yagoh, H; Shinoda, A; Suzuki, H; Yasuhara, A

2001-03-09

Simple gas chromatographic-mass spectrometric determination of hydrophilic organic compounds in environmental water was developed. A cartridge containing activated carbon fiber felt was made by way of trial and was evaluated for solid-phase extraction of the compounds in water. The hydrophilic compounds investigated were acrylamide, N,N-dimethylacetamide, N,N-dimethylformamide, 1,4-dioxane, furfural, furfuryl alcohol, N-nitrosodiethylamine and N-nitrosodimethylamine. Overall recoveries were good (80-100%) from groundwater and river water. The relative standard deviations ranged from 4.5 to 16% for the target compounds. The minimum detectable concentrations were 0.02 to 0.03 microg/l. This method was successfully applied to several river water samples.

WAYS TO IMPROVE RISK MANAGEMENT IN COMPLEX PROJECTS

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Emilia IORDACHE

2012-01-01

Full Text Available Risk is present in all human activities; it can be associated with health, security, economy or environment. The goal of risk management is to control, prevent or decrease potential damages. Technically speaking, risk management means all the activities coordinated so as to orient and monitor an organization from the risk perspective. Risk management helps formulate the most adequate decisions by taking account of uncertainties and their effects upon the accomplishment of proposed goals, and argues the need to lay down and implement coercive, preventive actions typical of the management of a company. The benefits of good risk management and also the consequences of bad management shall undoubtedly be felt by an organization’s board, employees, shareholders, customers as well as by all other entities concerned with organizational performance. Projects generally include a number of risks in common with those in business as well as certain typical ones. In complex projects, it is this very feature – complexity – which generates the need to implement risk management for the purpose to diminish, remove, and monitor the risks which can influence the development of a project.

Education on, Exposure to, and Management of Vascular Anomalies During Otolaryngology Residency and Pediatric Otolaryngology Fellowship.

Science.gov (United States)

Chun, Robert; Jabbour, Noel; Balakrishnan, Karthik; Bauman, Nancy; Darrow, David H; Elluru, Ravindhra; Grimmer, J Fredrik; Perkins, Jonathan; Richter, Gresham; Shin, Jennifer

2016-07-01

The field of vascular anomalies presents diverse challenges in diagnosis and management. Although many lesions involve the head and neck, training in vascular anomalies is not universally included in otolaryngology residencies and pediatric otolaryngology (POTO) fellowships. To explore the education in, exposure to, and comfort level of otolaryngology trainees with vascular anomalies. A survey was distributed to 39 POTO fellows and 44 residents in postgraduate year 5 who matched into POTO fellowships from April 22 through June 16, 2014. Survey responses from trainees on exposure to, education on, and comfort with vascular anomalies. Forty-four residents in postgraduate year 5 who applied to POTO fellowships and 39 POTO fellows were emailed the survey. Fourteen respondents were unable to be contacted owing to lack of a current email address. Thirty-six of 69 residents and fellows (18 fellows and 18 residents [52%]) responded to the survey. Twenty-seven trainees (75%) reported no participation in a vascular anomalies clinic during residency; 6 of these 27 individuals (22%) trained at institutions with a vascular anomalies clinic but did not participate in the clinic, and 28 of the 36 respondents (78%) reported that they had less than adequate or no exposure to vascular anomalies in residency. Among POTO fellows, 11 of 17 (65%) did not participate in a vascular anomalies clinic during fellowship, even though 8 of the 11 had a vascular anomalies clinic at their fellowship program. During fellowship training, 12 of 18 fellows (67%) reported that they had adequate exposure to vascular anomalies. Only 20 respondents (56%) felt comfortable distinguishing among diagnoses of vascular anomalies, and only 4 residents (22%) and 9 fellows (50%) felt comfortable treating patients with vascular anomalies. All fellows believed that training in vascular anomalies was important in fellowship, and 100% of respondents indicated that increased exposure to diagnosis and management of

Bismuth nanoparticle decorating graphite felt as a high-performance electrode for an all-vanadium redox flow battery.

Science.gov (United States)

Li, Bin; Gu, Meng; Nie, Zimin; Shao, Yuyan; Luo, Qingtao; Wei, Xiaoliang; Li, Xiaolin; Xiao, Jie; Wang, Chongmin; Sprenkle, Vincent; Wang, Wei

2013-03-13

Employing electrolytes containing Bi(3+), bismuth nanoparticles are synchronously electrodeposited onto the surface of a graphite felt electrode during operation of an all-vanadium redox flow battery (VRFB). The influence of the Bi nanoparticles on the electrochemical performance of the VRFB is thoroughly investigated. It is confirmed that Bi is only present at the negative electrode and facilitates the redox reaction between V(II) and V(III). However, the Bi nanoparticles significantly improve the electrochemical performance of VRFB cells by enhancing the kinetics of the sluggish V(II)/V(III) redox reaction, especially under high power operation. The energy efficiency is increased by 11% at high current density (150 mA·cm(-2)) owing to faster charge transfer as compared with one without Bi. The results suggest that using Bi nanoparticles in place of noble metals offers great promise as high-performance electrodes for VRFB application.

Mechanism of Reaction in NaAlCl4 Molten Salt Batteries with Nickel Felt Cathodes and Aluminum Anodes. Part II: Experimental Results and Comparison with Model Calculations

DEFF Research Database (Denmark)

Knutz, B.C.; Berg, Rolf W.; Hjuler, Hans Aage

1993-01-01

The battery systems: Al/NaCl-AlCl3-Al(2)X(3)/Ni-felt (X = S, Se, Te) and the corresponding system without chalcogen have been studied experimentally at 175 degrees C. Charge/discharge experimental performed on cells with NaCl saturated melts, show that advantages with regard to rate capability an...

Management of Therapy Patients. Chapter 20

Energy Technology Data Exchange (ETDEWEB)

Dauer, L. T. [Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York (United States)

2014-12-15

The basic principles of radiation protection and their implementation as they apply to nuclear medicine are covered in general in Chapter 3. This chapter will look at the specific case of nuclear medicine used for therapy. In addition to the standards discussed in Chapter 3, specific guidance on the release of patients after radionuclide therapy can be found in the IAEA’s Safety Reports Series No. 63 [20.1]. When the patient is kept in hospital following radionuclide therapy, the people at risk of exposure include hospital staff whose duties may or may not directly involve the use of radiation. This can be a significant problem. However, it is generally felt that it can be effectively managed with well trained staff and appropriate facilities. On the other hand, once the patient has been released, the groups at risk include members of the patient’s family, including children, and carers; they may also include neighbours, visitors to the household, co-workers, those encountered in public places, on public transport or at public events, and finally, the general public. It is generally felt that these risks can be effectively mitigated by the radiation protection officer (RPO) with patient-specific radiation safety precaution instructions.

[The case manager--from words to deeds?].

Science.gov (United States)

Lindegaard, Birthe Rosenkrantz; Qvist, Peter

2010-04-19

Allocation of a case manager is now mandatory for both in- and outpatients in Denmark. Case manager allocation is reported quarterly to the regions and results are generally satisfying. Knowledge about fulfillment of the case manager role is, however, sparse. This study aims to examine the degree of fulfillment of the case manager role for a sample of inpatients. Two medical and two surgical wards participated. Patients were interviewed in relation to discharge while staff assigned as case managers completed a survey. Both patients and case managers answered questions regarding the defined roles as case managers: Planning/coordination, continuous information and discharge planning. 107 of 125 eligible patients were interviewed. Only 25 declared themselves informed about the allocation of a case manager. The patients' assessment of the service provided by the staff in relation to case manager tasks was generally good, but the services were seldom provided by the named case manager. 22% of patients did not experience continuous information, while only 13% did not experience a generally coherent stay in hospital. 110 case managers completed the survey. Less than half felt themselves well informed about the case manager role. Only a few case managers feel that they succeed in fulfilling the role, particularly regarding the participation in discharge planning. There seems to be a need for a targeted effort to improve the conditions for case managers in Danish hospitals in order to meet the intentions of this initiative.

Facing Ethical Dilemmas in the Workplace: A Qualitative Study of HR Managers' Perceptions of the Influences on Their Behavior and the Implications for Building an Ethical Culture in Organizations

Science.gov (United States)

LaMontagne, Ramona Marie

2012-01-01

This qualitative study examined the perceptions of human resource managers who had faced ethical dilemmas in the workplace, to gain an understanding of how they felt their life experiences shaped their values in making ethical decisions. The experiences of ten human resource managers who believed they chose a right course of action when faced with…

Analysis of Participant Reactivity in Dyads Performing a Videotaped Conflict-Management Task.

Science.gov (United States)

Semeniuk, Yulia Y; Riesch, Susan K

2011-01-01

Videotaping is used frequently in nursing research. A threat to the validity of videotaping is participant reactivity, that is, being recorded by a camera may influence the behavior of interest. This paper's purpose is to report how youth ages 10 to 14 years old and their parent viewed participation in a videotaped conflict-management task. Five dyads, who were part of a randomized clinical trial testing an intervention to promote parent-child communication, participated in a structured interview. All parents were mothers. Youth were eighth graders. Three were boys and two were girls. Findings indicated that (a) dyads felt that the videotaped interaction had a progression of feeling unnatural in the beginning to feeling natural toward the end, (b) dyads found it relatively easy to choose a topic of discussion, and (c) dyads felt that the discussions were meaningful. Based on these data, recommendations for researchers to reduce participant reactivity are provided.

Amperometric detection of hydrazine utilizing synergistic action of prussian blue @ silver nanoparticles / graphite felt modified electrode

International Nuclear Information System (INIS)

Zhao, Jihua; Liu, Jianxin; Tricard, Simon; Wang, Lei; Liang, Yanling; Cao, Linghua; Fang, Jian; Shen, Weiguo

2015-01-01

Highlights: • Prussian Blue (PB) deposition on Ag/GF for electrochemical hydrazine sensing; • Lower detection limit of 4.9 × 10 −7 mol L −1 , stable over 24 days; • High sensitivity: 26.06 A mol −1 L. -- Abstract: In this study, a triple-component hydrazine sensor (PB@Ag/GF) was fabricated with freestanding graphite felt (GF), silver nanoparticles (Ag) and prussian blue (PB). The Ag nanoparticles were electrodeposited on GF ultrasonically (Ag/GF), and acted as a catalyst of the chemical deposition of PB. The electrode was characterized by scanning election microscopy (SEM), infrared spectroscopy (IR), X-ray diffraction (XRD), and energy-dispersive X-ray spectroscopy (EDS). The electrochemical behavior of PB@Ag/GF was measured by cyclic voltammetry and amperometric measurements. The sensor displayed a prominent electrocatalytic activity toward hydrazine oxidation, with a fast response time of 2 s, a low detection limit of 4.9 × 10 −7 mol L −1 and very high detection sensitivity of 26.06 A mol −1 L

Emotional reactions to deviance in groups: the relation between number of angry reactions, felt rejection, and conformity.

Science.gov (United States)

Heerdink, Marc W; van Kleef, Gerben A; Homan, Astrid C; Fischer, Agneta H

2015-01-01

How many members of a group need to express their anger in order to influence a deviant group member's behavior? In two studies, we examine whether an increase in number of angry group members affects the extent to which a deviant individual feels rejected, and we investigate downstream effects on conformity. We show that each additional angry reaction linearly increases the extent to which a deviant individual feels rejected, and that this relation is independent of the total number of majority members (Study 1). This felt rejection is then shown to lead to anti-conformity unless two conditions are met: (1) the deviant is motivated to seek reacceptance in the group, and (2) conformity is instrumental in gaining reacceptance because it is observable by the majority (Study 2). These findings show that angry reactions are likely to trigger anti-conformity in a deviant, but they are also consistent with a motivational account of conformity, in which conformity is strategic behavior aimed at gaining reacceptance from the group.

Patients' and physicians' satisfaction with a pharmacist managed anticoagulation program in a family medicine clinic.

Science.gov (United States)

Bishop, Lisa; Young, Stephanie; Twells, Laurie; Dillon, Carla; Hawboldt, John

2015-06-09

A pharmacist managed anticoagulation service was initiated in a multi-physician family medicine clinic in December 2006. In order to determine the patient and physician satisfaction with the service, a study was designed to describe the patients' satisfaction with the warfarin education and management they received from the pharmacist, and to describe the physicians' satisfaction with the level of care provided by the pharmacist for patients taking warfarin. A self-administered survey was completed by both eligible patients receiving warfarin and physicians prescribing warfarin between December 2006 and May 2008. The patient survey collected information on patient demographics, satisfaction with warfarin education and daily warfarin management. The physician survey collected data about the satisfaction with patient education and daily anticoagulation management by the pharmacist. Seventy-six of 94 (81%) patients completed the survey. Fifty-nine percent were male with a mean age of 65 years (range 24-90). Ninety-six percent agreed/strongly agreed the pharmacist did a good job teaching the importance of warfarin adherence, the necessity of INR testing and the risks of bleeding. Eighty-five percent agreed/strongly agreed the risk of blood clots was well explained, 79% felt the pharmacist did a good job teaching about dietary considerations and 77% agreed/strongly agreed the pharmacist explained when to see a doctor. All patients felt the pharmacist gave clear instructions on warfarin dosing and INR testing. Four of nine physicians (44%) completed the survey. All agreed/strongly agreed the pharmacist was competent in the care provided, were confident in the care their patients received, would like the pharmacist to continue the service, and would recommend this program to other clinics. Patients and family physicians were satisfied with the pharmacist managed anticoagulation program and recommended continuation of the program. These results support the role of the

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

Science.gov (United States)

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

2017-01-01

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

Synergetic effect between adsorption and photodegradation on nanostructured TiO{sub 2}/activated carbon fiber felt porous composites for toluene removal

Energy Technology Data Exchange (ETDEWEB)

Li, Min; Lu, Bin; Ke, Qin-Fei; Guo, Ya-Jun; Guo, Ya-Ping, E-mail: ypguo@shnu.edu.cn

2017-07-05

Highlights: • Nanostructured TiO{sub 2}/activated carbon fiber felt porous composites are prepared. • Nanostructures TiO{sub 2} particles on fibers are constructed by nanocrystals. • They have synergetic adsorption-photocatalytic activities for toluene removal. • The adsorption efficiency reaches 98% at toluene concentrations <1150 ppm. • Carbon fibers can hinder the recombination of electron-hole pairs on TiO{sub 2}. - Abstract: The low quantum efficiency and limited adsorption efficiency of TiO{sub 2} makes it only fit for the removal of VOCs with low concentrations. Herein, we for the first time fabricated nanostructured TiO{sub 2}/activated carbon fiber felt (TiO{sub 2}/ACFF) porous composites by the in situ deposition of TiO{sub 2} microspheres on the carbon fibers in ACFF. Interestingly, the TiO{sub 2} microspheres exhibit hierarchical nanostructures constructed by nanocrystals as building blocks. The TiO{sub 2}/ACFF porous composites possess excellent adsorption and photodegradation properties for toluene because of the synergetic effects between the nanostructured TiO{sub 2} and ACFF. The adsorption efficiencies of the TiO{sub 2}/ACFF porous composites reach approximately 98% at the toluene concentration (<1150 ppm) and approximately 77% even at the high concentration of 6900 ppm. Moreover, the ACFF in the TiO{sub 2}/ACFF porous composites significantly enhances photocatalytic property for toluene by hindering the recombination of electron-hole pairs, reducing the TiO{sub 2} band gap energy (E{sub g}) to 2.95 eV and accelerating toluene adsorption. At the toluene concentrations of 230 ppm and 460 ppm, the photocatalytic oxidation efficiency of toluene into CO{sub 2} arrives at 100% and 81.5%, respectively. Therefore, the TiO{sub 2}/ACFF porous composites with synergetic adsorption and photocatalytic activities have great potentials for toluene removal.

Homelessness Felt

OpenAIRE

Robinson, Catherine

2011-01-01

The felt—as both methodology and experiential terrain—remains under-explored and under-theorised in research on homelessness.  This experimental piece traces the multi-sensory engagement of ethnographic and biographic fieldwork undertaken for separate projects with homeless people in two capital cities on Australia’s east coast.  The epistemological contributions and emotional dimensions of seeing, tasting, touching, smelling and listening are explored.  Throu...

Report of the SRC working party on databases and database management systems

International Nuclear Information System (INIS)

Crennell, K.M.

1980-10-01

An SRC working party, set up to consider the subject of support for databases within the SRC, were asked to identify interested individuals and user communities, establish which features of database management systems they felt were desirable, arrange demonstrations of possible systems and then make recommendations for systems, funding and likely manpower requirements. This report describes the activities and lists the recommendations of the working party and contains a list of databses maintained or proposed by those who replied to a questionnaire. (author)

Binder-free graphene and manganese oxide coated carbon felt anode for high-performance microbial fuel cell.

Science.gov (United States)

Zhang, Changyong; Liang, Peng; Yang, Xufei; Jiang, Yong; Bian, Yanhong; Chen, Chengmeng; Zhang, Xiaoyuan; Huang, Xia

2016-07-15

A novel anode was developed by coating reduced graphene oxide (rGO) and manganese oxide (MnO2) composite on the carbon felt (CF) surface. With a large surface area and excellent electrical conductivity, this binder-free anode was found to effectively enhance the enrichment and growth of electrochemically active bacteria and facilitate the extracellular electron transfer from the bacteria to the anode. A microbial fuel cell (MFC) equipped with the rGO/MnO2/CF anode delivered a maximum power density of 2065mWm(-2), 154% higher than that with a bare CF anode. The internal resistance of the MFC with this novel anode was 79Ω, 66% lower than the regular one's (234Ω). Cyclic voltammetry (CV) and electrochemical impedance spectroscopy (EIS) analyses affirmed that the rGO/MnO2 composite significantly increased the anodic reaction rates and facilitated the electron transfer from the bacteria to the anode. The findings from this study suggest that the rGO/MnO2/CF anode, fabricated via a simple dip-coating and electro-deposition process, could be a promising anode material for high-performance MFC applications. Copyright © 2016 Elsevier B.V. All rights reserved.

Normal tension glaucoma management: a survey of contemporary practice.

Science.gov (United States)

Symes, Richard J; Mikelberg, Frederick S

2017-08-01

The aim of this study was to investigate contemporary practice patterns with respect to normal tension glaucoma (NTG) management and to determine whether the 2 largest NTG trials have influenced ophthalmologists' clinical practice. A survey questionnaire was sent to ophthalmologists via the American Glaucoma Society, the Canadian Glaucoma Society, and the Canadian Ophthalmological Society. The questionnaire was designed to investigate ophthalmologists' usual practice with respect to NTG and the extent to which practice has been influenced by the Collaborative Normal Tension Glaucoma Study (CNTGS) and the Low pressure Glaucoma Treatment Study (LoGTS). In total, 419 ophthalmologists completed the survey. Of these, 264 respondents were glaucoma subspecialists. The survey showed that 95% and 64% of ophthalmologists were familiar with the CNTGS and the LoGTS, respectively. Of the respondents, 70% indicated that they would initiate treatment in mild-to-moderate NTG without waiting for documented disease progression. Of the respondents, 61% of the total surveyed and 50% of the glaucoma subspecialists felt that the LoGTS results had no impact on their usual clinical practice. The first-choice topical drug for NTG was a prostaglandin analogue (88% of respondents) or brimonidine (10% of respondents). Most ophthalmologists treat NTG more aggressively than recommended by the CTNGS protocol. Most ophthalmologists felt that the LoGTS results had no impact on their normal clinical practice. The prostaglandin analogues are, by far, the most popular choice of drug for contemporary management of NTG. Copyright © 2017 Canadian Ophthalmological Society. Published by Elsevier Inc. All rights reserved.

Teaching empirical finance courses: A project on portfolio management

Directory of Open Access Journals (Sweden)

Bruce Morley

2016-12-01

Full Text Available The aim of this article was to assess the use of a group-based project for an empirical finance type of course. It examines the outline of the project, the methodology the students are encouraged to follow and how the course is assessed. This approach enables the students to apply many of the techniques learnt on this course and other courses such as econometrics, to determine an optimal portfolio of assets given their view on the risks in the economy. The emphasis is on risk management through portfolio diversification and the use of a simple hedge strategy. The overall aim was to introduce the students to the basics of portfolio management, as many work in this industry for their industrial placements and when they graduate. The main contribution to the literature is through the analysis of an empirically based portfolio management project. The feedback from the students suggests they felt that they had learnt useful concepts and information, in an enjoyable exercise.

National survey addressing the information needs of primary care physicians: Side effect management of patients on androgen deprivation therapy.

Science.gov (United States)

Soeyonggo, Tony; Locke, Jennifer; Giudice, Maria Elizabeth Del; Alibhai, Shabbir; Fleshner, Neil Eric; Warde, Padraig

2014-03-01

Androgen deprivation therapy (ADT) is a common treatment for prostate cancer with numerous side effects. We assess primary care physicians' (PCPs) knowledge of ADT side effects and their interest in increasing their knowledge in this area. A list of active Canadian PCPs was obtained using the Canadian Medical Directory. A cross-sectional survey was distributed to 600 randomly selected physicians. We collected PCPs' demographic information, experience with ADT management, knowledge regarding ADT side effects and desired sources for obtaining knowledge on ADT management. In total, we received 103 completed questionnaires. Of these, 89% of PCPs had patients on ADT. One-third of respondents prescribed ADT and over half of them administered ADT annually. Thirty-eight percent felt their knowledge of ADT side effects was inadequate and 50% felt uncomfortable counselling patients on ADT. Many PCPs were less familiar with the incidence of functional side effects of ADT (i.e., hot flashes, fatigue and erectile dysfunction) compared to life-threatening side effects (i.e., cardiovascular events, metabolic syndrome, fractures). In terms of increasing their knowledge of ADT side effects, 82% of PCPs would use educational resources if they were available (52% and 32% preferred continued medical education [CME] events and educational pamphlets, respectively). PCPs play an important role in managing ADT side effects. There is poor awareness of the prevalence of ADT side effects, and many are uncomfortable in managing these side effects. These areas may be addressed through CME programs and educational pamphlets.

Emotional Reactions to Deviance in Groups: The Relation between Number of Angry Reactions, Felt Rejection, and Conformity

Directory of Open Access Journals (Sweden)

Marc W. Heerdink

2015-06-01

Full Text Available How many members of a group need to express their anger in order to influence a deviant group member's behavior? In two studies, we examine whether an increase in number of angry group members affects the extent to which a deviant individual feels rejected, and we investigate downstream effects on conformity. We show that each additional angry reaction linearly increases the extent to which a deviant individual feels rejected, and that this relation is independent of the total number of majority members (Study 1. This felt rejection is then shown to lead to anti-conformity unless two conditions are met: (1 the deviant is motivated to seek reacceptance in the group, and (2 conformity is instrumental in gaining reacceptance because it is observable by the majority (Study 2. These findings show that angry reactions are likely to trigger anti-conformity in a deviant, but they are also consistent with a motivational account of conformity, in which conformity is strategic behavior aimed at gaining reacceptance from the group.

The need for time management training is universal: evidence from Turkey.

Science.gov (United States)

Kisa, Adnan; Ersoy, Korkut

2005-01-01

In many developing countries, healthcare administrators are currently facing challenges that are representative of those in the United States. Most healthcare administrators here are physicians with no formal training in healthcare administration, and this is perhaps most apparent in their difficulties with time management. The authors' purpose in this study was to characterize the time management difficulties of administrators working in primary healthcare facilities of the Ministry of Healthcare. In the study, 67 healthcare administrators each completed a 31-item time management questionnaire. Of the participants, 79.1% reported that they have never attended time management courses or workshops. Although 76.1% said they were free to choose the priority of their daily tasks, only 44.8% felt they knew how much time they should allow for each activity in their daily life. These and other findings in the study suggest that the need for time management education is a well-defined target for intervention, both in university-based programs for future healthcare administrators and in workplace-based programs, such as in-service training for healthcare administrators who are already working.

CEO expectation: the Star Wars materiel manager of the 1990s, or C-3PO as role model.

Science.gov (United States)

Zenty, T F; Olson, M R

1993-05-01

Materiel-intensive expenditures account for a significant portion of all hospital costs, second only to salaries and wages, yet materiel managers may often be overlooked as key members of the management team. This is alarming since the potential exists for materiel managers to impact annual savings of hundreds of thousands of dollars by operating efficient departments. Materiel managers have a tremendous opportunity to enhance their image and improve hospital productivity in the coming decade. The challenges of the 1990s will stretch materiel managers' skills toward enhancing their professionalism and achieving the expectations of themselves and top management. If materiel managers will effectively utilize (C3)PO they will increase their educational levels, continue to learn new skills, maintain a customer-oriented management style, exercise creativity, develop and adhere to standards, and be proactive in their responsibilities. The benefits of their success will be felt by patients, hospitals, the industry, and materiel managers everywhere.

Managing chronic orofacial pain: A qualitative study of patients', doctors', and dentists' experiences.

Science.gov (United States)

Peters, Sarah; Goldthorpe, Joanna; McElroy, Cheryl; King, Elizabeth; Javidi, Hanieh; Tickle, Martin; Aggarwal, Vishal R

2015-11-01

Persistent pain in the face, mouth, and jaws is a common presentation to dental and medical services. The aetiology remains unclear, but a growing evidence base recognizes the effectiveness of psychological rather than biomedical interventions. To understand how this approach might be implemented into clinical practice, knowledge is needed of patients' and clinicians' experience of chronic orofacial pain (COFP). The aim of this study was to explore the experience and understanding of COFP by patients and primary and secondary care medical and dental practitioners. Qualitative interview study. Audio-recorded semi-structured interviews with a purposive sample of 12 dentists, 11 general practitioners, and seven patients were thematically analysed. Clinicians and patients recognized the role that psychological factors could play in the development and maintenance of COFP, yet management and self-management strategies were largely limited to biomedical interventions. Achieving a diagnosis proved problematic but largely functional for both parties. GPs and dentists viewed COFP as a non-dental problem and felt inadequately equipped to manage the condition. GPs, unlike dentists, felt obligated to support patients using techniques for managing patients with other long-term conditions. Frustration at the current inadequacy of COFP management often led to conflict with (or disengagement from) the clinician-patient relationship. Current management of COFP is ineffective and unsatisfactory for patients and practitioners, which impacts on their relationship. Fundamental barriers to accessing and implementing psychological interventions for COFP arise from ineffective communication between physicians and patients, and between medical and dental practitioners. Statement of contribution What is already known on this subject? COFP is characterized by persistent pain in the face, mouth, or jaws that are not the result of organic disease or physical trauma. Patients with COFP present

Current UK practices in the management of subacromial impingement.

Science.gov (United States)

Bryceland, James K; Drury, Colin; Tait, Gavin R

2015-07-01

Controversy presently exists surrounding the management of patients with subacromial impingement. This study aims to highlight current UK practices in the management of these patients. BESS members were invited to complete a questionnaire and responses were received from 157 consultant shoulder surgeons. Physiotherapy is an integral part of management for 93% of surgeons with a minimum period of 12 weeks being most popular prior to consideration of arthroscopic subacromial decompression. Subacromial steroid injection is used by 95% and 86% repeat this if the patient has failed to respond to a previous injection by the general practioner. From initial presentation, 77% felt there should be at least 3 months of conservative management before proceeding to surgery. Good but transient response to subacromial injection was considered the best predictor of good surgical outcome by 77%. The coracoacromial ligament is fully released by 78%, although there was greater variation in how aggressive surgeons were with acromioplasty. Most (59%) do not include the nontender acromioclavicular joint to any extent in routine acromioplasty. Hospital physiotherapy protocols are used by 63% for postoperative rehabilitation. Variation exists in the management regimes offered to patients with subacromial impingement, but most employ a minimum period of 12 weeks of conservative management incorporating physiotherapy and at least 2 subacromial steriod injections.

Immobilization of Tyrosinase on (3-Aminopropyltriethoxysilane-Functionalized Carbon Felt-Based Flow-Through Detectors for Electrochemical Detection of Phenolic Compounds

Directory of Open Access Journals (Sweden)

Zheng Zhou

2017-07-01

Full Text Available Tyrosinase (TYR was covalently immobilized onto amino-functionalized carbon felt (CF surface via glutaraldehyde (GA. Prior to the TYR-immobilization, primary amino group was introduced to the CF surface by treatment with 3-aminopropyltriethoxysilane (APTES. The resulting TYR-immobilized CF was used as a working electrode unit of an electrochemical flow-through detector for mono- and di-phenolic compounds (i.e., catechol, p-cresol, phenol and p-chlorophenol. Additionally, flow injection peaks based on electroreduction of the enzymatically produced o-quinone species were detected at −0.05 V vs. Ag/AgCl. The resulting TYR/GA/APTES/CF biosensor responded well to all compounds tested with limits of detection range from 7.5 to 35 nmol−1 (based on three times S/N ratio. Moreover, such modified electrode exhibits good stability and reproducibility for catechol. No serious degradation of the peak current was found over 30 consecutive injections.

How Learning Goal Orientation Fosters Leadership Recognition in Self-managed Teams

DEFF Research Database (Denmark)

Lee, Yih-Teen; Paunova, Minna

2017-01-01

understudied. Drawing on social exchange theory, we propose and test an individual-level two-stage process model of generalised exchange linking LGO and leadership recognition in self-managed teams. Specifically, we posit that learning-oriented individuals will tend to feel safer in self-managed teams, which......Defined as a mental framework for how individuals interpret and respond to achievement situations, learning goal orientation (LGO) has received increasing attention in organisational research. However, its effect on leadership, especially in contexts absent of formal leadership, remains......, but that contextual role behavior alone does not mediate the effect of LGO on leadership recognition. LGO has an indirect effect on leadership recognition through the joint mediation of felt safety and contextual role behavior. Our results offer insight on the link between LGO and leadership, with practical...

An electrical-heating and self-sensing shape memory polymer composite incorporated with carbon fiber felt

International Nuclear Information System (INIS)

Gong, Xiaobo; Leng, Jinsong; Liu, Liwu; Liu, Yanju

2016-01-01

Shape memory polymers (SMPs) have the ability to adjust their stiffness, lock a temporary shape, and recover the permanent shape upon imposing an appropriate stimulus. They have found their way into the field of morphing structures. The electrically Joule resistive heating of the conductive composite can be a desirable stimulus to activate the shape memory effect of SMPs without external heating equipment. Electro-induced SMP composites incorporated with carbon fiber felt (CFF) were explored in this work. The CFF is an excellent conductive filler which can easily spread throughout the composite. It has a huge advantage in terms of low cost, simple manufacturing process, and uniform and tunable temperature distribution while heating. A continuous and compact conductive network made of carbon fibers and the overlap joints among them was observed from the microscopy images, and this network contributes to the high conductive properties of the CFF/SMP composites. The CFF/SMP composites can be electrical-heated rapidly and uniformly, and its’ shape recovery effect can be actuated by the electrical resistance Joule heating of the CFF without an external heater. The CFF/SMP composite get higher modulus and higher strength than the pure SMP without losing any strain recovery property. The high dependence of temperature and strain on the electrical resistance also make the composite a good self-sensing material. In general, the CFF/SMP composite shows great prospects as a potential material for the future morphing structures. (paper)

Evaluation of NRC maintenance team inspection reports for managing aging

International Nuclear Information System (INIS)

Fresco, A.; Gunther, W.

1991-01-01

A nuclear power plant's maintenance program is the principal vehicle through which age-related degradation is managed. Over the past two years, the NRC [Nuclear Regulatory Commission] has evaluated the maintenance program of every nuclear power plant in the U.S. The reports issued on these in-depth team inspections have been reviewed to ascertain the strengths and weaknesses of the programs as related to the need to understand and manage the effects of aging on nuclear power plant systems, structures, and components. Selected results of this review are presented in this paper, including examples of inspection and monitoring techniques successfully used by utilities to detect degradation due to aging. Attributes of plant maintenance programs where the NRC inspectors felt that improvement was needed to properly address the aging issue are also discussed. 6 refs., 1 tab

Consensus guidelines on management of childhood convulsive status epilepticus.

Science.gov (United States)

Mishra, Devendra; Sharma, Suvasini; Sankhyan, Naveen; Konanki, Ramesh; Kamate, Mahesh; Kanhere, Sujata; Aneja, Satinder

2014-12-01

Status epilepticus has a wide etiological spectrum, and significant morbidity and mortality. Management using a pre-determined uniform protocol leads to better outcomes. Multiple protocols for management of childhood status epilepticus are available, without much consensus. A 'Multi-disciplinary Consensus Development Workshop on Management of Status Epilepticus in Children in India' was organized. The invited experts included Pediatricians, Pediatric neurologists, Neurologists, Epileptologists, and Pediatric intensive care specialists from India, with experience in the relevant field. Experts had previously been divided into focus groups and had interacted on telephone and e-mail regarding their group recommendations, and developed consensus on the topic. During the meeting, each group presented their recommendations, which were deliberated upon by the house and a consensus was reached on various issues; the document was finalized after incorporating suggestions of experts on the draft document. To provide consensus guidelines on evaluation and management of convulsive status epilepticus in children in India (excluding neonatal and super-refractory status epilepticus). Each institution should use a pre-determined protocol for management of status epilepticus; pre-hospital management and early stabilization is the key to a satisfactory outcome of status epilepticus. Pharmacotherapy should not be delayed for any investigations; the initial management should consist of a parenteral benzodiazepine by any route feasible. Subsequent management has been detailed. The group also felt the need for more epidemiological research on status epilepticus from India, and identified certain research areas for the purpose.

Current UK practices in the management of subacromial impingement

Science.gov (United States)

Drury, Colin; Tait, Gavin R

2015-01-01

Background Controversy presently exists surrounding the management of patients with subacromial impingement. This study aims to highlight current UK practices in the management of these patients. Methods BESS members were invited to complete a questionnaire and responses were received from 157 consultant shoulder surgeons. Results Physiotherapy is an integral part of management for 93% of surgeons with a minimum period of 12 weeks being most popular prior to consideration of arthroscopic subacromial decompression. Subacromial steroid injection is used by 95% and 86% repeat this if the patient has failed to respond to a previous injection by the general practioner. From initial presentation, 77% felt there should be at least 3 months of conservative management before proceeding to surgery. Good but transient response to subacromial injection was considered the best predictor of good surgical outcome by 77%. The coracoacromial ligament is fully released by 78%, although there was greater variation in how aggressive surgeons were with acromioplasty. Most (59%) do not include the nontender acromioclavicular joint to any extent in routine acromioplasty. Hospital physiotherapy protocols are used by 63% for postoperative rehabilitation. Conclusions Variation exists in the management regimes offered to patients with subacromial impingement, but most employ a minimum period of 12 weeks of conservative management incorporating physiotherapy and at least 2 subacromial steriod injections. PMID:27582972

Trust that binds: the impact of collective felt trust on organizational performance.

Science.gov (United States)

Salamon, Sabrina Deutsch; Robinson, Sandra L

2008-05-01

The impact of employees' collective perceptions of being trusted by management was examined with a longitudinal study involving 88 retail stores. Drawing on the appropriateness framework (March, 1994; Weber, Kopelman, & Messick, 2004), the authors develop and test a model showing that when employees in an organization perceive they are trusted by management, increases in the presence of responsibility norms, as well as in the sales performance and customer service performance of the organization, are observed. Moreover, the relationship between perceptions of being trusted and sales performance is fully mediated by responsibility norms. PsycINFO Database Record (c) 2008 APA, all rights reserved.

Synergistic effect of carbon nanofiber/nanotube composite catalyst on carbon felt electrode for high-performance all-vanadium redox flow battery.

Science.gov (United States)

Park, Minjoon; Jung, Yang-jae; Kim, Jungyun; Lee, Ho il; Cho, Jeaphil

2013-10-09

Carbon nanofiber/nanotube (CNF/CNT) composite catalysts grown on carbon felt (CF), prepared from a simple way involving the thermal decomposition of acetylene gas over Ni catalysts, are studied as electrode materials in a vanadium redox flow battery. The electrode with the composite catalyst prepared at 700 °C (denoted as CNF/CNT-700) demonstrates the best electrocatalytic properties toward the V(2+)/V(3+) and VO(2+)/VO2(+) redox couples among the samples prepared at 500, 600, 700, and 800 °C. Moreover, this composite electrode in the full cell exhibits substantially improved discharge capacity and energy efficiency by ~64% and by ~25% at 40 mA·cm(-2) and 100 mA·cm(-2), respectively, compared to untreated CF electrode. This outstanding performance is due to the enhanced surface defect sites of exposed edge plane in CNF and a fast electron transfer rate of in-plane side wall of the CNT.

Evaluation and Management of Patch Test-Negative Patients With Generalized Dermatitis.

Science.gov (United States)

Spiker, Alison; Mowad, Christen M

Patients with generalized dermatitis are common in dermatology practices. Allergic contact dermatitis is often suspected, and patients frequently undergo patch testing. When the patch testing result is negative, further evaluation and management of these patients are challenging. The purpose of this study was to survey members of the American Contact Dermatitis Society regarding the evaluation and management of patch test-negative patients with generalized dermatitis. Generalized dermatitis was the most common term identified for patch test-negative patients with diffuse dermatitis. After having negative expanded patch testing results, most physicians proceeded with additional testing including skin biopsy, complete blood cell count with differential, and liver and renal function tests. The most commonly used systemic treatment is prednisone, followed by methotrexate. Narrow-band ultraviolet B (UVB) is the most commonly used light source. Antihistamines are frequently prescribed. Food allergy is not felt to be causative. This cohort of patients experiences significant impairment in quality of life, stress on personal relationships, and time off work. The management of patch test-negative patients with generalized dermatitis is challenging. This study provides insight into management of these complex patients. It also demonstrates practice gaps in the management of these patients, indicating a need for further studies to direct the evaluation and management of this patient population.

Anaerobic granule-based biofilms formation reduces propionate accumulation under high H2 partial pressure using conductive carbon felt particles.

Science.gov (United States)

Xu, Heng; Wang, Cuiping; Yan, Kun; Wu, Jing; Zuo, Jiane; Wang, Kaijun

2016-09-01

Syngas based co-digestion is not only more economically attractive than separate syngas methanation but also able to upgrade biogas and increase overall CH4 amount simultaneously. However, high H2 concentration in the syngas could inhibit syntrophic degradation of propionate, resulting in propionate accumulation and even failure of the co-digestion system. In an attempt to reduce propionate accumulation via enhancing both H2 interspecies transfer (HIT) and direct interspecies electron transfer (DIET) pathways, layered granule-based biofilms induced by conductive carbon felt particles (CCFP) was employed. The results showed that propionate accumulation was effectively reduced with influent COD load up to 7gL(-1)d(-1). Two types of granule-based biofilms, namely biofilm adhered to CCFP (B-CCFP) and granules formed by self-immobilization (B-SI) were formed in the reactor. Clostridium, Syntrophobacter, Methanospirillum were possibly involved in HIT and Clostridium, Geobacter, Anaerolineaceae, Methanosaeta in DIET, both of which might be responsible for the high-rate propionate degradation. Copyright © 2016 Elsevier Ltd. All rights reserved.

Inventory management in a metallurgical of the automotive industry

Directory of Open Access Journals (Sweden)

Marcos Antonio Maia de Oliveira

2015-12-01

Full Text Available This article aims to analyze the importance of inventory management in a metallurgical company, located in Santo André city, in Grande São Paulo, since the inventory management is crucial within a company that wants to survive nowadays, by studying the main features and trends in the methods used for inventory control. In this case study the basic concepts for good control were considered, showing tools currently used in the market, providing data for material purchase, sales control, parts in stock, future orders, MRP, storage space, among others once many companies have high and unnecessary cost of stock for not being aware of the real importance of this control. It is felt that the logistics of the company should invest in technology by purchasing the MRP system, visiting fairs and attending seminars. This way, the company will have better inventory control thus consequently decrease the purchase of materials.

SOCIAL ENVIRONMENTAL MANAGEMENT IN NGOS: A LOOK FROM THE BUSINESS PERFORMANCE AND THEIR PERCEPTIONS AS STAKEHOLDERS FROM OTHERS ORGANIZATIONS

Directory of Open Access Journals (Sweden)

Vivian Duarte Couto Fernandes

2014-05-01

Full Text Available The reflection of environmental management is felt by the entire chain of stakeholders of an organization. Within the environmental context, the NGOs act as important actors in the dissemination and engagement, being one of the key stakeholders which relate to the company. This article aims to discuss the concept of environmental management from the performance of environmental NGOs in Uberlândia/MG, checking their perception as one of all stakeholders from organizations. The research is descriptive and exploratory. Data collection started from semi-structured interviews with managers and research websites of entities. The results of this study show the relevance of the subject; how the environmental management of the NGOs involves both aspects of environmental and social; and the difficulty to relate and act together with government agencies and private sector, given the different goals that each ball has when it comes to environmental management.

Implementing complex innovations: factors influencing middle manager support.

Science.gov (United States)

Chuang, Emmeline; Jason, Kendra; Morgan, Jennifer Craft

2011-01-01

Middle manager resistance is often described as a major challenge for upper-level administrators seeking to implement complex innovations such as evidence-based protocols or new skills training. However, factors influencing middle manager support for innovation implementation are currently understudied in the U.S. health care literature. This article examined the factors that influence middle managers' support for and participation in the implementation of work-based learning, a complex innovation adopted by health care organizations to improve the jobs, educational pathways, skills, and/or credentials of their frontline workers. We conducted semistructured interviews and focus groups with 92 middle managers in 17 health care organizations. Questions focused on understanding middle managers' support for work-based learning as a complex innovation, facilitators and barriers to the implementation process, and the systems changes needed to support the implementation of this innovation. Factors that emerged as influential to middle manager support were similar to those found in broader models of innovation implementation within the health care literature. However, our findings extend previous research by developing an understanding about how middle managers perceived these constructs and by identifying specific strategies for how to influence middle manager support for the innovation implementation process. These findings were generally consistent across different types of health care organizations. Study findings suggest that middle manager support was highest when managers felt the innovation fit their workplace needs and priorities and when they had more discretion and control over how it was implemented. Leaders seeking to implement innovations should consider the interplay between middle managers' control and discretion, their narrow focus on the performance of their own departments or units, and the dedication of staff and other resources for empowering their

A mass merchandiser's role in enhancing pharmacy students' business plan development skills for medication therapy management services.

Science.gov (United States)

Moultry, Aisha Morris

2011-09-10

To develop a relationship between a pharmacy management course and a mass merchandiser and to determine whether involving pharmacy managers from the mass merchandiser in the course would enhance student skills in developing a business plan for medication therapy management services. The pharmacy managers from the mass merchandiser participated in lectures, provided panel discussions, and conducted a business plan competition. Learning was assessed by means of 4 examinations and 1 project (ie, the business plan). At the conclusion of the semester, surveys were administered to solicit student input and gain insight from pharmacy managers on the perceived value of this portion of the course. Students' average grade on the business plan assignment, which included the oral presentation, the peer assessment, and the written proposal, was 92.2%. Approximately 60% (n=53) of surveyed students agreed or strongly agreed that their management skills had improved because of the participation of pharmacy managers from the mass merchandiser. All of the managers enjoyed participating in the experience. The involvement of pharmacy managers from a mass merchandiser enhanced student learning in the classroom, and managers felt that their participation was an important contribution to the development of future pharmacists.

Distributed and Centralized Conflict Management Under Traffic Flow Management Constraints

Science.gov (United States)

Feron, Eric; Bilimoria, Karl (Technical Monitor)

2001-01-01

The past year's activity has concentrated on the following two activities: (1) Refining and completing our study on the stability of interacting flows of aircraft when they have to resolve conflicts in a decentralized and sequential manner. More specifically, it was felt that some of the modeling assumptions made during previous research (such offset maneuvering models) could be improved to include more realistic models such as heading changes when analyzing interacting flow stability problems. We extended our analysis to achieve this goal. The results of this study have been submitted for presentation at the 2002 American Control Conference; (2) Examining the issues associated with delay propagation across multiple enroute sectors. This study was initiated at NASA in cooperation with Dr. Karl Bilimoria. Considering a set of adjacent sectors, this ongoing study concentrates on the effect of various traffic flow management strategies on the propagation of delays and congestion across sectors. The problem description and findings so far are reported in the attached working paper "Enroute sector buffering capacity."

Nobody asked me how I felt: experiences of adult children of persons with young-onset dementia.

Science.gov (United States)

Barca, Maria Lage; Thorsen, Kirsten; Engedal, Knut; Haugen, Per Kristian; Johannessen, Aud

2014-12-01

There are few studies of young persons (old) with dementia, and the situation of their children has been a neglected research field. The aim is explore how adult children of a parent with young-onset dementia have experienced the development of their parents' dementia and what needs they have for assistance. Qualitative interviews with 14 informants (aged 20-37 years; 12 daughters, 2 sons) during 2011 were conducted and analyzed thematically. The informants experienced great burdens and felt neglected during the development of their parents' dementia, both by their family and by health and social services. They emphasized a need to be seen as individuals, with their experiences, feelings, and personal needs for assistance. The stresses experienced during the development of parental dementia seemed to increase conflicts in the family. There were variations in reactions between children, depending on age, gender, family structure and relationships, responsibilities, personal relations with both parents, and whether there was an adult primary caregiver. The length of time living together with the parent with dementia seemed to increase the stress and burden to the children. They expressed a great need for information and support. The findings strengthen the notion of the need for family-oriented support, combined with person-centered care for the children according to their needs. In addition, group meetings and contact with other young people in the same stage of life could be of interest for some.

Knowledge, attitudes, and practice of travelers' diarrhea management among frontline providers.

Science.gov (United States)

Hayat, Aatif M; Tribble, David R; Sanders, John W; Faix, Dennis J; Shiau, Danny; Armstrong, Adam W; Riddle, Mark S

2011-01-01

Many studies have found acute gastrointestinal infections to be among the most likely reason for clinic visits among forward deployed soldiers and are considered a significant contributor to morbidity in this population. This occurs despite the controlled food and water distribution systems under which military populations operate. Furthermore, recent studies have indicated that providers often fail to appropriately identify and treat the typical causes of these infections. To adequately address this issue, an assessment of gaps in knowledge, practice, and management of acute diarrhea in deployed troops was conducted. A multiple-choice survey was developed by clinical researchers with expertise in travelers' diarrhea (TD) and provided to a convenience sample of clinical providers with a broad range of training and operational experience. The survey evaluated provider's knowledge of TD along with their ability to identify etiologies of various syndromic categories of acute gastrointestinal infections. Providers were also queried on selection of treatment approaches to a variety of clinical-based scenarios. A total of 117 respondents completed the survey. Most were aware of the standard definition of TD (77%); however, their knowledge about the epidemiology was lower, with less than 24% correctly answering questions on etiology of diarrhea, and 31% believing that a viral pathogen was the primary cause of watery diarrhea during deployment. Evaluation of scenario-based responses showed that 64% of providers chose not to use antibiotics to treat moderate TD. Furthermore, 19% of providers felt that severe inflammatory diarrhea was best treated with hydration only while 25% felt hydration was the therapy of choice for dysentery. Across all provider types, three practitioner characteristics appeared to be related to better scores on responses to the nine management scenarios: having a Doctor of Medicine or Doctor of Osteopathy degree, greater knowledge of TD epidemiology

Decision making model and behavior of Iranian top managers

Directory of Open Access Journals (Sweden)

Aliakbar Farhangi

2010-01-01

Full Text Available Aesthetics relates to felt meaning generated from sensory perceptions, and involves subjective,tacit knowledge rooted in feeling and emotion. We believe the aesthetics of management isimportant, but little understood, aspect of organizational life. We propose that followers use theiraesthetic senses in making these assessments.In this article we try to discover the role of aesthetic in management and then try to find out thestyle of about 130 industrial and governmental top managers in Iran using some technique such asquestionnaire and interview. The personality and character of them will be recognized by some testsuch as KAI, MBIT, CPS, Cooper-Smith self-esteem, management style, machiavellism, internaland external control, behavior, attitude and their methods in problem solving and decision making,and the effect of this ability in productivity of their organization.At the end of this study we find out that they are strongly thinking, judging and intuition but half ofthem are extraversion. their personality & character, attitude, skills, professions, perception are soimportant for management and in making a decision more than Two-thirds:-If they make a decision never change it.-Use their aesthetic to judge others and events or found out the right way if it is rational and there isenough evidence.-Uses his experience and knowledge for decision but asks others to suggest a solution or solve theproblem.

The interaction between felt touch and tactile consequences of observed actions: an action-based somatosensory congruency paradigm.

Science.gov (United States)

Deschrijver, Eliane; Wiersema, Jan R; Brass, Marcel

2016-07-01

Action observation leads to a representation of both the motor aspect of an observed action (motor simulation) and its somatosensory consequences (action-based somatosensory simulation) in the observer's brain. In the current electroencephalography-study, we investigated the neuronal interplay of action-based somatosensory simulation and felt touch. We presented index or middle finger tapping movements of a human or a wooden hand, while simultaneously presenting 'tap-like' tactile sensations to either the corresponding or non-corresponding fingertip of the participant. We focused on an early stage of somatosensory processing [P50, N100 and N140 sensory evoked potentials (SEPs)] and on a later stage of higher-order processing (P3-complex). The results revealed an interaction effect of animacy and congruency in the early P50 SEP and an animacy effect in the N100/N140 SEPs. In the P3-complex, we found an interaction effect indicating that the influence of congruency was larger in the human than in the wooden hand. We argue that the P3-complex may reflect higher-order self-other distinction by signaling simulated action-based touch that does not match own tactile information. As such, the action-based somatosensory congruency paradigm might help understand higher-order social processes from a somatosensory point of view. © The Author (2015). Published by Oxford University Press. For Permissions, please email: journals.permissions@oup.com.

