WorldWideScience

Sample records for review aging management

  1. A Review of Information for Managing Aging in Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    WC Morgan; JV Livingston

    1995-09-01

    Age related degradation effects in safety related systems of nuclear power plants should be managed to prevent safety margins from eroding below the acceptable limits provided in plant design bases. The Nuclear Plant Aging Research (NPAR) Pro- gram, conducted under the auspices of the U.S. Nuclear Regulatory Commission (NRC), Office of Nuclear Regulatory Research, and other related aging management programs are developing technical information on managing aging. The aging management process central to these efforts consists of three key elements: 1) selecting structures, systems, and components (SSCs) in which aging should be controlled; 2) understanding the mechanisms and rates of degradation in these SSCs; and 3) managing degradation through effective inspection, surveillance, condition monitoring, trending, record keeping, mainten- ance, refurbishment, replacement, and adjustments in the operating environment and service conditions. This document concisely reviews and integrates information developed under the NPAR Program and other aging management studies and other available information related to understanding and managing age-related degradation effects and provides specific refer- ences to more comprehensive information on the same subjects.

  2. Experiences of registered nurses as managers and leaders in residential aged care facilities: a systematic review.

    Science.gov (United States)

    Dwyer, Drew

    2011-12-01

    The phenomenon of an ageing population is being experienced globally, as countries struggle to change and improve residential models of care and provide services to the elderly. The role of the registered nurse (RN) is considered crucial to the clinical governance and management of care given. To date, however, no systematic review has examined the RN's experience in leadership and management. The objective of this review is to critically appraise, synthesise and present best available evidence on the experiences of RNs as clinical leaders and managers in residential aged care facilities. This review considered qualitative research papers that addressed the experiences of RNs as clinical leaders and managers in residential aged care facilities. Participants of interest were RNs, nurse leaders, nurses holding registration and or regulation under a board of nursing, nurses working in residential aged care and long-term care facilities. The diversity and use of language to describe nurses' roles and models of care for the elderly care environment were considered in the review. The search strategy sought to find both published studies and papers, limited to the English language and published between January 1997 and February 2011. An initial limited search was done in Medical Literature Analysis and Retrieval System Online (MEDLINE) and Cumulative Index to Nursing and Allied Health Literature databases to identify the key words contained in the title or abstract and index terms used to describe the relevant terms in the article. A second extensive search was undertaken and extended to other relevant databases using all identified keywords and index terms. The third step involved searching reference lists and bibliographies of chosen articles for additional studies. Each paper was assessed by two independent reviewers for methodological quality prior to inclusion in the review using an appropriate critical appraisal instrument from the System for the Unified Management

  3. Regulatory instrument review: Aging management of LWR cables, containment and basemat, reactor coolant pumps, and motor-operated valves

    Energy Technology Data Exchange (ETDEWEB)

    Werry, E.V.; Somasundaram, S.

    1995-09-01

    The results of Stage 2 of the Regulatory Instrument Review are presented in this volume. Selected regulatory instruments, such as the Code of Federal Regulations (CFR), US Nuclear Regulatory Commission (NRC), Regulatory Guides, and ASME Codes, were investigated to determine the extent to which these regulations apply aging management to selected safety-related components in nuclear power plants. The Regulatory Instrument Review was funded by the NRC under the Nuclear Plant Aging Research (NPAR) program. Stage 2 of the review focused on four safety-related structures and components; namely, cables, containment and basemat, reactor coolant pumps, and motor-operated valves. The review suggests that the primary-emphasis of the regulatory instruments was on the design, construction, start-up, and operation of a nuclear power plant, and that aging issues were primarily addressed after an aging-related problem was recognized. This Stage 2 review confirms the results of the prior review; (see Regulatory Instrument Review: Management of Aging of LWR Major Safety-Related Components NUREG/CR-5490. The observations indicate that the regulations generally address management of age-related degradation indirectly. Specific age-related degradation phenomena frequently are dealt with in bulletins and notices or through generic issues, letters, etc. The major recommendation of this report, therefore, is that the regulatory instruments should more directly and explicitly address the aging phenomenon and the management of the age-related degradation process.

  4. Development of regulatory guide for review of aging management of the operating NPP

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Tae Myung; Lee, Jae Kyung [Cheongju Univ., Cheongju (Korea, Republic of); Kim, Young Ryul [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

    2001-03-15

    This is the final report of the second year study. Based on the first year study, proposal of revised guidelines, analysis of revised or newly issued IAEA safety guides and reference guidelines of developed countries, and proposal of detailed guidelines of aging management in PSR have been performed in the second year study. The summary of results in the study so far can be summarized as below, overall view on PSR and idea of effective domestic application were leaded through additional investigation and comparison of legal basis, experiences and current status of PSR implementation among the countries having operating NPPs including Korea. Strategies of adequate application of PSR are roughly reevaluated and totally reestablished in summary from the analysis in factor by factor basis of PSR implementation experience in foreign countries and background of IAEA guidelines. Models and draft framework of PSR report in the first year study were summarized and reevaluated, and structure and outline options of PSR guidelines for judging the PSR report are newly proposed with comparison of their strengths and weaknesses based on the first year study. Among the opt ions, guidelines framework equivalent to the PSR report was picked up as the best. For the judgement of aging management, the most appropriate one was chosen for the detailed judgement of aging management review in our PSR being based on the Standard Review Plan for License Renewal (SRP-LR) in United States considering potential future usage in the judgement for continued operation of old NPP at the time of expiration of its design life. A draft PSR guidelines is prepared and attached by revision of basic guidelines issued in 2000, considering the issues discussed for the draft revision of IAEA PSR guide, the draft IAEA document about 'experience of PSR implementation of member states', and the characteristics of Hungarian PSR Guidelines.

  5. The Optimal Management of Acute Febrile Encephalopathy in the Aged Patient: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Fereshte Sheybani

    2016-01-01

    Full Text Available The elderly comprise less than 13 percent of world population. Nonetheless, they represent nearly half of all hospitalized adults. Acute change in mental status from baseline is commonly seen among the elderly even when the main process does not involve the central nervous system. The term “geriatric syndrome” is used to capture those clinical conditions in older people that do not fit into discrete disease categories, including delirium, falls, frailty, dizziness, syncope, and urinary incontinence. Despite the growing number of elderly population, especially those who require hospitalization and the high burden of common infections accompanied by encephalopathy among them, there are several unresolved questions regarding the optimal management they deserve. The questions posed in this systematic review concern the need to rule out CNS infection in all elderly patients presented with fever and altered mental status in the routine management of febrile encephalopathy. In doing so, we sought to identify all potentially relevant articles using searches of web-based databases with no language restriction. Finally, we reviewed 93 research articles that were relevant to each part of our study. No prospective study was found to address how should AFE in the aged be optimally managed.

  6. Management of Neovascular Age-related Macular Degeneration: A Review on Landmark Randomized Controlled Trials.

    Science.gov (United States)

    Agarwal, Aniruddha; Aggarwal, Kanika; Gupta, Vishali

    2016-01-01

    In the last decade, a number of prospective clinical trials with carefully designed study protocols have been conducted for the treatment of neovascular age-related macular degeneration (AMD). These landmark clinical trials such as ANCHOR and MARINA and, more recently, the Comparison of AMD Treatment Trials and VIEW studies have revolutionized the management of neovascular AMD. While AMD continues to remain a leading cause of severe visual loss worldwide, advances in pharmacotherapeutics have led to substantial improvements in the outcome of these patients. The introduction of anti-vascular endothelial growth factor agents has resulted in improvement of visual outcomes and has had a positive impact on the quality of life among elderly population. While the contemporary management of neovascular AMD has been successful in tremendously reducing the visual morbidity, the financial burden of therapy has increased exponentially. To overcome these challenges, newer pharmacologic agents are evaluated for their efficacy and safety in AMD. Ground-breaking advances in bench to bedside research have led to discovery of new pathways that appear to be viable targets for preventing visual loss in AMD. In this review, study designs and results of landmark clinical trials in AMD from the past decade have been summarized.

  7. Management of neovascular Age-related macular degeneration: A review on landmark randomized controlled trials

    Directory of Open Access Journals (Sweden)

    Aniruddha Agarwal

    2016-01-01

    Full Text Available In the last decade, a number of prospective clinical trials with carefully designed study protocols have been conducted for the treatment of neovascular age.related macular degeneration (AMD. These landmark clinical trials such as ANCHOR and MARINA and, more recently, the Comparison of AMD Treatment Trials and VIEW studies have revolutionized the management of neovascular AMD. While AMD continues to remain a leading cause of severe visual loss worldwide, advances in pharmacotherapeutics have led to substantial improvements in the outcome of these patients. The introduction of anti.vascular endothelial growth factor agents has resulted in improvement of visual outcomes and has had a positive impact on the quality of life among elderly population. While the contemporary management of neovascular AMD has been successful in tremendously reducing the visual morbidity, the financial burden of therapy has increased exponentially. To overcome these challenges, newer pharmacologic agents are evaluated for their efficacy and safety in AMD. Ground.breaking advances in bench to bedside research have led to discovery of new pathways that appear to be viable targets for preventing visual loss in AMD. In this review, study designs and results of landmark clinical trials in AMD from the past decade have been summarized.

  8. The Effects of Self-Management Education for School-Age Children on Asthma Morbidity: A Systematic Review

    Science.gov (United States)

    Ahmad, Emily; Grimes, Deanna E.

    2011-01-01

    The effects of asthma self-management education for school-age children on number of school days missed, emergency department visits and hospital admissions were evaluated through a systematic review of the published research. A total of 9 studies on asthma education programs that were conducted in schools by school nurses and health educators and…

  9. The Effects of Self-Management Education for School-Age Children on Asthma Morbidity: A Systematic Review

    Science.gov (United States)

    Ahmad, Emily; Grimes, Deanna E.

    2011-01-01

    The effects of asthma self-management education for school-age children on number of school days missed, emergency department visits and hospital admissions were evaluated through a systematic review of the published research. A total of 9 studies on asthma education programs that were conducted in schools by school nurses and health educators and…

  10. Management of neovascular Age-related macular degeneration: A review on landmark randomized controlled trials

    OpenAIRE

    Aniruddha Agarwal; Kanika Aggarwal; Vishali Gupta

    2016-01-01

    In the last decade, a number of prospective clinical trials with carefully designed study protocols have been conducted for the treatment of neovascular age-related macular degeneration (AMD). These landmark clinical trials such as ANCHOR and MARINA and, more recently, the Comparison of AMD Treatment Trials and VIEW studies have revolutionized the management of neovascular AMD. While AMD continues to remain a leading cause of severe visual loss worldwide, advances in pharmacotherapeutics have...

  11. Dry aging of beef; Review

    OpenAIRE

    Dashdorj, Dashmaa; Tripathi, Vinay Kumar; Cho, Soohyun; Kim, Younghoon; Hwang, Inho

    2016-01-01

    The present review has mainly focused on the specific parameters including aging (aging days, temperature, relative humidity, and air flow), eating quality (flavor, tenderness and juiciness), microbiological quality and economic (shrinkage, retail yields and cost) involved beef dry aging process. Dry aging is the process where beef carcasses or primal cuts are hanged and aged for 28 to 55 d under controlling environment conditions in a refrigerated room with 0° to 4 °C and with relative humid...

  12. Motivations and marketing manager age

    Directory of Open Access Journals (Sweden)

    Gutić Dragutin

    2008-01-01

    Full Text Available Motivation research up to now perceive managers as a homogeneous group and do not include numerous individual differences. Age differences between people are an important factor which influences their motivation altogether. Motifs are not static but dynamic categories and structures which, among other things, also depend on a person's experience during person's development. This work's objective is first of all to define whether a real marketing manager's motivation profile in Croatia today corresponds to their expected or supposed profile? In this work secondary and primary data resources are used. Field examination of marketing manager's motives and motivation was conducted by a structured questionnaire on an intended occasional sample of 60 examinees (N=60 from the whole Croatia, the very same being marketing managers (marketing service managers, sales managers (sales service managers and tourist community directors. We divided the group of 60 examinees into three homogeneous age groups: :'A' (n = 20, aged to 35; 'B' (n = 20, aged between 35 and 50; 'C' (n = 20, aged over 50. Examinees' registered motives were classified into four groups: direct material motives (Ms; job safety and job (work promotion motives (Mt; professional improving and profession promotion motives: gaining new knowledge, abilities and skills (Mc; work climate and atmosphere, and other similar motives (Mp. Authors entered this research with belief that younger managers will be mostly motivated for professional improving and gaining new knowledge and skills; we expect middle aged managers to be mostly motivated for safety and job promotion, and managers in an advanced age should probably be mostly motivated for direct income and earnings.

  13. Dry aging of beef; Review.

    Science.gov (United States)

    Dashdorj, Dashmaa; Tripathi, Vinay Kumar; Cho, Soohyun; Kim, Younghoon; Hwang, Inho

    2016-01-01

    The present review has mainly focused on the specific parameters including aging (aging days, temperature, relative humidity, and air flow), eating quality (flavor, tenderness and juiciness), microbiological quality and economic (shrinkage, retail yields and cost) involved beef dry aging process. Dry aging is the process where beef carcasses or primal cuts are hanged and aged for 28 to 55 d under controlling environment conditions in a refrigerated room with 0° to 4 °C and with relative humidity of 75 to 80 %. However there are various opinions on dry aging procedures and purveyors of such products are passionate about their programs. Recently, there has been an increased interest in dry aging process by a wider array of purveyors and retailers in the many countries. Dry aging process is very costly because of high aging shrinkage (6 to15 %), trims loss (3 to 24 %), risk of contamination and the requirement of highest grades meat with. The packaging in highly moisture-permeable bag may positively impact on safety, quality and shelf stability of dry aged beef. The key effect of dry aging is the concentration of the flavor that can only be described as "dry-aged beef". But the contribution of flavor compounds of proteolysis and lipolysis to the cooked dry aged beef flavor is not fully known. Also there are limited scientific studies of aging parameters on the quality and palatability of dry aged beef.

  14. Effects of case management in community aged care on client and carer outcomes: a systematic review of randomized trials and comparative observational studies.

    Science.gov (United States)

    You, Emily Chuanmei; Dunt, David; Doyle, Colleen; Hsueh, Arthur

    2012-11-14

    Case management has been applied in community aged care to meet frail older people's holistic needs and promote cost-effectiveness. This systematic review aims to evaluate the effects of case management in community aged care on client and carer outcomes. We searched Web of Science, Scopus, Medline, CINAHL (EBSCO) and PsycINFO (CSA) from inception to 2011 July. Inclusion criteria were: no restriction on date, English language, community-dwelling older people and/or carers, case management in community aged care, published in refereed journals, randomized control trials (RCTs) or comparative observational studies, examining client or carer outcomes. Quality of studies was assessed by using such indicators as quality control, randomization, comparability, follow-up rate, dropout, blinding assessors, and intention-to-treat analysis. Two reviewers independently screened potentially relevant studies, extracted information and assessed study quality. A narrative summary of findings were presented. Ten RCTs and five comparative observational studies were identified. One RCT was rated high quality. Client outcomes included mortality (7 studies), physical or cognitive functioning (6 studies), medical conditions (2 studies), behavioral problems (2 studies) , unmet service needs (3 studies), psychological health or well-being (7 studies) , and satisfaction with care (4 studies), while carer outcomes included stress or burden (6 studies), satisfaction with care (2 studies), psychological health or well-being (5 studies), and social consequences (such as social support and relationships with clients) (2 studies). Five of the seven studies reported that case management in community aged care interventions significantly improved psychological health or well-being in the intervention group, while all the three studies consistently reported fewer unmet service needs among the intervention participants. In contrast, available studies reported mixed results regarding client physical

  15. Scope and selection of structures subject to aging management review; Alcance y seleccion de estructuras sujetas a revision de gestion de envejecimiento

    Energy Technology Data Exchange (ETDEWEB)

    Mendoza, G.; Diaz, A.; Viais, J.; Carmona, M. [ININ, Carretera Mexico-Toluca s/n, 52750 Ocoyoacac, Estado de Mexico (Mexico); Santander, L., E-mail: gonzalo.mendoza@inin.gob.mx [Comision Federal de Electricidad, Central Nucleoelectrica Laguna Verde, Carretera Cardel-Nautla Km. 42.5, Veracruz (Mexico)

    2014-10-15

    The purpose of this work is to determine the structures included within the scope of license renewal based on the performance of the functions and select those intended for aging management review; one purpose is to show the methodology used to establish the structure and structural components that are subject to a review of aging management, within the framework of license renewal rule. This is through the application of different types of structures and structural components related and unrelated to safety located in the rooms of the reactor building where there are components of the reactor core isolation cooling system (Rcic), these structures are poured concrete, concrete block, structural steel, shielding walls, attached metal, pile foundations, etc.; other non- security related , such as: 1) inherent characteristics not related to security that protect the equipment related to the safety of the missiles, that is, walls, low walls, dikes, doors, etc., which also provide flood barriers to structures, systems and components related to safety, 2 ) whipping restrictions on non- security, shields mitigation jet, vent panels , etc. that are designed and installed to protect equipment related with the safety of the effects of a broken line of high energy. Only rooms where there are components of the Rcic 68 structures within the scope were identified. (Author)

  16. Systematic review of the evidence for a liberalized diet in the management of diabetes mellitus in older adults residing in aged care facilities.

    Science.gov (United States)

    Farrer, Olivia; Yaxley, Alison; Walton, Karen; Healy, Erin; Miller, Michelle

    2015-04-01

    A systematic review of the literature was conducted to review and evaluate the evidence supporting a liberalized diet for the management of diabetes mellitus in aged care homes and examine the effect of this on glycaemia, nutritional status and diabetes comorbidity risk factors. A 3 step search of eight databases followed by independent data extraction and quality assessment by two authors was undertaken. Studies which compared therapeutic diets to a liberalized diet or observation studies reviewing the effects of therapeutic diets on glycaemia and nutritional status were included. Of the 546 studies identified, six met the inclusion criteria. Methodological quality of the studies was rated poor and the majority concluded no statistically significant change in diabetes management outcomes with a liberalized diet, but modest increases in glycaemia were observed. Inadequate data was available to determine effects of diet change on nutritional status or diabetes risk factors. Overall studies were in support of a liberalized diet but due to the low quality of the evidence and a lack of significant findings it may not be appropriate to extrapolate these conclusions to inform dietetic practice.

  17. Eyelid aging: pathophysiology and clinical management

    Directory of Open Access Journals (Sweden)

    Renato Wendell Damasceno

    2015-10-01

    Full Text Available ABSTRACTLife expectancy is increasing in most countries. With increasing age, many individuals may develop involutional ophthalmic diseases, such as eyelid aging. Dermatochalasis, ptosis, ectropion, and entropion are common disorders in middle-aged and older adults. This review outlines the pathophysiology and clinical management of these involutional eyelid disorders. Recently, a decrease in elastic fibers with ultrastructural abnormalities and an overexpression of elastin-degrading enzymes have been demonstrated in involutional ectropion and entropion. This may be the consequence of local ischemia, inflammation, and/or chronic mechanical stress. Eyelid aging with progressive loss of tone and laxity may affect the ocular surface and adnexal tissues, resulting in different clinical symptoms and signs. Surgical management depends on the appropriate correction of the underlying anatomical defect.

  18. Developing effective educational approaches for Liaison Old Age Psychiatry teams: a literature review of the learning needs of hospital staff in relation to managing the confused older patient.

    Science.gov (United States)

    Teodorczuk, Andrew; Welfare, Mark; Corbett, Sally; Mukaetova-Ladinska, Elizabeta

    2010-09-01

    Deficiencies in the knowledge, skills and attitudes of all healthcare professionals working within the general hospital contribute towards the suboptimal care of older hospitalized patients with confusion. In the U.K., policy dictates that Liaison Old Age Psychiatry teams deliver effective education to general hospital clinical staff. The purpose of this paper is to review the literature concerning the learning needs of healthcare professionals in relation to managing confusion in the older patient in order to inform effective educational approaches for Liaison Old Age Psychiatry teams. A broad range of medical and educational databases were searched. Identified English language studies were selected for further analysis if they had a specific educational focus in the hospital setting and then further subdivided into intervention and naturalistic studies. The impact of intervention studies was evaluated by Kirkpatrick's system. Learning needs, as determined from the naturalistic studies, were mapped to identify themes. 13 intervention studies were identified. Despite a high level of effectiveness for educational interventions, it was unclear what the active components were. A further 23 naturalistic studies were identified; their findings focused on knowledge gaps, diagnostic behaviors and experiences, attitudes and training issues. Few studies specifically researched learning needs or the educational role of liaison teams. Conspicuous by its absence was reference to relevant educational theories. The findings of this review can be incorporated in the planning of local curricula by Liaison Teams in order to design educational strategies. There is a need for further research, especially studies exploring the learning needs of all healthcare professionals.

  19. Role of the Whole Body Vibration Machine in the Prevention and Management of Osteoporosis in Old Age: A Systematic Review

    Science.gov (United States)

    Swe, Myint; Benjamin, Biju; Tun, Aye Aye; Sugathan, Sandheep

    2016-01-01

    A literature search of related articles was carried out in electronic data sources. Initially, 276 randomised controlled trials related to the title were collected, after which 44 were selected using the keywords. Overlapping articles, articles with a study duration of less than six months, and studies involving young participants were removed from the list. The remaining 20 articles were checked for entitlement using the PEDro scale. A total of nine eligible articles with 1486 participants were analysed. Seven trials used dual-energy x-ray absorptiometry (DXA) to measure bone mineral density (BMD). The six trials published from 2005 to 2013 found a significant increase in BMD. In the remaining one trial, there was no significant increase in BMD. One study published in 2013 reported a significant increase in BMD measured with peripheral qualitative computed tomography, whereas another trial published in 2014 stated that there was a reduction in calcaneal bone density measured by peripheral qualitative ultrasound. From these findings it can be concluded that the whole body vibration machine is a good adjunctive therapy for the prevention and management of osteoporosis in postmenopausal women. However, further investigations are necessary before the same can be recommended for elderly men. PMID:27904420

  20. 78 FR 70076 - Aging Management of Internal Surfaces, Fire Water Systems, Atmospheric Storage Tanks, and...

    Science.gov (United States)

    2013-11-22

    ... COMMISSION Aging Management of Internal Surfaces, Fire Water Systems, Atmospheric Storage Tanks, and... Guidance (LR-ISG), LR-ISG-2012-02, ``Aging Management of Internal Surfaces, Fire Water Systems, Atmospheric... aging management programs (AMPs), aging management review (AMR) items, and definitions in NUREG-...

  1. 78 FR 21980 - Aging Management of Internal Surfaces, Service Level III and Other Coatings, Atmospheric Storage...

    Science.gov (United States)

    2013-04-12

    ... COMMISSION Aging Management of Internal Surfaces, Service Level III and Other Coatings, Atmospheric Storage...-2012-02, ``Aging Management of Internal Surfaces, Service Level III and Other Coatings, Atmospheric... aging management programs (AMP) and aging management review (AMR) items in NUREG-1801, Revision 2...

  2. The Reviewing of Management Literature.

    Science.gov (United States)

    Murphy, Marcy; Rehman, Sajjad ur

    1987-01-01

    This study identified the most productive reviewing journals for newly published business management titles. Two assumptions were shown to be supported by the data: a small core of journals carry the greatest number of reviews and a few monographs are reviewed repeatedly but the majority rarely or not at all. (Author/EM)

  3. Effective maintenance practices to manage system aging

    Science.gov (United States)

    Chockie, Alan; Bjorkelo, Kenneth

    A study for the Nuclear Regulatory Commission was recently undertaken to identify effective maintenance practices that could be adapted by the nuclear industry in the United States to assist in managing the aging degradation of plant systems and components. Four organizations were examined to assess the influence of maintenance programs on addressing the system and component aging degradation issues. An effective maintenance program was found to be essential to the management of system and component aging. Four key elements of an effective maintenance program that are important to an aging management were identified: (1) the selection of critical systems and components; (2) the development of an understanding of aging through the collection and analysis of equipment performance information; (3) the development of appropriate preventive and predictive maintenance tasks to manage equipment and system aging degradation; and (4) the use of feedback mechanisms to continuously improve the management of aging systems and components. These elements were found to be common to all four organizations.

  4. Review of Handbook of New Age

    DEFF Research Database (Denmark)

    Davidsen, Markus Altena

    2011-01-01

    Review of Daren Kemp & James R. Lewis (eds.), Handbook of New Age, in the series Brill Handbooks on Contemporary Religion 1, 2007, Leiden & Boston: Brill.......Review of Daren Kemp & James R. Lewis (eds.), Handbook of New Age, in the series Brill Handbooks on Contemporary Religion 1, 2007, Leiden & Boston: Brill....

  5. Failing ageing? Risk management in the active ageing society

    DEFF Research Database (Denmark)

    Rostgaard, Tine

    2015-01-01

    According to the European Commission's recent policy initiative on social investment, Danish Long term care offers new and innovative perspectives in ageing and the management of the risks associated thereof with the introduction of reablement (rehabilitering). From the perspective...

  6. Invited review: Theories of aging.

    Science.gov (United States)

    Weinert, Brian T; Timiras, Poala S

    2003-10-01

    Several factors (the lengthening of the average and, to a lesser extent, of the maximum human life span; the increase in percentage of elderly in the population and in the proportion of the national expenditure utilized by the elderly) have stimulated and continue to expand the study of aging. Recently, the view of aging as an extremely complex multifactorial process has replaced the earlier search for a distinct cause such as a single gene or the decline of a key body system. This minireview keeps in mind the multiplicity of mechanisms regulating aging; examines them at the molecular, cellular, and systemic levels; and explores the possibility of interactions at these three levels. The heterogeneity of the aging phenotype among individuals of the same species and differences in longevity among species underline the contribution of both genetic and environmental factors in shaping the life span. Thus, the presence of several trajectories of the life span, from incidence of disease and disability to absence of pathology and persistence of function, suggest that it is possible to experimentally (e.g., by calorie restriction) prolong functional plasticity and life span. In this minireview, several theories are identified only briefly; a few (evolutionary, gene regulation, cellular senescence, free radical, and neuro-endocrineimmuno theories) are discussed in more detail, at molecular, cellular, and systemic levels.

  7. Aging and DNA repair capability. [Review

    Energy Technology Data Exchange (ETDEWEB)

    Tice, R R

    1977-01-01

    A review of the literature on DNA repair processes in relation to aging is presented under the following headings: DNA repair processes; age-related occurrence of unrepaired DNA lesions; DNA repair capability as a function of age; tissue-specific DNA repair capability; acceleration of the aging process by exposure to DNA damaging agents; human genetic syndromes; and longevity and DNA repair processes. (HLW)

  8. Space age management for social problems

    Science.gov (United States)

    Levine, A. L.

    1973-01-01

    Attempts to apply space age management to social problems were plagued with difficulties. Recent experience in the State of Delaware and in New York City, however, indicate new possibilities. Project management as practiced in NASA was applied with promising results in programs dealing with housing and social services. Such applications are feasible, according to recent research, because project management utilizes social and behavioral approaches, as well as advanced management tools, such as PERT, to achieve results.

  9. Integrated ageing management of Atucha NPP

    Energy Technology Data Exchange (ETDEWEB)

    Ranalli, Juan M.; Marchena, Martin H.; Zorrilla, Jorge R.; Antonaccio, Elvio E.; Brenna, Pablo; Yllanez, Daniela; Cruz, Gerardo Vera de la; Luraschi, Carlos, E-mail: ranalli@cnea.gov.ar [Gerencia Coordinacion Proyectos CNEA-NASA, Comision Nacional de Energia Atomica, Buenos Aires (Argentina); Sabransky, Mario, E-mail: msabransky@na-sa.com.ar [Departamento Gestion de Envejecimiento, Central Nuclear Atucha I-II Nucleoelectrica Argentina S.A., Provincia de Buenos Aires (Argentina)

    2013-07-01

    Atucha NPP is a two PHWR unit site located in Lima, Province of Buenos Aires, 120 km north of Buenos Aires, Argentina. Until recent, the site was split in Atucha I NPP, a 350 MW pressure vessel heavy water reactor in operation since 1974; and Atucha II, a similar design reactor, twice as big as Atucha I finishing a delayed construction. With the start-up of Atucha II and aiming to integrate the management of the plants, the Utility (Nucleolectrica Argentina Sociedad Anonima - NASA) has reorganized its operation units. Within this reorganization, an Ageing Management Department has been created to cope with all ageing issues of both Atucha I and II units. The Atomic Energy Commission of Argentina (Comision Nacional de Energia Atomica - CNEA) is a state-owned R and D organization that; among other functions such as designing and building research reactors, developing uranium mining and supplying radioisotopes to the medical market; is in charge of providing support and technological update to all Argentinean NPPs. The Ageing Management Department of Atucha NPP and the Ageing Management Division of CNEA has formed a joint working group in order to set up an Integrated Ageing Management Program for Atucha NPP following IAEA guidelines. In the present work a summary of the activities, documental structure and first outputs of the Integrated Ageing Management Program of Atucha NPP is presented. (author)

  10. Age Management Principles in Czech Agrarian Sector

    Directory of Open Access Journals (Sweden)

    H. Urbancová

    2014-09-01

    Full Text Available Within the frame of the entire economy, the modern conception of Age Management enables each and every employee to use their full potential without being put at a disadvantage for age reasons. Despite the fact that this area is important in terms of current demographic development, there are organisations that do not implement its measures. The article therefore concentrates on the identification and evaluation of Age Management application by Czech agricultural businesses. The data analysed was obtained based on a quantitative survey in which data was collected by means of a questionnaire survey (total companies: n=315, agricultural businesses: na=60. The outcomes show that Czech agricultural businesses are not quite familiar with the application of Age Management measures. One of the conclusions of the article is that from the social point of view Age Management measures may help improve the situation on the labour market, labour productivity, encourage young people to work in the agricultural sector and, last but not least, build, on the organisational level, an employer’s brand. Application of Age Management causes on the employees performance but also on the costs reduce and profit increase. This contribution is a follow-up to the project of University – wide internal grant agency (CIGA, number 20141002 - Human resource branding using of the new strategic trends in organisations in the Czech Republic.

  11. A Review on Ageing with Empowerment Approach

    Directory of Open Access Journals (Sweden)

    Maryam Ravanipour

    2011-09-01

    Full Text Available Older adult population is being increased in Iran as well as in the world. Power is a resource for living that is present in all individuals, and has a positively uplifting effect on quality of life. In this book it will be reviewed the ageing theories, successful ageing, self care in ageing, some problems in this age, factors influences on sense of power and empowerment, concept of power, empowerment theories and manifestations and outcomes of powerlessness and finally empowerment process. Studying of this book for policymakers, students, and colleagues is recommended.

  12. Aging and Family Life: A Decade Review

    Science.gov (United States)

    Silverstein, Merril; Giarrusso, Roseann

    2010-01-01

    In this review, we summarize and critically evaluate the major empirical, conceptual, and theoretical directions that studies of aging families have taken during the first decade of the 21st century. The field has benefited from an expanded perspective based on four overarching themes: (a) complexity in emotional relations, (b) diversity in family…

  13. Age to age: insight into managing a multigenerational staff.

    Science.gov (United States)

    Stanley, Kay B

    2007-01-01

    Diversity in age and culture-medical practices and healthcare entities mirror the business world in the diversity of culture and age groups among their employees and patients. Differences create challenges, but with understanding and skillful communication, distinctions become opportunities for growth and excellence. The concept we are exploring is that as a generation we are who we are because of what was going on in our world during our formative years. We find that just naming ourselves aspart ofa group is a good starting point. The objective of this article is to identify characteristics of various age groups and to present ways to promote harmony and to maximize performance through practical management techniques. The goal is to better understand ourselves and each other so that our work is more productive and rewarding.

  14. Theories and management of aging: modern and ayurveda perspectives.

    Science.gov (United States)

    Datta, Hema Sharma; Mitra, S K; Paramesh, Rangesh; Patwardhan, Bhushan

    2011-01-01

    Aging is a complex phenomenon, a sum total of changes that occur in a living organism with the passage of time and lead to decreasing ability to survive stress, increasing functional impairment and growing probability of death. There are many theories of aging and skin remains the largest organ of the study. Skin aging is described as a consequence of intrinsic and extrinsic factors. The most common amongst visible signs of skin aging are wrinkles and there are various therapies including antiaging cosmeceuticals, sunscreens, chemical peeling, injectable agents, such as botox, fibrel, autologous fat grafting as also few surgical procedures have been used. Ayurveda, the Indian traditional medicine, describes aging with great details. This review provides modern and Ayurvedic perspectives on theories and management of aging.

  15. Theories and Management of Aging: Modern and Ayurveda Perspectives

    Directory of Open Access Journals (Sweden)

    Hema Sharma Datta

    2011-01-01

    Full Text Available Aging is a complex phenomenon, a sum total of changes that occur in a living organism with the passage of time and lead to decreasing ability to survive stress, increasing functional impairment and growing probability of death. There are many theories of aging and skin remains the largest organ of the study. Skin aging is described as a consequence of intrinsic and extrinsic factors. The most common amongst visible signs of skin aging are wrinkles and there are various therapies including antiaging cosmeceuticals, sunscreens, chemical peeling, injectable agents, such as botox, fibrel, autologous fat grafting as also few surgical procedures have been used. Ayurveda, the Indian traditional medicine, describes aging with great details. This review provides modern and Ayurvedic perspectives on theories and management of aging.

  16. AREVA-Aging Management Concepts and Tools

    Energy Technology Data Exchange (ETDEWEB)

    Zander, A.; Nopper, H.

    2014-07-01

    n case of long term operation (LTO) it is necessary to ensure that safety and safety relevant systems, structures and components continue to perform their intended functions during long term operation. In order to fulfill these requirements a plant-wide and systematic Aging and Plant Life Management is essential. (Author)

  17. Pain management in trauma: A review study

    Directory of Open Access Journals (Sweden)

    Alireza Ahmadi

    2016-07-01

    Full Text Available Background: Pain in trauma has a role similar to the double-edged sword. On the one hand, pain is a good indicator to determine the severity and type of injury. On the other hand, pain can induce sever complications and it may lead to further deterioration of the patient. Therefore, knowing how to manage pain in trauma patients is an important part of systemic approach in trauma. The aim of this manuscript is to provide information about pain management in trauma in the Emergency Room settings. Method: In this review we searched among electronic and manual documents covering a 15-yr period between 2000 and 2016. Our electronic search included Pub Med, Google scholar, Web of Science, and Cochrane databases. We looked for articles in English and in peer-reviewed journals using the following keywords: acute pain management, trauma, emergency room and injury. Results: More than 3200 documents were identified. After screening based on the study inclusion criteria, 560 studies that had direct linkage to the study aim were considered for evaluation based World Health Organization (WHO pain ladder chart. Conclusion: To provide adequate pain management in trauma patients require: adequate assessment of age-specific pharmacologic pain management; identification of adequate analgesic to relieve moderate to severe pain; cognizance of serious adverse effects of pain medications and weighting medications against their benefits, and regularly reassessing patients and reevaluating their pain management regimen. Patient-centered trauma care will also require having knowledge of barriers to pain management and discussing them with the patient and his/her family to identify solutions.

  18. Library management for the digital age a new paradigm

    CERN Document Server

    Todaro, Julie

    2014-01-01

    This revolutionary introduction to library management is the first conceived in and written for a digital age. Library Management for the Digital Age covers hierarchies, policies, communication, working relationships, facilities, human resources, settings, customer services, budgeting, and emergency management.

  19. Design of a management information system for the Shielding Experimental Reactor ageing management

    Energy Technology Data Exchange (ETDEWEB)

    He Jie, E-mail: hejiejoe@163.co [Institute of Nuclear and New Energy Technology, Tsinghua University, Beijing 100084 (China); Xu Xianhong [Institute of Nuclear and New Energy Technology, Tsinghua University, Beijing 100084 (China)

    2010-01-15

    The problem of nuclear reactor ageing is a topic of increasing importance in nuclear safety recent years. Ageing management is usually implemented for reactors maintenance. In the practice, a large number of data and records need to be processed. However, there are few professional software applications that aid reactor ageing management, especially for research reactors. This paper introduces the design of a new web-based management information system (MIS), named the Shielding Experimental Reactor Ageing Management Information System (SERAMIS). It is an auxiliary means that helps to collect data, keep records, and retrieve information for a research reactor ageing management. The Java2 Enterprise Edition (J2EE) and network database techniques, such as three-tiered model, Model-View-Controller architecture, transaction-oriented operations, and JavaScript techniques, are used in the development of this system. The functionalities of the application cover periodic safety review (PSR), regulatory references, data inspection, and SSCs classification according to ageing management methodology. Data and examples are presented to demonstrate the functionalities. For future work, techniques of data mining will be employed to support decision-making.

  20. Characterization of tinnitus in different age groups: A retrospective review

    Directory of Open Access Journals (Sweden)

    Jamil Al-Swiahb

    2016-01-01

    Full Text Available Objectives: The aim of this study was to characterize tinnitus in affected patients. Methods: A retrospective review of medical records from 470 consecutive patients who visited a tertiary care hospital for evaluation of chronic subjective tinnitus between January 2009 and June 2010 was performed. Patients were divided into three subgroups based on age. Clinical, audiological, and psychological characteristics of each subgroup were analyzed. Results: Of the 470 patients evaluated, 85 were less than 40, 217 between 40 and 60, and 168 above 60 years of age. Most patients were men and complained of unilateral, acute high-pitched tinnitus. Most patients above the age of 40 years complained of loud and annoying tinnitus and had worse stress and severity scores. Conclusions: Chronic tinnitus in older adults is subjectively louder, more annoying, and more distressing than that found in younger patients. We recommend considering age in the patient management plan.