Quality management for nuclear power plant operation: A manual

International Nuclear Information System (INIS)

1990-01-01

The experience from well operated nuclear power plants shows that achievement of safe, reliable and economic performance is closely related to a strong commitment and involvement by the management personnel. A system of controls is necessary to ensure that satisfactory quality in operation is achieved and maintained over the long term. The key to achieving and assuring quality lies in the ability of management to define performance objectives and to ensure that significant safety and reliability problems are prevented or detected early and resolved. This Manual has been developed by the IAEA to assist plant managers in fulfilling their responsibility with regard to the control and direction of quality and of quality assurance activities in nuclear power plant operation. It emphasizes quality objectives for nuclear power plant operation and indicates the way in which a quality system based on quality assurance principles as established in the IAEA NUSS documents can be used by managers to accomplish these objectives. Since the Manual is mainly directed at management personnel, it is presented in the form of short highlighted practices complemented by typical examples of forms and procedures. Since not all the activities under the heading of quality in operation could be covered in a single document, the activities selected for this Manual comprise those where it was felt that practical advice is generally needed. A pragmatic document useful for direct application by plant managers was the envisaged objective

Barriers to Seizure Management in Schools: Perceptions of School Nurses.

Science.gov (United States)

Terry, Debbie; Patel, Anup D; Cohen, Daniel M; Scherzer, Daniel; Kline, Jennifer

2016-12-01

The purpose of this study was to assess school nurses' perceptions of barriers to optimal management of seizures in schools. Eighty-three school nurses completed an electronic survey. Most agreed they felt confident they could identify a seizure (97.6%), give rectal diazepam (83.8%), and handle cluster seizures (67.1%), but fewer were confident they could give intranasal midazolam (63.3%), had specific information about a student's seizures (56.6%), or could swipe a vagus nerve stimulator magnet (47.4%). Nurses were more likely to be available at the time of a seizure in rural (17/20) (85%) versus suburban (21/34) (62%) or urban (8/25) (32%) schools (P = .001). School nurses are comfortable managing seizures in the school setting. However, a specific seizure plan for each child and education on intranasal midazolam and vagus nerve stimulator magnet use are needed. A barrier in urban schools is decreased availability of a nurse to identify seizures and administer treatment. © The Author(s) 2016.

Graphene-Nanowall-Decorated Carbon Felt with Excellent Electrochemical Activity Toward VO2+/VO2+ Couple for All Vanadium Redox Flow Battery.

Science.gov (United States)

Li, Wenyue; Zhang, Zhenyu; Tang, Yongbing; Bian, Haidong; Ng, Tsz-Wai; Zhang, Wenjun; Lee, Chun-Sing

2016-04-01

3D graphene-nanowall-decorated carbon felts (CF) are synthesized via an in situ microwave plasma enhanced chemical vapor deposition method and used as positive electrode for vanadium redox flow battery (VRFB). The carbon fibers in CF are successfully wrapped by vertically grown graphene nanowalls, which not only increase the electrode specific area, but also expose a high density of sharp graphene edges with good catalytic activities to the vanadium ions. As a result, the VRFB with this novel electrode shows three times higher reaction rate toward VO 2 + /VO 2+ redox couple and 11% increased energy efficiency over VRFB with an unmodified CF electrode. Moreover, this designed architecture shows excellent stability in the battery operation. After 100 charging-discharging cycles, the electrode not only shows no observable morphology change, it can also be reused in another battery and practical with the same performance. It is believed that this novel structure including the synthesis procedure will provide a new developing direction for the VRFB electrode.

Graphene‐Nanowall‐Decorated Carbon Felt with Excellent Electrochemical Activity Toward VO2 +/VO2+ Couple for All Vanadium Redox Flow Battery

Science.gov (United States)

Li, Wenyue; Zhang, Zhenyu; Bian, Haidong; Ng, Tsz‐Wai

2015-01-01

3D graphene‐nanowall‐decorated carbon felts (CF) are synthesized via an in situ microwave plasma enhanced chemical vapor deposition method and used as positive electrode for vanadium redox flow battery (VRFB). The carbon fibers in CF are successfully wrapped by vertically grown graphene nanowalls, which not only increase the electrode specific area, but also expose a high density of sharp graphene edges with good catalytic activities to the vanadium ions. As a result, the VRFB with this novel electrode shows three times higher reaction rate toward VO2 +/VO2+ redox couple and 11% increased energy efficiency over VRFB with an unmodified CF electrode. Moreover, this designed architecture shows excellent stability in the battery operation. After 100 charging–discharging cycles, the electrode not only shows no observable morphology change, it can also be reused in another battery and practical with the same performance. It is believed that this novel structure including the synthesis procedure will provide a new developing direction for the VRFB electrode. PMID:27774399

Mechanism of reaction and cycling behavior of nickel felt cathodes in NaAlCl4 molten salt batteries

Energy Technology Data Exchange (ETDEWEB)

Hjuler, H.A.; Knutz, B.C.; Berg, R.W.; Bjerrum, N.J.

1990-11-01

The battery system: Al/NaCl-AlCl3-Al2X3/Ni-felt (X = S, Se, Te) and the corresponding system without chalcogen have been studied at 175 deg. C. Charge/discharge experiments, performed on cells with NaCl saturated melts, show that advantages with regard to rate capability, cyclability and probably energy density can be obtained with systems containing dissolved chalcogen compared with the chalcogen free system. The cells with sulfur added to the electrolyte exhibit the same charge/discharge curves as found for comparable cells prepared with a nickel sulfide cathode. Exchange of chalcogen between cathode and molten salt during cycling was studied by performing gravimetric analysis and Raman spectroscopy of the electrolytes. In the low charge state, formation and decomposition of nickel chalcogenides, associated with uptake/release of chalcogenide from the melt, take place to a large extent during cycling. Cathode reactions were studied by comparing coulometric titrations (performed on cells with slightly acidic NACl-AlCl3 melts containing approx 0.51 mole % AlCl3 and small amounts of chalcogen) with model calculations. The model set up describes equilibrium concentrations of constituent species in the electrolyte and equilibrium potentials of the electrodes versus number of coulombs passed through the cells, assuming probable cathode reactions. (author) 27 refs.

What is a feral cat?: Variation in definitions may be associated with different management strategies.

Science.gov (United States)

Gosling, Lara; Stavisky, Jenny; Dean, Rachel

2013-09-01

The definition of a true feral cat is an area of much contention, with many variations used worldwide. In this study, opinions were gathered from feral cat rescue workers and veterinary surgeons working in the United Kingdom to identify a practical definition of a feral cat, suitable for use in the field, education and research. A mixed methods approach, using questionnaires and focus groups, was used to collect data from feral cat workers and veterinary surgeons. Conflicts in opinion on the implications of taming feral cats exist. The rescue workers typically felt that most cats could be tamed, whereas the veterinary surgeons felt this was generally inappropriate, except in the case of young kittens. A consistent definition of feral cats would enable better communication regarding the welfare and management of these animals, and would be useful for further research and education of the public. PROPOSED DEFINITION: A feral cat is proposed by this study to be a cat that is unapproachable in its free-roaming environment and is capable of surviving with or without direct human intervention, and may additionally show fearful or defensive behaviour on human contact.

The Impact of Organizational Politics on The Effectiveness of Management Development In The Kenya Civil Service

Directory of Open Access Journals (Sweden)

Professor Roselyne W. Gakure

2013-07-01

The study found that managers were fully aware of the political context of the civil service but they did not think that Organizational Politics affected key management areas and felt that their supervisors supported them and ensured they were clear about their roles. They however thought that Organization Politics affected social relations at the workplace significantly. The study concluded that practices like performance contracting had reduced negative impacts and ensured that managers were clear on what was expected of them. The effect of politics on social relationships could be the reason for the ‘silo mentality’ pervading the civil service interfering with learning from each other, limiting benchmarking of successful interventions and resulting in duplication of effort that interferes with effective service delivery. The study recommends that the Government addresses the impact of politics on social relationships to improve work based learning through internal bench marking.

Airway Management During Upper GI Endoscopic Procedures: State of the Art Review.

Science.gov (United States)

Goudra, Basavana; Singh, Preet Mohinder

2017-01-01

With the growing popularity of propofol mediated deep sedation for upper gastrointestinal (GI) endoscopic procedures, challenges are being felt and appreciated. Research suggests that management of the airway is anything but routine in this setting. Although many studies and meta-analyses have demonstrated the safety of propofol sedation administered by registered nurses under the supervision of gastroenterologists (likely related to the lighter degrees of sedation than those provided by anesthesia providers and is under medicolegal controversy in the United States), there is no agreement on the optimum airway management for procedures such as endoscopic retrograde cholangiopancreatography. Failure to rescue an airway at an appropriate time has led to disastrous consequences. Inability to evaluate and appreciate the risk factors for aspiration can ruin the day for both the patient and the health care providers. This review apprises the reader of various aspects of airway management relevant to the practice of sedation during upper GI endoscopy. New devices and modification of existing devices are discussed in detail. Recognizing the fact that appropriate monitoring is important for timely recognition and management of potential airway disasters, these issues are explored thoroughly.

The Effects of Disruption on Strategic Management

DEFF Research Database (Denmark)

Drejer, Anders

2017-01-01

There is a lot of interest in Disruption these days even though the concept itself is still under formation. Disruption can be traced back to the idea of disruptive technological change and the late 1990s but has reemerged in the public eye in current years under guises such as Big Data......, Digitalization, Globalization and much more. Furthermore, the effects of disruption are now being felt by organizations and industries all over the world. In this paper, we will try to outline and illustrate some of those effects using the case-study of an international, Danish, SME. The case company has been...... forced to face some challenges caused by disruption and in the process of doing so has changed its strategy process significantly towards a more learning based approach to strategic management. Keywords: disruption; case- study; SME; strategy process....

Impact assessment of Public Relations in the Fiscal Control Management of the National Agency for Fiscal Administration

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D.Haranguş

2013-12-01

Full Text Available The present study examines the role of public relations as a socio-economic tool of persuasion and educating taxpayers of their civic responsibility to honor fair tax obligations. We propose solutions for improving and restructuring the fiscal control management by diversifying and expanding the range of the instrument constant communication/ public relations and increasing their efficiency in the National Agency for Fiscal Administration, diversifying forms of public communication. The proposed work aims to fill a niche in tax audit work of taxpayers to be felt in practice equitable collection of taxes.

A Mass Merchandiser's Role in Enhancing Pharmacy Students’ Business Plan Development Skills for Medication Therapy Management Services

Science.gov (United States)

2011-01-01

Objectives. To develop a relationship between a pharmacy management course and a mass merchandiser and to determine whether involving pharmacy managers from the mass merchandiser in the course would enhance student skills in developing a business plan for medication therapy management services. Design. The pharmacy managers from the mass merchandiser participated in lectures, provided panel discussions, and conducted a business plan competition. Learning was assessed by means of 4 examinations and 1 project (ie, the business plan). At the conclusion of the semester, surveys were administered to solicit student input and gain insight from pharmacy managers on the perceived value of this portion of the course. Assessment. Students’ average grade on the business plan assignment, which included the oral presentation, the peer assessment, and the written proposal, was 92.2%. Approximately 60% (n = 53) of surveyed students agreed or strongly agreed that their management skills had improved because of the participation of pharmacy managers from the mass merchandiser. All of the managers enjoyed participating in the experience. Conclusions. The involvement of pharmacy managers from a mass merchandiser enhanced student learning in the classroom, and managers felt that their participation was an important contribution to the development of future pharmacists. PMID:21969719

Utilization of Patient-Reported Outcomes to Guide Symptom Management during Stereotactic Body Radiation Therapy for Clinically Localized Prostate Cancer

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Malika Danner

2017-10-01

Full Text Available IntroductionUtilization of patient-reported outcomes (PROs to guide symptom management during radiation therapy is increasing. This study focuses on the use of the Expanded Prostate Cancer Index Composite for Clinical Practice (EPIC-CP as a tool to assess urinary and bowel bother during stereotactic body radiation therapy (SBRT and its utility in guiding medical management.MethodsBetween September 2015 and January 2017, 107 patients with clinically localized prostate cancer were treated with 35–36.25 Gy via SBRT in five fractions. PROs were assessed using EPIC-CP 1 h prior to the first fraction and after each subsequent fraction. Symptom management medications were prescribed based on the physician clinical judgment or if patients reported a moderate to big problem. Clinical significance was assessed using a minimally important difference of 1/2 SD from baseline score.ResultsA median baseline EPIC-CP urinary symptom score of 1.5 significantly increased to 3.7 on the day of the final treatment (p < 0.0001. Prior to treatment, 9.3% of men felt that their overall urinary function was a moderate to big problem that increased to 28% by the end of the fifth treatment. A median baseline EPIC-CP bowel symptom score of 0.3 significantly increased to 1.4 on the day of the final treatment (p < 0.0001. Prior to treatment, 1.9% of men felt that their overall bowel function was a moderate to big problem that increased to 3.7% by the end of the fifth treatment. The percentage of patients requiring an increased dose of alpha-antagonist increased to 47% by the end of treatment, and an additional 28% of patients required a short steroid taper to manage moderate to big urinary problems. Similarly, the percentage of patients requiring antidiarrheals reached 12% by the fifth treatment.ConclusionDuring the course of SBRT, an increasing percentage of patients experienced clinically significant symptoms many of which required medical management

Bio-electro oxidation of indigo carmine by using microporous activated carbon fiber felt as anode and bioreactor support.

Science.gov (United States)

Garcia, Luane Ferreira; Rodrigues Siqueira, Ana Claudia; Lobón, Germán Sanz; Marcuzzo, Jossano Saldanha; Pessela, Benevides Costa; Mendez, Eduardo; Garcia, Telma Alves; de Souza Gil, Eric

2017-11-01

The bioremediation and electro-oxidation (EO) processes are included among the most promising cleaning and decontamination mechanisms of water. The efficiency of bioremediation is dictated by the biological actuator for a specific substrate, its suitable immobilization and all involved biochemical concepts. The EO performance is defined by the anode efficiency to perform the complete mineralization of target compounds and is highlighted by the low or null use of reagent. Recently, the combination of both technologies has been proposed. Thus, the development of high efficient, low cost and eco-friendly anodes for sustainable EO, as well as, supporting devices for immobilization of biological systems applied in bioremediation is an open field of research. Therefore, the aim of this work was to promote the bio-electrochemical remediation of indigo carmine dye (widely common in textile industry), using new anode based on a microporous activated carbon fiber felt (ACFF) and ACFF with immobilized Laccase (Lcc) from Pycnoporus sanguineus. The results were discolorations of 62.7% with ACFF anode and 83.60% with ACFF-MANAE-Lcc anode, both for 60 min in tap water. This remediation rates show that this new anode has low cost and efficiency in the degradation of indigo dye and can be applied for other organic pollutant. Copyright © 2017 Elsevier Ltd. All rights reserved.

From Picnic Organizers to Strategists: Turn of the Wheel for Human Resource Managers

Directory of Open Access Journals (Sweden)

Feza Tabassum AZMI

2008-01-01

Full Text Available Human Resource (HR managers traditionally have not occupied a very significant position and Human Resource Management (HRM activities have often appeared to be disjointed and haphazard, giving little consideration to the organization’s strategy. However, recent developments have provided HR managers with the opportunity to move from their typecast role of picnic organizers to becoming strategic partners. This paper delves into the terrain of changing roles of HR executives by undertaking an analysis of the extant literature. It presents a review of various typologies of HR roles. It then highlights the emerging evidences vis-à-vis the changing HR roles. The paper further discusses the key strategic domains where HR executives are making their presence felt. The paper drives home the point that the mixed bag of empirical evidence on HR roles suggests that while the value of HR executives has indeed been elevated in recent years yet in several organizations they are still grappling with the challenge of proving their mettle. On the basis of the above discussion, various research propositions are presented for future research.

Indonesian heath care and the economic crisis: is managed care the needed reform?

Science.gov (United States)

Hotchkiss, D R; Jacobalis, S

1999-03-01

The ramifications of the current economic crisis are being felt throughout Asia, but problems are particularly acute in Indonesia; in the midst of high inflation and unemployment the government is considering expanding managed care reform. In this paper, we discuss the impact of the recent economic crisis on the health sector in Indonesia, and analyze the potential for implementing effective reform following the managed care model. The health sector is discussed, highlighting pre-existing problems in the health care supply environment. The determinants of the economic crisis are summarized, and the broad impacts of the crisis to date on the health sector are assessed. Next the prospects for success of current managed-care reform proposals are examined in some detail: viability of expanded managed care reform measures are assessed in light of the continuing crisis and its likely impacts on the consumers and suppliers of health care. Analysis of the potential impact of the continuing crisis focuses on key participants in health care reform: households, the government, and private health care providers. In conclusion the potential viability of managed care appears poor, given the current economic, political, and institutional conditions and likely future impacts, and suggest some alternative reform measures.

Managing bereavement in the classroom: a conspiracy of silence?

Science.gov (United States)

Lowton, Karen; Higginson, Irene J

2003-10-01

The ways in which teachers in British schools manage bereaved children are underreported. This article reports the impact of students' bereavement and their subsequent management in primary and secondary school classrooms in Southeast London. Thirteen school staff working in inner-city schools took part in in-depth interviews that focused on the impact of bereaved children on the school and how teachers responded to these children.All respondents had previously had contact with a local child bereavement service that aims to provide support, advice, and consultancy to children, their parents, and teachers. Interviews were audiotaped, transcribed verbatim, and analyzed using ATLAS-ti. Three main themes were identified from analysis of interview data. Firstly, British society, culture, local communities, and the family were significant influences in these teachers' involvement with bereaved students. Secondly, school staff managed bereaved students through contact with other adults and using practical classroom measures such as "time out" cards and contact books. Lastly, teachers felt they had to be strong, even when they were distressed. Surprise was expressed at the mature reaction of secondary school students to deaths of others. The article recommends that future research needs to concentrate on finding the most effective way of supporting routinely bereaved children, their families, and teachers.

Locus of emotion: the effect of task order and age on emotion perceived and emotion felt in response to music.

Science.gov (United States)

Schubert, Emery

2007-01-01

The relationship between emotions perceived to be expressed (external locus EL) versus emotions felt (internal locus--IL) in response to music was examined using 5 contrasting pieces of Romantic, Western art music. The main hypothesis tested was that emotion expressed along the dimensions of emotional-strength, valence, and arousal were lower in magnitude for IL than EL. IL and EL judgments made together after one listening (Experiment 2, n = 18) produced less differentiated responses than when each task was performed after separate listenings (Experiment 1, n = 28). This merging of responses in the locus-task-together condition started to disappear as statistical power was increased. Statistical power was increased by recruiting an additional subject pool of elderly individuals (Experiment 3, n = 19, mean age 75 years). Their valence responses were more positive, and their emotional-strength ratings were generally lower, compared to their younger counterparts. Overall data analysis revealed that IL responses fluctuated slightly more than EL emotions, meaning that the latter are more stable. An additional dimension of dominance-submissiveness was also examined, and was useful in differentiating between pieces, but did not return a difference between IL and EL. Some therapy applications of these findings are discussed.

Primary Care Providers' Knowledge and Practices of Diabetes Management During Ramadan.

Science.gov (United States)

Ali, Mujtaba; Adams, Alexandra; Hossain, Md Anwar; Sutin, David; Han, Benjamin Hyun

2016-01-01

There are an estimated 3.5 million Muslims in North America. During the holy month of Ramadan, healthy adult Muslims are to fast from predawn to after sunset. While there are exemptions for older and sick adults, many adults with diabetes fast during Ramadan. However, there are risks associated with fasting and specific management considerations for patients with diabetes. We evaluated provider practices and knowledge regarding the management of patients with diabetes who fast during Ramadan. A 15-question quality improvement survey based on a literature review and the American Diabetes Association guidelines was developed and offered to providers at the outpatient primary care and geriatric clinics at an inner-city hospital in New York City. Forty-five providers completed the survey. Most respondents did not ask their Muslim patients with diabetes if they were fasting during the previous Ramadan. Knowledge of fasting practices during Ramadan was variable, and most felt uncomfortable managing patients with diabetes during Ramadan. There is room for improvement in educating providers about specific cultural and medical issues regarding fasting for patients with diabetes during Ramadan. © The Author(s) 2015.

Evaluation of how a curriculum change in nurse education was managed through the application of a business change management model: A qualitative case study.

Science.gov (United States)

Chowthi-Williams, Annette; Curzio, Joan; Lerman, Stephen

2016-01-01

Curriculum changes are a regular feature of nurse education, yet little is known about how such changes are managed. Research in this arena is yet to emerge. Evaluation of how a curriculum change in nurse education was managed through the application of a business change management model. A qualitative case study: the single case was the new curriculum, the Primary Care Pathway. One executive, three senior managers, two academics and nineteen students participated in this study in one faculty of health and social care in a higher education institution. The findings suggest that leadership was pivotal to the inception of the programme and guiding teams managed the change and did not take on a leadership role. The vision for the change and efforts to communicate it did not reach the frontline. Whilst empowerment was high amongst stakeholders and students, academics felt dis-empowered. Short-term wins were not significant in keeping up the momentum of change. The credibility of the change was under challenge and the concept of the new programme was not yet embedded in academia. Differences between the strategic and operational part of the organisation surfaced with many challenges occurring at the implementation stage. The business change model used was valuable, but was found to not be applicable during curriculum changes in nurse education. A new change model emerged, and a tool was developed alongside to aid future curriculum changes. Copyright © 2015 Elsevier Ltd. All rights reserved.

Training chiropractic students in weight management counseling using standardized patients.

Science.gov (United States)

Hawk, Cheryl; Ramcharan, Michael; Kruger, Carla LeRiche

2017-03-01

The aim of this study was to describe and assess an activity that trained chiropractic students to counsel patients on weight management through the use of standardized patients. This was a descriptive study using mixed methods. Students were trained to apply health behavior theory and the transtheoretical model. Standardized patients were given a case to portray with the students. Students had 15 minutes for the encounter. The encounters were assessed in 2 ways: (1) standardized patients answered a brief questionnaire about the students' performance, and (2) students answered a questionnaire about the utility of the intervention. Numerical data were extracted from the audiovisual management platform, and statistics were computed for each question. Comments made by students and patients were transferred verbatim for content analysis. A total of 102 students took part in the activity. Students' performance in the encounter was uniformly high, with over 90% "yes" responses to all questions except "gave me printed information material" and "discussed the printed material with me." The key issue identified in the comments by standardized patients was that students tended not to connect weight management with their chief complaint (low back pain). Nearly all students (97%) thought the activity would be useful to their future practice, and 97% felt it had increased their confidence in providing weight management counseling. This experiential activity was assessed to be useful to students' future practice and appeared to provide them with skills to successfully communicate with patients on weight management.

Water management of Republic of Macedonia

International Nuclear Information System (INIS)

1999-01-01

The Republic of Macedonia is one of the countries that do not have sufficient water resources, and their shortage has been already felt during certain periods. The problem already mentioned as global: uneven distribution in time, space and quality are the main characteristics of the water resources. The water management a branch of the economy dealing with management, utilization, protection and planning of the water resources is considered a key implementation of all strategic plans for development of one country. The basic goal of the water management is to fully utilize the water resources in order to reach the most effective and most economic resolution of problems related to the water resources. The problem of pollution and wastage of water, which is more acute at times of intensive technological development of the society, is rapidly depleting supplies water and makes us seriously thinking no just our own survival, but also that of future generations. The concept of sustainable development means future planning for utilizing and protecting water resources bearing in mind not only the generations to come. In the book available water resources in Republic of Macedonia, current condition of the existing water management facilities - dams and reservoirs, as well as irrigation systems are presented. Also, the book deals with the water quality condition and activities for ecological water protection, including relevant measures for protection of catchment areas and the soil from erosion. In addition projects under construction are given. Namely, in the Republic of Macedonia two high dams and a small hydro system are under construction, as well as rehabilitation of three large irrigation schemes

Current practices are variable in the evaluation and management of patients with anomalous aortic origin of a coronary artery: Results of a survey.

Science.gov (United States)

Agrawal, Hitesh; Mery, Carlos M; Day, Patrick E; Sexson Tejtel, S Kristen; McKenzie, E Dean; Fraser, Charles D; Qureshi, Athar M; Molossi, Silvana

2017-09-01

Anomalous aortic origin of a coronary artery (AAOCA) is the second leading cause of sudden cardiac death in young athletes in the USA. Long-term outcome data for these patients are lacking to date. There is insufficient knowledge on the best approach to these patients and they are managed in a nonuniform manner. An online survey of 15 questions regarding management of AAOCA was sent out to 198 cardiac healthcare providers. The goal was to define gaps in knowledge to justify a dedicated scientific forum for discussion of AAOCA. Descriptive statistics were performed. A total of 91 providers (46%) completed the survey including pediatric cardiology subspecialists (40%), general pediatric cardiologists (24%), cardiovascular (CV) surgeons (22%), adult cardiologists (10%), nurse practitioners (8%), cardiology fellows (3%) and CV anesthesiologist (1%). Forty-eight percent had been practicing for over 15 years and 28% were in their first 5 years of practice. Fifty-two percent of the providers cared for adults and 93% cared for children/adolescents. Eighty-eight percent were affiliated with an academic institution. All but one provider practiced in the USA, 62% practiced in Texas. Half of participants (50%) were very comfortable managing AAOCA patients and 36% were somewhat comfortable. Providers utilized various imaging tests to confirm the anatomy including computed tomography angiography 88%, cardiac magnetic resonance imaging 70%, cardiac catheterization 60%, echocardiogram 12%, IVUS 2% and myocardial perfusion scan 1%. The majority felt comfortable in counseling the families and felt that depending on the type of lesion these patients should get surgical referral (85%) vs clinical follow up (67%) with exercise restriction (65%). There is heterogeneity in the way AAOCA patients are currently evaluated and managed. A knowledge gap exists even with participants from academic institutions. Long-term data with a defined approach to management of these patients may help to

Minimal care--a new concept for the management of urinary incontinence in an open access, interdisciplinary incontinence clinic. The way ahead?

DEFF Research Database (Denmark)

Andersen, J T; Sander, P

1996-01-01

A new concept for assessment and treatment of urinary incontinence in an open access, interdisciplinary clinic is evaluated prospectively. Based on the patients needs and expectations, a minimal relevant investigative programme was planned. The patients were primarily offered conservative, non...... of the patients were managed by conservative treatment modalities whereas only 10% of the patients were referred to in-hospital treatment with invasive treatment modalities, mainly surgical procedures for urinary incontinence. Subjectively, 68% felt cured or very much improved, 23% experienced improvement and 9...... and treatment of urinary incontinence....

"I'm Managing My Diabetes between Two Worlds": Beliefs and Experiences of Diabetes Management in British South Asians on Holiday in the East--A Qualitative Study.

Science.gov (United States)

Patel, Neesha R; Kennedy, Anne; Blickem, Christian; Reeves, David; Chew-Graham, Carolyn

2016-01-01

Diabetes is disproportionately high among British South Asians compared to the general UK population. Whilst the migrant British South Asians group has received most attention on research related to diabetes management, little consideration has been given to impact of travel back to the East. This study aimed to explore the role of social networks and beliefs about diabetes in British South Asians, to better understand their management behaviours whilst holidaying in the East. Semistructured interviews were conducted in Greater Manchester. Forty-four participants were recruited using random and purposive sampling techniques. Interviews were analysed thematically using a constant comparison approach. Migrant British South Asians expressed a strong preference to be in a hot climate; they felt they had a healthier lifestyle in the East and often altered or abandoned their diabetes medication. Information acquisition on diabetes and availability of social networks in the East was valued. Social networks in the East are a valued source of information and support for diabetes. The lack of adherence to medication whilst abroad suggests that some migrant British South Asians have a poor understanding of diabetes. Future research needs to explore whether patients are seeking professional advice on diabetes management prior to their extended holiday.

Solid waste management - Pakistan's perspective

International Nuclear Information System (INIS)

Hussain, M.

2003-01-01

The discipline of 'Solid Waste Management' is as old as human civilization itself. The problem had been felt when the human beings commenced living together in the form of communities. The situation got worsened with ever-increasing population and growing industrialization. The developed nations have endeavored to tackle the issue of the industrial and municipal wastes according to the principles of engineering and environment. Most of the developing countries have not dealt with the 'Third Pollution' in the eco-friendly manner. Ironically Pakistan is facing this serious menace because of ever-expanding population (2.2% per annum) and ill management of the wastes and effluents being generated from multifarious activities. These pollutants are degrading the land, air and water resources at alarming rates. In Pakistan about 7,250 tonnes of solid waste is generated per day. Of this quantity only 60-70% is collected and the remaining quantity is allowed to burn indiscriminately or decay in situ. Unfortunately the industrial waste, animal dung and hospital waste are allowed to mix with the municipal waste, which adds to inefficiency of the existing 'Solid Waste Management System'. Scores of faecal, fly, rodent and mosquito born diseases are caused due to open dumping of the waste besides aesthetic impairment of the surroundings. None of the scientifically recognized methods of disposal is practiced. It is not based on administrative, financial, environmental and technical consideration. There is dire necessity of educating the masses to adopt clean habits and resort to generation of minimum waste. Further, nothing is waste as the so-called 'waste material' is the raw material after reuse and recycling for another process. (author)

An Assessment of the Competence and Experience of Dentists with ...

African Journals Online (AJOL)

A structured questionnaire requesting to know demographic data, respondents attendance of life support training viz: Basic life support (BLS), advanced ... care support (ICS) 2(2.5% 73.3% of the respondents felt inadequate in the management of cardiovascular emergencies, while only 15.4% felt adequately prepared.

eHealth for inflammatory bowel disease self-management - the patient perspective.

Science.gov (United States)

Con, Danny; Jackson, Belinda; Gray, Kathleen; De Cruz, Peter

2017-09-01

Electronic health (eHealth) solutions may help address the growing pressure on IBD outpatient services as they encompass a component of self-management. However, information regarding patients' attitudes towards the use of eHealth solutions in IBD is lacking. The aim of this study was to evaluate eHealth technology use and explore the perspectives of IBD patients on what constitutes the ideal eHealth solution to facilitate self-management. A mixed methods qualitative and quantitative analysis of the outcomes of a discussion forum and an online survey conducted at a tertiary hospital in Melbourne, Australia between November 2015 and January 2016 was undertaken. Eighteen IBD patients and parents participated in the discussion forum. IBD patients expressed interest in eHealth tools that are convenient and improve access to care, communication, disease monitoring and adherence. Eighty six patients with IBD responded to the online survey. A majority of patients owned a mobile phone (98.8%), had access to the internet (97.7%), and felt confident entering data onto a phone or computer (73.3%). Most patients (98.8%) were willing to use at least one form of information and communication technology to help manage their IBD. Smartphone apps and internet websites were the two most preferred technologies to facilitate IBD self-management. This study demonstrates the willifngness of patients to engage with eHealth as a potential solution to facilitate IBD self-management. Future development and testing of eHealth solutions should be informed by all major stakeholders including patients to maximise their uptake and efficacy to facilitate IBD self-management.

INTEGRATED DOCUMENT MANAGEMENT SOLUTION FOR THE LOCAL GOVERNMENT

Directory of Open Access Journals (Sweden)

Nistor Razvan

2013-07-01

Full Text Available In this paper we present system analysis and design elements for the integrated document management solution at local governing authorities in the rural areas. While specifically dealing with the actual management of the Agricultural Register, an important primary unitary evidence document, we also keep a general character of the discussion, in order to argue for the generality of the proposed solution. Hence, for the identified and described problem space we propose an administrative and software infrastructure solution. This work is an empirical research in which our aim is primarily to identify key problems within the local governing authorities from several perspectives concerning the management of the Agricultural Register then to address those problems with an integrated document management system. For the proposed solution we give and argue the general system architecture and describe the key-mechanisms that support quality requirements. The relevance of this research concern is given by the impact of the actual Agricultural Register management on important stakeholders. This can be measured as the satisfaction felt by taxpayers and the performance of the local governing authorities, the Financial Administration, the Agency of Payments and Intervention in Agriculture and the Ministry of Agriculture and Rural Development. This work is also intended as a start-point for a new, modern thinking of the governing authorities in their pursue to improve public services. For this, in our work we highlight the importance of complete system analysis at all administrative levels as a main priority concern for all public managers. Our aim is the improvement of the public service by rising the awareness of the decision makers on the necessity of using integrated document management solutions for the provided services. Also, our work aims at increasing the efficiency with which nowadays, governing authorities invest public funds in various IT projects

DUT som didaktisk felt

DEFF Research Database (Denmark)

Qvortrup, Ane; Keiding, Tina B.

2015-01-01

undervisningsformer. [Abstract in English] The paper presents a systematic categorization of 115 papers published in the Danish Journal for Teaching and Learning in Higher Education. (DUT) from 2006 to 2013. The aim is to explore which didactic topics the journal deals with and how it contributes to the Danish...... the scholarship of teaching and learning. The categorization shows that most of the contributions deal with teaching methods. A subsequent analysis shows that the contributions almost exclusively deal with active and social teaching methods (teaching as experience and teaching as interaction)......(In Danish and English) Artiklen foretager en systematisk kategorisering og analyse af de bidrag, som har været bragt i Dansk Universitetspædagogisk Tidsskrift (DUT) fra 2006-2013. Formålet er at undersøge, hvilke didaktiske temaer tidskriftet har været optaget af og at diskutere mulige...

Emergence of Things Felt

DEFF Research Database (Denmark)

Zimmerman, Chris; Stein, Mari-Klara; Hardt, Daniel

2015-01-01

In 2013 Facebook launched a feature allowing users to add a feeling tag to their posts. We have collected 18 months worth of such public posts. Our aim is to map the semantic space of ‘Facebook feelings’ to understand patterns in how feelings are tagged and how they can be described in terms...... of valence and arousal. Our findings reveal temporal and social patterns in the most commonly shared feelings. In line with the ‘exhibitional’ nature of Facebook, our analyses indicate that ‘extreme’ feelings, such as excitement and anger, may be expressed in even more extreme levels of both valence...... and arousal. Facebook also provides novel emotional scripts (e.g., “meh”) that help people express feelings in ways that traditionally socialized feelings do not. This understanding of the semantic space of ‘Facebook feelings’ ultimately serves to inform the development of an automatic ‘Feelings Meter’....

The patients' perspective of international normalized ratio self-testing, remote communication of test results and confidence to move to self-management.

Science.gov (United States)

Grogan, Anne; Coughlan, Michael; Prizeman, Geraldine; O'Connell, Niamh; O'Mahony, Nora; Quinn, Katherine; McKee, Gabrielle

2017-12-01

To elicit the perceptions of patients, who self-tested their international normalized ratio and communicated their results via a text or phone messaging system, to determine their satisfaction with the education and support that they received and to establish their confidence to move to self-management. Self-testing of international normalized ratio has been shown to be reliable and is fast becoming common practice. As innovations are introduced to point of care testing, more research is needed to elicit patients' perceptions of the self-testing process. This three site study used a cross-sectional prospective descriptive survey. Three hundred and thirty patients who were prescribed warfarin and using international normalized ratio self-testing were invited to take part in the study. The anonymous survey examined patient profile, patients' usage, issues, perceptions, confidence and satisfaction with using the self-testing system and their preparedness for self-management of warfarin dosage. The response rate was 57% (n = 178). Patients' confidence in self-testing was high (90%). Patients expressed a high level of satisfaction with the support received, but expressed the need for more information on support groups, side effects of warfarin, dietary information and how to dispose of needles. When asked if they felt confident to adjust their own warfarin levels 73% agreed. Chi-squared tests for independence revealed that none of the patient profile factors examined influenced this confidence. The patients cited the greatest advantages of the service were reduced burden, more autonomy, convenience and ease of use. The main disadvantages cited were cost and communication issues. Patients were satisfied with self-testing. The majority felt they were ready to move to self-management. The introduction of innovations to remote point of care testing, such as warfarin self-testing, needs to have support at least equal to that provided in a hospital setting. © 2017 John

On performance capabilities of alkaline anolyte in wastewater management

International Nuclear Information System (INIS)

Shimkevich, Alexander

2014-01-01

A concept for electric converting a saline wastewater into basic solution (pH > 7) with a positive RedOx potential (alkaline anolyte) is considered. Such the medium can be obtained in situ at flowing wastewater via a special electrochemical cell with strongly polarized cathode (generating hydroxide anions) and quasi-equilibrium anode which intensively discharges hydroxide ions to hydroxyl radicals into the wastewater. The radicals will oxidize anions of strong acid and convert them into weak-acid micro precipitates in the flowing basic solution. These renewable nano-sorbents will uninterruptedly co-precipitate radioactive contamination from wastewater and be agglomerated as corrosion by-products in the felt-like anode. The consideration of liquid water as a chemical compound with a wide band gap shows that the anolyte (as a hyper-stoichiometric water, H 2 O 1+|x| ) is a simple and effective tool for varying physical and chemical properties of the aqueous solution due to forced changing its RedOx potential as one needs. This potential as Fermi level in the band gap of liquid water is the most convenient parameter for monitoring and managing the electrochemical potential of the aqueous medium. Its hyper-stoichiometric state is realized when Fermi level is shifted to the top of a valence band. This electro-oxidized state as the alkaline anolyte is characterized by an acceptor level, OH/OH - , partially occupied by electrons. Then, the hydroxyl radical (OH • ) as the strongest oxidizer will oxidize intensively the metal anode and renew its surface for great removal of radio-nuclides from the wastewater due to their large specific area of renewable surface of hydroxide absorber on the felt-like anode. (author)

Leadership and management training as a catalyst to health system strengthening in low-income settings: Evidence from implementation of the Zambia Management and Leadership course for district health managers in Zambia.

Science.gov (United States)

Mutale, Wilbroad; Vardoy-Mutale, Anne-Thora; Kachemba, Arthur; Mukendi, Roman; Clarke, Kupela; Mulenga, Dennis

2017-01-01

Research has shown that the modes of leadership and management may influence health outcomes. However, majority of health leaders and managers in many low-income countries are promoted on account of clinical expertise. It has been recognised that these new managers are often ill-prepared for managing complex health systems. In response to this challenge, the Zambian Ministry of Health (MoH) has developed the Governance and Management Capacity Building (GMCB) Strategic Plan (2012-2016), whose overarching goal is to improve health sector governance and create an environment that is result-oriented, accountable and transparent. This led to the introduction of a new in-service leadership and management course, which has come to be known as the Zambia Management and Leadership Academy (ZMLA). This paper presents the results of an impact evaluation of the ZMLA programme conducted in 2014. This was a cross-sectional mixed method study. The study targeted health workers, stakeholders and course implementers. ZMLA trainees were targeted to gain perspectives on the extent to which the programme affected levels of self-confidence resulting from knowledge gained. Perspectives were sought from both ZMLA and non ZMLA trainees to measure changes in the work environment. Stakeholder perspectives were collected from trainers and key informants involved in providing ZMLA training. On average, knowledge levels increased by 38% after each workshop. A comparison of the average self-rated scores from 444 management and leadership survey responses before ZMLA and after ZMLA training showed a significant increase in the proportion of participants that felt adequately trained to undertake management and leadership, from 63% (before) to 99% (after) in phase 1 and 43% (before) to 98% (after) in the phase II cohort. The calculated before and after percentage change for work environment themes ranged from 5.8% to 13.4%. Majority of respondents perceived improvements in the workplace

Leadership and management training as a catalyst to health system strengthening in low-income settings: Evidence from implementation of the Zambia Management and Leadership course for district health managers in Zambia.

Directory of Open Access Journals (Sweden)

Wilbroad Mutale

Full Text Available Research has shown that the modes of leadership and management may influence health outcomes. However, majority of health leaders and managers in many low-income countries are promoted on account of clinical expertise. It has been recognised that these new managers are often ill-prepared for managing complex health systems. In response to this challenge, the Zambian Ministry of Health (MoH has developed the Governance and Management Capacity Building (GMCB Strategic Plan (2012-2016, whose overarching goal is to improve health sector governance and create an environment that is result-oriented, accountable and transparent. This led to the introduction of a new in-service leadership and management course, which has come to be known as the Zambia Management and Leadership Academy (ZMLA. This paper presents the results of an impact evaluation of the ZMLA programme conducted in 2014.This was a cross-sectional mixed method study. The study targeted health workers, stakeholders and course implementers. ZMLA trainees were targeted to gain perspectives on the extent to which the programme affected levels of self-confidence resulting from knowledge gained. Perspectives were sought from both ZMLA and non ZMLA trainees to measure changes in the work environment. Stakeholder perspectives were collected from trainers and key informants involved in providing ZMLA training.On average, knowledge levels increased by 38% after each workshop. A comparison of the average self-rated scores from 444 management and leadership survey responses before ZMLA and after ZMLA training showed a significant increase in the proportion of participants that felt adequately trained to undertake management and leadership, from 63% (before to 99% (after in phase 1 and 43% (before to 98% (after in the phase II cohort. The calculated before and after percentage change for work environment themes ranged from 5.8% to 13.4%. Majority of respondents perceived improvements in the workplace

TraumaTutor: Perceptions of a Smartphone Application as a Learning Resource for Trauma Management

Directory of Open Access Journals (Sweden)

James Wigley

2013-01-01

Full Text Available Aim. We investigated perceptions of a new smartphone application (app as a learning resource. Methods. We developed TraumaTutor, an iPhone app consisting of 150 questions and explanatory answers on trauma management. This was used by 20 hospital staff that either had a special interest in managing trauma or who were studying for relevant exams, such as ATLS. A subsequent questionnaire assessed users’ experience of smartphone applications and their perceptions of TraumaTutor. Results. Of those surveyed, 85% had a device capable of running app software, and 94% of them had used apps for medical education. Specific to TraumaTutor, 85% agreed that it was pitched at the right level, 95% felt that the explanations improved understanding of trauma management, and 100% found the app easy to use. In fact, on open questioning, the clear user interface and the quality of the educational material were seen as the major advantages of TraumaTutor, and 85% agreed that the app would be a useful learning resource. Conclusions. Smartphone applications are considered a valuable educational adjunct and are commonly used by our target audience. TraumaTutor shows overwhelming promise as a learning supplement due to its immediacy, accessibility, and relevance to those preparing for courses and managing trauma.

'Self body-management and thinness in youth: survey study on Italian girls'.

Science.gov (United States)

Di Giacomo, Dina; De Liso, Giulia; Ranieri, Jessica

2018-06-08

Adherence to the thinness model, self-acceptance such as self-esteem is psychological dynamics influencing the young age and emerging adulthood of women life. The purpose of this study was to investigate the girls and young women' ability to deal with the adherence to thinness model according to their self-body management thought daily self-perception of ownhabits and aptitude. We analysed their emotional patterns and body management to elucidate the Italian phenomenon. A cross-sectional study was conducted on 2287 Italian female distribute in range age 15-25 years old and distributed in girl and young women groups. We conducted a Survey study by snowball sampling technique. Our results showed that girls had higher emotional pattern scores when their weight and shape fit the thinness model: skinny girls felt positively about their body even if when they did not take adequate care of it. Italian girls consider the underweight body mass index an adherence model. Findings suggest the urgent need to plan prevention programme to model healthy behaviours about their daily good practice overcoming social and cultural models based on appearance.

Sense of security felt by the armed police with different service length and influential factors

Directory of Open Access Journals (Sweden)

Jing CHEN

2011-02-01

Full Text Available Objective To investigate the status of sense of security felt by the armed police and the influential factors thereof.Methods The sense of security,stress level,comprehension of social supports and the coping styles were measured and evaluated by use of Security Questionnaire(SQ,Psychological Stress Self-Evaluation Test(PSET,Perceived Social Support Scale(PSSS and Coping Style Scale(CSS in 725 armed police,and the differences were compared between the servicemen with different service length(1,2 and 3 years.The correlation between security sense(expressed as personal safety and determination of control and comprehension of social supports,coping styles and T score on stress level were analyzed.A stepwise regression analysis was done to screen the factors influencing the security sense of servicemen with the overall score of security sense as the dependent variable and the comprehension of social supports(expressed as inside-and outside-family support,coping styles(expressed as illusion,resignation,rationalization,self-condemned determinant,resort and problem-solving capacity and T score on stress level as the independent variables.Results Compared with the armed police with 1 year of military service,those with 2 or 3 years of military service got lower scores in personal safety,determination of control,inside-and outside-family support,and resort and problem-solving capacity(P 0.05.The two factors of comprehension of social supports(inside-and outside-family support,and the two factors of coping styles(resort and problem-solving capacity were positively correlated with the sense of security(personal safety and determination of control(P < 0.001;while the four factors of coping styles(illusion,resignation,rationalization and self-condemned determinant and the T score on stress level were negatively correlated with the sense of security(P < 0.001.It was proved by multivariate linear regression analysis that outside-family support

Physician’s changes in management of return visits to the Emergency Department

Directory of Open Access Journals (Sweden)

Adrianna Long

2016-06-01

Full Text Available Return visits to the Emergency Department (ED are estimated between 2-3.1%, which impacts ED care costs and wait times. Adverse events for unscheduled return visits (URVs have been reported to be as high as 30%. The objective of this study was to characterize the attitudes and management of Emergency Medicine (EM physicians regarding patients presenting with the same chief complaint to the ED for an URV. An online survey questionnaire was developed and sent to 160 accredited EM Graduate Medical Education programs in the United States. The questionnaire consisted of case vignettes wherein providers were asked to submit what orders they would place for each scenario. The mean numbers of tests and treatments were compared from initial visit to repeat visit with same chief complaint. Physicians also provided feedback regarding their management of URVs. There were estimated 6988 eligible participants with 397 responses (response rate 5.7%. There was a statistical significance (P<0.001 in provider management of URVs with pediatric fever, but there was no statistical significance for management of the other chief complaints. There were 77% of physicians that felt an increased work up is warranted for URVs. The results of this study indicate that majority of EM residents and staff working in training programs feel that they should approach the management of URV patients with a more extensive workup despite no clinical change. These findings suggest that further analysis should be performed regarding provider management of URVs and the associated healthcare costs.

Role of ENT Surgeon in Managing Battle Trauma During Deployment.

Science.gov (United States)

Rajguru, Renu

2013-01-01

With technological improvements in body armour and increasing use of improvised explosive devices, it is the injuries to head, face and neck are the cause for maximum fatalities as military personnel are surviving wounds that would have otherwise been fatal. The priorities of battlefield surgical treatment are to save life, eyesight and limbs and then to give the best functional and aesthetic outcome for other wounds. Modern day battlefields pose unique demands on the deployed surgical teams and management of head and neck wounds demands multispecialty approach. Optimal result will depend on teamwork of head and neck trauma management team, which should also include otolaryngologist. Data collected by various deployed HFN surgical teams is studied and quoted in the article to give factual figures. Otorhinolaryngology becomes a crucial sub-speciality in the care of the injured and military otorhinolaryngologists need to be trained and deployed accordingly. The otolaryngologist's clinical knowledge base and surgical domain allows the ENT surgeon to uniquely contribute in response to mass casualty incident. Military planners need to recognize the felt need and respond by deploying teams of specialist head and neck surgeons which should also include otorhinolaryngologists.

Polypyrrole and graphene quantum dots @ Prussian Blue hybrid film on graphite felt electrodes: Application for amperometric determination of l-cysteine.

Science.gov (United States)

Wang, Lei; Tricard, Simon; Yue, Pengwei; Zhao, Jihua; Fang, Jian; Shen, Weiguo

2016-03-15

A novel polypyrrole (PPy) and graphene quantum dots (GQDs) @ Prussian Blue (PB) nanocomposite has been grafted on a graphite felt (GF) substrate (PPy/GQDs@PB/GF), and has been proven to be an efficient electrochemical sensor for the determination of l-cysteine (l-cys). GQDs, which were fabricated by carbonization of citric acid and adsorbed on GF surface ultrasonically, played an important role for promoting the synthesis process of PB via a spontaneous redox reaction between Fe(3+) and [Fe(CN)6](3-). The PPy film has been electro-polymerized to improve the electrochemical stability of the PPy/GQDs@PB/GF electrode. The as-prepared electrode was characterized by scanning electron microscopy (SEM), transmission electron microscopy (TEM), infrared spectroscopy (IR), X-ray diffraction (XRD) and electrochemical methods. It exhibited an excellent activity for the electrocatalytic oxidation of l-cys, with a detection sensitivity equal to 0.41 Amol(-1) L for a concentration range of 0.2-50 μmolL(-1), and equal to 0.15 Amol(-1) L for a concentration range of 50-1000 μmolL(-1). A low detection limit of 0.15 μmolL(-1), as well as a remarkable long-time stability and a negligible sensitivity to interfering analytes, were also ascertained. Copyright © 2015 Elsevier B.V. All rights reserved.

Land subsidence threats and its management in the North Coast of Java

Science.gov (United States)

Sarah, D.; Soebowo, E.

2018-02-01

Cities on the north coast of Java such as Jakarta, Semarang, Pekalongan, and Surabaya are vulnerable to environmental pressures such as sea level change and land subsidence. Land subsidence can be caused by natural and anthropogenic processes. Geologically, the north coastal plain of Java consists of unconsolidated Holocene alluvial deposit. The recent alluvial deposit is prone to compaction, and further aggravated by anthropogenic forces such as groundwater extraction and land development. Understanding the complex interaction of natural and manmade factors is essential to establish mitigation strategy. Although the impacts of land subsidence are widely felt, many do not realize that land subsidence is taking place. This paper presents a brief review of the land subsidence threats in the North coast of Java and proposes a recommendation for suitable management response.

Making the case for a fracture liaison service: a qualitative study of the experiences of clinicians and service managers.

Science.gov (United States)

Drew, Sarah; Gooberman-Hill, Rachael; Farmer, Andrew; Graham, Laura; Javaid, M Kassim; Cooper, Cyrus; Judge, Andrew

2015-10-01

To develop services, healthcare professionals must make business cases to managerial bodies within Hospital Trusts and if approved, to commissioning bodies. Patients with hip fracture are at high risk of subsequent fracture. To prevent this, guidance recommends structuring fracture prevention services around coordinator based models. These are known as Fracture Liaison Services (FLS). 33 semi-structured qualitative interviews were conducted with healthcare professionals with experience of making business cases for FLS. Data was analysed thematically. Challenges in the development of business cases included collecting all the relevant data and negotiating compartmentalised budgets that impeded service development. Participants described communication and cooperation between providers and commissioners as variable. They felt financial considerations were the most important factor in funding decisions, while improved quality of care was less influential. Other factors included national guidelines and political priorities. The personalities of clinicians championing services, and the clinical interests of commissioners were seen to influence the decision-making process, suggesting that participants felt that decisions were not always made on the basis of evidence-based care. Effective strategies included ways of providing support, demonstrating potential cost effectiveness and improved quality of care. Using a range of sources including audit data collected on the successful Glasgow FLS, and improving cooperation between stakeholders was advocated. Participants felt that the work of commissioners and providers should be better integrated and suggested strategies for doing this. This study provides information to healthcare professionals about how best to develop business cases for FLS. We conclude with recommendations on how to develop effective cases. These include using guidance such as toolkits, aligning the aims of FLS with national priorities and benchmarking

Supporting the self-management of hypertension: Patients' experiences of using a mobile phone-based system.

Science.gov (United States)

Hallberg, I; Ranerup, A; Kjellgren, K

2016-02-01

Globally, hypertension is poorly controlled and its treatment consists mainly of preventive behavior, adherence to treatment and risk-factor management. The aim of this study was to explore patients' experiences of an interactive mobile phone-based system designed to support the self-management of hypertension. Forty-nine patients were interviewed about their experiences of using the self-management system for 8 weeks regarding: (i) daily answers on self-report questions concerning lifestyle, well-being, symptoms, medication intake and side effects; (ii) results of home blood-pressure measurements; (iii) reminders and motivational messages; and (iv) access to a web-based platform for visualization of the self-reports. The audio-recorded interviews were analyzed using qualitative thematic analysis. The patients considered the self-management system relevant for the follow-up of hypertension and found it easy to use, but some provided insight into issues for improvement. They felt that using the system offered benefits, for example, increasing their participation during follow-up consultations; they further perceived that it helped them gain understanding of the interplay between blood pressure and daily life, which resulted in increased motivation to follow treatment. Increased awareness of the importance of adhering to prescribed treatment may be a way to minimize the cardiovascular risks of hypertension.

Proceedings of RIKEN BNL Research Center Workshop: P- and CP-odd Effects in Hot and Dense Matter

Energy Technology Data Exchange (ETDEWEB)

Deshpande, A.; Fukushima, K.; Kharzeev, D.; Warringa, H.; Voloshin, S.

2010-04-26

This volume contains the proceedings of the RBRC/CATHIE workshop on 'P- and CP-odd Effects in Hot and Dense Matter' held at the RIKEN-BNL Research Center on April 26-30, 2010. The workshop was triggered by the experimental observation of charge correlations in heavy ion collisions at RHIC, which were predicted to occur due to local parity violation (P- and CP-odd fluctuations) in hot and dense QCD matter. This experimental result excited a significant interest in the broad physics community, inspired a few alternative interpretations, and emphasized the need for a deeper understanding of the role of topology in QCD vacuum and in hot and dense quark-gluon matter. Topological effects in QCD are also closely related to a number of intriguing problems in condensed matter physics, cosmology and astrophysics. We therefore felt that a broad cross-disciplinary discussion of topological P- and CP-odd effects in various kinds of matter was urgently needed. Such a discussion became the subject of the workshop. Specific topics discussed at the workshop include the following: (1) The current experimental results on charge asymmetries at RHIC and the physical interpretations of the data; (2) Quantitative characterization of topological effects in QCD matter including both analytical (perturbative and non-perturbative using gauge/gravity duality) and numerical (lattice-QCD) calculations; (3) Topological effects in cosmology of the Early Universe (including baryogenesis and dark energy); (4) Topological effects in condensed matter physics (including graphene and superfiuids); and (5) Directions for the future experimental studies of P- and CP-odd effects at RHIC and elsewhere. We feel that the talks and intense discussions during the workshop were extremely useful, and resulted in new ideas in both theory and experiment. We hope that the workshop has contributed to the progress in understanding the role of topology in QCD and related fields. We thank all the speakers and

Proceedings of RIKEN BNL Research Center Workshop: P- and CP-odd Effects in Hot and Dense Matter

International Nuclear Information System (INIS)

Deshpande, A.; Fukushima, K.; Kharzeev, D.; Warringa, H.; Voloshin, S.

2010-01-01

This volume contains the proceedings of the RBRC/CATHIE workshop on 'P- and CP-odd Effects in Hot and Dense Matter' held at the RIKEN-BNL Research Center on April 26-30, 2010. The workshop was triggered by the experimental observation of charge correlations in heavy ion collisions at RHIC, which were predicted to occur due to local parity violation (P- and CP-odd fluctuations) in hot and dense QCD matter. This experimental result excited a significant interest in the broad physics community, inspired a few alternative interpretations, and emphasized the need for a deeper understanding of the role of topology in QCD vacuum and in hot and dense quark-gluon matter. Topological effects in QCD are also closely related to a number of intriguing problems in condensed matter physics, cosmology and astrophysics. We therefore felt that a broad cross-disciplinary discussion of topological P- and CP-odd effects in various kinds of matter was urgently needed. Such a discussion became the subject of the workshop. Specific topics discussed at the workshop include the following: (1) The current experimental results on charge asymmetries at RHIC and the physical interpretations of the data; (2) Quantitative characterization of topological effects in QCD matter including both analytical (perturbative and non-perturbative using gauge/gravity duality) and numerical (lattice-QCD) calculations; (3) Topological effects in cosmology of the Early Universe (including baryogenesis and dark energy); (4) Topological effects in condensed matter physics (including graphene and superfiuids); and (5) Directions for the future experimental studies of P- and CP-odd effects at RHIC and elsewhere. We feel that the talks and intense discussions during the workshop were extremely useful, and resulted in new ideas in both theory and experiment. We hope that the workshop has contributed to the progress in understanding the role of topology in QCD and related fields. We thank all the speakers and

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

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Walter Darren

2007-12-01

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

The Bsc and the Health Management Consortia: A Case Study of its Applicability

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Juliana Caroline Coutinho Coelho Guimarães

2012-12-01

Full Text Available The professional management development consistent with the demands of society is an undeniable reality in Public Health. The enactment of 11.107/2005 Law inserts an agenda for change in the reality of Health Consortia. Against this backdrop of change, uncertainty and social costs, we need to rethink management practices. The management supporting tools have been evolving rapidly since 1980, highlighting the Balanced Scorecard (BSC. The adoption of the BSC as a management supporting tool to consortia comes to meet the existing demand to improve professionalization in public administration. This article aims to analyze the applicability of a support management tool to a Health Consortia, based on BSC through a proposed pilot project in a consortium selected to do so. Thus, for the realization of this work, designed a Case Study in CISMEV - Consortium Health of Middle Velhas River, and developed a proposal for the construction of the BSC with nine distinct steps. Thus, it was possible to identify the key steps to be met for the adoption of new procedures and routines, as well as the challenges encountered in the development process of the BSC by public institutions. We also identified the possible gains from deploying this tool culminating in fulfilling the mission and building the organizational vision. It was felt that identifying motivators for choosing this tool, as well as their strengths and limitations are essential to the construction of this process with greater criticality.

Men's and women's experiences with HIV and stigma in Swaziland.

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Shamos, Sara; Hartwig, Kari A; Zindela, Nomsa

2009-12-01

To explore how gender differentially affects the stigma experiences of people living with HIV (PLHIV) in Swaziland, the extent and dimensions of HIV-related felt and enacted stigma and social support were analyzed. Thirty-seven semistructured, face-to-face interviews were conducted with PLHIV in Swaziland between 2004 and 2006. Through the process of conceptual analysis, themes, including felt stigma, information management, enacted stigma, and social support, were explored, coded, and analyzed in the contexts of partner and familial relationships, and workplace and neighborhood settings. Findings revealed that there were high levels of felt stigma in all contexts, yet fewer than anticipated accounts of enacted stigma in family, work, and neighborhood contexts compared to their expressions of felt stigma. The amount and characteristics of felt and enacted stigma and social support differed based on gender, as women often experienced more felt and enacted stigma than men, and had less definite financial or emotional support.

Pre-hospital advanced airway management by anaesthesiologists: is there still room for improvement?

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Sollid, Stephen J M; Heltne, Jon Kenneth; Søreide, Eldar; Lossius, Hans Morten

2008-07-21

Endotracheal intubation is an important part of pre-hospital advanced life support that requires training and experience, and should only be performed by specially trained personnel. In Norway, anaesthesiologists serve as Helicopter Emergency Medical Service HEMS physicians. However, little is known about how they themselves evaluate the quality and safety of pre-hospital advanced airway management. Using a semi-structured questionnaire, we interviewed anaesthesiologists working in the three HEMS programs covering Western Norway. We compared answers from specialists and non-specialists as well as full- and part-time HEMS physicians. Of the 17 available respondents, most (88%) felt that their continuous exposure to intubations was not sufficient. Additional training was mainly acquired through other clinical practice and mannequin- or cadaver-based skills training. Of the respondents, 77% and 35% reported having experienced difficult and failed intubations, respectively. Further, 59% reported knowledge of airway management-related deaths in their HEMS program. Significantly more full- than part-time HEMS physicians had experienced these problems. All respondents had airway back-up equipment in their service, but 29% were not familiar with all the equipment. The majority of anaesthesiologists working as HEMS physicians view pre-hospital advanced airway management as a high-risk procedure. Relevant airway management competencies for HEMS physicians in Norway seem to be insufficiently trained and maintained. A better-defined level of competence with better training methods and systems seems warranted.

Factors associated with advance care planning discussions by area agency on aging care managers.

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Hazelett, Susan; Baughman, Kristin R; Palmisano, Barbara R; Sanders, Margaret; Ludwick, Ruth E

2013-12-01

Initiating advance care planning (ACP) discussions in the home may prevent avoidable hospitalizations by elucidating goals of care. Area agencies on aging care managers (AAACMs) work in the home with high-risk consumers. To determine which AAACM characteristics contribute to an increased frequency of ACP discussions. Cross-sectional investigator-generated surveys administered to AAACMs at 3 AAAs in Ohio. Of 289 AAACMs, 182 (63%) responded. The more experience and comfort AAACMs felt with ACP discussions, the more likely they were to initiate ACP discussions. It may be necessary to build interactive educational experiences where, for example, AAACMs are asked to fill out their own advance directives and/or facilitate others in ACP discussions to improve experience and comfort with ACP discussions.

Knowledge and Preparedness of Dental Practitioners on Management of Medical Emergencies in Jazan Province

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Ghassan M. Al-Irany

2018-02-01

Full Text Available Medical emergencies are one of the most stressful situations the staff in a dental practice might encounter. The duty of care toward the attending patients obligates suitable preparedness to provide the necessary care if such emergencies ensue. Unfortunately, we found that 22% of the investigated dental clinics had no emergency kit available. Only 38% of the interviewed dentists felt confident to perform CPR, and 18% had no confidence to manage any medical emergency. An MCQ test of 20 questions examining the dentists’ knowledge in medical emergencies was distributed, and the level of knowledge was found to be suboptimal. The average score of the interviewed dentists was 10.87 out of 20. Experience and specialty training had a negligible effect on the level of knowledge.

Taking up national safety alerts to improve patient safety in hospitals: The perspective of healthcare quality and risk managers.

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Pfeiffer, Yvonne; Schwappach, David

2016-01-01

National safety alert systems publish relevant information to improve patient safety in hospitals. However, the information has to be transformed into local action to have an effect on patient safety. We studied three research questions: How do Swiss healthcare quality and risk managers (qm/rm(1)) see their own role in learning from safety alerts issued by the Swiss national voluntary reporting and analysis system? What are their attitudes towards and evaluations of the alerts, and which types of improvement actions were fostered by the safety alerts? A survey was developed and applied to Swiss healthcare risk and quality managers, with a response rate of 39 % (n=116). Descriptive statistics are presented. The qm/rm disseminate and communicate with a broad variety of professional groups about the alerts. While most respondents felt that they should know the alerts and their contents, only a part of them felt responsible for driving organizational change based on the recommendations. However, most respondents used safety alerts to back up their own patient safety goals. The alerts were evaluated positively on various dimensions such as usefulness and were considered as standards of good practice by the majority of the respondents. A range of organizational responses was applied, with disseminating information being the most common. An active role is related to using safety alerts for backing up own patient safety goals. To support an active role of qm/rm in their hospital's learning from safety alerts, appropriate organizational structures should be developed. Furthermore, they could be given special information or training to act as an information hub on the issues discussed in the alerts. Copyright © 2016. Published by Elsevier GmbH.

Mindfulness-based lifestyle programs for the self-management of Parkinson's disease in Australia.

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Vandenberg, Brooke E; Advocat, Jenny; Hassed, Craig; Hester, Jennifer; Enticott, Joanne; Russell, Grant

2018-04-11

Despite emerging evidence suggesting positive outcomes of mindfulness training for the self-management of other neurodegenerative diseases, limited research has explored its effect on the self-management of Parkinson's disease (PD). We aimed to characterize the experiences of individuals participating in a facilitated, group mindfulness-based lifestyle program for community living adults with Stage 2 PD and explore how the program influenced beliefs about self-management of their disease. Our longitudinal qualitative study was embedded within a randomized controlled trial exploring the impact of a 6-week mindfulness-based lifestyle program on patient-reported function. The study was set in Melbourne, Australia in 2012-2013. We conducted semi-structured interviews with participants before, immediately after, and 6 months following participation in the program. Sixteen participants were interviewed prior to commencing the program. Of these, 12 were interviewed shortly after its conclusion, and 9 interviewed at 6 months. Prior to the program, participants felt a lack of control over their illness. A desire for control and a need for alternative tools for managing the progression of PD motivated many to engage with the program. Following the program, where participants experienced an increase in mindfulness, many became more accepting of disease progression and reported improved social relationships and self-confidence in managing their disease. Mindfulness-based lifestyle programs have the potential for increasing both participants' sense of control over their reactions to disease symptoms as well as social connectedness. Community-based mindfulness training may provide participants with tools for self-managing a number of the consequences of Stage 2 PD.

Seismicity in the block mountains between Halle and Leipzig, Central Germany: centroid moment tensors, ground motion simulation, and felt intensities of two M ≈ 3 earthquakes in 2015 and 2017

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Dahm, Torsten; Heimann, Sebastian; Funke, Sigward; Wendt, Siegfried; Rappsilber, Ivo; Bindi, Dino; Plenefisch, Thomas; Cotton, Fabrice

2018-05-01

On April 29, 2017 at 0:56 UTC (2:56 local time), an M W = 2.8 earthquake struck the metropolitan area between Leipzig and Halle, Germany, near the small town of Markranstädt. The earthquake was felt within 50 km from the epicenter and reached a local intensity of I 0 = IV. Already in 2015 and only 15 km northwest of the epicenter, a M W = 3.2 earthquake struck the area with a similar large felt radius and I 0 = IV. More than 1.1 million people live in the region, and the unusual occurrence of the two earthquakes led to public attention, because the tectonic activity is unclear and induced earthquakes have occurred in neighboring regions. Historical earthquakes south of Leipzig had estimated magnitudes up to M W ≈ 5 and coincide with NW-SE striking crustal basement faults. We use different seismological methods to analyze the two recent earthquakes and discuss them in the context of the known tectonic structures and historical seismicity. Novel stochastic full waveform simulation and inversion approaches are adapted for the application to weak, local earthquakes, to analyze mechanisms and ground motions and their relation to observed intensities. We find NW-SE striking normal faulting mechanisms for both earthquakes and centroid depths of 26 and 29 km. The earthquakes are located where faults with large vertical offsets of several hundred meters and Hercynian strike have developed since the Mesozoic. We use a stochastic full waveform simulation to explain the local peak ground velocities and calibrate the method to simulate intensities. Since the area is densely populated and has sensitive infrastructure, we simulate scenarios assuming that a 12-km long fault segment between the two recent earthquakes is ruptured and study the impact of rupture parameters on ground motions and expected damage.

The impact of participative management perceptions on customer service, medical errors, burnout, and turnover intentions.

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Angermeier, Ingo; Dunford, Benjamin B; Boss, Alan D; Boss, R Wayne

2009-01-01

Numerous challenges confront managers in the healthcare industry, making it increasingly difficult for healthcare organizations to gain and sustain a competitive advantage. Contemporary management challenges in the industry have many different origins (e.g., economic, financial, clinical, and legal), but there is growing recognition that some of management's greatest problems have organizational roots. Thus, healthcare organizations must examine their personnel management strategies to ensure that they are optimized for fostering a highly committed and productive workforce. Drawing on a sample of 2,522 employees spread across 312 departments within a large U.S. healthcare organization, this article examines the impact of a participative management climate on four employee-level outcomes that represent some of the greatest challenges in the healthcare industry: customer service, medical errors, burnout, and turnover intentions. This study provides clear evidence that employee perceptions of the extent to which their work climate is participative rather than authoritarian have important implications for critical work attitudes and behavior. Specifically, employees in highly participative work climates provided 14 percent better customer service, committed 26 percent fewer clinical errors, demonstrated 79 percent lower burnout, and felt 61 percent lower likelihood of leaving the organization than employees in more authoritarian work climates. These findings suggest that participative management initiatives have a significant impact on the commitment and productivity of individual employees, likely improving the patient care and effectiveness of healthcare organizations as a whole.

[The influence of quality management on job satisfaction and work load--exemplary study in a German hospital].

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Hein, Sandra; Lauterbach, Karl W; Plamper, Evelyn; Gerber, Andreas

2009-01-01

Surveys among employees are getting more and more relevant in hospital settings since an increase in both (1) efficiency and (2) quality in connection with (3) enhanced patient orientation will only be achieved, if at the same time the employees' health status and satisfaction are taken into account. Thus, the objective of this study was to compare the satisfaction of employees in a single hospital enquired in 2002 with that of 2005. Particular consideration was given to their view of quality management. Is there a correlation between employees' satisfaction, their degree of information on quality management, and their assessment of quality management? In the survey of 2005 employees were more satisfied with their work and their working conditions than in the previous inquiry conducted in 2002. They felt less mental stress, despite the declining length of hospitalisation combined with a higher turnover of in-hospital cases and with lower numbers of full-time staff. The employees' satisfaction, however, differed widely among the three departments with regard to the items "involvement with decisions" and "support by the superiors". The overall assessment of quality management is positive. Specific items such as the assessment of the management's commitment to quality management were strongly influenced by the employees' degree of information on quality management, which varies between departments. In the department with the lowest work satisfaction quality management was attributed a high potential for change and improvement. After quality management will have been implemented throughout the hospital, a new survey should be undertaken to evaluate whether quality management affects the employees' satisfaction with their work.

Self-management-support in dementia care: A mixed methods study among nursing staff.

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Verkaik, Renate; van Antwerpen-Hoogenraad, Paulien; de Veer, Anke; Francke, Anneke; Huis In Het Veld, Judith

2017-11-01

Background Self-management in patients and family caregivers confronted with dementia is not self-evident. Self-management skills may be limited because of the progressive cognitive decline of the patient and because family caregivers are often also very aged. Self-management support by nursing staff is therefore of paramount importance. Objectives To gain insight into how nursing staff perceive their self-management support tasks, and how they put them into practice. Research questions are: 'What are the opinions and experiences of Dutch nursing staff working in home care or residential elderly care regarding self-management support for people with dementia and their family caregivers?' and 'Do nursing staff feel sufficiently trained and skilled for self-management support?'. Methods A mixed methods approach was used, combining cross-sectional quantitative survey data from 206 Dutch nursing professionals with qualitative interviews among 12 nursing staff working in home care or residential elderly care in The Netherlands. Results Nursing staff working in home care experienced self-management support of people with dementia as a part of their job and as an attractive task. They consider 'helping people with dementia to maintain control over their lives by involving them in decisions in daily care' the essence of self-management support. Nursing staff saw family caregivers as their main partners in providing self-management support to the patient. They were less aware that family caregivers themselves might also need self-management support. Nursing staff often felt insufficiently trained to give adequate self-management support. RN's and CNA's did not differ in their opinions, experiences and training needs. Conclusions Nursing staff in home care do consider self-management support an important and attractive task in dementia care. Their skills for providing self-management support to patients with dementia and family caregivers need improvement. Recommendations

The technology management process at the European space agency

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Guglielmi, M.; Williams, E.; Groepper, P.; Lascar, S.

2010-03-01

Technology is developed at the European Space Agency (ESA) under several programmes: corporate and domain specific, mandatory and optional, with different time horizons and covering different levels of the TRL scale. To improve the transparency and efficiency of the complete process, it was felt necessary to establish an agreed end to end process for the management of all technology R&D activity that could: Include all ESA programmes and consider the requirements of European users Lead to coordinated multi-year work plan and yearly procurement plans Prepare and enable future European space programmes Be harmonized with national initiatives in Europe Thereby establishing the basis for a product policy to reduce risks to technology users, reduce costs and delays, and enhance industrial competitiveness and non-dependence. In response to the above needs, ESA has developed a technology management process called the ESA End-to-End process (E2E), from establishment of the strategy to the monitoring and evaluation of R&D results. In this paper, the complete process will be described in detail including a discussion on its strengths and limitations, and its links to the wider European Harmonization process. The paper will be concluded with the introduction of the ESA Technology Tree: a basic tool to structure and facilitate communication about technology issues.

A Required Rotation in Clinical Laboratory Management for Pathology Residents

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Hoda, Syed T.; Crawford, James M.

2016-01-01

Leadership and management training during pathology residency have been identified repeatedly by employers as insufficient. A 1-month rotation in clinical laboratory management (CLM) was created for third-year pathology residents. We report on our experience and assess the value of this rotation. The rotation was one-half observational and one-half active. The observational component involved being a member of department and laboratory service line leadership, both at the departmental and institutional level. Observational participation enabled learning of both the content and principles of leadership and management activities. The active half of the rotation was performance of a project intended to advance the strategic trajectory of the department and laboratory service line. In our program that matriculates 4 residents per year, 20 residents participated from April 2010 through December 2015. Their projects either activated a new priority area or helped propel an existing strategic priority forward. Of the 16 resident graduates who had obtained their first employment or a fellowship position, 9 responded to an assessment survey. The majority of respondents (5/9) felt that the rotation significantly contributed to their ability to compete for a fellowship or their first employment position. The top reported benefits of the rotation included people management; communication with staff, departmental, and institutional leadership; and involvement in department and institutional meetings and task groups. Our 5-year experience demonstrates both the successful principles by which the CLM rotation can be established and the high value of this rotation to residency graduates. PMID:28725766

A Required Rotation in Clinical Laboratory Management for Pathology Residents

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Arvind Rishi MD

2016-05-01

Full Text Available Leadership and management training during pathology residency have been identified repeatedly by employers as insufficient. A 1-month rotation in clinical laboratory management (CLM was created for third-year pathology residents. We report on our experience and assess the value of this rotation. The rotation was one-half observational and one-half active. The observational component involved being a member of department and laboratory service line leadership, both at the departmental and institutional level. Observational participation enabled learning of both the content and principles of leadership and management activities. The active half of the rotation was performance of a project intended to advance the strategic trajectory of the department and laboratory service line. In our program that matriculates 4 residents per year, 20 residents participated from April 2010 through December 2015. Their projects either activated a new priority area or helped propel an existing strategic priority forward. Of the 16 resident graduates who had obtained their first employment or a fellowship position, 9 responded to an assessment survey. The majority of respondents (5/9 felt that the rotation significantly contributed to their ability to compete for a fellowship or their first employment position. The top reported benefits of the rotation included people management; communication with staff, departmental, and institutional leadership; and involvement in department and institutional meetings and task groups. Our 5-year experience demonstrates both the successful principles by which the CLM rotation can be established and the high value of this rotation to residency graduates.

The Use of Best Practice in the Treatment of a Complex Diabetic Foot Ulcer: A Case Report

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Melodie Blakely

2016-03-01

Full Text Available Background and Purpose: Published guidelines for effective management of diabetic foot ulcers (DFU include total contact casting (TCC. The purpose of this case study is to describe the application of best practice guidelines for the treatment of a diabetic foot ulcer (DFU in a complex patient where TCC offloading could not be utilized. Case Description: The patient was a 47 year-old female with a five-plus year history of a full-thickness DFU on the left plantar mid-foot. Treatment included sharp and ultrasound debridement, the use of a silver hydrofiber dressing, edema management via compression therapy, negative pressure wound therapy, offloading via customized 1/4 inch adhesive-backed felt applied to the plantar foot in addition to an offloading boot and use of a wheelchair, patient education regarding diabetes management, and the application of a bilayered living skin-equivalent biologic dressing. Outcomes: At 15 weeks the wound was closed and the patient was transitioned into diabetic footwear. Discussion: The felt offloading was a beneficial alternative to TCC. The patient’s longer than average healing rate may have been complicated by the duration of her wound, her 41 year history of diabetes, and the fact that gold standard offloading (TCC was not able to be used. Further research is needed regarding the use of felt for offloading, such as application technique for wounds on different areas of the foot, comparison of different types of felt, and the use of felt in conjunction with various offloading devices.

Leadership and management training as a catalyst to health system strengthening in low-income settings: Evidence from implementation of the Zambia Management and Leadership course for district health managers in Zambia

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Mutale, Wilbroad; Vardoy-Mutale, Anne-Thora; Kachemba, Arthur; Mukendi, Roman; Clarke, Kupela; Mulenga, Dennis

2017-01-01

Background Research has shown that the modes of leadership and management may influence health outcomes. However, majority of health leaders and managers in many low-income countries are promoted on account of clinical expertise. It has been recognised that these new managers are often ill-prepared for managing complex health systems. In response to this challenge, the Zambian Ministry of Health (MoH) has developed the Governance and Management Capacity Building (GMCB) Strategic Plan (2012–2016), whose overarching goal is to improve health sector governance and create an environment that is result-oriented, accountable and transparent. This led to the introduction of a new in-service leadership and management course, which has come to be known as the Zambia Management and Leadership Academy (ZMLA). This paper presents the results of an impact evaluation of the ZMLA programme conducted in 2014. Methods This was a cross-sectional mixed method study. The study targeted health workers, stakeholders and course implementers. ZMLA trainees were targeted to gain perspectives on the extent to which the programme affected levels of self-confidence resulting from knowledge gained. Perspectives were sought from both ZMLA and non ZMLA trainees to measure changes in the work environment. Stakeholder perspectives were collected from trainers and key informants involved in providing ZMLA training. Results On average, knowledge levels increased by 38% after each workshop. A comparison of the average self-rated scores from 444 management and leadership survey responses before ZMLA and after ZMLA training showed a significant increase in the proportion of participants that felt adequately trained to undertake management and leadership, from 63% (before) to 99% (after) in phase 1 and 43% (before) to 98% (after) in the phase II cohort. The calculated before and after percentage change for work environment themes ranged from 5.8% to 13.4%. Majority of respondents perceived

UK medical students' perceptions, attitudes, and interest toward medical leadership and clinician managers.

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Rouhani, Maral J; Burleigh, Eleanor J; Hobbis, Chloe; Dunford, Charlotte; Osman, Nadir I; Gan, Christine; Gibbons, Norma B; Ahmed, Hashim U; Miah, Saiful

2018-01-01

We aimed to determine UK medical students' perceptions and attitudes and interest toward medical leadership and clinician managers. A cross-sectional study was conducted during the academic year 2015-2016. An online questionnaire was distributed to 2,349 final-year students from 10 UK medical schools. Participants were asked to complete a 5-point Likert scale on their current perceptions, attitudes, and interest toward medical leadership and clinician managers. They were also asked to self-rate their leadership competences set by the Medical Leadership Competency Framework and to rate the quality of management and leadership training they received from their medical school. In total, we received 114 complete responses. Only 7.9% of respondents were in agreement (strongly agree or agree) when asked whether they felt they were well informed about what a managerial position in medicine entails. When asked whether clinicians should influence managerial decisions within a clinical setting, 94.7% of respondents were in agreement with the statement. About 85% of respondents were in agreement that it is important for clinicians to have managerial or leadership responsibilities, with 63.2% of students in agreement that they would have liked more management or leadership training during medical school. Over half the respondents rated their management and leadership training they received during medical school as "very poor" or "poor" (54.4%). Our study suggests that UK medical students have an appetite for management and leadership training and appreciate its importance but feel that the training they are receiving is poor. This suggests that there is a gap between the demand for management and leadership training and the quality of training supplied by UK medical schools.

Spiritual beliefs and barriers among managed care practitioners.

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McCauley, Jeanne; Jenckes, Mollie W; Tarpley, Margaret J; Koenig, Harold G; Yanek, Lisa R; Becker, Diane M

2005-01-01

Ninety percent of American adults believe in God and 82% pray weekly. A majority wants their physicians to address spirituality during their health care visit. However, clinicians incorporate spiritual discussion in less than 20% of visits. Our objectives were to measure clinician beliefs and identify perceived barriers to integrating spirituality into patient care in a statewide, primary care, managed care group. Practitioners completed a 30-item survey including demographics and religious involvement (DUREL), spirituality in patient care (SPC), and barriers (BAR). We analyzed data using frequencies, means, standard deviations, and ANOVA. Clinicians had a range of religious denominations (67% Christian, 14% Jewish, 11% Muslim, Hindu or Buddhist, 8% agnostic), were 57% female and 24% had training in spirituality. Sixty-six percent reported experiencing the divine. Ninety-five percent felt that a patient's spiritual outlook was important to handling health difficulties and 68% percent agreed that addressing spirituality was part of the physician's role. Ninety-five percent of our managed care group noted 'lack of time' as an important barrier, 'lack of training' was indicated by 69%, and 21% cited 'fear of response from administration'. Managed care practitioners in a time constrained setting were spiritual themselves and believed this to be important to patients. Respondents indicated barriers of time and training to implementing these beliefs. Comparing responses from our group to those in other published surveys on clinician spirituality, we find similar concerns. Clinician education may overcome these barriers and improve ability to more fully meet their patients' expressed needs regarding spirituality and beliefs.

Starting early: integration of self-management support into an acute stroke service.

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Mäkelä, Petra; Gawned, Sara; Jones, Fiona

2014-01-01

Self-management support following stroke is rare, despite emerging evidence for impact on patient outcomes. The promotion of a common approach to self-management support across a stroke pathway requires collaboration between professionals. To date, the feasibility of self-management support in acute stroke settings has not been evaluated. The Bridges stroke self-management package (SMP) is based on self-efficacy principles. It is delivered by professionals and supported by a patient-held workbook. The aim of this project was to introduce the Bridges stroke SMP to the multidisciplinary staff of a London hyperacute and acute stroke unit. The 'Plan Do Study Act' (PDSA) cycle guided iterative stages of project development, with normalisation process theory helping to embed the intervention into existing ways of working. Questionnaires explored attitudes, beliefs and experiences of the staff who were integrating self-management support into ways of working in the acute stroke setting. Self-management support training was delivered to a total of 46 multidisciplinary stroke staff. Of the staff who attended the follow-up training, 66% had implemented Bridges self-management support with patients since initial training, and 100% felt their practice had changed. Questionnaire findings demonstrated that staff attitudes and beliefs had changed following training, particularly regarding ownership and type of rehabilitation goals set, and prioritisation of self-management support within acute stroke care. Staff initiated an audit of washing and dressing practices pre- and post-training. This was designed to evaluate the number of occasions when techniques were used by staff to facilitate patients' independence and self-management. They found that the number of occasions featuring optimum practice went from 54% at baseline to 63% at three months post-training. This project demonstrated the feasibility of integrating self-management support into an acute stroke setting. Further

Power in health care organizations: contemplations from the first-line management perspective.

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Isosaari, Ulla

2011-01-01

The aim of this paper is to examine health care organizations' power structures from the first-line management perspective. What liable power structures derive from the theoretical bases of bureaucratic, professional and result based organizations, and what power type do health care organizations represent, according to the empirical data? The paper seeks to perform an analysis using Mintzberg's power configurations of instrument, closed system, meritocracy and political arena. The empirical study was executed at the end of 2005 through a survey in ten Finnish hospital districts in both specialized and primary care. Respondents were all first-line managers in the area and a sample of staff members from internal disease, surgical and psychiatric units, as well as out-patient and primary care units. The number of respondents was 1,197 and the response percentage was 38. The data were analyzed statistically. As a result, it can be seen that a certain kind of organization structure supports the generation of a certain power type. A bureaucratic organization generates an instrument or closed system organization, a professional organization generates meritocracy and also political arena, and a result-based organization has a connection to political arena and meritocracy. First line managers regarded health care organizations as instruments when staff regarded them mainly as meritocracies having features of political arena. Managers felt their position to be limited by rules, whereas staff members regarded their position as having lots of space and influence potential. If the organizations seek innovative and active managers at the unit level, they should change the organizational structure and redistribute the work so that there could be more space for meaningful management. This research adds to the literature and gives helpful suggestions that will be of interest to those in the position of first-line management in health care.

Athletic Trainers' Roles and Responsibilities Regarding Academic Adjustments as Part of the Concussion-Management Process in the Secondary School Setting.

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Bacon, Cailee E Welch; Kay, Melissa C; McLeod, Tamara C Valovich

2017-10-01

  Athletic trainers (ATs) play a vital role in managing the care of student-athletes after a sport-related concussion, yet little is known about their specific involvement in the implementation of academic adjustments as part of the concussion-management plan.   To explore ATs' perceived roles and responsibilities regarding the implementation of academic adjustments for concussed student-athletes.   Qualitative study.   Individual telephone interviews.   Sixteen ATs employed in the secondary school setting (8 women, 8 men; age = 39.6 ± 7.9 years; athletic training experience = 15.1 ± 5.6 years), representing 12 states, were interviewed.   One telephone interview was conducted with each participant. After the interviews were transcribed, the data were analyzed and coded into themes and categories, which were determined via consensus of a 4-person research team. To decrease researcher bias, triangulation occurred through participant member checking, the inclusion of multiple researchers, and an internal auditor.   Several categories related to participants' perceptions regarding their roles and responsibilities within the academic-adjustments process emerged from data analysis: (1) understanding of academic adjustments, (2) perceptions of their roles in academic adjustments, (3) initiation of academic adjustments, (4) facilitation of academic adjustments, and (5) lack of a role in the academic-adjustments process. Although most ATs perceived that they had a role in the initiation and facilitation of academic adjustments for concussed student-athletes, some reported they did not want a role in the process. Regardless, participants frequently suggested the need for further education.   These findings highlight that ATs either wanted to be involved in the implementation of academic adjustments but felt further education was needed or they did not want to be involved because they felt that it was not in their area of expertise. To create a cohesive

Physiotherapists supporting self-management through health coaching: a mixed methods program evaluation.

Science.gov (United States)

Dufour, Sinéad Patricia; Graham, Shane; Friesen, Josh; Rosenblat, Michael; Rous, Colin; Richardson, Julie

2015-01-01

To evaluate a program in support of chronic disease self-management (CDSM) that is founded on a health coaching (HC) approach, includes supervised exercise and mindfulness-based stress reduction components and is delivered within a private practice physiotherapy setting. An explanatory mixed method design, framed by theory-based program evaluation, was employed to evaluate an eight-week group-based program. Standardized self-rated and performance measures were evaluated pre- and post intervention. Additionally, participant focus groups were conducted following the intervention period. An inductive thematic approach was undertaken to analyze the qualitative data. Seventeen participants (N = 17) completed the study. Improvements were seen in both self-report and performance outcomes. Participants explained how and why they felt the program was beneficial. Six themes were generated: (1) group dynamic; (2) learning versus doing; (3) holism and comprehensive care; (4) self-efficacy and empowerment; (5) previous solutions versus new management strategies; and (6) healthcare provider support. This study established that a group program in support of CDSM founded on a HC approach demonstrated potential value from participants as well as favorable outcomes. A pragmatic randomized control trial is required to determine efficacy of this intervention.

Managing uncertainty: a qualitative study of GPs' views on the diagnosis and immediate management of transient ischaemic attack and the potential of a diagnostic tool.

Science.gov (United States)

Bose, Priyanka; Tarrant, Carolyn; Mistri, Amit K; Wilson, Andrew

2018-04-12

Most patients with transient ischaemic attack (TIA) present to their GP. Early identification and treatment reduces the risk of subsequent stroke and consequent disability and mortality. To explore GPs' views on the diagnosis and immediate management of suspected TIA, and the potential utility of a diagnostic tool. This is a qualitative interview study based in Leicestershire, UK. A purposive sample of 10 GPs participated in 30-minute semi-structured telephone interviews. Data were analysed thematically. GPs reported that TIA was more likely to be suspected when patients were more obvious candidates for TIA based on their history, characteristics and symptom presentation. Referrals were in part a strategy to manage risk under conditions of uncertainty and to seek reassurance. GPs valued using a TIA risk stratification tool but felt this did not inform their diagnostic decision making. A diagnostic tool for TIA in primary care was seen to have potential to improve the decision-making process about diagnosis and management and enhance confidence of GPs, particularly in ruling out TIAs. GPs saw benefits of using hard thresholds, but remained concerned about missing TIAs and saw a tool as an adjunct to clinical judgement. GPs weigh up the likelihood of TIA in the context of assessments of candidacy and diverse, often vague, symptoms. A diagnostic tool could support GPs in this process and help reduce reliance on referrals to TIA clinics for reassurance, provided the tool was designed to support decision making in cases of less 'typical' presentations.

Report from the UK consensus conference on radioactive waste management, May 1999

International Nuclear Information System (INIS)

Hiett, A.

2000-01-01

A Consensus Conference took place in the UK in May 1999 to address the issue of Radioactive Waste Management. Sixteen members of the public were invited, at random, to take part in the conference, and initially were unaware of the topic. After two preparation weekends, the citizen's panel held a two day conference at which they cross examined expert 'witnesses' on issues which they felt to be relevant to the topic. The remit of the panel was as follows: ''The Consensus Conference is to focus on the effective and publicly acceptable long term management of nuclear waste in the UK, both civil and military, concentrating particularly on intermediate and high level waste. This will be considered by the citizens' panel in their capacity as members of the public, taking into account what they see as the relevant issues''. Following the conference itself, the panel produced a report on their findings and conclusions. Retrievability was just one of the many areas that the panel covered. In relation to the area of public acceptance for long term management of radioactive waste, the recommendations of the panel were as follows: ''In conclusion the panel was unanimous that in order for a solution to be publicly acceptable, the waste MUST remain accessible and monitorable to give future generations a chance to deal with the problem if/when a solution is found''. (author)

Economic hardship associated with managing chronic illness: a qualitative inquiry

Directory of Open Access Journals (Sweden)

Jan Stephen

2009-10-01

Full Text Available Abstract Background Chronic illness and disability can have damaging, even catastrophic, socioeconomic effects on individuals and their households. We examined the experiences of people affected by chronic heart failure, complicated diabetes and chronic obstructive pulmonary disease to inform patient centred policy development. This paper provides a first level, qualitative understanding of the economic impact of chronic illness. Methods Interviews were conducted with patients aged between 45 and 85 years who had one or more of the index conditions and family carers from the Australian Capital Territory and Western Sydney, Australia (n = 66. Content analysis guided the interpretation of data. Results The affordability of medical treatments and care required to manage illness were identified as the key aspects of economic hardship, which compromised patients' capacity to proactively engage in self-management and risk reduction behaviours. Factors exacerbating hardship included ineligibility for government support, co-morbidity, health service flexibility, and health literacy. Participants who were on multiple medications, from culturally and linguistically diverse or Indigenous backgrounds, and/or not in paid employment, experienced economic hardship more harshly and their management of chronic illness was jeopardised as a consequence. Economic hardship was felt among not only those ineligible for government financial supports but also those receiving subsidies that were insufficient to meet the costs of managing long-term illness over and above necessary daily living expenses. Conclusion This research provides insights into the economic stressors associated with managing chronic illness, demonstrating that economic hardship requires households to make difficult decisions between care and basic living expenses. These decisions may cause less than optimal health outcomes and increased costs to the health system. The findings support the necessity

Pre-hospital advanced airway management by anaesthesiologists: Is there still room for improvement?

Directory of Open Access Journals (Sweden)

Søreide Eldar

2008-07-01

Full Text Available Abstract Background Endotracheal intubation is an important part of pre-hospital advanced life support that requires training and experience, and should only be performed by specially trained personnel. In Norway, anaesthesiologists serve as Helicopter Emergency Medical Service HEMS physicians. However, little is known about how they themselves evaluate the quality and safety of pre-hospital advanced airway management. Method Using a semi-structured questionnaire, we interviewed anaesthesiologists working in the three HEMS programs covering Western Norway. We compared answers from specialists and non-specialists as well as full- and part-time HEMS physicians. Results Of the 17 available respondents, most (88% felt that their continuous exposure to intubations was not sufficient. Additional training was mainly acquired through other clinical practice and mannequin- or cadaver-based skills training. Of the respondents, 77% and 35% reported having experienced difficult and failed intubations, respectively. Further, 59% reported knowledge of airway management-related deaths in their HEMS program. Significantly more full- than part-time HEMS physicians had experienced these problems. All respondents had airway back-up equipment in their service, but 29% were not familiar with all the equipment. Conclusion The majority of anaesthesiologists working as HEMS physicians view pre-hospital advanced airway management as a high-risk procedure. Relevant airway management competencies for HEMS physicians in Norway seem to be insufficiently trained and maintained. A better-defined level of competence with better training methods and systems seems warranted.

Development and pilot of Case Manager: a virtual-patient experience for veterinary students.

Science.gov (United States)

Byron, Julie K; Johnson, Susan E; Allen, L Clare V; Brilmyer, Cheryl; Griffiths, Robert P

2014-01-01

There is an increasing demand in veterinary education to engage students, teach and reinforce clinical reasoning, and provide access anytime/anywhere to quality learning opportunities. In addition, accrediting bodies are asking for more concrete documentation of essential clinical-skills outcomes. Unfortunately, during the clinical year in a referral hospital setting, students are at the mercy of chance regarding the types of cases they will encounter and the opportunities they will have to participate. Patient- and case-simulation technology is becoming more popular as a way to achieve these objectives in human and veterinary medical education. Many of the current options available to the veterinary medical education community to develop virtual-patient cases are too time-consuming, cost prohibitive, or difficult for the instructor or learner to use. In response, we developed a learning tool, Case Manager, which is low-cost and user-friendly. Case Manager was designed to meet the demands of veterinary education by providing students with an opportunity to cultivate clinical reasoning skills and allowing for real-time student feedback. We launched a pilot test with 37 senior veterinary medical students as part of their Small Animal Internal Medicine clinical rotation. Students reported that Case Manager increased their engagement with the material, improved diagnostic and problem-solving skills, and broadened their exposure to a variety of cases. In addition, students felt that Case Manager was superior to a more traditional, less interactive case presentation format.

Microbial studies in the Canadian Nuclear Fuel Waste Management Program

International Nuclear Information System (INIS)

Stroes-Gascoyne, S.

1996-01-01

The management of the high level radioactive waste is an issue which generates Multifaceted conflicts. These conflicts are multi-determined, but are nonetheless, based on a myriad of associated concerns including but not exclusive to: effects of radiation on public health and safety, uncertainty associated with long-term assessments and effects, confidence in technology and in government and industry to protect public health and safety, and concerns regarding concurrent and intergenerational equity. These concerns are likely to be deeply felt by the many potential actors and stakeholders who will be impacted during the process of site selection for a nuclear waste disposal facility. Because this site selection is sure to be a controversial undertaking, it is in the interests of those who wish to promote the use of the high-level radioactive waste disposal concept, to understand fully the potential for conflict and consider alternative means of proactively preventing and/or resolving conflicts

Feeling Safe and Taking on Responsibilities: Newly Graduated Nurses' Perceptions and Evaluations of Their Transition Into a Forensic Mental Health Inpatient Setting.

Science.gov (United States)

Sørensen, Tanja; Tingleff, Ellen B; Gildberg, Frederik A

2018-03-30

Forensic mental health care is faced with serious problems in the recruitment and retention of newly graduated nurses (NGNs). Research into NGNs' experiences of their transition to and evaluations of transition programs in forensic care is sparse, and more studies are called for. This study aimed to investigate the characteristics of NGNs' experiences and perceptions of their transition into a forensic setting and their evaluations of the introduction period. Three focus group interviews were carried out, involving 13 NGNs, lasting 79.68 minutes on average. They were analyzed using thematic analysis. Results show two main themes: "feeling safe" and "taking on responsibilities." If NGNs felt overburdened with clinical responsibilities during their transition, their feeling of safety reduced. The converse also applied; theThe safer they felt, the greater clinical responsibility they felt capable of handling. The more difficult the NGNs perceived the informal transition, the more unsafe they felt, and the more negatively they perceived the responsibilities placed upon them. Tailored programs designed to support both the informal and formal transitions are recommended, along with preceptorship, theoretical training, and role-based support, such as a shift manager, along with early introduction to conflict management and security measures.

AN OVERVIEW OF NURSES' MANAGEMENT OF SECONDARY HYPERPARATHYROIDISM: HOW IS EUROPE DOING?

Science.gov (United States)

de Barbieri, Ilaria; Baumann, Jacqueline; Casal, Maria Cruz; Gurevich, Andrey; Pancirova, Jitka; Poulia, Kalliopi-Anna; Riemann, Aase

2015-09-01

Nurses have an important role to play in the management of secondary hyperparathyroidism (SHPT). An online survey conducted by the European Dialysis and Transplant Nurses Association/European Renal Care Association (EDTNA/ERCA) in conjunction with Amgen (Europe) GmbH surveyed nephrology nurses' knowledge of secondary hyperparathyroidism, treatment targets, current treatments, patient adherence and nephrology nurse training education needs. The survey's aim was to establish common practices being used by nurses in the management of secondary hyperparathyroidism and to identify nephrology nurses' training and educational needs in order to improve patient care. Descriptive study. An online survey of multiple choice and closed questions. A sample of nephrology nurses from Spain, Italy, France and the Netherlands. A total of 111 nurses completed the questionnaire (98% response rate, 82% of which were fully completed). Collected data revealed that there were specific aspects of SHPT patient management where nurses lacked confidence, despite the majority of respondents having 15 years nephrology nursing experience. These aspects included explaining the disorder and therapies to patients, managing side effects of drugs and appreciating the significance of controlling biochemical targets. Over 40% of the respondents felt they did not have sufficient training to support patients who were non-compliant. Nursing skills are integral to SHPT patient management as part of the multidisciplinary approach. The nurse's role is particularly important in patient assessment and monitoring, and in the provision of patient education and support, particularly with treatment adherence. Nephrology nurses who are better informed about SHPT and who receive training on practical patient care may improve the care of patients. © 2015 European Dialysis and Transplant Nurses Association/European Renal Care Association.

Qualitative study of depression management in primary care: GP and patient goals, and the value of listening

Science.gov (United States)

Johnston, Olwyn; Kumar, Satinder; Kendall, Kathleen; Peveler, Robert; Gabbay, John; Kendrick, Tony

2007-01-01

Background Guidelines for depression management have been developed but little is known about GP and patient goals, which are likely to influence treatment offers, uptake, and adherence. Aim To identify issues of importance to GPs, patients, and patients' supporters regarding depression management. GP and patient goals for depression management became a focus of the study. Design of study Grounded theory-based qualitative study. Setting GPs were drawn from 28 practices. The majority of patients and supporters were recruited from 10 of these practices. Method Sixty-one patients (28 depressed, 18 previously depressed, 15 never depressed), 18 supporters, and 32 GPs were interviewed. Results GPs described encouraging patients to view depression as separate from the self and ‘normal’ sadness. Patients and supporters often questioned such boundaries, rejecting the notion of a medical cure and emphasising self-management. The majority of participants who were considering depression-management strategies wanted to ‘get out’ of their depression. However, a quarter did not see this as immediately relevant or achievable. They focused on getting by from day to day, which had the potential to clash with GP priorities. GP frustration and uncertainty could occur when depression was resistant to cure. Participants identified the importance of GPs listening to patients, but often felt that this did not happen. Conclusion Physicians need greater awareness of the extent to which their goals for the management of depression are perceived as relevant or achievable by patients. Future research should explore methods of negotiating agreed strategies for management. PMID:17976282

Organizational Downsizing and Career Development.

Science.gov (United States)

Bozionelos, Nikos

2001-01-01

A study of 123 "survivors" of corporate downsizing and 13 senior managers indicated that the organization lacked a coherent career development plan and the performance management/appraisal process was inadequate. Managers perceived lateral transfers as effective; some employees felt they undermined career progression. Employees thought…

The national survey of health administration program graduates on management information systems education.

Science.gov (United States)

Zalkind, D; Malec, B

1988-01-01

A national survey of alumni of AUPHA programs from the classes of 1983, 1984, and 1985 was undertaken to assess their experiences in management information systems education, both formally and on the job. The survey covered 38 AUPHA graduate member programs and resulted in 1,181 responses. Over 40 percent of the alumni indicated that they had had an introductory management information systems (MIS) course in a health administration program. Since graduation, almost 90 percent have had some significant on-the-job involvement with computers, computer-generated information, or MIS. More than one-third of the respondents felt that their MIS course work did not adequately prepare them for what was expected on the job. Alumni stressed that microcomputer software applications, such as spreadsheets and data bases, are important areas for student hands-on experiences. When asked the importance of certain areas to be included in a required introductory MIS course, the alumni also recommended spreadsheet analysis and design, report writing and data presentation, and other management areas. Additional comments suggested more access to personal computers (PCs), more relevance in the curriculum to the "real world," and the importance of MIS to the career paths of alumni. Faculty suggestions from a 1984-85 survey are compared with alumni responses in order to identify curricular changes needed. Recommendations are outlined for consideration.

The Use of Science in Environmental Advocacy for Coastal Resource Management

Directory of Open Access Journals (Sweden)

Maria Maida Aguinaldo

2000-12-01

Full Text Available Environmental advocacy in Bolinao has played an important role in the prevention, remediation, and rehabilitation of potential and felt impacts of the various activities in the coastal zone. Most initiatives have been spurred by the sharing of knowledge and information in mobilizing community advocates. Facilitating action in four key areas–development planning, coastal aquaculture, concession systems, and tourism– involved the provision of venues for information transfer. These included the conduct of orientations and consultations, sharing of results of research project undertaken, lobbying, and use of primers, newsletters, and theater. Mechanisms for sustaining these actions and upholding the Coastal Resource Management (CRM principles (sustainable, equitable, empowering long after projects have been phased out were initiated through the establishment of a Coastal Resource Management Center, and the institutionalization activities through existing institutions, such as the local government, academic institutions, and peoples’ organizations.Maximizing knowledge and information, popularizing information, and sharing this with members of the community and getting them to use it, as well as enjoining them to act, are the challenges that must be faced. Environmental advocacy, as a tool for empowering different community sectors in evolving a consensus for CRM has become an integral feature of development work in Bolinao.