  1. Checklist for Reviewing EPA Quality Management Plans

    Science.gov (United States)

    This checklist will be used to review the Quality Management Plans (QMPs) that are submitted to the Quality Staff of the Office of Environmental Information (OEI) for Agency review under EPA Order 5360.1 A2.

  2. Evaluating an interprofessional disease state and medication management review model.

    Science.gov (United States)

    Hoti, Kreshnik; Forman, Dawn; Hughes, Jeffery

    2014-03-01

    There is lack of literature data reporting an incorporation of medication management reviews in students' interprofessional education (IPE) and practice programs in aged care settings. This pilot study reports how an interprofessional disease state and medication management review program (DSMMR) was established in a residential aged care facility in Perth, Western Australia. Students from the professions of nursing, pharmacy and physiotherapy focused on a wellness check in the areas of cognition, falls and continence while integrating a medication management review. Students' attitudes were explored using a pre- and post-placement questionnaire. Students indicated positive experience with the IPE DSMMR program which also resulted in their positive attitudinal shift towards IPE and practice. These findings indicated that aged care can be a suitable setting for student interprofessional programs focusing on DSMMR.

  3. Aging with HIV: a practical review

    Directory of Open Access Journals (Sweden)

    Sandra Wagner Cardoso

    2013-08-01

    Full Text Available The worldwide elderly population is expected to grow by an additional 694 million people by 2025. By that time, there will be approximately two billion elderly people in the world, most of whom (80% will be living in developing countries. Based on recent estimates, this population will number over 40 million in 2030 in Brazil and a consequent increase in governmental spending for this population can be expected. Since highly active antiretroviral therapy became available in the mid-1990s, the life expectancy of people living with HIV has increased significantly. Approximately 12 million life years were added to the world between 1996 and 2008 as a consequence of wider access to highly active antiretroviral therapy. In Brazil, the incidence of AIDS among the population aged >50 years doubled between 1996 and 2006. The development of antiretroviral therapy has allowed individuals diagnosed at a younger age to live longer, which partially explains the aging tendency associated with the HIV/AIDS epidemic. It is estimated that by 2015, subjects aged >50 years will represent 50% of the people living with HIV undergoing clinical treatment. This scenario presents some challenges, including the fact that the diagnosis of HIV tends to be delayed in older patients compared to younger patients because the symptoms of HIV can be confused with those of other common diseases among the elderly and also because healthcare professionals do not consider this population to be at high risk for HIV infection. In regard to the individuals diagnosed with HIV, a further challenge is presented by the morbidity normally associated with aging. Finally, the elderly also exhibit higher susceptibility to the toxic effects and pharmacological interactions of medications. The present article reviews the literature regarding the profile of HIV infection among individuals aged >50 years focusing on practical features related to the clinical approach and long-term follow-up of

  4. 76 FR 69292 - Aging Management of Stainless Steel Structures and Components in Treated Borated Water

    Science.gov (United States)

    2011-11-08

    ... COMMISSION Aging Management of Stainless Steel Structures and Components in Treated Borated Water AGENCY... Staff Guidance (LR-ISG), LR- ISG-2011-01, ``Aging Management of Stainless Steel Structures and Components in Treated Borated Water.'' This LR-ISG revises the guidance in the Standard Review Plan...

  5. A review of the time management literature

    NARCIS (Netherlands)

    Claessens, B.J.C.; van Eerde, W.; Rutte, C.G.; Roe, R.A.

    2007-01-01

    Purpose - The purpose of this article is to provide an overview for those interested in the current state-of-the-art in time management research. Design/methodology/approach - This review includes 32 empirical studies on time management conducted between 1982 and 2004. Findings - The review demonstr

  6. A review of the time management literature

    NARCIS (Netherlands)

    Claessens, B.J.C.; van Eerde, W.; Rutte, C.G.; Roe, R.A.

    2007-01-01

    Purpose - The purpose of this article is to provide an overview for those interested in the current state-of-the-art in time management research. Design/methodology/approach - This review includes 32 empirical studies on time management conducted between 1982 and 2004. Findings - The review

  7. Effective recordkeeping technologies to manage aging

    Energy Technology Data Exchange (ETDEWEB)

    Dukelow, J.S.; Johnson, A.B. Jr. (Pacific Northwest Lab., Richland, WA (United States)); Vora, J.P. (Nuclear Regulatory Commission, Washington, DC (United States))

    1992-10-01

    Pacific Northwest Laboratory has investigated the capability of current recordkeeping technology to support aging management. This paper discusses technical issues associated with potential enhancements of nuclear plant records systems--from the perspective of the lessons learned about equipment aging degradation mechanisms and associated surveillance and monitoring techniques during the U. S. Nuclear Regulatory Commission's Nuclear Plant Aging Research Program. The paper considers both the specific types of technical data needed to ensure continued safe operation and the use of new technology to upgrade record systems. Specific topics discussed include: equipment reliability data needed to support the assessment of the impact of aging on the continued operation of the plant; operational history data to support the assessment of residual life of mechanical and structural components and piping; tools for the analysis and trending of equipment reliability data and operational history data; design and implementation of plant record systems that will provide a comprehensive and usable engineering design basis for the plant; proposed improvements in the data input process for the plant records system; computerization of plant records systems, including conversion of existing records into machine-readable forms.

  8. Effective recordkeeping technologies to manage aging

    Energy Technology Data Exchange (ETDEWEB)

    Dukelow, J.S.; Johnson, A.B. Jr. [Pacific Northwest Lab., Richland, WA (United States); Vora, J.P. [Nuclear Regulatory Commission, Washington, DC (United States)

    1992-10-01

    Pacific Northwest Laboratory has investigated the capability of current recordkeeping technology to support aging management. This paper discusses technical issues associated with potential enhancements of nuclear plant records systems--from the perspective of the lessons learned about equipment aging degradation mechanisms and associated surveillance and monitoring techniques during the U. S. Nuclear Regulatory Commission`s Nuclear Plant Aging Research Program. The paper considers both the specific types of technical data needed to ensure continued safe operation and the use of new technology to upgrade record systems. Specific topics discussed include: equipment reliability data needed to support the assessment of the impact of aging on the continued operation of the plant; operational history data to support the assessment of residual life of mechanical and structural components and piping; tools for the analysis and trending of equipment reliability data and operational history data; design and implementation of plant record systems that will provide a comprehensive and usable engineering design basis for the plant; proposed improvements in the data input process for the plant records system; computerization of plant records systems, including conversion of existing records into machine-readable forms.

  9. Cheese whey management: a review.

    Science.gov (United States)

    Prazeres, Ana R; Carvalho, Fátima; Rivas, Javier

    2012-11-15

    Cheese whey is simultaneously an effluent with nutritional value and a strong organic and saline content. Cheese whey management has been focused in the development of biological treatments without valorization; biological treatments with valorization; physicochemical treatments and direct land application. In the first case, aerobic digestion is reported. In the second case, six main processes are described in the literature: anaerobic digestion, lactose hydrolysis, fermentation to ethanol, hydrogen or lactic acid and direct production of electricity through microbial fuel cells. Thermal and isoelectric precipitation, thermocalcic precipitation, coagulation/flocculation, acid precipitation, electrochemical and membrane technologies have been considered as possible and attractive physicochemical processes to valorize or treat cheese whey. The direct land application is a common and longstanding practice, although some precautions are required. In this review, these different solutions are analyzed. The paper describes the main reactors used, the influence of the main operating variables, the microorganisms or reagents employed and the characterizations of the final effluent principally in terms of chemical oxygen demand. In addition, the experimental conditions and the main results reported in the literature are compiled. Finally, the comparison between the different treatment alternatives and the presentation of potential treatment lines are postulated.

  10. Basal ganglia stroke due to mild head trauma in pediatric age - clinical and therapeutic management: a case report and 10 year literature review

    Directory of Open Access Journals (Sweden)

    Salvati Maurizio

    2011-01-01

    Full Text Available Abstract Ischemia of the basal ganglia as an immediate consequence of minor head injury in children is rare ( Young patients should be closely monitored and treated conservatively with osmotic diuretics to reduce perilesional edema. At the same time, however, it is very important to exclude, by means of instrumental and laboratory studies, conditions that could favour the onset of ischemia, including emboligen heart disease, thrombophilia and acute traumatic arterial dissections. Generally speaking, the prognosis in these cases is good. The authors describe their experience treating a 10-month old baby girl, with a left lenticular nucleus ischemia and report a literature review.

  11. Uranium enrichment management review: summary of analysis

    Energy Technology Data Exchange (ETDEWEB)

    1981-01-01

    In May 1980, the Assistant Secretary for Resource Applications within the Department of Energy requested that a group of experienced business executives be assembled to review the operation, financing, and management of the uranium enrichment enterprise as a basis for advising the Secretary of Energy. After extensive investigation, analysis, and discussion, the review group presented its findings and recommendations in a report on December 2, 1980. The following pages contain background material on which that final report was based. This report is arranged in chapters that parallel those of the uranium enrichment management review final report - chapters that contain summaries of the review group's discussion and analyses in six areas: management of operations and construction; long-range planning; marketing of enrichment services; financial management; research and development; and general management. Further information, in-depth analysis, and discussion of suggested alternative management practices are provided in five appendices.

  12. Research Review: Magazine Management and Economics.

    Science.gov (United States)

    Worthington, Robert

    1994-01-01

    Reviews research on magazine management and economics. Finds that most citations are from business and trade publications; research is being presented at conferences but not published; most management research covers industry trends rather than specific industry topics; and no solid base of conceptual and theoretical magazine management research…

  13. Clinical implications of ageing for the management of IBD.

    Science.gov (United States)

    Ha, Christina Y; Katz, Seymour

    2014-02-01

    As the global population ages, the number of older people (≥65 years) living with IBD is expected to increase. IBD therapeutics have advanced considerably over the past few decades with the introduction of multiple steroid-sparing agents as well as numerous clinical trials that have tested new therapeutic targets. However, the current paradigms for IBD management might not be directly translatable to older patients with IBD. Age-related factors such as immunodeficiency relative to younger patients, comorbidity, polypharmacy and diminished physical reserve directly or indirectly affect the natural history of their disease. This Review highlights how these age-associated variables can affect older patients with IBD and also illustrates the multiple gaps in our current knowledge of IBD in the elderly.

  14. Annual research review: Harms experienced by child users of online and mobile technologies: the nature, prevalence and management of sexual and aggressive risks in the digital age.

    Science.gov (United States)

    Livingstone, Sonia; Smith, Peter K

    2014-06-01

    The usage of mobile phones and the internet by young people has increased rapidly in the past decade, approaching saturation by middle childhood in developed countries. Besides many benefits, online content, contact or conduct can be associated with risk of harm; most research has examined whether aggressive or sexual harms result from this. We examine the nature and prevalence of such risks, and evaluate the evidence regarding the factors that increase or protect against harm resulting from such risks, so as to inform the academic and practitioner knowledge base. We also identify the conceptual and methodological challenges encountered in this relatively new body of research, and highlight the pressing research gaps. Given the pace of change in the market for communication technologies, we review research published since 2008. Following a thorough bibliographic search of literature from the key disciplines (psychology, sociology, education, media studies and computing sciences), the review concentrates on recent, high quality empirical studies, contextualizing these within an overview of the field. Risks of cyberbullying, contact with strangers, sexual messaging ('sexting') and pornography generally affect fewer than one in five adolescents. Prevalence estimates vary according to definition and measurement, but do not appear to be rising substantially with increasing access to mobile and online technologies, possibly because these technologies pose no additional risk to offline behaviour, or because any risks are offset by a commensurate growth in safety awareness and initiatives. While not all online risks result in self-reported harm, a range of adverse emotional and psychosocial consequences is revealed by longitudinal studies. Useful for identifying which children are more vulnerable than others, evidence reveals several risk factors: personality factors (sensation-seeking, low self-esteem, psychological difficulties), social factors (lack of parental support

  15. Basal ganglia stroke due to mild head trauma in pediatric age - clinical and therapeutic management: a case report and 10 year literature review.

    Science.gov (United States)

    Landi, Alessandro; Marotta, Nicola; Mancarella, Cristina; Marruzzo, Daniele; Salvati, Maurizio; Delfini, Roberto

    2011-01-06

    Ischemia of the basal ganglia as an immediate consequence of minor head injury in children is rare (< 2% of all ischemic stroke in childhood) and is due to vasospasm of the lenticulostriate arteries. The clinical history of these lesions is particularly favourable because they are usually small, and also because the facial-brachial-crural hemiparesis typical of this pathology usually regresses after a period ranging from several weeks to several months, despite the persistence of an ischemic area on MRI. This is due to the well known neuronal plasticity of the CNS, in particular, of the primary motor cortex. The most effective therapeutic approach appears to be the conservative one, although the best treatment regimen is still not well defined.Young patients should be closely monitored and treated conservatively with osmotic diuretics to reduce perilesional edema. At the same time, however, it is very important to exclude, by means of instrumental and laboratory studies, conditions that could favour the onset of ischemia, including emboligen heart disease, thrombophilia and acute traumatic arterial dissections. Generally speaking, the prognosis in these cases is good. The authors describe their experience treating a 10-month old baby girl, with a left lenticular nucleus ischemia and report a literature review.

  16. Wastewater management through the ages: a history of mankind.

    Science.gov (United States)

    Lofrano, Giusy; Brown, Jeanette

    2010-10-15

    Although much has been written about the history of water supply systems, there is a lack of corresponding information on wastewater management. This is surprising since the lack of sanitation affects human development to the same or even greater extent as the lack of clean water. While there may be an added stigma to discussing waste treatment, sanitation is widely perceived as meriting a significant claim on financial and political resources as well on the evolution of mankind. A literature review is presented on the evolution of wastewater management through the ages and its concurrent impact on human health and environment. Hopefully this information will improve the awareness of the past with a view to impacting future policies and technical developments. The review highlights the connection of environmental contamination with the ability to measure it, as well as the ways pollution control has been changed by advances in scientific knowledge. Attention is also drawn to the effects of political and societal events on wastewater management. A sanitation timeline has been constructed pointing out significant developments in the treatment of wastewater and improvements in analytical environmental chemistry. This review has been written in the belief that historical research showing the collective experience and "philosophy of sanitation" can provide inspiration to face future challenges.

  17. A literature review of idea management

    DEFF Research Database (Denmark)

    Jensen, Anna Rose Vagn

    2012-01-01

    The objective of the paper is primarily to conduct a state-of-the-art literature review of Idea Management and secondary to point out unanswered questions which are left behind in the reviewed literature. Scientific knowledge is primarily represented in innovation management literature but also...... considerably in literature on software and IT. On the background of the literature review, there are some weaknesses in the literature to be considered. These weaknesses concern the understanding of how people interact with idea management in their daily work practices and how different types of ideas...

  18. The Management of Pediatric Polytrauma: Review

    NARCIS (Netherlands)

    H. Mevius; M. van Dijk (Monique); A. Numanoglu (Alp); A.B. van As (Àrjan Bastiaan)

    2014-01-01

    textabstractPolytrauma is a major cause of mortality and morbidity in both developed and developing countries. The primary goal of this review is to provide a comprehensive overview on current knowledge in the management of pediatric polytrauma patients (PPPs). A database review was con- ducted base

  19. Influences on Case-Managed Community Aged Care Practice.

    Science.gov (United States)

    You, Emily Chuanmei; Dunt, David; Doyle, Colleen

    2016-10-01

    Case management has been widely implemented in the community aged care setting. In this study, we aimed to explore influences on case-managed community aged care practice from the perspectives of community aged care case managers. We conducted 33 semistructured interviews with 47 participants. We drew these participants from a list of all case managers working in aged care organizations that provided publicly funded case management program(s)/packages in Victoria, Australia. We used a multilevel framework that included such broad categories of factors as structural, organizational, case manager, client, and practice factors to guide the data analysis. Through thematic analysis, we found that policy change, organizational culture and policies, case managers' professional backgrounds, clients with culturally and linguistically diverse backgrounds, and case management models stood out as key influences on case managers' practice. In the future, researchers can use the multilevel framework to undertake implementation research in similar health contexts.

  20. Ageing management experience at NUR Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Melllal, Sabrina; Rezig, Mohamed; Zamoun, Rachid; Ameur, Azeddin [Nuclear Research Center of Draria, Algiers (Algeria)

    2013-07-01

    NUR is a 1 MW, open pool reactor moderated and cooled by light water. It was commissioned in 1989. NUR is used for education and training in Nuclear Engineering and related topics for COMENA and National Scientific Community. It is also used to perform R and D works and services at national and regional levels. In this presentation, we describe the methodology and the main development activities related to the ageing management at NUR reactor. These activities include inspection actions and development actions to introduce modifications, to solve obsolescence issues in view to implement the required preventive and curative maintenance programs and to improve the performances of the installation. These actions involved mainly the Operation Assistance System of the Reactor (OAS), the secondary cooling loop, the cooling tower. A new OAS using a new technology and having more possibilities than the older one was introduced in the control system of the reactor. The OAS hardware structure, software structure and the main functions performed are presented. The second loop is entirely refurbished. Two new cooling towers are installed and connected to the main heat exchanger with new piping and valves. The architecture of this new installation is described and the performance assessed. Other actions which involve auxiliary systems like emergency electrical system, air pneumatic system and automatic fire extinguishing are presented.

  1. Comprehensive management of hydrocarbon storage tanks ageing

    Energy Technology Data Exchange (ETDEWEB)

    Lesueur, V.; Riethmuller, M.; Chauveau, D. [IS Services, Villepinte (France)

    2006-07-01

    Corrosion generates considerable material losses in industry and can result in irreversible damages to the environment and some times in losses in human lives. Hydrocarbon storage tanks are subject to various corrosion types like generalised corrosion resulting in large areas thickness reduction, or potentially dangerous local damage (pitting, crevice or craters). To keep safe storage conditions and save service life, it is essential: - to identify the risks by taking into account the stored products, the storage type, the environmental factors, the type of coating and the storage history, - to select the most appropriate NDT technique (acoustic emission, thickness ultrasonic measurement, TOFD, ACFM, visual inspection, remote UT..) depending on the part to be inspected and on the expected type of damage, - to propose the best solution for storage tank restoration (repair, improved protection..) - to modify the operating conditions - to define the NDT periodicity and the appropriate technique to apply according to the type of risks, to the former inspection results and to the regulation context, - to determine the remaining life of storage tank. This approach is named Comprehensive Management of hydrocarbon storage tank ageing. IS Services has developed a software called ''AGIR'' aiming at providing guidance and support to apply this approach. (orig.)

  2. Managing stress and change during service reviews.

    Science.gov (United States)

    Sweeney, Corinne

    2009-01-01

    Service reviews occur throughout the National Health Service from time to time, and changes in commissioning policies have recently led many Primary Care Trusts to hold reviews of the community health services. Although reviews can provide opportunities for fresh thinking, the process can be a time of considerable stress and apprehension for many staff as current systems and ways of working are challenged and possibly changed. If this stress is not managed appropriately, staff may suffer ill health leading to possible staff absences and pressure on services. Leaders and managers are ideally placed to manage this time of stress, if they have the necessary skills and qualities. Self-help measures are also beneficial and recommended as part of a healthy lifestyle. This article discusses how change can affect people in different stages of their life and how it can be managed more positively in the workplace.

  3. Empirical perspectives on services integration and aging: a review.

    Science.gov (United States)

    Lago, D; Zarit, S H

    1992-01-01

    This article combines a review of social service literature with interviews of key informants on the issue of integrating services for the elderly into human services across the life span. Empirical findings concerning the relative benefits and drawbacks of age-integrated vs. specialized service organizational structures are emphasized. Surprisingly few empirical studies were identified. Instead of empirically based reports, the literature is largely comprised of polemics, which essentially restate long-standing positions on the preferred handling of integration. A persistent difficulty in discussions of federal and state service integration objectives has been the wide differences in definitions of "integration." The lack of data demonstrating that older persons benefit in integrated service systems, along with substantial progress in development of specialized services for the aged, suggest that aging advocates should be cautious in embracing age-integrated service integration proposals. Research within management information systems oriented toward client outcomes is necessary to gain valid knowledge of the merits of various integrated service models.

  4. Time Perspective and Age: A Review of Age Associated Differences.

    Science.gov (United States)

    Laureiro-Martinez, Daniella; Trujillo, Carlos A; Unda, Juliana

    2017-01-01

    We investigate the relationship between age and the five dimensions of time perspective measured by the Zimbardo Time Perspective Inventory (ZTPI) (past negative, past positive, present hedonistic, present fatalistic, and future). Time perspective is related to well-being, decision-making, level of development, and many other psychological issues. Hence, the existence of a systematic relationship between time perspective and age should be considered in all studies for which time is a relevant variable. However, no specific research about this has been conducted. We collected 407 papers that referenced the ZTPI between 2001 and 2015. From those, 72 studies met our inclusion criteria. They included 29,815 participants from 19 countries whose age spans most phases of adulthood (from 13.5 to 75.5 years, mean 28.7). We analyzed these studies adapting meta-analytical techniques. We found that present hedonistic and past negative dimensions are negatively related to aging with partial eta squared effect sizes of roughly 0.15. Our results have implications for the design of studies related to time as our findings highlight the importance of taking into account the differences associated with age.

  5. Time Perspective and Age: A Review of Age Associated Differences

    Science.gov (United States)

    Laureiro-Martinez, Daniella; Trujillo, Carlos A.; Unda, Juliana

    2017-01-01

    We investigate the relationship between age and the five dimensions of time perspective measured by the Zimbardo Time Perspective Inventory (ZTPI) (past negative, past positive, present hedonistic, present fatalistic, and future). Time perspective is related to well-being, decision-making, level of development, and many other psychological issues. Hence, the existence of a systematic relationship between time perspective and age should be considered in all studies for which time is a relevant variable. However, no specific research about this has been conducted. We collected 407 papers that referenced the ZTPI between 2001 and 2015. From those, 72 studies met our inclusion criteria. They included 29,815 participants from 19 countries whose age spans most phases of adulthood (from 13.5 to 75.5 years, mean 28.7). We analyzed these studies adapting meta-analytical techniques. We found that present hedonistic and past negative dimensions are negatively related to aging with partial eta squared effect sizes of roughly 0.15. Our results have implications for the design of studies related to time as our findings highlight the importance of taking into account the differences associated with age. PMID:28261119

  6. Literature review on cutback management

    NARCIS (Netherlands)

    R. Raudla (Ringa); R. Savi (Riin); T. Randma-Liiv (Tiina)

    2013-01-01

    textabstractIntroduction The literature review at hand is the first deliverable of Work Package no. 7 The global financial crisis in the public sector as an emerging coordination challenge of the EU Seventh Framework program project Coordinating for Cohesion in the Public Sector of the Future (COCOP

  7. A Review of Forensic Science Management Literature.

    Science.gov (United States)

    Houck, M M; McAndrew, W P; Porter, M; Davies, B

    2015-01-01

    The science in forensic science has received increased scrutiny in recent years, but interest in how forensic science is managed is a relatively new line of research. This paper summarizes the literature in forensic science management generally from 2009 to 2013, with some recent additions, to provide an overview of the growth of topics, results, and improvements in the management of forensic services in the public and private sectors. This review covers only the last three years or so and a version of this paper was originally produced for the 2013 Interpol Forensic Science Managers Symposium and is available at interpol.int.

  8. Development of the ageing management database of PUSPATI TRIGA reactor

    Energy Technology Data Exchange (ETDEWEB)

    Ramli, Nurhayati, E-mail: nurhayati@nm.gov.my; Tom, Phongsakorn Prak; Husain, Nurfazila; Farid, Mohd Fairus Abd; Ramli, Shaharum [Reactor Technology Centre, Malaysian Nuclear Agency, MOSTI, Bangi, 43000 Kajang, Selangor (Malaysia); Maskin, Mazleha [Science Program, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Selangor (Malaysia); Adnan, Amirul Syazwan; Abidin, Nurul Husna Zainal [Faculty of Petroleum and Renewable Energy Engineering, Universiti Teknologi Malaysia (Malaysia)

    2016-01-22

    Since its first criticality in 1982, PUSPATI TRIGA Reactor (RTP) has been operated for more than 30 years. As RTP become older, ageing problems have been seen to be the prominent issues. In addressing the ageing issues, an Ageing Management (AgeM) database for managing related ageing matters was systematically developed. This paper presents the development of AgeM database taking into account all RTP major Systems, Structures and Components (SSCs) and ageing mechanism of these SSCs through the system surveillance program.

  9. Aging management guideline for commercial nuclear power plants - heat exchangers

    Energy Technology Data Exchange (ETDEWEB)

    Booker, S.; Lehnert, D.; Daavettila, N.; Palop, E.

    1994-06-01

    This Aging Management Guideline (AMG) describes recommended methods for effective detection and mitigation of age-related degradation mechanisms in commercial nuclear power plant heat exchangers important to license renewal. The intent of this AMG is to assist plant maintenance and operations personnel in maximizing the safe, useful life of these components. It also supports the documentation of effective aging management programs required under the License Renewal Rule 10 CFR 54. This AMG is presented in a manner that allows personnel responsible for performance analysis and maintenance to compare their plant-specific aging mechanisms (expected or already experienced) and aging management program activities to the more generic results and recommendations presented herein.

  10. Occupational health and safety management practices and musculoskeletal disorders in aged care.

    Science.gov (United States)

    Oakman, Jodi; Bartram, Timothy

    2017-05-15

    Purpose The purpose of this paper is to examine whether occupational health and safety (OHS) management used to manage musculoskeletal disorders (MSDs) in the aged care sector reflects contemporary research evidence of best practice to reduce the incidence of these disorders. Design/methodology/approach In total, 58 interviews were conducted with managers and supervisors in the aged care sector across four organisations in Australia. Policies and procedures relating to MSDs were reviewed for each organisation. Findings Policies and procedures for managing MSDs do not reflect contemporary evidence, which supports a complex aetiology, related to a range of physical and psychosocial workplace factors. Despite strong evidence that psychosocial factors contribute to MSD development, these were not included in the policies and procedures reviewed. Findings from the interviews management practices including leadership and various components of HRM were functioning well but fragmentation was evident due to the challenging nature of the aged care sector. Practical implications To address the significant burden of MSDs in the aged care sector, policies and procedures need to include coverage of psychosocial and physical workplace factors. The development of systematic and integrated OHS management at the workplace level may play an important role in the effective management of MSDs. Originality/value This study offers insights into the previously unexplored area of MSD risk management and the role of management practices such as HRM in the aged care sector.

  11. Redefining Book Reviews for the Digital Age

    Science.gov (United States)

    Butler, Deirdre; Leahy, Margaret; McCormack, Ciaran

    2010-01-01

    This paper describes the results of a pilot study conducted in Ireland to examine the effectiveness of an online book review project. The project focused on the production of book reviews by primary school children in the form of digital video. The videos created were uploaded to a password protected website, which was available to the schools…

  12. BOOK REVIEW: Case Studies in Knowledge Management

    OpenAIRE

    BOYACI, Reviewed By Dr. Adnan

    2005-01-01

    161Case Studies in Knowledge ManagementEdited by Murray JennexHersley: PA: Idea Group, 2005, pp. 372, ISBN 1-59140-352-9Reviewed by Dr. Adnan BOYACIAnadolu UniversityEskişehir-TurkeyKnowledge management (KM) as a structured system and the way to the effectiveness isrelatively new field for the contemporary organizations functioning in different andcompetitive domain of public and private sectors in terms of getting optimal effectivenessunderlined by the concepts such as quality, productivity…...

  13. Pain management in pediatric age group

    Directory of Open Access Journals (Sweden)

    R Namrata

    2009-01-01

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

  14. Recommendations for managing cutaneous disorders associated with advancing age

    Directory of Open Access Journals (Sweden)

    Humbert P

    2016-02-01

    Full Text Available Philippe Humbert,1 Brigitte Dréno,2 Jean Krutmann,3 Thomas Anton Luger,4 Raoul Triller,5 Sylvie Meaume,6 Sophie Seité71Research and Studies Centre on the Integument (CERT, Clinical Investigation Centre (CIC BT506, Department of Dermatology, Besançon University Hospital, University of Franche-Comté, Besançon, France; 2Department of Dermato-Cancerology, Nantes University Hospital, Nantes, France; 3IUF-Leibniz Research Institute for Environmental Medicine, Heinrich-Heine-University, Düsseldorf, Germany; 4Department of Dermatology, University of Münster, Münster, Germany; 5International Centre of Dermatology, Hertford British Hospital, Levallois, France; 6Geriatric Service, Wounds and Healing, Rothschild Hôspital, Paris, France; 7La Roche-Posay Dermatological Laboratories, Asnières, FranceAbstract: The increasingly aged population worldwide means more people are living with chronic diseases, reduced autonomy, and taking various medications. Health professionals should take these into consideration when managing dermatological problems in elderly patients. Accordingly, current research is investigating the dermatological problems associated with the loss of cutaneous function with age. As cell renewal slows, the physical and chemical barrier function declines, cutaneous permeability increases, and the skin becomes increasingly vulnerable to external factors. In geriatric dermatology, the consequences of cutaneous aging lead to xerosis, skin folding, moisture-associated skin damage, and impaired wound healing. These problems pose significant challenges for both the elderly and their carers. Most often, nurses manage skin care in the elderly. However, until recently, little attention has been paid to developing appropriate, evidence-based, skincare protocols. The objective of this paper is to highlight common clinical problems with aging skin and provide some appropriate advice on cosmetic protocols for managing them. A review of the

  15. 41 CFR 109-27.5105 - Management reviews and audits.

    Science.gov (United States)

    2010-07-01

    ... PROCUREMENT 27-INVENTORY MANAGEMENT 27.51-Management of Precious Metals § 109-27.5105 Management reviews and... 41 Public Contracts and Property Management 3 2010-07-01 2010-07-01 false Management reviews and audits. 109-27.5105 Section 109-27.5105 Public Contracts and Property Management Federal...

  16. Seizure Management for School-Age Children

    Science.gov (United States)

    Frueh, Eileen

    2008-01-01

    As many as 325,000 school-age children, ages 5-14, have epilepsy in the U.S. Thankfully, with medication, surgery, a special diet or vagus nerve stimulation, most go to school and fully participate in school activities. Children who continue to have seizures, however, may run into problems. Many of these problems can be overcome or prevented…

  17. Computational Intelligence in Highway Management: A Review

    Directory of Open Access Journals (Sweden)

    Ondrej Pribyl

    2015-10-01

    Full Text Available Highway management systems are used to improve safety and driving comfort on highways by using control strategies and providing information and warnings to drivers. They use several strategies starting from speed and lane management, through incident detection and warning systems, ramp metering, weather information up to, for example, informing drivers about alternative roads. This paper provides a review of the existing approaches to highway management systems, particularly speed harmonization and ramp metering. It is focused only on modern and advanced approaches, such as soft computing, multi-agent methods and their interconnection. Its objective is to provide guidance in the wide field of highway management and to point out the most relevant recent activities which demonstrate that development in the field of highway management is still important and that the existing research exhibits potential for further enhancement.

  18. The Digital Age: Challenges for Records Management.

    Science.gov (United States)

    Plocher, David

    1999-01-01

    Discusses advances in information technology that are being embraced by federal agencies and considers the implications for records management. Highlights include federal Web sites; the National Archives and Records Administration (NARA); and the impact of changing technology. (Author/LRW)

  19. Management of anaphylaxis : a systematic review

    NARCIS (Netherlands)

    Dhami, S.; Panesar, S. S.; Roberts, G.; Muraro, A.; Worm, M.; Bilo, M. B.; Cardona, V.; Dubois, A. E. J.; DunnGalvin, A.; Eigenmann, P.; Fernandez-Rivas, M.; Halken, S.; Lack, G.; Niggemann, B.; Rueff, F.; Santos, A. F.; Vlieg-Boerstra, B.; Zolkipli, Z. Q.; Sheikh, A.

    2014-01-01

    To establish the effectiveness of interventions for the acute and long-term management of anaphylaxis, seven databases were searched for systematic reviews, randomized controlled trials, quasi-randomized controlled trials, controlled clinical trials, controlled before-after studies and interrupted t

  20. A review of hydrofluoric acid burn management

    OpenAIRE

    McKee, Daniel; Thoma, Achilleas; Bailey, Kristy; Fish, Joel

    2014-01-01

    The clinical presentation and severity of hydrofluoric acid burns vary considerably, making management particularly challenging. Given that current knowledge of HF burns is derived from small case series, case reports, animal studies and anecdotal evidence, this narrative review discusses the current understanding of the effects associated with severe hydrofluoric acid burns, describing the mechanism of injury, systemic toxicity and treatment options.

  1. Culture and International Management: A Review.

    Science.gov (United States)

    Miroshnik, Victoria

    2002-01-01

    A literature review explored the effectiveness of cross-cultural managements of multinational companies. The effect of national culture on organizational culture was analyzed and ways in which multinational companies can adopt the national differences were suggested. (Contains 42 references.) (JOW)

  2. International Journal of Development and Management Review

    African Journals Online (AJOL)

    PROMOTING ACCESS TO AFRICAN RESEARCH ... International Journal of Development and Management Review ... Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives. Journal Homepage Image. The journal aims to be proactive in initiating and sustaining quality academic debates in ...

  3. Chronobiology of Aging: A Mini-Review.

    Science.gov (United States)

    Cornelissen, Germaine; Otsuka, Kuniaki

    2017-01-01

    Aging is generally associated with weakening of the circadian system. The circadian amplitude is reduced and the circadian acrophase becomes more labile, tending to occur earlier with advancing age. As originally noted by Franz Halberg, similar features are observed in the experimental laboratory after bilateral lesioning of the suprachiasmatic nuclei, suggesting the involvement of clock genes in the aging process as they are in various disease conditions. Recent work has been shedding light on underlying pathways involved in the aging process, with the promise of interventions to extend healthy life spans. Caloric restriction, which is consistently and reproducibly associated with prolonging life in different animal models, is associated with an increased circadian amplitude. These results indicate the critical importance of chronobiology in dealing with problems of aging, from the circadian clock machinery orchestrating metabolism to the development of geroprotectors. The quantitative estimation of circadian rhythm characteristics interpreted in the light of time-specified reference values helps (1) to distinguish effects of natural healthy aging from those associated with disease and predisease; (2) to detect alterations in rhythm characteristics as markers of increased risk before there is overt disease; and (3) to individually optimize by timing prophylactic and/or therapeutic interventions aimed at restoring a disturbed circadian system and/or enhancing a healthy life span. Mapping changes in amplitude and/or acrophase that may overshadow any change in average value also avoids drawing spurious conclusions resulting from data collected at a fixed clock hour. Timely risk detection combined with treatment optimization by timing (chronotherapy) is the goal of several ongoing comprehensive community-based studies focusing on the well-being of the elderly, so that longevity is not achieved at the cost of a reduced quality of life.

  4. Reliability methods in nuclear power plant ageing management

    Energy Technology Data Exchange (ETDEWEB)

    Simola, K. [VTT Automation, Espoo (Finland). Industrial Automation

    1999-07-01

    The aim of nuclear power plant ageing management is to maintain an adequate safety level throughout the lifetime of the plant. In ageing studies, the reliability of components, systems and structures is evaluated taking into account the possible time-dependent degradation. The phases of ageing analyses are generally the identification of critical components, identification and evaluation of ageing effects, and development of mitigation methods. This thesis focuses on the use of reliability methods and analyses of plant- specific operating experience in nuclear power plant ageing studies. The presented applications and method development have been related to nuclear power plants, but many of the approaches can also be applied outside the nuclear industry. The thesis consists of a summary and seven publications. The summary provides an overview of ageing management and discusses the role of reliability methods in ageing analyses. In the publications, practical applications and method development are described in more detail. The application areas at component and system level are motor-operated valves and protection automation systems, for which experience-based ageing analyses have been demonstrated. Furthermore, Bayesian ageing models for repairable components have been developed, and the management of ageing by improving maintenance practices is discussed. Recommendations for improvement of plant information management in order to facilitate ageing analyses are also given. The evaluation and mitigation of ageing effects on structural components is addressed by promoting the use of probabilistic modelling of crack growth, and developing models for evaluation of the reliability of inspection results. (orig.)

  5. Olfaction and Aging: A Mini-Review.

    Science.gov (United States)

    Attems, Johannes; Walker, Lauren; Jellinger, Kurt A

    2015-01-01

    Decreased olfactory function is very common in the older population, being present in >50% of individuals aged between 65 and 80 years and in 62-80% of those >80 years of age. Smell dysfunction significantly influences physical well-being, quality of life, nutritional status as well as everyday safety and is associated with increased mortality. Multiple factors contribute to age-related olfactory sensory loss, including nasal engorgement, cumulative damage of the olfactory epithelium from environmental insults, a reduction in mucosal metabolizing enzymes, sensory loss of receptor cells to odorants, and changes in neurotransmitter and neuromodulator systems. In addition, structural and functional abnormalities of the olfactory epithelium, olfactory bulb, central olfactory cortex, and basic olfactory circuitry, which are related to the neuronal expression of aberrant proteins in these areas, may result in olfactory sensory impairment in aging and neurodegenerative diseases. Impaired odour identification is associated with a decrease in cognitive abilities and memory decline. A reduction in the sense of smell is considered to potentially represent an early and important warning of neurodegenerative disorders, particularly of Parkinson's disease and Alzheimer's disease, and, in mild cognitive impairment, olfactory impairment may herald progression to dementia. Further investigations of the potential role of olfactory dysfunction in the early diagnosis and treatment of neurodegenerative diseases are warranted.

  6. Aging in Africa: a critical review.

    Science.gov (United States)

    Makoni, Sinfree

    2008-06-01

    My goal in this article is to analyze gerontological discourses in Africa using articles in this collection as a spring board. The broad intention is to explore the possible areas of intersection between research in African aging and other social science disciplines such as history, politics and linguistics as a way of demonstrating how gerontology may contribute to scholarship in other disciplines.

  7. Managing Virtual Product Development team: A Review

    Directory of Open Access Journals (Sweden)

    Amir Mohammad Colabi

    2014-05-01

    Full Text Available Although there are many potential benefits associated with the use of virtual product development teams, exploiting these benefits requires an appropriate management. Managing virtual product development team is a critical issue as many of these teams fail to accomplish their goals. Review of previous literature shows that body of knowledge in managing virtual product development teams is fragmented and inconsistent. The main objective of this paper is to categorize the previous research on the subject of virtual product development team management in order to integrate the research into a thematic model and to enable recommendations for future research. So, this study reviews and summarizes empirical research in the field, also conceptual and qualitative papers, experiences, reports and explorative case studies. Results show that there are three fields of research in this area, including: Virtual production and Virtual team in Product Development, Managing virtual team in R&D[1] and product development, Managing global virtual product development teams. In order to organize previous studies in this area, a thematic map is proposed which shows the structure and sequence of research. Finally, a comprehensive discussion on the future directions in this field is proposed.

  8. 31 CFR 206.6 - Cash management planning and review.

    Science.gov (United States)

    2010-07-01

    ... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Cash management planning and review... planning and review. (a) An agency shall periodically perform cash management reviews to identify areas...) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE MANAGEMENT OF FEDERAL AGENCY...

  9. Remote home management for chronic kidney disease: A systematic review.

    Science.gov (United States)

    He, Ting; Liu, Xing; Li, Ying; Wu, Qiaoyu; Liu, Meilin; Yuan, Hong

    2017-01-01

    Background Remote home management is a new healthcare model that uses information technology to enhance patients' self-management of disease in a home setting. This study is designed to identify the effects of remote home management on patients with chronic kidney disease (CKD). Methods A comprehensive search of PubMed, MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials was performed in January 2015. The reference listings of the included articles in this review were also manually examined. Randomized controlled trials (RCTs) designed to evaluate the effects of remote home management on patients with CKD were included. Results Eight trials were identified. The results of this study suggest that the quality of life (QOL) enabled by remote home management was higher than typical care in certain dimensions. However, the effects of remote home management on blood pressure (BP) remain inconclusive. The studies that assessed health service utilization demonstrated a significant decrease in hospital readmission, emergency room visits, and number of days in the hospital. Another favorable result of this study is that regardless of their gender, age or nationality, patients tend to comply with remote home management programs and the use of related technologies. Conclusions The available data indicate that remote home management may be a novel and effective disease management strategy for improving CKD patients' QOL and influencing their attitudes and behaviors. And, relatively little is known about BP and cost-effectiveness, so future research should focus on these two aspects for the entire population of patients with CKD.

  10. Management of the aging risk factor for Parkinson's disease.

    Science.gov (United States)

    Phillipson, Oliver T

    2014-04-01

    The aging risk factor for Parkinson's disease is described in terms of specific disease markers including mitochondrial and gene dysfunctions relevant to energy metabolism. This review details evidence for the ability of nutritional agents to manage these aging risk factors. The combination of alpha lipoic acid, acetyl-l-carnitine, coenzyme Q10, and melatonin supports energy metabolism via carbohydrate and fatty acid utilization, assists electron transport and adenosine triphosphate synthesis, counters oxidative and nitrosative stress, and raises defenses against protein misfolding, inflammatory stimuli, iron, and other endogenous or xenobiotic toxins. These effects are supported by gene expression via the antioxidant response element (ARE; Keap/Nrf2 pathway), and by peroxisome proliferator-activated receptor gamma co-activator 1 alpha (PGC-1 alpha), a transcription coactivator, which regulates gene expression for energy metabolism and mitochondrial biogenesis, and maintains the structural integrity of mitochondria. The effectiveness and synergies of the combination against disease risks are discussed in relation to gene action, dopamine cell loss, and the accumulation and spread of pathology via misfolded alpha-synuclein. In addition there are potential synergies to support a neurorestorative role via glial derived neurotrophic factor expression.

  11. Ageing management and refurbishment of Ghana Research Reactor-1 (GHARR-1)

    Energy Technology Data Exchange (ETDEWEB)

    Amponsahabu, Edward Oscar; Gbadago, Joseph Korbla; Addo, Moses Ankamah; Sogbadji, Robert Bright Mawuko; Odoi, Henry Cecil; Gyamfi, Kwame; Ampong, Atta Gyekye; Opate, Nicholas Sackitey [Ghana Atomic Energy Commission, Accra (Ghana)

    2013-07-01

    Ageing management is an essential component of the routine practices at the Ghana Research Reactor-1 (GHARR-1) Facility. The reactor is Miniature Neutron Source Reactor with a rated power of 30 kW. GHARR-1 was installed and attained criticality on December 17, 1994 and commissioned on 8th March, 1995. It has since been in operation. The routine practices and operational procedures have been set out with clear emphasis on ageing policy at the facility. Some electronic components are changed regularly during maintenance sessions and keeping to regular purification of the reactor and pool water to mitigate against corrosion. This paper outlines the ageing management programme, mitigation practices, strategies for ageing management, periodic safety reviews, consideration of ageing during designing, design features for components and unit replacement, top beryllium shim addition, and succession planning. Information sharing with other operating organization is one of the means considered by GHARR-1 to attain excellence.

  12. Managing aging workers: a mixed methods study on bundles of HR practices for aging workers

    NARCIS (Netherlands)

    Kooij, Dorien T. A. M.; Jansen, Paul G. W.; Dikkers, Josje S. E.; de Lange, Annet H.

    2014-01-01

    Since abilities and motives change with age and common human resource (HR) practices might be less suitable for aging employees, scholars and practitioners are currently challenged to find new ways of managing aging workers and motivating them to continue working. Therefore, this mixed methods study

  13. Managing aging workers: a mixed methods study on bundles of HR practices for aging workers

    NARCIS (Netherlands)

    Kooij, D.T.A.M.; Jansen, P.G.W.; Dikkers, J.S.E.; Lange, A.H. de

    2014-01-01

    Since abilities and motives change with age and common human resource (HR) practices might be less suitable for aging employees, scholars and practitioners are currently challenged to find new ways of managing aging workers and motivating them to continue working. Therefore, this mixed methods study

  14. A Review of Green Supply Chain Management

    DEFF Research Database (Denmark)

    Maditati, Dhanavanth Reddy; Munim, Ziaul Haque; Schramm, Hans-Joachim

    2017-01-01

    Purpose: Recently, green supply chain management (GSCM) has received great attention in SCM domain. This paper reviews the research progress in GSCM over time, and proposes a holistic view by identifying associations of GSCM drivers, practice indicators and performance measures. Design /methodology...... that Journal of Cleaner Production has the highest number of published articles while Journal of Operations Management leads in terms of yearly local citations per article in the GSCM field. Using HistCiteTM software, evolution of GSCM research since the early 2000s was mapped, and six research sub...

  15. Cost-Effectiveness of Social Work Services in Aging: An Updated Systematic Review

    Science.gov (United States)

    Rizzo, Victoria M.; Rowe, Jeannine M.

    2016-01-01

    Objectives: This study examines the impact of social work interventions in aging on quality of life (QOL) and cost outcomes in four categories (health, mental health, geriatric evaluation and management, and caregiving). Methods: Systematic review methods are employed. Databases were searched for articles published in English between 2004 and 2012…

  16. Clinical Review: Emergency management of acute poisoning

    Directory of Open Access Journals (Sweden)

    D.J. van Hoving

    2011-06-01

    The aim of this commissioned review was to establish concise guidelines for the initial management of the acutely poisoned patient in the Emergency Centre. The American Academy of Clinical Toxicology and the European Association of Poisons Centres and Clinical Toxicologists are the international leaders in the field of toxicology and the guidelines in their position papers were generally followed. Most of the dosage regimes are according to the South African Medicines Formulary.

  17. Aging management guideline for commercial nuclear power plants-pumps

    Energy Technology Data Exchange (ETDEWEB)

    Booker, S.; Katz, D.; Daavettila, N.; Lehnert, D. [MDC-Ogden Environmental and Energy Services, Southfield, MI (United States)

    1994-03-01

    This Aging Management Guideline (AMG) describes recommended methods for effective detection and mitigation of age-related degradation mechanisms in BWR and PWR commercial nuclear power plant pumps important to license renewal. The intent of this AMG is to assist plant maintenance and operations personnel in maximizing the safe, useful life of these components. It also supports the documentation of effective aging management programs required under the License Renewal Rule 10 CFR Part 54. This AMG is presented in a manner that allows personnel responsible for performance analysis and maintenance to compare their plant-specific aging mechanisms (expected or already experienced) and aging management program activities to the more generic results and recommendations presented herein.

  18. Aging, inflammation and depressive behavior: a review

    Directory of Open Access Journals (Sweden)

    Adriana Uzoni

    2015-04-01

    Full Text Available One of the most common co-morbidities of cerebrovascular disorders is neuroinflammation, a hallmark and decisive contributor to many central nervous system (CNS diseases. Although neuropathological conditions differ in etiology and in the way in which the inflammatory response is mounted, cellular and molecular mechanisms of neuroinflammation are probably similar in aging, hypertension, depression and cognitive impairment or after cerebral insult such as stroke. Moreover, a number of highly prevalent risk factors such as hypertension, diabetes and atherosclerosis are increasingly understood to act as “silent contributors” to neuroinflammation – not only establishing the condition as a central pathophysiological mechanism, but also constantly fuelling it. Mild, but continuous neuroinflammation can provide the ground for disorders such as cerebral small vessel disease (cSVD and subsequent dementia. Acute neuroinflammation, often in the context of traumatic or ischemic CNS lesions, aggravates the acute damage and can lead to depression, post-stroke dementia and neurodegeneration. All of these sequelae impair recovery and provide the ground for further cerebrovascular events. http://dx.doi.org/10.7175/rhc.v6i2.1170

  19. Metabolic syndrome in women of childbearing age and pregnancy: recognition and management of dyslipidemia.

    Science.gov (United States)

    Paramsothy, Pathmaja; Knopp, Robert H

    2005-01-01

    The obesity pandemic engenders the global threat of metabolic syndrome and its related disorders, including diabetes and coronary artery disease (CAD). The purpose of this review is to discuss the deleterious effects of metabolic syndrome on women of childbearing age, including pregnancy, with a discussion of lipid management. Treatment options will also be presented.

  20. A mini-review of the evolutionary theories of aging.

    Directory of Open Access Journals (Sweden)

    2001-02-01

    Full Text Available This article reviews some studies testing evolutionary theories of aging and shows that they are not always confirmed. Nevertheless, many gerontologists consider now that these theories provide a general explanation of the aging process. In such conditions, we may wonder whether time has come to provisionally accept these theories in order to redirect the research efforts of gerontologists towards other directions, such as the search for new means to modulate the aging process.

  1. Age, interpersonal attraction, and social interaction. A review and assessment.

    Science.gov (United States)

    Webb, L; Delaney, J J; Young, L R

    1989-03-01

    This essay reviews over 40 extant research reports on attraction and aging. The review indicated that (a) perceived agreement in attitude tends to neutralize young adults' general perception of older adults as unattractive, (b) elders prefer to associate with middle-aged and older adults more than they desire to associate with younger adults, regardless of the relative physical attraction of the target individuals, and (c) elders' marital satisfaction appears to be related to perceived physical attractiveness of the husband, not the wife. The authors provide critique and analysis of the research methods employed in the reviewed studies. Avenues for further research are identified.

  2. Age Estimation from Faces and Voices: A Review

    Directory of Open Access Journals (Sweden)

    Evelyne Moyse

    2014-05-01

    Full Text Available Age estimation is a skill that we use in everyday life and that is also important in more specific settings such as police testimony. Researchers investigated age estimation either from faces or voices but a direct comparison between voices and faces was rather infrequently performed. This paper reviews the literature on age estimation from faces and voices and highlights some similarities and differences. Data from a series of experiments suggest that age estimation from faces and voices can be fairly accurate, but in some cases, a superiority of faces is observed. The age of participants and stimuli both seem to affect age estimation from faces and voices in the same way: (1 age estimation is more accurate for young stimuli than for older stimuli, (2 younger participants are more accurate than older participants irrespective of the age of stimuli, and (3 an own-age bias affects age estimation. By contrast, the influence of ethnicity and gender has been less documented. Available data support that ethnicity influence age estimation from faces but not clearly age estimation from voices. Regarding the effect of stimuli gender, results were opposite: in age estimation from faces, an advantage for male faces was reported whereas in age estimation from voices, the advantage is in favor of female voices.

  3. Parental perception and management of school-age children's fevers.

    Science.gov (United States)

    Andersen, A R

    1988-05-01

    Fever is a major childhood complaint. Parents have numerous means at their disposal to assess and manage childhood fevers. Previous studies of parents of infants and preschoolers have uncovered parental fears and misconceptions surrounding fever ("fever phobia"). A study of 84 parents of otherwise well school-age children revealed that these misconceptions remain, regardless of the child's age or parental level of education. The nurse practitioner must understand both parental fears and the body-temperature dynamics of children to successfully access and manage fever in the school-age child.

  4. 28 CFR 34.110 - Management of peer reviews.

    Science.gov (United States)

    2010-07-01

    ... 28 Judicial Administration 1 2010-07-01 2010-07-01 false Management of peer reviews. 34.110 Section 34.110 Judicial Administration DEPARTMENT OF JUSTICE OJJDP COMPETITION AND PEER REVIEW PROCEDURES Peer Review § 34.110 Management of peer reviews. A technical support contractor may assist in...

  5. Managing depression in older age: psychological interventions.

    Science.gov (United States)

    Cuijpers, Pim; Karyotaki, Eirini; Pot, Anne Margriet; Park, Mijung; Reynolds, Charles F

    2014-10-01

    The number of studies on psychological treatments of depression in older adults has increased considerably in the past years. Therefore, we conducted an updated meta-analysis of these studies. A total of 44 studies comparing psychotherapies to control groups, other therapies or pharmacotherapy could be included. The overall effect size indicating the difference between psychotherapy and control groups was g=0.64 (95% CI: 0.47-0.80), which corresponds with a NNT of 3. These effects were maintained at 6 months or longer post randomization (g=0.27; 95%CI: 0.16-0.37). Specific types of psychotherapies that were found to be effective included cognitive behavior therapy (g=0.45; 95% CI: 0.29-0.60), life review therapy (g=0.59; 95% CI: 0.36-0.82) and problem-solving therapy (g=0.46; 95% CI: 0.18-0.74). Treatment compared to waiting list control groups resulted in larger effect sizes than treatments compared to care-as-usual and other control groups (peffect sizes than high-quality studies (pcognitive behavior therapy and problem-solving therapy may be more effective than non-directive counseling and other psychotherapies may be less effective than other therapies. This should be considered with caution, however, because of the small number of studies. There were not enough studies to examine the long-term effects of psychotherapies and to compare psychotherapy with pharmacotherapy or combined treatments. We conclude that it is safe to assume that psychological therapies in general are effective in late-life depression, and this is especially well-established for cognitive behavior therapy and problem-solving therapy.

  6. A review of hydrofluoric acid burn management.

    Science.gov (United States)

    McKee, Daniel; Thoma, Achilleas; Bailey, Kristy; Fish, Joel

    2014-01-01

    Hydrofluoric acid (HF) causes a unique chemical burn. Much of the current treatment knowledge of HF burns is derived from case reports, small case series, animal studies and anecdotal evidence. The management can be challenging because clinical presentation and severity of these burns vary widely. Plastic surgeons managing burn patients must have a basic understanding of the pathophysiology, the range of severity in presentation and the current treatment options available for HF burns. The present article reviews the current understanding of the pathophysiology and systemic effects associated with severe HF burns. Furthermore, it distinguishes between minor and life-threatening HF burns and describes several of the basic techniques that are available to treat patients with HF burns.

  7. Speed Management Strategies; A Systematic Review

    Directory of Open Access Journals (Sweden)

    Homayoun Sadeghi-Bazargani

    2016-07-01

    Full Text Available Objective: To systematically identify the various methods of speed management and their effects. Methods: A systematic search was performed in Science Direct, Ovid Medline, Scopus, PubMed and ProQuest databases from April to June 2015. Hand searching and reference of selected articles were used to improve article identification. Articles published after 1990 which had reported on efficacy/effectiveness of speed management strategies were included. Data were extracted using pre-defined extraction table. Results: Of the 803 retrieved articles, 22 articles were included in this review. Most of the included articles (63% had before-after design and were done in European countries. Speed cameras, engineering schemes, intelligent speed adaption (ISA, speed limits and zones, vehicle activated sign and integrated strategies were the most common strategies reported in the literature. Various strategies had different effects on mean speed of the vehicles ranging from 1.6 to 10 km/h. Moreover, 8-65% and 11-71% reduction was reported in person injured accidents and fatal accidents, respectively as a result of employing various strategies. Conclusion: Literature revealed positive effects of various speed management strategies. Using various strategies was mostly dependent on road characteristics, driver’s attitude about the strategy as well as economic and technological capabilities of the country. Political support is considered as a main determinant in selecting speed management strategies.

  8. Conceptualisation of ageing in relation to factors of importance for extending working life - a review.

    Science.gov (United States)

    Nilsson, Kerstin

    2016-07-01

    The aim of this study was to explore and understand the complexity of ageing in relation to factors of importance for extending working life. Discourse analysis of documents was used in an integrative review including 128 articles. Four different conceptualisation of ageing are shown to affect older workers' ability to extend their working life: (a) biological ageing people's health in relation to their physical and mental work environment, their pace of work and recuperation needs; (b) chronological ageing statutory retirement age and policies and economic incentives devised for older workers by society, unions and organisations/enterprises; (c) social ageing inclusion in different social groups, the attitude of managers, organisations and family members, the leisure activities and surrounding environment; and (d) mental/cognitive ageing self-crediting, motivating and meaningful activities, competence and skills in working life. CONCLUSIONS SOCIETIES TODAY FOCUS MOSTLY ON CHRONOLOGICAL AGEING AND ARE LOOKING TO INCREASE THE RETIREMENT AGE WITH REGARD TO STATUTORY PENSION SYSTEMS, EG BEYOND 65 YEARS OF AGE THE INTER-RELATIONSHIPS BETWEEN CHRONOLOGICAL, MENTAL, BIOLOGICAL AND SOCIAL AGEING AND THE NINE AREAS IDENTIFIED AS BEING IMPORTANT TO OLDER WORKERS IN THESE RESPECTS NEED TO BE CONSIDERED WHEN AIMING TO PROVIDE A SUSTAINABLE WORKING LIFE FOR THE INCREASING NUMBERS OF OLDER WORKERS IN MODERN SOCIETY THE THEORETICAL MODEL DEVELOPED IS A CONTRIBUTION TO THE CRITICAL DEBATE THAT CAN BE APPLIED BY SOCIETIES, EMPLOYERS AND MANAGERS IN ORDER TO PROVIDE OLDER WORKERS WITH AN INCLUSIVE AND SUSTAINABLE EXTENDED WORKING LIFE. © 2016 the Nordic Societies of Public Health.

  9. A review of asphalt and asphalt mixture aging

    Directory of Open Access Journals (Sweden)

    Wilmar Darío Fernández-Gómez

    2012-09-01

    Full Text Available This paper presents an extensive review of the pertinent literature regarding asphalt and asphalt mixture Aging. Aging affects flexible pavement performance and is produced by intrinsic and extrinsic variables as well as exposure time. Intrinsic variables include asphalt and aggregate properties, a mixture’s asphalt content, binder film thickness and air void content; extrinsic variables are associated with production (short-term aging and exposure to environmental field conditions (long-term aging. Taken together, both variables demonstrate that aging results from three distinct mechanisms: volatilisation, oxidation and steric hardening. Temperature, pressure and photo degradation treatments are used to simulate aging in the laboratory and empirical and semi-empirical models are created to represent and study aging. Aging increases asphalt complex modulus and decreases the phase angle. Mixtures become stiffer while fatigue life becomes reduced. Carbonyl and sulfoxide group formation in asphalt are often studied as such chemical changes show oxidation in aged asphalts. The prevailing models used to predict asphalt aging are discussed, though more comprehensive research into asphalt aging is still needed.

  10. Aging, circadian rhythms and depressive disorders: a review

    OpenAIRE

    2013-01-01

    Introduction: Aging is typically associated with impairing behavioral patterns that are frequently and inappropriately seen as normal. Circadian rhythm changes and depressive disorders have been increasingly proposed as the two main overlapping and interpenetrating changes that take place in older age. This study aims to review the state of the art on the subject concerning epidemiology, pathophysiological mechanism, clinical findings and relevance, as well as available treatment options. Mat...

  11. Contribution of Systematic Reviews to Management Decisions

    Science.gov (United States)

    COOK, CARLY N; POSSINGHAM, HUGH P; FULLER, RICHARD A

    2014-01-01

    Systematic reviews comprehensively summarize evidence about the effectiveness of conservation interventions. We investigated the contribution to management decisions made by this growing body of literature. We identified 43 systematic reviews of conservation evidence, 23 of which drew some concrete conclusions relevant to management. Most reviews addressed conservation interventions relevant to policy decisions; only 35% considered practical on-the-ground management interventions. The majority of reviews covered only a small fraction of the geographic and taxonomic breadth they aimed to address (median = 13% of relevant countries and 16% of relevant taxa). The likelihood that reviews contained at least some implications for management tended to increase as geographic coverage increased and to decline as taxonomic breadth increased. These results suggest the breadth of a systematic review requires careful consideration. Reviews identified a mean of 312 relevant primary studies but excluded 88% of these because of deficiencies in design or a failure to meet other inclusion criteria. Reviews summarized on average 284 data sets and 112 years of research activity, yet the likelihood that their results had at least some implications for management did not increase as the amount of primary research summarized increased. In some cases, conclusions were elusive despite the inclusion of hundreds of data sets and years of cumulative research activity. Systematic reviews are an important part of the conservation decision making tool kit, although we believe the benefits of systematic reviews could be significantly enhanced by increasing the number of reviews focused on questions of direct relevance to on-the-ground managers; defining a more focused geographic and taxonomic breadth that better reflects available data; including a broader range of evidence types; and appraising the cost-effectiveness of interventions. Contribuciones de las Revisiones Sistemáticas a las

  12. Fibrous dysplasia. Clinical review and therapeutic management.

    Science.gov (United States)

    Florez, Helena; Peris, Pilar; Guañabens, Núria

    2016-12-16

    Fibrous dysplasia is a skeletal disorder that is associated with a wide spectrum of clinical manifestations, including localized asymptomatic forms and extensive severe forms with severe bone deformities and endocrinological alterations, depending on age, location, extent and associated processes. Although the treatment of choice is based on bisphosphonates, the therapeutic efficacy of these agents in the control of disease activity remains uncertain. This article reviews the current data available on the treatment of this disease as well as the preliminary data on new therapeutic approaches. Copyright © 2016 Elsevier España, S.L.U. All rights reserved.

  13. Invited review: piglet mortality: management solutions.

    Science.gov (United States)

    Kirkden, R D; Broom, D M; Andersen, I L

    2013-07-01

    Preweaning mortality varies greatly among herds and this is partly attributed to differences in farrowing house management. In this review, we describe the various management strategies than can be adopted to decrease mortality and critically examine the evidence that exists to support their use. First, we consider which management procedures are effective against specific causes of death: intrapartum stillbirth, hypothermia, starvation, disease, crushing, and savaging. The most effective techniques include intervention to assist dystocic sows, measures to prevent and treat sow hypogalactia, good farrowing house hygiene, providing newborn piglets with a warm microenvironment, early fostering of supernumerary piglets, methods that assist small and weak piglets to breathe and obtain colostrum, and intervention to prevent deaths from crushing and savaging. The provision of nest-building material and modifications to the pen to assist the sow when lying down may also be beneficial, but the evidence is less clear. Because most deaths occur around the time of farrowing and during the first few days of life, the periparturient period is a particularly important time for management interventions intended to reduce piglet mortality. A number of procedures require a stockperson to be present during and immediately after farrowing. Second, we consider the benefits of farrowing supervision for preweaning mortality in general, focusing particularly on methods for the treatment of dystocia and programs of piglet care that combine multiple procedures. Third, we discuss the need for good stockmanship if farrowing supervision is to be effective. Stockmanship refers not only to technical skills but also to the manner in which sows are handled because this influences their fearfulness of humans. We conclude that piglet survival can be improved by a range of management procedures, many of which occur in the perinatal period and require the supervision of farrowing by trained staff

  14. Aging management at G.A. Siwabessy Multipurpose Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Jupiter Sitorus Pane; Taswanda Taryo; Alim Tarigan; Alfahari Mardi; Koes Indra

    1998-10-01

    Aging phenomena was raised as an important issue at GAS-MPR after having some component degradation reported within its ten years operational record. This phenomena was anticipated by developing a program of aging management, where its purpose is to prevent an enlargement of degradation of the systems and components and failure. The aging managements include identification of system and component which have aging process enlargement and impact to the reactor operational safety, developing operational operation and maintenance practices, developing operational and maintenance data base, developing predictive maintenance program, and identifying and studying method and technology for inspection, testing, and surveillance. The result of studying on method and technology of testing, surveillance, and diagnostic conclude that FFT based noise spectrum analysis can be used to detect an anomaly of system and component performance. This analysis will be developed in the future using Auto Regressive Method, Kalman Filter, and Neural Network. (author)

  15. Review of relative age effects and potential ways to reduce them in sport and education

    Directory of Open Access Journals (Sweden)

    David Gutiérrez Díaz del Campo

    2013-01-01

    Full Text Available Differences on chronological age within a peer/age group are known as Relative Age, and its consecuences as Relative Age Effec (RAE. This article is a review of the most relevant publications in both the educative and sportive contexts. The decision of reviewing both contexts in the same article is based on the existence of many points in common between them. Furthermore when research is made on youth sport, all the participants are at the same time in the educational system. The hypothesis of the origin of RAE and possible solutions are discussed and analysed at the end of the paper. Besides the objective of compiling and analyse what literature says about RAE, this article has the aim of raisig awareness about this problem and wish of intervention in educators and sportive managers.

  16. AGE-ility challenges, and management agendas for the organisation

    NARCIS (Netherlands)

    Millar, C.C.J.M.; Culpin, Vicki

    2014-01-01

    Purpose - The purpose of this paper is to provide an update of the Special Issue's field of research, give the structure of the Special Issue and introduce the papers in the collection, including management issues. Design/methodology/approach - A review of the Call for Papers and further research

  17. AGE-ility challenges, and management agendas for the organisation

    NARCIS (Netherlands)

    Millar-Schijf, Carla C.J.M.; Culpin, Vicki

    2014-01-01

    Purpose - The purpose of this paper is to provide an update of the Special Issue's field of research, give the structure of the Special Issue and introduce the papers in the collection, including management issues. Design/methodology/approach - A review of the Call for Papers and further research

  18. Motor unit changes in normal aging: a brief review.

    Science.gov (United States)

    Tudoraşcu, Iulia; Sfredel, Veronica; Riza, Anca Lelia; Dănciulescu Miulescu, Rucsandra; Ianoşi, Simona Laura; Dănoiu, Suzana

    2014-01-01

    Aging is explored by multiple lines of research, in a pursuit of understanding this natural process. The motor response is usually the main dependent variable in studies regarding physical or cognitive decline in aging. It is therefore critical to understand how the motor function changes with age. The present review, aims at presenting briefly some of the most recently published works in the field, focusing on the three key components of the motor unit. The changes that the skeletal muscle undergoes aging sarcopenia, alteration of fiber type distribution and also intimate metabolic transformations. The neuromuscular junction suffers at cellular and molecular level, with possible implications of various cell components, mediators and oxidative stress. Motoneuron loss and change in their physiological properties accompany remodeling in the motor units. The applicability of knowledge in this field lies in possible interventions intended to counteract these age-related losses.

  19. Teaching Pain Management to Student Nurses: A Literature Review

    Directory of Open Access Journals (Sweden)

    Ekatrina Wijayanti

    2014-04-01

    Full Text Available Purpose: To provide nursing students knowledge of pain prior, during, and post- surgery, recovery and rehabilitation. Methods: Review articles published during 2005 until 2012 that focused on pain assessment and pain management. The databases used in this study were Medline and CINAHL.Results: Postoperative pains need special approach and care. It needs teach patient how to adapt pain, control pain, monitor result of treatment. Conclusion: Nursing students need to learn how to assess pain using appropriate tools for each age level and in patients with special needs. The students also need to learn about pain management including pharmacology and non-pharmacology means and consider pain as the fifth vital sign. As student nurses learn pain assessment, they should be considerate about culture, and different languages that might happen during practical rotations.

  20. A review of supervised machine learning applied to ageing research.

    Science.gov (United States)

    Fabris, Fabio; Magalhães, João Pedro de; Freitas, Alex A

    2017-04-01

    Broadly speaking, supervised machine learning is the computational task of learning correlations between variables in annotated data (the training set), and using this information to create a predictive model capable of inferring annotations for new data, whose annotations are not known. Ageing is a complex process that affects nearly all animal species. This process can be studied at several levels of abstraction, in different organisms and with different objectives in mind. Not surprisingly, the diversity of the supervised machine learning algorithms applied to answer biological questions reflects the complexities of the underlying ageing processes being studied. Many works using supervised machine learning to study the ageing process have been recently published, so it is timely to review these works, to discuss their main findings and weaknesses. In summary, the main findings of the reviewed papers are: the link between specific types of DNA repair and ageing; ageing-related proteins tend to be highly connected and seem to play a central role in molecular pathways; ageing/longevity is linked with autophagy and apoptosis, nutrient receptor genes, and copper and iron ion transport. Additionally, several biomarkers of ageing were found by machine learning. Despite some interesting machine learning results, we also identified a weakness of current works on this topic: only one of the reviewed papers has corroborated the computational results of machine learning algorithms through wet-lab experiments. In conclusion, supervised machine learning has contributed to advance our knowledge and has provided novel insights on ageing, yet future work should have a greater emphasis in validating the predictions.

  1. Medication management policy, practice and research in Australian residential aged care: Current and future directions.

    Science.gov (United States)

    Sluggett, Janet K; Ilomäki, Jenni; Seaman, Karla L; Corlis, Megan; Bell, J Simon

    2017-02-01

    Eight percent of Australians aged 65 years and over receive residential aged care each year. Residents are increasingly older, frailer and have complex care needs on entry to residential aged care. Up to 63% of Australian residents of aged care facilities take nine or more medications regularly. Together, these factors place residents at high risk of adverse drug events. This paper reviews medication-related policies, practices and research in Australian residential aged care. Complex processes underpin prescribing, supply and administration of medications in aged care facilities. A broad range of policies and resources are available to assist health professionals, aged care facilities and residents to optimise medication management. These include national guiding principles, a standardised national medication chart, clinical medication reviews and facility accreditation standards. Recent Australian interventions have improved medication use in residential aged care facilities. Generating evidence for prescribing and deprescribing that is specific to residential aged care, health workforce reform, medication-related quality indicators and inter-professional education in aged care are important steps toward optimising medication use in this setting.

  2. Adult Age Differences in Processing Narrative Text: Managing Character Representations

    Science.gov (United States)

    Noh, Soo Rim

    2009-01-01

    Understanding a narrative situation depends on keeping track of multiple characters that enter and exit dynamically as the plot unfolds. Because there has been no systematic investigation of age differences in the ability to manage multiple characters during narrative comprehension, this project was designed to examine those differences in this…

  3. Management of OAB in those over age 65.

    Science.gov (United States)

    Natalin, Ricardo; Lorenzetti, Fabio; Dambros, Miriam

    2013-10-01

    The International Continence Society (ICS) defines overactive bladder (OAB) as an association of symptoms including "urgency, with or without urge incontinence, usually with increased frequency and nocturia". This conditon has been associated with a decrease in quality of life and a higher related risk of overall health condition decrease, and is rising since its prevalence increases with age and the forecast for the world population estimates an increase of those over 65 years old. Aging alone can be considered a major risk factor for developing OAB symptoms that are considered multifactorial and due to body tissue and anatomic changes, lifestyle-associated factors, comorbidities and personal characteristics. The high prevalence of this condition and multiple etiology factors makes of its treatment a challenge-especially in the older population. A major concern over OAB treatment of elderly patients is the risk of cognitive side effects due to the pharmacologic treatment with anticholinergic drugs. First-line treatment for OAB symptoms are the use of pharmacologic therapy with antimuscarinic drugs, which has been proved to be effective in controlling urgency, urge incontinence episodes, incontinence episodes, and nocturia. The impact caused by this condition is significant regarding the economic and human costs associated bringing into attention the need of studying and reviewing this specific population. Conservative Management and Lifestyle Modifications: Behavioral therapy's aims are to reduce urinary frequency and urgency to an accepted level and to increase bladder outlet volume. It consists of actions to teach patients to improve and learn bladder control. Lifestyle modifications are a conjunct of daily activities that can be managed to have the lowest interference on the functioning of the urinary tract. Pharmacologic Therapy: There are various medications with antimuscarinic properties available for the treatment of OAB symptoms. The most commonly used are

  4. Bilateral deep neck space infection in the paediatric age group: a case report and review of the literature.

    Science.gov (United States)

    Songu, M; Demiray, U; Adibelli, Z H; Adibelli, H

    2011-06-01

    Deep neck space infections can occur at any age but require more intimate management in the paediatric age group because of their rapidly progressive nature. Concurrent abscess in distinct neck spaces has rarely been reported in healthy children. Herewith, a rare case of bilateral neck abscess is reported in a 16-month-old female and the clinical presentation and management are discussed with a review of the literature.

  5. PSYCHOLOGICAL PROBLEMS OF THE AGED AND ITS MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Sahoo Srinibash

    2013-10-01

    Full Text Available Aging is an inevitable biological phenomenon resulting from intrinsic and extrinsic damage to the various organs and systems. One does not know when old age begins. The “biological age” of a person is not identical to the “chronological age”. Victor Hugo once said 40 is the old age of youth where as 50 is the youth of old age. So in countries like India we are considering the age of 60 as the start of old age. The decline in cognitive functions is very common consequence of aging. It is significantly associated with poor self-perception, depression, fear, worry, anxiety, decreased memory, angry etc., which are sometimes life-threatening conditions. In Astanga Ayurveda, Jara Chikitsa exists as a separate branch but detailed descriptions are not available. We got the scattered references regarding prevention of Jara and management of old age problems. Mainly Rasayanas of different types are mentioned for prevention as well as promotion of health in old age. The Rasayana drugs and Panchakarma. Therapies not only promote the physical health but beneficial effects also seen on brain and its functional areas. Different Rasayanas and Panchakarma therapies with their effects will be detailed described in full paper.

  6. Wetlands Management Review of St. Vincent Island NWR

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of this wetland review was to evaluate past management and provide recommendations for future management of the impounded wetlands on St. Vincent Island....

  7. Fire Management Review of St. Vincent Island NWR

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This Fire Management Review for St. Vincent National Wildlife Refuge covers habitat management including: open sand ridges, marshes, pine flatwoods, scrub, and oak...

  8. A REVIEW OF ENTERPRISE SUPPLY CHAIN RISK MANAGEMENT

    Institute of Scientific and Technical Information of China (English)

    Dailun SHI

    2004-01-01

    This paper reviews enterprise risk management practices in the context of supply chains. Starting with the importance of managing supply chain risks, the paper established the benefits of managing risks using an enterprise-wise integrated approach. The rest of the paper then presents a practical framework for enterprises to manage risks in their extended supply chains.

  9. Employer Branding and Talent Management in the Digital Age

    Directory of Open Access Journals (Sweden)

    Alina MIHALCEA

    2017-06-01

    Full Text Available In the digital age, organizations need to reinvent themselves at a structural level and to become agiler. Digital maturity of human resources management implies a shift from traditional paradigm on workplace towards engagement, learning and development of employees and search for talent. This paper focuses on identifying the major trends and strategies concerning talent management programs and development of digital skills for employees and managers. The study reveals that in an open talent economy, employer brand is very important in recruiting and retention of high potential employees and must be focused on learning & leadership development, mobility, rewards and competency systems. At present, in order to obtain a business value, one of the major challenges that HR needs to face is the development of digital skills for managers and employees.

  10. Practical examples of how knowledge management is addressed in Point Lepreau heat transport ageing management programs

    Energy Technology Data Exchange (ETDEWEB)

    Slade, J. [NB Power Nuclear, Lepreau, New Brunswick (Canada)], E-mail: JSlade@NBPower.com; Gendron, T. [Atomic Energy of Canada Limited, Chalk River, Ontario (Canada); Greenlaw, G. [NB Power Nuclear, Lepreau, New Brunswick (Canada)

    2009-07-01

    In the mid-1990s, New Brunswick Power Nuclear implemented a Management System Process Model at the Point Lepreau Generating Station that provides the basic elements of a knowledge management program. As noted by the IAEA, the challenge facing the nuclear industry now is to make improvements in knowledge management in areas that are more difficult to implement. Two of these areas are: increasing the value of existing knowledge, and converting tacit knowledge to explicit knowledge (knowledge acquisition). This paper describes some practical examples of knowledge management improvements in the Point Lepreau heat transport system ageing management program. (author)

  11. Management Reviewing Literature: An Evaluation of Selected Characteristics.

    Science.gov (United States)

    Rehman, Sajjad ur

    1987-01-01

    Reports results of a study which compared the treatment of selected characteristics of the reviewing literature of management in professional and trade journals. The characteristics examined included lag time, review length, descriptive or analytic nature of reviews, positive or negative evaluations, and affiliation of the reviewer. (CLB)

  12. Notes on Aging of the Stomatognathic System. A Literature Review

    Directory of Open Access Journals (Sweden)

    Rogelio Cabo García

    2016-06-01

    Full Text Available Aging is a natural process of varying length that occurs similarly in each species. It is a time-dependent process characterized by a progressive increase in the vulnerability and a decrease in the viability of the organism. It is necessary to know the age-related changes in order to diagnose and treat temporomandibular disorders. This literature review aims to provide an update of the main aspects related to aging of the stomatognathic system. An Internet search was conducted using specialized search engines and descriptors related to this subject. Health databases were also consulted. It was concluded that the main characteristics of the temporomandibular joint during aging are degenerative changes, without necessarily causing clinical manifestations and without a linear relationship between age and radiographic changes in condylar morphology. It is suggested that aging of the stomatognathic muscles is related to the depletion of the stem cell pool and the vascular remodeling that occurs with aging, which may be responsible for changes in muscle function.