Women's Management of Recurrent Bacterial Vaginosis and Experiences of Clinical Care: A Qualitative Study.

Directory of Open Access Journals (Sweden)

Jade Bilardi

Full Text Available Few data are available on how women manage recurring bacterial vaginosis (BV and their experiences of the clinical care of this condition. This study aimed to explore women's recurrent BV management approaches and clinical care experiences, with a view to informing and improving the clinical management of BV.A descriptive, social constructionist approach was chosen as the framework for the study. Thirty-five women of varying sexual orientation who had experienced recurrent BV in the past 5 years took part in semi-structured interviews.The majority of women reported frustration and dissatisfaction with current treatment regimens and low levels of satisfaction with the clinical management of BV. Overall, women disliked taking antibiotics regularly, commonly experienced adverse side effects from treatment and felt frustrated at having symptoms recur quite quickly after treatment. Issues in clinical care included inconsistency in advice, misdiagnosis and inappropriate diagnostic approaches and insensitive or dismissive attitudes. Women were more inclined to report positive clinical experiences with sexual health physicians than primary care providers. Women's frustrations led most to try their own self-help remedies and lifestyle modifications in an attempt to treat symptoms and prevent recurrences, including well-known risk practices such as douching.In the face of considerable uncertainty about the cause of BV, high rates of recurrence, unacceptable treatment options and often insensitive and inconsistent clinical management, women are trying their own self-help remedies and lifestyle modifications to prevent recurrences, often with little effect. Clinical management of BV could be improved through the use of standardised diagnostic approaches, increased sensitivity and understanding of the impact of BV, and the provision of evidence based advice about known BV related risk factors.

Mechanical behavior of nonwoven felts

OpenAIRE

Ridruejo Rodríguez, Álvaro

2011-01-01

Los fieltros son materiales fabricados a partir de agrupaciones desordenadas de fibras que se consolidan mediante enlaces de distintos tipos. Durante los últimos años las aplicaciones industriales de estos materiales han experimentado un rápido crecimiento gracias a la incorporación de nuevas fibras y procedimientos de consolidación. Con el propósito de tener una mayor perspectiva, en este estudio se han elegido dos fieltros distintos. El primero de ellos es un fieltro de fibra de vidrio unid...

Felt Quality of Sociomaterial Relations

DEFF Research Database (Denmark)

Stein, Mari-Klara; Newell, Sue; Wagner, Erica L.

2014-01-01

Sociomateriality, in helping to overcome the longstanding dualism between the social and the technical, has become an increasingly popular theoretical perspective in Information Systems (IS) research. However, while recognizing the usefulness of sociomaterial theorizing, we contend that it also...... in IS research (one founded on critical realism, and the other on agential realism), we provide researchers with the conceptual tools to generate richer practical and theoretical insights....

Do urologists and gynaecologists manage posterior compartment ...

African Journals Online (AJOL)

driven training, which occurs locally and internationally. We felt that the practice of an individual physician would reflect the overall training that he or she had received. Before commencement of this study, we hypothesised that gynaecologists would be less dependent on industry- driven surgical techniques than urologists.

Management of radioactive wastes from the nuclear fuel cycle

International Nuclear Information System (INIS)

1976-01-01

The increased emphasis in many countries on the development and utilization of nuclear power is leading to an expansion of all sectors of the nuclear fuel cycle, giving rise to important policy issues and radioactive-waste management requirements. Consequently, the IAEA and the Nuclear Energy Agency of OECD felt that it would be timely to review latest technology for the management of the radioactive wastes arising from nuclear fuel cycle facilities, to identify where important advances have been made, and to indicate those areas where further technological development is needed. Beginning in 1959, the IAEA, either by itself or jointly with OECD/NEA has held seven international symposia on the management of radioactive wastes. The last symposium, on the management of radioactive wastes from fuel reprocessing, was held jointly by the IAEA and OECD/NEA in Paris in November 1972. An objective of the 1976 symposium was to update the information presented at the previous symposia with the latest technological developments and thinking regarding the management and disposal of all categories of radioactive wastes. Consequently, although the scope of the symposium was rather broad, attention was focussed on operational experience and progress in unresolved areas of radioactive waste management. The programme dealt primarily with the solidification of liquid radioactive wastes and disposal of the products, especially the high-level fission products and actinide-containing waste from fuel reprocessing. Other topics covered policy and planning, treatment of hulls and solvent, management of plutonium-contaminated waste, and removal of gaseous radionuclides. The major topic of interest was the current state of the technology for the reduction and incorporation of the high-level radioactive liquid from fuel reprocessing into solid forms, such as calcines, glasses or ceramics, for safe interim storage and eventual disposal. The approaches to vitrification ranged from two stage

Families' perceived benefits of home visits for managing paediatric obesity outweigh the potential costs and barriers.

Science.gov (United States)

Gehring, Nicole D; Ball, Geoff D C; Perez, Arnaldo; Holt, Nicholas L; Neuman, Daniel; Spence, Nicholas; Mercier, Laura; Jetha, Mary

2018-02-01

Home visits have successfully been used to deliver various health services, but what role could they play in paediatric weight management? Low treatment initiation and high attrition prompted our multidisciplinary paediatric weight management clinic to investigate how families perceived the benefits and barriers of home visits. We focused on children with obesity aged 2-17 who were enrolled in our tertiary-level clinic in Alberta, Canada. None had received a home visit. The families were interviewed face-to-face from October 2015 to October 2016, and we used a qualitative description methodological framework and manifest content analysis. The parents were the main interviewees. Of the 56 families, 89% were interested in a home visit, 82% wanted support from a dietician and 54% from an exercise specialist. The perceived benefits of home visits included comprehensive assessment (95%), convenience (86%), tailored care (29%) and family involvement (13%), while the costs and barriers included clinicians' potential judgmental attitudes (30%), loss of privacy (19%) and distractions (10%). Some thought clinicians would find home visits inconvenient (25%), with bureaucratic challenges (14%) and sustainability issues (5%). Families felt home visits were a convenient option for managing paediatric obesity and identified important benefits and barriers that could guide such interventions. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

Experience from the third international nuclear emergency exercise (INEX 3) on consequence management

International Nuclear Information System (INIS)

2007-01-01

Since the beginning of the 1990's, the OECD Nuclear Energy Agency (NEA) has offered its member countries a forum for improving efficiency and effectiveness in nuclear emergency management, focusing in particular on the international aspects of emergency preparedness and response. A central approach to this has been the preparation and conduct of the International Nuclear Emergency Exercise (INEX) series. The INEX 3 consequence management exercises were developed by the NEA Working Party on Nuclear Emergency Matters in response to its members desire to better prepare for the longer-term response following a nuclear or radiological emergency. The INEX 3 exercise series was developed in 2002-2004, and conducted throughout 2005 and early 2006 by 15 participating countries. The INEX 3 evaluation workshop held in Paris (France) in May 2006 was convened with the objective of allowing participants to share their national experiences with INEX 3, compare approaches, analyse the implications on decision making and identify key needs in longer-term consequence management. In addition to providing a valuable discussion forum for participants, the workshop concluded by establishing a set of identified needs in longer-term consequence management to which the participants felt that the NEA and international community could usefully contribute. These included the four main areas addressed by the exercise agriculture and food countermeasures, decisions on countermeasures such as travel, trade or tourism, recovery management and public information as well as stakeholder involvement and liability/compensation issues. This report summarises the development of the INEX 3 exercise, the major evaluation outcomes of the national exercises, and the key policy-level outcomes, recommendations and follow-up activities arising from the exercise and workshop. (authors)

Current status of management, control, complications and psychosocial aspects of patients with diabetes in India: Results from the DiabCare India 2011 Study

Directory of Open Access Journals (Sweden)

Viswanathan Mohan

2014-01-01

Full Text Available Objectives: DiabCare India 2011 was a cross-sectional study in patients with diabetes mellitus, undertaken to investigate the relationship between diabetes control, management and complications in a subset of urban Indian diabetes patients treated at referral diabetes care centres in India. Materials and Methods: This was a cross-sectional, multicentre (330 centres survey in 6168 diabetes patients treated at general hospitals, diabetes clinics and referral clinics across India. Patient data, including medical and clinical examination reports during the past year were collected during their routine visit. The patients′ and physicians′ perceptions about diabetes management were recorded using a questionnaire. Results: A total of 6168 subjects with diabetes (95.8% type 2, mean age 51.9 ± 12.4 years and mean duration of diabetes, 6.9 ± 6.4 years were included. Mean HbA1c was 8.9 ± 2.1% and the mean fasting (FPG, post prandial (PPG and random (RBG plasma glucose levels were 148 ± 50 mg/dl 205 ± 66 mg/dl and 193 ± 68mg/dl respectively. Neuropathy was the most common complication (41.4%; other complications were: Foot (32.7%, eye (19.7%, cardiovascular (6.8% and nephropathy (6.2%. The number of diabetic complications increased with mean duration of diabetes. Most (93.2% of the patients were on oral anti-diabetic drugs (OADs and 35.2% were on insulin (±OADs. More than 15% physicians felt that the greatest barrier to insulin therapy from patient′s perspective were pain and fear of using injectable modality; 5.2% felt that the greatest barrier to insulin therapy from physician′s perspective was the treatment cost; 4.8% felt that the major barriers to achieve optimum diabetic care in practice was loss to follow-up followed by lack of counselling (3.9% and treatment compliance (3.6%. Conclusion: DiabCare India 2011 has shown that type 2 diabetes sets in early in Indians and glycaemic control is often sub-optimal in these patients. These

Managing anemia in low-income toddlers: barriers, challenges and context in primary care.

Science.gov (United States)

Crowell, Rebecca; Pierce, Michelle B; Ferris, Ann M; Slivka, Hilda; Joyce, Patricia; Bernstein, Bruce A; Russell-Curtis, Suzanne

2005-11-01

Iron-deficiency remains a concern among low-income toddlers in the U.S. This formative study describes how primary care providers serving high-risk 1- to 3-year-old children in an urban ambulatory care setting approach anemia. Data collection included a retrospective review of randomly selected medical records (n=264) and semi-structured interviews with clinicians (n=41). Thirty-eight percent of the children presented with anemia (Hgb variable. While providers felt clinically comfortable with anemia, they felt burdened and challenged by follow-up. Communication and system barriers weighed most heavily on perceived treatment outcomes.

Implementing Traceability Systems in Specific Supply Chain Management (SCM through Critical Success Factors (CSFs

Directory of Open Access Journals (Sweden)

Shahbaz Khan

2018-01-01

Full Text Available Traceability plays a vital role in the success of Halal Supply Chain (HSC. HSC revolve around the essential dimension of Halal Integrity (HI, whereas traceability is seemed to be medium to assure integrity. Thus, a need is felt to identify the factors which are critical to the successful implementation of traceability in Halal Supply Chain Management (HSCM. Identified Twelve Critical Success Factors (CSFs through an extensive review of literature and opinion of experts. Further, a contextual relationship among the CSFs is developed using Total Interpretive Structure Modelling (TISM approach and derived a model. The structural model is analyzed using Fuzzy MICMAC (Matrice d’Impacts Croises-Multipication Applique and Classment-cross-impact matrix multiplication applied to classification approach to identify the importance of CSFs by driving and dependence power. The primary result indicates towards; that improving the HSCM with the higher level of Halal awareness. Assuring HI will enhance the consumer satisfaction which leads to a competitive advantage for the organization. Academic researchers, industrial practitioners and Supply Chain executives can understand the complex interrelationship of CSFs by visualizing the TISM. It can help the management, lobbies and government to develop the policies regarding the implementation.

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

Science.gov (United States)

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

2009-06-01

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

The Decision Tree for Teaching Management of Uncertainty

Science.gov (United States)

Knaggs, Sara J.; And Others

1974-01-01

A 'decision tree' consists of an outline of the patient's symptoms and a logic for decision and action. It is felt that this approach to the decisionmaking process better facilitates each learner's application of his own level of knowledge and skills. (Author)

Australasian emergency physicians: a learning and educational needs analysis. Part two: confidence of FACEM for tasks and skills.

Science.gov (United States)

Paltridge, Debbie; Dent, Andrew W; Weiland, Tracey J

2008-02-01

To determine the degree of confidence perceived by Fellows of the Australasian College for Emergency Medicine for a variety of procedural, patient management, educational and research skills, and tasks that may be required of them. Mailed survey with Likert scales and grouped qualitative responses. More than 90% of emergency physicians (EP) feel usually or always confident of their skills for peripheral vascular access, procedural sedation, fluid resuscitation, tube thoracostomy, managing patients with altered conscious state, cardiac emergencies, behavioural disturbance, and interpreting acid base and other blood tests. Less than 50% felt confident performing surgical airways, ED ultrasound, managing neonatal emergencies or interpreting MRI. Of non-clinical skills, while most EP were confident of their ability to write references, debrief staff, lead group tutorials and prepare slides, a minority felt usually or always confident about budgeting and finance, preparing submissions, dealing with the media, appearing in court or marking examination papers. Whilst nearly 75% were confident about the information technology skills required of them for clinical practice, less than 25% of EP felt confident about conducting research and less than 15% were confident applying or interpreting statistics. This information may assist in the planning of future educational interventions for EP.

Predictors of disclosure management behavior at the end of 1-year follow-up in Korean adults with newly diagnosed epilepsy.

Science.gov (United States)

Lee, Sang-Ahm; No, Soon-Kee; Park, Hyungkook; Kim, Ok-Joon; Kwon, Jee-Hyun; Ryu, Ji-Yeon; Lee, Sang-Moo; Jo, Kwang-Deog

2017-09-01

Epilepsy is a concealable stigmatizing condition. We investigated the factors predicting disclosure management behavior in Korean adults with newly diagnosed epilepsy. This longitudinal multicenter study included Korean adults with newly diagnosed epilepsy. Using statistical analyses, we determined at the end of a 1-year follow-up whether Disclosure Management Scale (DMS) scores were predicted by demographic, clinical, and psychosocial variables, including felt stigma, stress coping style, personality traits, social support, and experienced discrimination from society. Of a total of 121 participants, 69% reported that they often or sometimes kept their diagnosis a secret from others and rarely or never talked to others about their epilepsy. The average DMS score was 5.8 (SD=2.9, range 0-11). In univariate analyses, DMS scores were significantly associated with an emotion-focused coping style (r=0.320, pepilepsy often or sometimes keep their epilepsy a secret. Emotion-focused coping is the most important predictor of concealment of epilepsy diagnosis at the end of a 1-year follow-up, although social support and episodes of experienced discrimination are also associated with disclosure management strategies. Copyright © 2017 Elsevier Inc. All rights reserved.

Child-management techniques. Are there differences in the way female and male pediatric dentists in Israel practice?

Directory of Open Access Journals (Sweden)

Peretz Benjamin

2003-01-01

Full Text Available The purpose of this study was to assess differences in the management techniques used by Israeli female and male pediatric dentists. All 112 participants of the meeting of the Israeli Society of Dentistry for Children that was held in February 1999 received a questionnaire which sought information regarding age, sex, behavioral and pharmacological methods used to treat children, having a course in nitrous oxide, general anesthesia, and feelings towards pediatric patients. No differences between female and male dentists were found regarding most management techniques. The majority of dentists used tell-show-do, and gave presents at the end of the appointments. Hypnosis was the least used technique. Papoose board was more prevalent among male dentists than among female dentists. Most dentists reported having the parents present during treatment, and more male dentists used their assistance when restraint was needed. General anesthesia was significantly more prevalent among males than among females (p = 0.01. One-third of the dentists reported feeling aggression toward the pediatric patient. Although not statistically significant, more female dentists reported about feeling aggression than male dentists. Most dentists felt authority towards the pediatric patient. Our findings imply that female and male dentists use similar management techniques when treating children.

A food-manufacturing manager’s experiences and perceptions of the implementation of an incentive scheme

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Celita Begbie

2011-06-01

Research purpose: Identifying the contributors to negative feelings and demotivation, or conversely, excitement and motivation, will ultimately assist managers to implement an incentive scheme to motivate staff and improve performance. Motivation for the study: There is little research on how participants perceive incentive schemes and whether or not they motivate employees and improve overall performance. Research design, approach and method: The researcher used a modernistic qualitative research approach and, more specifically, a case study. Main findings: The participants in the research were unaware of the performance goals they needed to achieve. They felt that there was no link between their performance and their earnings. They felt that some objectives were demeaning and insulting, as was the payment they received. They felt that achieving their goals was outside their control and influence. Practical/managerial implications: Participants felt excited and motivated to perform when their managers presented the department’s overall goals to them and asked the participants to set their own goals based on the department’s objectives. Contribution/value-add: Although this study is explorative and descriptive, it suggests that it is how departments implement an incentive scheme, rather than merely having one, that will motivate or demotivate employees to perform.

Chemistry indices for long term plant health management

International Nuclear Information System (INIS)

Galt, K.J.; Cerisier, S.D.M.; Caris, N.B.

1998-01-01

Eskom's Koeberg Nuclear Power Station has maintained and reported on the WANO Chemistry Performance Index for a number of years. Because of the masking effects of multiple averaging, the value of the Index was questionable. The modified WANO Chemistry Performance Indicator, introduced recently, was considered an improvement. However, it was felt that it is too general to adequately address the long-term plant health management needs of a specific plant; a more tailored, plant-specific indicator is needed. A system of indices for measuring and managing long-term plant health at Eskom's 10 large fossil-fired power stations had been developed in 1996. The major success of these indices in improving plant performance management lay in their inclusion in station performance contracts. The Fossil Chemistry Index was based on the original WANO Chemistry Performance Index and suffered from the same shortcomings. Consequently, a major revision of this index was initiated to address these deficiencies. The objectives set for the revised common indicator were that target and limit values from Eskom Chemistry Standards should be incorporated, that the masking effect of multiple averaging be minimised or eliminated, that weighting factors be introduced to reflect the relative importance of selected parameters, that conditioning chemical effectiveness be monitored, and that ranges of values be accommodated. In tandem with this revision, there was requirement to include Koeberg in the reporting of long term plant health indicators. Instead of developing completely separate chemistry indicators for fossil and nuclear plant. A commonality of approach to Long Term Plant Health indicators was sought. This has resulted in a single indicator determination, with parameter selection, limit values, and target values providing the required plant specificity. (J.P.N.)

The effect of an anger management program for family members of patients with alcohol use disorders.

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Son, Ju-Young; Choi, Yun-Jung

2010-02-01

This study was aimed to test the structured anger management nursing program for the family members of patients with alcohol use disorders (AUDs). Families with the AUDs suffer from the dysfunctional family dynamic caused by the patients' deteriorative disease processes of alcohol dependence. Family members of AUDs feel bitter and angry about the uncontrolled behaviors and relapses of the patients in spite of great effort for a long time. This chronic anger threatens the optimal function of the family as well as obstructs the family to help the patients who are suffering from AUDs. Sixty three subjects were participated who were referred from community mental health centers, alcohol consultation centers, and an alcohol hospital in Korea. Pre-post scores of the Korean Anger Expression Inventory were used to test the program. An anger management program was developed and implemented to promote anger expression and anger management for the family members of the patients with AUDs. The total anger expression score of the experimental group was significantly more reduced as compared with that of the control group. Subjects in the experimental group reported after the program that they felt more comfortable and their life was changed in a better way. The anger management program was effective to promote anger expression and anger management for family members of AUDs. Nurses need to include family members in their nursing process as well as to care of patients with AUDs to maximize nursing outcome and patient satisfaction. 2010 Elsevier Inc. All rights reserved.

Its System to Manage Parking Supply: Considerations on Application to the “Ring” in the City of Brescia

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Susanna Bulferetti

2014-05-01

Full Text Available Brescia’s downtown is outlined by link roads built up at the Venetian walls, known as “Ring. The “Ring” is characterized by high traffic flows, as well as by the presence of several paid parking lots located on and off street. Furthermore, several facilities are located on these link roads. Nowadays city of Brescia is equipped with an ITS system able to manage off street parking spaces, allowing the share of information about parking availability to potential users, through the use of variable message panels. The parking supply issue and its management are strongly felt by citizens, as well as many other cities communities, whether European or not. This contribution aims to encourage an integration of the existing ITS system for the off street parking management with additional devices, which allow to manage also the on street paid parking supply located on “Ring” roads. The minimization of so-called “shared traffic” component of traffic flows, as well as the increase of road safety, in the context of a medium-sized Italian city are the main objectives of the ITS system integration. ITS asset chosen for the Brescia case study springs from the analysis of some non-European experiences about on street parking management (for example, San Francisco and Boston and certainly can be considered suitable for the parking supply management of the whole city. It could become the main starting point in Italian cities for the application of performance based parking pricing, widely experienced in many U.S. cities.

RIKEN accelerator progress report, vol. 36. January - December 2002

International Nuclear Information System (INIS)

Asahi, K.; Abe, T.; Ichihara, T.

2003-03-01

This issue of RIKEN Accelerator Progress Report reports research activities of the RIKEN Accelerator Research Facility (RARF) during the calendar year of 2002. The research programs have been coordinated in the framework of the project entitled Multidisciplinary Researches on Heavy Ion Science. The project involves a variety of fields such as: nuclear physics, nuclear astrophysics, atomic physics, nuclear chemistry, radiation biology, condensed matter physics in terms of accelerator or radiation application, plant mutation, material characterization, application to space science, accelerator physics and engineering, laser technology, and computational technology. These activities involved ten laboratories, five Centers involving seven divisions, the RIKEN-RAL (Rutherford-Appleton Laboratory) Center, and the RBRC (RIKEN-Brookhaven Research Center at Brookhaven National Laboratory), and more than 350 researchers from domestic and foreign institutions. Thirty-six universities and institutes from within Japan and 33 institutes from 10 countries are involved. (J.P.N.)

Why do managers allocate resources to workplace health promotion programmes in countries with national health coverage?

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Downey, Angela M; Sharp, David J

2007-06-01

There is extensive evidence that worksite health promotion (WHP) programmes reduce healthcare costs and improve employee productivity. In many countries, a large proportion of healthcare costs are borne by the state. While the full benefits of WHP are still created, they are shared between employers and the state, even though the employer bears the full (after-tax) cost. Employers therefore have a lower incentive to implement WHP activity. We know little about the beliefs of managers with decision responsibility for the approval and implementation of WHP programmes in this context. This article reports the results of a study of the attitudes of Canadian senior general managers (GMs) and human resource managers (HRMs) in the auto parts industry in Ontario, Canada towards the consequences of increasing discretionary spending on WHP, using Structural Equation Modelling and the Theory of Planned Behaviour. We identified factors that explain managers' intentions to increase discretionary spending on wellness programmes. While both senior GMs and HRMs are motivated primarily by their beliefs that WHP reduces indirect costs of health failure, GMs were also motivated by their moral responsibility towards employees (but surprisingly HRMs were not). Importantly, HRMs, who usually have responsibility for WHP, felt constrained by a lack of power to commit resources. Most importantly, we found no social expectation that organizations should provide WHP programmes. This has important implications in an environment where the adoption of WHP is very limited and cost containment within the healthcare system is paramount.

Knowledge, attitudes, and practices of public sector primary health care physicians of rural north karnataka towards obesity management

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Manjunath S Somannavar

2014-01-01

Full Text Available Introduction: Obesity is a risk factor for cardiovascular disease (CVD, diabetes mellitus (DM, and hypertension (HTN. In an era of rapidly growing prevalence of obesity, it is important to explore the current knowledge, attitude, and practices of primary care physicians. Materials and Methods: Study participants were medical officers (MOs of primary health centers in three districts of North Karnataka. The questionnaire was developed by a review of literature in the field and validated with five participants for scope, length, and clarity. Results/Discussion: Of the 102 participants, only 15% were aware about the burden of obesity in India. HTN, DM, and CVD were indicated as comorbidities by 73, 78, and 60 participants, respectively. Only 25 and 12 participants indicated appropriate body mass index (BMI cut-off values for overweight and obesity diagnosis. Of the 102 participants, 54 were not aware of the guidelines for obesity management. Practices and attitudes of the participants were encouraging. Nearly all of them felt that the adults with BMI within the healthy range should be encouraged to maintain their weight and, three-fourth of them agreed that most overweight persons should be treated for weight loss and small weight loss can achieve major medical benefit. However, nearly half of the participants′ responses were stereotypical as they felt only obese and overweight with comorbidities should be treated for weight loss. Two-thirds of them use BMI to diagnose overweight/obese and nearly all of them advice their patients to increase physical activity and restrict fat. Most of the participants were advising their patients to restrict sugar intake, increase fruits and vegetable consumption, reduce red meat, and avoid alcohol consumption. Conclusion: Present study exposed the lack of knowledge regarding obesity. However, practices and attitudes of the participants were promising. There is a need of in-service training to MOs to further

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

LENUS (Irish Health Repository)

Wallace, Elaine

2012-05-25

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

Implementing a self-management strategy in inflammatory bowel disease (IBD): patient perceptions, clinical outcomes and the impact on service.

Science.gov (United States)

Squires, Seth Ian; Boal, Allan John; Lamont, Selina; Naismith, Graham D

2017-10-01

Patient self-management and its service integration is not a new concept but it may be a key component in the long-term sustainability of inflammatory bowel disease (IBD) service provision, when considering growing disease prevalence and limited resources. The IBD team at the Royal Alexandra and Vale of Leven Hospitals in the Clyde Valley region developed a self-management tool, called the 'flare card'. Patients were asked to complete a questionnaire which reflected their opinion on its viability as a self-management intervention. In addition, its utility in terms of service use over a 10-month period in 2016 was compared with a similar cohort of patients over 10 months in 2015. Patients overall felt that the 'flare card' was a viable self-management tool. Positive feedback identified that the intervention could help them aid control over their IBD, improve medication adherence, reduce symptoms and reflected a feeling of patient-centred IBD care. The comparison between 2015 and 2016 service use revealed a significant reduction in IBD and non-IBD service usage, Steroid prescribing and unscheduled IBD care in the flare card supported cohort. IBD services must continue to adapt to changes within the National Health Service bearing in mind long-term sustainability and continued care provision. The 'flare card' goes further in an attempt to optimise Crohn's disease and ulcerative colitis management by harmonising clinician evaluation and patient's self-initiation of therapy and investigation.

U.S. Geological Survey and Bureau of Land Management Cooperative Coalbed Methane Project in the Powder River Basin, Wyoming

Science.gov (United States)

,

2006-01-01

Introduction: Evidence that earthquakes threaten the Mississippi, Ohio, and Wabash River valleys of the Central United States abounds. In fact, several of the largest historical earthquakes to strike the continental United States occurred in the winter of 1811-1812 along the New Madrid seismic zone, which stretches from just west of Memphis, Tenn., into southern Illinois (fig. 1). Several times in the past century, moderate earthquakes have been widely felt in the Wabash Valley seismic zone along the southern border of Illinois and Indiana (fig. 1). Throughout the region, between 150 and 200 earthquakes are recorded annually by a network of monitoring instruments, although most are too small to be felt by people. Geologic evidence for prehistoric earthquakes throughout the region has been mounting since the late 1970s. But how significant is the threat? How likely are large earthquakes and, more importantly, what is the chance that the shaking they cause will be damaging?The Bureau of Land Management (BLM) Wyoming Reservoir Management Group and the U.S. Geological Survey (USGS) began a cooperative project in 1999 to collect technical and analytical data on coalbed methane (CBM) resources and quality of the water produced from coalbeds in the Wyoming part of the Powder River Basin. The agencies have complementary but divergent goals and these kinds of data are essential to accomplish their respective resource evaluation and management tasks. The project also addresses the general public need for information pertaining to Powder River Basin CBM resources and development. BLM needs, which relate primarily to the management of CBM resources, include improved gas content and gas in-place estimates for reservoir characterization and resource/reserve assessment, evaluation, and utilization. USGS goals include a basinwide assessment of CBM resources, an improved understanding of the nature and origin of coalbed gases and formation waters, and the development of predictive

Out-of-Hospital Surgical Airway Management: Does Scope of Practice Equal Actual Practice?

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Molly Furin

2016-05-01

Full Text Available Introduction: Pennsylvania, among other states, includes surgical airway management, or cricothyrotomy, within the paramedic scope of practice. However, there is scant literature that evaluates paramedic perception of clinical competency in cricothyrotomy. The goal of this project is to assess clinical exposure, education and self-perceived competency of ground paramedics in cricothyrotomy. Methods: Eighty-six paramedics employed by four ground emergency medical services agencies completed a 22-question written survey that assessed surgical airway attempts, training, skills verification, and perceptions about procedural competency. Descriptive statistics were used to evaluate responses. Results: Only 20% (17/86, 95% CI [11-28%] of paramedics had attempted cricothyrotomy, most (13/17 or 76%, 95% CI [53-90%] of whom had greater than 10 years experience. Most subjects (63/86 or 73%, 95% CI [64-82%] did not reply that they are well-trained to perform cricothyrotomy and less than half (34/86 or 40%, 95% CI [30-50%] felt they could correctly perform cricothyrotomy on their first attempt. Among subjects with five or more years of experience, 39/70 (56%, 95% CI [44-68%] reported 0-1 hours per year of practical cricothyrotomy training within the last five years. Half of the subjects who were able to recall (40/80, 50% 95% CI [39-61%] reported having proficiency verification for cricothyrotomy within the past five years. Conclusion: Paramedics surveyed indicated that cricothyrotomy is rarely performed, even among those with years of experience. Many paramedics felt that their training in this area is inadequate and did not feel confident to perform the procedure. Further study to determine whether to modify paramedic scope of practice and/or to develop improved educational and testing methods is warranted.

Management of gestational trophoblastic disease: a survey of New Zealand O&G practice.

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Kladnitski, Maria; Kenwright, Diane

2016-03-11

The aim of the study was to obtain information on pathways for diagnosis and management of molar pregnancy/gestational trophoblastic disease (GTD) across New Zealand, the protocols used, and, in addition, to consider the view of O&G Specialists on a national GTD reference centre. An electronic survey approved by the RANZCOG Continues Professional Development Committee was distributed amongst registered O&G Specialists currently working in New Zealand. Data were analysed using Microsoft Excel 2011. Frequency distributions were used to determine the percentage of participants responding to the listed alternatives for each question. There were 234 potential responders, but only 68 complete questionnaires were received and available for analysis. The diagnosis of GTD requires histopathological analysis of pregnancy tissue, however only 79.7% of participants request this test routinely. Sixty-five percent of Fellows thought that a number of molar pregnancies can be missed with increasing proportion of medically-managed miscarriages, reliance on ultrasound and appearance of the tissue being contributing factors. Sixty-six percent of specialists were directly involved in the management of patients with GTD to various degrees. Follow-up responsibilities were divided between designated O&G specialists (52.3%), specialised gynaecology clinics (29.2%), acute assessment units (13.8%), nurse specialists (12%), O&G registrars (10.8%), GPs (6.2%), and others (6.2%). NZGCG guidelines were used by the majority of responders (54.8%), followed by local (29%) and RCOG (27.4%) guidelines. Seventy-two percent of specialists felt that some form of centralisation in the management of GTD is needed. In spite of the low response rate, our research demonstrates existing practice heterogeneity at every level of care. It also confirms that there is a desire for some form of centralisation in diagnosis and management of GTD, and a definite need for data collection in the form of a national

Acute care simulation training for foundation doctors: the perceived impact on practice in the workplace.

Science.gov (United States)

Patel, P; Sockalingam, I

2013-01-01

High fidelity simulation allows training of foundation doctors in a safe, structured environment. We explored the perceived impact of such training on subsequent clinical practice. 82 doctors attended and 52% responded to a follow up questionnaire sent two months after their training. 88% felt better able to manage the acutely ill patient than they did before their training. All cited simulation training as a reason for this and 44% felt simulation training was the main contributor. The remainder cited clinical experience as the main contributor. 53% gave real clinical examples where they applied skills attributed to simulation training. Doctors reflected positively on simulation training sometime after the experience, demonstrated transference of learnt skills and felt more confident at work.

Cultural competency and communication skills of dental students: clinical supervisors' perceptions.

Science.gov (United States)

Mariño, R; Ghanim, A; Morgan, M; Barrow, S

2017-11-01

This study explored clinical supervisor's (CS) views and experiences of dental students' cultural competence (CC) at the Melbourne Dental School, The University of Melbourne, Australia. Additionally, this study explored CS insights into how CC could be taught. Semi-structured one-to-one interviews were organised with consenting CS. Interview topics included the following: the importance of CC, communication and rapport, the role of culture in oral health and the need for curriculum enhancement. Interviews were recorded, transcribed and thematically analysed to identify key areas using NVivo software. A total of 12 CS participated in this study. CS acknowledged the importance of CC and felt that it was important for good patient management. CS's definition of CC focused primarily on language and communication skills. CS felt that dental students were generally able to manage culturally diverse patients. However, CS indicated that additional training in this area would be beneficial. Concerns were raised about the students' ability to establish good rapport and communication, with CS highlighting areas such as misuse of interpreters and use of jargon. CS felt that clinical experience, confidence and a positive attitude are effective tools for overcoming cultural barriers. Furthermore, some CS also felt that cultural competency was a skill that is learnt through experience. For most CS, cultural competence was an important part of the clinician-patient exchange which would benefit from enhanced curriculum. They also highlighted areas where transcultural education could be improved. The majority of CS believed dental students managed culturally diverse patients well. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

"Pets Negotiable": How Do the Perspectives of Landlords and Property Managers Compare with Those of Younger Tenants with Dogs?

Science.gov (United States)

Graham, Taryn M; Milaney, Katrina J; Adams, Cindy L; Rock, Melanie J

2018-02-27

Previous research has shown that housing insecurity contributes to animal relinquishment and that tenants with dogs face disadvantages in the rental market. Still, little is known about how dog owners navigate rental markets, nor how landlords and property managers perceive dogs and other pets. This case study reports on in-depth interviews with younger tenants with dogs and on open-ended survey responses from landlords and property managers. In their housing searches, tenants with dogs reported feeling powerless in negotiations and feeling discriminated against. They described settling for substandard properties, often located in less desirable neighborhoods. Also, some said they felt obliged to stay put in these rentals, given how difficult it had been to find a place that would accommodate their dogs. Meanwhile, landlords and property managers indicated that listings advertised as "pet-friendly" tend to receive more applicants than listings in which pets are prohibited. Suggestions for improvement included meeting pets prior to signing the lease; getting everything in writing; steering clear from furnished units; charging utilities to tenants; and speeding up the pet approval process when dealing with condominium boards. These suggestions offer implications for future research, partnerships, and policy options to improve the prospects of pets and their people in rental housing.

A Quebec survey of issues in cancer pain management.

Science.gov (United States)

MacDonald, Neil; Ayoub, Joseph; Farley, Justine; Foucault, Claudette; Lesage, Pauline; Mayo, Nancy

2002-01-01

We report the results of a cancer pain survey mailed to Quebec hematologist-oncologists and palliative care physicians in 1999. The survey was designed to sample views on the current status of pain management and on obstacles to the provision of adequate pain relief for patients. The survey, formulated by an ethics network centered at the Clinical Research Institute of Montreal, was distributed to all members of the Association of Hematologist-Oncologists of Quebec and to all physician members of the Quebec Palliative Care Association. Responses were obtained from 138 Palliative Care Association members (response rate 61%) and 76 hematologist-oncologists (response rate 45%). Major obstacles reported included inadequate assessment of both contributory psychosocial issues and severity of pain, patient reluctance to take opioids, and inadequate access to non-drug techniques for pain relief. Access to opioids was not regarded as a problem. Both groups felt generally competent in their ability to manage various aspects of cancer pain therapy. They gave little credit to their formal medical school or residency training. Fifty-six percent of the palliative care group and 57% of the hemato-oncologists rated their medical school experience as only "poor" or "fair" on a 4-point scale. Residency ratings were modestly better. We conclude that medical faculties should assign a high priority to teaching health professionals patient assessment techniques. Simple symptom assessment scales should be routinely used in oncology/palliative care practice. Medical school training in pain management is not highly regarded and should be enhanced. We also note that, based on response to the scenario of a patient presenting with severe pain, many physicians, while feeling competent in the use of opioids, may be overly conservative in their initial use.

Research nurse manager perceptions about research activities performed by non-nurse clinical research coordinators.

Science.gov (United States)

Jones, Carolynn Thomas; Hastings, Clare; Wilson, Lynda Law

2015-01-01

There has been limited research to document differences in roles between nurses and non-nurses who assume clinical research coordination and management roles. Several authors have suggested that there is no acknowledged guidance for the licensure requirements for research study coordinators and that some non-nurse research coordinators may be assuming roles that are outside of their legal scopes of practice. There is a need for further research on issues related to the delegation of clinical research activities to non-nurses. This study used nominal group process focus groups to identify perceptions of experienced research nurse managers at an academic health science center in the Southern United States about the clinical research activities that are being performed by non-nurse clinical research coordinators without supervision that they believed should only be performed by a nurse or under the supervision of a nurse. A total of 13 research nurse managers volunteered to be contacted about the study. Of those, 8 participated in two separate nominal group process focus group sessions. The group members initially identified 22 activities that they felt should only be performed by a nurse or under the direct supervision of a nurse. After discussion and clarification of results, activities were combined into 12 categories of clinical research activities that participants believed should only be performed by a nurse or under the direct supervision of a nurse. Copyright © 2015 Elsevier Inc. All rights reserved.

Pressure reducing capacity of felt: a feasibility study using a new portable system with thin sensors.

Science.gov (United States)

Deschamps, Kevin; Messier, Benjamin

2015-03-01

Pressure redistribution and off-loading is a vital component in the management of the foot in diabetes. In the present study, a new portable system encompassing thin piezoresistors was tested for clinical utility and efficacy with respect to a commonly used pressure relieving dressing for the foot in diabetes. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Meeting the expectations of chronic tinnitus patients: comparison of a structured group therapy program for tinnitus management with a problem-solving group.

Science.gov (United States)

Wise, K; Rief, W; Goebel, G

1998-06-01

Two different group treatments were evaluated in 144 in-patients suffering from impairment due to chronic tinnitus. A tinnitus management therapy (TMT) was developed using principles of cognitive-behavioral therapy and compared with problem solving group therapy. Self-ratings were used to evaluate the help patients found in dealing with life problems and tinnitus as well as the degree to which they felt they were being properly treated and taken seriously. Patients showed significantly more satisfaction with the TMT group and evaluated the help they found in coping with tinnitus and life problems significantly higher. Thus, in the light of unsatisfactory medical solutions and the poor acceptance of some psychological treatments for tinnitus, TMT appears to be an acceptable and helpful treatment program.

Foot care education and self management behaviors in diverse veterans with diabetes

Directory of Open Access Journals (Sweden)

Jonathan M Olson

2009-01-01

Full Text Available Jonathan M Olson1, Molly T Hogan2, Leonard M Pogach3, Mangala Rajan3, Gregory J Raugi4, Gayle E Reiber51University of Washington School of Medicine, Seattle, WA, USA; 2Department of Internal Medicine, University of Washington School of Medicine, Seattle, WA, USA; 3Department of Veterans Affairs, New Jersey Healthcare System, Center for Healthcare Knowledge Management, East Orange, NJ, USA; 4Division of Dermatology, VA Puget Sound Healthcare System, Department of Veterans Affairs, Seattle, WA, USA; 5Research and Development, VA Puget Sound Healthcare System, Department of Veterans Affairs, Seattle, WA, USAAbstract: The objective of this study was to examine differences in self-reported diabetes foot care education, self management behaviors, and barriers to good foot care among veterans with diabetes by race and ethnicity. Data was collected using the Veterans Health Administration Footcare Survey, a validated tool that assessed demographic, general health, diabetes and foot self-care information, barriers to foot self-care, receipt of professional foot care, and satisfaction with current care. We mailed surveys to a random sample of patients with diabetes from eight VA medical centers. Study participants were 81% White; 13% African American; 4% Asian, and 2% American Indian and Pacific Islanders. The majority of respondents felt that they did not know enough about foot self-care. There were large gaps between self-reported knowledge and actual foot care practices, even among those who reported “knowing enough” on a given topic. There were significant differences in self-reported foot care behaviors and education by race and ethnicity. These findings document the need for culturally-specific self-management education to address unique cultural preferences and barriers to care.Keywords: diabetes mellitus, diabetic foot, patient self-management, ethnic groups, education

“Pets Negotiable”: How Do the Perspectives of Landlords and Property Managers Compare with Those of Younger Tenants with Dogs?

Directory of Open Access Journals (Sweden)

Taryn M. Graham

2018-02-01

Full Text Available Previous research has shown that housing insecurity contributes to animal relinquishment and that tenants with dogs face disadvantages in the rental market. Still, little is known about how dog owners navigate rental markets, nor how landlords and property managers perceive dogs and other pets. This case study reports on in-depth interviews with younger tenants with dogs and on open-ended survey responses from landlords and property managers. In their housing searches, tenants with dogs reported feeling powerless in negotiations and feeling discriminated against. They described settling for substandard properties, often located in less desirable neighborhoods. Also, some said they felt obliged to stay put in these rentals, given how difficult it had been to find a place that would accommodate their dogs. Meanwhile, landlords and property managers indicated that listings advertised as “pet-friendly” tend to receive more applicants than listings in which pets are prohibited. Suggestions for improvement included meeting pets prior to signing the lease; getting everything in writing; steering clear from furnished units; charging utilities to tenants; and speeding up the pet approval process when dealing with condominium boards. These suggestions offer implications for future research, partnerships, and policy options to improve the prospects of pets and their people in rental housing.

Friendship with a robot: Children's perception of similarity between a robot's physical and virtual embodiment that supports diabetes self-management.

Science.gov (United States)

Sinoo, Claudia; van der Pal, Sylvia; Blanson Henkemans, Olivier A; Keizer, Anouk; Bierman, Bert P B; Looije, Rosemarijn; Neerincx, Mark A

2018-02-21

The PAL project develops a conversational agent with a physical (robot) and virtual (avatar) embodiment to support diabetes self-management of children ubiquitously. This paper assesses 1) the effect of perceived similarity between robot and avatar on children's' friendship towards the avatar, and 2) the effect of this friendship on usability of a self-management application containing the avatar (a) and children's motivation to play with it (b). During a four-day diabetes camp in the Netherlands, 21 children participated in interactions with both agent embodiments. Questionnaires measured perceived similarity, friendship, motivation to play with the app and its usability. Children felt stronger friendship towards the physical robot than towards the avatar. The more children perceived the robot and its avatar as the same agency, the stronger their friendship with the avatar was. The stronger their friendship with the avatar, the more they were motivated to play with the app and the higher the app scored on usability. The combination of physical and virtual embodiments seems to provide a unique opportunity for building ubiquitous long-term child-agent friendships. an avatar complementing a physical robot in health care could increase children's motivation and adherence to use self-management support systems. Copyright © 2018 Elsevier B.V. All rights reserved.

Managing a Bone Healthy Lifestyle After Attending Multifaceted Group Education

DEFF Research Database (Denmark)

Jensen, Annesofie Lunde; Lomborg, Kirsten; Langdahl, Bente Lomholt

2016-01-01

more on how to implement osteoporosis preventive actions or activities. Participants who felt confident on how to act and experienced a clear need and motivation, or who could make the preventive activity into a social event, demonstrated an increased implementation of the preventive activity...

Management of hypertension in an Australian community pharmacy setting - patients' beliefs and perspectives.

Science.gov (United States)

Bajorek, Beata V; LeMay, Kate S; Magin, Parker J; Roberts, Christopher; Krass, Ines; Armour, Carol L

2017-08-01

To explore patients' perspectives and experiences following a trial of a pharmacist-led service in hypertension management. A qualitative study comprising individual interviews was conducted. Patients of a community pharmacy, where a pharmacist-led hypertension management service had been trialled in selected metropolitan regions in Sydney (Australia), were recruited to the study. Emergent themes describing patients' experiences and perspectives on the service were elicited via thematic analysis (using manual inductive coding). Patients' (N = 18) experiences of the service were extremely positive, especially around pharmacists' monitoring of blood pressure and provision of advice about medication adherence. Patients' participation in the service was based on their trust in, and relationship with, their pharmacist. The perception of working in a 'team' was conveyed through the pharmacist's caring style of communication and the relaxed atmosphere of the community pharmacy. Patients felt that the community pharmacy was an obvious place for such a service because of their regular contact with the pharmacist, but was limited because the pharmacists were not able to prescribe medication. Patients were extremely positive about the role of, and their experience of, the pharmacy-based hypertension management service. Factors contributing to the patients' positive experiences provide important insights for community pharmacy practice. Good rapport with the pharmacist and a long-term relationship underpin patient engagement in such services. Restrictions on the pharmacists' scope of practice prevent their expertise, and the benefits of their accessibility as a primary point of contact, from being fully realised. © 2016 Royal Pharmaceutical Society.

Retention of health workers in Malawi: perspectives of health workers and district management.

Science.gov (United States)

Manafa, Ogenna; McAuliffe, Eilish; Maseko, Fresier; Bowie, Cameron; MacLachlan, Malcolm; Normand, Charles

2009-07-28

provision of job descriptions were not present in many cases. Health workers felt that they were inadequately supervised, with no feedback on performance. In contrast to health workers, managers did not perceive these human resources management deficiencies in the system as having an impact on motivation. A strong human resource management function operating at the district level is likely to improve worker motivation and performance.

Retention of health workers in Malawi: perspectives of health workers and district management

Directory of Open Access Journals (Sweden)

MacLachlan Malcolm

2009-07-01

management practices such as performance appraisal and the provision of job descriptions were not present in many cases. Health workers felt that they were inadequately supervised, with no feedback on performance. In contrast to health workers, managers did not perceive these human resources management deficiencies in the system as having an impact on motivation. Conclusion A strong human resource management function operating at the district level is likely to improve worker motivation and performance.

2016 American Thyroid Association Guidelines for Diagnosis and Management of Hyperthyroidism and Other Causes of Thyrotoxicosis.

Science.gov (United States)

Ross, Douglas S; Burch, Henry B; Cooper, David S; Greenlee, M Carol; Laurberg, Peter; Maia, Ana Luiza; Rivkees, Scott A; Samuels, Mary; Sosa, Julie Ann; Stan, Marius N; Walter, Martin A

2016-10-01

Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This document describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspecialty physicians and others providing care for patients with this condition. The American Thyroid Association (ATA) previously cosponsored guidelines for the management of thyrotoxicosis that were published in 2011. Considerable new literature has been published since then, and the ATA felt updated evidence-based guidelines were needed. The association assembled a task force of expert clinicians who authored this report. They examined relevant literature using a systematic PubMed search supplemented with additional published materials. An evidence-based medicine approach that incorporated the knowledge and experience of the panel was used to update the 2011 text and recommendations. The strength of the recommendations and the quality of evidence supporting them were rated according to the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation Group. Clinical topics addressed include the initial evaluation and management of thyrotoxicosis; management of Graves' hyperthyroidism using radioactive iodine, antithyroid drugs, or surgery; management of toxic multinodular goiter or toxic adenoma using radioactive iodine or surgery; Graves' disease in children, adolescents, or pregnant patients; subclinical hyperthyroidism; hyperthyroidism in patients with Graves' orbitopathy; and management of other miscellaneous causes of thyrotoxicosis. New paradigms since publication of the 2011 guidelines are presented for the evaluation of the etiology of thyrotoxicosis, the management of Graves' hyperthyroidism with antithyroid drugs, the management of pregnant hyperthyroid patients, and the

Integration of nidotherapy into the management of mental illness and antisocial personality: a qualitative study.

Science.gov (United States)

Spencer, Sarah-Jane; Rutter, Deborah; Tyrer, Peter

2010-01-01

Nidotherapy is a new treatment aimed at the systematic alteration of the environment in order to make a better fit for a person with chronic mental health difficulties. Preliminary work has suggested that it might have particular value in those with antisocial personality disorder. To examine the views of patients with mental illness combined with antisocial personality features about the acceptability and value of nidotherapy when given over a six-month period as an adjunct to conventional care. A two-phase study was used. First, a set of key informant interviews was carried out to determine how nidotherapy was perceived in order to identify potentially important themes. Specific topic guides derived from these themes were drawn up for use in the second stage of the study, involving semi-structured interviews with a sample of patients, members of their care teams and their nidotherapists. Nine patients were purposively selected to ensure that a range of demographic and clinical factors was covered. Analysis of the results showed that the common threads of the perception of nidotherapy were that it was both feasible and acceptable to those with antisocial personality disturbance and that the nidotherapists were felt to be valuable allies in what was otherwise seen as a hostile world. It was also seen to improve adherence to other therapies. It was much less valuable when the staff on the clinical teams were not able to embrace the collaborative approach necessary with this therapy. Nidotherapy is an acceptable form of management and was perceived in this study to have largely positive results for both patients and clinical teams as it offered intervention beyond that provided by conventional teams. It was felt to require more than six months of treatment and was less successful when there was inadequate communication between the nidotherapist and clinical teams and when the philosophy of care was not congruent.

A Required Rotation in Clinical Laboratory Management for Pathology Residents: Five-Year Experience at Hofstra Northwell School of Medicine.

Science.gov (United States)

Rishi, Arvind; Hoda, Syed T; Crawford, James M

2016-01-01

Leadership and management training during pathology residency have been identified repeatedly by employers as insufficient. A 1-month rotation in clinical laboratory management (CLM) was created for third-year pathology residents. We report on our experience and assess the value of this rotation. The rotation was one-half observational and one-half active. The observational component involved being a member of department and laboratory service line leadership, both at the departmental and institutional level. Observational participation enabled learning of both the content and principles of leadership and management activities. The active half of the rotation was performance of a project intended to advance the strategic trajectory of the department and laboratory service line. In our program that matriculates 4 residents per year, 20 residents participated from April 2010 through December 2015. Their projects either activated a new priority area or helped propel an existing strategic priority forward. Of the 16 resident graduates who had obtained their first employment or a fellowship position, 9 responded to an assessment survey. The majority of respondents (5/9) felt that the rotation significantly contributed to their ability to compete for a fellowship or their first employment position. The top reported benefits of the rotation included people management; communication with staff, departmental, and institutional leadership; and involvement in department and institutional meetings and task groups. Our 5-year experience demonstrates both the successful principles by which the CLM rotation can be established and the high value of this rotation to residency graduates.