  13. Manual for Internal Audits and Management Review Energy Care; Handreiking Interne Audits en Management Review Energiezorg

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2008-09-15

    This document offers practical support for two important aspects of energy care: establishing an internal audit and a management review. Both are logical next steps following planned and implemented energy saving measures. They will help test if measures have (had) the desired effect or if they need to be adjusted and to establish if any follow-up measures are needed. (mk) [Dutch] Deze handreiking biedt praktische ondersteuning bij twee belangrijke onderdelen van Energiezorg: het opzetten van een interne audit en een management review. Beide onderdelen zijn een logisch vervolg op geplande en al genomen energiebesparende maatregelen. Het is een toetsing of de maatregelen effect hebben (gehad), of ze bijgesteld moeten worden en of er eventuele vervolgmaatregelen nodig zijn.

  14. Smoking and Age-Related Macular Degeneration: Review and Update

    Science.gov (United States)

    Velilla, Sara; García-Medina, José Javier; García-Layana, Alfredo; Pons-Vázquez, Sheila; Pinazo-Durán, M. Dolores; Gómez-Ulla, Francisco; Arévalo, J. Fernando; Díaz-Llopis, Manuel; Gallego-Pinazo, Roberto

    2013-01-01

    Age-related macular degeneration (AMD) is one of the main socioeconomical health issues worldwide. AMD has a multifactorial etiology with a variety of risk factors. Smoking is the most important modifiable risk factor for AMD development and progression. The present review summarizes the epidemiological studies evaluating the association between smoking and AMD, the mechanisms through which smoking induces damage to the chorioretinal tissues, and the relevance of advising patients to quit smoking for their visual health. PMID:24368940

  15. Smoking and Age-Related Macular Degeneration: Review and Update

    Directory of Open Access Journals (Sweden)

    Sara Velilla

    2013-01-01

    Full Text Available Age-related macular degeneration (AMD is one of the main socioeconomical health issues worldwide. AMD has a multifactorial etiology with a variety of risk factors. Smoking is the most important modifiable risk factor for AMD development and progression. The present review summarizes the epidemiological studies evaluating the association between smoking and AMD, the mechanisms through which smoking induces damage to the chorioretinal tissues, and the relevance of advising patients to quit smoking for their visual health.

  16. Ageing management of french NPP civil work structures

    Science.gov (United States)

    Gallitre, E.; Dauffer, D.

    2011-04-01

    This paper presents EDF practice about concrete structure ageing management, from the mechanisms analysis to the formal procedure which allows the French company to increase 900 MWe NPP lifetime until 40 years; it will also introduce its action plan for 60 years lifetime extension. This practice is based on a methodology which identifies every ageing mechanism; both plants feedback and state of the art are screened and conclusions are drawn up into an "ageing analysis data sheet". That leads at first to a collection of 57 data sheets which give the mechanism identification, the components that are concerned and an analysis grid which is designed to assess the safety risk. This analysis screens the reference documents describing the mechanism, the design lifetime hypotheses, the associated regulation or codification, the feedback experiences, the accessibility, the maintenance actions, the repair possibility and so one. This analysis has to lead to a conclusion about the risk taking into account monitoring and maintenance. If the data sheet conclusion is not clear enough, then a more detailed report is launched. The technical document which is needed, is a formal detailed report which summarizes every theoretical knowledge and monitoring data: its objective is to propose a solution for ageing management: this solution can include more inspections or specific research development, or additional maintenance. After a first stage on the 900 MWe units, only two generic ageing management detailed reports have been needed for the civil engineering part: one about reactor building containment, and one about other structures which focuses on concrete inflating reactions. The second stage consists on deriving this generic analysis (ageing mechanism and detailed reports) to every plant where a complete ageing report is required (one report for all equipments and structures of the plant, but specific for each reactor). This ageing management is a continuous process because the

  17. A comprehensive Aging Management Program of a German NPP

    Energy Technology Data Exchange (ETDEWEB)

    Wildner, U.

    2014-07-01

    The majority of System, Structure and Components (SSC) in a nuclear power plants are designed to experience a service life, which is far above the intended design life. In most cases, only a small percentage of SSCs are subject to significant aging effects, which may affect the integrity or the function of the component. The process of aging management (AM) has the objective to monitor and control degradation effects which may compromise safety functions of the plant. And furthermore, to ensure, that testing and maintenance programs sufficiently provide preventive measures to control degradation effects. (Author)

  18. Systematic review of guidelines for the physical management of osteoarthritis.

    Science.gov (United States)

    Larmer, Peter J; Reay, Nicholas D; Aubert, Elizabeth R; Kersten, Paula

    2014-02-01

    To undertake a systematic critical appraisal of guidelines to provide a summary of recommendations for the physical management of osteoarthritis (OA). The Cochrane Library, MEDLINE, CINAHL, SPORTDiscus with Full Text, Scopus, ScienceDirect, PEDro, and Google Scholar databases were searched (2000-2013) to identify all guidelines, protocols, and recommendations for the management or treatment of OA. In addition, Internet searches of all relevant arthritis organizations were undertaken. All searches were performed between July 2012 and end of April 2013. Guidelines that included only pharmacological, injection therapy, or surgical interventions were excluded. Guidelines published only in English were retrieved. OA guidelines developed from evidence-based research, consensus, and/or expert opinion were retrieved. There were no restrictions on severity or site of OA, sex, or age. Nineteen guidelines were identified for evaluation. The quality of all guidelines was critically appraised using the Appraisal of Guidelines for REsearch and Evaluation II instrument. Each guideline was independently reviewed. All relevant recommendations for the physical management of OA were synthesized, graded, and ranked according to available evidence. Seventeen guidelines with recommendations on the physical management of OA met the inclusion criteria and underwent a full critical appraisal. There were variations in the interventions, levels of evidence, and strength of recommendations across the guidelines. Forty different interventions were identified. Recommendations were graded from "strongly recommended" to "unsupported." Exercise and education were found to be strongly recommended by most guidelines. Exercise and education were key recommendations supporting the importance of rehabilitation in the physical management of OA. This critical appraisal can assist health care providers who are involved in the management of people with OA. Copyright © 2014 American Congress of

  19. Pharmacotherapy in the ageing patient: The impact of age per se (A review).

    Science.gov (United States)

    Singh, Shamsher; Bajorek, Beata

    2015-11-01

    A literature search was carried out to review the influence of 'ageing' on pharmacotherapeutic decision-making, specifically how 'age' is defined and considered in the utilisation of medication. Embase, Medline, International Pharmaceutical Abstracts, and Google scholar were canvassed in a three-tiered search according to pre-established inclusion criteria. In tier 1, a total of 22 studies were identified highlighting the underutilisation of medication in elderly patients, with a particular focus on warfarin. Four studies highlighted an age-bias in medication-prescribing for elderly patients, specifically in relation to medicines for rheumatoid arthritis, angina, and hypertension. Tier 2 identified diverse definitions for 'elderly', including biological age, chronological age, physiological age, as well as various descriptions of 'elderly' in clinical trials and guidelines. Finally, medication optimisation tools were identified through the third tier, emphasising the use of chronological age to describe the 'elderly'. Old age influences pharmacotherapeutic decision-making at various levels, however, what complicates the situation is the absence of a comprehensive definition of 'elderly'. Clinical recommendations need to be based more on objective factors known to affect medication effectiveness and safety.

  20. Aging and intestinal motility: a review of factors that affect intestinal motility in the aged.

    LENUS (Irish Health Repository)

    O'Mahony, Denis

    2012-02-03

    Normal aging is associated with significant changes in the function of most organs and tissues. In this regard, the gastrointestinal tract is no exception. The purpose of this review is to detail the important age-related changes in motor function of the various parts of the gastrointestinal tract and to highlight some of the important motility changes that may occur, either in relation to common age-related disorders, or as a result of certain drugs commonly prescribed in the aged. A major confounding factor in the interpretation of motor phenomena throughout the gastrointestinal tract in this age group is the frequent coexistence of neurological, endocrinological and other disease states, which may be independently associated with dysmotility. Overall, current data are insufficient to implicate normal aging as a cause of dysmotility in the elderly. Normal aging is associated with various changes in gastrointestinal motility, but the clinical significance of such changes remains unclear. More important is the impact of various age-related diseases on gastrointestinal motility in the elderly: for example, long-standing diabetes mellitus may reduce gastric emptying in up to 50% of patients; depression significantly prolongs whole-gut transit time; hypothyroidism may prolong oro-caecal transit time; and chronic renal failure is associated with impaired gastric emptying. In addition, various, frequently used drugs in the elderly cause disordered gastrointestinal motility. These drugs include anticholinergics, especially antidepressants with an anticholinergic effect, opioid analgesics and calcium antagonists.

  1. Necrotizing pancreatitis: a review of multidisciplinary management.

    Science.gov (United States)

    Sabo, Anthony; Goussous, Naeem; Sardana, Neeraj; Patel, Shirali; Cunningham, Steven C

    2015-03-20

    The objective of this review is to summarize the current state of the art of the management of necrotizing pancreatitis, and to clarify some confusing points regarding the terminology and diagnosis of necrotizing pancreatitis, as these points are essential for management decisions and communication between providers and within the literature. Acute pancreatitis varies widely in its clinical presentation. Despite the publication of the Atlanta guidelines, misuse of pancreatitis terminology continues in the literature and in clinical practice, especially regarding the local complications associated with severe acute pancreatitis. Necrotizing pancreatitis is a manifestation of severe acute pancreatitis associated with significant morbidity and mortality. Diagnosis is aided by pancreas-protocol computed tomography or magnetic resonance imaging, ideally 72 h after onset of symptoms to achieve the most accurate characterization of pancreatic necrosis. The extent of necrosis correlates well with the incidence of infected necrosis, organ failure, need for debridement, and morbidity and mortality. Having established the diagnosis of pancreatic necrosis, goals of appropriately aggressive resuscitation should be established and adhered to in a multidisciplinary approach, ideally at a high-volume pancreatic center. The role of antibiotics is determined by the presence of infected necrosis. Early enteral feeds improve outcomes compared with parenteral nutrition. Pancreatic necrosis is associated with a multitude of complications which can lead to long-term morbidity or mortality. Interventional therapy should be guided by available resources and the principle of a minimally invasive approach. When open debridement is necessary, it should be delayed at least 3-6 weeks to allow demarcation of necrotic from viable tissue.

  2. Review: quantifying mitochondrial dysfunction in complex diseases of aging.

    Science.gov (United States)

    Horan, Martin P; Pichaud, Nicolas; Ballard, J William O

    2012-10-01

    There is accumulating evidence that mitochondrial respiratory malfunction is associated with aging-associated complex diseases. However, progress in our understanding of these diseases has been hampered by the sensitivity and throughput of systems employed to quantify dysfunction and inherent limitations of the biological systems studied. In this review, we describe and contrast two methodologies that have been developed for measuring mitochondrial function to address the need for improved sensitivity and increased throughput. We then consider the utility of each methodology in studying three biological systems: isolated mitochondria, cultured cells, and cell fibers and tissues. Finally, we discuss the application of each methodology in the study of mitochondrial dysfunction in Alzheimer's disease, type 2 diabetes mellitus, and aging-associated autophagy impairment and mitochondrial malfunction. We conclude that the methodologies are complementary, and researchers may need to examine multiple biological systems to unravel complex diseases of aging.

  3. Effects of Aging in Multisensory Integration: A Systematic Review

    Science.gov (United States)

    de Dieuleveult, Alix L.; Siemonsma, Petra C.; van Erp, Jan B. F.; Brouwer, Anne-Marie

    2017-01-01

    Multisensory integration (MSI) is the integration by the brain of environmental information acquired through more than one sense. Accurate MSI has been shown to be a key component of successful aging and to be crucial for processes underlying activities of daily living (ADLs). Problems in MSI could prevent older adults (OA) to age in place and live independently. However, there is a need to know how to assess changes in MSI in individuals. This systematic review provides an overview of tests assessing the effect of age on MSI in the healthy elderly population (aged 60 years and older). A literature search was done in Scopus. Articles from the earliest records available to January 20, 2016, were eligible for inclusion if assessing effects of aging on MSI in the healthy elderly population compared to younger adults (YA). These articles were rated for risk of bias with the Newcastle-Ottawa quality assessment. Out of 307 identified research articles, 49 articles were included for final review, describing 69 tests. The review indicated that OA maximize the use of multiple sources of information in comparison to YA (20 studies). In tasks that require more cognitive function, or when participants need to adapt rapidly to a situation, or when a dual task is added to the experiment, OA have problems selecting and integrating information properly as compared to YA (19 studies). Additionally, irrelevant or wrong information (i.e., distractors) has a greater impact on OA than on YA (21 studies). OA failing to weigh sensory information properly, has not been described in previous reviews. Anatomical changes (i.e., reduction of brain volume and differences of brain areas’ recruitment) and information processing changes (i.e., general cognitive slowing, inverse effectiveness, larger time window of integration, deficits in attentional control and increased noise at baseline) can only partly explain the differences between OA and YA regarding MSI. Since we have an interest in

  4. 48 CFR 2901.603-72 - Administrative procurement management reviews.

    Science.gov (United States)

    2010-10-01

    ... Authority, and Responsibilities 2901.603-72 Administrative procurement management reviews. (a) The Senior... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Administrative procurement management reviews. 2901.603-72 Section 2901.603-72 Federal Acquisition Regulations System DEPARTMENT OF...

  5. Leprosy among children under 15 years of age: literature review.

    Science.gov (United States)

    Oliveira, Marcela Bahia Barretto de; Diniz, Lucia Martins

    2016-04-01

    Leprosy is a chronic infectious disease caused by Mycobacterium leprae, representing a public health issue in some countries. Though more prevalent in adults, the detection of new cases in children under 15 years of age reveals an active circulation of bacillus, continued transmission and lack of disease control by the health system, as well as aiding in the monitoring of the endemic. Among patients under 15 years of age, the most affected age group is children between 10 and 14 years of age, although cases of patients of younger than 1 year of age have also been reported. Household contacts are the primary source of infection, given that caretakers, such as babysitters and others, must be considered in this scenario. Paucibacillary forms of the disease prevailed, especially borderline-tuberculoid leprosy, with a single lesion in exposed areas of the body representing the main clinical manifestation. Reactional states: Lepra reactions are rare, although some authors have reported high frequencies of this phenomenon, the most frequent of which is Type 1 Lepra Reaction. Peripheral nerve involvement has been described at alarming rates in some studies, which increases the chance of deformities, a serious problem, especially if one considers the age of these patients. The protective effect of BCG vaccination was found in some studies, but no consensus has been reached among different authors. Children must receive the same multidrug therapy regimen and the doses should, ideally, be calculated based on the child´s weight. Adverse reactions to this therapy are rare within this age group. This article aims to review epidemiological, clinical, and therapeutic aspects of leprosy in patients under 15 years of age.

  6. Leprosy among children under 15 years of age: literature review*

    Science.gov (United States)

    de Oliveira, Marcela Bahia Barretto; Diniz, Lucia Martins

    2016-01-01

    Leprosy is a chronic infectious disease caused by Mycobacterium leprae, representing a public health issue in some countries. Though more prevalent in adults, the detection of new cases in children under 15 years of age reveals an active circulation of bacillus, continued transmission and lack of disease control by the health system, as well as aiding in the monitoring of the endemic. Among patients under 15 years of age, the most affected age group is children between 10 and 14 years of age, although cases of patients of younger than 1 year of age have also been reported. Household contacts are the primary source of infection, given that caretakers, such as babysitters and others, must be considered in this scenario. Paucibacillary forms of the disease prevailed, especially borderline-tuberculoid leprosy, with a single lesion in exposed areas of the body representing the main clinical manifestation. Reactional states: Lepra reactions are rare, although some authors have reported high frequencies of this phenomenon, the most frequent of which is Type 1 Lepra Reaction. Peripheral nerve involvement has been described at alarming rates in some studies, which increases the chance of deformities, a serious problem, especially if one considers the age of these patients. The protective effect of BCG vaccination was found in some studies, but no consensus has been reached among different authors. Children must receive the same multidrug therapy regimen and the doses should, ideally, be calculated based on the child´s weight. Adverse reactions to this therapy are rare within this age group. This article aims to review epidemiological, clinical, and therapeutic aspects of leprosy in patients under 15 years of age. PMID:27192519

  7. Cutaneous wound healing in aging small mammals: a systematic review.

    Science.gov (United States)

    Kim, Dong Joo; Mustoe, Thomas; Clark, Richard A F

    2015-01-01

    As the elderly population grows, so do the clinical and socioeconomic burdens of nonhealing cutaneous wounds, the majority of which are seen among persons over 60 years of age. Human studies on how aging effects wound healing will always be the gold standard, but studies have ethical and practical hurdles. Choosing an animal model is dictated by costs and animal lifespan that preclude large animal use. Here, we review the current literature on how aging effects cutaneous wound healing in small animal models and, when possible, compare healing across studies. Using a literature search of MEDLINE/PubMed databases, studies were limited to those that utilized full-thickness wounds and compared the wound-healing parameters of wound closure, reepithelialization, granulation tissue fill, and tensile strength between young and aged cohorts. Overall, wound closure, reepithelialization, and granulation tissue fill were delayed or decreased with aging across different strains of mice and rats. Aging in mice was associated with lower tensile strength early in the wound healing process, but greater tensile strength later in the wound healing process. Similarly, aging in rats was associated with lower tensile strength early in the wound healing process, but no significant tensile strength difference between young and old rats later in healing wounds. From studies in New Zealand White rabbits, we found that reepithelialization and granulation tissue fill were delayed or decreased overall with aging. While similarities and differences in key wound healing parameters were noted between different strains and species, the comparability across the studies was highly questionable, highlighted by wide variability in experimental design and reporting. In future studies, standardized experimental design and reporting would help to establish comparable study groups, and advance the overall knowledge base, facilitating the translatability of animal data to the human clinical condition.

  8. A literature review on innovation management tools

    Directory of Open Access Journals (Sweden)

    Marco Botarelli

    2008-12-01

    Full Text Available The study of a complex phenomenon such as innovation, influences and effects of which are tangible in manifold contexts, traditionally requires the integration of different levels of analysis and the interaction among distant disciplines. The enterprise appears to be the fundamental agent of economic change; in this context, innovation, by intervening in the sphere of technology, constitutes a fundamental dimension also for social change. In addition, it interacts in the circle of a complex matrix of cultural, economic and institutional factors which are the base of social and economical evolution. In this context, the research questions (RQ investigated by the authors are: “what is innovation?” [RQ 1] and “which are the main evolutions of innovation management models?” [RQ 2]. Literature on this matter has exponentially evolved in recent years. Nevertheless, innovation literature presents a large heterogeneity of results, while the innovation process concept itself is still poorly understood. In order to investigate the first research question, authors review forms and structures of innovation models developed throughout the years. At the end a discussion on the characteristics of literature evolution, through a strength-weakness analysis, is presented by the authors.

  9. Managing Prolactinomas During Pregnancy: Mini Review

    Directory of Open Access Journals (Sweden)

    Mussa eAlmalki

    2015-05-01

    Full Text Available Prolactinomas are the most prevalent functional benign pituitary tumors due to a pituitary micro- or macroadenoma. The majority of patients presents with infertility and gonadal dysfunction.A dopamine agonist (DAs (bromocriptine or cabergoline is the treatment of choice that can normalize prolactin levels, reduce tumor size and restore ovulation and fertility. Cabergoline generally preferred over bromocriptine because of its higher efficacy and tolerability. Managing prolactinomas during pregnancy may be challenging. During pregnancy, the pituitary gland undergoes global hyperplasia due to a progressive increase in serum estrogens level that may lead to increase of the tumor volume with potential mass effect and visual loss.The risk of tumor enlargement may occur in 3 % of those with microadenomas, 32 % in those with macroadenomas that were not previously operated on and 4.8% of those with macroadenomas with prior ablative treatment. Though both drugs appear to be safe during pregnancy, the data on fetal exposure to DAs during pregnancy have been reported with bromocriptine far exceeds that of cabergoline with no association of increased risk of pregnancy loss and premature delivery. It is advisable to stop the use of DAs immediately once pregnancy is confirmed, except in the case of women with invasive macroprolactinomas or pressure symptoms. This review outlines the therapeutic approach to, prolactinoma during pregnancy, with emphasis on the safety of available DA therapy.

  10. Even-Aged vs. Uneven-Aged Silviculture: Implications for Multifunctional Management of Southern Pine Ecosystems

    Directory of Open Access Journals (Sweden)

    Ajay Sharma

    2016-04-01

    Full Text Available We evaluated even- and uneven-aged silvicultural options for slash pine (Pinus elliottii Engelm. using empirical data and the Forest Vegetation Simulator (FVS model. Data were collected from a mature unthinned slash pine plantation in a flatwoods site in Florida, and used to simulate six scenarios of even- and uneven-aged silvicultural regimes applied to slash pine stands, including a no-action option. These alternative silvicultural regimes were evaluated for multiple benefits including timber production, carbon storage and stand structural diversity over a period of 100 years. None of the silvicultural regimes maximized all the benefits. While even-aged management options were more efficient in total merchantable timber production (9.78 to 11.02 m3·ha−1·year−1 and overall carbon stocks (3.05 to 3.47 metric tons·ha−1·year−1, uneven-aged management options created overall more complex stand structure (Stand Structural Diversity (computed from Shannon’s Indices values = 1.92 and maintained a steady flow of yields, particularly sawtimber (34.29 to 58.46 m3·ha−1 every 10 year and aboveground carbon stocks (56.9 to 77.2 metric tons·ha−1. Optimal achievement of multiple benefits across the landscape, therefore, may require maintaining an assortment of management strategies. Both even- and uneven-aged management options have the potential to improve production and carbon storage of pine forests and are a substantial improvement over no action.

  11. Healthy Aging in Older Women Living with HIV Infection: a Systematic Review of Psychosocial Factors.

    Science.gov (United States)

    Rubtsova, Anna A; Kempf, Mirjam-Colette; Taylor, Tonya N; Konkle-Parker, Deborah; Wingood, Gina M; Holstad, Marcia McDonnell

    2017-02-13

    Due to life-enhancing effects of antiretroviral therapy, HIV-positive persons have the potential for long life comparable to their uninfected peers. Older women (age 50+) living with HIV (OWLH) are often an under-recognized aging group. We conducted a systematic review to examine psychosocial factors that impact how OWLH live, cope, and age with HIV. Initial key word search yielded 1527 records, and 21 studies met our inclusion criteria of original quantitative or qualitative research published between 2013 and 2016 with results specific to OWLH. These focused on health care and self-management, sexual health and risk, stigma, loneliness, mental health (depression, substance use), and protective factors (coping, social support, well-being). Due to the scarcity of studies on each topic and inconclusive findings, no clear patterns of results emerged. As the number of OWLH continues to grow, more research, including longitudinal studies, is needed to fully characterize the psychosocial factors that impact aging with HIV.

  12. The management of hypogonadism in aging male patients.

    Science.gov (United States)

    Sharma, Vishwamitra; Perros, Petros

    2009-01-01

    This article focuses on the evaluation and management of hypogonadism in aging male patients in the light of recent guidelines. The benefits of treating severe hypogonadism resulting from identifiable pituitary or primary gonadal disease are well established. Milder forms of hypogonadism in the aging male, known as andropause, are common, and constitute an expanding area of clinical interest and research. Several studies indicate that testosterone replacement therapy may produce a wide range of benefits for men with hypogonadism, including improvement in libido, bone density, muscle mass, body composition, mood, and cognition. Currently available data are insufficient to permit a definitive verdict on the balance between risks and benefits of testosterone replacement therapy in aging males.

  13. Age Management and Sustainable Careers for the Improvement of the Quality of Ageing at Work.

    Science.gov (United States)

    Marcaletti, Francesco

    2014-01-01

    Prolonging working careers by increasing the statutory age for retirement has become compulsory in most Western societies in order to tackle the shrinking of the labour force, preserve economic productivity, foster knowledge transfer and reduce the risks of financial imbalances in social security systems. This imperative currently results in working careers that already exceed 40 years and come to an end after the age of 65 (e.g. in Italy). Over the next few decades, both career length and retirement age are expected to rise. Thus, creating more inclusive workplaces by increasing their quality is the precondition of a win-win situation for both employers and employees, regardless of age. A request for support in the development of sustainable careers from both private and public labour organisations has led to innovating the mainstream methodologies and research tools in the field of age management. Based on the key elements of the mainstream "work ability concept" - i.e. health, competencies, motivation and work organisation - the Quality of Ageing at Work questionnaire (QAW-q), developed by a team from the WWELL Research Centre, broadens its perspective by surveying elements bridging intra-organisational dimensions and which affect employees' conditions and external socio-institutional constraints: i.e. work-life balance, economic stability, professional identity and relationships in the workplace. The QAW-q is designed to analyse the influence of the different meanings of age (chronological age, seniority within the company and in the labour market) and correlate them with the different dimensions at individual and organisational levels; all these dimensions are weighted by the effect exerted by the passage of time. The results of the QAW-q survey, taken by employees of both private and public companies, serve as a basis for the implementation of measures addressing all the relevant dimensions of the human resource management cycle.

  14. Can aging in place be cost effective? A systematic review.

    Science.gov (United States)

    Graybill, Erin M; McMeekin, Peter; Wildman, John

    2014-01-01

    To systematically review cost, cost-minimization and cost-effectiveness studies for assisted living technologies (ALTs) that specifically enable older people to 'age in place' and highlight what further research is needed to inform decisions regarding aging in place. People aged 65+ and their live-in carers (where applicable), using an ALT to age in place at home opposed to a community-dwelling arrangement. Studies were identified using a predefined search strategy on two key economic and cost evaluation databases NHS EED, HEED. Studies were assessed using methods recommended by the Campbell and Cochrane Economic Methods Group and presented in a narrative synthesis style. Eight eligible studies were identified from North America spread over a diverse geographical range. The majority of studies reported the ALT intervention group as having lower resource use costs than the control group; though the low methodological quality and heterogeneity of the individual costs and outcomes reported across studies must be considered. The studies suggest that in some cases ALTs may reduce costs, though little data were identified and what there were was of poor quality. Methods to capture quality of life gains were not used, therefore potential effects on health and wellbeing may be missed. Further research is required using newer developments such as the capabilities approach. High quality studies assessing the cost-effectiveness of ALTs for ageing in place are required before robust conclusion on their use can be drawn.

  15. Can aging in place be cost effective? A systematic review.

    Directory of Open Access Journals (Sweden)

    Erin M Graybill

    Full Text Available PURPOSE OF THE STUDY: To systematically review cost, cost-minimization and cost-effectiveness studies for assisted living technologies (ALTs that specifically enable older people to 'age in place' and highlight what further research is needed to inform decisions regarding aging in place. DESIGN: People aged 65+ and their live-in carers (where applicable, using an ALT to age in place at home opposed to a community-dwelling arrangement. METHODS: Studies were identified using a predefined search strategy on two key economic and cost evaluation databases NHS EED, HEED. Studies were assessed using methods recommended by the Campbell and Cochrane Economic Methods Group and presented in a narrative synthesis style. RESULTS: Eight eligible studies were identified from North America spread over a diverse geographical range. The majority of studies reported the ALT intervention group as having lower resource use costs than the control group; though the low methodological quality and heterogeneity of the individual costs and outcomes reported across studies must be considered. IMPLICATIONS: The studies suggest that in some cases ALTs may reduce costs, though little data were identified and what there were was of poor quality. Methods to capture quality of life gains were not used, therefore potential effects on health and wellbeing may be missed. Further research is required using newer developments such as the capabilities approach. High quality studies assessing the cost-effectiveness of ALTs for ageing in place are required before robust conclusion on their use can be drawn.

  16. Relaxation and physical aging in network glasses: a review

    Science.gov (United States)

    Micoulaut, Matthieu

    2016-06-01

    Recent progress in the description of glassy relaxation and aging are reviewed for the wide class of network-forming materials such as GeO2, Ge x Se1-x , silicates (SiO2-Na2O) or borates (B2O3-Li2O), all of which have an important usefulness in domestic, geological or optoelectronic applications. A brief introduction of the glass transition phenomenology is given, together with the salient features that are revealed both from theory and experiments. Standard experimental methods used for the characterization of the slowing down of the dynamics are reviewed. We then discuss the important role played by aspects of network topology and rigidity for the understanding of the relaxation of the glass transition, while also permitting analytical predictions of glass properties from simple and insightful models based on the network structure. We also emphasize the great utility of computer simulations which probe the dynamics at the molecular level, and permit the calculation of various structure-related functions in connection with glassy relaxation and the physics of aging which reveal the non-equilibrium nature of glasses. We discuss the notion of spatial variations of structure which leads to the concept of ‘dynamic heterogeneities’, and recent results in relation to this important topic for network glasses are also reviewed.

  17. BOOK REVIEW: Case Studies in Knowledge Management

    Directory of Open Access Journals (Sweden)

    Reviewed by Dr. Adnan BOYACI

    2005-10-01

    Full Text Available 161Case Studies in Knowledge ManagementEdited by Murray JennexHersley: PA: Idea Group, 2005, pp. 372, ISBN 1-59140-352-9Reviewed by Dr. Adnan BOYACIAnadolu UniversityEskişehir-TurkeyKnowledge management (KM as a structured system and the way to the effectiveness isrelatively new field for the contemporary organizations functioning in different andcompetitive domain of public and private sectors in terms of getting optimal effectivenessunderlined by the concepts such as quality, productivity…etc. Because of the growingimportance and the popularity of the KM either as a research topic or specialized coursesubject, a crucial need for understanding, conceptualization and implementation of KM asa system has emerged since the mid 1990’s. In this sense, the book contributes criticallyto fill the gap between theory and implementation as a teaching material.This edited book is published by Idea Group Publishing. The book has twenty chaptersdivided into seven sections. In addition to a section of authors’ biography contributing thebook and an index, there is a preface that the basic terms and key concepts underliningthe cases discussed following chapters, which is explained in a schematized way.Besides the editor, total of 47 authors have contributed to the book. These authors arefrom different countries, academic backgrounds, and institutions. Although approximatelyone third of the authors are from USA, the rest of the authors are from Canada, England,Austria, Germany, Australia, New Zealand, Egypt, Bahrain and China. The authorsrepresent a variety of universities, private companies, and military institutions. Most ofthem have strong professional backgrounds, which help them address the issues bothfrom theoretical and practical perspectives. Contributions of authors having differentbackgrounds and institutions enable the book to have very comprehensive spectrum andthis makes the book attractive practically for those working different sectors

  18. The influence of ageing on the development and management of rheumatoid arthritis.

    Science.gov (United States)

    Boots, Annemieke M H; Maier, Andrea B; Stinissen, Piet; Masson, Pierre; Lories, Rik J; De Keyser, Filip

    2013-10-01

    The population of elderly individuals with rheumatoid arthritis (RA) is expanding, due mainly to increasing life expectancy. A variety of theories have been proposed to explain the ageing process, including accumulation of DNA damage and resultant changes in biological processes. Such changes can influence the development and/or course of disease. Furthermore, alterations in biological function determine the biological age-as opposed to chronological age-of an individual, which strongly influences their ability to cope with disease. Moreover, comorbidities are more frequent in elderly individuals. Together, these factors complicate treatment of disease and necessitate careful patient management. Indeed, although evidence from clinical trials suggests that DMARDs and biologic agents have good efficacy and are well tolerated in elderly patients with RA, such individuals are often undertreated and inadequately managed. Unfortunately, insufficient data are available for the development of evidence-based guidelines for this population, as elderly patients are often excluded from clinical trials owing to age restrictions or comorbidities. Thus, additional clinical studies in elderly patients are warranted, with treatment regimens tailored according to vitality or frailty parameters. This Review focuses on the pathophysiological aspects of ageing and their implications for the management of RA in elderly patients.

  19. A Perspective on a Management Information Systems (MIS) Program Review

    Science.gov (United States)

    Yew, Bee K.

    2008-01-01

    This paper highlights relevant curriculum issues that were identified in a Management Information Systems (MIS) program review undertaken by a group of business faculty in a small regional university. The program review was initiated to improve job marketability of graduates and student enrollment. The review process is described as a collective…

  20. 75 FR 59704 - Office of Management; Performance Review Board Membership

    Science.gov (United States)

    2010-09-28

    ... Office of Management; Performance Review Board Membership AGENCY: Department of Education. ACTION: Notice of membership of the Performance Review Board. SUMMARY: The Secretary announces the members of the Performance Review Board (PRB) for the Department of Education for the Senior Executive Service...

  1. A Perspective on a Management Information Systems (MIS) Program Review

    Science.gov (United States)

    Yew, Bee K.

    2008-01-01

    This paper highlights relevant curriculum issues that were identified in a Management Information Systems (MIS) program review undertaken by a group of business faculty in a small regional university. The program review was initiated to improve job marketability of graduates and student enrollment. The review process is described as a collective…

  2. Aging hemostasis: changes to laboratory markers of hemostasis as we age - a narrative review.

    Science.gov (United States)

    Favaloro, Emmanuel J; Franchini, Massimo; Lippi, Giuseppe

    2014-09-01

    The incidence of venous thromboembolism (VTE) is well recognized to increase with aging. Concurrently, the plasma concentrations of many coagulation factors (e.g., fibrinogen, factor [F] V, FVII, FVIII, and FIX) increase with aging, as does von Willebrand factor (VWF), thrombin generation, and platelet activation. Data are conflicting regarding age-related changes in the natural anticoagulants, including protein C, protein S, and antithrombin. Changes are also observed with components of the fibrinolytic pathway. All in all, aging is associated with a variety of hemostasis changes that on balance reflects a heightened procoagulant status compared with earlier age. It has to be recognized that as this occurs in the otherwise normal general population, this can also be considered a normal phenomenon of progressive life. An element of this heightened procoagulant status may reflect ongoing inflammatory processes, given some markers, notably FVIII and fibrinogen, are acute phase reactants. A variety of acquired prothrombotic risk factors (e.g., cancer, autoimmune disorders, and diabetes) also gradually develop with aging, some of which may induce profound abnormalities of hemostasis, and confound the age-related changes in hemostasis, as well as their influence on thrombotic risk. In this article, we review the changes in hemostasis markers measurable within many hemostasis laboratories, and consider many of the important implications for clinical and laboratory practice. Apart from representing an increased thrombotic risk, additional considerations entail the potential need (1) to utilize age-adjusted normal ranges (e.g., for D-dimer), (2) to consider the consequence on previous diagnoses (e.g., "mild type 1" von Willebrand disease [VWD], where VWF test results may "normalize" with aging), and (3) to consider the effect of these changes of risk factors on the (perceived) therapeutic efficacy of antithrombotic medications such as aspirin.

  3. 77 FR 27815 - Aging Management of Stainless Steel Structures and Components in Treated Borated Water

    Science.gov (United States)

    2012-05-11

    ... COMMISSION Aging Management of Stainless Steel Structures and Components in Treated Borated Water AGENCY..., ``Aging Management of Stainless Steel Structures and Components in Treated Borated Water.'' This LR-ISG... Power Plants (SRP-LR) and Generic Aging Lessons Learned (GALL) Report for the aging management...

  4. 77 FR 16270 - Updated Aging Management Criteria for Reactor Vessel Internal Components of Pressurized Water...

    Science.gov (United States)

    2012-03-20

    ... COMMISSION Updated Aging Management Criteria for Reactor Vessel Internal Components of Pressurized Water... license renewal interim staff guidance (LR-ISG), LR-ISG-2011-04, ``Updated Aging Management Criteria for... Aging Lessons Learned (GALL) Report for the aging management of stainless steel structures...

  5. What do we know about care home managers? Findings of a scoping review.

    Science.gov (United States)

    Orellana, Katharine; Manthorpe, Jill; Moriarty, Jo

    2017-03-01

    This article reports selected findings from a scoping review of the literature about care home managers in England. The review was undertaken between December 2013 and April 2014, with searches conducted in December 2013, and completed in July 2014. Its aim was to identify the characteristics of care home managers, descriptions of their leadership and managerial roles, their experience, skills and support, and the managers' perceptions of their work and status and to identify knowledge gaps. The databases searched included Web of Knowledge, EBSCO, ASSIA, Embase, AgeInfo, NHS Evidence, Social Care Online and the publication platforms IngentaConnect, Wiley Online and JSTOR together with specialist sites and national information providers. Sixteen relevant studies directly about care home managers, reported in 24 articles, were identified. A further body of literature pertinent to the questions was located (n = 84), including sector reports, professional press, expert opinion, enquiries and reviews, and other material, which also informed the review. A consultation exercise with stakeholders informed the findings of the review. The review found that, despite frequent allusions to their impact on organisational culture, few studies have focused on care home managers, and, such as there are, mainly relate to managers of care homes for older people. This is despite managers' major responsibilities for the care of many frail and disabled people. © 2016 John Wiley & Sons Ltd.