Technology-assisted self-testing and management of oral anticoagulation therapy: a qualitative patient-focused study.

Science.gov (United States)

Kuljis, Jasna; Money, Arthur G; Perry, Mark; Barnett, Julie; Young, Terry

2017-09-01

Oral anticoagulation therapy requires regular blood testing to ensure therapeutic levels are maintained and excessive bleeding/clotting is avoided. Technology-assisted self-testing and management is seen as one of the key areas in which quality of care can be improved whilst reducing costs. Nevertheless, levels of patient engagement in self-testing and management remain low. To date, little research emphasis has been placed on understanding the patients' perspectives for low engagement. The typical approach adopted by healthcare providers is to provide patient education programmes, with the expectation that individual patients will change their behaviour and adopt new self-care strategies. However, if levels of patient engagement are to be increased, healthcare providers must also develop a better understanding of how their clinical service provision is perceived by patients and make adaptations. To explore patient views, needs and expectations of an anticoagulation service and the self-testing and management services provided. Interviews were conducted with 17 patients who currently engage in international normalised ratio (INR) self-testing and management. Thematic coding and analysis were carried out on the interview transcripts. Four high-level themes emerged from interviews: (i) role of clinic, (ii) motivations for self-testing, (iii) managing INR and (iv) trust. The clinic was seen as adding value in terms of specifying testing frequency, dosage profiles and calibrating equipment. Prompt communication from clinic to patient was also valued, although more personalised/real-time communication would help avoid feelings of isolation. Patients felt more in control as self-tester/managers and often took decisions about treatment adjustments themselves. However, some also manipulated their own test results to avoid 'unnecessary' interventions. More personalised/real-time communication, pragmatic and collaborative patient-clinician partnerships and recognition of

Perspectives of patients with haematological cancer on how clinicians meet their information needs: "Managing" information versus "giving" it.

Science.gov (United States)

Atherton, Kirsten; Young, Bridget; Kalakonda, Nagesh; Salmon, Peter

2018-03-23

Practitioners treating patients with haematological cancers have extensive clinical information available to give to patients, and patients need to be informed. However, many patients want to be protected from having information that is too detailed or threatening. To illuminate how practitioners can address this dilemma and help patients feel appropriately informed, we explored patients' experience of feeling informed or uninformed. Semi-structured interviews were conducted with 20 patients who had been diagnosed with haematological cancer and had recently received results from clinical investigations or from evaluations of treatment response. Inductive and interpretive analysis of the transcribed audio-recorded interviews drew on constant comparison. Patients described the need for practitioners carefully to manage the information that they provided, and many felt alarmed by information that they did not experience as having been managed for them. A few patients who had difficulty trusting practitioners were not content with the information provided. These findings can be understood using attachment theory, whereby practitioners' careful management of information demonstrates their care for patients, and patients' trust in the practitioner enables them to feel informed. It follows that, when patients do not feel informed, the solution will not necessarily be more information but might be to help patients feel more secure in a caring clinical relationship. Copyright © 2018 John Wiley & Sons, Ltd.

Antologi om Visuelle Felt-& Analyse Metoder

DEFF Research Database (Denmark)

Lundberg, Pia

andet baseret på det poetiske princip, af Edgar Allan Poe, som blev udgivet posthumt i 1850. Derudover anvendes antropologerne Victor Turner & Edward Bruners teoretiske arbejder om forskellige kulturæstetiske fænomener og udtryk (fx Bruner 1986). Sidst men ikke mindst anvendes de kulturvidenskabelige...

Med Wacquant i det ghettopolitiske felt

DEFF Research Database (Denmark)

Schultz Larsen, Troels

2011-01-01

og de danske forsømte boligområder indtager samme position i det (bolig)sociale hierarki og dermed kan betegnes som homologe, er de historisk, socialt, politisk og strukturelt betinget af væsentligt forskellige årsager. Som erstatning for ”ghetto”-begrebet anføres i stedet begrebet ”de forsømte...

Evaluation of a simple, non-surgical concept for management of urinary incontinence (minimal care) in an open-access, interdisciplinary incontinence clinic

DEFF Research Database (Denmark)

Sander, P; Mouritsen, L; Andersen, J T

2000-01-01

influence on lower urinary tract function. More than half of the patients had urge or mixed incontinence. Most of the patients were managed with conservative treatment. Fifteen percent were referred to in-hospital treatment, with 5% to incontinence surgery. In total 44% felt cured or very much improved......Our objective was to evaluate a new concept for assessment and treatment of urinary incontinence in an open-access, interdisciplinary incontinence clinic. A standardized program for investigation and treatment of incontinence was based on minimal relevant investigations, primarily non......-surgical treatment with a limited consumption of resources ("minimal care"). This was a prospective observational study of 408 consecutive women examined and treated in the clinic. The main characteristics of the women were a high median age and a high prevalence of severe concomitant diseases with possible...

Spirituality and business : Exploring possibilities for a new management paradigm

NARCIS (Netherlands)

Nandram, S.S.; Borden, M.E.

2009-01-01

The effects of globalization influence corporate life and entrepreneurial culture and the implications are felt, directly or indirectly, by every world citizen. This book examines our inevitable relationship with business and the drives behind the way we do business. In a nutshell: ‘me and mine’ or

Y2K medical disaster preparedness in New York City: confidence of emergency department directors in their ability to respond.

Science.gov (United States)

Silber, S H; Oster, N; Simmons, B; Garrett, C

2001-01-01

To study the preparedness New York City for large scale medical disasters using the Year 2000 (Y2K) New Years Eve weekend as a model. Surveys were sent to the directors of 51 of the 9-1-1-receiving hospitals in New York City before and after the Y2K weekend. Inquiries were made regarding hospital activities, contingencies, protocols, and confidence levels in the ability to manage critical incidents, including weapons of mass destruction (WMD) events. Additional information was collected from New York City governmental agencies regarding their coordination and preparedness. The pre-Y2K survey identified that 97.8% had contingencies for loss of essential services, 87.0% instituted their disaster plan in advance, 90.0% utilized an Incident Command System, and 73.9% had a live, mock Y2K drill. Potential terrorism influenced Y2K preparedness in 84.8%. The post-Y2K survey indicated that the threat of terrorism influenced future preparedness in 73.3%; 73.3% had specific protocols for chemical; 62.2% for biological events; 51.1% were not or only slightly confident in their ability to manage any potential WMD incidents; and 62.2% felt very or moderately confident in their ability to manage victims of a chemical event, but only 35.6% felt similarly about victims of a biological incident. Moreover, 80% felt there should be government standards for hospital preparedness for events involving WMD, and 84% felt there should be government standards for personal protective and DECON equipment. In addition, 82.2% would require a moderate to significant amount of funding to effect the standards. Citywide disaster management was coordinated through the Mayor's Office of Emergency Management. Although hospitals were on a heightened state of alert, emergency department directors were not confident in their ability to evaluate and manage victims of WMD incidents, especially biological exposures. The New York City experience is an example for the rest of the nation to underscore the need

Project management for profit a failsafe guide to keeping projects on track and on budget

CERN Document Server

Knight, Joe; Angus, Brad; Case, John

2012-01-01

If your work involves projects, then this book is for you. It will show every company owner and project manager—at businesses large and small—how to run projects differently. You’ll benefit if you’ve ever: • been over budget on a project • exceeded a timeline on a project • worked on a project that completely stalled as you neared the finish line • lost money on a sure-thing project and had no idea why • noticed that scope and feature creep held you back • watched a project take three times as long as planned • felt too embarrassed to perform a review of your successes and failures • wondered whether your project actually made any money By the time you finish the book, you’ll be ready to implement Project Management for Profit in your own company—and be prepared to keep your projects on track and on budget.

Perception of quality control by personnel in diagnostic radiology ...

African Journals Online (AJOL)

This situation may be due to the perceived lack of interest and lack of cooperation from management of their facilities.The personnel also felt that they did not have sufficient training to implement QC and that QC results were difficult to analyse. Keywords: perception, quality control, personnel, management, diagnostic ...

Diagnosis and management of perinatal depression and anxiety in general practice: a meta-synthesis of qualitative studies.

Science.gov (United States)

Ford, Elizabeth; Lee, Suzanne; Shakespeare, Judy; Ayers, Susan

2017-08-01

Up to 20% of women experience anxiety and depression during the perinatal period. In the UK, management of perinatal mental health falls under the remit of GPs. This review aimed at synthesising the available information from qualitative studies on GPs' attitudes, recognition, and management of perinatal anxiety and depression. Meta-synthesis of the available published qualitative evidence on GPs' recognition and management of perinatal anxiety and depression. A systematic search was conducted on Embase, Medline, PsycInfo, Pubmed, Scopus, and Web of Science, and grey literature was searched using Google, Google Scholar, and British Library EThOS. Papers and reports were eligible for inclusion if they reported qualitatively on GPs' diagnosis or treatment of perinatal anxiety or depression. The synthesis was constructed using meta-ethnography. Five themes were established from five eligible papers: labels: diagnosing depression; clinical judgement versus guidelines; care and management; use of medication; and isolation: the role of other professionals. GPs considered perinatal depression to be a psychosocial phenomenon, and were reluctant to label disorders and medicalise distress. GPs relied on their own clinical judgement more than guidelines. They reported helping patients make informed choices about treatment, and inviting them back regularly for GP visits. GPs sometimes felt isolated when dealing with perinatal mental health issues. GPs often do not have timely access to appropriate psychological therapies and use several strategies to mitigate this shortfall. Training must focus on these issues and must be evaluated to consider whether this makes a difference to outcomes for patients. © British Journal of General Practice 2017.

Challenges in managing telemedicine centers in remote tribal hilly areas of Uttarakhand

Directory of Open Access Journals (Sweden)

S Suresh

2013-12-01

Full Text Available Background: Healthcare Information Technology advances in the Information, Communication and Telecommunication (ICT sector have made telemedicine a common and alternate medical service delivery in remote areas. Indian Space and Research Organization (ISRO established village resource centers managed by Non-government Organizations (NGO’s all over the country in 2010. While ISRO provided satellite connectivity and required equipment for communication, tele-education, and telemedicine in Uttarakhand, Himalayan Institute Hospital Trust provided primary health care through tele-consultation to remote tribal hilly areas through village resource centers. This paper features the technical and financial challenges faced in providing tele-consultation. Methods: A cross-sectional study of 115 clients, 4 health supervisors and co-ordinating doctor from three districts was done using semi-structured questionnaires for interview. Parameters at both doctor’s and patients’ end for communication, costs involved, quality of doctor-patient interaction and patient satisfaction from Tele-consultation sessions were assessed. Results: Video quality was more satisfactory than audio. The physical presence of a doctor was felt necessary only in 33/115 (30% of the time. The average cost for telemedicine consultation works out to just Rs. 15 per patient. Around 48.7% of the queries were processed in less than 10 minutes of satellite time. Around 67% of the beneficiaries felt that their privacy was not maintained as per their expectations.  The request to extend the timing of the session was made by 85% of the clients. Conclusions: Long periods of non- connectivity due to satellite failure, lack of technical staff, lack of patient’s privacy during sessions, lack of income generation for self-sustainability, were the major challenges faced. However many patients benefitted, did not have to travel long distances for medical advice and easy follow ups were

Ethical communication in clinical trials. Issues faced by data managers in obtaining informed consent.

Science.gov (United States)

Loh, Winnie Y; Butow, Phyllis N; Brown, Richard F; Boyle, Frances

2002-12-01

Informed consent has been proposed as the optimal method for ensuring the ethical entry of patients into clinical trials. However, it is known that problems with informed consent exist from the perspective of both patients and physicians. This has led to the suggestion that a third party, such as a research nurse or data manager, should be responsible for obtaining informed consent. The objective of this study was to explore the views of data managers concerning the nature, challenges, and rewards of their role and the similarities and differences between their role and that of physicians in obtaining informed consent. Four focus groups in three large teaching hospitals were conducted. Twenty-one data managers who were involved in cancer or pain clinical trials participated. The focus groups were audiotaped, transcribed, and subjected to content analysis to identify themes. Data managers identified three primary roles complementary to that of physicians: information provision, quality assurance of the informed consent process, and ongoing support during the trial. Despite expressed concern that medical and drug company interests may lead to subtle coercion of the patient, participants did not support the notion that they may be solely responsible for the consent process. Participants described a range of ethical dilemmas they confronted, including patients asking them for medical details they could not provide and situations in which they felt that informed consent was compromised in some way, for example, dealing with situations in which the patient appeared to be entering the trial for the wrong reasons due to misunderstanding, need, or passivity. Effective functioning of the multidisciplinary team assisted data managers in performing their role. A range of training needs were identified, particularly communication skills training and trial start-up briefing. The issues raised by these data managers have important implications for the successful conduct of

Barriers and outcomes of an evidence-based approach to diagnosis and management of chronic obstructive pulmonary disease (COPD) in Australia: a qualitative study.

Science.gov (United States)

Dennis, Sarah; Reddel, Helen K; Middleton, Sandy; Hasan, Iqbal; Hermiz, Oshana; Phillips, Rosemary; Crockett, Alan J; Vagholkar, Sanjyot; Marks, Guy B; Zwar, Nicholas

2017-08-01

Chronic obstructive pulmonary disease (COPD) is commonly managed in primary care but there is poor awareness of evidence-based guidelines and the quality and interpretation of spirometry is suboptimal. The aims of this qualitative study were to explore how an intervention involving case finding and management of COPD was implemented, and the extent to which the GPs and practice nurses (PNs) worked in partnership to diagnose and manage COPD. Semi-structured interviews with PNs (n = 7), GPs (n = 4) and patients (n = 26) who had participated in the Primary care EarLy Intervention for Copd mANagement (PELICAN) study. The Theoretical Domains Framework was used to guide the coding and analysis of the interviews with PN and GPs. The patient interviews were analysed thematically. PNs developed technical skills and understood the requirements for good-quality spirometry. However, many lacked confidence in its interpretation and felt this was not part of their professional role. This was reflected in responses from the GPs. Once COPD was diagnosed, the GPs tended to manage the patients with the PNs less involved. This was in contrast with PNs' active role in managing patients with other chronic diseases such as diabetes. The extent to which the GPs and PNs worked in partnership to manage COPD varied. PNs improved their skills and confidence in performing spirometry. Beliefs about their professional role, identity and confidence influenced the extent to which PNs were involved in interpretation of the spirometry results and managing the patient in partnership with the GP. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

MANIKIN DEMONSTRATION IN TEACHING CONSERVATIVE MANAGEMENT OF POSTPARTUM HAEMORRHAGE: A COMPARISON WITH CONVENTIONAL METHODS

Directory of Open Access Journals (Sweden)

Sathi Mangalam Saraswathi

2016-07-01

Full Text Available BACKGROUND Even though there are many innovative methods to make classes more interesting and effective, in my department, topics are taught mainly by didactic lectures. This study attempts to compare the effectiveness of manikin demonstration and didactic lectures in teaching conservative management of post-partum haemorrhage. OBJECTIVE To compare the effectiveness of manikin demonstration and didactic lectures in teaching conservative management of postpartum haemorrhage. MATERIALS AND METHODS This is an observational study. Eighty four ninth-semester MBBS students posted in Department of Obstetrics and Gynaecology, Government Medical College, Kottayam were selected. They were divided into 2 groups by lottery method. Pre-test was conducted for both groups. Group A was taught by manikin demonstration. Group B was taught by didactic lecture. Feedback response from the students collected after demonstration class was analysed. Post-test was conducted for both the groups after one week. Gain in knowledge of both the groups were calculated from pre-test and post-test scores and compared by Independent sample t test. RESULTS The mean gain in knowledge in group A was 6.4 when compared to group B which is 4.3 and the difference was found to be statistically significant. All of the students in group A felt satisfied and more confident after the class and wanted more topics to be taken by demonstration. CONCLUSION Manikin demonstration class is more effective in teaching conservative management of post-partum haemorrhage and this method can be adopted to teach similar topics in clinical subjects.

Review of American Thyroid Association guidelines for diagnosis and management of hyperthyroidism and other causes of thyrotoxicosis.

Directory of Open Access Journals (Sweden)

Valentin V. Fadeyev

2017-12-01

Full Text Available Thyrotoxicosis has multiple etiologies, manifestations, and potential therapies. Appropriate treatment requires an accurate diagnosis and is influenced by coexisting medical conditions and patient preference. This document describes evidence-based clinical guidelines for the management of thyrotoxicosis that would be useful to generalist and subspecialty physicians and others providing care for patients with this condition. The American Thyroid Association (ATA previously cosponsored guidelines for the management of thyrotoxicosis that were published in 2011. Considerable new literature has been published since then, and the ATA felt updated evidence-based guidelines were needed. The association assembled a task force of expert clinicians who authored this report. They examined relevant literature using a systematic PubMed search supplemented with additional published materials. An evidence-based medicine approach that incorporated the knowledge and experience of the panel was used to update the 2011 text and recommendations. The strength of the recommendations and the quality of evidence supporting them were rated according to the approach recommended by the Grading of Recommendations, Assessment, Development, and Evaluation Group. Clinical topics addressed include the initial evaluation and management of thyrotoxicosis; management of Graves’ hyperthyroidism using radioactive iodine, antithyroid drugs, or surgery; management of toxic multinodular goiter or toxic adenoma using radioactive iodine or surgery; Graves’ disease in children, adolescents, or pregnant patients; subclinical hyperthyroidism; hyperthyroidism in patients with Graves’ orbitopathy; and management of other miscellaneous causes of thyrotoxicosis. New paradigms since publication of the 2011 guidelines are presented for the evaluation of the etiology of thyrotoxicosis, the management of Graves’ hyperthyroidism with antithyroid drugs, the management of pregnant

Perceptions of Barriers to Effective Obesity Care: Results from the National ACTION Study.

Science.gov (United States)

Kaplan, Lee M; Golden, Angela; Jinnett, Kimberly; Kolotkin, Ronette L; Kyle, Theodore K; Look, Michelle; Nadglowski, Joseph; O'Neil, Patrick M; Parry, Thomas; Tomaszewski, Kenneth J; Stevenin, Boris; Lilleøre, Søren Kruse; Dhurandhar, Nikhil V

2018-01-01

ACTION (Awareness, Care, and Treatment in Obesity maNagement) examined obesity-related perceptions, attitudes, and behaviors among people with obesity (PwO), health care providers (HCPs), and employer representatives (ERs). A total of 3,008 adult PwO (BMI ≥ 30 by self-reported height and weight), 606 HCPs, and 153 ERs completed surveys in a cross-sectional design. Despite several weight loss (WL) attempts, only 23% of PwO reported 10% WL during the previous 3 years. Many PwO (65%) recognized obesity as a disease, but only 54% worried their weight may affect future health. Most PwO (82%) felt "completely" responsible for WL; 72% of HCPs felt responsible for contributing to WL efforts; few ERs (18%) felt even partially responsible. Only 50% of PwO saw themselves as "obese," and 55% reported receiving a formal diagnosis of obesity. Despite HCPs' reported comfort with weight-related conversations, time constraints deprioritized these efforts. Only 24% of PwO had a scheduled follow-up to initial weight-related conversations. Few PwO (17%) perceived employer-sponsored wellness offerings as helpful in supporting WL. Although generally perceived as a disease, obesity is not commonly treated as such. Divergence in perceptions and attitudes potentially hinders better management. This study highlights inconsistent understanding of the impact of obesity and need for both self-directed and medical management. © 2017 The Obesity Society.

Managing for climate change on federal lands of the western United States: perceived usefulness of climate science, effectiveness of adaptation strategies, and barriers to implementation

Directory of Open Access Journals (Sweden)

Kerry B. Kemp

2015-06-01

Full Text Available Recent mandates in the United States require federal agencies to incorporate climate change science into land management planning efforts. These mandates target possible adaptation and mitigation strategies. However, the degree to which climate change is actively being considered in agency planning and management decisions is largely unknown. We explored the usefulness of climate change science for federal resource managers, focusing on the efficacy of potential adaptation strategies and barriers limiting the use of climate change science in adaptation efforts. Our study was conducted in the northern Rocky Mountains region of the western United States, where we interacted with 77 U.S. Forest Service and Bureau of Land Management personnel through surveys, semistructured interviews, and four collaborative workshops at locations across Idaho and Montana. We used a mixed-methods approach to evaluate managers' perceptions about adapting to and mitigating for climate change. Although resource managers incorporate general language about climate change in regional and landscape-level planning documents, they are currently not planning on-the-ground adaptation or mitigation projects. However, managers felt that their organizations were most likely to adapt to climate change through use of existing management strategies that are already widely implemented for other non climate-related management goals. These existing strategies, (e.g., thinning and prescribed burning are perceived as more feasible than new climate-specific methods (e.g., assisted migration because they already have public and agency support, accomplish multiple goals, and require less anticipation of the future timing and probability of climate change impacts. Participants reported that the most common barriers to using climate change information included a lack of management-relevant climate change science, inconsistent agency guidance, and insufficient time and resources to access

Management of chronic kidney disease–mineral and bone disorder: Korean working group recommendations

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Eunah Hwang

2015-03-01

Full Text Available For Korean dialysis patients, chronic kidney disease–mineral bone disorder is a serious burden because of cardiovascular calcification and mortality. However, recent epidemiologic data have demonstrated that many patients undergoing maintenance hemodialysis are out of the target ranges of serum calcium, phosphorus, and intact parathyroid hormone. Thus, we felt the necessity for the development of practical recommendations to treat abnormal serum phosphorus, calcium, and iPTH in dialysis patients. In this paper, we briefly comment on the measurement of serum calcium, phosphorus, iPTH, dialysate calcium concentration, dietary phosphorus restriction, use of phosphate binders, and medical and surgical options to correct secondary hyperparathyroidism. In particular, for the optimal management of secondary hyperparathyroidism, we suggest a simplified medication adjustment according to certain ranges of serum phosphorus and calcium. Large-scale, well-designed clinical studies are required to support our strategies to control chronic kidney disease–mineral bone disorder in this country. Based on such data, our practice guidelines could be established and better long-term outcomes should be anticipated in our dialysis patients.

Provider Experiences with Chronic Care Management (CCM) Services and Fees: A Qualitative Research Study.

Science.gov (United States)

O'Malley, Ann S; Sarwar, Rumin; Keith, Rosalind; Balke, Patrick; Ma, Sai; McCall, Nancy

2017-12-01

Support for ongoing care management and coordination between office visits for patients with multiple chronic conditions has been inadequate. In January 2015, Medicare introduced the Chronic Care Management (CCM) payment policy, which reimburses providers for CCM activities for Medicare beneficiaries occurring outside of office visits. To explore the experiences, facilitators, and challenges of practices providing CCM services, and their implications going forward. Semi-structured telephone interviews from January to April 2016 with 71 respondents. Sixty billing and non-billing providers and practice staff knowledgeable about their practices' CCM services, and 11 professional society representatives. Practice respondents noted that most patients expressed positive views of CCM services. Practice respondents also perceived several patient benefits, including improved adherence to treatment, access to care team members, satisfaction, care continuity, and care coordination. Facilitators of CCM provision included having an in-practice care manager, patient-centered medical home recognition, experience developing care plans, patient trust in their provider, and supplemental insurance to cover CCM copayments. Most billing practices reported few problems obtaining patients' consent for CCM, though providers felt that CMS could better facilitate consent by marketing CCM's goals to beneficiaries. Barriers reported by professional society representatives and by billing and non-billing providers included inadequacy of CCM payments to cover upfront investments for staffing, workflow modification, and time needed to manage complex patients. Other barriers included inadequate infrastructure for health information exchange with other providers and limited electronic health record capabilities for documenting and updating care plans. Practices owned by hospital systems and large medical groups faced greater bureaucracy in implementing CCM than did smaller, independent practices

General practitioners believe that hypnotherapy could be a useful treatment for irritable bowel syndrome in primary care

Directory of Open Access Journals (Sweden)

de Lusignan Simon

2004-10-01

Full Text Available Abstract Background Irritable bowel syndrome is a common condition in general practice. It occurs in 10 to 20% of the population, but less than half seek medical assistance with the complaint. Methods A questionnaire was sent to the 406 GPs listed on the West Sussex Health Authority Medical List to investigate their views of this condition and whether they felt hypnotherapy had a place in its management Results 38% of general practitioners responded. The achieved sample shared the characteristics of target sample. Nearly half thought that irritable bowel syndrome (IBS was a "nervous complaint" and used a combination of "the placebo effect of personal care," therapeutic, and dietary advice. There is considerable divergence in the perceived effectiveness of current approaches. Over 70% thought that hypnotherapy may have a role in the management of patients with IBS; though the majority (68% felt that this should not be offered by general practitioners. 84% felt that this should be offered by qualified hypnotherapist, with 40% feeling that this should be offered outside the health service. Conclusions General practitioners vary in their perceptions of what constitutes effective therapy in IBS. They are willing to consider referral to a qualified hypnotherapist.

Managing patient demand: a qualitative study of appointment making in general practice.

Science.gov (United States)

Gallagher, M; Pearson, P; Drinkwater, C; Guy, J

2001-04-01

Managing patients' requests for appointments is an important general practice activity. No previous research has systematically observed how patients and receptionists negotiate appointments. To observe appointment making and investigate patients' and professionals' experiences of appointment negotiations. A qualitative study using participant observation. Three general practices on Tyneside; a single-handed practice, a practice comprising three doctors, and a seven-doctor practice. Participant observation sessions, consisting of 35 activity recordings and 34 periods of observation and 38 patient and 15 professional interviews, were set up. Seven groups of patients were selected for interview. These included patients attending an 'open access' surgery, patients who complained about making an appointment, and patients who complimented the receptionists. Appointment making is a complex social process. Outcomes are dependent on the process of negotiation and factors, such as patients' expectations and appointment availability. Receptionists felt that patients in employment, patients allocated to the practice by the Health Authority, and patients who did not comply with practice appointment rules were most demanding. Appointment requests are legitimised by receptionists enforcing practice rules and requesting clinical information. Patients volunteer information to provide evidence that their complaint is appropriate and employ strategies, such as persistence, assertiveness, and threats, to try and persuade receptionists to grant appointments. Appointment making is a complex social process where outcomes are negotiated. Receptionists have an important role in managing patient demand. Practices should be explicit about how appointments are allocated, including publishing practice criteria.

Evaluation of how a real time pre-registration health care curricula was managed through the application of a newly designed Change Management Model: A qualitative case study.

Science.gov (United States)

Chowthi-Williams, Annette

2018-02-01

Curricula change in nurse education is of international importance. The pace of such change has been continuous and has triggered criticisms of inadequate preparation of practitioners. There are no change formulae for managing curricula change and despite a raft of change methods, globally change success remains low. A lack of a unified voice, undue focus on cognition, and arguably no existing models for academia and a literature gap contribute to change challenge. A new Change Management Model designed from research with emotion as its underpinning philosophy is evaluated. Evaluation of a newly designed Change Management Model through a real time pre-registration health care curricula change. A qualitative case study was adopted. The single case study was the new pre-registration health care curricula. This study took place in a Faculty of Health and Social care in one HEI in the UK. Four senior academics and fifteen academics across professions and specialisms involved in the curricula change took part in the study. The findings suggested that leadership operated differently throughout the organisation. Distributive and collective leadership created a critical mass of people to help deliver the new curricula but academics felt excluded at the strategic level. Emotion at the strategic level inhibited innovation but boosted engagement, emotional relationships and creativity at the operational level. Face to face communication was favoured for its emotional connection. A top down approach created an emotional disconnect and impacted inclusiveness, engagement, empowerment, vision and readiness for change. Testing the new model widely not only in organisations, practice and team changes but personal change in improving health and wellbeing could be beneficial. The continuing gap in knowledge on the link between emotion and curricula change, practice and organisational change and therapeutic value of the model also warrants further research. Crown Copyright © 2017

Physical punishment. Positively no smacking.

Science.gov (United States)

Pound, R

1991-09-01

Like many health visitors Robyn Pound felt uncomfortable when clients threatened or smacked their children, yet seldom felt able to broach the subject as a topic for health promotion. The mother who raises her hand in threat to her toddler is demonstrating a method of management which may well be stacking up problems for the future. Every child needs to learn in a warm and encouraging environment which fosters self esteem. Having clarified in her own mind why parents should not hit their children she describes how she has gone public.

Awareness in Primary School Teachers regarding Traumatic Dental Injuries in Children and Their Emergency Management: A Survey in South Jaipur.

Science.gov (United States)

Nirwan, Mitakshara; Syed, Ather Ahmed; Chaturvedi, Shefali; Goenka, Puneet; Sharma, Swati

2016-01-01

Trauma to primary and permanent teeth and their supporting structures is one of the most common dental problems seen in children. The prognosis of traumatized teeth depends on timely attention with prompt and appropriate treatment, which often relies on knowledge of the teachers who may be present at the place of accidents. Thus, the aim of this study was to evaluate via a questionnaire the knowledge level of primary school teachers in South Jaipur regarding dental trauma. Questionnaire survey. A self-designed questionnaire was administered to 300 primary school teachers from 20 randomly selected private and semi-aided schools of South Jaipur. A total of 278 teachers responded to the survey. The collected data were subjected to statistical analysis. It was found that most of the respondents had accepted poor knowledge regarding dental trauma, with a mean knowledge of 10.56 ± 2.58. This study highlighted inadequate knowledge regarding emergency management of traumatic dental injuries, and teachers felt the need for training in the management of dental trauma as part of their training program. How to cite this article: Nirwan M, Syed AA, Chaturvedi S, Goenka P, Sharma S. Awareness in Primary School Teachers regarding Traumatic Dental Injuries in Children and Their Emergency Management: A Survey in South Jaipur. Int J Clin Pediatr Dent 2016;9(1):62-66.

Feasibility of an interactive ICT-platform for early assessment and management of patient-reported symptoms during radiotherapy for prostate cancer.

Science.gov (United States)

Sundberg, Kay; Eklöf, Ann Langius; Blomberg, Karin; Isaksson, Ann-Kristin; Wengström, Yvonne

2015-10-01

The aim of this study was to test the feasibility and acceptability of an Information and Communication Technology platform for assessing and managing patient reported symptoms during radiotherapy for prostate cancer. In cooperation with a health management company, using a patient experience co-design, we developed the platform operated by an interactive application for reporting and managing symptoms in real time. Nine patients diagnosed with prostate cancer and receiving radiotherapy were recruited from two university hospitals in Sweden. Evidence-based symptoms and related self-care advice specific to prostate cancer were implemented in the application based on a literature review and interviews with patients and health care professionals. In the test of the platform the patients reported symptoms, via a mobile phone, daily for two weeks and were afterwards interviewed about their experiences. Overall, the patients found the symptom questionnaire and the self-care advice relevant and the application user friendly. The alert system was activated on several occasions when the symptoms were severe leading to a nurse contact and support so the patients felt safe and well cared for. The platform enabled increased patient involvement and facilitated symptom assessment and communication between the patient and the health care provider. The study's results support further development of the platform, as well as tests in full-scale studies and in other populations. Copyright © 2015 Elsevier Ltd. All rights reserved.

A critique of the design, implementation, and delivery of a culturally-tailored self-management education intervention: a qualitative evaluation.

Science.gov (United States)

Sidhu, Manbinder S; Gale, Nicola K; Gill, Paramjit; Marshall, Tom; Jolly, Kate

2015-02-07

Self-management education is at the forefront of addressing the increasing prevalence of chronic diseases. For those at greatest risk, such as minority-ethnic and/or socio-economically deprived groups, self-management education can be culturally-tailored to encourage behavioural change. Yet, the application of culturally appropriate material and expertise within health promotion services continues to be debated. We critique the design, implementation, and delivery of a culturally-tailored self-management intervention, with particular focus on the experiences of lay educators. A mixed methods qualitative evaluation was undertaken to understand self-management service provision to culturally diverse communities (i.e. how components such as lay workers, group-based design, and culturally-appropriate educational material are intended to encourage behavioural change). We interviewed lay educators delivering the Chronic Disease Educator programme along with attendees, whilst observing workshops. Data were thematically analysed using a content-based constant comparison approach through a number of interpretative analytical stages. Lay educators felt part of the local community, relating to attendees from different races and ethnicities. However, lay educators faced challenges when addressing health beliefs and changing lifestyle practices. Culturally-tailored components aided communication, with educator's cultural awareness leading to close relationships with attendees, while the group-based design facilitated discussions of the emotional impact of illness. Lay educators bring with them a number of nuanced skills and knowledge when delivering self-management education. The development and training required for this role is inhibited by financial constraints at policy-level. The interpretation of being from the 'community' links with the identity and status of the lay role, overlapping notions of race, ethnicity, and language.

Action Competence Obstacles to Managing Childhood Overweight

DEFF Research Database (Denmark)

Brødsgaard, Anne; Wagner, Lis; Peitersen, Birgit

2013-01-01

for their children's habits, including those leading to overweight. They also felt that competent and had the opportunity to take preventive measures against child overweight but they did not always have the energy to do so. Even resourceful mothers required support from nurses and health professionals. Our results...... contribute to better understanding how to approach, motivate and support mothers to draw on their own competencies to benefit their children's weight and health....

Routines and rituals: a grounded theory of the pain management of drug users in acute care settings.

Science.gov (United States)

McCreaddie, May; Lyons, Imogen; Watt, Debbie; Ewing, Elspeth; Croft, Jeanette; Smith, Marion; Tocher, Jennifer

2010-10-01

This study reviewed the perceptions and strategies of drug users and nurses with regard to pain management in acute care settings. Drug users present unique challenges in acute care settings with pain management noted to be at best suboptimal, at worst non-existent. Little is known about why and specifically how therapeutic effectiveness is compromised. Qualitative: constructivist grounded theory. A constructivist grounded theory approach incorporating a constant comparative method of data collection and analysis was applied. The data corpus comprised interviews with drug users (n = 11) and five focus groups (n = 22) of nurses and recovering drug users. Moral relativism as the core category both represents the phenomenon and explains the basic social process. Nurses and drug users struggle with moral relativism when addressing the issue of pain management in the acute care setting. Drug users lay claim to expectations of compassionate care and moralise via narration. Paradoxically, nurses report that the caring ideal and mutuality of caring are diminished. Drug users' individual sensitivities, anxieties and felt stigma in conjunction with opioid-induced hyperalgesia complicate the processes. Nurses' and hospitals' organisational routines challenge drug user rituals and vice versa leading both protagonists to become disaffected. Consequently, key clinical issues such as preventing withdrawal and managing pain are left unaddressed and therapeutic effectiveness is compromised. This study provides a robust account of nurses' and drug users' struggle with pain management in the acute care setting. Quick technological fixes such as urine screens, checklists or the transient effects of (cognitive-based) education (or training) are not the answer. This study highlights the need for nurses to engage meaningfully with this perceptibly 'difficult' group of patients. The key aspects likely to contribute to problematic interactions with this patient cohort are outlined so that

Six-month Outcomes of Mobile Phone Application-based Self-management in a Patient with Type 2 Diabetes.

Science.gov (United States)

Hong, Mi Kyeong; Cho, Young Yun; Rha, Mi Yong; Kim, Jae Hyeon; Lee, Moon-Kyu

2015-07-01

We report the case in order to examine the effect of a mobile application program ("Diabetes & Nutrition") developed in 2011-2012 for self-management in patients with type 2 diabetes and to recommend important considerations when the mobile application program is developed. A 46-year-old man was newly diagnosed with type 2 diabetes in 2013 and had no complications. The height of the patient was 168 cm and the body weight was 75.6 kg. Nutrition education was conducted according to a medical prescription, and follow-up nutrition education was conducted after 3 and 6 months. After nutrition education, the patient was engaged in self-management using "Diabetes & Nutrition" program during 3 months. At 3 months, the body weight had decreased by 4.4 kg (from 75.6 to 71.2 kg), waist circumference by 5 cm (from 88 to 83 cm) and HbA1c level from 7.9% to 6.1%. Also at 3 months, the medication was reduced from from the dose of 850 mg to the dose of 500 mg metformin per twice a day. Since then, the patient did not continue to use the "Diabetes & Nutrition" because the level of blood glucose had stabilized, and the patient felt inconvenient and annoying to use the program. At 6 months, no significant change in the body weight and body composition was observed in comparison with those at 3 months. The present case demonstrates that the early use of "Diabetes & Nutrition" could be helpful for self-management of glycemic control in patients with type 2 diabetes. Developing self-management mobile application programs in the future will require strategies of how to promote continuous use of application program and self-management of type 2 diabetes.

Climate Project Screening Tool

Science.gov (United States)

Forest Service U.S. Department of Agriculture

2011-01-01

Climate change poses a challenge for resource managers as they review current management practices. Adaptation is a critical means of addressing climate change in the near future because, due to inherent time lags in climate impacts, the effects of increased atmospheric greenhouse gases will be felt for decades even if effective mitigation begins now. To address the...

UK medical students’ perceptions, attitudes, and interest toward medical leadership and clinician managers

Directory of Open Access Journals (Sweden)

Rouhani MJ

2018-02-01

Full Text Available Maral J Rouhani,1 Eleanor J Burleigh,2 Chloe Hobbis,2 Charlotte Dunford,1 Nadir I Osman,3 Christine Gan,1 Norma B Gibbons,1 Hashim U Ahmed,1,4 Saiful Miah1,5 1Department of Urology, Imperial College Healthcare NHS Trust, Charing Cross Hospital, London, UK; 2Medical School, University of Sheffield, Sheffield, UK; 3Department of Urology, Royal Hallamshire Hospital, Sheffield, UK; 4Division of Surgery, Department of Surgery and Cancer, Imperial College London, London, UK; 5Division of Surgery and Interventional Science, University College London, London, UK Background: We aimed to determine UK medical students’ perceptions and attitudes and interest toward medical leadership and clinician managers. Methods: A cross-sectional study was conducted during the academic year 2015–2016. An online questionnaire was distributed to 2,349 final-year students from 10 UK medical schools. Participants were asked to complete a 5-point Likert scale on their current perceptions, attitudes, and interest toward medical leadership and clinician managers. They were also asked to self-rate their leadership competences set by the Medical Leadership Competency Framework and to rate the quality of management and leadership training they received from their medical school. Results: In total, we received 114 complete responses. Only 7.9% of respondents were in agreement (strongly agree or agree when asked whether they felt they were well informed about what a managerial position in medicine entails. When asked whether clinicians should influence managerial decisions within a clinical setting, 94.7% of respondents were in agreement with the statement. About 85% of respondents were in agreement that it is important for clinicians to have managerial or leadership responsibilities, with 63.2% of students in agreement that they would have liked more management or leadership training during medical school. Over half the respondents rated their management and leadership

Managing aging in nuclear power plants: Insights from NRC maintenance team inspection reports

Energy Technology Data Exchange (ETDEWEB)

Fresco, A.; Subudhi, M.; Gunther, W.; Grove, E.; Taylor, J. [Brookhaven National Lab., Upton, NY (United States)

1993-12-01

A plant`s maintenance program is the principal vehicle through which age-related degradation is managed. From 1988 to 1991, the NRC evaluated the maintenance program of every nuclear power plant in the United States. Forty-four out of a total of 67 of the reports issued on these in-depth team inspections were reviewed for insights into the strengths and weaknesses of the programs as related to the need to understand and manage the effects of aging on nuclear plant systems, structures, and components. Relevant information was extracted from these inspection reports and sorted into several categories, including Specific Aging Insights, Preventive Maintenance, Predictive Maintenance and Condition Monitoring, Post Maintenance Testing, Failure Trending, Root Cause Analysis and Usage of Probabilistic Risk Assessment in the Maintenance Process. Specific examples of inspection and monitoring techniques successfully used by utilities to detect degradation due to aging have been identified. The information also was sorted according to systems and components, including: Auxiliary Feedwater, Main Feedwater, High Pressure Injection for both BWRs and PWRs, Service Water, Instrument Air, and Emergency Diesel Generator Air Start Systems, and Emergency Diesel Generators Air Start Systems, emergency diesel generators, electrical components such as switchgear, breakers, relays, and motor control centers, motor operated valves and check valves. This information was compared to insights gained from the Nuclear Plant Aging Research (NPAR) Program. Attributes of plant maintenance programs where the NRC inspectors felt that improvement was needed to properly address the aging issue also are discussed.

Stakeholder Perceptions of Welfare Issues and Indicators for Extensively Managed Sheep in Australia.

Science.gov (United States)

Doughty, Amanda K; Coleman, Grahame J; Hinch, Geoff N; Doyle, Rebecca E

2017-03-23

An online survey was designed to form the basis of a framework for the welfare assessment of extensively managed sheep in Australia. The survey focused on welfare compromise and useful welfare indicators. A total of 952 people completed the survey in its entirety, representing four stakeholder groups: Public (53.6%), Producer (27.4%), Scientist (9.9%), and Service provider (9.1%). Animal welfare was considered to be important by all participating groups in this survey (average score of 3.78/4). Respondents felt the welfare of grazing sheep was generally adequate but improvement was desired (2.98/5), with female members of the public rating sheep welfare significantly worse than other respondents ( p risk to welfare (3.87/5), followed by heat stress (3.79), lameness (3.57) and husbandry practices (3.37). Key indicators recognised by all respondents were those associated with pain and fear (3.98/5), nutrition (4.23), mortality/management (4.27), food on offer (4.41) and number of illness/injures in a flock (4.33). There were gender and stakeholder differences in the perceived importance of both welfare issues and indicators with women and the public consistently rating issues (all p indicators (all p < 0.05) to be of greater significance than other respondents. These results highlight the importance of including all stakeholders and an even balance of genders when developing a welfare framework that can address both practical and societal concerns.

An information management system for patients with tuberculosis: usability assessment with end-users.

Science.gov (United States)

Darby, Jonathan; Black, Jim; Morrison, David; Buising, Kirsty

2012-01-01

Information systems with clinical decision support (CDS) offer great potential to assist the co-ordination of patients with chronic diseases and to improve patient care. Despite this, few have entered routine clinical use. Tuberculosis (TB) is an infection of public health importance. It has complex interactions with many comorbid conditions, requires close supervised care and prolonged treatment for effective cure. These features make it suitable for use with an information management system with CDS features. In close consultation with key stakeholders, a clinical application was developed for the management of TB patients in Victoria. A formal usability assessment using semi-structured case-scenario based exercises was performed. Subjects were 12 individuals closely involved in the care of TB patients, including Infectious Diseases and Respiratory Physicians, and Public Health Nurses. Two researchers conducted the sessions, independently analysed responses and discrepancies compared to the voice record for validity. Despite varied computer experience, responses were positive regarding user interface and content. Data location was not always intuitive, however this improved with familiarity of the program. Decision support was considered valuable, with useful suggestions for expansion of these features. Automated reporting for correspondence and notification to the Health Department were felt worth the initial investment in data entry. An important workflow-based issue regarding dismissal of alerts and several errors were detected. Usability assessment validated many design elements of the system, provided a unique insight into workflow issues faced by users and hopefully will impact on its ultimate clinical utility.

Management of Occupational Stress

Directory of Open Access Journals (Sweden)

Trandafir Lenuţa

2015-06-01

Full Text Available Stress is an important problem in the majority of countries. Apart from the fact that it is responsible for numerous diseases, it also causes much suffering. Stress appears as an adaptation reaction of our body to those external factors that we perceive as being agressive and which frequently lead us to an alarm state, felt both psychically (tension, fear, anxiety, and physically (increase of the adrenaline secretion, intensity of heartbeats, sweating. It isn’t actually a disease, but it can lead to sickness in time. This is why it is good to know what stresses us and how we can escape stress.

Barriers faced by healthcare professionals when managing falls in older people in Kuala Lumpur, Malaysia: a qualitative study.

Science.gov (United States)

Loganathan, Annaletchumy; Ng, Chirk Jenn; Tan, Maw Pin; Low, Wah Yun

2015-11-05

To explore the barriers faced by healthcare professionals (HCPs) in managing falls among older people (aged above 60 years) who have a high risk of falling. The study used a qualitative methodology, comprising 10 in-depth interviews and two focus group discussions. A semistructured topic guide was used to facilitate the interviews, which were audio recorded, transcribed verbatim and checked for accuracy. Data were analysed thematically using WeftQDA software. 20 HCPs who managed falls in older people. This study was conducted at the Primary Care Clinic in the University Malaya Medical Centre (UMMC), Malaysia. Four categories of barriers emerged-these were related to perceived barriers for older people, HCPs' barriers, lack of caregiver support and healthcare system barriers. HCPs perceived that older people normalised falls, felt stigmatised, were fatalistic, as well as in denial regarding falls-related advice. HCPs themselves trivialised falls and lacked the skills to manage falls. Rehabilitation was impeded by premature decisions to admit older people to nursing homes. Lastly, there was a lack of healthcare providers as well as a dearth of fall education and training on fall prevention for HCPs. This study identified barriers that explain poor fall management in older people with a high risk of falls. The lack of structured fall prevention guidelines and insufficient training in fall management made HCPs unable to advise patients on how to prevent falls. The findings of this study warrant evidence-based structured fall prevention intervention targeted to patients as well as to HCPs. 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/

Physiotherapy management of joint hypermobility syndrome--a focus group study of patient and health professional perspectives.

Science.gov (United States)

Palmer, S; Terry, R; Rimes, K A; Clark, C; Simmonds, J; Horwood, J

2016-03-01

To develop an understanding of patient and health professional views and experiences of physiotherapy to manage joint hypermobility syndrome (JHS). An explorative qualitative design. Seven focus groups were convened, audio recorded, fully transcribed and analysed using a constant comparative method to inductively derive a thematic account of the data. Four geographical areas of the U.K. 25 people with JHS and 16 health professionals (14 physiotherapists and two podiatrists). Both patients and health professionals recognised the chronic heterogeneous nature of JHS and reported a lack of awareness of the condition amongst health professionals, patients and wider society. Diagnosis and subsequent referral to physiotherapy services for JHS was often difficult and convoluted. Referral was often for acute single joint injury, failing to recognise the long-term multi-joint nature of the condition. Health professionals and patients felt that if left undiagnosed, JHS was more difficult to treat because of its chronic nature. When JHS was treated by health professionals with knowledge of the condition patients reported satisfactory outcomes. There was considerable agreement between health professionals and patients regarding an 'ideal' physiotherapy service. Education was reported as an overarching requirement for patients and health care professionals. Physiotherapy should be applied holistically to manage JHS as a long-term condition and should address injury prevention and symptom amelioration rather than cure. Education for health professionals and patients is needed to optimise physiotherapy provision. Further research is required to explore the specific therapeutic actions of physiotherapy for managing JHS. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

The 5As team intervention: bridging the knowledge gap in obesity management among primary care practitioners.

Science.gov (United States)

Ogunleye, Ayodele; Osunlana, Adedayo; Asselin, Jodie; Cave, Andrew; Sharma, Arya Mitra; Campbell-Scherer, Denise Lynn

2015-12-22

Despite opportunities for didactic education on obesity management, we still observe low rates of weight management visits in our primary care setting. This paper describes the co-creation by front-line interdisciplinary health care providers and researchers of the 5As Team intervention to improve obesity prevention and management in primary care. We describe the theoretical foundations, design, and core elements of the 5AsT intervention, and the process of eliciting practitioners' self-identified knowledge gaps to inform the curricula for the 5AsT intervention. Themes and topics were identified through facilitated group discussion and a curriculum relevant to this group of practitioners was developed and delivered in a series of 12 workshops. The research question and approach were co-created with the clinical leadership of the PCN; the PCN committed internal resources and a practice facilitator to the effort. Practice facilitation and learning collaboratives were used in the intervention For the content, front-line providers identified 43 topics, related to 13 themes around obesity assessment and management for which they felt the need for further education and training. These needs included: cultural identity and body image, emotional and mental health, motivation, setting goals, managing expectations, weight-bias, caregiver fatigue, clinic dynamics and team-based care, greater understanding of physiology and the use of a systematic framework for obesity assessment (the "4Ms" of obesity). The content of the 12 intervention sessions were designed based on these themes. There was a strong innovation values fit with the 5AsT intervention, and providers were more comfortable with obesity management following the intervention. The 5AsT intervention, including videos, resources and tools, has been compiled for use by clinical teams and is available online at http://www.obesitynetwork.ca/5As_Team . Primary care interdisciplinary practitioners perceive important

Simulating the physician as healthcare manager: An innovative course to train for the manager role

Directory of Open Access Journals (Sweden)

Gradel, Maximilian

2016-05-01

hospital is selected in advance by the course organizers in coordination with the hospital’s executive board. Students then work on this issue in the third and final phase of the course under the supervision of tutors and with assistance from hospital employees. At the end of the course the students formally present the results of their work to the hospital’s executive and supervisory boards.Results: The course undergoes written student evaluation, a round of oral feedback, evaluation of the final projects, and feedback from the hospital’s executive and supervisory boards. All attendees to date have reported a substantial gain in general knowledge and increased knowledge about the healthcare system, and rate the relevance of the course as being high. The majority felt the content was important for their future practice of medicine. Overall, students evaluated the course very positively [overall rating on a six-point grading scale (1=excellent; 6=unsatisfactory: 1.28 (mean±0.45 (standard deviation].Discussion: The importance of the physician’s role as manager in medical organizations and as a guiding force in the healthcare system is neglected in medical degree programs. Our seminar course attempts to address this shortcoming, is the object of great interest and receives positive evaluations from seminar participants, our cooperative partners and the executive and supervisory boards of the University Hospital in Munich.

Simulating the physician as healthcare manager: An innovative course to train for the manager role.

Science.gov (United States)

Gradel, Maximilian; Moder, Stefan; Nicolai, Leo; Pander, Tanja; Hoppe, Boj; Pinilla, Severin; Von der Borch, Philip; Fischer, Martin R; Dimitriadis, Konstantinos

2016-01-01

in coordination with the hospital's executive board. Students then work on this issue in the third and final phase of the course under the supervision of tutors and with assistance from hospital employees. At the end of the course the students formally present the results of their work to the hospital's executive and supervisory boards. The course undergoes written student evaluation, a round of oral feedback, evaluation of the final projects, and feedback from the hospital's executive and supervisory boards. All attendees to date have reported a substantial gain in general knowledge and increased knowledge about the healthcare system, and rate the relevance of the course as being high. The majority felt the content was important for their future practice of medicine. Overall, students evaluated the course very positively [overall rating on a six-point grading scale (1=excellent; 6=unsatisfactory): 1.28 (mean)±0.45 (standard deviation)]. The importance of the physician's role as manager in medical organizations and as a guiding force in the healthcare system is neglected in medical degree programs. Our seminar course attempts to address this shortcoming, is the object of great interest and receives positive evaluations from seminar participants, our cooperative partners and the executive and supervisory boards of the University Hospital in Munich.

Subsistence fishers were legally recognized in South Africa for the ...

African Journals Online (AJOL)

denise

This is particularly evident in Section 35 (Environmental. Management ..... sions felt strongly that they should be given priority access to .... others were skeptical of any intervention by the authori- ties. .... Natural features such as tide and ...

The impact of managed care on substance abuse treatment: a report of the American Society of Addiction Medicine.

Science.gov (United States)

Galanter, M; Keller, D S; Dermatis, H; Egelko, S

2000-01-01

This report examines the impact of managed care (MC) and related developments on substance abuse treatment, and evaluates how it has been associated with a decline in the availability of proper treatment for many addicted patients. A trend toward carve-out and for-profit MC organizations is associated with lower financial incentives for intensive treatment than in earlier staff-model and not-for-profit MC organizations. The value of substance abuse insurance coverage has declined by 75% between 1988 and 1998 for employees of mid-to large-size companies, compared with only an 11.5% decline for general health insurance. The shift towards MC has also been associated with a drastic reduction in frequency and duration of inpatient hospitalization, and there is no clear evidence that this reduction has been offset by a corresponding increase in outpatient support. In a survey of physicians treating addiction, the majority felt that MC had a negative impact on detoxification and rehabilitation, and on their ethical practice of addiction medicine.

Qualities and attributes of a safe practitioner: identification of safety skills in healthcare.

Science.gov (United States)

Long, S; Arora, S; Moorthy, K; Sevdalis, N; Vincent, C

2011-06-01

OBJECTIVES (1) To identify a range of safety skills (attributes of a safe practitioner) relevant across clinical specialities. 2) To obtain the views of clinicians regarding their importance and trainability. DESIGN We used a survey and focus group of 10 patient safety experts to extract a list of safety skills. 50 experienced clinicians rated the skills in terms of importance and trainability in an electronic questionnaire. SETTING A Clinical Safety Research Unit and its associated NHS Trust, within an Academic Health Science Centre. RESULTS 73 skills, in 18 broad categories, were identified from the focus group and survey. The majority of clinicians felt the skills were important (most important: technical skills (98%), crisis management (98%), honesty (97.5%); least important: open-mindedness (82%), patient awareness/empathy (81.7%), humility (81.2%)). There was less agreement about trainability (16/18 categories were felt to be trainable; most trainable: technical skills (98%), anticipation/preparedness (84%), organisational skills/efficiency (83%); least trainable: conscientiousness (56%), humility (40%), open-mindedness (30%)). More surgeons than physicians felt that team awareness and crisis management skills were trainable (p=0.0099, p=0.025, respectively). CONCLUSIONS We have identified a preliminary set of safety skills, which with further refinement could form the template for the development of a formal taxonomy of the qualities and attributes of the safe practitioner. Experts and practitioners agree about the importance of the individual skills. The fact that the majority of these were felt by experienced cross-speciality clinicians to be trainable is encouraging in terms of the possibility of developing generic safety curricula.

Effective degradation of rhodamine B by electro-Fenton process, using ferromagnetic nanoparticles loaded on modified graphite felt electrode as reusable catalyst: in neutral pH condition and without external aeration.

Science.gov (United States)

Tian, Jiangnan; Zhao, Jixiang; Olajuyin, Ayobami Matthew; Sharshar, Moustafa Mohamed; Mu, Tingzhen; Yang, Maohua; Xing, Jianmin

2016-08-01

Polytetrafluoroethylene/ferromagnetic nanoparticle/carbon black (PTFE/MNP/CB)-modified graphite felt (GF) was successfully applied as cathode for the mineralization of rhodamine B (RhB) in electro-Fenton (EF) process. The modified cathode showed high decolorization efficiency for RhB solution even in neutral pH condition and without external aeration, achieving nearly complete decolorization and 89.52 % total organic carbon (TOC) removal after 270-min oxidation with the MNP load 1.2 g at 50 A/m(2). Moreover, the operational parameters (current density, MNP load, initial pH, and airflow rate) were optimized. After that, adsorption isotherm was also conducted to compare the absorption quantity of CB and carbon nanotube (CNT). Then, the surface morphologies of MNPs were characterized by transmission electron microscope (TEM), energy-dispersive X-ray detector (EDX), and Fourier transform infrared spectroscopy (FTIR); and the modified cathode was characterized by SEM and contact angle. Finally, the stability and reusability of modified cathode were tested. Result uncovered that the PTFE/MNP/CB-modified cathode has the potential for industrial application and the solution after treatment was easily biodegradable.

One of a kind complex offers unique energy management challenges

Energy Technology Data Exchange (ETDEWEB)

Hansen, K. (West Edmonton Mall, Engineering and Maintenance, AB (Canada))

1993-10-01

The West Edmonton Mall in Alberta covers ca 5.2 million ft[sup 2] and has over 800 stores and services, 110 eating places, 5 major amusement facilities, a hotel, and 19 movie theaters. The mall was built in three phases, the first of which had a rather standard electrical and mechanical system. The later phases incorporated more complex electric and mechanical equipment. The electrical billing structure for the mall is based on peak demand, and reduction of peak demand is more important than reducing consumption. As may be expected at such a complex facility, opportunities for energy management are numerous. The lighting system was the first to receive attention. The old practice of leaving lights on at all times was replaced by establishing a time clock system on all mall corridor lighting and time controls to all skylight perimeter lighting. Several thousand watts of excess lighting was removed, time clocks were installed on yard and parkade lighting, and energy efficient lamps were installed. These measures not only reduced energy consumption but lowered air conditioning requirements and achieved savings on purchases of lamps and ballasts. In heating systems, it is felt that 2 MW of power can be saved by converting electrical heating units to gas-fired units. A night setback system was installed on the ice plant, and unnecessary loads were eliminated from the parkade ramp heating system. Winter peaks were shaved by installing 4,700 KVAR of power factor correction; this measure paid for itself in 13 months. Further energy management options include converting fans to variable speed drives, installing a cogeneration unit, and installing a more efficient wave generator in the water park. 3 figs.

Closing the loop in person-centered care: patient experiences of a chronic kidney disease self-management intervention

Directory of Open Access Journals (Sweden)

Havas K

2017-11-01

Full Text Available Kathryn Havas,1,2 Clint Douglas,1 Ann Bonner1–3 1School of Nursing, Queensland University of Technology, 2NHMRC Chronic Kidney Disease Centre for Research Excellence, University of Queensland, 3Kidney Health Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia Purpose: The provision of self-management support (SMS for people with earlier stages (1–4 of chronic kidney disease (CKD can improve patient outcomes and extend time to dialysis. However, attempts to deliver such support have often not taken patient preferences into account. After the development, implementation, and quantitative evaluation of the person-centered CKD-SMS intervention, the aim of this study was to investigate participant experiences and perceptions of the program, as well as to seek suggestions to improve future SMS attempts.Patients and methods: Semi-structured, face-to-face interviews were conducted with almost all (63/66 participants in the CKD-SMS. Deductive categories were derived from previous research into self-management from the CKD patient’s perspective, and this was supplemented by categories that emerged inductively during multiple readings of interview transcripts. Content analysis was used to analyze interview data.Results: Participants recognized self-management of CKD as complex and multifaceted. They felt that the CKD-SMS helped them develop skills to engage in necessary self-management tasks, as well as their knowledge about their condition and confidence to take an active role in their healthcare. These participants experience a healthcare environment that is characterized by complexity and inconsistency, and participation in the intervention helped them to navigate it. The benefit of participating in this research to contribute to the scientific literature was also recognized by participants. Overall, participants found the CKD-SMS useful in its current format, and made some suggestions for future interventions

[Impact of music therapy on anxiety and depression for patients with Alzheimer's disease and on the burden felt by the main caregiver (feasibility study)].

Science.gov (United States)

Guetin, S; Portet, F; Picot, M-C; Defez, C; Pose, C; Blayac, J-P; Touchon, J

2009-02-01

The impact of music therapy on dementia care for patients with Alzheimer's disease (AD) is well-recognized. Music alters the different components of the disease through sensory, cognitive, emotional, behavioral and social impacts. The academic aspect of music therapy in this area was based on the fact that music can alter the various components of the overall evolution of this disease. We found around 10 case studies presenting various results from receptive music therapy sessions on patients with Alzheimer's disease. The results of these studies point out the interest of music therapy in the multidisciplinary care of Alzheimer's disease and its related syndromes. It has been deemed useful for significantly reducing the medication given to AD patients. A music therapy protocol, specifically tailored to the patient's needs has been shown to significantly reduce anxiety, depression and aggressiveness in patients suffering from Alzheimer's disease. This technique has also demonstrated its impact on helping AD patients recall their previous life experience. To demonstrate the feasibility and to evaluate the impact of music therapy on anxiety and depression at the early to moderate stage of Alzheimer's disease and on the main caregiver burden. Five outpatients suffering from early stage of Alzheimer's disease (MMS: 18-26) were prospectively included. They were living in Montpellier with a reliable caregiver. A weekly receptive music therapy session was delivered to patients over a 10-week period, according to the U method standardized protocol. This technique was based on the recommendations made by Gardner and Good relating to the importance given to an individualized choice of music. Instrumental tracks were selected from various music styles (classic, jazz, world music...) and were tailored to the patient's requirements. This individual session was always followed by an interview with the music therapist in order to allow the patient to express the emotions felt

Survey of community pharmacy residents' perceptions of transgender health management.

Science.gov (United States)

Leach, Caitlin; Layson-Wolf, Cherokee

2016-01-01

1) To measure the general perceptions and attitudes of community pharmacy residents toward transgender patients and health; 2) to identify gaps in didactic education regarding transgender health care among residents; and 3) to evaluate residents' level of support for pharmacists receiving education in transgender health care. This study was a cross-sectional survey delivered online. Community residency directors were e-mailed a cover letter and a 34-question online survey. The directors were asked to forward the survey to their residents for completion within 4 weeks. Responses were anonymous with no identifiers collected on the survey. Survey responses used a combination of open-response, multiple-choice, and Likert-scale questions aimed at gathering respondents' demographic information, perceptions of managing transgender patients and the need for receiving additional education in transgender health care. Overall, the results of the survey indicated that community pharmacy residents support integrating transgender health management into pharmacy education and recognize that the overwhelming barriers to care for these patients include discrimination and lack of provider knowledge. Significant findings include: 82.7% of community residents think that community pharmacists play an important role in providing care for transgender patients; 98.2% think that they have a responsibility to treat transgender patients; and 71.4% were not educated about transgender patient issues in pharmacy school. Only 36.2% of community residents felt confident in their ability to treat transgender patients. Community pharmacy residents list discrimination and lack of provider knowledge as the major barriers to care for transgender patients. Residents do not feel confident in their ability to treat and manage transgender patients. The majority of residents were not educated about transgender patient issues while in pharmacy school and think that community pharmacists need more education

Preparing to implement a self-management program for back pain in new york city senior centers: what do prospective consumers think?

Science.gov (United States)

Townley, Sarah; Papaleontiou, Maria; Amanfo, Leslie; Henderson, Charles R; Pillemer, Karl; Beissner, Katherine; Reid, M C

2010-03-01

Prior to testing the feasibility/potential efficacy of a newly developed self-management pain program for seniors with back pain, this study sought to: 1) determine prospective consumers' prior exposure to self-management pain programs, 2) determine their willingness to participate in the new program, and 3) ascertain perceived barriers/facilitators to program participation. Cross-sectional survey. Six senior centers located in New York City. We enrolled a race/ethnicity stratified (African American, Hispanic, or non-Hispanic White) sample of 90 subjects who were ages 60 years or older and had chronic back pain. While 60% of non-Hispanic Whites reported prior participation in a self-management pain program, fewer Hispanic (23%) and African Americans (20%) participants reported prior participation. Most participants (80%) were strongly willing to participate in the new program. Multivariate analyses revealed that only pain intensity had a trend toward significance (P = 0.07), with higher pain scores associated with greater willingness to participate. Few barriers to participation were identified, however, respondents felt that tailoring the course to best meet the needs of those with physical disabilities, providing flexibility in class timing, and informing individuals about program benefits prior to enrollment could help maximize program reach. No race/ethnicity differences were identified with respect to willingness to participate or program participation barriers. These data support efforts to disseminate self-management pain programs in older populations, particularly minority communities. The recommendations made by participants can help to guide implementation efforts of the newly developed pain program and may help to enhance both their reach and success.

A Visitor Control Policy for Martin Army Hospital,

Science.gov (United States)

1978-04-05

gathered at York Hospital resulted in the limitation of two visitors per patient at one time. This was not an arbitrary decision by management but...management is required to receive input from the consumer on many management decisions . Even discounting the above, the patient was felt to be a logical...proximity of the parking areas to the primary entrances, no additional staff entrances ,4 are needed, therefore no special locking devices for any auxillary

Marked improvement in the success rate of medical management of early pregnancy failure following the implementation of a novel institutional protocol and treatment guidelines: a follow-up study.

Science.gov (United States)

Colleselli, V; Nell, T; Bartosik, T; Brunner, C; Ciresa-Koenig, A; Wildt, L; Marth, C; Seeber, B

2016-11-01

To analyze the success rate, time to passage of tissue and subjective patient experience of a newly implemented protocol for medical management of early pregnancy failure (EPF) over a 2-year period. A retrospective chart review of all patients with early pregnancy failure primarily opting for medical management was performed. 200 mg mifepristone were administered orally, followed by a single vaginal dose of 800 mcg misoprostol after 36-48 h. We followed-up with our patients using a written questionnaire. 167 women were included in the present study. We observed an overall success rate of 92 %, defined as no need for surgical management after medication administration. We could not identify predictive values for success in a multivariate regression analysis. Most patients (84 %) passed tissue within 6 h after misoprostol administration. The protocol was well tolerated with a low incidence of side effects. Pain was managed well with sufficient analgesics. Responders to the questionnaire felt adequately informed prior to treatment and rated their overall experience as positive. The adaption of the institutional medical protocol resulted in a marked improvement of success rate when compared to the previously used protocol (92 vs. 61 %). We credit this increase to the adjusted medication schema as well as to targeted physician education on the expected course and interpretation of outcome measures. Our results underscore that the medical management of EPF is a safe and effective alternative to surgical evacuation in the clinical setting.

The Role of Information Security Management Systems in Supply Chain Performance Improvement

Directory of Open Access Journals (Sweden)

Mohammad Reza Taghva

2012-02-01

Full Text Available In recent years, the researchers have emphasized on positive effect of information system on supply chain performance such as organizational processes integration, information sharing, information technology, etc. In other hand, information security management system is one of the subjects that researches considered its effects on increase accuracy and effective information exchange, access to accurate and timely information and reduce errors of information system. Since, any research has not been done on this ground (the importance of ISMS on supply chain performance. Therefore, it was felt that a research should have done on these approaches on supply chain. In this respect, current research was seeking that how ISMS had impact on supply chain performance in automotive industry and this was the innovative aspect of this paper. So first of all, after the review of the information security management system literature, supply chain performance was considered by the balanced scorecard approach then the most important factors of these two subjects was extracted by correlation analysis. In this way, it was considered that how ISMS had impact on supply chain performance by correlation analysis. The results showed that different dimensions of ISMS (information uniformity, prevent the human and machine mistake, information be accuracy, and rectitude and instruction for users had impact on four dimensions of supply chain performance (customers, financial, internal processes and learning and growth in three levels (strategic, technical, and operational in supply chain. At the end, it was showed that ISMS lays the ground for increase supply chain performance.

Veterinary herd health management-Experience among farmers and farm managers in Swedish dairy production.

Science.gov (United States)

Svensson, C; Alvåsen, K; Eldh, A C; Frössling, J; Lomander, H

2018-07-01

A preventive herd health approach will most likely reduce incidences of clinical and subclinical disease. Swedish veterinary organizations offer specific veterinary herd health management (HHM) programs, but these services are not used to a large extent. The aim of this study was to investigate dairy farmers' experience of HHM and the conditions for collaboration with veterinarians in HHM. Six focus group discussions were conducted in March 2015 in West Sweden. In total, 33 dairy farmers participated. The recordings were transcribed and coded using thematic analysis, and the transcripts were reviewed to identify potential factors indicating barriers for farmers to engage a veterinarian in HHM. The participants reported HHM to be important, but they had difficulty defining the actions included in the concept. They described a wide range of their work duties as preventive. The farmers' list of potential contributions by the veterinarians in HHM was strikingly short compared to the considerable number of preventive measures they performed themselves. Four main obstacles for farmers and farm managers to engage a veterinarian in HHM on their farm were identified in the analysis: "costs", "veterinary knowledge, skills, and organization", "farmer attitudes", and "veterinarian-farmer relationships". Costs were proposed as the main reason against engaging a veterinarian in HHM and included a high veterinary bill, low cost-benefit of veterinary services, and high costs to implement advice. Poor veterinary competence in HHM and poor knowledge about effective measures, practical farming, and farm economics were other important obstacles. Veterinarians were perceived to insufficiently describe their services and their benefits, and several participants felt they had never been offered veterinary HHM. Although veterinary HHM may be initiated by the farmer, the participants expected the veterinarian to have special responsibility for the initiation. A firm trust between farmer

Increasing sustainable stormwater management adaption through transdisciplinary research

Science.gov (United States)

Wingfield, Thea; Potter, Karen; Jones, Gareth; Spees, Jack; Macdonald, Neil

2016-04-01

The Ribble Rivers Trust leads a partnership of land and water management organisations that use a holistic approach to water management in the Ribble catchment. They are interested in incorporating sustainable stormwater systems, into their program of delivery with a view to ensuring that their activities to improve the environments and habitats of the catchment also contribute to reducing flood risk. A methodology, to locate interventions that would slow water within the catchment are identified; however partner buy in, institutional caution and economic barriers are felt to be hindering delivery. In response a transdisciplinary research project in which both the academics of the University of Liverpool and the practitioners of The Ribble Rivers Trust are active investigators has been established. The project aims to increase the uptake of sustainable stormwater management techniques through the analysis of the institutional, experiential and governance processes and their interactions with the physical hydrological processes governing stormwater systems. Research that is transdisciplinary must integrate academic knowledge with practitioner, local understanding and practice. Furthermore methodologies belonging to different academic fields must be blended together to collect, analyse and interpret data in order to examine complex problems through different disciplinary lenses in an integrated way. This approach has been developed in response to the complex relationships of cause and effect of contemporary inter-related economic, environmental and societal challenges. There have been a number of challenges to overcome as transdisciplinary researchers, the first and most important was to understand the different research philosophies and theoretical assumptions behind various natural science and social science research methods. Without this understanding research methodologies could be flawed and would not be effectively integrated and the data would not be

Minding the Gaps in Cancer Pain Management Education: A Multicenter Study of Clinical Residents and Fellows in a Low- Versus High-Resource Setting.

Science.gov (United States)

Odonkor, Charles Amoatey; Osei-Bonsu, Ernest; Tetteh, Oswald; Haig, Andy; Mayer, Robert Samuel; Smith, Thomas J

2016-12-01

Inadequate pain management training has been reported as a major cause of undertreatment of cancer pain. Yet, past research has not comprehensively compared the quality of cancer pain management education among physicians in training in high-resource countries (HRCs) with those in low-resource countries (LRCs). The purpose of this study was to examine and compare gaps in cancer pain management education among physician trainees in an HRC (United States) versus an LRC (Ghana). A cross section of physicians at four major academic medical centers completed surveys about the adequacy of cancer pain training. Participation in the study was completely voluntary, and paper or online surveys were completed anonymously. The response rate was 60% (N = 120). Major gaps were identified in cancer pain management education across the spectrum of medical school training. Training was rated as inadequate (by approximately 80% of trainees), although approximately 10% more trainees in HRCs versus LRCs felt this way; 35% said residency training was inadequate in both settings; and 50% in LRCs versus 44% in HRCs said fellowship training was less than good. On the basis of the lowest group means, the three key areas of perceived deficits included interventional pain procedures (2.34 ± 1.12), palliative care interventions (2.39 ± 1.12), and managing procedural and postoperative pain (2.94 ± 0.97), with significant differences in the distribution of deficits in 15 cancer-pain competencies between LRCs and HRCs ( P < .05). This study identifies priority areas that could be targeted synergistically by LRCs and HRCs to advance cancer care globally. The findings underscore differential opportunities to broaden and improve competencies in cancer pain management via exchange training, in which physicians from HRCs spend time in LRCs and vice versa.

Early Realignment Versus Delayed Urethroplasty in Management of Pelvic Fracture Urethral Injury: A Meta-analysis.

Science.gov (United States)

Firmanto, Rama; Irdam, Gampo A; Wahyudi, Irfan

2016-04-01

this meta-analysis study will evaluate the incidence of urethral stricture as a successfull parameter in the management of PFUI through early realignment, compared with delayed urethroplasty. Long-term complications such as erectile dysfunction and incontinence on both methods will also be evaluated. online literature was sourced from Pubmed, Embase, Cochrane, and Google Scholar. The incidence of stricture was evaluated from the entire study group of ER and DU. Stricture of the urethra is diagnosed by the symptoms such as the obstruction that felt by the patient, uroflowmetry examination, and urine residual post micturition that supported by urethrography examination at regular interval. In some cases the incidence of stricture also diagnosed by urethroscopy. The patient is assessed as not having stricture when it is no longer needed to do urethral dilatation or advanced urethrotomy. The rate of incontinence was assessed subjectively from the patient's complaints. The erectile function assessed subjectively; decreased of tumesen's degree, reduced the duration of erection, and penetration failure diagnosed as erection dysfunction. The data were processed as dichotomy data to calculate the risk ratio using Review Manager 5.1. five relevant literatures reviewed in this study. The incidence of urethral strictures are statistically significant lower in early realignment group (RR=0.70, 95% CI 0.50-0.99, Purethroplasty method. Between the two methos, the complications such as erectile dysfunction and incontinence; however, there was no significant difference.

Customers' perspectives on the impact of the Pathways to Work condition management programme on their health, well-being and vocational activity.

Science.gov (United States)

Secker, Jenny; Pittam, Gail; Ford, Fiona

2012-11-01

Pathways to Work is a UK initiative aimed at supporting customers on incapacity benefits to return to work. This qualitative study complements previous evaluations of Pathways to Work by exploring customers' perceptions of the impact of the Condition Management Programme (CMP) offered to claimants with long-term health conditions. 39 customers took part in focus groups held at the seven sites where Pathways was originally piloted. The main focus of the discussions was on perceptions of the ways in which participation had impacted on health, well-being and return to work. The discussions were audio-recorded and fully transcribed for analysis using a text analysis framework to enable the development and refinement of categories and overarching patterns in the data. Perceived impacts on health and well-being included a more positive outlook, social contact, changed perceptions of conditions and improvements in health. Some customers also reported an increase in their vocational activity and others felt ready to embark on new activities. Factors associated with positive outcomes included the extent and quality of contact with CMP staff and practical advice about condition management. Factors impeding positive employment outcomes related mainly to obstacles to returning to work. The results indicated that CMP can assist customers to learn about and manage their health conditions and increase their vocational activity, and that CMP therefore provides a promising means of enabling people with long-term health conditions to regain a fulfilling, productive life.

Plant life management for long term operation of light water reactors. Principles and guidelines

International Nuclear Information System (INIS)

2006-01-01

The subject of this report was originally suggested by the IAEA Technical Working Group on Life Management of Nuclear Power Plants. It was then approved by the IAEA for work to begin in 2004. The participants in the group felt that it was time to address plant life management and ageing issues from the point of view of long term operation and licence renewal. It is believed that the nuclear power industry will only be able to survive if plant economics are favourable and safety is maintained. Therefore, the issue of ageing and obsolescence has to be addressed from an operational and safety standpoint, but also in the context of plant economics in terms of the cost of electricity production, including initial and recurring capital costs. Use of new technologies, such as advanced in-service inspection and condition based maintenance, should be considered, not only to predict the consequences of ageing and guard against them, but also to monitor equipment performance throughout the lifetime of the plant and to help establish replacement schedules for critical systems, structures and components, and to better estimate the optimum end of the operating licence, which means the end of the nuclear power plant's lifetime. The importance of nuclear power plant life management in facilitating the technical and economic goals of long term operation is presented in this report in terms of the requirement to ensure safe long term supplies of electricity in the most economically competitive way. Safe and reliable operation is discussed in terms of the overall economic benefits when plant life management is implemented. Preconditions for plant life management for long term operation are identified and approaches are reviewed. Plant life management should not be associated only with the extension of the operational lifetime of the nuclear power plant, but with an owner's attitude and a rational approach of the operating company towards running the business economically and safely

cyber livestock communication in rural india: a strategic model

African Journals Online (AJOL)

The cyber extension system focuses the overall development of the livestock farmers including production, management, marketing and other rural developmental activities, thus conceptualizing a livestock communication model and defining anything that can be fit into this model as Cyber Communication was felt ...

Optimal timing of renal replacement therapy initiation in acute kidney injury: the elephant felt by the blindmen?

Science.gov (United States)

Shiao, Chih-Chung; Huang, Tao-Min; Spapen, Herbert D; Honore, Patrick M; Wu, Vin-Cent

2017-06-20

Renal replacement therapy (RRT) is a key component in the management of severe acute kidney injury (AKI) in critically ill patients. Many cohort studies, meta-analyses, and two recent large randomized prospective trials which evaluated the relationship between the timing of RRT initiation and patient outcome remain inconclusive due to substantial differences in study design, patient population, AKI definition, and RRT indication. A cause-specific diagnosis of AKI based on current staging criteria plus a sensitive biomarker (panel) that allows creating a homogeneous study population is definitely needed to assess the impact of early versus late initiation of RRT on patient outcome.

Implementation of evidence into practice for cancer-related fatigue management of hospitalized adult patients using the PARIHS framework.

Directory of Open Access Journals (Sweden)

Li Tian

Full Text Available This study aimed to explore an evidence-based nursing practice model of CRF management in hospitalized adult patients using the PARIHS evidence-implementation framework as the theoretical structure to provide guidance for similar nursing practices. The implementation of guideline evidence into clinical practice was conducted on the oncology and radiotherapy wards of a university-affiliated hospital. The process of integrating the guideline into the symptom management system of cancer patients was described. The impact of the evidence implementation was evaluated from three aspects: organizational innovations and outcome measures associated with nurses and with patients pre- and post-evidence implementation. During the implementation of evidence into practice on the wards, a nursing process, health education, a quality control sheet and CRF training courses were established. Through this implementation, compliance with evidence related to CRF increased significantly on the two wards, with that of ward B being higher than that of ward A. Regarding nursing outcomes, nursing knowledge, attitude and behavior scores with respect to CRF nursing care increased substantially after its application on the two wards, and the ward B nurses' scoring was higher than that of the ward A nurses. Qualitative analysis concerning the nurses suggested that leadership, patient concern about CRF management, and the need for professional development were the main motivators of the application, whereas the shortage and mobility of nursing human resources and insufficient communication between doctors and nurses were the main barriers. Additionally, most nurses felt more professional and confident about their work. Regarding patient outcomes, patient knowledge, attitude and behavior scores regarding CRF self-management increased significantly. Patients' post-implementation CRF was alleviated compared with the pre-implementation treatment cycle. The PARIHS framework may

The value of a core clinical rotation in urology for medical students.

Science.gov (United States)

Patel, Premal; Nayak, Jasmir G; McGregor, Thomas B

2015-01-01

In 2013, our institution underwent a change to the undergraduate medical curriculum whereby a clinical urology rotation became mandatory. In this paper, we evaluated the perceived utility and value of this change in the core curriculum. Third year medical students, required to complete a mandatory 1-week clinical urology rotation, were asked to complete a survey before and after their rotation. Fourth year medical students, not required to complete this rotation, were also asked to complete a questionnaire. Chi-squared and Fisher's exact test were used for data analysis. In total, 108 third year students rotated through urology during the study period. Of these, 66 (61%) completed the pre-rotation survey and 54 (50%) completed the post-rotation survey. In total, there were 110 fourth year students. Of these, 44 (40%) completed the questionnaire. After completing their mandatory rotations, students felt more comfortable managing and investigating common urological problems, such as hematuria and renal colic. Students felt they had a better understanding of how to insert a Foley catheter and felt comfortable independently inserting a Foley catheter. Importantly, students felt they knew when to consult urology and were also more likely to consider a career in urology. Compared to fourth year students, third year students felt urology was an important component to a family medicine practice and felt they had a better understanding of when to consult urology. The introduction of a mandatory urology rotation for undergraduate medical students leads to a perceived improvement in fundamental urological knowledge and skill set of rotating students. This mandatory rotation provides a valuable experience that validates its inclusion.

Setting a good example: supervisors as work-life-friendly role models within the context of boundary management.

Science.gov (United States)

Koch, Anna R; Binnewies, Carmen

2015-01-01

This multisource, multilevel study examined the importance of supervisors as work-life-friendly role models for employees' boundary management. Particularly, we tested whether supervisors' work-home segmentation behavior represents work-life-friendly role modeling for their employees. Furthermore, we tested whether work-life-friendly role modeling is positively related to employees' work-home segmentation behavior. Also, we examined whether work-life-friendly role modeling is positively related to employees' well-being in terms of feeling less exhausted and disengaged. In total, 237 employees and their 75 supervisors participated in our study. Results from hierarchical linear models revealed that supervisors who showed more segmentation behavior to separate work and home were more likely perceived as work-life-friendly role models. Employees with work-life-friendly role models were more likely to segment between work and home, and they felt less exhausted and disengaged. One may conclude that supervisors as work-life-friendly role models are highly important for employees' work-home segmentation behavior and gatekeepers to implement a work-life-friendly organizational culture. PsycINFO Database Record (c) 2014 APA, all rights reserved.

Non-reporting of work injuries and aspects of jobsite safety climate and behavioral-based safety elements among carpenters in Washington State.

Science.gov (United States)

Lipscomb, Hester J; Schoenfisch, Ashley L; Cameron, Wilfrid

2015-04-01

Declining work injury rates may reflect safer work conditions as well as under-reporting. Union carpenters were invited to participate in a mailed, cross-sectional survey designed to capture information about injury reporting practices. Prevalence of non-reporting and fear of repercussions for reporting were compared across exposure to behavioral-based safety elements and three domains of the Nordic Safety Climate Questionnaire (NOSACQ-50). The majority (>75%) of the 1,155 participants felt they could report work-related injuries to their supervisor without fear of retribution, and most felt that the majority of injuries on their jobsites got reported. However, nearly half indicated it was best not to report minor injuries, and felt pressures to use their private insurance for work injury care. The prevalence of non-reporting and fear of reporting increased markedly with poorer measures of management safety justice (NOSACQ-50). Formal and informal policies and practices on jobsites likely influence injury reporting. © 2015 Wiley Periodicals, Inc.

On Deletion of Sutra Translation

Institute of Scientific and Technical Information of China (English)

CHEN Shu-juan

2017-01-01

Dao An's the metaphor of translation "wine diluted with water' ' expressed a view about translation that had been abridged.Later Kumarajiva provided metaphor "rice chewed—tasteless and downright disgusting".Both of them felt regretted at the weakening of taste,sometimes even the complete loss of flavor caused by deletion in translation of Buddhist sutras.In early sutra translation,deletion is unavoidable which made many sutra translators felt confused and drove them to study it further and some even managed to give their understanding to this issue.This thesis will discuss the definition,and what causes deletion and the measures adopted by the sutra translators.

"I just start crying for no reason": the experience of stress and depression in pregnant, urban, African-American adolescents and their perception of yoga as a management strategy.

Science.gov (United States)

Kinser, Patricia; Masho, Saba

2015-01-01

Perinatal health disparities are of particular concern with pregnant, urban, African-American (AA) adolescents, who have high rates of stress and depression during pregnancy, higher rates of adverse pregnancy and neonatal outcomes, and many barriers to effective treatment. The purpose of this study was to explore pregnant, urban, AA teenagers' experience of stress and depression and examine their perceptions of adjunctive nonpharmacologic management strategies, such as yoga. This community-based, qualitative study used nontherapeutic focus groups to allow for exploration of attitudes, concerns, beliefs, and values regarding stress and depression in pregnancy and nonpharmacologic management approaches, such as mind-body therapies and other prenatal activities. The sample consisted of pregnant, AA, low-income adolescents (n=17) who resided in a large urban area in the United States. The themes that arose in the focus group discussions were that 1) stress and depression symptoms are pervasive in daily life, 2) participants felt a generalized sense of isolation, 3) stress/depression management techniques should be group based, interactive, and focused on the specific needs of teenagers, and 4) yoga is an appealing stress management technique to this population. Findings from this study suggest that pregnant, urban, adolescents are highly stressed; they interpret depression-like symptoms to be signs of stress; they desire group-based, interactive activities; and they are interested in yoga classes for stress/depression management and relationship building. It is imperative that health care providers and researchers focus on these needs, particularly when designing prevention and intervention strategies. Copyright © 2015 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

Ethnic Minorities' Impression Management in the Interview: Helping or Hindering?

Science.gov (United States)

Derous, Eva

2017-01-01

Cross-cultural impression management (IM) has not been considered much, which is remarkable given the fast rate at which the labor market is becoming multicultural. This study investigated whether ethnic minorities and majorities differed in their preference for IM-tactics and how this affected ethnic minorities' interview outcomes. A preliminary study (focus groups/survey) showed that ethnic minorities (i.e., Arab/Moroccans) preferred 'entitlements' whereas majorities (i.e., Flemish/Belgians) preferred 'opinion conformity' as IM-tactics. An experimental follow-up study among 163 ethnic majority raters showed no main effect of IM-tactics on interview ratings. Ethnic minorities' use of IM-tactics only affected interview ratings if rater characteristics were considered. Specifically, interview ratings were higher when ethnic minorities used opinion conformity (i.e., majority-preferred IM-tactic) and lower when minorities used entitlements (i.e., minority-preferred IM-tactic) if recruiters were high in social dominance orientation, and when they felt more experienced/proficient with interviewing. IM-tactics are a human capital factor that might help applicants to increase their job chances on the labor market. It is concluded that ethnic minority applicants' preferences for certain IM-tactics might lead to bias even in structured interview settings, but that this depends on ethnic majority recruiters' interview experience and ingroup/outgroup attitudes. Implications for research and practice are discussed.

Open Access and Authors’ Rights Management: A Possibility for Theology?

Directory of Open Access Journals (Sweden)

Kevin L. Smith

2009-05-01

Full Text Available Several academic disciplines have begun to understand the benefits of open access to scholarship, both for scholars and for the general public. Scientific disciplines have led the way, partially due to the nature of scholarship in those areas and partially because they have felt the crisis in serials pricing more acutely than others. Theological studies, however, have largely been insulated from the push for open access; considering the reasons for that is the first task of this article. It is also the case, however, that the missionary impulse that stands behind much theological scholarship is a strong incentive to embrace the opportunities afforded by digital, online dissemination of research and writing. After discussing this imperative for global distribution, the bulk of the article focuses on how theological institutions, and especially their libraries, can encourage and support scholars in making their work freely accessible. Copyright issues, including the elements of a successful copyright management program, are discussed, as are some of the technological elements necessary for an efficient and discoverable open access repository. Options for licensing, both at ingestion of content and at dissemination to users are also considered. Finally, it is argued that the role of consortia and professional organizations in supporting these initiatives is especially important because of the relatively small size of so many theological institutions.

Ethnic Minorities’ Impression Management in the Interview: Helping or Hindering?

Science.gov (United States)

Derous, Eva

2017-01-01

Cross-cultural impression management (IM) has not been considered much, which is remarkable given the fast rate at which the labor market is becoming multicultural. This study investigated whether ethnic minorities and majorities differed in their preference for IM-tactics and how this affected ethnic minorities’ interview outcomes. A preliminary study (focus groups/survey) showed that ethnic minorities (i.e., Arab/Moroccans) preferred ‘entitlements’ whereas majorities (i.e., Flemish/Belgians) preferred ‘opinion conformity’ as IM-tactics. An experimental follow-up study among 163 ethnic majority raters showed no main effect of IM-tactics on interview ratings. Ethnic minorities’ use of IM-tactics only affected interview ratings if rater characteristics were considered. Specifically, interview ratings were higher when ethnic minorities used opinion conformity (i.e., majority-preferred IM-tactic) and lower when minorities used entitlements (i.e., minority-preferred IM-tactic) if recruiters were high in social dominance orientation, and when they felt more experienced/proficient with interviewing. IM-tactics are a human capital factor that might help applicants to increase their job chances on the labor market. It is concluded that ethnic minority applicants’ preferences for certain IM-tactics might lead to bias even in structured interview settings, but that this depends on ethnic majority recruiters’ interview experience and ingroup/outgroup attitudes. Implications for research and practice are discussed. PMID:28203211

Attitudes, norms and controls influencing lifestyle risk factor management in general practice

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McKenzie Suzanne H

2009-08-01

Full Text Available Abstract Background With increasing rates of chronic disease associated with lifestyle behavioural risk factors, there is urgent need for intervention strategies in primary health care. Currently there is a gap in the knowledge of factors that influence the delivery of preventive strategies by General Practitioners (GPs around interventions for smoking, nutrition, alcohol consumption and physical activity (SNAP. This qualitative study explores the delivery of lifestyle behavioural risk factor screening and management by GPs within a 45–49 year old health check consultation. The aims of this research are to identify the influences affecting GPs' choosing to screen and choosing to manage SNAP lifestyle risk factors, as well as identify influences on screening and management when multiple SNAP factors exist. Methods A total of 29 audio-taped interviews were conducted with 15 GPs and one practice nurse over two stages. Transcripts from the interviews were thematically analysed, and a model of influencing factors on preventive care behaviour was developed using the Theory of Planned Behaviour as a structural framework. Results GPs felt that assessing smoking status was straightforward, however some found assessing alcohol intake only possible during a formal health check. Diet and physical activity were often inferred from appearance, only being assessed if the patient was overweight. The frequency and thoroughness of assessment were influenced by the GPs' personal interests and perceived congruence with their role, the level of risk to the patient, the capacity of the practice and availability of time. All GPs considered advising and educating patients part of their professional responsibility. However their attempts to motivate patients were influenced by perceptions of their own effectiveness, with smoking causing the most frustration. Active follow-up and referral of patients appeared to depend on the GPs' orientation to preventive care, the

Attitudes, norms and controls influencing lifestyle risk factor management in general practice.

Science.gov (United States)

Ampt, Amanda J; Amoroso, Cheryl; Harris, Mark F; McKenzie, Suzanne H; Rose, Vanessa K; Taggart, Jane R

2009-08-26

With increasing rates of chronic disease associated with lifestyle behavioural risk factors, there is urgent need for intervention strategies in primary health care. Currently there is a gap in the knowledge of factors that influence the delivery of preventive strategies by General Practitioners (GPs) around interventions for smoking, nutrition, alcohol consumption and physical activity (SNAP). This qualitative study explores the delivery of lifestyle behavioural risk factor screening and management by GPs within a 45-49 year old health check consultation. The aims of this research are to identify the influences affecting GPs' choosing to screen and choosing to manage SNAP lifestyle risk factors, as well as identify influences on screening and management when multiple SNAP factors exist. A total of 29 audio-taped interviews were conducted with 15 GPs and one practice nurse over two stages. Transcripts from the interviews were thematically analysed, and a model of influencing factors on preventive care behaviour was developed using the Theory of Planned Behaviour as a structural framework. GPs felt that assessing smoking status was straightforward, however some found assessing alcohol intake only possible during a formal health check. Diet and physical activity were often inferred from appearance, only being assessed if the patient was overweight. The frequency and thoroughness of assessment were influenced by the GPs' personal interests and perceived congruence with their role, the level of risk to the patient, the capacity of the practice and availability of time. All GPs considered advising and educating patients part of their professional responsibility. However their attempts to motivate patients were influenced by perceptions of their own effectiveness, with smoking causing the most frustration. Active follow-up and referral of patients appeared to depend on the GPs' orientation to preventive care, the patient's motivation, and cost and accessibility of

General practitioners knowledge and management of whiplash associated disorders and post-traumatic stress disorder: implications for patient care.

Science.gov (United States)

Brijnath, Bianca; Bunzli, Samantha; Xia, Ting; Singh, Nabita; Schattner, Peter; Collie, Alex; Sterling, Michele; Mazza, Danielle

2016-07-20

In Australia, general practitioners (GPs) see around two-thirds of people injured in road traffic crashes. Road traffic crash injuries are commonly associated with diverse physical and psychological symptoms that may be difficult to diagnose and manage. Clinical guidelines have been developed to assist in delivering quality, consistent care, however the extent to which GPs knowledge and practice in diagnosing and managing road traffic crash injuries concords with the guidelines is unknown. This study aimed to explore Australian GPs knowledge, attitudes and practices regarding the diagnosis and management of road traffic crash injuries, specifically whiplash associated disorders (WAD) and post-traumatic stress disorder (PTSD). A cross-sectional survey of 423 GPs across Australia conducted between July and December 2014. We developed a questionnaire to assess their knowledge of WAD and PTSD, confidence in diagnosing and managing WAD and PTSD, frequency of referral to health providers, barriers to referral, and attitudes towards further education and training. Factor analysis, Spearman's correlation, and multiple ordered logistic regressions were performed. Overall, GPs have good level knowledge of WAD and PTSD; only 9.6 % (95 % CI: 7.1 %, 12.8 %) and 23.9 % (95 % CI: 20.8 %, 28.2 %) of them were deemed to have lower level knowledge of WAD and PTSD respectively. Key knowledge gaps included imaging indicators for WAD and indicators for psychological referral for PTSD. GPs who were male, with more years of experience, working in the urban area and with higher knowledge level of WAD were more confident in diagnosing and managing WAD. Only GPs PTSD knowledge level predicted confidence in diagnosing and managing PTSD. GPs most commonly referred to physiotherapists and least commonly to vocational rehabilitation providers. Barriers to referral included out-of-pocket costs incurred by patients and long waiting times. Most GPs felt positive towards further education

Tourists' Perceptions of the Free-Roaming Dog Population in Samoa.

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Beckman, Magnus; Hill, Kate E; Farnworth, Mark J; Bolwell, Charlotte F; Bridges, Janis; Acke, Els

2014-09-29

A study was undertaken to establish how visiting tourists to Samoa perceived free-roaming dogs (Canis familiaris) and their management, additionally some factors that influence their perceptions were assessed. Questionnaires were administered to 281 tourists across Samoa over 5 weeks. Free-roaming dogs were seen by 98.2% (n = 269/274) of respondents, with 64.9% (n = 137/211) reporting that their presence had a negative effect on overall holiday experience. Respondents staying in the Apia (capital city) area were more likely to consider dogs a problem (p < 0.0001), and there was a significant association between whether the respondent owned a dog and if they thought dogs were a nuisance in Samoa (p < 0.003). Forty-four percent (20/89) of non-dog owners agreed that dogs were a nuisance compared to 22% (80/182) of dog owners. The majority felt that dogs required better control and management in Samoa (81%, n = 222) and that there were too many "stray" dogs (67.9%, n = 188). More respondents were negatively affected by the dogs' presence (64.9%, 137/211), and felt that the dogs made their holiday worse, than respondents that felt the dogs' presence improved their holiday experience (35.1%, 74/211). Most respondents stated that the dogs had a low impact (one to three; 68%, 187/275) on their stay in Samoa, whilst 24% (65/275) and 8% (23/275) stated they had a medium or high impact, respectively, on their stay. Respondents showed strong support for humane population management. Free-roaming dogs present a complex problem for Samoa and for its tourism industry in particular. The findings of this study further support the need for more discussion and action about the provision of veterinary services and population management for dogs in Samoa. It also provides information complementing an earlier study of the attitudes of local Samoans.

Determinants of village doctors' job satisfaction under China's health sector reform: a cross-sectional mixed methods study.

Science.gov (United States)

Li, Tongtong; Lei, Trudy; Sun, Fiona; Xie, Zheng

2017-04-18

To strengthen rural health workforce, the Chinese government has launched a series of policies to promote the job satisfaction of village doctors since the health sector reform. The purpose of this mixed-method study is to describe village doctors' job satisfaction under the context of health sector reform and investigate the associated factors. Data was obtained from a survey of village doctors across three Chinese provinces in 2014. Using a multistage sampling process, quantitative data was collected from village doctors through the self-administered questionnaire and analyzed by multilevel logistic regression models. Qualitative data was collected through face-to-face semi-structured interviews on both village doctors and health managers. Theoretical coding was then conducted to analyze qualitative data. Among the 1221 respondents, 48.6% felt satisfied with their job. Older village doctors with less of a workload and under high-level integrated management were more likely to feel satisfied with their job. Village doctors who earned the top level of monthly income felt more satisfied, while on the county level, those who lived in counties with the highest GDP felt less satisfied. However, enrollment in a pension plan showed no significant difference in regards to village doctors' job satisfaction. Among 34 participants of qualitative interviews, most believed that age, income, and integrated management had a positive influence on the job satisfaction, while pension plan and basic public health care policies exhibited negative effects. Also, the increasing in availability of healthcare and health resources along with local economic development had negative effects on village doctors' job satisfaction. Village doctors' job satisfaction was quite low in regards to several determinants including age, income, workload, enrollment in a pension plan, integrated management, and county economic and medical availability development.

Nuclear waste: A problem of perspective

International Nuclear Information System (INIS)

Williams, I.G.K.

1979-01-01

In the light of the suspicion to be felt in the public towards the problem of nuclear waste management, the author in his article attempts to correct the impression created by somewhat sensational reports in the daily press by giving a more accurate description of nuclear waste management. He points out that responsible and fruitful research work has been done and should be made known to the public. (RB) [de

EVALUATION OF COST CENTER OPERATIONS USING ABC METHOD

OpenAIRE

Madalina Aurelia GRIGORE; Elena Daniela NICOLAE; George Ciprian GIJU; Daniela MITRAN

2010-01-01

The continuous changes appearing in the industrial and economic environment, upgrading of manufacturing technologies, the need to obtain relevant information to facilitate management decision making, have made absolutely necessary the rethinking of the cost calculation system. Both traditional and modern methods used in management accounting for costing is based on cropping the enterprise into responsibility centers. But within the organization is being felt the interdependence that is imposs...

Web 2.0 chronic disease self-management for older adults: a systematic review.

Science.gov (United States)

Stellefson, Michael; Chaney, Beth; Barry, Adam E; Chavarria, Enmanuel; Tennant, Bethany; Walsh-Childers, Kim; Sriram, P S; Zagora, Justin

2013-02-14

Participatory Web 2.0 interventions promote collaboration to support chronic disease self-management. Growth in Web 2.0 interventions has led to the emergence of e-patient communication tools that enable older adults to (1) locate and share disease management information and (2) receive interactive healthcare advice. The evolution of older e-patients contributing to Web 2.0 health and medical forums has led to greater opportunities for achieving better chronic disease outcomes. To date, there are no review articles investigating the planning, implementation, and evaluation of Web 2.0 chronic disease self-management interventions for older adults. To review the planning, implementation, and overall effectiveness of Web 2.0 self-management interventions for older adults (mean age ≥ 50) with one or more chronic disease(s). A systematic literature search was conducted using six popular health science databases. The RE-AIM (Reach, Efficacy, Adoption, Implementation and Maintenance) model was used to organize findings and compute a study quality score (SQS) for 15 reviewed articles. Most interventions were adopted for delivery by multidisciplinary healthcare teams and tested among small samples of white females with diabetes. Studies indicated that Web 2.0 participants felt greater self-efficacy for managing their disease(s) and benefitted from communicating with health care providers and/or website moderators to receive feedback and social support. Participants noted asynchronous communication tools (eg, email, discussion boards) and progress tracking features (eg, graphical displays of uploaded personal data) as being particularly useful for self-management support. Despite high attrition being noted as problematic, this review suggests that greater Web 2.0 engagement may be associated with improvements in health behaviors (eg, physical activity) and health status (eg, HRQoL). However, few studies indicated statistically significant improvements in medication

Flood Risk in Australia: Whose Responsibility Is It, Anyway?

Directory of Open Access Journals (Sweden)

Robin van den Honert

2013-10-01

Full Text Available This paper presents research into four key stakeholders in flood risk management in Australia: local councils, the insurance industry, the State Emergency Service (SES, and local residents; examining the perception of their own roles and responsibilities, and those of the other stakeholders. Key informant interviews were conducted in four locations—Brisbane and Emerald, in Queensland, Dora Creek, in New South Wales, and Benalla, in Victoria. We find that understanding of the roles and responsibilities of each stakeholder varied considerably between research participants. Insurance representatives felt their concerns about increasing flood risk costs were unheeded until the 2010–2011 floods made them the “canary in the coal mine”. Councils felt they had limited options for reducing flood risk. SES representatives felt they were too relied upon for event response, with requests for assistance outstripping their capacity to assist, and many residents were uncertain how to prepare for flood, relying on emergency agencies and the local council to protect them. Key lessons for flood risk management in Australia are (a an urgent need for all stakeholders to better understand each others’ roles and responsibilities; and (b residents must take greater responsibility for their own personal protection. Only then can the vision of shared responsibility presented by the 2009 National Strategy for Disaster Resilience be achieved.

Use of a customer satisfaction survey by health care regulators: a tool for total quality management.