  6. Book Review: Online Privacy: Issues in the Digital Age

    Directory of Open Access Journals (Sweden)

    Darlene M Tester

    2011-09-01

    Full Text Available Currie, Stephen (2012: Online Privacy: Issues in the Digital Age, San Diego, CA, Reference Point Press, Inc. 96 pages, ISBN: 13-978-1-60152-194-1, US $27.95.Reviewed by Darlene M Tester, CISSP, CISM, ITIL, CHSS, JD, Metropolitan State University, Minnesota (nonsequitr60@gmail.comThis book is one of a series of books Currie has written about online areas of concern. This is the sixth book in the series. The purpose of the book is to act as a primer for people in the IT field who may need a point of reference for Internet issues such as gaming, security and privacy. The book takes a high level look at the complexities of privacy online from social networking to hackers and provides insight into what the most pressing issues of privacy are online today.(see PDF for full review

  7. Interventions to Improve Asthma Management of the School-Age Child.

    Science.gov (United States)

    Friend, Mary; Morrison, Amber

    2015-06-01

    Improvement of medication adherence in the school-age child can lead to improvement in quality of life, decreased morbidity, and a potential decreased risk of deferred academic, social, and emotional development. The objective of this article is to review barriers to asthma medication adherence and identify evidence-based techniques that improve medication management of the asthmatic child 5 to 12 years of age. A literature review was performed and articles were obtained through database searches within Medline, CINAHL (Cumulative Index to Nursing and Allied Health Literature), and PubMed. Research indicates that barriers to the adherence of medication regimens required for asthmatic children include poor understanding of the medication regimen, substandard education on symptom recognition and environmental triggers, rejection of the diagnosis, and a lack of support or understanding within the community. Researched techniques aimed to improve medication management in 5- to 12-year-olds include: computer-based education; workshops for parents, teachers, and children; incorporation of asthma education into classroom lessons; use of case managers; the introduction of a nurse practitioner in the school to provide care, including medication prescriptions for the asthmatic child; and assessment and evaluation of environmental and emotional triggers in the home and school. Collaboration of current data may help lead to a successful interventional model that can improve asthma management in this population.

  8. A review of Spacelab mission management approach

    Science.gov (United States)

    Craft, H. G., Jr.

    1979-01-01

    The Spacelab development program is a joint undertaking of the NASA and ESA. The paper addresses the initial concept of Spacelab payload mission management, the lessons learned, and modifications made as a result of the actual implementation of Spacelab Mission 1. The discussion covers mission management responsibilities, program control, science management, payload definition and interfaces, integrated payload mission planning, integration requirements, payload specialist training, payload and launch site integration, payload flight/mission operations, and postmission activities. After 3.5 years the outlined overall mission manager approach has proven to be most successful. The approach does allow the mission manager to maintain the lowest overall mission cost.

  9. Management of breast cancer brain metastases: A practical review.

    Science.gov (United States)

    Phillips, Claire; Jeffree, Rosalind; Khasraw, Mustafa

    2017-02-01

    Brain metastases are a common, and frequently challenging, clinical problem in the contemporary management of metastatic breast cancer. While the management of extracranial metastatic breast cancer is now strongly defined by tumour phenotype, this approach is not so well defined for brain metastases. We review available evidence regarding management of brain metastases, including the limited breast-cancer-specific data. A framework for management according to breast cancer phenotype is proposed. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

  10. The teaching of nursing management in undergraduate: an integrative review

    OpenAIRE

    Mara Solange Gomes Dellaroza; Cristiane Nakaya Tada; Maria do Carmo Lourenço Haddad; Marli Terezinha Oliveira Vannuchi; Vanessa Gomes Maziero

    2015-01-01

    The study aims to identify the dynamics of teaching management in nursing degree. It is an integrative literature review with research conducted in the following online database platforms: SciELO, Medline, Lilacs and BDENF. The keywords used in the study were: competency-based education, professional competence, education, nursing, organization and administration, management, nursing, educational assessment, organization of management services, management of professional practice and educatio...

  11. 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.

  12. Framatome ANP worldwide experience in ageing and plant life management

    Energy Technology Data Exchange (ETDEWEB)

    Daeuwel, W.; Kastner, B.; Nopper, H. [Framatome ANP (Germany)

    2004-07-01

    The deregulation of the power generation industry has resulted in increased competitive pressure and is forcing operators to improve plant operating economy while maintaining high levels of plant safety. A key factor to meet this challenge is to apply a comprehensive plant life management (PLIM) approach which addresses all relevant ageing and degradation mechanisms regarding the safety concept, plant components and documentation, plant personnel, consumables, operations management system and administrative controls. For this reason, Framatome ANP has developed an integrated PLIM concept focussing on the safety concept, plant components and documentation. Representative examples for plant wide analyses are described in the following. The results of the analyses support the plant owner for taking the strategic decisions, involved in plant life extension (PLEX). (orig.)

  13. The Management of Visibilities in the Digital Age

    DEFF Research Database (Denmark)

    Flyverbom, Mikkel; Leonardi, Paul; Stohl, Cynthia

    2016-01-01

    What we see, what we show and how we look are fundamental organizational concerns made ever more salient by the affordances, dynamics, and discourses of the digital age. Contemporary organizing practices are awash with material, mediated and managed visibilities: companies erect glass buildings...... with open and networked office spaces to efficiently share information, respond to stakeholder demands by crafting extensive transparency policies, and orchestrate the massive distribution of information online in the name of accountability. At the same time, states and corporations aggregate digital traces...

  14. The Management of Visibilities in the Digital Age

    DEFF Research Database (Denmark)

    Flyverbom, Mikkel; Leonardi, Paul; Stohl, Cynthia;

    2016-01-01

    What we see, what we show and how we look are fundamental organizational concerns made ever more salient by the affordances, dynamics, and discourses of the digital age. Contemporary organizing practices are awash with material, mediated and managed visibilities: companies erect glass buildings...... with open and networked office spaces to efficiently share information, respond to stakeholder demands by crafting extensive transparency policies, and orchestrate the massive distribution of information online in the name of accountability. At the same time, states and corporations aggregate digital traces...

  15. Disaster waste management: a review article.

    Science.gov (United States)

    Brown, Charlotte; Milke, Mark; Seville, Erica

    2011-06-01

    Depending on their nature and severity, disasters can create large volumes of debris and waste. The waste can overwhelm existing solid waste management facilities and impact on other emergency response and recovery activities. If poorly managed, the waste can have significant environmental and public health impacts and can affect the overall recovery process. This paper presents a system overview of disaster waste management based on existing literature. The main literature available to date comprises disaster waste management plans or guidelines and isolated case studies. There is ample discussion on technical management options such as temporary storage sites, recycling, disposal, etc.; however, there is little or no guidance on how these various management options are selected post-disaster. The literature does not specifically address the impact or appropriateness of existing legislation, organisational structures and funding mechanisms on disaster waste management programmes, nor does it satisfactorily cover the social impact of disaster waste management programmes. It is envisaged that the discussion presented in this paper, and the literature gaps identified, will form a basis for future comprehensive and cohesive research on disaster waste management. In turn, research will lead to better preparedness and response to disaster waste management problems. Copyright © 2011 Elsevier Ltd. All rights reserved.

  16. Healthy aging by staying selectively connected: a mini-review.

    Science.gov (United States)

    Antonenko, Daria; Flöel, Agnes

    2014-01-01

    behavioral performance in older versus young adults. Finally, studies using noninvasive brain stimulation techniques like transcranial direct current stimulation (tDCS) to simultaneously modulate behavior and functional connectivity support the importance of 'selective connectivity' of aging brain networks for preserved cognitive functions. These studies demonstrate that enhancing task performance by tDCS is paralleled by increased connectivity within functional networks. In this review, we outline the network perspective on healthy brain aging and discuss recent developments in this field.

  17. Status of computerized cognitive testing in aging: a systematic review.

    Science.gov (United States)

    Wild, Katherine; Howieson, Diane; Webbe, Frank; Seelye, Adriana; Kaye, Jeffrey

    2008-11-01

    Early detection of cognitive decline in the elderly has become of heightened importance in parallel with the recent advances in therapeutics. Computerized assessment might be uniquely suited to early detection of changes in cognition in the elderly. We present here a systematic review of the status of computer-based cognitive testing, focusing on detection of cognitive decline in the aging population. All studies purporting to assess or detect age-related changes in cognition or early dementia/mild cognitive impairment by means of computerized testing were included. Each test battery was rated on availability of normative data, level of evidence for test validity and reliability, comprehensiveness, and usability. All published studies relevant to a particular computerized test were read by a minimum of two reviewers, who completed rating forms containing the above mentioned criteria. Of the 18 test batteries identified from the initial search, 11 were appropriate to cognitive testing in the elderly and were subjected to systematic review. Of those 11, five were either developed specifically for application with the elderly or have been used extensively with that population. Even within the computerized testing genre, great variability existed in manner of administration, ranging from fully examiner-administered to fully self-administered. All tests had at least minimal reliability and validity data, commonly reported in peer-reviewed articles. However, level of rigor of validity testing varied widely. All test batteries exhibited some of the strengths of computerized cognitive testing: standardization of administration and stimulus presentation, accurate measures of response latencies, automated comparison in real time with an individual's prior performance as well as with age-related norms, and efficiencies of staffing and cost. Some, such as the Mild Cognitive Impairment Screen, adapted complicated scoring algorithms to enhance the information gathered from

  18. Maintaining skin integrity in the aged: a systematic review.

    Science.gov (United States)

    Kottner, J; Lichterfeld, A; Blume-Peytavi, U

    2013-09-01

    Ageing is associated with structural and functional changes of the skin that result in increased vulnerability. The aim of this systematic review is to synthesize empirical evidence about the efficacy and effectiveness of basic skin care interventions for maintaining skin integrity in the aged. The databases Medline, EMBASE, CINAHL (1990-2012), Scopus, SCI (February 2013) and reference lists were searched. Inclusion criteria were primary intervention studies using skin care products in physiologically aged skin (lower age limit 50 years). Study and sample characteristics, interventions and outcomes were extracted. The methodological quality was assessed and a level of evidence was assigned. From 1535 screened articles 188 were read in full text. From these, 33 articles were included reporting results on treating dry skin conditions, and preventing incontinence-associated dermatitis and superficial ulcerations. Most studies had lower levels of evidence of 3 or 4. Skin-cleansing products containing syndets or amphoteric surfactants compared with standard soap and water washing improved skin dryness and demonstrated skin-protecting effects. Moisturizers containing humectants consistently showed statistically significant improvements in skin dryness. Skin barrier products containing occlusives reduced the occurrence of skin injuries compared with standard or no treatment. Owing to methodological limitations the current evidence base for basic skin care in the aged is weak. Using low-irritating cleansing products and humectant- or occlusive-containing moisturizers seems to be the best strategy for maintaining the skin barrier function and integrity. We know little about the effects of cleansing regimens and about the benefits of moisturizers when compared with each other.

  19. Review on hygroscopic aging of cellulose fibres and their biocomposites.

    Science.gov (United States)

    Mokhothu, Thabang H; John, Maya Jacob

    2015-10-20

    This review presents critical literature on effects of humidity and temperature on the properties of natural fibres and its composites. The drawback of moisture absorption on the mechanical properties of natural fibre and its composites is evaluated. Numerous researchers have been working to address the moisture absorption issue, with specific attention paid to the surface treatment of fibres and refining the fibre-matrix interface. Because of the natural fibre's positive commercial and environmental outcomes, as well as their desirable properties such as high specific strength, natural fibre reinforced composites are displaying a good potential to be used in various applications such as automotive, aerospace and packaging. This review addresses a comprehensive survey on hygroscopic factors (long term environmental aging) affecting natural fibres and their performance as reinforcement in polymer composites. The effects of cellulose surface chemistry and topography on hydrophobicity are addressed. Furthermore, the review also addresses the progress in the development of superhydrophobic materials based on cellulose material for better moisture resistance. In addition, recent investigations dealing with bio-based coatings prepared from renewable resources are also discussed.

  20. Active Aging for Individuals with Parkinson’s Disease: Definitions, Literature Review, and Models

    Directory of Open Access Journals (Sweden)

    Seyed-Mohammad Fereshtehnejad

    2014-01-01

    Full Text Available Active aging has been emerged to optimize different aspects of health opportunities during the aging process in order to enhance quality of life. Yet, most of the efforts are on normal aging and less attention has been paid for the elderly suffering from a chronic illness such as Parkinson’s disease (PD. The aim of this review was to investigate how the concept of “active aging” fit for the elderly with PD and to propose a new model for them using the recent improvements in caring models and management approaches. For this purpose, biomedical databases have been assessed using relevant keywords to find out appropriate articles. Movement problems of PD affect physical activity, psychiatric symptoms lessen social communication, and cognitive impairment could worsen mental well-being in elderly with PD, all of which could lead to earlier retirement and poorer quality of life compared with healthy elderly. Based on the multisystematic nature of PD, a new “Active Aging Model for Parkinson’s Disease” is proposed consisting of self-care, multidisciplinary and interdisciplinary care, palliative care, patient-centered care, and personalized care. These strategies could potentially help the individuals with PD to have a better management approach for their condition towards the concept of active aging.

  1. The teaching of nursing management in undergraduate: an integrative review

    Directory of Open Access Journals (Sweden)

    Mara Solange Gomes Dellaroza

    2015-03-01

    Full Text Available The study aims to identify the dynamics of teaching management in nursing degree. It is an integrative literature review with research conducted in the following online database platforms: SciELO, Medline, Lilacs and BDENF. The keywords used in the study were: competency-based education, professional competence, education, nursing, organization and administration, management, nursing, educational assessment, organization of management services, management of professional practice and education. All articles published in the last 10 years which answered the question presented to approach the teaching of nursing management in Brazil, published in any language were included. Those that were not presented in full text were excluded. Of the 1432 studies identified after matching the keywords, only 8 were selected for answering objective of this review. From these results, three related themes emerged: the teaching plans, workload and program content; methodologies of teaching and learning in nursing management; challenges faced in developing the teaching of nursing management.

  2. Aging and its consequences in the mouth; A review

    Directory of Open Access Journals (Sweden)

    Maryam Rabiei

    2017-03-01

    Full Text Available Geriatric is a growing phenomenon which recently rises so fast. With increasing age, the biological and physiological changes occur in different organs. Socioeconomic situation with emerging multiple diseases, disability and changes in oral status can all affect the quality of life of people. The aim of this study was to overview on aging process and consideration on oral changes in particular. This study was carried out by reviewing different scientific sources from Pub Med, Google scholar and Iranian articles (SID since 2005 to 2016. Oral condition may be according to the systemic diseases or solely. The changes in the hard tissue and soft tissue occur. Each of these changes is the result of damage due to the people’s situations which sometimes make it difficult to repair. Nevertheless, rising age in global and in Iran have to be considerd. Periodic visits are important because they reduce the risk of some diseases, including cancers in the mouth. Also, the influence of maintaining the oral and periodontal health conditions not only specifically in oral health but more broadly on some systemic diseases such as heart disease, lung disease, diabetes and etc. are quite important.

  3. Age management in Slovenian enterprises: the viewpoint of older employees

    Directory of Open Access Journals (Sweden)

    Jana Žnidaršič

    2010-12-01

    Full Text Available The main aim of this research is to highlight age management within Slovenian enterprises from the viewpoint of older employees by finding out what influences older employees to decide “should I stay or should I go”. The empirical research methodology is based on mixed strategy of approaching organizations (employees, which means that the quantitative (factor analysis, cluster analysis, correlation, regression, descriptive statistics and frequency distributions and qualitative parts (in-depth interviews analysis of research were conducted simultaneously. The results of the research indicate that there are in fact two groups of older employees, which can be referred to as “susceptible” and “insusceptible” in terms of how the employer can affect their decisions. “The unsusceptible” have already decided to retire as soon as possible and they cannot be influenced by any employer measure. On the other hand, “the susceptible” employees are sensitive to employers’ measures aimed at prolonging their working lives. Besides, a regression analysis confirmed a statistically significant correlation between the inclination towards extending one’s employment period and the susceptibility to the employer measures. It can thus be concluded that, through age management measures, an employer has an impact on an extended employment period of older employees. However, employers should be interested primarily in those employees who are inclined towards extending their working lives.

  4. Surgical Management of Rib Fractures: Strategies and Literature Review.

    Science.gov (United States)

    de Jong, M B; Kokke, M C; Hietbrink, F; Leenen, L P H

    2014-06-01

    Rib fractures can cause significant problems in trauma patients, often resulting in pain and difficulty with respiration. To prevent pulmonary complications and decrease the morbidity and mortality rates of patients with rib fractures, currently there is a trend to provide surgical management of patients with flail chest. However, the indications for rib fracture fixation require further specification. Past and current strategies are described according to a review of the medical literature. A systematic review was performed including current indications for rib fracture fixation. MEDLINE (2000-2013) was searched, as well as Embase (2000-2013) and Cochrane Databases, using the keywords rib, fracture, fixation, plate, repair, and surgery. Three retrospective studies were found that described different techniques for rib fracture fixation. The results demonstrated a reduced number of ventilation days, decreased long-term morbidity and pain, and satisfactory rehabilitation after surgical treatment. In addition to flail chest, age, Injury Severity Score, and the number of rib fractures were important predictive factors for morbidity and mortality. Surgical rib fracture fixation might be indicated in a broader range of cases than is currently performed. Prospective randomized trials are needed for further confirmation. © The Finnish Surgical Society 2014.

  5. Lake Woodruff National Wildlife Refuge Wildlife and Habitat Management Review

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The Lake Woodruff National Wildlife Refuge Wildlife and Habitat Management Review identifies several critical needs of the Refuge in order of a priority.

  6. Crisis management aspects of bam catastrophic earthquake: review article

    National Research Council Canada - National Science Library

    Sadeghi-Bazargani, Homayoun; Azami-Aghdash, Saber; Kazemi, Abdolhassan; Ziapour, Behrad

    2015-01-01

    Bam earthquake was the most catastrophic natural disasters in recent years. The aim of this study was to review different aspects of crisis management during and after the catastrophic earthquake in Bam City, Iran...

  7. Historical review of avian botulism at Stillwater Wildlife Management Area

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — The purpose of this report is to review historical information on avian botulism at Stillwater Wildlife Management Area. This report includes incidental reports of...

  8. Abattoir operations and waste management in Nigeria: A review of ...

    African Journals Online (AJOL)

    Abattoir operations and waste management in Nigeria: A review of challenges and ... meat have been issues of public health and global environmental concerns. ... if the current challenges militating against the establishment, operations and ...

  9. The (safety-related) heat exchangers aging management guideline for commercial nuclear power plants, and developments since 1994

    Energy Technology Data Exchange (ETDEWEB)

    Clauss, J.M.

    1998-08-01

    The US Department of Energy (DOE), in cooperation with the Electric Power Research Institute (EPRI) and US nuclear power plant utilities, is preparing a series of aging management guidelines (AMGs) for commodity types of components (e.g., heat exchangers, electrical cable and terminations, pumps). Commodities are included in this series based on their importance to continued nuclear plant operation and license renewal. The AMGs contain a detailed summary of operating history, stressors, aging mechanisms, and various types of maintenance and surveillance practices that can be combined to create an effective aging management program. Each AMG is intended for use by the systems engineers and plant maintenance staff (i.e., an AMG is intended to be a hands-on technical document rather than a licensing document). The heat exchangers AMG, published in June 1994, includes the following information of interest to nondestructive examination (NDE) personnel: aging mechanisms determined to be non-significant for all applications; aging mechanisms determined to be significant for some applications; effective conventional programs for managing aging; and effective unconventional programs for managing aging. Since the AMG on heat exchangers was published four years ago, a brief review has been conducted to identify emerging regulatory issues, if any. The results of this review and lessons learned from the collective set of AMGs are presented.

  10. Policy options to improve leadership of middle managers in the Australian residential aged care setting: a narrative synthesis

    Science.gov (United States)

    2010-01-01

    Background The prevalence of both chronic diseases and multi-morbidity increases with longer life spans. As Australia's population ages, the aged care sector is under increasing pressure to ensure that quality aged care is available. Key to responding to this pressure is leadership and management capability within the aged care workforce. A systematic literature review was conducted to inform the policy development necessary for the enhancement of clinical and managerial leadership skills of middle managers within residential aged care. Methods Using scientific journal databases, hand searching of specialist journals, Google, snowballing and suggestions from experts, 4,484 papers were found. After a seven-tiered culling process, we conducted a detailed review (narrative synthesis) of 153 papers relevant to leadership and management development in aged care, incorporating expert and key stakeholder consultations. Results • Positive staff experiences of a manager's leadership are critical to ensure job satisfaction and workforce retention, the provision of quality care and the well-being of care recipients, and potentially a reduction of associated costs. • The essential attributes of good leadership for aged care middle management are a hands-on accessibility and professional expertise in nurturing respect, recognition and team building, along with effective communication and flexibility. However, successful leadership and management outcomes depend on coherent and good organisational leadership (structural and psychological empowerment). • There is inadequate preparation for middle management leadership roles in the aged care sector and a lack of clear guidelines and key performance indicators to assess leadership and management skills. • Theory development in aged care leadership and management research is limited. A few effective generic clinical leadership programs targeting both clinical and managerial leaders exist. However, little is known regarding

  11. Policy options to improve leadership of middle managers in the Australian residential aged care setting: a narrative synthesis

    Directory of Open Access Journals (Sweden)

    Merlyn Teri

    2010-07-01

    Full Text Available Abstract Background The prevalence of both chronic diseases and multi-morbidity increases with longer life spans. As Australia's population ages, the aged care sector is under increasing pressure to ensure that quality aged care is available. Key to responding to this pressure is leadership and management capability within the aged care workforce. A systematic literature review was conducted to inform the policy development necessary for the enhancement of clinical and managerial leadership skills of middle managers within residential aged care. Methods Using scientific journal databases, hand searching of specialist journals, Google, snowballing and suggestions from experts, 4,484 papers were found. After a seven-tiered culling process, we conducted a detailed review (narrative synthesis of 153 papers relevant to leadership and management development in aged care, incorporating expert and key stakeholder consultations. Results • Positive staff experiences of a manager's leadership are critical to ensure job satisfaction and workforce retention, the provision of quality care and the well-being of care recipients, and potentially a reduction of associated costs. • The essential attributes of good leadership for aged care middle management are a hands-on accessibility and professional expertise in nurturing respect, recognition and team building, along with effective communication and flexibility. However, successful leadership and management outcomes depend on coherent and good organisational leadership (structural and psychological empowerment. • There is inadequate preparation for middle management leadership roles in the aged care sector and a lack of clear guidelines and key performance indicators to assess leadership and management skills. • Theory development in aged care leadership and management research is limited. A few effective generic clinical leadership programs targeting both clinical and managerial leaders exist. However

  12. Qualification of Electrical Equipment in Nuclear Power Plants - Management of ageing

    Energy Technology Data Exchange (ETDEWEB)

    Spaang, Kjell [KS Miltek, Vaestra Froelunda, Goeteborg (Sweden); Staahl, Gunnar [Westinghouse Electric Sweden AB, Vaesteraas (Sweden)

    2013-02-15

    The purpose of this report is to describe programs and tools for assessment of accomplished and documented qualification with respect to ageing of electrical equipment and for development of complimentary ageing management programs. In addition to description of complete programs for management of ageing, tools for validation of the status with regard to ageing of installed ('old') equipment and, where needed, for complementation of their qualification are also included. The report is restricted to safety related equipment containing ageing sensitive parts, mainly organic materials. To this category belong cables and cable joints and a number of equipment containing oils, seals (o-rings), etc. For equipment located in the containment, the possibilities of continuous supervision are limited. The accessibility for regular inspections is also limited in many cases. The main part of this report deals with the qualification of such equipment. Some safety related equipment outside the containment can be located in areas where they are subjected to high temperature and other excessive environmental stresses during normal operation and in areas affected by an accident. Therefore, some material is given also on qualification of equipment located outside containment with better possibilities for frequent inspection and supervision. Part 1 of the report is an executive summary with a general review of the methodologies and their application. The more detailed description of the programs and underlying material, useful data, etc. is given in Part 2.

  13. Literature Review of Knowledge Management in Business

    Institute of Scientific and Technical Information of China (English)

    彭艳坤

    2015-01-01

    Knowledge management in Business is mainly about productivity,knowledge worker,knowledge workers’ problems,and the knowledge they are required to do their work.To fulfill productivities,there are five theories to tackle that problem.

  14. Management of radioactive waste: A review

    Directory of Open Access Journals (Sweden)

    Luis Paulo Sant'ana

    2016-06-01

    Full Text Available The issue of disposal of radioactive waste around the world is not solved by now and the principal reason is the lack of an efficient technologic system. The fact that radioactive waste decays of radioactivity with time are the main reasons for setting nuclear or radioactive waste apart from the other common hazardous wastes management. Radioactive waste can be classified according to the state of matter and level of radioactivity and this classification can be differently interpreted from country to country. Furthermore, microbiological procedures, plasma vitrification process, chemical precipitation, ion exchange, evaporation and reverse osmosis are strategies used for the treatment of radioactive wastes. The major challenge is to manage these radioactive substances after being used and discharged. This report brings data from the literature published worldwide from 2009 to 2014 on radioactive waste management studies and it covers production, classification and management of radioactive solid, liquid and gas waste.

  15. Managing and Coding References for Systematic Reviews and Scoping Reviews in EndNote.

    Science.gov (United States)

    Peters, Micah D J

    2017-01-01

    This article describes a novel approach for using EndNote to manage and code references in the conduct and reporting of systematic reviews and scoping reviews. The process is simple and easy for reviewers new to both EndNote and systematic reviews. This process allows reviewers to easily conduct and report systematic reviews in line with the internationally recognized PRISMA reporting guidelines and also facilitates the overall task of systematic or scoping review conduct and reporting from the initial search through to structuring the results, discussion, and conclusions in a rigorous, reproducible, and user-friendly manner.

  16. Development of the regulatory guide on the management of aging for the operating NPP

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Tae Myung; Lee, Jae Kyung; Byeon, Chang Soo; Kim, Hyo Soo [Chungju Univ., Cheongju (Korea, Republic of); Kim, Young Ryul; Eun, Hui Kwang [Korea Advanced Institute of Science and Technology, Taejon (Korea, Republic of)

    2000-03-15

    this is the first final report, and it includes the analysis of PSR regulation status for the operating NPP of foreign countries and thus established scope and method of Korean PSR. The detailed requirements of aging management, as one of the most important factors, is planned to be dealt in the second final report, The result of study so far can be summarized as below, The necessity and feasibility of domestic PSR application is confirmed through the investigation, comparison and review of PSR implementation and regulation status in foreign countries, And, detailed analysis of vaseline guidelines of IAEA performed to establish a skeleton of desirable safety review guideline for Korean NPP. Our own objectives, scope and strategy of review for PWR are roughly set up form factor by factor analysis of PSR implementation experience in foreign countries and background of IAEA guidelines. The essential elements of review for each PSR safety factors are classified and proposed. For efficient review of proposed safety factors and elements, three different option of framework for PSR guidelines are proposed and compared. Through analysis of strength safety factors and elements, three different options of framework for PSR guidelines are proposed and compared. Through analysis of strength and weakness of the three optional frameworks proposed for Korean PSR guideline, the third one is recommended as the best for both owner and regulator. By maintaining the current framework of SAR at maximum and, at the same time, referring the basic concept of IAEA PSR guide, the detailed contents and its review elements are chosen. The standards on the aging was proposed preliminarily for the application of aging evaluation in PSR.

  17. Review of Groundwater Protection and Management in China

    Institute of Scientific and Technical Information of China (English)

    LIU Dan; ZHANG Ai-ping

    2008-01-01

    This review begins with an introduction of groundwater resources in China and their distribution characteristic, followed by an elaboration of the exploitation and utilization of groundwater and the negative environmental effects from groundwater overexploitation, and a description of the existing groundwater protection and management measures. At last, the existing problems in groundwater protection and management, with some suggestions, are presented.

  18. Barriers to Asthma Management for School Nurses: An Integrative Review

    Science.gov (United States)

    Hanley Nadeau, Ellen; Toronto, Coleen E.

    2016-01-01

    Childhood asthma is a growing health concern. Asthma is the most common chronic illness of childhood and a leading cause of emergency room visits, hospitalizations, and school absenteeism. School nurses play a valuable role in asthma management. The purpose of this integrative review is to examine barriers to asthma management for school nurses in…

  19. Conflict Management in Education. ERIC/CEM Research Review.

    Science.gov (United States)

    Piele, Philip K.

    Because conflict has become a pervasive element within the school environment as well as in the larger community, this review, based on reports abstracted in RIE, focuses on conflict management. Such management seeks and uses ways to understand and deal with the differing opinions, needs, and ideas that are a part of the contemporary school. The…

  20. Assessing natural hazards in forestry for risk management: a review

    Science.gov (United States)

    Marc Hanewinkel; Susan Hummel; Axel. Albrecht

    2011-01-01

    We address the problem of how to integrate risk assessment into forest management and therefore provide a comprehensive review of recent and past literature on risk analysis and modeling and, moreover, an evaluation and summary on these papers. We provide a general scheme on how to integrate concepts of risk into forest management decisions. After an overview of the...

  1. Managing postharvest innovation: a review of developments and trends

    NARCIS (Netherlands)

    Batterink, M.H.; Omta, S.W.F.; Wubben, E.F.M.

    2005-01-01

    Purpose of the review: With the fast developments in technologies, combined with increased global competition and changing customer demands, innovation is increasingly seen as a means for sustainable growth. This paper reviews literature on the management of innovation and the most prominent finding

  2. A Review of Literature on Teacher Efficacy and Classroom Management

    Science.gov (United States)

    Dibapile, Waitshega Tefo Smitta

    2012-01-01

    The purpose of this paper was to review the literature on teacher efficacy and classroom management. The conceptual framework of this paper was based on the theories of Rotter (1966) and Bandura (1977). The review of literature indicated that teacher efficacy helps teachers plan effective instructional strategies, increases performance, and…

  3. Managing postharvest innovation: a review of developments and trends

    NARCIS (Netherlands)

    Batterink, M.H.; Omta, S.W.F.; Wubben, E.F.M.

    2005-01-01

    Purpose of the review: With the fast developments in technologies, combined with increased global competition and changing customer demands, innovation is increasingly seen as a means for sustainable growth. This paper reviews literature on the management of innovation and the most prominent

  4. Intellectual Property Management in Organizations. A Review of Recent Literature

    OpenAIRE

    Lis-Gutiérrez, Jenny-Paola

    2013-01-01

    This paper makes a review of the literature on the intellectual property management (IPM) in organizations. The sources of the documentation reviewed are Scopus, Emerald, SciELO and SSRN indexed papers. This exploration includes works published from 2003 given that Hanel (2004) developed a comprehensive review of practices in IPM. This paper analyzes the relationship in the literature among IPM, organizations and Universities, as well as some case studies in the United States, China, Japan, E...

  5. Dental adhesion review: aging and stability of the bonded interface.

    Science.gov (United States)

    Breschi, Lorenzo; Mazzoni, Annalisa; Ruggeri, Alessandra; Cadenaro, Milena; Di Lenarda, Roberto; De Stefano Dorigo, Elettra

    2008-01-01

    Most of current dental adhesive systems show favorable immediate results in terms of retention and sealing of bonded interface, thereby counteracting polymerization shrinkage that affects resin-based restorative materials. Despite immediate efficacy, there are major concerns when dentin bonded interfaces are tested after aging even for short time period, i.e. 6 months. This study critically discusses the latest peer-reviewed reports related to formation, aging and stability of resin bonding, focusing on the micro and nano-phenomena related to adhesive interface degradation. Most simplified one-step adhesives were shown to be the least durable, while three-step etch-and-rinse and two-step self-etch adhesives continue to show the highest performances, as reported in the overwhelming majority of studies. In other words, a simplification of clinical application procedures is done to the detriment of bonding efficacy. Among the different aging phenomena occurring at the dentin bonded interfaces, some are considered pivotal in degrading the hybrid layer, particularly if simplified adhesives are used. Insufficient resin impregnation of dentin, high permeability of the bonded interface, sub-optimal polymerization, phase separation and activation of endogenous collagenolytic enzymes are some of the recently reported factors that reduce the longevity of the bonded interface. In order to overcome these problems, recent studies indicated that (1) resin impregnation techniques should be improved, particularly for two-step etch-and-rinse adhesives; (2) the use of conventional multi-step adhesives is recommended, since they involve the use of a hydrophobic coating of nonsolvated resin; (3) extended curing time should be considered to reduce permeability and allow a better polymerization of the adhesive film; (4) proteases inhibitors as additional primer should be used to increase the stability of the collagens fibrils within the hybrid layer inhibiting the intrinsic

  6. Surgical management of abnormal uterine bleeding in fertile age women.

    Science.gov (United States)

    Finco, Andrea; Centini, Gabriele; Lazzeri, Lucia; Zupi, Errico

    2015-07-01

    Abnormal uterine bleeding is a common gynecological disease and represents one of the most frequent reasons for hospital admission to a specialist unit, often requiring further surgical treatment. Following the so-called PALM-COEIN system we will attempt to further clarify the surgical treatments available today. The first group (PALM) is characterized by structural lesions, which may be more appropriately treated by means of surgical management. Although hysterectomy remains the definitive and decisive choice, there are many alternative techniques available. These minimally invasive procedures offer the opportunity for a more conservative approach. Precise and accurate counseling facilitates better patient selection, based on the patient's desires, age and disease type, allowing treatment to be individually tailored to each woman.

  7. Management of systemic sclerosis--a review.

    Science.gov (United States)

    Ng, S C; Clements, P J; Paulus, H E

    1990-06-01

    Establishing a correct diagnosis is the first step in the management of this condition. The ARA (American Rheumatism Association) diagnostic criteria is a useful guideline. Next, a multisystem evaluation is needed to define the extent of visceral involvement. Patient education is important to enable them to understand and participate in the management of their disease. Skin care and protection from trauma and cold and physiotherapy to retard contractures are taught. Raynaud's phenomenon may be helped by topical nitrates, ketanserin, nifedipine and vasodilatory prostaglandins. D-penicillamine may be tried for patients with generalised scleroderma of less than 3 years' duration. Colchicine may help but other drugs like N-acetylcysteine and chlorambucil have tested and found ineffective. Cyclosporin seems promising. Finally, all visceral complications should be managed accordingly.

  8. A review of community management of paediatric burns.

    Science.gov (United States)

    Cox, S G; Martinez, R; Glick, A; Numanoglu, A; Rode, H

    2015-12-01

    This study was a component of a broader review to evaluate burn care in South Africa. A prospective audit of 353 children with thermal injuries admitted to the Red Cross War Memorial Children's Hospital in Cape Town was performed during 2012/2013. The audit was based to assess the adherence of initial burn management to the provincial policy guidelines on the clinical management of the burn wound. The community management of each patient prior to admission to a burns centre was assessed for the following: basic demographics, emergency home management, wound cover, analgesia and transport to medical facilities. Their ages ranged from 1 month to 14 years. The average total body surface area [TBSA] was 15% [1-86%]. Most of the injuries were due to hot water accidents [78.5%] followed by flame burns (9%), direct contact and electricity burns. Two hundred and twenty five children [63%] received first aid measures at home, including cooling with water [166] ice [30] and a cooling agent. No cooling was instituted in 130 and 65% of the patient's wounds were cooled for 10 min or less. Eighty percent proceeded to the referral centre or burns unit without their wounds being covered; with only 19 patients having any medical type of dressing available at home. Two hundred and ninety five children [83.6%] received pain medication prior to admission at the burns unit. Of the 316 patients not directly attending the burns unit, 137 received i.v. fluids of which 95 had burns greater than 10% TBSA. None of the patients were in shock on admission and all i.v. lines were functioning. Forty-four children with burns greater than 10% did not receive i.v. fluids. The audit identified six factors that were inadequately addressed during the pre-admission period: first aid, cooling of the wound, early covering of the wound, resuscitation, pain management and transfer. If these could be readdressed, basic burn care would be substantially improved in the study area.

  9. Managing Preventive Maintenance, In-Service Inspection, Ageing Management within a Production Environment

    Energy Technology Data Exchange (ETDEWEB)

    Tillwick, D.L.; Bruyn, J.F. du; D' Arcy, A.J., E-mail: koos.dubruyn@necsa.co.z [SAFARI-1 Research Reactor, Necsa, PO Box 582 Pretoria (South Africa)

    2011-07-01

    SAFARI-1, the Nuclear Research Reactor located at Pelindaba, South Africa, has to meet a multitude of requirements relating to corporate policies and strategies, preventative maintenance, in-service inspection, plant ageing management, quality management, conventional and radiological safety, regulatory compliance; and security, commercial and financial goals which need to be incorporated into an integrated management system. The control of these various requirements and activities within the nuclear research reactor organisation becomes quite complex if the processes and systems are to be integrated maintained and at the same time managed so as to achieve the objectives and targets within the resources available. Plant maintenance is one aspect which became a challenge over the last decade to implement and optimize. This has been evidenced by the shorter reactor shut downs which are carefully planned to maintain operational schedules required for production and other interested parties. Although SAFARI-1 maintains ISO 9001 and ISO 14001 certification, its present commercial and operational schedules need a very well coordinated management system to achieve all stakeholder requirements and still function within the design and safety requirements. In order for SAFARI-1 to maintain an exceptionally high operational level of more than 300 full power days per year, the planning, implementation and coordination of routine maintenance, in-service inspection, and projects related to upgrades and ageing management need to be well structured and controlled. The effective and efficient implementation of such a management system will ultimately ensure the success of the reactor in the competitive environment. This becomes particularly relevant where the development and the responsibility of implementation of systems and processes lie not only within the SAFARI-1 organization but also within various other departments in the parent South African Nuclear Energy Corporation

  10. Digital Natives Coming of Age: Challenges for Managers

    Directory of Open Access Journals (Sweden)

    Andreea MITAN

    2014-10-01

    Full Text Available Youth unemployment is currently a stringent problem in many European countries. Most of the time, both the public opinion and the national and European institutions blame the economic crisis, the social conditioning of these youngsters, and point to the failure of the educational systems to provide them with the necessary qualifications needed on the market. There are a few initiatives, such as the Youth Guarantee launched in 2013, led by European public authorities in order to reduce this phenomenon, but these initiatives address solely the professional proficiency of the youngsters. And most authorities perceive them as citizens who need to be trained to fit with the existing working environments. The situation is, in fact, more complex, as todays youngsters are different from the previous generations in terms of the values they share and the basic way they process information. When speaking of the youth, the high unemployment rate due to system imbalance between people training and work fields’ requirements are just one side of the coin. The other side speaks about the impact digital technology has upon young people, favouring the emergence of the so called digital natives, and about the fact that the working environment in itself has to incorporate changes in order to accommodate these youngsters and fully benefit from their capabilities.     As Romanian digital natives come of age, minimizing the mind gap between elder managers and younger employees and candidates becomes an important issue that companies increasingly have to deal with. This article explores the digital natives’ expectations from their managers and from the companies they aim to work for, based upon a survey conducted in four universities in Bucharest. We propose a series of recommendations for managers who work closely with digital natives, in order to improve the work environment and create the premises for better job performance in their teams, possibly reducing

  11. Insomnia management for ageing employees with job stress

    Directory of Open Access Journals (Sweden)

    Roja I.