Science.gov (United States)

Andrzejewski, N; Lagua, R T

1997-01-01

To conduct a survey of health care providers to determine the quality of service provided by the staff of a regulatory agency; to collect information on provider needs and expectations; to identify perceived and potential problems that need improvement; and to make changes to improve regulatory services. The authors surveyed health care providers using a customer satisfaction questionnaire developed in collaboration with a group of providers and a research consultant. The questionnaire contained 20 declarative statements that fell into six quality domains: proficiency, judgment, responsiveness, communication, accommodation, and relevance. A 10% level of dissatisfaction was used as the acceptable performance standard. The survey was mailed to 324 hospitals, nursing homes, home care agencies, hospices, ambulatory care centers, and health maintenance organizations. Fifty-six percent of provider agencies responded; more than half had written comments. The three highest levels of customer satisfaction were in courtesy of regulatory staff (90%), efficient use of onsite time (84%), and respect for provider employees (83%). The three lowest levels of satisfaction were in the judgment domain; only 44% felt that there was consistency among regulatory staff in the interpretation of regulations, only 45% felt that interpretations of regulations were flexible and reasonable, and only 49% felt that regulations were applied objectively. Nine of 20 quality indicators had dissatisfaction ratings of more than 10%; these were considered priorities for improvement. Responses to the survey identified a number of specific areas of concern; these findings are being incorporated into the continuous quality improvement program of the office.

Promoting weight management services in community pharmacy: perspectives of the pharmacy team in Scotland.

Science.gov (United States)

Weidmann, Anita Elaine; MacLure, Katie; Marshall, Sarah; Gray, Gwen; Stewart, Derek

2015-08-01

Obesity has reached pandemic levels with more than 1.4 billion adults affected worldwide. While there is a need to systematically develop and evaluate community pharmacy based models of weight management, it is imperative to describe and understand the perspectives of pharmacy staff. In the UK, trained and accredited community pharmacy medicines counter assistants (MCAs) are commonly the front line staff involved in patient consultations and sale of over-the-counter medicines. To explore the beliefs and experiences of pharmacists and MCAs in the North-East of Scotland on community pharmacy weight management. All 135 community pharmacies in the North-East of Scotland. A qualitative approach of semi-structured telephone interviews with 31 pharmacists and 20 MCAs in the North-East of Scotland. The semi-structured interview schedule was developed with reference to key domains describing professional practice (i.e. awareness and knowledge, skills, practicalities, motivation, acceptance and beliefs) and contextualised with policy documents and published research on community pharmacy based weight management. Interviews were audio-recorded, transcribed and analysed thematically. Pharmacists' and MCAs' beliefs and experiences with delivering weight management services in community pharmacy. There were mixed responses from pharmacists and MCAs around pharmacy based weight management services from positive views of providing the service in community pharmacy to those more reticent who would always favour patients visiting their physician. While all described similar services e.g. measurement of weight, healthy eating advice, supply of products, they acknowledged that support was often opportunistic at the request of customers, with little integration of other providers. Roles described varied from pharmacist only functions to any staff member. While pharmacists generally felt comfortable and confident, MCAs gave more diverse responses. Both Pharmacist and MCAs highlighted

Management of dental trauma in primary care: a postal survey of general dental practitioners.

Science.gov (United States)

Jackson, N G; Waterhouse, P J; Maguire, A

2005-03-12

referral. Eighty-eight per cent of GDPs felt that aids to management would be useful. Although GDPs believed that financial remuneration was inadequate, this did not prevent them treating trauma cases. They strongly agreed that they had responsibility for the management of dental trauma in primary care and that they believed trauma could be treated more effectively in practice if payment was greater. Time constraints were perceived as a barrier to long-term management of complex trauma cases in primary care. GDPs would welcome the use of management aids.

[Cases of pertussis among healthcare workers in a maternity ward: management of a health alert].

Science.gov (United States)

Vanjak, D; Delaporte, M F; Bonmarin, I; Levardon, M; Fantin, B

2006-03-01

Pertussis is a highly contagious acute respiratory tract infection, with a poor prognosis in non-vaccinated new-borns. The authors had for aim to investigate an epidemic of 5 pertussis cases among health care workers (HCW) in our maternity ward with potential exposure of new-borns and to evaluate HCW compliance and experience gain. A retrospective study was made using a questionnaire with HCW on preventive measures taken (antibiotic prophylaxis with erythromycin and wearing a mask). Two hundred and thirty-eight patients were warned of a potential pertussis contamination. No nosocomial case was detected among patients or their new borns. Ten proved or probable cases were identified among 101 HCW having answered (N=101/210, 48%). Sixty percent of HCW people followed the antibiotic treatment and 85% wore a mask among whom 46% adequately. Non-compliance factors were mainly related to adverse effects (41%), delayed information (41%), and false vaccine protection (22%). Crisis communication was felt as unsatisfactory for 72% of HCW and recommendations not adapted for 39% of the staff. This survey points out the difficulty of managing a pertussis alert in a medical ward.

Examination of Teacher Knowledge, Dissemination Preferences, and Classroom Management of Student Concussions: Implications for Return-to-Learn Protocols.

Science.gov (United States)

Dreer, Laura E; Crowley, Maria T; Cash, Augusta; O'Neill, Jilian A; Cox, Molly K

2017-05-01

To determine teacher knowledge of (1) concussion symptomatology, (2) dissemination preferences, and (3) classroom management practices of student concussions. A cross-sectional survey assessing concussion-related information was completed by teachers/instructors in the state of Alabama. One-hundred and thirty participants completed the survey. Only a quarter perceived they were "very" or "extremely" confident enough to recognize signs related to a concussion (22.3%), and only 12.4% reported they were "very knowledgeable" about concussions. The majority were able to recognize more common concussion symptoms/challenges: headaches (95.4%), trouble concentrating (86.2%), memory (82.3%), balance problems/dizziness (82.3%), changes vision/hearing (76.2%), difficulty completing tasks (70.8%), difficulty making decisions (66.2%), changes in sleep (61.5%), and fatigue (60.8%); only half recognized emotional symptoms (e.g., mood) or symptoms associated with more prolonged recovery. Concussion informants were school nurses (74.4%), followed by parents (46.2%), students (46.2%), and coaches/athletic trainers (45.4%). A little under half of participants received concussion information as part of their job (41.9%). About 14.1% of teachers reported that someone had come to their school to talk with them as a group about concussions, and 82% felt they needed more information. Of the 37% who taught a concussed student, 83% reported they altered the classroom management strategies. In general, teachers were able to recognize the more commonly experienced concussion symptoms as well as management strategies. However, they appear to want greater concussion information and training. Given the daily influence of teachers on student tasks involving cognitive exertion, incorporation of formal concussion education for teachers is warranted.

EDUCATION MANAGEMENT DECISION-MAKERS IN EUROPEAN PRE – UNIVERSITY EDUCATION

Directory of Open Access Journals (Sweden)

DUMITRAȘCU DANUȚ DUMITRU

2012-12-01

Full Text Available EDUCATION MANAGEMENT DECISION-MAKERS IN EUROPEAN PRE – UNIVERSITY EDUCATION Ana Tuºa, 1 Affiliation , “Lucian Blaga” University of Sibiu, Faculty of Economics, Department of management Claudiu Sorin Voinia 2 , Affiliation, “Lucian Blaga” University of Sibiu Faculty of Engineering, Department of Industrial Engineering Dãnuþ Dumitru Dumitraºcu 3 Affiliation, “Lucian Blaga” University of Sibiu, Faculty of Economics, Department of management The theme paper consists in a comparative analysis of European preuniveristary education decision makers. Decision makers in preuniversity education management remain the key issue in the political agenda of most European countries. The diversity of educational policies in each European country aims to increase school autonomy, in a way that allows comparison of their main elements of management. Scientific research carried out aimed both theoretical and practical terms: - comparative analysis of how the makers of European schools are responsible for the management practiced in the educational institution. - identification of the achievement of school autonomy. Lately, in terms of policy makers and school autonomy, schools have gone through many reforms. It was felt the need to improve the democratic management and the quality of the educational process. The analysis and the approaches differ in terms of pace of reform, scale transfer of authority and areas that apply. No approach can be chosen as the ideal one or more effective than others, because the contexts in which they were made are so diverse. However, as it moves along, educational policy makers can learn from the approaches and experiences of others. The methodology was based on: the study of scientific literature from the country and abroad, on the theory and practice regarding the decision in the management of school education activities. Comparative analysis was conducted based on questionnaires

A survey of the assessment and management of gout in general practitioners and medical officers within the Illawarra Network, Australia.

Science.gov (United States)

Terrill, Matthew; Riordan, John

2017-08-01

To review the assessment and management of gout by general practitioners (GPs) and medical officers (MOs) within the Illawarra Network, Australia. A survey was sent to GPs and MOs within the Illawarra Network. Of 110 GPs, 45 responded. Of 129 MOs, 42 responded. The overall response was 32.6%. On analysis, 65.1% felt their knowledge of gout to be adequate and 61.6% thought they had been educated well. In acute assessment, 59.1% of GPs responded that the diagnosis of gout best be confirmed with a joint aspiration and 36.4% clinical suspicion. Differing, 85.7% of MOs chose a joint aspiration. In acute management, if colchicine were used, 59.1% of GPs would give 1 mg followed by 0.5 mg an hour later, then 0.5 mg twice daily, compared to 9.5% of MOs, while 20.5% of GPs would use 1 mg twice daily. Chronic management was answered poorly. After an acute attack, urate lowering therapy (ULT) would be started 14 days after by 47.7% of GPs, compared to 69.0% of MOs. GPs were more likely to start ULT within 7 days (52.3% vs. 31.0%). With dosing of ULT, 45.3% would treat to target, while 46.5% would dose to the creatinine clearance. Prophylactic therapy with ULT would be started by 81.8%, although only 17.4% would continue it for 3-6 months. There is poor adherence to recommended practice for dosing of colchicine in acute gout. Also in the management of chronic gout, in particular, the timing of starting ULT and the use of prophylaxis when initiating ULT. © 2016 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

Management of Heat and Cold Stress - Guidance to NATO Medical Personnel

Science.gov (United States)

2012-12-01

Soldiers with UCHS Arm Immersion Cooling Device. To use, Soldiers place their forearms in the cool water, covering the area from the fingers to...UCHS. 1.7 MICROCLIMATE AND OTHER COOLING TECHNOLOGIES  Microclimate cooling systems are effective in alleviating heat stress and...systems are effective in reducing heat strain and in some environments are felt to be as effective as water- cooled devices. In addition, air- cooled vests

Cervical screening program and the psychological impact of an abnormal Pap smear: a self-assessment questionnaire study of 590 patients.

Science.gov (United States)

Thangarajah, Fabinshy; Einzmann, Thomas; Bergauer, Florian; Patzke, Jan; Schmidt-Petruschkat, Silke; Theune, Monika; Engel, Katja; Puppe, Julian; Richters, Lisa; Mallmann, Peter; Kirn, Verena

2016-02-01

Invasive cervical cancer is today the fourth most common cancer of women in western civilization. Screening programs have led to a continuously decrease. Nevertheless, both screening and a positive test result are known to be associated with a negative psychological impact. Screening programs in European countries differ and thus psychological impact might as well. The aim of this study was to evaluate the psychological impact of women with an abnormal Pap smear in a German cohort. Between July 2013 and May 2014, a self-assessment questionnaire was distributed to 595 patients that were referred to a special clinic for cervical dysplasia for further evaluation of an abnormal Pap smear. Patients were recruited in five different centers. Most patients (45.9 %) were informed about the test result via phone call by their doctor. 68.8 % of the patients felt anxious and 26.3 % even felt panic. After having talked to their physician, 51.4 % of our cohort still felt worried and only 24.4 % felt reassured. Concerning disease management, 48.4 % underwent a control Pap smear in 6 months. The preferred information source was the physician (63.9 %). Compared to the results in other European countries, our study cohort showed differences concerning age distribution, patients living in a partnership, number of children and especially disease management. Cancer screening itself and abnormal test results have an impact on patient's feelings. To reduce the psychological impact, patients need to be better informed about the risks and benefits of cancer screening programs and in case of cervical cancer screening about the meaning of an abnormal test result. Our results underline the importance of a trustful physician-patient relationship in that matter.

Shared decision making in the management of children with newly diagnosed immune thrombocytopenia.

Science.gov (United States)

Beck, Carolyn E; Boydell, Katherine M; Stasiulis, Elaine; Blanchette, Victor S; Llewellyn-Thomas, Hilary; Birken, Catherine S; Breakey, Vicky R; Parkin, Patricia C

2014-10-01

This study aimed to examine the treatment decision-making process for children hospitalized with newly diagnosed immune thrombocytopenia (ITP). Using focus groups, we studied children with ITP, parents of children with ITP, and health care professionals, inquiring about participants' experience with decision support and decision making in newly diagnosed ITP. Data were examined using thematic analysis. Themes that emerged from children were feelings of "anxiety, fear, and confusion"; the need to "understand information"; and "treatment choice," the experience of which was age dependent. For parents, "anxiety, fear, and confusion" was a dominant theme; "treatment choice" revealed that participants felt directed toward intravenous immune globulin (IVIG) for initial treatment. For health care professionals, "comfort level" highlighted factors contributing to professionals' comfort with offering options; "assumptions" were made about parental desire for participation in shared decision making (SDM) and parental acceptance of treatment options; "providing information" was informative regarding modes of facilitating SDM; and "treatment choice" revealed a discrepancy between current practice (directed toward IVIG) and the ideal of SDM. At our center, families of children with newly diagnosed ITP are not experiencing SDM. Our findings support the implementation of SDM to facilitate patient-centered care for the management of pediatric ITP.

水和丙酮工质的金属纤维毡蒸气腔热管的传热性能%Thermal performance of vapor chamber heat pipe with metal felt wick of water or acetone working fluid

Institute of Scientific and Technical Information of China (English)

徐鹏程; 陶汉中; 张红

2015-01-01

通过实验研究了金属纤维毡吸液芯蒸气腔热管的传热特性，测试了在单一热源下，不同热通量、风速以及工质种类时蒸气腔热管的启动性能与均温特性，并使用红外热像仪对蒸气腔热管冷凝端拍摄。实验中蒸气腔热管使用的工质分别为水与丙酮。实验结果表明：金属纤维毡蒸气腔热管的启动时间基本在3000 s左右；蒸气腔热管的蒸发端与冷凝端的等温性能良好，其中水工质的冷热端最小温差为1.35℃，因此使用金属纤维毡吸液芯蒸气腔热管可以避免电子器件的局部高温。%The heat transfer characteristics of the vapor chamber heat pipe with metal fiber felt wick were studied by experiments. Under different conditions, the isothermal characteristics and startup performance of the vapor chamber heat pipe using a single heat source were tested. The variables were heat flux, cooling wind speed and working fluid. The condenser section of the vapor chamber heat pipe was filmed by infrared thermography. The working fluid used in the vapor chamber heat pipe was water or acetone. The vapor chamber heat pipe could startup smoothly from ambient temperature at different heating powers, and startup time was about 3000 s. Both evaporator and condenser sections of the vapor chamber heat pipe had good isothermal performance, and the minimum temperature difference of the heat pipe using water as working fluid was 1.35℃. So electronic devices could avoid local high temperature by using the vapor chamber heat pipe with metal fiber felt wick.

Transforming LEGO for the Digital Economy

DEFF Research Database (Denmark)

Andersen, Peter; Ross, Jeanne

2016-01-01

processes. The goal of the new transformation is “to become a digital company.” Although the company already looked digital in 2016, management felt it had not become digital—in its products and processes. This case describes the LEGO Group’s journey to become a successful digital company....

78 FR 33193 - Airworthiness Directives; The Boeing Company Airplanes

Science.gov (United States)

2013-06-04

... modifications (such as the installation of felt on Model 767 airplanes per Figure 18 of Boeing Special Attention... information identified in this AD, contact Boeing Commercial Airplanes, Attention: Data & Services Management... Transportation, Docket Operations, M-30, West Building Ground Floor, Room W12-140, 1200 New Jersey Avenue SE...

Are general surgery residents adequately prepared for hepatopancreatobiliary fellowships? A questionnaire-based study

Science.gov (United States)

Osman, Houssam; Parikh, Janak; Patel, Shirali; Jeyarajah, D Rohan

2015-01-01

Background The present study was conducted to assess the preparedness of hepatopancreatobiliary (HPB) fellows upon entering fellowship, identify challenges encountered by HPB fellows during the initial part of their HPB training, and identify potential solutions to these challenges that can be applied during residency training. Methods A questionnaire was distributed to all HPB fellows in accredited HPB fellowship programmes in two consecutive academic years (n = 42). Reponses were then analysed. Results A total of 19 (45%) fellows responded. Prior to their fellowship, 10 (53%) were in surgical residency and the rest were in other surgical fellowships or surgical practice. Thirteen (68%) were graduates of university-based residency programmes. All fellows felt comfortable in performing basic laparoscopic procedures independently at the completion of residency and less comfortable in performing advanced laparoscopy. Eight (42%) fellows cited a combination of inadequate case volume and lack of autonomy during residency as the reasons for this lack of comfort. Thirteen (68%) identified inadequate preoperative workup and management as their biggest fear upon entering practice after general surgery training. A total of 17 (89%) fellows felt they were adequately prepared to enter HPB fellowship. Extra rotations in transplant, vascular or minimally invasive surgery were believed to be most helpful in preparing general surgery residents pursing HPB fellowships. Conclusions Overall, HPB fellows felt themselves to be adequately prepared for fellowship. Advanced laparoscopic procedures and the perioperative management of complex patients are two of the challenges facing HPB fellows. General surgery residents who plan to pursue an HPB fellowship may benefit from spending extra rotations on certain subspecialties. Focus on perioperative workup and management should be an integral part of residency and fellowship training. PMID:25387852

College Students' Attitudes & Responses toward the Current Economy and Its Implications for Marketing Managers

Science.gov (United States)

Gray, Lauren; Lamanette, Michelle; Silva, Alberto; Budden, Michael C.

2009-01-01

Since the early months of 2009, the undeniable woes of the economy are being felt by many. With a record number of corporate closings, rising unemployment and the crises in the financial markets, this may prove to be a difficult year for many. This paper uses empirical evidence collected from Southeastern Louisiana University students to learn how…

Increasing emergency medicine residents' confidence in disaster management: use of an emergency department simulator and an expedited curriculum.

Science.gov (United States)

Franc, Jeffrey Michael; Nichols, Darren; Dong, Sandy L

2012-02-01

Disaster Medicine is an increasingly important part of medicine. Emergency Medicine residency programs have very high curriculum commitments, and adding Disaster Medicine training to this busy schedule can be difficult. Development of a short Disaster Medicine curriculum that is effective and enjoyable for the participants may be a valuable addition to Emergency Medicine residency training. A simulation-based curriculum was developed. The curriculum included four group exercises in which the participants developed a disaster plan for a simulated hospital. This was followed by a disaster simulation using the Disastermed.Ca Emergency Disaster Simulator computer software Version 3.5.2 (Disastermed.Ca, Edmonton, Alberta, Canada) and the disaster plan developed by the participants. Progress was assessed by a pre- and post-test, resident evaluations, faculty evaluation of Command and Control, and markers obtained from the Disastermed.Ca software. Twenty-five residents agreed to partake in the training curriculum. Seventeen completed the simulation. There was no statistically significant difference in pre- and post-test scores. Residents indicated that they felt the curriculum had been useful, and judged it to be preferable to a didactic curriculum. In addition, the residents' confidence in their ability to manage a disaster increased on both a personal and and a departmental level. A simulation-based model of Disaster Medicine training, requiring approximately eight hours of classroom time, was judged by Emergency Medicine residents to be a valuable component of their medical training, and increased their confidence in personal and departmental disaster management capabilities.

Towards an adaptive management approach for the conservation of rare antelope in the Kruger National Park - outcome of a workshop held in May 2000

Directory of Open Access Journals (Sweden)

C.C. Grant

2000-07-01

Full Text Available A precipitous drop in rare antelope numbers specifically roan (Hippotragus equinis sable (Hippotragus niger and tsessebe (Damaliscus lunatus since 1986 has become one of the main concerns of management. The zebra (Equus burchelli population in the preferred habitats of these species had increased with the development of artificial waterpoints especially in the areas occupied by roan and tsessebe, and these events are hypothesised to be the main cause of the decline. Closure of artificial waterpoints resulted in moving the high-density, water-dependent zebra from the northern basalt plains, the preferred roan habitat. However, the expected responding increase in the rare antelope populations did not materialise. This lack of response over six years necessitated a critical re-evaluation of the management of rare antelope in the Kruger National Park. Subsequently, a workshop was held at Skukuza during May 2000. The options for adaptive management of the declining rare antelope populations, which was discussed at the workshop, is the subject of this manuscript. The participants felt that the removal/closure of artificial waterpoints was the most unintrusive management tool available to move high density grazers from the habitats preferred by rare antelope. Waterpoints to be closed should be carefully evaluated, and time allowed for rare antelope to respond to habitat changes. Boosting populations of roan and tsessebe by supplementing animals was seriously considered, with the proviso that it should be done under favourable circumstances. Small patch fires that could provide green grazing over extended periods were recommended. Predator control was discussed but could not obtain general support as a viable option in the Kruger National Park.

Competences and life management programmes

International Nuclear Information System (INIS)

Brunatti, S.; Bergara, A.; Ranalli, J.; Versaci, R.

2007-01-01

Full text: The nuclear industry is, at present, at a crucial juncture, where it has to decide about the future of the first generation of nuclear plants, which are approaching the end of their licensed service life. At the same time, long term experience and new advances have established that it is possible to extend the life of nuclear plants beyond their initially licensed life by another 20-30 years. Extending the operating life of existing nuclear plants will help to reduce the short term need for new generating capacity - without new capital costs. However, these extensions must take place in the context of careful safety analysis and monitoring of equipment ageing concerns. A nuclear power plant must be managed in a safe and efficient manner throughout all the life cycle stages from design through decommissioning. The consequences of management decisions about nuclear power plants can have profound economic impacts for the nuclear power plant owner, and possibly for the national economy. In addition, the consequence of a major failure or accident can have catastrophic national socio-economic effects that may be felt internationally. The safe and effective management of a nuclear power plant therefore requires dramatically different perspectives in time from the majority of other industries. The impact of some decisions extends beyond the normal strategic perspective of both owners and governments. The integration of activities for ageing management, safety management and business management of a nuclear power plant are an essential element of 'life cycle management'. The loss of information at any stage of a nuclear power plants life deprives people, at later stages, of knowledge that could be important to safe, economic completion of work or which could aid the analysis of problems and options. It is costly to go through the learning process again, with a risk of potential events or incidents, programme delays, physical injury and increased regulatory

General Practitioner's Attitudes and Confidence in Managing Patients with Dementia in Singapore.

Science.gov (United States)

Subramaniam, Mythily; Ong, Hui Lin; Abdin, Edimansyah; Chua, Boon Yiang; Shafie, Saleha; Siva Kumar, Fiona Devi; Foo, Sophia; Ng, Li Ling; Lum, Alvin; Vaingankar, Janhavi A; Chong, Siow Ann

2018-03-01

The number of people living with dementia is increasing globally as a result of an ageing population. General practitioners (GPs), as the front-line care providers in communities, are important stakeholders in the system of care for people with dementia. This commentary describes a study conducted to understand GPs' attitudes and self-perceived competencies when dealing with patients with dementia and their caregivers in Singapore. A set of study information sheet and survey questionnaires were mailed to selected GP clinics in Singapore. The survey, comprising the "GP Attitudes and Competencies Towards Dementia" questionnaire, was administered. A total of 400 GPs returned the survey, giving the study a response rate of 52.3%. About 74% of the GPs (n=296) were seeing dementia patients in their clinics. Almost all the GPs strongly agreed that early recognition of dementia served the welfare of the patients (n=385; 96%) and their relatives (n=387; 97%). About half (51.5%) of the respondents strongly agreed or agreed that they felt confident carrying out an early diagnosis of dementia. Factor analysis of questionnaire revealed 4 factors representing "benefits of early diagnosis and treatment of patients with dementia", "confidence in dealing with patients and caregiver of dementia", "negative perceptions towards dementia care" and "training needs". GPs in Singapore held a generally positive attitude towards the need for early dementia diagnosis but were not equally confident or comfortable about making the diagnosis themselves and communicating with and managing patients with dementia in the primary care setting. Dementia education and training should therefore be a critical step in equipping GPs for dementia care in Singapore. Shared care teams could further help build up GPs' knowledge, confidence and comfort in managing patients with dementia.

Recruiting Young Volunteers in an Area of Selective Education: A Qualitative Case Study

Science.gov (United States)

Dean, Jon

2016-01-01

This article presents findings from a small qualitative case study of a youth volunteering brokerage organisation in England, operating in an area of selective state education. Data show how brokerage workers felt grammar schools managed their students in a concerted way to improve students' chances of attending university. Conversely, workers…

Updating Financial Ratios: Seeking Greater Understanding, Precision, and Practicality.

Science.gov (United States)

Jenny, Hans H.; Minter, W. John

1993-01-01

Modifications to current methods of calculating and reporting financial ratios are outlined for college managers. The modified ratios, felt to be more realistic, are illustrated with applications in three areas: (1) student revenues; (2) endowment and other investment income; and (3) public and private gifts, grants, and contracts revenue. (MSE)

Diabetes Attitudes, Wishes and Needs second study (DAWN2™)

DEFF Research Database (Denmark)

Holt, Richard I G; Nicolucci, Antonio; Kovacs Burns, K

2013-01-01

across 17 countries participated in an online survey designed to assess diabetes healthcare provision, self-management and training. RESULTS: Between 61.4 and 92.9% of healthcare professionals felt that people with diabetes needed to improve various self-management activities; glucose monitoring (range......, 29.3-92.1%) had the biggest country difference, with a between-country variance of 20%. The need for a major improvement in diabetes self-management education was reported by 60% (26.4-81.4%) of healthcare professionals, with a 12% between-country variance. Provision of diabetes services differed...

Necessity of management for minor earthquake to improve public acceptance of nuclear energy in South Korea

Directory of Open Access Journals (Sweden)

Hyun-Tae Choi

2018-04-01

Full Text Available As public acceptance of nuclear energy in Korea worsens due to the Fukushima accident and the earthquakes that occurred in the Gyeongju area near the Wolsong nuclear power plant (NPP, estimating the effects of earthquakes has become more essential for the nuclear industry. Currently, most countermeasures against earthquakes are limited to large-scale disasters. Minor-scale earthquakes used to be ignored. Even though people do not feel the shaking due to minor earthquakes and minor earthquakes incur little damage to NPPs, they can change the environmental conditions, for instance, underground water level and the conductivity of the groundwater. This study conducted a questionnaire survey of residents living in the vicinity of an NPP to determine their perception and acceptance of plant safety against minor earthquakes. The results show that the residents feel earthquakes at levels that can be felt by people, but incur little damage to NPPs, as minor earthquakes (magnitude of 2.0–3.9 and set this level as a standard for countermeasures. Even if a minor earthquake has little impact on the safety of an NPP, there is still a possibility that public opinion will get worse. This study provides analysis results about problems of earthquake measures of Korean NPPs and specific things that can bring about an effect of deterioration of public acceptance. Based on these data, this article suggests that active management of minor earthquakes is necessary for the sustainability of nuclear energy. Keywords: Earthquake Measures, Management, Minor Earthquake, Nuclear Energy, Public Acceptance

Enhanced solid waste management by understanding the effects of gender, income, marital status, and religious convictions on attitudes and practices related to street littering in Nablus - Palestinian territory

International Nuclear Information System (INIS)

Al-Khatib, Issam A.; Arafat, Hassan A.; Daoud, Raeda; Shwahneh, Hadeel

2009-01-01

Litter is recognized as a form of street pollution and a key issue for solid waste managers. Nablus district (West Bank, Palestinian Territory), which has an established network of urban and rural roads, suffers from a wide-spread litter problem that is associated with these roads and is growing steadily with a well-felt negative impact on public health and the environment. The purpose of this research was to study the effects of four socio-economic characteristics (gender, income, marital status, and religious convictions) of district residents on their attitudes, practices, and behavior regarding street litter generation and to suggest possible remedial actions. All four characteristics were found to have strong correlations, not only with littering behavior and practices, but also with potential litter prevention strategies. In particular, the impact of religious convictions of the respondents on their littering habits and attitudes was very clear and interesting to observe

Management in a neotropical show cave: planning for invertebrates conservation

Directory of Open Access Journals (Sweden)

Thais Giovannini Pellegrini

2012-07-01

Full Text Available Lapa Nova is a dolomitic cave about 4.5 km long located in northwestern Minas Gerais state, Brazil. The cave experiences intense tourism, concentrated over a single period of the year, during the Feast of Our Lady of Lapa. In order to evaluate the impacts felt by the invertebrate community from this tourism, a new methodology was proposed. Four types of areas (intense visitation area, outlying visitation areas, moderate visitation areas and no-visitation areas were sampled for invertebrates. There was one sampling prior and another on the last day of the 128th feast, to evaluate the effects of visitation on cave-dwelling invertebrates. Results show that invertebrate populations residing in more intensely visited areas of the cave undergo changes in distribution following the event. As a consequence of tourism, invertebrates shift to outlying locations from the visited area, which serve as refuges to the communities. Apparently, the fact that there are places inside Lapa Nova inaccessible to tourists reduces the impact suffered by the invertebrate community, as those sites serve as refuges for cave-dwelling organisms during the pilgrimage. A proper management plan was devised for the tourism/religious use of the cave. It consists basically of delimiting marked pathways for tourists, allowing invertebrates to seek shelter at locations outside visited areas and keeping no-visitation areas off-limits to tourism based on the results of the visitation effects on cave-dwelling invertebrates.

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

Training in childhood obesity management in the United States: a survey of pediatric, internal medicine-pediatrics and family medicine residency program directors

Directory of Open Access Journals (Sweden)

Rhodes Erinn T

2010-02-01

Full Text Available Abstract Background Information about the availability and effectiveness of childhood obesity training during residency is limited. Methods We surveyed residency program directors from pediatric, internal medicine-pediatrics (IM-Peds, and family medicine residency programs between September 2007 and January 2008 about childhood obesity training offered in their programs. Results The response rate was 42.2% (299/709 and ranged by specialty from 40.1% to 45.4%. Overall, 52.5% of respondents felt that childhood obesity training in residency was extremely important, and the majority of programs offered training in aspects of childhood obesity management including prevention (N = 240, 80.3%, diagnosis (N = 282, 94.3%, diagnosis of complications (N = 249, 83.3%, and treatment (N = 242, 80.9%. However, only 18.1% (N = 54 of programs had a formal childhood obesity curriculum with variability across specialties. Specifically, 35.5% of IM-Peds programs had a formal curriculum compared to only 22.6% of pediatric and 13.9% of family medicine programs (p Conclusions While most residents receive training in aspects of childhood obesity management, deficits may exist in training quality with a minority of programs offering a formal childhood obesity curriculum. Given the high prevalence of childhood obesity, a greater emphasis should be placed on development and use of effective training strategies suitable for all specialties training physicians to care for children.

Training in childhood obesity management in the United States: a survey of pediatric, internal medicine-pediatrics and family medicine residency program directors.

Science.gov (United States)

Wolff, Margaret S; Rhodes, Erinn T; Ludwig, David S

2010-02-17

Information about the availability and effectiveness of childhood obesity training during residency is limited. We surveyed residency program directors from pediatric, internal medicine-pediatrics (IM-Peds), and family medicine residency programs between September 2007 and January 2008 about childhood obesity training offered in their programs. The response rate was 42.2% (299/709) and ranged by specialty from 40.1% to 45.4%. Overall, 52.5% of respondents felt that childhood obesity training in residency was extremely important, and the majority of programs offered training in aspects of childhood obesity management including prevention (N = 240, 80.3%), diagnosis (N = 282, 94.3%), diagnosis of complications (N = 249, 83.3%), and treatment (N = 242, 80.9%). However, only 18.1% (N = 54) of programs had a formal childhood obesity curriculum with variability across specialties. Specifically, 35.5% of IM-Peds programs had a formal curriculum compared to only 22.6% of pediatric and 13.9% of family medicine programs (p obesity training was competing curricular demands (58.5%). While most residents receive training in aspects of childhood obesity management, deficits may exist in training quality with a minority of programs offering a formal childhood obesity curriculum. Given the high prevalence of childhood obesity, a greater emphasis should be placed on development and use of effective training strategies suitable for all specialties training physicians to care for children.

Exploring weight loss services in primary care and staff views on using a web-based programme.

Science.gov (United States)

Ware, Lisa J; Williams, Sarah; Bradbury, Katherine; Brant, Catherine; Little, Paul; Hobbs, F D Richard; Yardley, Lucy

2012-01-01

Demand is increasing for primary care to deliver effective weight management services to patients, but research suggests that staff feel inadequately resourced for such a role. Supporting service delivery with a free and effective web-based weight management programme could maximise primary care resource and provide cost-effective support for patients. However, integration of e-health into primary care may face challenges. To explore primary care staff experiences of delivering weight management services and their perceptions of a web-based weight management programme to aid service delivery. Focus groups were conducted with primary care physicians, nurses and healthcare assistants (n = 36) involved in delivering weight loss services. Data were analysed using inductive thematic analysis. Participants thought that primary care should be involved in delivering weight management, especially when weight was aggravating health problems. However, they felt under-resourced to deliver these services and unsure as to the effectiveness of their input, as routine services were not evaluated. Beliefs that current services were ineffective resulted in staff reluctance to allocate more resources. Participants were hopeful that supplementing practice with a web-based weight management programme would enhance patient services and promote service evaluation. Although primary care staff felt they should deliver weight loss services, low levels of faith in the efficacy of current treatments resulted in provision of under-resourced and 'ad hoc' services. Integration of a web-based weight loss programme that promotes service evaluation and provides a cost-effective option for supporting patients may encourage practices to invest more in weight management services.

Exploring weight loss services in primary care and staff views on using a web-based programme

Directory of Open Access Journals (Sweden)

Lisa J Ware

2013-09-01

Full Text Available Background Demand is increasing for primary care to deliver effective weight management services to patients, but research suggests that staff feel inadequately resourced for such a role. Supporting service delivery with a free and effective web-based weight management programme could maximise primary care resource and provide cost-effective support for patients. However, integration of ehealth into primary care may face challenges.Objectives To explore primary care staff experiences of delivering weight management services and their perceptions of a web-based weight management programme to aid service delivery.Methods Focus groups were conducted with primary care physicians, nurses and healthcare assistants (n = 36 involved in delivering weight loss services. Data were analysed using inductive thematic analysis.Results Participants thought that primary care should be involved in delivering weight management, especially when weight was aggravating health problems. However, they felt under-resourced to deliver these services and unsure as to the effectiveness of their input, as routine services were not evaluated. Beliefs that current services were ineffective resulted in staff reluctance to allocate more resources. Participants were hopeful that supplementing practice with a web-based weight management programme would enhance patient services and promote service evaluation.Conclusions Although primary care staff felt they should deliver weight loss services, low levels of faith in the efficacy of current treatments resulted in provision of under-resourced and ‘ad hoc’ services. Integration of a web-based weight loss programme that promotes service evaluation and provides a cost-effective option for supporting patients may encourage practices to invest more in weight management services.

Human taeniasis: current insights into prevention and management strategies in endemic countries

Science.gov (United States)

Okello, Anna L; Thomas, Lian Francesca

2017-01-01

Human taeniasis is a zoonotic condition resulting from infection with the adult stages of Taenia saginata (“beef tapeworm”), Taenia solium (“pork tapeworm”) or Taenia asiatica (“Asian tapeworm”). Although these parasites have a worldwide distribution, the overwhelming burden is felt by communities in low- and middle-income countries. This is particularly true for T. solium, whereby infection of the central nervous system with the larval stage of the parasite (neurocysticercosis) is a major cause of acquired epilepsy in low-resource settings. With a focus on endemic countries, this review provides an insight into the prevention and management of human taeniasis, concluding with some recent case studies describing their implementation. Discussion of the opportunities and challenges regarding current fecal and serological diagnostic assays for detecting Taenia spp. highlights the importance of accurate and accessible diagnostic options for the field situation. The lack of long-term impact on the parasites’ lifecycle from human anthelmintic treatment, coupled with the propensity for adverse reactions, highlights the importance of a “two-pronged” approach that considers the relevant animal hosts, particularly in the case of T. solium. Aside from the therapeutic options, this review reiterates the importance of adequate assessment and consideration of the associated behavioral and policy aspects around sanitation, hygiene and meat inspection that have been shown to support parasite control, and potential elimination, in endemic regions. PMID:28615981

Felt and behavioral engagement in workgroups of professionals

NARCIS (Netherlands)

Stumpf, S.A.; Tymon, W.G.; Dam, van N.H.M.

2013-01-01

This research proposes a two-dimensional measure of engagement for professionals in technically-oriented workgroups. It examines the relationship of their engagement to five workgroup outcomes: innovation, performance, satisfaction with the organization, career success, and intentions to stay. Three

Arbejdsmiljø og sygeplejen i et magtpolitisk felt

DEFF Research Database (Denmark)

Thomassen, Ole Jacob; Larsen, Kristian

2015-01-01

af nogle store generelle forandringer i arbejdsmiljøforskningen og via sociologiske tilgange gøre rede for ændringer i de institutionelle forhold som sygepleje er del af. Den norske Arbeidsmiljøloven fra 2006 innførte begrepet integritet og markerte med det betydningen av å respektere og ivareta...... likevekt. Det er en central pointe at når vi skal beskrive, forstå, forklare og også forandre problemer med arbejdsmiljø – så skal vi bevæge os væk fra fokus på moral (de ansatte er dårlige/umoralske), pædagogisering (vi skal uddanne os ud af problemerne), social-psykologi-individualisering (det er...... enkeltindivider og faktorer der bærer problemerne). Vi vil gøre rede for at analysen kræver et historisk og strukturelt blik som vi kan lære af sociologien. Der vil således være tale om et fokus på arbejdsmiljø – med streg under miljø dvs. nogle samfundsmæssige perspektiver....

Kønsforskningens status i et dansk faghistorisk felt

DEFF Research Database (Denmark)

Madsen, Rikke Juel

2012-01-01

’. Based on these findings, it is argued that gender studies is given meaning in terms of key phenomena in the collective self-perception of the field of history, which has negative consequences for how the discipline is perceived. Thus, the article concludes that gender studies as a subject faces several...

Father Absence Effects on Military Children

Science.gov (United States)

1981-03-01

during his absence. Then there’s the problem of learning how to drive an automobile after being on a cruise for nine months." For those who felt that...D.C. 20370 3. Director for HRM Plans and Policy (OP-150) Human Resource Management Division Deputy Chief of Naval Operations (Manpoer. Personnel

Work-related stress: A survey of Indian anesthesiologists

Directory of Open Access Journals (Sweden)

Sumitra Ganesh Bakshi

2017-01-01

Conclusion: The majority of participants rated their stress as moderate-extreme and was higher in anesthesiologists working long hours, over the weekend and those handling high-risk patients. A majority of participants felt the survey made them think about work-related stress and expressed their willingness to participate in stress management programs.

Are Mentors Ready To Make a Difference? A Survey of Mentors' Attitudes towards Nurse Education.

Science.gov (United States)

Pulsford, David; Boit, Kath; Owen, Sharon

2002-01-01

Responses from 198 of 400 British nurses who mentor students showed that mentors felt supported by colleagues but less so by managers or universities. They wanted more time for mentoring, closer links with the universities, and better assessment documentation. Mentor update sessions were often not attended, due to staff shortages or lack of…

Cancer-Related Post-traumatic Stress (PDQ®)—Patient Version

Science.gov (United States)

Cancer-related post-traumatic stress can occur any time from diagnosis to after treatment ends. Shock, fear, helplessness, or horror can be felt by cancer patients and lead to cancer-related post-traumatic stress. Learn about the causes and ways doctors can help manage these symptoms of distress in this expert-reviewed summary.

Impact of the Dapivirine Vaginal Ring on Sexual Experiences and Intimate Partnerships of Women in an HIV Prevention Clinical Trial: Managing Ring Detection and Hot Sex.

Science.gov (United States)

Laborde, Nicole D; Pleasants, Elizabeth; Reddy, Krishnaveni; Atujuna, Millicent; Nakyanzi, Teopista; Chitukuta, Miria; Naidoo, Sarita; Palanee-Phillips, Thesla; Baeten, Jared M; Montgomery, Elizabeth T

2018-02-01

Vaginally-inserted HIV prevention methods have been reported to impact the sexual experience for women and their partners, and hence impacts acceptability of and adherence to the method. We analyzed in-depth interviews and focus group discussions about participants' sexual experiences while wearing the ring, collected during the MTN-020/ASPIRE phase 3 safety and effectiveness trial of a dapivirine vaginal ring for HIV prevention in Malawi, South Africa, Uganda, and Zimbabwe. Most women reported that partners did not feel the ring during sex, however, women felt they had to manage their partners' interaction with or reaction to the ring. In maintaining positive relationships, women were concerned about partners' discovering ring use and about ensuring that partners had a good sexual experience with them. Finally women were concerned about how they themselves experienced sex with the ring. Some found that the ring made the vaginal environment more desirable for their partners and themselves.

Impact of the Dapivirine Vaginal Ring on Sexual Experiences and Intimate Partnerships of Women in an HIV Prevention Clinical Trial: Managing Ring Detection and Hot Sex

Science.gov (United States)

Pleasants, Elizabeth; Reddy, Krishnaveni; Atujuna, Millicent; Nakyanzi, Teopista; Chitukuta, Miria; Naidoo, Sarita; Palanee-Phillips, Thesla; Baeten, Jared M.; Montgomery, Elizabeth T.

2018-01-01

Vaginally-inserted HIV prevention methods have been reported to impact the sexual experience for women and their partners, and hence impacts acceptability of and adherence to the method. We analyzed in-depth interviews and focus group discussions about participants’ sexual experiences while wearing the ring, collected during the MTN-020/ASPIRE phase 3 safety and effectiveness trial of a dapivirine vaginal ring for HIV prevention in Malawi, South Africa, Uganda, and Zimbabwe. Most women reported that partners did not feel the ring during sex, however, women felt they had to manage their partners’ interaction with or reaction to the ring. In maintaining positive relationships, women were concerned about partners’ discovering ring use and about ensuring that partners had a good sexual experience with them. Finally women were concerned about how they themselves experienced sex with the ring. Some found that the ring made the vaginal environment more desirable for their partners and themselves. PMID:29151197

Coordination and resource-related difficulties encountered by Quebec's public health specialists and infectious diseases/medical microbiologists in the management of A (H1N1 - a mixed-method, exploratory survey

Directory of Open Access Journals (Sweden)

Nhan Charles

2012-02-01

Full Text Available Abstract Background In Quebec, the influenza A (H1N1 pandemic was managed using a top-down style that left many involved players with critical views and frustrations. We aimed to describe physicians' perceptions - infectious diseases specialists/medical microbiologists (IDMM and public health/preventive medicine specialists (PHPMS - in regards to issues encountered with the pandemics management at the physician level and highlight suggested improvements for future healthcare emergencies. Methods In April 2010, Quebec IDMM and PHPMS physicians were invited to anonymously complete a web-based learning needs assessment. The survey included both open-ended and multiple-choice questions. Descriptive statistics were used to report on the frequency distribution of multiple choice responses whereas thematic content analysis was used to analyse qualitative data generated from the survey and help understand respondents' experience and perceptions with the pandemics. Results Of the 102 respondents, 85.3% reported difficulties or frustrations in their practice during the pandemic. The thematic analysis revealed two core themes describing the problems experienced in the pandemic management: coordination and resource-related difficulties. Coordination issues included communication, clinical practice guidelines, decision-making, roles and responsibilities, epidemiological investigation, and public health expert advisory committees. Resources issues included laboratory resources, patient management, and vaccination process. Conclusion Together, the quantitative and qualitative data suggest a need for improved coordination, a better definition of roles and responsibilities, increased use of information technologies, merged communications, and transparency in the decisional process. Increased flexibility and less contradiction in clinical practice guidelines from different sources and increased laboratory/clinical capacity were felt critical to the proper

Value Tools in Managed Care Decision Making: Current Hurdles and Future Opportunities.

Science.gov (United States)

Schafer, Jeremy; Galante, Dominic; Shafrin, Jason

2017-06-01

Organizations such as the National Comprehensive Cancer Network, American Society of Clinical Oncology, Institute for Clinical and Economic Review, and Memorial Sloan Kettering have created distinct tools to help different stakeholders assess the value of oncology treatments. However, the oncology value tools were not necessarily created for payers, and it is unclear whether payers are using these tools as part of their drug management process. To understand what value tools payers are using in oncology management and what benefits and shortcomings the tools may have from the payer perspective. A survey targeting drug coverage decision makers at health plans was conducted in August 2016. Respondents attesting to using 2 or more value tools in drug management were eligible for an additional in-depth interview to understand the respondents' perceived benefits and shortcomings of current value tools. Respondents also were asked to describe desired attributes of a hypothetical payer-centric value tool. A total of 28 respondents representing approximately 160 million commercially insured medical lives completed the survey. Twenty respondents (71%) reported using at least 1 value tool in their drug management process. Twelve respondents (43%) used at least 2 tools, and 4 respondents (14%) used at least 3 tools. A total of 6 respondents were selected for in-depth interviews. Interviewees praised value tools for advancing the discussion on drug value and incorporating clinical evidence. However, interviewees felt available value tools varied on providing firm recommendations and relevant price benchmarks. Respondents most commonly recommended the following attributes of a proposed payer-centric value framework: taking a firm position on product value; product comparisons in lieu of comparative clinical trials; web-based tool access; and tool updates at least quarterly. Interview respondents also expressed some support for allowing manipulation of inputs and inclusion of

Knowledge, Attitude And Practices of Healthcare Workers (HCWs Regarding Biomedical Waste (BMW Management: A Multispeciality Hospital Based CrossSectional Study In Eastern India

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Ravishekar N. Hiremath

2016-10-01

Full Text Available Background: The evolving health care system of India, in its goal of solving health issues and minimizing possible health risks, has unavoidably created waste, which itself may be harmful for health. Inefficient and inadequate knowledge of managing health care waste may have detrimental effects on health and environment. Aim and Objectives: To asses level of Knowledge, Attitude, Practices (KAP about Biomedical Waste (BMW management among Health Care Workers (HCWs with an endeavor to improve the standards and protect the health of HCWs and the environment. Methodology: A Hospital- based cross sectional descriptive study was carried out at one of the Multispecialty Hospital in Eastern India. A total of 80 HCWs who were available at the time of study were included and the data were collected by means of 'personal interview technique' by using a pre-designed semi-structured questionnaire in Hindi (local language. The relevant data was collected, compiled and analyzed using SPSS 17.0 version. Results: Assessment of KAP with pre-decided scoring system showed, 17.5 % had excellent knowledge, 70% with good to average and 12.5% had poor knowledge with respect to BMW management. Knowledge status was not significantly associated with any of the sociodemographic characteristics. When asked about needle stick injuries, 88% felt that needle stick injury was a concern to them and 86% of them were well aware about the consequences of needle-stick injuries. Conclusion: Although the awareness level was high with various aspects of BMW management among HCWs compared to other studies, but still there exists scope for more improvement. Regular awareness capsule with proper BMW committee monitoring is the need of the hour. All measures to sensitize the HCWs against needle stick injuries including both pre and post incident measures need to be taken.

Covariance of engineering management characteristics with engineering employee performance

Science.gov (United States)

Hesketh, Andrew Arthur

1998-12-01

As business in the 1990's grapples with the impact of continuous improvement and quality to meet market demands, there is an increased need to improve the leadership capabilities of our managers. Engineers have indicated desire for certain managerial characteristics in their leadership but there have been no studies completed that approached the problem of determining what managerial characteristics were best at improving employee performance. This study addressed the idea of identifying certain managerial characteristics that enhance employee performance. In the early 1990's, McDonnell Douglas Aerospace in St. Louis used a forced distribution system and allocated 35% of its employees into a "exceeds expectations" category and 60% into a "meets expectations" category. A twenty-question 5 point Likert scale survey on managerial capabilities was administered to a sample engineering population that also obtained their "expectations" category. A single factor ANOVA on the survey results determined a statistical difference between the "exceeds" and "meets" employees with four of the managerial capability questions. The "exceeds expectations" employee indicated that supervision did a better job of supporting subordinate development, clearly communicating performance expectations, and providing timely performance feedback when compared to the "meets expectations" employee. The "meets expectations" employee felt that their opinions, when different from their supervisor's, were more often ignored when compared to the "exceeds expectations" employee. These four questions relate to two specific managerial characteristics, "gaining (informal) authority and support" or "control" characteristic and "providing assistance and guidance" or "command" characteristic, that can be emphasized in managerial training programs.

Assessment of paediatric clinical audit.

LENUS (Irish Health Repository)

Perrem, L M

2012-02-01

Consultant paediatricians in Ireland were surveyed to evaluate their perceptions of the hospital audit environment and assess their involvement in the audit process. Eighty nine (77%) replied of whom 66 (74%) had an audit department and 23 (26%) did not. Sixteen (18%) felt their hospital was well resourced for audit and 25 (28%) felt the culture was very positive but only 1 (1%) had protected time. For 61 (69%) consultants audit was very important with 38 (43%) being very actively involved in the process. The most frequent trigger for audit was non consultant hospital doctor (NCHD) career development, cited by 77 (87%). The new Professional Competence Scheme and the National Quality and Risk Management Standards will require the deficiencies identified in this survey be addressed.