    2014-01-01

    Full Text Available In Latvia, the number of aging employees suffering from sleep disorders caused by job stress and poor sleep hygiene is increasing. The non-pharmacologic and pharmacologic treatment is prescribed for these employees in the sleep management. The aim of this research is to clarify the efficiency of using psychotherapy with learning and observing sleep hygiene, combined with the melatonergic drug during a six-week treatment course applied to 25 both male and female intellectual workers over 65 years suffering from insomnia caused by job stress. For the patients representing Group “A” cognitive hypnotherapy, intervention for improving coping with job stress and usage of the melatonergic drug was prescribed, while Group “B” patients received six weeks only drug. The severity of depressive episodes in employees was measured by Montgomery- Åsberg Depression Rating Scale, the level of anxiety was assessed by use Rosenberg Self-Esteem Scale. The results of the research show that insomnia patterns disappeared for 75% of women and 80% of men employees in Group A, but in Group B individuals, – only for 20% of women employees. The results acquired let concluding that the six-week treatment – cognitive hypnotherapy combined with melatonergic drug – is an effective treatment for aging workers suffering from sleep disorders.

  12. Review of the management of pneumocephalus

    Directory of Open Access Journals (Sweden)

    Carlos B Dabdoub

    2015-01-01

    Conclusion: The review of the literature, we did not find any cases of tension pneumocephalus documented previously through a supraorbital keyhole approach. There are a few cases reported of patients with Mount Fuji signs that do not require surgical procedures. The conservative treatment in our report leads to clinical and radiological improvement as well as a reduction in hospitalization time.

  13. Innovations in data collection, management, and archiving for systematic reviews.

    Science.gov (United States)

    Li, Tianjing; Vedula, S Swaroop; Hadar, Nira; Parkin, Christopher; Lau, Joseph; Dickersin, Kay

    2015-02-17

    Data abstraction is a key step in conducting systematic reviews because data collected from study reports form the basis of appropriate conclusions. Recent methodological standards and expectations highlight several principles for data collection. To support implementation of these standards, this article provides a step-by-step tutorial for selecting data collection tools; constructing data collection forms; and abstracting, managing, and archiving data for systematic reviews. Examples are drawn from recent experience using the Systematic Review Data Repository for data collection and management. If it is done well, data collection for systematic reviews only needs to be done by 1 team and placed into a publicly accessible database for future use. Technological innovations, such as the Systematic Review Data Repository, will contribute to finding trustworthy answers for many health and health care questions.

  14. Linking an agency strategic review to increase knowledge management: San Francisco County Human Service Agency.

    Science.gov (United States)

    Harrison, Lindsay

    2012-01-01

    Led by the agency director, the agency engaged in a Strategic Review, based on a comprehensive assessment of agency performance that identified strategies to improve organizational effectiveness through increased data-informed practice and knowledge management. The Strategic Review gathered information on staff perceptions, perceptions of external stakeholders, changing citywide and neighborhood demographics, policy mandates, and budget and workload issues. The need for the review was based upon multiple, substantial changes not addressed in the 2000 Strategic Plan, including the 2004 merger of the Department of Human Services and the Department of Aging and Adult Services, changes among the executive management team, transitions among key political entities, new policy mandates and changing budget allocations. This case study describes the Strategic Review process and content, summarizing key challenges and lessons related to addressing workload demands, fostering positive staff attitudes, balancing internal and external information needs, and integrating data use and planning processes across the agency. Copyright © Taylor & Francis Group, LLC

  15. Perioperative Management of Diabetes: A Review

    Directory of Open Access Journals (Sweden)

    Md Nazmul Kayes

    2014-07-01

    Full Text Available Diabetes increases the requirements of surgery as well as perioperative morbidity and mortality. Careful preoperative evaluation and treatment of cardiac and renal diseases, intensive intraoperative and postoperative management are essential to optimize the best outcome. Stress hyperglycemia in response to surgery, osmotic diuresis and hypoinsulinemia can lead to life threatening complications like ketoacidosis or hyperglycemic hyperosmolar syndrome. Wound healing is impaired by hyperglycemia and chance of postoperative wound infection is more in diabetics. Therefore aseptic precautions must be taken. Adequate insulin, glucose, fluid and electrolytes should be provided for good metabolic control. Though some current study reveals that oral hypoglycemic agents can be used for the effective management of perioperative diabetes; the adverse effects of newly introduced agents need more clinical observations. Subcutaneous administration of insulin as in Sliding Scale may be a less preferable method, because of unreliable absorption and unpredictable blood glucose. Intravenous administration of rapid onset soluble (short acting insulin as in Alberti (GIK regimen, is safe and effective method controlling perioperative hyperglycemia. Patient with type 1 diabetes needs frequent monitoring of glucose, electrolytes and acid-base balance as chance of high hyperglycemia and ketoacidosis is more. In case of emergency surgery assessment for diabetic ketoacidosis (DKA and meticulous management is essential. Postoperative pain and hyperglycemia should be treated carefully to avoid complications.

  16. Healthcare in the age of open innovation - A literature review.

    Science.gov (United States)

    Wass, Sofie; Vimarlund, Vivian

    2016-12-01

    In spite of an increased interest in open innovation and strategies that call for an increased collaboration between different healthcare actors, there is a lack of open innovation research in public contexts. This article presents the results of a review regarding the healthcare sector's engagement in open innovation as well as constraining factors and positive outcomes of open innovation in healthcare. The literature search focused on papers published in English between 2003 and 2014. Based on specified inclusion criteria, 18 articles were included. Results reveal that most studies focus on inbound open innovation where external knowledge is integrated with the internal knowledge base at an initial phase of the innovation process. Innovation primarily results in products and services through innovation networks. We also identified constraining factors for open innovation in healthcare, including the complex organizations of healthcare, the need to establish routines for capturing knowledge from patients and clinicians, regulations and healthcare data laws as well as the positive outcome patient empowerment. The healthcare sector's engagement in open innovation is limited, and it is necessary to perform further research with a focus on how open innovation can be managed in healthcare. © The Author(s) 2016.

  17. Genetics and age-related macular degeneration: a practical review for the clinician

    Directory of Open Access Journals (Sweden)

    Schwartz SG

    2016-07-01

    Full Text Available Stephen G Schwartz,1 Blake M Hampton,1 Jaclyn L Kovach,1 Milam A Brantley Jr2 1Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, FL, USA; 2Department of Ophthalmology, Vanderbilt Eye Institute, Vanderbilt University Medical Center, Nashville, TN, USA Abstract: Age-related macular degeneration is a complex disease, with both genetic and environmental risk factors interacting in unknown ways. Currently, 52 gene variants within 34 loci have been significantly associated with age-related macular degeneration. Two well-studied major genes are complement factor H (CFH and age-related maculopathy susceptibility 2 (ARMS2. There exist several commercially available tests that are proposed to stratify patients into high-risk and low-risk groups, as well as predict response to nutritional supplementation. However, at present, the bulk of the available peer-reviewed evidence suggests that genetic testing is more useful as a research tool than for clinical management of patients. Keywords: age-related macular degeneration, age-related maculopathy susceptibility 2, ARMS2, complement factor H, CFH, pharmacogenetics, vascular endothelial growth factor

  18. Managing and mitigating conflict in healthcare teams: an integrative review.

    Science.gov (United States)

    Almost, Joan; Wolff, Angela C; Stewart-Pyne, Althea; McCormick, Loretta G; Strachan, Diane; D'Souza, Christine

    2016-07-01

    To review empirical studies examining antecedents (sources, causes, predictors) in the management and mitigation of interpersonal conflict. Providing quality care requires positive, collaborative working relationships among healthcare team members. In today's increasingly stress-laden work environments, such relationships can be threatened by interpersonal conflict. Identifying the underlying causes of conflict and choice of conflict management style will help practitioners, leaders and managers build an organizational culture that fosters collegiality and create the best possible environment to engage in effective conflict management. Integrative literature review. CINAHL, MEDLINE, PsycINFO, Proquest ABI/Inform, Cochrane Library and Joanne Briggs Institute Library were searched for empirical studies published between 2002-May 2014. The review was informed by the approach of Whittemore and Knafl. Findings were extracted, critically examined and grouped into themes. Forty-four papers met the inclusion criteria. Several antecedents influence conflict and choice of conflict management style including individual characteristics, contextual factors and interpersonal conditions. Sources most frequently identified include lack of emotional intelligence, certain personality traits, poor work environment, role ambiguity, lack of support and poor communication. Very few published interventions were found. By synthesizing the knowledge and identifying antecedents, this review offers evidence to support recommendations on managing and mitigating conflict. As inevitable as conflict is, it is the responsibility of everyone to increase their own awareness, accountability and active participation in understanding conflict and minimizing it. Future research should investigate the testing of interventions to minimize these antecedents and, subsequently, reduce conflict. © 2016 John Wiley & Sons Ltd.

  19. Ageing, mate preferences and sexuality: a mini-review.

    Science.gov (United States)

    Oberzaucher, Elisabeth; Grammer, Karl

    2009-01-01

    The evolutionary constraints that lead to the evolution of sexual reproduction are framed by the better repair mechanisms that repair fatal mutations, as well as the need for variable immune systems imposed on large organisms by parasites, such as viruses and bacteria. Besides the evolution of sexual reproduction, these factors also affect mate choice, especially as regards the gene complex that encodes the immune system. The need to increase both the likelihood of gametes to encounter each other as well as sufficient provision of nutrition for the offspring then leads to the evolution of two sexes: large numbers of small mobile sperms ensure that gametes meet, whereas large egg cells full of energy provide for the zygote, thus leading to a developmental advantage. The asymmetric investment in the offspring then affects not only mate choice criteria, but also cognitive strategies. Men place more importance on youthfulness and fertility than women, who regard resource holding potential as a more relevant criterion. Consequently, female jealousy is connected to endangered access to resources, whereas male jealousy is rooted in paternal uncertainty. Cognitive adaptations developed to ensure reproductive success show sex differences, such as in error management. The most obvious function of sexual behavior is reproduction. To foster the benefits for the offspring, reproduction partners should also develop an emotional bond, which is mediated by hormones connected to sexual intercourse. With increasing age, reproduction loses importance, while pair bonding functions remain relevant. Therefore, sexuality never ceases to be part of a relationship. Copyright 2009 S. Karger AG, Basel.

  20. Nongenetic Determinants of Age at Menarche: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Anna Yermachenko

    2014-01-01

    Full Text Available Background. The acceleration of pubertal development is an important medical and social problem, as it may result in increased morbidity and mortality in later life. This systematic review summarizes relevant data about nongenetic factors, which contribute to age at menarche (AAM, and suggests those which may be the most important. Methods. The available literature from 1980 till July 2013 was searched using PubMed and Google Scholar databases. Finally, 154 papers were selected for the analysis. Results. Environmental factors, which may affect AAM, vary in populations of different ethnicity. The prenatal, infancy, and early childhood periods are the most susceptible to these factors. Body weight, high animal protein intake, family stressors (e.g., single parenting, and physical activity seem to influence AAM in most populations. Conclusions. The data about influence of nongenetic factors on AAM are still inconsistent. The factors affecting prenatal and early childhood growth seem to have a larger effect on further sexual maturation. Further studies are needed in order to validate the association between other environmental determinants and AAM in different ethnical groups.

  1. Kaposi sarcoma: review and medical management update.

    Science.gov (United States)

    Fatahzadeh, Mahnaz

    2012-01-01

    Despite recent advances in our understanding of pathogenic mechanisms involved, the true nature of Kaposi sarcoma remains an enigma. Four clinical variants have been described for the disease, differing in natural history, site of predilection, and prognosis. All forms of Kaposi sarcoma may manifest in the oral cavity and Kaposi sarcoma-associated virus appears essential to development of all clinical variants. The spectrum of therapeutic strategies is broad and selection of appropriate intervention mandates a thorough understanding of disease spread and the patient's symptomatology, as well as risks and benefits of therapy. This article provides an overview of epidemiology, subtypes, clinical course, pathogenesis, and management strategies for Kaposi sarcoma.

  2. Managing and reviewing evidence-based changes.

    Science.gov (United States)

    Carter, Helen; Price, Lynda

    Nurses lead many projects to manage change aimed at improving patient safety and care. This two-part series offers practical guidance on how to bring about an evidence-based change in practice, and how to demonstrate the success, or otherwise, of that change. Part 2 is concerned with discovering why the practice is falling short, how to implement improvements and measure the effect of the changes. It also highlights ways in which nurses can use their work as part of the revalidation process.

  3. 76 FR 74831 - Aging Management of Stainless Steel Structures and Components in Treated Borated Water

    Science.gov (United States)

    2011-12-01

    ... COMMISSION Aging Management of Stainless Steel Structures and Components in Treated Borated Water AGENCY...- ISG-2011-01, ``Aging Management of Stainless Steel Structures and Components in Treated Borated Water... management of stainless steel structures and components exposed to treated borated water. In response to...

  4. 77 FR 23513 - Updated Aging Management Criteria for Reactor Vessel Internal Components of Pressurized Water...

    Science.gov (United States)

    2012-04-19

    ... COMMISSION Updated Aging Management Criteria for Reactor Vessel Internal Components of Pressurized Water... Management Criteria for PWR Reactor Vessel Internal Components.'' The original notice provided the ADAMS... published a notice requesting public comments on draft LR-ISG-2011-04, ``Updated Aging Management...

  5. Surgical management of moyamoya disease: a review.

    Science.gov (United States)

    Baaj, Ali A; Agazzi, Siviero; Sayed, Zafar A; Toledo, Maria; Spetzler, Robert F; van Loveren, Harry

    2009-04-01

    Moyamoya disease (MMD) is a progressive, occlusive disease of the distal internal carotid arteries associated with secondary stenosis of the circle of Willis. Symptoms include ischemic infarcts in children and hemorrhages in adults. Bypass of the stenotic vessel(s) is the primary surgical treatment modality for MMD. Superficial temporal artery-to-middle cerebral artery bypass is the most common direct bypass method. Indirect techniques rely on the approximation of vascularized tissue to the cerebral cortex to promote neoangiogenesis. This tissue may be in the form of muscle, pericranium, dura, or even omentum. This review highlights the surgical options available for the treatment of MMD.

  6. Management and leadership competence in hospitals: a systematic literature review.

    Science.gov (United States)

    Pihlainen, Vuokko; Kivinen, Tuula; Lammintakanen, Johanna

    2016-01-01

    Purpose - The purpose of this study is to describe the characteristics of management and leadership competence of health-care leaders and managers, especially in the hospital environment. Health-care leaders and managers in this study were both nursing and physician managers. Competence was assessed by evaluating the knowledge, skills, attitudes and abilities that enable management and leadership tasks. Design/methodology/approach - A systematic literature review was performed to find articles that identify and describe the characteristics of management and leadership competence. Searches of electronic databases were conducted using set criteria for article selection. Altogether, 13 papers underwent an inductive content analysis. Findings - The characteristics of management and leadership competence were categorized into the following groups: health-care-context-related, operational and general. Research limitations/implications - One limitation of the study is that only 13 articles were found in the literature regarding the characteristics of management and leadership competence. However, the search terms were relevant, and the search process was endorsed by an information specialist. The study findings imply the need to shift away from the individual approach to leadership and management competence. Management and leadership need to be assessed more frequently from a holistic perspective, and not merely on the basis of position in the organizational hierarchy or of profession in health care. Originality/value - The authors' evaluation of the characteristics of management and leadership competence without a concentrated profession-based approach is original.

  7. Qualification of Electrical Components in Nuclear Power Plants. Management of Ageing

    Energy Technology Data Exchange (ETDEWEB)

    Spaang, Kjell [Ingemansson Technology AB, Goeteborg (Sweden); Staahl, Gunnar [Westinghouse Atom, Vaesteraas (Sweden)

    2002-05-01

    This report reviews R and D results and experiences forming the bases for the preparation of a report on management of ageing. It includes basic information and descriptions of value for persons who work with the questions and some data from investigations of the ageing characteristics of various materials: limit levels, dose-rate effects, activation energies, methods for condition monitoring, etc. This report is restricted to safety related components containing ageing sensitive parts, mainly organic materials (polymers). For components located in the containment, the possibilities of continuous supervision are limited. The accessibility for regular inspections is also limited in many cases. Therefore, the main part of this report deals with the qualification of such components. In addition, some material is given on qualification located outside containment with better possibilities for frequent inspection and supervision. A survey is made of activities, programs and tools for ageing qualification in connection with initial environmental qualification (type testing) as well as after installation (condition monitoring, extension of qualified life through on-going qualification). Tools are also given for supplementary ageing qualification of already installed components.

  8. Knowledge management for efficient quantitative analyses during regulatory reviews.

    Science.gov (United States)

    Krudys, Kevin; Li, Fang; Florian, Jeffry; Tornoe, Christoffer; Chen, Ying; Bhattaram, Atul; Jadhav, Pravin; Neal, Lauren; Wang, Yaning; Gobburu, Joga; Lee, Peter I D

    2011-11-01

    Knowledge management comprises the strategies and methods employed to generate and leverage knowledge within an organization. This report outlines the activities within the Division of Pharmacometrics at the US FDA to effectively manage knowledge with the ultimate goal of improving drug development and advancing public health. The infrastructure required for pharmacometric knowledge management includes provisions for data standards, queryable databases, libraries of modeling tools, archiving of analysis results and reporting templates for effective communication. Two examples of knowledge management systems developed within the Division of Pharmacometrics are used to illustrate these principles. The benefits of sound knowledge management include increased productivity, allowing reviewers to focus on research questions spanning new drug applications, such as improved trial design and biomarker development. The future of knowledge management depends on the collaboration between the FDA and industry to implement data and model standards to enhance sharing and dissemination of knowledge.

  9. Examining End-of-Life Case Management: Systematic Review

    Directory of Open Access Journals (Sweden)

    Roger E. Thomas

    2014-01-01

    Full Text Available Case management was initiated in the 1970s to reduce care discontinuity. A literature review focused on end-of-life (EOL case management identified 17 research articles, with content analysis revealing two themes: (a seeking to determine or establish the value of EOL case management and (b identifying ways to improve EOL case management. The evidence, although limited, suggests that EOL case management is helpful to dying individuals and their families. Research is needed to more clearly illustrate its usefulness or outcomes and the extent of need for it and actual availability. Among other benefits, EOL case management may help reduce hospital utilization, a major concern with the high cost of hospital-based care and the increased desire for home-based EOL care.

  10. Solutions in radiology services management: a literature review*

    Science.gov (United States)

    Pereira, Aline Garcia; Vergara, Lizandra Garcia Lupi; Merino, Eugenio Andrés Díaz; Wagner, Adriano

    2015-01-01

    Objective The present study was aimed at reviewing the literature to identify solutions for problems observed in radiology services. Materials and Methods Basic, qualitative, exploratory literature review at Scopus and SciELO databases, utilizing the Mendeley and Illustrator CC Adobe softwares. Results In the databases, 565 papers – 120 out of them, pdf free – were identified. Problems observed in the radiology sector are related to procedures scheduling, humanization, lack of training, poor knowledge and use of management techniques, and interaction with users. The design management provides the services with interesting solutions such as Benchmarking, CRM, Lean Approach, ServiceBlueprinting, continued education, among others. Conclusion Literature review is an important tool to identify problems and respective solutions. However, considering the small number of studies approaching management of radiology services, this is a great field of research for the development of deeper studies. PMID:26543281

  11. Applied simulation to the project management: a review

    Directory of Open Access Journals (Sweden)

    Leonardo Rosas Leal

    2011-05-01

    Full Text Available The objective of this article is to show a literature review of Applied Simulation to the Project Management as for the last twenty years. This article reviews the main Simulation methodologies, as well as some of their properties, that have stimulated the application of Simulation in project management. Besides that, a review of historical marks is presented, since the Monte Carlo Simulation proposal as a solution to PERT/CPM methodology limitations. In addition, this work intends to outline the theme through stratifications in order to offer a holistic overview of the theme. As a result, there will be the possibility of realize some important connections and tendencies in relation to the stratifications, as the application of the Discrete Event Simulation and Monte Carlo Simulation methodologies for the schedule and cost risk management. Such applications are mainly related with high level risk projects, such as civil projects, software development, design Engineering and Oil & gas projects.

  12. Solutions in radiology services management: a literature review

    Directory of Open Access Journals (Sweden)

    Aline Garcia Pereira

    2015-10-01

    Full Text Available AbstractObjective:The present study was aimed at reviewing the literature to identify solutions for problems observed in radiology services.Materials and Methods:Basic, qualitative, exploratory literature review at Scopus and SciELO databases, utilizing the Mendeley and Illustrator CC Adobe softwares.Results:In the databases, 565 papers – 120 out of them, pdf free – were identified. Problems observed in the radiology sector are related to procedures scheduling, humanization, lack of training, poor knowledge and use of management techniques, and interaction with users. The design management provides the services with interesting solutions such as Benchmarking, CRM, Lean Approach, ServiceBlueprinting, continued education, among others.Conclusion:Literature review is an important tool to identify problems and respective solutions. However, considering the small number of studies approaching management of radiology services, this is a great field of research for the development of deeper studies.

  13. Solutions in radiology services management: a literature review.

    Science.gov (United States)

    Pereira, Aline Garcia; Vergara, Lizandra Garcia Lupi; Merino, Eugenio Andrés Díaz; Wagner, Adriano

    2015-01-01

    The present study was aimed at reviewing the literature to identify solutions for problems observed in radiology services. Basic, qualitative, exploratory literature review at Scopus and SciELO databases, utilizing the Mendeley and Illustrator CC Adobe softwares. In the databases, 565 papers - 120 out of them, pdf free - were identified. Problems observed in the radiology sector are related to procedures scheduling, humanization, lack of training, poor knowledge and use of management techniques, and interaction with users. The design management provides the services with interesting solutions such as Benchmarking, CRM, Lean Approach, ServiceBlueprinting, continued education, among others. Literature review is an important tool to identify problems and respective solutions. However, considering the small number of studies approaching management of radiology services, this is a great field of research for the development of deeper studies.

  14. DIABETIC WOUND HEALING MANAGEMENT- A PEER REVIEW

    Directory of Open Access Journals (Sweden)

    Harshavardhan Pathapati

    2014-10-01

    Full Text Available Objectives: Diabetes is a metabolic disorder mainly impairs the body glucose utilization capacity due to this perforcely repressing the immuno-dysfunction (decreases chemotaxis, phagocytosis and intracellular killing actions and collagen synthesis which are essential in wound debridement management of diabetic patients. Delayed wound healing is considered as one of the most repulsive disabling and costly complication of diabetes. People with diabetes have extenuated circulation, poor resistance to infection and mitigate local nutrition, thus their wounds are meticulously susceptible to infection. Moreover diabetes agonizes the equilibrium exists between accumulation of extra-cellular matrix components and their re-modeling by matrix metallo-proteinases (meltrin, due to this extenuated proliferation action of fibroblasts and finally freezes the progress of wound healing frequency in hyper glycemics. However in diabetic persons the nervous system becomes numb and all feasible actions of neurons are skipped, that condition is called as diabetic neuropathy. In that situation patient body features elevated a glucose level which stiffens the arteries and lack of pain sensation in foot resulting in commencement of new wounds. Conclusion: Consider all problems associated with wound healing in diabetic persons, a proper wound healing management which includes controlling measures like optimized systemic and local factors as well as implement suitable wound dressing for necessary wound in diabeties patients.

  15. Medication and finance management among HIV-infected adults: the impact of age and cognition.

    Science.gov (United States)

    Thames, April D; Kim, Michelle S; Becker, Brian W; Foley, Jessica M; Hines, Lindsay J; Singer, Elyse J; Heaton, Robert K; Castellon, Steven A; Hinkin, Charles H

    2011-02-01

    This study examined the effects of aging and cognitive impairment on medication and finance management in an HIV sample. We observed main effects of age (older finance management. The interaction of advancing age and cognitive impairment may confer significant functional limitations for HIV individuals that may be better detected by performance-based measures of functional abilities rather than patient self-report.

  16. Epidemiology and management of head injury in paediatric age group in North-Eastern Nigeria

    Directory of Open Access Journals (Sweden)

    J Y Chinda

    2013-01-01

    Full Text Available Background: Paediatric head injury (HI is the single most common cause of death and permanent disability in children world over, and this is increasingly becoming worrisome in our society because of increased risks and proneness to road traffic accidents on our highways and streets. The study set to determine causes and management of HI among children in our society. Patients and Methods: A retrospective review of all children aged 0-15 years with traumatic head injury (THIs who were managed at the University of Maiduguri Teaching Hospital between July, 2006 and August, 2008. Results: A total of 45 children with THIs presented to the casualty unit of the hospital; 30 (66.7% were boys and 15 (33.3% were girls. Three (6.7% children were less than 1 year of age, 21 (46.7% were between 1 years and 6 years while 16 (35.6% and 5 (11.0% were aged 7-11 years and 12-15 years respectively. Thirty six (80.0% of the children were pedestrians, 6 (13.4% fell from a height, while 2 (4.4% and 1 (2.2% were as a result of home accident and assault, respectively. Twenty one patients (46.7% had mild HI, while 53.3% had moderate to severe category. Forty one (91.1% of children were managed as in-patients, mostly (95.1% by conservative non-operative management, while 4 (8.9% were treated on the out-patient basis. The mortality rate was 17.8%. Conclusion: H1 among children is of a great concern, because of its incremental magnitude, due to increasing child labour and interstate religious discipleship among children, with attendant high mortality and permanent disabilities. Necessary laws and legislations should be formulated and implemented with organized campaigns and public enlightenment to prevent and mitigate this menace.

  17. 77 FR 60177 - Senior Executive Service; Financial Management Service Performance Review Board (PRB)

    Science.gov (United States)

    2012-10-02

    ... Senior Executive Service; Financial Management Service Performance Review Board (PRB) AGENCY: Financial Management Service, Treasury. ACTION: Notice. SUMMARY: This notice announces the appointment of members to the Financial Management Service (FMS) Performance Review Board (PRB). DATES: This notice is...

  18. 75 FR 54445 - Senior Executive Service; Financial Management Service Performance Review Board (PRB)

    Science.gov (United States)

    2010-09-07

    ... Fiscal Service Senior Executive Service; Financial Management Service Performance Review Board (PRB) AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice. SUMMARY: This notice announces the appointment of members to the Financial Management Service (FMS) Performance Review Board...

  19. Process innovation in tourism management: A review of the literature

    Directory of Open Access Journals (Sweden)

    Irma Elia Damian

    2015-06-01

    Full Text Available Purpose: Identifying gaps in the academic literature regarding three great management topics: Process Innovation, Tourism Management and Process Innovation in Tourism Management in order to establish the conceptual framework and identify future lines of research. Design/methodology: For this research, a systematic review was conducted on items obtained from accredited databases recognized as EBSCO, OECD, among others, the literature on Process Innovation, Tourism Management and Process Innovation in Tourism Management. Findings: As a result of this review the opportunity for academic research was identified, this due to a theoretical gap which exists on the subject of Process Innovation in Tourism Management. Research limitations/implications: For the realization of this research the databases used were: EBSCO, Emerald, OECD, ProQuest and Scientific Research. The authors are aware that there may be other papers of the subject that were not considered in this article. Practical implications: Following this research the road to research other issues is opened, such as: what impact does it have and how do Process Innovations in Tourism Management are carried along in organizations belonging to Sector Originality/value: The knowledge of how process innovation in tourism management occurs in hospitality organizations gives a better understanding and comprehension of this subjects opening the possibility, for other organizations, of adopting and adapting them in areas related to customer satisfaction, improvement of the image of the organization and quality of the service offered.

  20. Huntington's disease: review and anesthetic case management.

    Science.gov (United States)

    Cangemi, C F; Miller, R J

    1998-01-01

    Huntington's disease is a dominantly inherited progressive autosomal disease that affects the basal ganglia. Symptoms appear later in life and manifest as progressive mental deterioration and involuntary choreiform movements. Patients with Huntington's disease develop a progressive but variable dementia. Dysphagia, the most significant related motor symptom, hinders nutrition intake and places the patient at risk for aspiration. The combination of involuntary choreoathetoid movements, depression, and apathy leads to cachexia. Factors of considerable concern to the anesthesiologist who treats patients with Huntington's disease may include how to treat frail elderly people incapable of cooperation, how to treat patients suffering from malnourishment, and how to treat patients with an increased risk for aspiration or exaggerated responses to sodium thiopental and succinylcholine. The successful anesthetic management of a 65-yr-old woman with Huntington's disease who presented for full-mouth extractions is described.

  1. REVIEW OF TOTAL QUALITY MANAGEMENT CONCEPT

    Directory of Open Access Journals (Sweden)

    Daniel Indarto Prajogo

    1999-01-01

    Full Text Available The definition of TQM continues to be a debated issue to organizational management. Not only is there an absence of a uniform definition but also there is no prescriptive standard outlining TQM concepts. This supports an argument that TQM is not merely a tool or method that is ready for use, but there is a set of underlying principles, philosophies and paradigms that must be applied in the unique organizational context. This paper will discuss the concept of TQM at three integrated levels in an organization from inside out; namely paradigm level, system and structural level and technical and operational level in the purpose for helping organizations to grasp the comprehensive substance of TQM.

  2. Cloud Infrastructure Service Management - A Review

    Directory of Open Access Journals (Sweden)

    A. Anasuya Threse Innocent

    2012-03-01

    Full Text Available The new era of computing called Cloud Computing allows the user to access the cloud services dynamically over the Internet wherever and whenever needed. Cloud consists of data and resources; and the cloud services include the delivery of software, infrastructure, applications, and storage over the Internet based on user demand through Internet. In short, cloud computing is a business and economic model allowing the users to utilize high-end computing and storage virtually with minimal infrastructure on their end. Cloud has three service models namely, Cloud Software-as-a-Service (SaaS, Cloud Platform-as-a-Service (PaaS, and Cloud Infrastructure-as-a-Service (IaaS. This paper talks in depth of cloud infrastructure service management.

  3. Inventory management strategies that reduce the age of red blood cell components at the time of transfusion.

    Science.gov (United States)

    Poisson, Jessica L; Tuma, Christopher W; Shulman, Ira A

    2016-07-01

    There has been interest concerning patient outcomes when older red blood cell (RBC) components are utilized. Inventory management is key to maintaining a stock of fresher RBCs for general transfusion needs. We have altered our practice for RBC management to reduce RBC age at the time of transfusion. Retrospective review of RBC age at time of transfusion at a tertiary care hospital with active trauma service was performed. The baseline nonirradiated RBC inventory was decreased from 12 to 15 days of stock to 7 to 10 days of stock, with request made to the blood supplier for fresher RBCs, specified at 75% of RBCs less than 14 days old. The age of RBCs at time of receipt and at time of transfusion was tracked on a monthly basis for the next 12 months. The mean age of RBCs at transfusion was decreased by 9 days on average for the year. Significant decreases in the mean age of RBCs at transfusion were seen in the second half of the year, with 4 of 6 months seeing a mean age of less than 20 days. There were no documented incidences of hospital blood shortages after the reduction in inventory; no surgery was canceled or delayed because of inventory. Inventory age depends on active management, combined with vendor cooperation to receive fresher components. Reducing the age of RBC components transfused is possible without experiencing blood component shortages. Longer periods of observation may allow for further adjustment of stocking levels on a seasonal basis. © 2016 AABB.

  4. POULTRY WASTE MANAGEMENT IN BOTSWANA: A REVIEW

    Directory of Open Access Journals (Sweden)

    J.C. Moreki

    2011-11-01

    Full Text Available A literature review was conducted to identify methods that are used to dispose of poultry waste in Botswana. It appears that the predominant methods of poultry waste disposal in Botswana are direct disposal at the landfills, application as a fertilizer in gardens or farms, burning and compositing. The use of poultry manure and/or litter to raise fertility status of the soil appears to be appropriate given that soils in Botswana are generally poor in plant nutrients, especially phosphorus. Given the high feed costs in Botswana it is suggested that the use of poultry manure and/or litter as livestock feed should be considered in areas where foot and mouth disease (FMD is endemic such as Chobe and North West Districts, as meat from these districts does not enter the European Union market.

  5. Reviewing the economic efficiency of disaster risk management

    Science.gov (United States)

    Mechler, Reinhard

    2013-04-01

    There is a lot of rhetoric suggesting that disaster risk management (DRM) pays, yet surprisingly little in the way of hard facts. Cost-benefit analysis (CBA) is one major tool that can provide quantitative information about the prioritization of disaster risk management (DRM) (and climate adaptation) based on economic principles. Yet, on a global scale, there has been surprisingly little robust evidence on the economic efficiency and benefits of risk management measures. This review shows that for the limited evidence reported the economic case for DRM across a range of hazards is strong and that the benefits of investing in DRM outweigh the costs of doing so, on average, by about four times the cost in terms of avoided and reduced losses. Most studies using a CBA approach focus on structural DRM and most information has been made available on physical flood prevention. There have been some limited studies on preparedness and risk financing. The global evidence base is limited and estimates appear not very solid, and overall, in line with the conclusion of the recent IPCC SREX report, there is limited evidence and medium agreement across the literature. Some of the factors behind the limited robustness are inherent to CBA more widely: these challenges comprise the inability to price intangibles, evaluating strategies rather than single projects, difficulties in assessing softer rather than infrastructure-related options, choices regarding a proper discount rate, lack of accounting for the distribution of benefits and costs and difficulties with assessing nonmarket values such as those related to health, the environment, or public goods. Although techniques exist to address some of these challenges, they are not very likely to easily go away. Other challenges associated specifically with DRM, such as the need and difficulty to undertake risk -based analysis can be overcome, and there have been manuals and reports providing a way forward. In an age of austerity, cost

  6. Coeliac disease: review of diagnosis and management.

    Science.gov (United States)

    Walker, Marjorie M; Ludvigsson, Jonas F; Sanders, David S

    2017-08-21

    Coeliac disease is an immune-mediated systemic disease triggered by exposure to gluten, and manifested by small intestinal enteropathy and gastrointestinal and extra-intestinal symptoms. Recent guidelines recommend a concerted use of clear definitions of the disease. In Australia, the most recent estimated prevalence is 1.2% in adult men (1:86) and 1.9% in adult women (1:52). Active case finding is appropriate to diagnose coeliac disease in high risk groups. Diagnosis of coeliac disease is important to prevent nutritional deficiency and long term risk of gastrointestinal malignancy. The diagnosis of coeliac disease depends on clinico-pathological correlation: history, presence of antitransglutaminase antibodies, and characteristic histological features on duodenal biopsy (when the patient is on a gluten-containing diet). Human leucocyte antigen class II haplotypes DQ2 or DQ8 are found in nearly all patients with coeliac disease, but are highly prevalent in the general population at large (56% in Australia) and testing can only exclude coeliac disease for individuals with non-permissive haplotypes. Adhering to a gluten free diet allows duodenal mucosal healing and alleviates symptoms. Patients should be followed up with a yearly review of dietary adherence and a health check. Non-coeliac gluten or wheat protein sensitivity is a syndrome characterised by both gastrointestinal and extra-intestinal symptoms related to the ingestion of gluten and possibly other wheat proteins in people who do not have coeliac disease or wheat allergy recognised by diagnostic tests.

  7. Drivers for inappropriate fever management in children: a systematic review.

    Science.gov (United States)

    Kelly, M; McCarthy, S; O'Sullivan, R; Shiely, F; Larkin, P; Brenner, M; Sahm, L J

    2016-08-01

    Background Fever is one of the most common childhood symptoms and accounts for numerous consultations with healthcare practitioners. It causes much anxiety amongst parents as many struggle with managing a feverish child and find it difficult to assess fever severity. Over- and under-dosing of antipyretics has been reported. Aim of the review The aim of this review was to synthesise qualitative and quantitative evidence on the knowledge, attitudes and beliefs of parents regarding fever and febrile illness in children. Method A systematic search was conducted in ten bibliographic databases from database inception to June 2014. Citation lists of studies and consultation with experts were used as secondary sources to identify further relevant studies. Titles and abstracts were screened for inclusion according to pre-defined inclusion and exclusion criteria. Quantitative studies using a questionnaire were analysed using narrative synthesis. Qualitative studies with a semi-structured interview or focus group methodology were analysed thematically. Results Of the 1565 studies which were screened for inclusion in the review, the final review comprised of 14 studies (three qualitative and 11 quantitative). Three categories emerged from the narrative synthesis of quantitative studies: (i) parental practices; (ii) knowledge; (iii) expectations and information seeking. A further three analytical themes emerged from the qualitative studies: (i) control; (ii) impact on family; (iii) experiences. Conclusion Our review identifies the multifaceted nature of the factors which impact on how parents manage fever and febrile illness in children. A coherent approach to the management of fever and febrile illness needs to be implemented so a consistent message is communicated to parents. Healthcare professionals including pharmacists regularly advise parents on fever management. Information given to parents needs to be timely, consistent and accurate so that inappropriate fever

  8. Physiotherapy management of low back pain - a review of surveys

    Directory of Open Access Journals (Sweden)

    A. Basson

    2011-02-01

    Full Text Available Low back pain (LBP is an increasingly debilitating and costly problem. One of the research focuses in LBP is an attempt to improve patient outcomes. It is believed that the promotion of evidence based practice (EBP should improve patient outcomes and also reduce the cost of care. There seems to be a need to establish how physiotherapists manage LBP and whether management is in accordance with best practice based on published research evidence. The aim of this study was to determine what management strategies physiotherapists employ in the management of LBP by performing a review of the literature and to compare this with recent guidelines Fourteen studies were included for the review.  The treatments most frequently reported as being used for the management of LBP were education/ advice, exercise, spinal mobilisation and electrotherapy. Over a 14 year period there were no major changes in the way physiotherapists manage LBP. Physiotherapist use interventions that are evidence based as well as interventions with little evidence in the management of LBP.

  9. Knowledge management in health: a systematic literature review.

    Science.gov (United States)

    Rocha, Elyrose Sousa Brito; Nagliate, Patricia; Furlan, Claudia Elisangela Bis; Rocha, Kerson; Trevizan, Maria Auxiliadora; Mendes, Isabel Amélia Costa

    2012-01-01

    Knowledge has been used as a resource for intelligent and effective action planning in organizations. Interest in research on knowledge management processes has intensified in different areas. A systematic literature review was accomplished, based on the question: what are the contributions of Brazilian and international journal publications on knowledge management in health? The sample totaled 32 items that complied with the inclusion criteria. The results showed that 78% of journals that published on the theme are international, 77% of researchers work in higher education and 65% have a Ph.D. The texts gave rise to five thematic categories, mainly: development of knowledge management systems in health (37.5%), discussion of knowledge management application in health (28.1%) and nurses' function in knowledge management (18.7%).

  10. Telemonitoring can assist in managing cardiovascular disease in primary care: a systematic review of systematic reviews.

    Science.gov (United States)

    Purcell, Renee; McInnes, Susan; Halcomb, Elizabeth J

    2014-03-07

    There has been growing interest regarding the impact of telemonitoring and its ability to reduce the increasing burden of chronic diseases, including chronic cardiovascular disease (CVD), on healthcare systems. A number of randomised trials have been undertaken internationally and synthesised into various systematic reviews to establish an evidence base for this model of care. This study sought to synthesise and critically evaluate this large body of evidence to inform clinicians, researchers and policy makers. A systematic review of systematic reviews investigating the impact of telemonitoring interventions in the primary care management of CVD was conducted. Reviews were included if they explored primary care based telemonitoring in either CVD, heart failure or hypertension, were reported in the English language and were published between 2000 and 2013. Data was extracted by one reviewer and checked by a second reviewer using a standardised form. Two assessors then rated the quality of each review using the Overview Quality Assessment Questionnaire (OQAQ). Of the 13 included reviews, four focused on telemonitoring interventions in hypertension or CVD management and the remaining 9 reviews investigated telemonitoring in HF management. Seven reviews scored a five or above on the OQAQ evidencing good quality reviews. Findings suggest that telemonitoring can contribute to significant reductions in blood pressure, decreased all-cause and HF related hospitalisations, reduced all-cause mortality and improved quality of life. Telemonitoring was also demonstrated to reduce health care costs and appears acceptable to patients. Telemonitoring has the potential to enhance primary care management of CVD by improving patient outcomes and reducing health costs. However, further research needs to explore the specific elements of telemonitoring interventions to determine the relative value of the various elements. Additionally, the ways in which telemonitoring care improves

  11. Guideline for ageing management in nuclear power plants; Leitlinie zum Alterungsmanagement in Kernkraftwerken

    Energy Technology Data Exchange (ETDEWEB)

    Herter, K.H.; Schuler, X. [Materialpruefungsanstalt (MPA), Univ. Stuttgart, Stuttgart (Germany); Hienstorfer, W.; Pompe, W. [TUeV SUeD Energietechnik GmbH, Filderstadt (Germany)

    2007-07-01

    During operation of nuclear power plants, the quality of systems, structures and components may change as a result of ageing (conceptional ageing, technological ageing or physical ageing), which will affect the system quality. Ageing management is necessary to ensure safety and availability throughout the life of the systems. This necessitates a systematic, integrative and knowledge-based approach. Systems, structures and components are grouped according to their relevance for meeting the set goals. Ageing mangement should be process-oriented and should be integrated in the organisational procedure in cooperation with the safety manager. The procedure should follow the PDCA principle (plan - do - check - act). The data, documents, knowledge and evaluations required for ageing management are part of the knowledge base of the nuclear power station and are updated regularly. The efficiency of ageing management must be reassessed at regular intervals. (orig.)

  12. Stormwater Management Effects on Ecosystem Services: A Literature Review

    Science.gov (United States)

    Prudencio, L.; Null, S. E.

    2016-12-01

    Managing stormwater provides benefits for enhancing water supplies while reducing urban runoff. Yet, there has been little research focused on understanding how stormwater management affects ecosystem services, the benefits that ecosystems provide to humans. Garnering more knowledge of the changes to ecosystem services from stormwater management will ultimately improve management and decision-making. The objective of this research is to review and synthesize published literature on 1) ecosystem services and stormwater management and 2) changes in ecosystem services from anthropogenic impacts and climate warming, to establish a foundation for research at the intersection of ecosystems services, stormwater management, and global environmental change. We outline four research areas for ecosystem services and stormwater management that should be further explored. These four areas, named after the four types of ecosystem services, highlight context-specific research questions and human and climate change effects. We conclude that effective and sustainable stormwater management requires incorporating engineering, social, and environmental criteria to quantify benefits of provisioning, regulating, cultural, and supporting ecosystem services. Lastly, improved current and potential stormwater management policy may better support sustainable stormwater methods at the institutional level. Stormwater quality and monitoring could be improved through the use of the Clean Water Act (e.g. Total Maximum Daily Loads), the Endangered Species Act, and public health measures. Additional policies regulating groundwater quantity and quality have been and may continue to be implemented by states, encouraging sustainable and cleaner stormwater practices.

  13. Sickle cell disease pain management in adolescents: a literature review.

    Science.gov (United States)

    Wilson, Bridget H; Nelson, Jessica

    2015-04-01

    Sickle cell disease (SCD) pain continues to emerge in adolescents. More than 98,000 individuals are believed to have SCD in the United States. In fact, 1 in 500 Black infants will be affected by SCD. Identifying standards of care for this unique population can improve pain management and treatment. A significant effect of vaso-occlusive crisis is a decrease in the quality of life in children. Therefore, pain management is multidimensional and includes pharmacologic, physical, and psychological strategies. A review of the literature was conducted to identify best practices regarding pain management in adolescents with sickle cell anemia. Key words such as pain, pain management, adolescent sickle cell anemia, and acute sickle cell pain were entered into databases to reveal qualitative and quantitative studies from 2009 to the present. Many of the research articles identified poor SCD pain management. Studies showed that acute SCD pain management is essential and should be evaluated and robustly managed to achieve optimum pain relief for patients. Acute SCD pain usually occurs as a result of vaso-occlusive crisis. Untreated acute SCD pain can result in morbidity and mortality in adolescents. Nursing knowledge is critical to reducing the stigma and improving management of SCD pain. Nurses play a vital role in the introduction of evidence-based practice within the clinical setting. In an effort to educate nurses and other health care professionals about SCD, this article is a literature review of studies concerning SCD and pain management in emergency rooms. Copyright © 2015 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

  14. Management Control in Enterprise System Enabled Organizations: A Literature Review

    DEFF Research Database (Denmark)

    Rikhardsson, Pall M.; Rohde, C.; Rom, A.

    2006-01-01

    The objective of this paper is to add to the limited body of knowledge on the relationship between enterprise systems (ES) and management control. Based on a literature review, we describe and classify studies that empirically address this relationship. Apart from not being extensive, the research...

  15. Performance measurement for product lifecycle management: a systemact literature review

    Directory of Open Access Journals (Sweden)

    Fernando Fonseca

    2012-01-01

    Full Text Available The aim of this study is to identify recommendations as well as the main performance indicator for developing a performance measurement system (PMS for product lifecycle management (PLM approach. Thus it was performed a systematic literature review that identified 22 recommendations and 296 performance indicators.

  16. A review of the current literature on management of halitosis.

    NARCIS (Netherlands)

    Broek, A.M. van den; Feenstra, L.; Baat, C. de

    2008-01-01

    Halitosis is an unpleasant or offensive odour, emanating from the oral cavity. In approximately 80% of all cases, halitosis is caused by microbial degradation of oral organic substrates. Major degradation products are volatile sulphur-containing compounds. In this review, the available management me

  17. A review of the current literature on management of halitosis.

    NARCIS (Netherlands)

    Broek, A.M. van den; Feenstra, L.; Baat, C. de

    2008-01-01

    Halitosis is an unpleasant or offensive odour, emanating from the oral cavity. In approximately 80% of all cases, halitosis is caused by microbial degradation of oral organic substrates. Major degradation products are volatile sulphur-containing compounds. In this review, the available management

  18. Traits and emotions : A review of their structure and management

    NARCIS (Netherlands)

    De Raad, B; Kokkonen, M

    2000-01-01

    This paper reviews literature on traits and emotions focusing on both structure and management, or 'having' and 'doing'. The cognitive perspective of this paper implies that traits and emotions are viewed as provisions to frame people and their behaviours in situations in meaningful ways. The focus

  19. Anger Management and Intellectual Disabilities: A Systematic Review

    Science.gov (United States)

    Hamelin, Jeffery; Travis, Robert; Sturmey, Peter

    2013-01-01

    We conducted a systematic literature review of anger management in people with intellectual disabilities (ID). We identified 2 studies that used randomized controlled trials and 6 that used pretest-posttest nonequivalent control group designs. The mean between-group effect size was 1.52 for randomized controlled trials and 0.89 for the other…

  20. Anger Management and Intellectual Disabilities: A Systematic Review

    Science.gov (United States)

    Hamelin, Jeffery; Travis, Robert; Sturmey, Peter

    2013-01-01

    We conducted a systematic literature review of anger management in people with intellectual disabilities (ID). We identified 2 studies that used randomized controlled trials and 6 that used pretest-posttest nonequivalent control group designs. The mean between-group effect size was 1.52 for randomized controlled trials and 0.89 for the other…

  1. Graphic visualization of program performance aids management review

    Science.gov (United States)

    Eisenhart, G. N.

    1967-01-01

    Chart technique /PERTREE/ which displays the essential status elements of a PERT system in a vertical flow array, of high graphic quality, enables visual review by management of program performance. Since the display is versatile, it can accommodate any aspect of the program which the presenter wishes to accent.

  2. Sigmoid volvulus: A pediatric case report and review of management

    Directory of Open Access Journals (Sweden)

    Lena M. O'Keefe

    2016-04-01

    Full Text Available Volvulus in the pediatric population commonly occurs in the small bowel associated with malrotation or internal hernia whereas sigmoid volvulus (SV is extremely rare. Herein we report a case of SV, review the literature and provide a suggested algorithm for diagnosis and management.

  3. Patient empowerment in cancer pain management: an integrative literature review

    NARCIS (Netherlands)

    Boveldt, N.D. te; Vernooij-Dassen, M.; Leppink, I.; Samwel, H.; Vissers, K.; Engels, Y.M.

    2014-01-01

    OBJECTIVE: More than 50% of patients with cancer experience pain. Patient empowerment has been highlighted as central to success in pain management. Up to now, no clear model for this patient group exists, yet several strategies to empower patients have been used in clinical practice. This review ex

  4. Stress Management in Medical Education: A Review of the Literature.

    Science.gov (United States)

    Shapiro, Shauna L.; Shapiro, Daniel E.; Schwartz, Gary E. R.

    2000-01-01

    Review of clinical studies providing empirical data on stress management programs in medical education found that student participants in such programs demonstrated improved immunologic functioning, decreased depression and anxiety, increased spirituality and empathy, enhanced knowledge of alternative therapies, improved knowledge of stress…

  5. Assessment methods for solid waste management: A literature review.

    Science.gov (United States)

    Allesch, Astrid; Brunner, Paul H

    2014-06-01

    Assessment methods are common tools to support decisions regarding waste management. The objective of this review article is to provide guidance for the selection of appropriate evaluation methods. For this purpose, frequently used assessment methods are reviewed, categorised, and summarised. In total, 151 studies have been considered in view of their goals, methodologies, systems investigated, and results regarding economic, environmental, and social issues. A goal shared by all studies is the support of stakeholders. Most studies are based on life cycle assessments, multi-criteria-decision-making, cost-benefit analysis, risk assessments, and benchmarking. Approximately 40% of the reviewed articles are life cycle assessment-based; and more than 50% apply scenario analysis to identify the best waste management options. Most studies focus on municipal solid waste and consider specific environmental loadings. Economic aspects are considered by approximately 50% of the studies, and only a small number evaluate social aspects. The choice of system elements and boundaries varies significantly among the studies; thus, assessment results are sometimes contradictory. Based on the results of this review, we recommend the following considerations when assessing waste management systems: (i) a mass balance approach based on a rigid input-output analysis of the entire system, (ii) a goal-oriented evaluation of the results of the mass balance, which takes into account the intended waste management objectives; and (iii) a transparent and reproducible presentation of the methodology, data, and results.

  6. Wet age related macular degeneration management and follow-up.

    Science.gov (United States)

    Alexandru, Malciolu Radu; Alexandra, Nica Maria

    2016-01-01

    Age-related macular degeneration (AMD) is referred to as the leading cause of irreversible visual loss in developed countries, with a profound effect on the quality of life. The neovascular form of AMD is characterized by the formation of subretinal choroidal neovascularization, leading to sudden and severe visual loss. Research has identified the vascular endothelial growth factor (VEGF) as an important pathophysiological component in neovascular AMD and its intraocular inhibition as one of the most efficient therapies in medicine. The introduction of anti-VEGF as a standard treatment in wet AMD has led to a great improvement in the prognosis of patients, allowing recovery and maintenance of visual function in the vast majority of cases. However, the therapeutic benefit is accompanied by a difficulty in maintaining the treatment schedule due to the increase in the amount of patients, stress of monthly assessments, as well as the associated economic burden. Therefore, treatment strategies have evolved from fixed monthly dosing, to individualized regimens, aiming for comparable results, with fewer injections. One such protocol is called "pro re nata", or "treat and observe". Patients are given a loading dose of 3 monthly injections, followed by an as-needed decision to treat, based on the worsening of visual acuity, clinical evidence of the disease activity on fundoscopy, or OCT evidence of retinal thickening in the presence of intra or subretinal fluid. A different regimen is called "treat and extend", in which the interval between injections is gradually increased, once the disease stabilization is achieved. This paper aims to review the currently available anti-VEGF agents--bevacizumab, ranibizumab, aflibercept, and the aforementioned treatment strategies.

  7. Training doctors to manage patients with multimorbidity: a systematic review

    Directory of Open Access Journals (Sweden)

    Cliona Lewis

    2016-08-01

    Full Text Available Background: Patients with multimorbidity (two or more chronic conditions are now the norm in clinical practice, and place an increasing burden on the healthcare system. Management of these patients is challenging, and requires doctors who are skilled in the complexity of multiple chronic diseases. Objective: To perform a systematic review of the literature to ascertain whether there are education and training formats which have been used to train postgraduate medical doctors in the management of patients with multimorbidity in primary and/or secondary care, and which have been shown to improve knowledge, skills, attitudes, and/or patient outcomes. Methods: Overall, 75,110 citations were screened, of which 65 full-text articles were then independently assessed for eligibility by two reviewers, and two studies met the inclusion criteria for the review. Results: The two included studies implemented and evaluated multimorbidity workshops, and highlight the need for further research addressing the learning needs of doctors tasked with managing patients with multimorbidity in their daily practice. Conclusion: While much has been published about the challenges presented to medical staff by patients with multimorbidity, published research regarding education of doctors to manage these problems is lacking. Further research is required to determine whether there is a need for, or benefit from, specific training for doctors to manage patients with multimorbidity. PROSPERO registration number: CRD42013004010. Journal of Comorbidity 2016;6(2:85–94

  8. Proceedings of the Inaugural Meeting of the International Forum for Reactor Aging Management (IFRAM)

    Energy Technology Data Exchange (ETDEWEB)

    Bond, Leonard J.; Brenchley, David L.

    2011-09-01

    In almost all countries with nuclear power plants (NPPs), regulatory authorities and the nuclear industry are looking at some form of extended operating periods. To support life extension activities it is necessary to ensure the continued safety and reliability of system, structures, and components, and the component materials. Internationally, a variety of individual national and international activities have been initiated including Plant Life Management through the International Atomic Energy Agency, Electric Power Research Institute’s Long Term Operation program, and various national programs in managing materials degradation and related topics. The U.S. Nuclear Regulatory Commission (NRC) engaged the international community in workshops in 2005-2006 to identify research needs and to collect information in an expert panel report on Proactive Management of Materials Degradation (PMMD), which was reported in NUREG/CR-6923. These results are also available via an Information Tool on the internet at http://pmmd.pnl.gov. This information builds on the extensive compilations known as the GALL Report (Generic Aging Lessons Learned, NUREG-1801, Vols. 1 and 2). Pacific Northwest National Laboratory (PNNL) recently issued a report on the review of various international activities in PMMD (PNNL-17779). There have also been initiatives by Electricite de France, Tokyo Electric Power Company, EPRI, and others to establish a "Materials Aging Institute." Within the materials degradation research community there are also networks and technical meetings focused on some elements of PMMD. In spite of all these efforts, there is currently no forum to bring together these diverse activities and provide coordinated information exchange and prioritization of materials aging management/PMMD topics. It is believed that the International Forum for Reactor Aging Management (IFRAM) would be a good way to achieve this goal and help develop new approaches for ensuring continued safe

  9. Risk management in the construction industry: a new literature review

    Directory of Open Access Journals (Sweden)

    Renault Berenger Y.

    2016-01-01

    Full Text Available The construction industry is well known as a highly risk prone industry owing to the complexity of its activities and dynamic project environments generating an atmosphere of risks that must be taken into consideration in the decision process. For this reason, we have developed this treatise to elucidate the fundamentals of risk management through a concise new proposal of literature review for risk management in construction. Our explanation of this is venture is that over the years, this area has been acknowledged as a crucial process in the business institutions and the most discussed subject among experts and researchers in the construction sector. We have tried in this report to present the most recent studies considering the impossibility to present all definitions of the concept of risk. This study is mainly a literature review; it looks at the literature relating to the concept of risk, risk management in construction as well as methods used in construction industry.

  10. Medical management of cerebellar abscess: a case report and review of the literature.

    Science.gov (United States)

    Turner, Ryan C; Dodson, Sean C; Rosen, Charles L

    2011-01-01

    A large abscess of the posterior fossa often warrants surgical intervention. We report a case of a 50-year-old male presenting with a cerebellar abscess measuring 2.8 cm x 1.6 cm located in the left cerebellar hemisphere at the level of the middle cerebellar peduncle that was treated conservatively and successfully with antibiotics. Therapeutic management options are discussed in regards to this case specifically as well as a review of the literature. This case illustrates the successful medical management of a cerebellar abscess of otogenic origin in an adult, a unique result in terms of abscess size and age of the patient.

  11. Computer technology for self-management: a scoping review.

    Science.gov (United States)

    Jacelon, Cynthia S; Gibbs, Molly A; Ridgway, John Ve

    2016-05-01

    The purpose of this scoping review of literature is to explore the types of computer-based systems used for self-management of chronic disease, the goals and success of these systems, the value added by technology integration and the target audience for these systems. Technology is changing the way health care is provided and the way that individuals manage their health. Individuals with chronic diseases are now able to use computer-based systems to self-manage their health. These systems have the ability to remind users of daily activities, and to help them recognise when symptoms are worsening and intervention is indicated. However, there are many questions about the types of systems available, the goals of these systems and the success with which individuals with chronic illness are using them. This is a scoping review in which the Cumulative Index of Nursing and Allied Health Literature, PubMed and IEEE Xplore databases were searched. A total of 303 articles were reviewed, 89 articles were read in-depth and 30 were included in the scoping review. The Substitution, Augmentation, Modification, Redefinition model was used to evaluate the value added by the technology integration. Research on technology for self-management was conducted in 13 countries. Data analysis identified five kinds of platforms on which the systems were based, some systems were focused on a specific disease management processes, others were not. For individuals to effectively use systems to maintain maximum wellness, the systems must have a strong component of self-management and provide the user with meaningful information regarding their health states. Clinicians should choose systems for their clients based on the design, components and goals of the systems. © 2016 John Wiley & Sons Ltd.

  12. Review: milk composition as management tool of sustainability

    Directory of Open Access Journals (Sweden)

    Arnould, VMR.

    2013-01-01

    Full Text Available The main objective of this paper is the use of milk composition data as a management tool. Milk composition, and in particular, milk fat content and fatty acid profiles may be significantly altered due to a variety of factors. These factors are reviewed in the literature; they include diet, animal (genetic selection, management aspects and animal health. Changes in milk composition can be used as an indicator of the animal's metabolic status or the efficiency of the feed management system. The advantages of using this kind of data as a management tool would be to allow the early detection of metabolic or management problems. The present review suggests that milk and, especially milk fat composition may be used as a sustainability management tool and as a monitoring and prevention tool for several pathologies or health disorders in dairy cattle. Further, due to the use of mid-infrared spectrometry (MIR technology, these tools may be easily implemented in practice and are relatively cheap. In the field, milk labs or milk recording agencies would be able to alert farmers whenever threshold values for disease were reached, allowing them to improve their dairy production from an economic, ecological and animal (welfare point of view.

  13. Gamification in Stress Management Apps: A Critical App Review.

    Science.gov (United States)

    Hoffmann, Alexandra; Christmann, Corinna A; Bleser, Gabriele

    2017-06-07

    In today's society, stress is more and more often a cause of disease. This makes stress management an important target of behavior change programs. Gamification has been suggested as one way to support health behavior change. However, it remains unclear to which extend available gamification techniques are integrated in stress management apps, and if their occurrence is linked to the use of elements from behavior change theory. The aim of this study was to investigate the use of gamification techniques in stress management apps and the cooccurrence of these techniques with evidence-based stress management methods and behavior change techniques. A total of 62 stress management apps from the Google Play Store were reviewed on their inclusion of 17 gamification techniques, 15 stress management methods, and 26 behavior change techniques. For this purpose, an extended taxonomy of gamification techniques was constructed and applied by 2 trained, independent raters. Interrater-reliability was high, with agreement coefficient (AC)=.97. Results show an average of 0.5 gamification techniques for the tested apps and reveal no correlations between the use of gamification techniques and behavior change techniques (r=.17, P=.20), or stress management methods (r=.14, P=.26). This leads to the conclusion that designers of stress management apps do not use gamification techniques to influence the user's behaviors and reactions. Moreover, app designers do not exploit the potential of combining gamification techniques with behavior change theory.

  14. Discussion on software aging management of nuclear power plant safety digital control system.

    Science.gov (United States)

    Liang, Huihui; Gu, Pengfei; Tang, Jianzhong; Chen, Weihua; Gao, Feng

    2016-01-01

    Managing the aging of digital control systems ensures that nuclear power plant systems are in adequate safety margins during their life cycles. Software is a core component in the execution of control logic and differs between digital and analog control systems. The hardware aging management for the digital control system is similar to that for the analog system, which has matured over decades of study. However, software aging management is still in the exploratory stage. Software aging evaluation is critical given the higher reliability and safety requirements of nuclear power plants. To ensure effective inputs for reliability assessment, this paper provides the required software aging information during the life cycle. Moreover, the software aging management scheme for safety digital control system is proposed on the basis of collected aging information.

  15. Management accounting in supply chain management – literature review and survey results

    Directory of Open Access Journals (Sweden)

    Justyna Dobroszek

    2016-09-01

    Full Text Available The concept of supply chain management has been evolving at a rapid pace in economic practice as wellas in scientific research, mainly in the field of logistics and supply chains. It also constitutes a reference point for researchers specializing in accounting, especially in management accounting. As a result, in recent years there has been an increasing number of publications on this research in the world, including in Poland. So far, however, there is a lack of publications that would present comprehensively the aspects of management accounting in the context of supply chain management. Therefore, this article has the following research objective: identification of the degree of development of management accounting, in research and practice, for the purposes of supply chain management. As research methods were used:review of the content of scientific articles and surveys conducted among companies in Poland. The results of survey study and literature review revealed that the most frequently addressed issues in business and in theory include cost management and performance measurement using financial indicators. In the case of other issues addressed in the publications there are discrepancies between theory and business practice. In effect, this means the need to improve the communication and integration of these two dimensions in the context of implementation of management accounting tools and methods for supply chain management support. The results presented in the article could be the basis for further, in-depth research in this area.

  16. Review of: Islam, Migration and Integration: The Age of Securitization

    DEFF Research Database (Denmark)

    Vinding, Niels Valdemar

    2010-01-01

    Islam, Migration and Integration: The Age of Securitization. By Ayhan Kaya. (Migration, Minorities and Citizenship). Houndmills, Basingstoke: Palgrave Macmillan, 2009. Pp. xiv+249. Hbk 978-0-230-51679-3. £55.......Islam, Migration and Integration: The Age of Securitization. By Ayhan Kaya. (Migration, Minorities and Citizenship). Houndmills, Basingstoke: Palgrave Macmillan, 2009. Pp. xiv+249. Hbk 978-0-230-51679-3. £55....

  17. A Conceptual Review of Age Effect on L2 Acquisition

    Science.gov (United States)

    Sang, Yuan

    2017-01-01

    The importance of age effect on an additional language (L2) acquisition has long been recognized in the field of L2 education. Research was conducted to reveal the influence of age to the rate and ultimate attainment of L2 teaching and learning, yet controversial results were discovered. Consequently, stereotypes and misunderstanding exist among…

  18. Mechanisms of the anorexia of aging-a review.

    Science.gov (United States)

    Wysokiński, Adam; Sobów, Tomasz; Kłoszewska, Iwona; Kostka, Tomasz

    2015-08-01

    Many, even healthy, older people fail to adequately regulate food intake and experience loss of weight. Aging-associated changes in the regulation of appetite and the lack of hunger have been termed as the anorexia of aging. The etiology of the anorexia of aging is multi-factorial and includes a combination of physiological changes associated with aging (decline in smell and taste, reduced central and peripheral drive to eat, delayed gastric emptying), pathological conditions (depression, dementia, somatic diseases, medications and iatrogenic interventions, oral-health status), and social factors (poverty, loneliness). However, exact mechanisms of the anorexia of aging remain to be elucidated. Many neurobiological mechanisms may be secondary to age-related changes in body composition and not associated with anorexia per se. Therefore, further studies on pathophysiological mechanisms of the anorexia of aging should employ accurate measurement of body fat and lean mass. The anorexia of aging is associated with protein-energy malnutrition, sarcopenia, frailty, functional deterioration, morbidity, and mortality. Since this symptom can lead to dramatic consequences, early identification and effective interventions are needed. One of the most important goals in the geriatric care is to optimize nutritional status of the elderly.

  19. Interventions to prevent and manage overweight or obesity in preschool children: A systematic review.

    Science.gov (United States)

    Ling, Jiying; Robbins, Lorraine B; Wen, Fujun

    2016-01-01

    The preschool period is a pivotal time for lifestyle interventions to begin the establishment of long-term physical activity and healthy eating habits. This systematic review sought to (a) examine the effects of prevention and management interventions on overweight/obesity among children aged 2-5 years, and (b) explore factors that may influence intervention effects. A systematic review of randomized controlled studies was conducted. Six databases, including PubMed, CINAHL, EMBASE, PsycINFO, ERIC, and Cochrane library, were searched for relevant studies. Data were extracted and checked by two reviewers. Each study was appraised based on 4 quality indicators adapted from the Cochrane Handbook for Systematic Reviews of Interventions. A narrative summary technique was used to describe the review findings. Thirty-seven articles describing 32 randomized controlled trials and 29 unique interventions were retained. Eight of 23 prevention and 4 of 6 management interventions resulted in significant weight loss, with 3 prevention and 5 management interventions showing sustained effects over 6 to 24 months. Of the 12 efficacious interventions, 10 included physical activity and nutrition components, 9 actively involved parents, and only 4 were theory-based. Interactive education was the most common strategy used for parents in prevention interventions, compared to behavioral therapy techniques in management interventions. For children, interactive education and hands-on experiences involving physical activity and healthy eating were equally used. Management interventions showed greater effects in weight loss compared to prevention interventions. Future prevention interventions in preschool children should target both parents and children, and focus on physical activity and nutrition through interactive education and hands-on experiences, although intervention effects were less than optimal. Management interventions should focus on parents as the "agents of change" for physical

  20. Obesity management interventions: a review of the evidence.

    Science.gov (United States)

    Yaskin, Joseph; Toner, Richard W; Goldfarb, Neil

    2009-12-01

    The burden of disease associated with the obesity epidemic shortens lives, and prevalence is accelerating. As with other chronic diseases, improved outcomes are associated with effective self-management of obesity across the life span. The disease of obesity, then, fits squarely within the disease management and chronic care models. This article reviews selected interventions, described in peer-reviewed literature, designed to achieve significant weight loss for individuals identified as overweight or obese. The study objective is to provide an overview of the full range of methods and models for weight loss, including some available without medical supervision. The intended audience includes individuals and organizations with an expressed interest in disease management and the chronic care models. Our review identified promising lines of investigation for future research that span diverse medical disciplines applied to obesity. The quality of the studies included in our review was uneven, and compromises the current evidence for effectiveness and efficacy. Generally, our results showed that combination approaches-surgical or pharmacologic, combined with a behavioral intervention-were most likely to be effective.

  1. Ethics and Sustainability: A Review of Water Policy and Management

    Directory of Open Access Journals (Sweden)

    Ravichandran Moorthy

    2012-01-01

    Full Text Available Problem statement: This is a review paper that examines the extent aspects such as ethics, sustainability and the environment manifest in the water policy and water management in Malaysia. The study examines two aspects of this topic; firstly it examines the various objectives and considerations in the National Water Policy and secondly it discusses the issues that arise regarding water policy and management, especially with regard to federal-states jurisdiction issues, legislations in water management and the problems related to inter-agency coordination, especially among agencies involved in the management of rivers. Approach: A qualitative approach is employed in this study. It provides a comprehensive review of the stated problem based on document analysis and interviews with individuals involved in policy formulation and from agencies involved in water management. Results: The study reveals two major findings; the first shows that the National Water Policy provide a holistic approach in dealing with water-by providing safe, adequate and affordable water supply to people; providing sufficient water that will ensure national and food security and promote rural development; sufficient water to spur and sustain economic growth; and protection of the water environment to preserve water resources. Second, it examines issues regarding water management such as the jurisdiction between federal and state governments, legislations and enforcement and inefficiency in inter-agency coordination that hinder the realization of this policys objectives. Conclusion: The study concludes that despite the holistic coverage of the national water policy, there are apparent problems with regard to the jurisdiction, legislation and coordination initiatives that have resulted in the poor management of water resources. The study postulates that, in addition to better coordination between water related agencies and more cohesive water legislations structure, it is

  2. A Survey of Cable Ageing Management and Condition Monitoring in Nuclear Power Plants

    Energy Technology Data Exchange (ETDEWEB)

    Goo, Cheol Soo; Kim, In Young; Kim, Bok Ryul [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of)

    2011-05-15

    Cable is one of the major nuclear power plant components that are directly related to safety, so that life assessment of the cable system is an important issue as one of international nuclear safety concerns. In general, cables installed in nuclear power plants have been regarded as maintenance-free component. However, for the long term operation, maintenance activities for cables important to safety should be done appropriately to ensure their capability for the required function This paper is summarized the findings from a review of published documents dealing with research on ageing management of safety-related electric cables used in nuclear power plants. Significant research in this area has been performed in several countries and international research projects

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

    NARCIS (Netherlands)

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

    2014-01-01

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

  4. Aging Methodologies and Prognostic Health Management for Electrolytic Capacitors

    Data.gov (United States)

    National Aeronautics and Space Administration — Understanding the ageing mechanisms of electronic components critical avionics systems such as the GPS and INAV are of critical importance. Electrolytic capacitors...

  5. Towards Accelerated Aging Methodologies and Health Management of Power MOSFETs

    Data.gov (United States)

    National Aeronautics and Space Administration — Understanding aging mechanisms of electronic components is of extreme importance in the aerospace domain where they are part of numerous critical subsystems...

  6. Solid waste management in the hospitality industry: a review.

    Science.gov (United States)

    Pirani, Sanaa I; Arafat, Hassan A

    2014-12-15

    Solid waste management is a key aspect of the environmental management of establishments belonging to the hospitality sector. In this study, we reviewed literature in this area, examining the current status of waste management for the hospitality sector, in general, with a focus on food waste management in particular. We specifically examined the for-profit subdivision of the hospitality sector, comprising primarily of hotels and restaurants. An account is given of the causes of the different types of waste encountered in this sector and what strategies may be used to reduce them. These strategies are further highlighted in terms of initiatives and practices which are already being implemented around the world to facilitate sustainable waste management. We also recommended a general waste management procedure to be followed by properties of the hospitality sector and described how waste mapping, an innovative yet simple strategy, can significantly reduce the waste generation of a hotel. Generally, we found that not many scholarly publications are available in this area of research. More studies need to be carried out on the implementation of sustainable waste management for the hospitality industry in different parts of the world and the challenges and opportunities involved. Copyright © 2014 Elsevier Ltd. All rights reserved.

  7. Evaluating participation in water resource management: A review

    Science.gov (United States)

    Carr, G.; BlöSchl, G.; Loucks, D. P.

    2012-11-01

    Key documents such as the European Water Framework Directive and the U.S. Clean Water Act state that public and stakeholder participation in water resource management is required. Participation aims to enhance resource management and involve individuals and groups in a democratic way. Evaluation of participatory programs and projects is necessary to assess whether these objectives are being achieved and to identify how participatory programs and projects can be improved. The different methods of evaluation can be classified into three groups: (i) process evaluation assesses the quality of participation process, for example, whether it is legitimate and promotes equal power between participants, (ii) intermediary outcome evaluation assesses the achievement of mainly nontangible outcomes, such as trust and communication, as well as short- to medium-term tangible outcomes, such as agreements and institutional change, and (iii) resource management outcome evaluation assesses the achievement of changes in resource management, such as water quality improvements. Process evaluation forms a major component of the literature but can rarely indicate whether a participation program improves water resource management. Resource management outcome evaluation is challenging because resource changes often emerge beyond the typical period covered by the evaluation and because changes cannot always be clearly related to participation activities. Intermediary outcome evaluation has been given less attention than process evaluation but can identify some real achievements and side benefits that emerge through participation. This review suggests that intermediary outcome evaluation should play a more important role in evaluating participation in water resource management.

  8. Operations research in intensive care unit management: a literature review.

    Science.gov (United States)

    Bai, Jie; Fügener, Andreas; Schoenfelder, Jan; Brunner, Jens O

    2016-08-12

    The intensive care unit (ICU) is a crucial and expensive resource largely affected by uncertainty and variability. Insufficient ICU capacity causes many negative effects not only in the ICU itself, but also in other connected departments along the patient care path. Operations research/management science (OR/MS) plays an important role in identifying ways to manage ICU capacities efficiently and in ensuring desired levels of service quality. As a consequence, numerous papers on the topic exist. The goal of this paper is to provide the first structured literature review on how OR/MS may support ICU management. We start our review by illustrating the important role the ICU plays in the hospital patient flow. Then we focus on the ICU management problem (single department management problem) and classify the literature from multiple angles, including decision horizons, problem settings, and modeling and solution techniques. Based on the classification logic, research gaps and opportunities are highlighted, e.g., combining bed capacity planning and personnel scheduling, modeling uncertainty with non-homogenous distribution functions, and exploring more efficient solution approaches.

  9. Improving Cognitive Function from Children to Old Age: A Systematic Review of Recent Smart Ageing Intervention Studies

    Directory of Open Access Journals (Sweden)

    Rui Nouchi

    2014-01-01

    Full Text Available Background. Cognitive functions are important for daily life at any age. One purpose of Smart Ageing is to investigate how to improve cognitive functions. This systematic review evaluates beneficial effects of the intervention on cognitive functions. Method. We conducted a systematic review of intervention studies of improvements of cognitive functions published or in press before December 2013. Because of the heterogeneity of the intervention programs, a systematic and critical review of the interventions and outcomes was conducted instead of a meta-analysis. Results. We identified nine completed and published studies, which were divided into four categories: cognitive training using video game, cognitive training using PC, cognitive training using paper and pencil, and exercise training. Review results showed that various intervention programs can improve cognitive functions such as executive functions, working memory, episodic memory, processing speed, and general cognitive ability/IQ. Conclusions. The systematic review demonstrated that some intervention programs can be effective for improving various aspects of cognitive functioning at any age. Some limitations to this review include its small sample size and heterogeneity of programs and cognitive function measures, in addition to unresolved issues such as transfer of everyday skills and effectiveness for nonhealthy people.