Exploring parent attitudes around using incentives to promote engagement in family-based weight management programs

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Elizabeth Jacob-Files

2018-06-01

Full Text Available Incentives can promote adult wellness. We sought to examine whether incentives might help overcome barriers to engagement in child weight management programs and the ideal value, type and recipient of incentives. In 2017, we conducted semi-structured phone interviews with parents of children ≤17 years old, formerly or currently affected by obesity, who had (n = 11 or had never (n = 12 participated in family-based behavioral treatment (FBT for obesity. Interviews explored the range and type of incentives families would be willing to accept. Interview transcripts were coded and data were analyzed using a thematic analysis. We found that some parents were skeptical about receiving cash incentives. However, once treatment-related costs were identified, some became more interested in reimbursement for out of pocket expenditures. Most parents felt up to $100/month would be adequate and that incentives should be tied to changing behaviors, not BMI. Some interviewees expressed preferences for non-cash incentives (e.g. a gift card over cash incentives. Parents were willing to share incentives with adolescents, up to $50/month, but there was concern about incentives affecting a child's intrinsic motivation for behavior change. All parents acknowledged that moderate incentives alone couldn't overcome the realities of structural and familial barriers to engaging in weight management programs. In summary, we identified aspects of an incentive program to promote engagement in FBT that would be desirable and feasible to implement. Future quantitative work can reveal the value and structure of incentives that are effective for improving obesogenic health behaviors and outcomes. Keywords: Behavioral economics, Family-based treatment, Financial incentives, Health incentives, Childhood obesity

Gastroenterology training and career choices: a prospective longitudinal study of the impact of gender and of managed care.

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Arlow, Freda L; Raymond, Patricia L; Karlstadt, Robyn G; Croitoru, Raquel; Rybicki, Benjamin A; Sastri, Suriya V

2002-02-01

We aimed to determine if gender differences exist in the selection and training of female and male gastroenterology fellows. One hundred seventy-six of 218 training program directors returned an 18-question survey about their programs, including leave policies, training, and prevalence of female faculty. Two cohorts of graduating trainees from 1993 and 1995 (N = 393) returned anonymous surveys regarding their training program experiences, demographics, and business training. Female gastroenterology trainees are more likely to choose programs according to parental leave policies (p family reasons" (p family planning because of training program restrictions (20% vs 7%, p gender discrimination (39%) and sexual harassment (19%) during gastroenterology training. Trainees of both sexes had mentorship during training (65% vs 71%, ns); female trainees were more likely to have an opposite sex mentor (71% vs 3.4%) despite an almost 50% prevalence of female full-time and clinical faculty. Female trainees were apt to be less trained in advanced endoscopy (p gender felt adequately prepared for the business aspects of gastroenterology. Alterations in gastroenterology training are needed to attract qualified female applicants. New graduates of both sexes lack practice management education.

Impact of a disease-management program on symptom burden and health-related quality of life in patients with idiopathic pulmonary fibrosis and their care partners.

Science.gov (United States)

Lindell, Kathleen Oare; Olshansky, Ellen; Song, Mi-Kyung; Zullo, Thomas G; Gibson, Kevin F; Kaminski, Naftali; Hoffman, Leslie A

2010-01-01

Patients were recruited from the Dorothy P. and Richard P. Simmons Center for Interstitial Lung Disease, located within the University of Pittsburgh Medical Center. Idiopathic pulmonary fibrosis results in scarring of the lung and respiratory failure, and has a median survival of 3 to 5 years from the time of diagnosis. The purpose of this study was to determine whether patients with idiopathic pulmonary fibrosis and their care partners could be more optimally managed by a disease-management intervention entitled "Program to Reduce Idiopathic Pulmonary Fibrosis Symptoms and Improve Management," which nurses delivered using the format of a support group. We hypothesized that participation would improve perceptions of health-related quality of life (HRQoL) and decrease symptom burden. Subjects were 42 participants randomized to an experimental (10 patient/care partner dyads) or control (11 patient/care partner dyads) group. Experimental group participants attended the 6-week program, and controls received usual care. Before and after the program, all participants completed questionnaires designed to assess symptom burden and HRQoL. Patients and care partners in the intervention group were also interviewed in their home to elicit information on their experience after participating in the Program to Reduce Idiopathic Pulmonary Fibrosis Symptoms and Improve Management. After the intervention, experimental group patients rated their HRQoL less positively (P = .038) and tended to report more anxiety (P = .077) compared with controls. Care partners rated their stress at a lower level (P = .018) compared with controls. Course evaluations were uniformly positive. Post-study qualitative interviews with experimental group participants suggested benefits not exemplified by these scores. Patient participants felt less isolated, were able to put their disease into perspective, and valued participating in research and helping others. Further exploration of the impact of disease-management

Health Technology Integration for Clinical, Patient Records and Financial Management Related to the Military

Science.gov (United States)

2012-09-01

as intended.  Apprehension about EHR systems: Some nurses expressed apprehension about and resistance to the new system because they felt it would...community services, he/she is admitted to the hospital. (Note: Your patient is not pregnant ) Update to Patient Information 1) Create a manual...Diabetes, requesting physician number = 712345 7) Humulin N Units= 10; route = SubCutaneous, frequency= morning and evening; begin insulin

Parent training education program: a pilot study, involving families of children with Prader-Willi syndrome.

Science.gov (United States)

Kodra, Yllka; Kondili, Loreta A; Ferraroni, Alessia; Serra, Maria Antonietta; Caretto, Flavia; Ricci, Maria Antonietta; Taruscio, Domenica

2016-01-01

Prader-Willi syndrome (PWS) is a rare genetic disorder characterized by severe hypotonia during the neonatal period and the first two years of life, the onset of hyperphagia with a risk of obesity during infancy and adulthood, learning difficulties and behavioral or severe psychiatric problems. This complex disease has severe consequences and difficult management issues also for patients' families. Parents of children with PWS need appropriate psychoeducational intervention in order to better manage their children with PWS. The purpose of this study was the implementation and evaluation of a PWS psychoeducational parent training program. The Italian National Center for Rare Diseases implemented a pilot parent training program offered to parents of children with PWS. The intervention's effects was evaluated using questionnaires comprised of 11 items rated on a 7 point Likert scale. The intervention was offered to 43 parents. The behavior problems management, dietary restrictions, autonomy and relationships were indicated by parents as the priority topics which needed to be addressed. Evaluations, immediately post-intervention and after 6 months, were reported by parents, fulfilling specific questionnaires. 90% of parents involved in the study, appreciated the methodology, 86% felt more informed about PWS, 47-62% felt more capable to better approach behaviour's problems, 20-25% felt better about the child's health situation and future expectations. Feeling more capable to help the child autonomy and relationships were reported in 62% and 63% of parents respectively, which decreased significantly (p < 0.05) according to the evaluation 6 months after the intervention. Younger age of parents (< 44 years of age) was significantly correlated with better understanding on how to help the child's autonomy (OR: 0.05; CI: 0.04-0.8) and to better collaborate with the child's teachers (OR: 0.02; CI: 0.001-0.9). Parent training is a promising intervention for parents of children

Tourists’ Perceptions of the Free-Roaming Dog Population in Samoa

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Magnus Beckman

2014-09-01

Full Text Available A study was undertaken to establish how visiting tourists to Samoa perceived free-roaming dogs (Canis familiaris and their management, additionally some factors that influence their perceptions were assessed. Questionnaires were administered to 281 tourists across Samoa over 5 weeks. Free-roaming dogs were seen by 98.2% (n = 269/274 of respondents, with 64.9% (n = 137/211 reporting that their presence had a negative effect on overall holiday experience. Respondents staying in the Apia (capital city area were more likely to consider dogs a problem (p < 0.0001, and there was a significant association between whether the respondent owned a dog and if they thought dogs were a nuisance in Samoa (p < 0.003. Forty-four percent (20/89 of non-dog owners agreed that dogs were a nuisance compared to 22% (80/182 of dog owners. The majority felt that dogs required better control and management in Samoa (81%, n = 222 and that there were too many “stray” dogs (67.9%, n = 188. More respondents were negatively affected by the dogs’ presence (64.9%, 137/211, and felt that the dogs made their holiday worse, than respondents that felt the dogs’ presence improved their holiday experience (35.1%, 74/211. Most respondents stated that the dogs had a low impact (one to three; 68%, 187/275 on their stay in Samoa, whilst 24% (65/275 and 8% (23/275 stated they had a medium or high impact, respectively, on their stay. Respondents showed strong support for humane population management. Free-roaming dogs present a complex problem for Samoa and for its tourism industry in particular. The findings of this study further support the need for more discussion and action about the provision of veterinary services and population management for dogs in Samoa. It also provides information complementing an earlier study of the attitudes of local Samoans.

The Cultural Relevance of Mindfulness Meditation as a Health Intervention for African Americans

Science.gov (United States)

Woods-Giscombé, Cheryl L.; Gaylord, Susan A.

2014-01-01

African Americans experience a disproportionate rate of stress-related health conditions compared to European Americans. Mindfulness meditation has been shown to be effective for managing stress and various stress-related health conditions. This study explored the cultural relevance of mindfulness meditation training for African Americans adults. Fifteen African American adults with past or current experience with mindfulness meditation training were interviewed. Participants felt that mindfulness meditation helped them with enhanced stress management, direct health improvement, and enhanced self-awareness and purposefulness. They felt that they would recommend it and that other African Americans would be open to the practice but suggested that its presentation may need to be adapted. They suggested emphasizing the health benefits, connecting it to familiar spiritual ideology and cultural practices, supplementing the reading material with African American writers, increasing communication (education, instructor availability, “buddy system,” etc.), and including African Americans as instructors and participants. By implementing minor adaptations that enhance cultural relevance, mindfulness meditation can be a beneficial therapeutic intervention for this population. PMID:24442592

How are clinical commissioning groups managing conflicts of interest under primary care co-commissioning in England? A qualitative analysis.

Science.gov (United States)

Moran, Valerie; Allen, Pauline; McDermott, Imelda; Checkland, Kath; Warwick-Giles, Lynsey; Gore, Oz; Bramwell, Donna; Coleman, Anna

2017-11-08

From April 2015, NHS England (NHSE) started to devolve responsibility for commissioning primary care services to clinical commissioning groups (CCGs). The aim of this paper is to explore how CCGs are managing potential conflicts of interest associated with groups of GPs commissioning themselves or their practices to provide services. We carried out two telephone surveys using a sample of CCGs. We also used a qualitative case study approach and collected data using interviews and meeting observations in four sites (CCGs). We conducted 57 telephone interviews and 42 face-to-face interviews with general practitioners (GPs) and CCG staff involved in primary care co-commissioning and observed 74 meetings of CCG committees responsible for primary care co-commissioning. Conflicts of interest were seen as an inevitable consequence of CCGs commissioning primary care. Particular problems arose with obtaining unbiased clinical input for new incentive schemes and providing support to GP provider federations. Participants in meetings concerning primary care co-commissioning declared conflicts of interest at the outset of meetings. Different approaches were pursued regarding GPs involvement in subsequent discussions and decisions with inconsistency in the exclusion of GPs from meetings. CCG senior management felt confident that the new governance structures and policies dealt adequately with conflicts of interest, but we found these arrangements face limitations. While the revised NHSE statutory guidance on managing conflicts of interest (2016) was seen as an improvement on the original (2014), there still remained some confusion over various terms and concepts contained therein. Devolving responsibility for primary care co-commissioning to CCGs created a structural conflict of interest. The NHSE statutory guidance should be refined and clarified so that CCGs can properly manage conflicts of interest. Non-clinician members of committees involved in commissioning primary care

Managing plutonium in Britain. Current options

International Nuclear Information System (INIS)

1998-01-01

This is the report of a two day meeting to discuss issues arising from the reprocessing of plutonium and production of mixed oxide nuclear fuels in Britain. It was held at Charney Manor, near Oxford, on June 25 and 26, 1998, and was attended by 35 participants, including government officials, scientists, policy analysts, representatives of interested NGO's, journalists, a Member of Parliament, and visiting representatives from the US and Irish governments. The topic of managing plutonium has been a consistent thread within ORG's work, and was the subject of one of our previous reports, CDR 12. This particular seminar arose out of discussions earlier in the year between Dr. Frank Barnaby and the Rt. Hon. Michael Meacher MP, Minister for the Environment. With important decisions about the management of plutonium in Britain pending, ORG undertook to hold a seminar at which all aspects of the subject could be aired. A number of on-going events formed the background to this initiative. The first was British Nuclear Fuels' [BNFL] application to the Environment Agency to commission a mixed oxide fuel [MOX] plant at Sellafield. The second was BNFL's application to vary radioactive discharge limits at Sellafield. Thirdly, a House of Lords Select Committee was in process of taking evidence, on the disposal of radioactive waste. Fourthly, the Royal Society, in a recent report entitled Management of Separated Plutonium, recommended that 'the Government should commission a comprehensive review... of the options for the management of plutonium'. Four formal presentations were made to the meeting, on the subjects of Britain's plutonium policy, commercial prospects for plutonium use, problems of plutonium accountancy, and the danger of nuclear terrorism, by experts from outside the nuclear industry. It was hoped that the industry's viewpoint would also be heard, and BNFL were invited to present a paper, but declined on the grounds that they were 'currently involved in a formal

GP views on strategies to cope with increasing workload: a qualitative interview study.

Science.gov (United States)

Fisher, Rebecca Fr; Croxson, Caroline Hd; Ashdown, Helen F; Hobbs, Fd Richard

2017-02-01

The existence of a crisis in primary care in the UK is in little doubt. GP morale and job satisfaction are low, and workload is increasing. In this challenging context, finding ways for GPs to manage that workload is imperative. To explore what existing or potential strategies are described by GPs for dealing with their workload, and their views on the relative merits of each. Semi-structured, qualitative interviews with GPs working within NHS England. All GPs working within NHS England were eligible. Of those who responded to advertisements, a maximum-variation sample was selected and interviewed until data saturation was reached. Data were analysed thematically. Responses were received from 171 GPs, and, from these, 34 were included in the study. Four main themes emerged for workload management: patient-level, GP-level, practice-level, and systems-level strategies. A need for patients to take greater responsibility for self-management was clear, but many felt that GPs should not be responsible for this education. Increased delegation of tasks was felt to be key to managing workload, with innovative use of allied healthcare professionals and extended roles for non-clinical staff suggested. Telephone triage was a commonly used tool for managing workload, although not all participants found this helpful. This in-depth qualitative study demonstrates an encouraging resilience among GPs. They are proactively trying to manage workload, often using innovative local strategies. GPs do not feel that they can do this alone, however, and called repeatedly for increased recruitment and more investment in primary care. © British Journal of General Practice 2017.

A case series of an off-the-shelf online health resource with integrated nurse coaching to support self-management in COPD

Directory of Open Access Journals (Sweden)

Early F

2017-10-01

Full Text Available Frances Early,1 Jane S Young,2 Elizabeth Robinshaw,3 Emma Z Mi,4 Ella Z Mi,4 Jonathan P Fuld1 1Centre for Self Management Support, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK; 2Faculty of Health, Social Care and Education, School of Nursing and Midwifery, Anglia Ruskin University, Cambridge, UK; 3Gloucestershire Hospitals NHS Foundation Trust, Gloucester, UK; 4School of Clinical Medicine, University of Cambridge, Cambridge, UK Background: COPD has significant psychosocial impact. Self-management support improves quality of life, but programs are not universally available. IT-based self-management interventions can provide home-based support, but have mixed results. We conducted a case series of an off-the-shelf Internet-based health-promotion program, The Preventive Plan (TPP, coupled with nurse-coach support, which aimed to increase patient activation and provide self-management benefits. Materials and methods: A total of 19 COPD patients were recruited, and 14 completed 3-month follow-up in two groups: groups 1 and 2 with more and less advanced COPD, respectively. Change in patient activation was determined with paired t-tests and Wilcoxon signed-rank tests. Benefits and user experience were explored in semistructured interviews, analyzed thematically. Results: Only group 1 improved significantly in activation, from a lower baseline than group 2; group 1 also improved significantly in mastery and anxiety. Both groups felt significantly more informed about COPD and reported physical functioning improvements. Group 1 reported improvements in mood and confidence. Overall, group 2 reported fewer benefits than group 1. Both groups valued nurse-coach support; for group 1, it was more important than TPP in building confidence to self-manage. The design of TPP and lack of motivation to use IT were barriers to use, but disease severity and poor IT skills were not. Discussion: Our findings demonstrate the feasibility of combining

Chinese herbal therapy and Western drug use, belief and adherence for hypertension management in the rural areas of Heilongjiang province, China.

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Xia Li

Full Text Available Traditional Chinese medicine (TCM including Chinese herbal therapy has been widely practiced in China. However, little is known about Chinese herbal therapy use for hypertension management, which is one of the most prevalent chronic conditions in China. Thus we described Chinese herbal therapy and western drug users, beliefs, hypertension knowledge, and Chinese herbal and western drug adherence and determinants of Chinese herbal therapy use among patients with hypertension in rural areas of Heilongjiang Province, China.This face-to-face cross sectional survey included 665 hypertensive respondents aged 30 years or older in rural areas of Heilongjiang Province, China. Of 665 respondents, 39.7% were male, 27.4% were aged 65 years or older. At the survey, 14.0% reported using Chinese herbal therapy and 71.3% reported using western drug for hypertension management. A majority of patients had low level of treatment adherence (80.6% for the Chinese herbal therapy users and 81.2% for the western drug users. When respondents felt that their blood pressure was under control, 72.0% of the Chinese herbal therapy users and 69.2% of the western drug users sometimes stopped taking their medicine. Hypertensive patients with high education level or better quality of life are more likely use Chinese herbal therapy.Majority of patients diagnosed with hypertension use western drugs to control blood pressure. Chinese herbal therapy use was associated with education level and quality of life.

Nurse managers' challenges in project management.

Science.gov (United States)

Suhonen, Marjo; Paasivaara, Leena

2011-11-01

To analyse the challenges that nurse managers meet in project management. Project management done by nurse managers has a significant role in the success of projects conducted in work units. The data were collected by open interviews (n = 14). The participants were nurse managers, nurses and public health nurses. Data analysis was carried out using qualitative content analysis. The three main challenges nurse managers faced in project management in health-care work units were: (1) apathetic organization and management, (2) paralysed work community and (3) cooperation between individuals being discouraged. Nurse managers' challenges in project management can be viewed from the perspective of the following paradoxes: (1) keeping up projects-ensuring patient care, (2) enthusiastic management-effective management of daily work and (3) supporting the work of a multiprofessional team-leadership of individual employees. It is important for nurse managers to learn to relate these paradoxes to one another in a positive way. Further research is needed, focusing on nurse managers' ability to promote workplace spirituality, nurse managers' emotional intelligence and their enthusiasm in small projects. © 2011 Blackwell Publishing Ltd.

The synergy between mass-media and public management: a positive perspective for the Departments of Communication and Public Relations

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Prodan (Mocanu Ana-Maria

2012-12-01

Full Text Available The aim of this article is to emphasize the major role the departments of communication and public relations detains in the synergy process between mass-media and public institutions, starting from a series of short-circuits which have occurred in Romanian public sector and led to the misunderstanding of messages, due to an unprofessional communication. Synergy, on its basic meaning, represents a simultaneous action oriented in the same direction, which involves several agents who have the same purposes (DEI, 1999. In the present context, I define synergy as intensifying two activities with a determinant role in the proper functioning of public management which contributes, to a large extent, on informing and educating the general public. The premises I start with are that crisis situations occur because of a faulty communication department and these could be avoided if there would be a permanent and efficient relationship between mass-media and public institutions. In other words, an efficiently organized department of communication could enhance company’s activity starting from the partnership between media and public institutions. Through collaboration, both units could present advantages to be felt at the organizational, social, economic and cultural levels.

Perceptions of female sexual health and sexual dysfunction in a ...

African Journals Online (AJOL)

These respondents further defined FSD as either the inability of a female to respond to sex, a lack of urge to engage in sexual activities, or inability to attain orgasm. About half of the respondents (n=21) did not know that FSD could be managed; however, 70% of them felt comfortable with discussing FSD symptoms with a ...

Under surveillance: using cameras to improve care home practice.

Science.gov (United States)

Pearce, Lynne

2017-05-03

When the owner of Bramley Court in Birmingham mooted the idea of installing surveillance cameras inside the care home, manager and nurse Ann Willey was unenthusiastic. 'It felt like Big Brother was watching you,' she says. But then she considered how cameras might reduce the risk of poor practice and the potential benefits for vulnerable residents.

Parents' Experiences of Pain and Discomfort in People with Learning Disabilities

Science.gov (United States)

Clarke, Zara Jane; Thompson, Andrew R.; Buchan, Linda; Combes, Helen

2008-01-01

There are few measures of pain for people with limited ability to communicate. Eight parents of adults with a known learning disability and associated physical health complaint were interviewed to explore their experience of identifying and managing the pain felt by their children. The parents did not often perceive their son or daughter to be in…

PERT and CPM: Workshop Material.

Science.gov (United States)

Burroughs Corp., Detroit, MI.

This is a workbook containing problems in PERT (program evaluation review technique). It is intended to be used in a workshop or classroom to train management personnel in the basic methodology and capability of PERT. This material is not adequate in depth to create an expert in these techniques, but it is felt that the material is adequate to…

Socio-Economic Concerns and Essential Elements in Estuary Management Strategies; Haliç Case, Istanbul

Science.gov (United States)

Alpar, Bedri; Isil Cetin, Basak

2016-04-01

Estuaries are transitional areas between the land and sea and home to a large and growing proportion of the world's population. They are highly productive ecosystems which create jobs, and boosts local economic growth with a higher percentage of collective and private enterprises and a larger share of production. They serve many important socio-economic functions and therefore receive untreated urban wastes and riverine inputs and concentrate various pollutants coming from inland domestic, agricultural and industrial activities. Therefore such kinds of complex systems are highly vulnerable because they are usually the sink for the hinterlands. Due to serious environmental problems felt more intensively day by day, central and local governments must adopt an integrated policy and decision making process to promote a balance of uses. As surrounded by many historical attractions, heritage sites, buzzing cultural scenes and other natural resources, the Haliç (the Golden Horn estuary) offers great opportunities and has a vitality fed by widespread economic and cultural factors. The typical landscape of the estuary, its bridges, geomorphic features, oceanographic and hydrodynamic features of its waters, sea bottom characteristics, environmental pollution, make this estuary a critical marine environment which impacts to economy, environment and community. However, rapid urban growth and uncontrolled industrial development (1950-1985) led to a severe increase in pollution levels of its water and cohesive sediments. The siltation due to liquid and solid waste dumped by two streams caused anaerobic decomposition problems. In addition, the ecological processes occurring in the Haliç are rather complex as they are interacted with the socio-economic system. This study focuses on the essential elements of integrated coastal zone management for the Haliç, and its probable impacts to economy, environment and community. All objectives and probable impacts need to be integrated

Managing knowledge management

DEFF Research Database (Denmark)

Lystbæk, Christian Tang

2016-01-01

today is that knowledge about health and health care is generated from a multitude of sources and circulated rapidly across professional and Karin Knorr Cetina (2006, 2007) stresses that to understand knowledge management practices we need to magnify the space of knowledge in action and consider......This work-in-progress focuses on the management of knowledge management and its socio-material implications. More specifically, it focuses on the management of epistemic objects and objectives in professional health care organisations. One of the main characteristics of professional health care...... the presentation and circulation of epistemic objects in extended contexts. In other words, we need to consider that the routes from research to practice – and the relation between knowledge and management – is not straightforward. First epistemic objects and objectives may lead to contrasting results...

Management Of Competition And Besting Among Crew Members: A Study At The Mars Desert Research Station (MDRS) In Utah, USA

Science.gov (United States)

Allner, Matthew; Bishop, Sheryl; Gushin, Vadim; McKay, Chris; Rygalov, Vadim; Allner, Matthew

Introduction: Psychosocial group functioning has become an increased international focus of many space faring nations due to the recent shift in focus of colonizing the Moon and then preparing to travel to Mars and beyond. Purpose: This study investigates the effects of competition and besting among crewmembers in isolated and confined extreme (ICE) environments. Furthermore, the study investigates the effects associated with both preand intra-mission management efforts, which included crewmember assessments at various mission phases (pre-, intra-, and end-mission). Suggestions on how to manage competition and besting within a crew were investigated by implementing preand intra-mission awareness strategies as well as group participation in the development and implementation of countermeasures to manage crewmember tendency towards competition and besting to promote the development of positive group functioning. Methods: A six person heterogeneous American crew conducted a Mars simulation mission at the Mars Society's Mars Desert Research Station in Utah, USA in 2006 as part of a new NASA training program called Spaceward Bound. Participants were administered assessments of personality, personal and group identity/functioning, subjective stress, and subjective motivation. All participants were also provided information (pre-mission) regarding past research findings and tendencies of group functioning, stressors, cognitive functioning, and competition and besting. Results: Anecdotal data obtained from personal interviews with crewmembers strongly showed that pre-mission discussions regarding competition and besting provided awareness that allowed crewmembers to continually self-assess to prevent this tendency from surfacing during the mission. The assessment data results showed support for recorded diary materials which indicated crewmembers felt strongly that continual reminders of the besting concept, along with being allowed to participate in the development and

Menstrual hygiene management among women and adolescent girls in the aftermath of the earthquake in Nepal.

Science.gov (United States)

Budhathoki, Shyam Sundar; Bhattachan, Meika; Castro-Sánchez, Enrique; Sagtani, Reshu Agrawal; Rayamajhi, Rajan Bikram; Rai, Pramila; Sharma, Gaurav

2018-02-02

Menstrual hygiene management (MHM) is an essential aspect of hygiene for women and adolescent girls between menarche and menopause. Despite being an important issue concerning women and girls in the menstruating age group MHM is often overlooked in post-disaster responses. Further, there is limited evidence of menstrual hygiene management in humanitarian settings. This study aims to describe the experiences and perceptions of women and adolescent girls on menstrual hygiene management in post-earthquake Nepal. A mixed methods study was carried out among the earthquake affected women and adolescent girls in three villages of Sindhupalchowk district of Nepal. Data was collected using a semi-structured questionnaire that captured experiences and perceptions of respondents on menstrual hygiene management in the aftermath of the Nepal earthquake. Quantitative data were triangulated with in-depth interview regarding respondent's personal experiences of menstrual hygiene management. Menstrual hygiene was rated as the sixth highest overall need and perceived as an immediate need by 18.8% of the respondents. There were 42.8% women & girls who menstruated within first week of the earthquake. Reusable sanitary cloth were used by about 66.7% of the respondents before the earthquake and remained a popular method (76.1%) post-earthquake. None of the respondents reported receiving menstrual adsorbents as relief materials in the first month following the earthquake. Disposable pads (77.8%) were preferred by respondents as they were perceived to be clean and convenient to use. Most respondents (73.5%) felt that reusable sanitary pads were a sustainable choice. Women who were in the age group of 15-34 years (OR = 3.14; CI = (1.07-9.20), did not go to school (OR = 9.68; CI = 2.16-43.33), married (OR = 2.99; CI = 1.22-7.31) and previously used reusable sanitary cloth (OR = 5.82; CI = 2.33-14.55) were more likely to use the reusable sanitary cloth. In

What I wish I'd learned at dental school.

Science.gov (United States)

Oliver, G R; Lynch, C D; Chadwick, B L; Santini, A; Wilson, N H F

2016-08-26

Background Much concern appears to exist as to the scope and content of contemporary dental school programmes, with the oft-cited criticism being made that dental graduates are 'no longer as good as they used to be'.Aim The aim of this project was to survey the views of dentists - both new graduates and more established practitioners - on aspects of their own dental school training they felt had been deficient as well as commenting on what aspects of dental school education they would like to see improved/enhanced in current times.Methods An invitation to complete an Internet-based questionnaire was emailed to the Fellows and Members of the Faculty of General Dental Practice (UK). Topics in the questionnaire included the respondent's own dental education history, how well they felt their dental school training had covered certain clinical and non-clinical topics; and their opinions on areas they felt should be included in contemporary dental school programmes.Results Six hundred and forty-nine responses were received from 3,348 emailed invitations (response rate = 19.4%). Sixty-one percent (395) of respondents were qualified for 10 years or more. Among clinical skills and techniques, a majority of respondents reported they felt they had not had sufficient teaching/training in dental school in surgical endodontics (76%), conscious sedation (72%), root surface debridement (71%), fixed orthodontic appliances (68%), porcelain veneers (63%), implants (56%) and posterior composites (53%). If designing a new dental school programme, the most common topics respondents would seek to include/increase were business and practice management (21%), communication skills (including patient management and leadership skills) (10%), and increased clinical time and experience (8%).Conclusions The findings of this project are of interest and relevance to those working with student dentists and young dental practitioners. A greater emphasis is needed on the teaching of certain non

Knowledge management: another management fad?

Directory of Open Access Journals (Sweden)

Leonard J. Ponzi

2002-01-01

Full Text Available Knowledge management is a subject of a growth body of literature. While capturing the interest of practitioners and scholars in the mid-1990s, knowledge management remains a broadly defined concept with faddish characteristics. Based on annual counts of article retrieved from Science Citation Index, Social Science Citation Index, and ABI Inform referring to three previous recognized management fad, this paper introduces empirical evidence that proposes that a typical management movement generally reveals itself as a fad in approximately five years. In applying this approach and assumption to the case of knowledge management, the findings suggest that knowledge management is at least living longer than typical fads and perhaps is in the process of establishing itself as a new aspect of management. To further the understanding of knowledge management's development, its interdisciplinary activity and breadth are reported and briefly discussed.

Case management for at-risk elderly patients in the English integrated care pilots: observational study of staff and patient experience and secondary care utilisation

Directory of Open Access Journals (Sweden)

Martin Roland

2012-07-01

Full Text Available Introduction: In 2009, the English Department of Health appointed 16 integrated care pilots which aimed to provide better integrated care. We report the quantitative results from a multi-method evaluation of six of the demonstration projects which used risk profiling tools to identify older people at risk of emergency hospital admission, combined with intensive case management for people identified as at risk. The interventions focused mainly on delivery system redesign and improved clinical information systems, two key elements of Wagner's Chronic Care Model.Methods: Questionnaires to staff and patients. Difference-in-differences analysis of secondary care utilisation using data on 3,646 patients and 17,311 matched controls, and changes in overall secondary care utilisation.Results: Most staff thought that care for their patients had improved. More patients reported having a care plan but they found it significantly harder to see a doctor or nurse of their choice and felt less involved in decisions about their care. Case management interventions were associated with a 9% increase in emergency admissions. We found some evidence of imbalance between cases and controls which could have biased this estimate, but simulations of the possible effect of unobserved confounders showed that it was very unlikely that the sites achieved their goal of reducing emergency admissions. However, we found significant reductions of 21% and 22% in elective admissions and outpatient attendance in the six months following an intervention, and overall inpatient and outpatient costs were significantly reduced by 9% during this period. Area level analyses of whole practice populations suggested that overall outpatient attendances were significantly reduced by 5% two years after the start of the case management schemes.Conclusion: Case management may result in improvements in some aspects of care and has the potential to reduce secondary care costs. However, to improve

From risk management to uncertainty management: a significant change in project management

Institute of Scientific and Technical Information of China (English)

LI Gui-jun; ZHANG Yue-song

2006-01-01

Starting with the meanings of the terms "risk" and "uncertainty,"" he paper compares uncertainty management with risk management in project management. We bring some doubt to the use of "risk" and "uncertainty" interchangeably in project management and deem their scope, methods, responses, monitoring and controlling should be different too. Illustrations are given covering terminology, description, and treatment from different perspectives of uncertainty management and risk management. Furthermore, the paper retains that project risk management (PRM) processes might be modified to facilitate an uncertainty management perspective,and we support that project uncertainty management (PUM) can enlarge its contribution to improving project management performance, which will result in a significant change in emphasis compared with most risk management.

The Management Skills of SALL Managers

Directory of Open Access Journals (Sweden)

David Gardner

2013-12-01

Full Text Available This paper looks at the management skills of SALL managers. It is based on data collected using quantitative and qualitative instruments with six SALL managers in tertiary contexts in Hong Kong. With reference to the literature in the field of management, the paper reviews the data in terms of identifiable management skills. This provides a picture of the skills possessed by these managers and also identifies gaps in their skill-sets. The paper provides a checklist of skills relevant to SALL management which individual managers may find useful, and also discusses the 4 key management areas of leadership, scope, expectations and evaluation.

Teaching Managers How to Manage

International Nuclear Information System (INIS)

Hylko, J.M.

2006-01-01

Following graduation from a college or university with a technical degree, or through years of experience, an individual's training and career development activities typically focus on enhancing technical problem-solving skills. However, as these technical professionals, herein referred to as 'Techies', advance throughout their careers, they may be required to accept and adapt to the role of being a manager, and must undergo a transition to learn and rely on new problem-solving skills. However, unless a company has a specific manager-trainee class to address this subject and develop talent from within, an employee's management style is learned and developed 'on the job'. Both positive and negative styles are nurtured by those managers having similar qualities. Unfortunately, a negative style often contributes to the deterioration of employee morale and ultimate closing of a department or company. This paper provides the core elements of an effective management training program for 'Teaching Managers How to Manage' derived from the Department of Energy's Integrated Safety Management System and the Occupational Safety and Health Administration 's Voluntary Protection Program. Discussion topics and real-life examples concentrate on transitioning an employee from a 'Techie' to a manager; common characteristics of being a manager; the history and academic study of management; competition, change and the business of waste management; what to do after taking over a department by applying Hylko's Star of Success; command media; the formal and informal organizational charts; chain of command; hiring and developing high-degree, autonomous employees through effective communication and delegation; periodic status checks; and determining if the program is working successfully. These common characteristics of a strong management/leadership culture and practical career tips discussed herein provide a solid foundation for any company or department that is serious about developing

Participatory Design of an Online Self-Management Tool for Users With Spinal Cord Injury: Qualitative Study

Science.gov (United States)

Shepherd, John; Tomasone, Jennifer; Munce, Sarah; Linassi, Gary; Hossain, Saima Noreen; Jaglal, Susan

2018-01-01

about information credibility. In general, participants indicated that they felt more confident with information received from trusted, in-person sources (eg, peers or health care professionals) than information found online. The discovery stage saw participants propose and discuss concepts to filter credible information and highlight community expertise, namely (1) a community-curated resource database, (2) online information navigators, and (3) group chats with peers. Several tools and techniques were collectively prototyped in an effort to foster trust and community; these are illustrated in the Results section. Conclusions A PD process engaging users as codesigners, codevelopers, and informants can be used to identify design concerns and prototype online solutions to promote self-management after SCI. Future work will assess the usability of the collectively designed tools among a broad population of Canadians with SCI and the tools’ impact on self-efficacy and health. PMID:29563075

“Pets Negotiable”: How Do the Perspectives of Landlords and Property Managers Compare with Those of Younger Tenants with Dogs?

Science.gov (United States)

Graham, Taryn M.; Milaney, Katrina J.; Adams, Cindy L.

2018-01-01

Simple Summary In rental housing policy, pets are rarely considered as valued household members. Instead, landlords and property managers are often permitted to ban pets outright, or to advertise them as merely negotiable in their listings for rental housing. In fact, previous research has shown that moving and renting are key reasons for animal relinquishment. To reduce the number of animals that are given up each year due to housing issues, we surveyed landlords and property managers about their perspectives towards pets. Also, because younger adults are disproportionately tenants and because dogs are often banned from rental housing, we interviewed younger tenants with dogs about their recent experiences in the rental market. Our results confirm that dog owners face difficulties in finding rental housing. To keep their pets, tenants made compromises on where and how they lived, which held consequences for their health and that of their pets. Suggestions for improvement are provided, as are implications for research, policy, and practice. Abstract Previous research has shown that housing insecurity contributes to animal relinquishment and that tenants with dogs face disadvantages in the rental market. Still, little is known about how dog owners navigate rental markets, nor how landlords and property managers perceive dogs and other pets. This case study reports on in-depth interviews with younger tenants with dogs and on open-ended survey responses from landlords and property managers. In their housing searches, tenants with dogs reported feeling powerless in negotiations and feeling discriminated against. They described settling for substandard properties, often located in less desirable neighborhoods. Also, some said they felt obliged to stay put in these rentals, given how difficult it had been to find a place that would accommodate their dogs. Meanwhile, landlords and property managers indicated that listings advertised as “pet-friendly” tend to receive

Hepatitis B virus infection in US correctional facilities: a review of diagnosis, management, and public health implications.

Science.gov (United States)

Gupta, Shaili; Altice, Frederick L

2009-03-01

Among the blood-borne chronic viral infections, hepatitis B virus (HBV) infection is one that is not only treatable but also preventable by provision of vaccination. Despite the availability of HBV vaccine for the last 15 years, more than 1.25 million individuals in the USA have chronic HBV infection, and about 5,000 die each year from HBV-related complications. From a societal perspective, access to treatment of chronic viral infections, like HIV and viral hepatitis, is highly cost-effective and has lasting benefits by reducing risk behaviors, morbidity, mortality, as well as disease transmission in the community. Individuals in correctional facilities are specially predisposed to such chronic viral infections because of their high-risk behaviors. The explosion of incarceration in the USA over the last few decades and the disproportionate burden of morbidity and mortality from chronic infections among the incarcerated have put incredible strains on an overcrowded system that was not originally designed to provide comprehensive medical care for chronic illnesses. Recently, there has been a call to address medical care for individuals with chronic medical conditions in correctional settings, including those with infectious diseases. The economic and public health burden of chronic hepatitis B and its sequelae, including cirrhosis and hepatocellular carcinoma, is felt most prominently in managed care settings with limited budgets, like correctional facilities. Prevalence of HBV infection among the incarcerated in the USA is fivefold that of the general population. We present a review of diagnosis, prevention, and the recently streamlined treatment guidelines for management of HBV infection in correctional settings, and discuss the implications and public health impact of these measures.

Process evaluation of the Living Green, Healthy and Thrifty (LiGHT) web-based child obesity management program: combining health promotion with ecology and economy.

Science.gov (United States)

Jogova, Maria; Song, Joshua Eun-Soo; Campbell, Audrey Clare; Warbuton, Darren; Warshawski, Tom; Chanoine, Jean-Pierre

2013-04-01

To conduct a process evaluation of the Living Green, Healthy and Thrifty (LiGHT) program, a novel virtual child obesity management program that combines health promotion with ecology and economy (Phase 1). We carried out a mixed methods process evaluation involving qualitative and quantitative data collection in 3 phases: among 3 child-parent units, (group 1) that informed program development; 9 child-parent units (group 2) that tested the draft program and further aided program refinement; and 17 child-parent units (group 3) for a 4-week pilot of the program. In the program pilot, we assessed participants' knowledge and readiness to change pre- and postintervention and explored perceptions of the program. Participants generally felt that the online format for program delivery was convenient and accessible, the content was practical, and the integration of health-environment-economy was well received. Many parents also appreciated the involvement of the family. However, the lack of visual appeal and overabundance of text was identified as a challenge, and children/youth in particular requested assurance that their personal information (e.g. weight) was not seen by their parents. The online method of program delivery holds the unique challenge of requiring special efforts to create a sense of personal connection and community. The presence of a "Way-finder" to assist participants and discussion boards/forums are potential solutions. The LiGHT online weight management program offers an accessible, convenient weight management resource that children and families appreciate for its availability, broader educational scope, and practicality. Outcome evaluation of LiGHT will be carried out in Phase 2 of the project. Copyright © 2013 Canadian Diabetes Association. Published by Elsevier Inc. All rights reserved.

Early Realignment Versus Delayed Urethroplasty in Management of Pelvic Fracture Urethral Injury: A Meta-analysis

Directory of Open Access Journals (Sweden)

Rama Firmanto

2016-09-01

Full Text Available Aim: this meta-analysis study will evaluate the incidence of urethral stricture as a successfull parameter in the management of PFUI through early realignment, compared with delayed urethroplasty. Long-term complications such as erectile dysfunction and incontinence on both methods will also be evaluated. Methods: online literature was sourced from Pubmed, Embase, Cochrane, and Google Scholar. The incidence of stricture was evaluated from the entire study group of ER and DU. Stricture of the urethra is diagnosed by the symptoms such as the obstruction that felt by the patient, uroflowmetry examination, and urine residual post micturition that supported by urethrography examination at regular interval. In some cases the incidence of stricture also diagnosed by urethroscopy. The patient is assessed as not having stricture when it is no longer needed to do urethral dilatation or advanced urethrotomy. The rate of incontinence was assessed subjectively from the patient’s complaints. The erectile function assessed subjectively; decreased of tumesen’s degree, reduced the duration of erection, and penetration failure diagnosed as erection dysfunction. The data were processed as dichotomy data to calculate the risk ratio using Review Manager 5.1. Results: five relevant literatures reviewed in this study. The incidence of urethral strictures are statistically significant lower in early realignment group (RR=0.70, 95% CI 0.50-0.99, P<0.05. There were no statistically significant differences between both treatment groups on the incidence of erectile dysfunction (RR=0.72, 95% CI 0.39-1.34 nor the incidence of incontinence (RR=0.74, 95% CI 0.36-1.51. Conclusion: early realignment decrease the occurrence of stricture on PFUI treatment compared to delayed urethroplasty method. Between the two methos, the complications such as erectile dysfunction and incontinence; however, there was no significant difference.

Meteorological risks as drivers of innovation for agroecosystem management

Science.gov (United States)

Gobin, Anne; Van de Vyver, Hans; Zamani, Sepideh; Curnel, Yannick; Planchon, Viviane; Verspecht, Ann; Van Huylenbroeck, Guido

2015-04-01

season. A methodology for identifying agro-ecosystem vulnerability was developed using spatially explicit information and was tested for arable crop production in Belgium. The different components of vulnerability for a region include spatial information on meteorology, soil available water content, soil erosion, the degree of waterlogging, crop share and the diversity of potato varieties. The level of vulnerability and resilience of an agro-ecosystem is also determined by risk management. The types of agricultural risk and their relative importance differ across sectors and farm types. Risk types are further distinguished according to production, market, institutional, financial and liability risks. Strategies are often combined in the risk management strategy of a farmer and include reduction and prevention, mitigation, coping and impact reduction. Based on an extensive literature review, a portfolio of potential strategies was identified at farm, market and policy level. Research hypotheses were tested using an on-line questionnaire on knowledge of agricultural risk, measuring the general risk aversion of the farmer and risk management strategies. The "chain of risk" approach adopted as a research methodology allows for investigating the hypothesis that meteorological risks act as drivers for agricultural innovation. Risks related to extreme weather events in Belgium are mainly caused by heat, frost, excess rainfall, drought and storms, and their impact is predominantly felt by arable, horticultural and extensive dairy farmers. Quantification of the risk is evaluated in terms of probability of occurrence, magnitude, frequency and extent of impact on several agro-ecosystems services. The spatial extent of vulnerability is developed by integrating different layers of geo-information, while risk management is analysed using questionnaires and economic modelling methods. Future work will concentrate on the further development and testing of the currently developed

Process Evaluation of Communitisation Programme in Public Sector Health Facilities, Mokokchung District, Nagaland, 2015.

Science.gov (United States)

Tushi, Aonungdok; Kaur, Prabhdeep

2017-01-01

Public sector health facilities were poorly managed due to a history of conflict in Nagaland, India. Government of Nagaland introduced "Nagaland Communitisation of Public Institutions and Services Act" in 2002. Main objectives of the evaluation were to review the functioning of Health Center Managing Committees (HCMCs), deliver health services in the institutions managed by HCMC, identify strengths as well as challenges perceived by HCMC members in the rural areas of Mokokchung district, Nagaland. The evaluation was made using input, process and output indicators. A doctor, the HCMC Chairman and one member from each of the three community health centers (CHC) and four primary health centers (PHC) were surveyed using a semi-structured questionnaire and an in-depth interview guide. Proportions for quantitative data were computed and key themes from the same were identified. Overall; the infrastructure, equipment and outpatient/inpatient service availability was satisfactory. There was a lack of funds and shortage of doctors, drugs as well as laboratory facilities. HCMCs were in place and carried out administrative activities. HCMCs felt ownership, mobilized community contributions and managed human resources. HCMC members had inadequate funds for their transport and training. They faced challenges in service delivery due to political interference and lack of adequate human, material, financial resources. Communitisation program was operational in the district. HCMC members felt the ownership of health facilities. Administrative, political support and adequate funds from the government are needed for effective functioning of HCMCs and optimal service delivery in public sector facilities.

Attitudes to Exercise and Diabetes in Young People with Type 1 Diabetes Mellitus: A Qualitative Analysis.

Science.gov (United States)

Ryninks, Kirsty; Sutton, Eileen; Thomas, Elizabeth; Jago, Russell; Shield, Julian P H; Burren, Christine P

2015-01-01

To investigate young people's attitudes to, and understanding of, physical activity on glycaemic control in Type 1 Diabetes Mellitus. Four focus groups with 11-14 and 15-16 year olds were conducted with twelve young people with Type 1 Diabetes, from within a larger study investigating physical activity and fitness. Qualitative analysis of the focus group data was performed using Interpretative Phenomenological Analysis. Four superordinate themes were identified: Benefits of Exercise, Knowledge and Understanding, Information and Training and "You can do anything". Young people felt that exercising helped them to manage their diabetes and had a beneficial psychological and physical impact on their bodies. They reported a lack of knowledge and understanding about diabetes among school staff and other young people. The overwhelming sense from young people was that although diabetes impacts upon their lives, with preparation, physical activity can take place as normal. Whilst young people had an awareness of the physical and psychological benefits of exercise in managing their diabetes, they experienced difficulties at school. Professional support and discussions with young people, giving tailored strategies for managing Type 1 Diabetes during exercise are needed. Healthcare teams should ensure that the support and educational needs of school staff are met. Providing more opportunities to empower young people to take on the responsibility for their Type 1 Diabetes care is merited. Young people felt diabetes did not stop them from participating in activities; it is simply a part of them that needs managing throughout life.

Waste Management Program management plan. Revision 1

Energy Technology Data Exchange (ETDEWEB)

NONE

1997-02-01

As the prime contractor to the Department of Energy Idaho Operations Office (DOE-ID), Lockheed Martin Idaho Technologies Company (LMITCO) provides comprehensive waste management services to all contractors at the Idaho National Engineering and Environmental Laboratory (INEEL) through the Waste Management (WM) Program. This Program Management Plan (PMP) provides an overview of the Waste Management Program objectives, organization and management practices, and scope of work. This document will be reviewed at least annually and updated as needed to address revisions to the Waste Management`s objectives, organization and management practices, and scope of work. Waste Management Program is managed by LMITCO Waste Operations Directorate. The Waste Management Program manages transuranic, low-level, mixed low-level, hazardous, special-case, and industrial wastes generated at or transported to the INEEL.

Inpatient Nursing and Parental Comfort in Managing Pediatric Tracheostomy Care and Emergencies.

Science.gov (United States)

Pritchett, Cedric V; Foster Rietz, Melissa; Ray, Amrita; Brenner, Michael J; Brown, David

2016-02-01

Tracheostomy is a critical and often life-saving intervention, but associated risks are not negligible. The vulnerability of the pediatric population underlies the importance of caregiver comfort and competence in tracheostomy care. To assess inpatient nursing staff and parental perspectives in managing tracheostomy care. Cross-sectional analysis of survey data from (1) a volunteer sample of inpatient nurses in a tertiary care, freestanding pediatric hospital in the Midwest, assigned to clinical wards that provide care for children with tracheostomy tubes and (2) a consecutive sample of families whose child underwent tracheostomy tube placement at the same institution between March 1 and December 31, 2013. Nurse and parental comfort in managing acute and established tracheostomy tubes. Nursing data were analyzed with attention to years' experience and primary unit of practice. Respondents included 129 of 820 nurses (16% response rate) and family members of 19 of 38 children (50% response rate). When queried about changing established tracheostomies, 59 of 128 nurses (46%) reported being "totally comfortable," including 46 of 82 intensive care unit (ICU) nurses (56%) vs 13 of 46 floor nurses (28%) (P = .002) and 48 of 80 nurses with at least 5 years' experience (60%) vs 12 of 49 less experienced nurses (24%) (P tracheostomy, 61 nurses (47%) described being completely uncomfortable, including 27 of 83 ICU nurses (33%) vs 34 of 46 floor nurses (73%) (P = .006), and 33 of 80 nurses with at least 5 years' experience (41% ) vs 28 of 49 less experienced nurses (57%) (P = .03). Most families felt prepared for discharge (16 of 17 [94%]) and found the health care team accessible (16 of 17 [94%]), although only 5 of 18 families (28%) indicated that tracheostomy teaching was consistent. Nurses' comfort with tracheostomy was higher among nurses with at least 5 years' experience and primary ICU location. Whereas parental comfort with tracheostomy care was high

Management of anterior teeth damage caused by complex caries through aesthetic endorestoration

Directory of Open Access Journals (Sweden)

Nanik Zubaidah

2011-03-01

Full Text Available Background: Dental caries is a microbiological disease that result in localized dissolution and destruction of the calcified tissue. It is multifactorial, therefore prevention must be based on a multifactorial approach. The damage of anterior teeth due to complex caries, for certain person may interfere their performance and decrease their self confidence aesthetically. Restoration of tooth form and function, especially on anterior teeth is highly valuable. Purpose: To present a case of maxillary anterior teeth with complex caries, through endorestoration treatment for recovering its original function and aesthetic. Case: The 21 years old male patient with complex carries on maxillary anterior teeth number 12, 11, 21, 22 and 23. The patient felt bad about his performance and affect his self confidence. The patient visited the clinic to repair his teeth and to get its form and function aesthetically. Case management: The endorestoration treatment was performed for carious teeth through pulpectomy followed by insertion of post retention and porcelain fused to metal crowns. Conclusion: Anterior teeth with severed complex caries can be managed through endorestoration treatment to recover its performance and function aesthetically.Latar belakang: Dental karies adalah penyakit infeksi yang berakibat kerusakan jaringan kalsifikasi dan bersifat multifactorial. Oleh karena itu pencegahan dilakukan dengan pendekatan multifactorial. Kerusakan gigi anterior karena karies kompleks untuk orang-orang tertentu mungkin berdampak pada penampilan dan penurunan kepercayaan diri karena factor estetik. Perbaikan gigi anterior dari berbagai kerusakan baik dalam hal bentuk maupun fungsinya sangat besar nilainya. Tujuan: Untuk menunjukkan kasus gigi anterior rahang atas karena karies kompleks melalui perawatan endorestorasi untuk mengembalikan fungsi gigi asli dan estetik. Kasus: Laki-laki usia 21 tahun dengan karies kompleks pada gigi anterior rahang atas 12, 11, 21