  10. Smokey comes of age: Unmanned aerial systems for fire management

    Science.gov (United States)

    Twidwell, Dirac; Allen, Craig R.; Detweiler , Carrick; Higgins, James; Laney, Christian; Elbaum, Sebastian

    2016-01-01

    During the past century, fire management has focused on techniques both to protect human communities from catastrophic wildfire and to maintain fire-dependent ecological systems. However, despite a large and increasing allocation of resources and personnel to achieve these goals, fire management objectives at regional to global scales are not being met. Current fire management techniques are clearly inadequate for the challenges faced by fire managers, and technological innovations are needed. Advances in unmanned aerial systems (UAS) technology provide opportunities for innovation in fire management and science. In many countries, fire management organizations are beginning to explore the potential of UAS for monitoring fires. We have taken the next step and developed a prototype that can precisely ignite fires as part of wildfire suppression tactics or prescribed fires (fire intentionally ignited within predetermined conditions to reduce hazardous fuels, improve habitat, or mitigate for large wildfires). We discuss the potential for these technologies to benefit fire management activities, while acknowledging the sizeable sociopolitical barriers that prevent their immediate broad application.

  11. Expanding access to gerontological education via distance learning: the Management of Aging Services Masters Program at UMass Boston.

    Science.gov (United States)

    Nadash, Pamela; Miller, Edward Alan; Porell, Frank W; Birchander, Ellen; Glickman, Lillian; Burr, Jeffrey A

    2014-01-01

    This article describes the online Management of Aging Services Masters Program at the University of Massachusetts Boston and reports on a recent Program review. The Program has experienced rapid growth, evolving from seven matriculating students in 2003 to 108 in 2012. It has graduated 125 students and boasts a 78% completion rate. The authors describe the Program and report on faculty and student perceptions of performance. The Program demonstrates sound pedagogical practice for online education, incorporating techniques to foster community and encourage students and faculty interaction. Distance learning holds considerable promise for expanding access to gerontological education to reach future aging services professionals.

  12. [Anesthesia for geriatric patients : Part 2: anesthetics, patient age and anesthesia management].

    Science.gov (United States)

    Herminghaus, A; Löser, S; Wilhelm, W

    2012-04-01

    Part 2 of this review on geriatric anesthesia primarily describes the multiple influences of age on the pharmacokinetics and pharmacodynamics of different anesthetic agents and their impact on clinical practice. In the elderly the demand for opioids is reduced by almost 50% and with total intravenous anesthesia the dosages of propofol and remifentanil as well as recovery times are more determined by patient age than by body weight. As a result depth of anesthesia monitoring is recommended for geriatric patients to individually adjust the dosing to patients needs. With muscle relaxants both delayed onset of action and prolonged duration of drug effects must be considered with increasing age and as this may lead to respiratory complications, neuromuscular monitoring is highly recommended. The following measures appear to be beneficial for geriatric patients: thorough preoperative assessment, extended hemodynamic monitoring, use of short-acting anesthetics in individually adjusted doses best tailored by depth of anesthesia monitoring, intraoperative normotension, normothermia and normocapnia, complete neuromuscular recovery at the end of the procedure and well-planned postoperative pain management in order to reduce or avoid the use of opioids.

  13. School Age Populations Research Needs - NCS Dietary Assessment Literature Review

    Science.gov (United States)

    Drawing conclusions about the validity of available dietary assessment instruments in school age children is hampered by the differences in instruments, research design, reference methods, and populations in the validation literature.

  14. Environmental restoration and waste management department independent safety review committee program management plan

    Energy Technology Data Exchange (ETDEWEB)

    1992-10-01

    This Program Management Plan (PMP) describes and governs the Independent Safety Review Committee (ISRC) established within the Environmental Restoration and Waste Management Department (ER WMD). The ISRC performs independent safety reviews for the ER WMD as required and specified by the governing documents mentioned above. This PMP defines the ISRC organization, work plan, and scope of work. The PMP is organized consistent with the requirements of DOE Order 4700.1, Project Management System. For the purpose of readability, this document shall use the term program'' to include not only the chartered activities of the ISRC, but also the related activities conducted by the chairman and staff. This PMP is subordinate to the ER WMD Implementing Program Management Plan, EGG-WM-10220.

  15. Environmental restoration and waste management department independent safety review committee program management plan

    Energy Technology Data Exchange (ETDEWEB)

    1992-10-01

    This Program Management Plan (PMP) describes and governs the Independent Safety Review Committee (ISRC) established within the Environmental Restoration and Waste Management Department (ER&WMD). The ISRC performs independent safety reviews for the ER&WMD as required and specified by the governing documents mentioned above. This PMP defines the ISRC organization, work plan, and scope of work. The PMP is organized consistent with the requirements of DOE Order 4700.1, Project Management System. For the purpose of readability, this document shall use the term ``program`` to include not only the chartered activities of the ISRC, but also the related activities conducted by the chairman and staff. This PMP is subordinate to the ER&WMD Implementing Program Management Plan, EGG-WM-10220.

  16. Individual Performance Management: A Review of Current Practices

    Directory of Open Access Journals (Sweden)

    Ian O’ Boyle

    2013-05-01

    Full Text Available This paper provides a review of current practice in relation to individual performance management systems and process within the traditional business environment. There is a consensus that the role of the individual is central to the overall performance of any organization and how individual performances are managed and evaluated can have significant impacts on overall organizational success. Many organizations employ the traditional performance appraisal in order to monitor and assess individual employee performances. However, new approaches, such as 360-degree feedback have also become commonplace within the business environment. An analysis of each approach including benefits and challenges associated with each process is presented within this paper.

  17. Design for Sustainability and Project Management Literature – A Review

    DEFF Research Database (Denmark)

    Ali, Faheem; Boks, Casper; Bey, Niki

    2016-01-01

    management literature has hardly been considered in design for sustainability research, this article attempts to review the points of intersection between these two fields, and explores the potential that knowledge from project management literature has in improving efficiency and effectiveness......The growing pressure on natural resources and increasing global trade have made sustainability issues a prime area of concern for all businesses alike. The increased focus on sustainability has impacted the way projects are conceived, planned, executed and evaluated in industries. Since project...

  18. An integrative review of systematic reviews related to the management of breathlessness in respiratory illnesses

    Directory of Open Access Journals (Sweden)

    Smith Jaclyn

    2010-12-01

    Full Text Available Abstract Background Breathlessness is a debilitating and distressing symptom in a wide variety of diseases and still a difficult symptom to manage. An integrative review of systematic reviews of non-pharmacological and pharmacological interventions for breathlessness in non-malignant disease was undertaken to identify the current state of clinical understanding of the management of breathlessness and highlight promising interventions that merit further investigation. Methods Systematic reviews were identified via electronic databases between July 2007 and September 2009. Reviews were included within the study if they reported research on adult participants using either a measure of breathlessness or some other measure of respiratory symptoms. Results In total 219 systematic reviews were identified and 153 included within the final review, of these 59 addressed non-pharmacological interventions and 94 addressed pharmacological interventions. The reviews covered in excess of 2000 trials. The majority of systematic reviews were conducted on interventions for asthma and COPD, and mainly focussed upon a small number of pharmacological interventions such as corticosteroids and bronchodilators, including beta-agonists. In contrast, other conditions involving breathlessness have received little or no attention and studies continue to focus upon pharmacological approaches. Moreover, although there are a number of non-pharmacological studies that have shown some promise, particularly for COPD, their conclusions are limited by a lack of good quality evidence from RCTs, small sample sizes and limited replication. Conclusions More research should focus in the future on the management of breathlessness in respiratory diseases other than asthma and COPD. In addition, pharmacological treatments do not completely manage breathlessness and have an added burden of side effects. It is therefore important to focus more research on promising non

  19. Aging in bacteria, immortality or not-a critical review.

    Science.gov (United States)

    Gómez, José M G

    2010-12-01

    Bacteria were traditionally thought to have a symmetrical binary fission without a clear distinction between soma and germ-line, being thus considered as immortal biological entities. Yet it has been recently described that bacteria also undergo replicative aging (RA). That is, they exhibit finite replicative abilities under good conditions to growth. The apparently initial indistinguishability of sibling cells after cytokinesis is broken. After division, the daughter cell that inherits the "old" pole present in the "mother cell" progressively exhibits a decline in its proliferative capacity with increasing cell pole age. This is a clear hallmark and phenotypic manifestation of a bona fide RA phenomenon in toto. While the exact molecular mechanism(s) underlying to this lost of replicative potential are not yet fully understood, the "old pole cell" is considered as an aging parent that in a repeatedly manner is able to produce rejuvenated offspring which inherit a resetting of the biological clock. On the order hand, bacteria exhibit in addition to this "mandatory" RA the dubbed conditional senescence (CS). CS is defined as a decline in cellular viability observed in arrested-growing bacteria populations, a phenomenon apparently not related to RA under growing active conditions. To understand bacterial aging, it is necessary to put it within the sociality-multicellularity framework. This is a new conceptual paradigm that expresses the natural reality of the bacterial world. From this more ecological perspective these bacterial aging phenomena probably should represent an insurance/bethedging anticipative survival strategy. This is underpinned in a self-generation of an appropriate level of populational phenotypic diversity. That is, bacterial aging could be considered a communitarian adaptive response to cope with different environmental stresses and threats. I have highlighted the necessity to construct an integrative conceptual framework to achieve a unified view

  20. Structural Aging Program approach to providing an improved basis for aging management of safety-related concrete structures

    Energy Technology Data Exchange (ETDEWEB)

    Naus, D.J.; Oland, C.B. [Oak Ridge National Lab., TN (United States); Ellingwood, B. [Johns Hopkins Univ., Baltimore, MD (United States)

    1993-11-01

    The Structural Aging (SAG) Program is being conducted at the Oak Ridge National Laboratory (ORNL) for the United States Nuclear Regulatory Commission (USNRC). The SAG Program is addressing the aging management of safety-related concrete structures in nuclear power plants for the purpose of providing improved technical bases for their continued service. The program is organized into four tasks: Program Management, Materials Property Data Base, Structural Component Assessment/Repair Technologies, and Quantitative Methodology for Continued Service Determinations. Objectives and a summary of recent accomplishments under each of these tasks are presented.

  1. Open abdomen management: A review of its history and a proposed management algorithm

    Science.gov (United States)

    Kreis, Barbara Elize; de Mol van Otterloo, Johan Coenraad Alexander; Kreis, Robert Walter

    2013-01-01

    In this review we look into the historical development of open abdomen management. Its indication has spread in 70 years from intra-abdominal sepsis to damage control surgery and abdominal compartment syndrome. Different temporary abdominal closure techniques are essential to benefit the potential advantages of open abdomen management. Here, we discuss the different techniques and provide a new treatment strategy, based on available evidence, to facilitate more consistent decision making and further research on this complicated surgical topic. PMID:23823991

  2. Municipal solid waste management in Indian cities - A review.

    Science.gov (United States)

    Sharholy, Mufeed; Ahmad, Kafeel; Mahmood, Gauhar; Trivedi, R C

    2008-01-01

    Municipal solid waste management (MSWM) is one of the major environmental problems of Indian cities. Improper management of municipal solid waste (MSW) causes hazards to inhabitants. Various studies reveal that about 90% of MSW is disposed of unscientifically in open dumps and landfills, creating problems to public health and the environment. In the present study, an attempt has been made to provide a comprehensive review of the characteristics, generation, collection and transportation, disposal and treatment technologies of MSW practiced in India. The study pertaining to MSWM for Indian cities has been carried out to evaluate the current status and identify the major problems. Various adopted treatment technologies for MSW are critically reviewed, along with their advantages and limitations. The study is concluded with a few fruitful suggestions, which may be beneficial to encourage the competent authorities/researchers to work towards further improvement of the present system.

  3. Managing anxiety related to anaphylaxis in childhood: a systematic review.

    Science.gov (United States)

    Manassis, Katharina

    2012-01-01

    Objectives. This paper reviews the relationship between anxiety and anaphylaxis in children and youth, and principles for managing anxiety in the anaphylactic child and his or her parents. Methods. A review of the medical literature (Medline) was done using the keywords "anxiety," "anaphylaxis," and "allergy," limited to children and adolescents. Findings were organized into categories used in the treatment of childhood anxiety disorders, then applied to managing anxiety in the anaphylactic child. Results. Twenty-four relevant papers were identified. These varied widely in methodology. Findings emphasized included the need to distinguish anxiety-related and organic symptoms, ameliorate the anxiety-related impact of anaphylaxis on quality of life, and address parental anxiety about the child. Conclusion. Children with anaphylaxis can function well despite anxiety, but the physical, cognitive, and behavioral aspects of anxiety associated with anaphylactic risk must be addressed, and parents must be involved in care in constructive ways.

  4. Review of the diagnosis and management of gastrointestinalbezoars

    Institute of Scientific and Technical Information of China (English)

    Masaya Iwamuro; Hiroyuki Okada; Kazuhiro Matsueda; Tomoki Inaba; Chiaki Kusumoto; Atsushi Imagawa; Kazuhide Yamamoto

    2015-01-01

    The formation of a bezoar is a relatively infrequentdisorder that affects the gastrointestinal system.Bezoars are mainly classified into four types dependingon the material constituting the indigestible mass of thebezoar phytobezoars, trichobezoars, pharmacobezoars,and lactobezoars. Gastric bezoars often cause ulcerativelesions in the stomach and subsequent bleeding,whereas small intestinal bezoars present with smallbowel obstruction and ileus. A number of articles haveemphasized the usefulness of Coca-Cola? administrationfor the dissolution of phytobezoars. However, persimmonphytobezoars may be resistant to such dissolutiontreatment because of their harder consistency comparedto other types of phytobezoars. Better understanding ofthe etiology and epidemiology of each type of bezoarwill facilitate prompt diagnosis and management.Here we provide an overview of the prevalence, classification,predisposing factors, and manifestations ofbezoars. Diagnosis and management strategies arealso discussed, reviewing mainly our own case series.Recent progress in basic research regarding persimmonphytobezoars is also briefly reviewed.

  5. Review of the diagnosis and management of gastrointestinal bezoars.

    Science.gov (United States)

    Iwamuro, Masaya; Okada, Hiroyuki; Matsueda, Kazuhiro; Inaba, Tomoki; Kusumoto, Chiaki; Imagawa, Atsushi; Yamamoto, Kazuhide

    2015-04-16

    The formation of a bezoar is a relatively infrequent disorder that affects the gastrointestinal system. Bezoars are mainly classified into four types depending on the material constituting the indigestible mass of the bezoar: phytobezoars, trichobezoars, pharmacobezoars, and lactobezoars. Gastric bezoars often cause ulcerative lesions in the stomach and subsequent bleeding, whereas small intestinal bezoars present with small bowel obstruction and ileus. A number of articles have emphasized the usefulness of Coca-Cola(®) administration for the dissolution of phytobezoars. However, persimmon phytobezoars may be resistant to such dissolution treatment because of their harder consistency compared to other types of phytobezoars. Better understanding of the etiology and epidemiology of each type of bezoar will facilitate prompt diagnosis and management. Here we provide an overview of the prevalence, classification, predisposing factors, and manifestations of bezoars. Diagnosis and management strategies are also discussed, reviewing mainly our own case series. Recent progress in basic research regarding persimmon phytobezoars is also briefly reviewed.

  6. A review of sustainable facilities management knowledge and practice

    Directory of Open Access Journals (Sweden)

    Baaki Timothy Kurannen

    2016-01-01

    Full Text Available Sustainability is seen as a far-reaching issue now, and one which the facilities management [FM] profession cannot overlook. This paper explores current sustainable facilities management [SFM] knowledge and practice with specific focus on performance as part of a research focus toward proposing a sustainable FM performance management framework for sustainable healthcare waste management in Malaysia. This paper utilized a review of extant literature on the subject of SFM, FM performance and FM development in Malaysia as source of information. Findings reflect the increasing recognition of the need for the strategic FM function, and how facilities managers are best positioned to drive organizations’ sustainability agendas. In Malaysian context, this recognition is barely evident as findings show FM practice is still immature and predominantly operational. Unlike developed FM markets, FM relevance in Malaysia is being driven by the public sector. Also findings show a disharmony between organizations’ sustainability priority areas and the responsibilities for facilities managers to execute them where the sustainability policy of organizations prioritize one FM service and the facilities managers’ responsibilities prioritize another. As most of SFM implementation is driven by legislation this seems to strengthen the position that, organizations continue to view support services as non-value-adding, as unavoidable liabilities. The implication of this is the pressure on the FM function to continually express its strategic relevance to organizations by tangible value-adding performance output. This creates a new perspective to measuring and managing facilities performance. This paper therefore elevates the importance of FM performance management in SFM context taking into account the peculiar position of the facilities manager. This is seen as a way forward for FM to better express its value to the organization

  7. A Review of Deterministic Optimization Methods in Engineering and Management

    Directory of Open Access Journals (Sweden)

    Ming-Hua Lin

    2012-01-01

    Full Text Available With the increasing reliance on modeling optimization problems in practical applications, a number of theoretical and algorithmic contributions of optimization have been proposed. The approaches developed for treating optimization problems can be classified into deterministic and heuristic. This paper aims to introduce recent advances in deterministic methods for solving signomial programming problems and mixed-integer nonlinear programming problems. A number of important applications in engineering and management are also reviewed to reveal the usefulness of the optimization methods.

  8. Behavioral Therapies for Management of Premature Ejaculation: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Katy Cooper, PhD

    2015-09-01

    Conclusions: There is limited evidence that physical behavioral techniques for PE improve IELT and other outcomes over waitlist and that behavioral therapies combined with drug treatments give better outcomes than drug treatments alone. Further RCTs are required to assess psychotherapeutic approaches to PE. Cooper K, Martyn‐St James M, Kaltenthaler E, Dickinson K, Cantrell A, Wylie K, Frodsham L, and Hood C. Behavioral therapies for management of premature ejaculation: A systematic review. Sex Med 2015;3:174–188.

  9. Review of dynamic optimization methods in renewable natural resource management

    Science.gov (United States)

    Williams, B.K.

    1989-01-01

    In recent years, the applications of dynamic optimization procedures in natural resource management have proliferated. A systematic review of these applications is given in terms of a number of optimization methodologies and natural resource systems. The applicability of the methods to renewable natural resource systems are compared in terms of system complexity, system size, and precision of the optimal solutions. Recommendations are made concerning the appropriate methods for certain kinds of biological resource problems.

  10. Perioperative Management of Patients with Obstructive Sleep Apnoea - A Review

    Directory of Open Access Journals (Sweden)

    Fauzia A Khan

    2008-01-01

    The anaesthetic implications include the presence of comorbidities like cardiovascular, respiratory and cerebrovascular sequelae. Obesity is a commonly associated condition. Effects of sedatives, hypnotics and other anaesthetic drugs are of major concern and there are potential complications associated with the postoperative period. The purpose of this review is to update the readers on the recent literature available on the topic. The American Society of Anesthesiologists has recently suggested guidelines on the perioperative management of these patients.

  11. Ameloblastoma: a clinical review and trends in management.

    Science.gov (United States)

    McClary, Andrew C; West, Robert B; McClary, Ashley C; Pollack, Jonathan R; Fischbein, Nancy J; Holsinger, Christopher F; Sunwoo, John; Colevas, A Dimitrios; Sirjani, Davud

    2016-07-01

    Ameloblastoma is a rare odontogenic neoplasm of the mandible and maxilla, with multiple histologic variants, and high recurrence rates if improperly treated. The current mainstay of treatment is wide local excision with appropriate margins and immediate reconstruction. Here we review the ameloblastoma literature, using the available evidence to highlight the change in management over the past several decades. In addition, we explore the recent molecular characterization of these tumors which may point towards new potential avenues of personalized treatment.

  12. Age of the Vindhyan Supergroup: A review of recent findings

    Indian Academy of Sciences (India)

    Jyotiranjan S Ray

    2006-02-01

    The Vindhyan Supergroup of India is one of the largest and thickest sedimentary successions of the world.Deposited in an intra-cratonic basin,it is composed mostly of shallow marine deposits. It is believed to have recorded a substantial portion of Proterozoic time and therefore,likely to contain valuable information on the evolution of the atmosphere,climate,and life on our planet. It also contains some of the most disputed fossils of earliest animal life.Despite their importance, the absolute age of these rocks had remained unknown until recently.In this work I evaluate all the recent chronological information and discuss their implications.From the present findings it appears that the issues surrounding the age of the Lower Vindhyans in the Son valley are now resolved,whereas problems with the age of the Upper Vindhyans and that with the stratigraphic correlations remain to be answered.

  13. Aging in Persons with Rett Syndrome: An Updated Review

    Directory of Open Access Journals (Sweden)

    Meir Lotan

    2010-01-01

    Full Text Available Rett syndrome (RS is a neurological disease affecting mainly females, characterized by an arrest of brain development caused by an X-linked mutation. Rett syndrome is the first human disease found to be caused by defects in a protein involved in regulating gene expression through its interaction with methylated DNA. The disease has been traced to a defective gene called MECP2. The case stories presented here and recent findings show that females with RS are able to live into old age. Due to the observed longevity of individuals with RS, and the fact that individuals with RS present the therapist/physician with specific clinical challenges, it is suggested that proper, long-term, and individually tailored, intensive care should be provided at all ages in the hope to prevent or at least reduce the age-related deterioration that is typical of this population.

  14. Hospital waste management in developing countries: A mini review.

    Science.gov (United States)

    Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz; Geng, Yong

    2017-06-01

    Health care activities can generate different kinds of hazardous wastes. Mismanagement of these wastes can result in environmental and occupational health risks. Developing countries are resource-constrained when it comes to safe management of hospital wastes. This study summarizes the main issues faced in hospital waste management in developing countries. A review of the existing literature suggests that regulations and legislations focusing on hospital waste management are recent accomplishments in many of these countries. Implementation of these rules varies from one hospital to another. Moreover, wide variations exist in waste generation rates within as well as across these countries. This is mainly attributable to a lack of an agreement on the definitions and the methodology among the researchers to measure such wastes. Furthermore, hospitals in these countries suffer from poor waste segregation, collection, storage, transportation and disposal practices, which can lead to occupational and environmental risks. Knowledge and awareness regarding proper waste management remain low in the absence of training for hospital staff. Moreover, hospital sanitary workers, and scavengers, operate without the provision of safety equipment or immunization. Unsegregated waste is illegally recycled, leading to further safety risks. Overall, hospital waste management in developing countries faces several challenges. Sustainable waste management practices can go a long way in reducing the harmful effects of hospital wastes.

  15. Center for Reinventing Aging Infrastructure for Nutrient Management

    Data.gov (United States)

    Federal Laboratory Consortium — The mission of RAINmgt is to achieve sustainable and cost-effective health and environmental outcomes by re-imagining aging coastal urban infrastructure communities....

  16. Clinical management of alcohol withdrawal: A systematic review

    Directory of Open Access Journals (Sweden)

    Shivanand Kattimani

    2013-01-01

    Full Text Available Alcohol withdrawal is commonly encountered in general hospital settings. It forms a major part of referrals received by a consultation-liaison psychiatrist. This article aims to review the evidence base for appropriate clinical management of the alcohol withdrawal syndrome. We searched Pubmed for articles published in English on pharmacological management of alcohol withdrawal in humans with no limit on the date of publication. Articles not relevant to clinical management were excluded based on the titles and abstract available. Full-text articles were obtained from this list and the cross-references. There were four meta-analyses, 9 systematic reviews, 26 review articles and other type of publications like textbooks. Alcohol withdrawal syndrome is a clinical diagnosis. It may vary in severity. Complicated alcohol withdrawal presents with hallucinations, seizures or delirium tremens. Benzodiazepines have the best evidence base in the treatment of alcohol withdrawal, followed by anticonvulsants. Clinical institutes withdrawal assessment-alcohol revised is useful with pitfalls in patients with medical comorbidities. Evidence favors an approach of symptom-monitored loading for severe withdrawals where an initial dose is guided by risk factors for complicated withdrawals and further dosing may be guided by withdrawal severity. Supportive care and use of vitamins is also discussed.

  17. Early Onset Ageing and Service Preparation in People with Intellectual Disabilities: Institutional Managers' Perspective

    Science.gov (United States)

    Lin, Jin-Ding; Wu, Chia-Ling; Lin, Pei-Ying; Lin, Lan-Ping; Chu, Cordia M.

    2011-01-01

    Although longevity among older adults with intellectual disabilities is increasing, there is limited information on their premature aging related health characteristics and how it may change with increasing age. The present paper provides information of the institutional manager's perception on early onset aging and service preparation for this…

  18. Critical study of Jara (aging) and its management

    OpenAIRE

    Parmar, Nisha; Vyas, Mahesh; Vyas, Hitesh

    2012-01-01

    Jara Avastha (stage of old age) is the later phase of life in which maximum decline of bodily elements is observed. Paramanuvibhaga (cell division) takes place at every moment; particularly in old age, it will be fast in comparison with other phases of life. Some organ related changes also take place during this period, which are the decades of Balya, Vridhhi, Chhavi, Medha, Twak, etc., In this study, applied aspects of Medha Hani, Twak Hani, and Drishti Hani were evaluated subjectively as we...

  19. Key management issue in SCADA networks: A review

    Directory of Open Access Journals (Sweden)

    Abdalhossein Rezai

    2017-02-01

    Full Text Available Supervisory Control And Data Acquisition (SCADA networks have a vital role in Critical Infrastructures (CIs such as public transports, power generation systems, gas, water and oil industries, so that there are concerns on security issues in these networks. The utilized Remote Terminal Units (RTUs and Intelligence Electronic Devices (IEDs in these networks have resource limitations, which make security applications a challenging issue. Efficient key management schemes are required besides lightweight ciphers for securing the SCADA communications. Many key management schemes have been developed to address the tradeoff between SCADA constrain and security, but which scheme is the most effective is still debatable. This paper presents a review of the existing key management schemes in SCADA networks, which provides directions for further researches in this field.

  20. Critical Review On Management Information System And Accounting Information System

    Directory of Open Access Journals (Sweden)

    Galuh Tresna Murti

    2015-08-01

    Full Text Available This paper is aimed at investigating the correlation between management information system and accounting information system to gain better understanding of each system.After conducting reviews on available literatures it is concluded in this article that arguments among experts still clearly prevail about both system. Different arguments are not to be eliminated as each argument is supported by adequate literatures and difference in system is a common thing due to differences in experiences point of views and interests of the experts.This paper argues that since management information system is available in every part of an organization therefore accounting information system is the sub-system of management information system which main objective is to use organization information system effectively.

  1. Environmental review of options for managing radioactively contaminated carbon steel

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-10-01

    The U.S. Department of Energy (DOE) is proposing to develop a strategy for the management of radioactively contaminated carbon steel (RCCS). Currently, most of this material either is placed in special containers and disposed of by shallow land burial in facilities designed for low-level radioactive waste (LLW) or is stored indefinitely pending sufficient funding to support alternative disposition. The growing amount of RCCS with which DOE will have to deal in the foreseeable future, coupled with the continued need to protect the human and natural environment, has led the Department to evaluate other approaches for managing this material. This environmental review (ER) describes the options that could be used for RCCS management and examines the potential environmental consequences of implementing each. Because much of the analysis underlying this document is available from previous studies, wherever possible the ER relies on incorporating the conclusions of those studies as summaries or by reference.

  2. Road map for pain management in pancreatic cancer: A review

    Institute of Scientific and Technical Information of China (English)

    Marie José Lahoud; Hampig Raphael Kourie; Joelle Antoun; Lana El Osta; Marwan Ghosn

    2016-01-01

    Beside its poor prognosis and its late diagnosis, pancreatic cancer remains one of the most painful malignancies. Optimal management of pain in this cancer represents a real challenge for the oncologist whose objective is to ensure a better quality of life to his patients. We aimed in this paper to review all the treatment modalities incriminated in the management of pain in pancreatic cancer going from painkillers, chemotherapy, radiation therapy and interventional techniques to agents under investigation and alternative medicine. Although specific guidelines and recommendations for pain management in pancreatic cancer are still absent, we present all the possible pain treatments, with a progression from medical multimodal treatment to radiotherapy and chemotherapy then interventional techniques in case of resistance. In addition, alternative methods such as acupuncture and hypnosis can be added at any stage and seems to contribute to pain relief.

  3. A SYSTEMATIC REVIEW OF UNCERTAINTIES IN SOFTWARE PROJECT MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Marcelo Marinho

    2014-12-01

    Full Text Available It is no secret that many projects fail, regardless of the business sector, software projects are notoriously disaster victims, not necessarily because of technological failure, but more often due to their uncertainties. The threats identified by uncertainty in day-to-day of a project are real and immediate and the stakes in a project are often high. This paper presents a systematic review about software project management uncertainties. It helps to identify the difficulties and the actions that can minimize the uncertainties effects in the projects and how managers and teams can prepare themselves for the challenges of their projects scenario, with the aim of contributing to the improvement of project management in organizations as well as contributing to project success

  4. Review on light management by nanostructures in chalcopyrite solar cells

    Science.gov (United States)

    Schmid, M.

    2017-04-01

    Light management has gained wide interest for various types of solar cells. This paper reviews the application of nanostructures for light management to chalcopyrite (CIGSe) type solar cells. Firstly, the relevance of light management for CIGSe solar cells will be introduced and concepts of nanostructures for absorption enhancement discussed. The development of ultra-thin CIGSe solar cells and examples for nanoparticle fabrication techniques together with their chances and challenges for application to CIGSe will be presented. Particular attention will be paid to nanostructures that have been applied to CIGSe solar cells, revealing many theoretical and some experimental results. Metallic and dielectric nanostructures as well as intrinsic nanotextures will be covered. For the future, combined considerations of optical and electrical properties will gain in importance.

  5. Multifaceted Impacts of Sustainable Land Management in Drylands: A Review

    Directory of Open Access Journals (Sweden)

    Maria Jose Marques

    2016-02-01

    Full Text Available Biophysical restoration or rehabilitation measures of land have demonstrated to be effective in many scientific projects and small-scale environmental experiments. However circumstances such as poverty, weak policies, or inefficient scientific knowledge transmission can hinder the effective upscaling of land restoration and the long term maintenance of proven sustainable use of soil and water. This may be especially worrisome in lands with harsh environmental conditions. This review covers recent efforts in landscape restoration and rehabilitation with a functional perspective aiming to simultaneously achieve ecosystem sustainability, economic efficiency, and social wellbeing. Water management and rehabilitation of ecosystem services in croplands, rangelands, forests, and coastlands are reviewed. The joint analysis of such diverse ecosystems provides a wide perspective to determine: (i multifaceted impacts on biophysical and socio-economic factors; and (ii elements influencing effective upscaling of sustainable land management practices. One conclusion can be highlighted: voluntary adoption is based on different pillars, i.e. external material and economic support, and spread of success information at the local scale to demonstrate the multidimensional benefits of sustainable land management. For the successful upscaling of land management, more attention must be paid to the social system from the first involvement stage, up to the long term maintenance.

  6. Nevada Risk Assessment/Management Program scientific peer review

    Energy Technology Data Exchange (ETDEWEB)

    Bentz, E.J. Jr.; Bentz, C.B.; O`Hora, T.D. [E.J. Bentz and Associates, Inc., Alexandria, VA (United States); Chen, S.Y. [Argonne National Lab., IL (United States). Environmental Assessment Div.

    1997-04-01

    The 1,350 square-mile Nevada Test Site and additional sites in Nevada served as the continental sites for US nuclear weapons testing from 1951 to 1992. The Nevada Risk Assessment/Management Program (NRAMP) is a currently on-going effort of the Harry Reid Center for Environmental Studies at the University of Nevada, Las Vegas (UNLV) and the firm of E. J. Bentz and Associates, Inc., in cooperation with the US Department of Energy (DOE) Environmental Management Program. Argonne National Laboratory is one of several public and private organizations supporting personnel appointed by the NRAMP to the NRAMP Scientific Peer Review Panel. The NRAMP is part of a national effort by the DOE to develop new sources of information and approaches to risk assessment, risk management, risk communication, and public outreach relevant to the ecological and human health effects of radioactive and hazardous materials management and site remediation activities. This paper describes the development, conduct, and current results of the scientific peer review process which supports the goals of the NRAMP.

  7. Human Capital Management in Banking Institutions in Connection with the Population Ageing Process, Age Management Philosophy and the Concept of Corporate Social Responsibility in the Czech Republic

    Directory of Open Access Journals (Sweden)

    Jiří Bejtkovský

    2015-01-01

    Full Text Available The aim of the article is, besides other things, to identify awareness of the Age Management philosophy in respect of the Corporate Social Responsibility concept in Czech banking institutions and further think about how to implement the philosophy in the process of human resource management so as to be targeted and efficient for all entities involved. From research methods, questionnaire survey and observation were used. These methods were further supplemented with a semi-structured interview with the employees of banking institutions. The obtained data were analyzed by statistical methods. In association with the conducted researches it can be generally stated that the addressed respondents agree with the statement that their banking institution does implement age diversity of employees in a certain form and Age Management principles – the idea of heterogeneous structure of employees, development of working conditions and environment for performance of required working conditions or cooperation on corporate projects.

  8. Facilitating age diversity in organizations – part II: managing perceptions and interactions

    NARCIS (Netherlands)

    Hertel, Guido; Heijden, van der Beatrice I.J.M.; Lange, de Annet H.; Deller, Jürgen

    2013-01-01

    Purpose – Due to demographic changes in most industrialized countries, the average age of working people is continuously increasing, and the workforce is becoming more age-diverse. This review, together with the earlier JMP Special Issue “Facilitating age diversity in organizations – part I: challen

  9. Facilitating age diversity in organizations – part II: managing perceptions and interactions

    NARCIS (Netherlands)

    Hertel, Guido; van der Heijden, Beatrice; de Lange, Annet H.; Deller, Jürgen

    2013-01-01

    Purpose – Due to demographic changes in most industrialized countries, the average age of working people is continuously increasing, and the workforce is becoming more age-diverse. This review, together with the earlier JMP Special Issue “Facilitating age diversity in organizations – part I: challen

  10. Facilitating age diversity in organizations ‐ part II: managing perceptions and interactions

    NARCIS (Netherlands)

    Beatrice van der Heijden; Guido Hertel; Annet de Lange; Jürgen Deller

    2013-01-01

    Purpose ‐ Due to demographic changes in most industrialized countries, the average age of working people is continuously increasing, and the workforce is becoming more age-diverse. This review, together with the earlier JMP Special Issue "Facilitating age diversity in organizations ‐ part I: challen

  11. Facilitating age diversity in organizations – part II: managing perceptions and interactions

    NARCIS (Netherlands)

    Hertel, Guido; van der Heijden, Beatrice; de Lange, Annet H.; Deller, Jürgen

    2013-01-01

    Purpose – Due to demographic changes in most industrialized countries, the average age of working people is continuously increasing, and the workforce is becoming more age-diverse. This review, together with the earlier JMP Special Issue “Facilitating age diversity in organizations – part I:

  12. Facilitating age diversity in organizations ‐ part II: managing perceptions and interactions

    NARCIS (Netherlands)

    Beatrice van der Heijden; Guido Hertel; Annet de Lange; Jürgen Deller

    2013-01-01

    Purpose ‐ Due to demographic changes in most industrialized countries, the average age of working people is continuously increasing, and the workforce is becoming more age-diverse. This review, together with the earlier JMP Special Issue "Facilitating age diversity in organizations ‐ part I:

  13. Facilitating age diversity in organizations ‐ part II: managing perceptions and interactions

    NARCIS (Netherlands)

    Hertel, Guido; Heijden, Beatrice van der; Lange, Annet de; Deller, Jürgen

    2013-01-01

    Purpose ‐ Due to demographic changes in most industrialized countries, the average age of working people is continuously increasing, and the workforce is becoming more age-diverse. This review, together with the earlier JMP Special Issue "Facilitating age diversity in organizations ‐ part I: challen

  14. Uneven-aged forest management in boreal Sweden: local forestry stakeholders' perceptions of different sustainability dimensions

    OpenAIRE

    Axelsson, Robert; Angelstam, Per

    2011-01-01

    To implement policies on sustainable forest management (SFM), there is a need to satisfy economical, ecological and socio-cultural sustainability objectives. Due to a long history of sustained yield wood production to satisfy the needs of the forest industry, clearfelling management systems are used in similar to 96 per cent of managed forests in Sweden. To satisfy the intentions of contemporary forest and land use policies, uneven-aged forest management systems as a complement are currently ...

  15. Risk Management in the Age of Turbulence - Failures and Challenges

    Directory of Open Access Journals (Sweden)

    Alexandru CAPATINA

    2012-08-01

    Full Text Available Today’s business, being affected by the continuous changes in economic environment, must reinvent the “prudent risk taking” concept to strike an appropriate balance between risk, return and growth, in order to create lasting value. This paper is focused on describing the nature of risk and the objectives of risk management. In the context of more attractive risk conceptual simplifications which often lead to significant errors, the paper explains the failures in risk management, the way of their occurrence and the methods of reducing their occurrence.

  16. Management of cerebral cavernous malformations in the pediatric population: a literature review and case illustrations.

    Science.gov (United States)

    Kosnik-Infinger, L; Carroll, C; Greiner, H; Leach, J; Mangano, F T

    2015-09-01

    Cavernous malformations (CM) are vascular malformations of the central nervous system that may occur in the brain and spinal cord. They are one of the four major types of vascular malformations that also includes developmental venous anomalies (DVA)s, arteriovenous malformations (AVMs), and capillary telangiectasias. CMs are a common vascular malformation, and 25% of them occur in the pediatric age group. They can present with acute or chronic symptoms including headache, neurologic deficits secondary to hemorrhage, mass effect, or epilepsy. This review will focus on the neurosurgical management of intracranial cavernous malformations in children. Pediatric CMs have special considerations different from CM that occur in the adult population which are highlighted throughout this review. Characteristics specific to pediatric CM epidemiology, genetics, presentation, pathology, location, size, epilepsy, and management will be discussed. Specific considerations must be entertained with the diagnosis of pediatric CM in that management needs to include consideration of the lifetime risk of hemorrhage, as well as the possibility of development of epilepsy. If in an accessible location, most cavernomas should be surgically removed in a timely fashion to provide lifelong cure for pediatric patients. The review closes with the discussion of two interesting cavernous malformation cases occurring in a 12-year old male and a 12-year old female that exhibit many of the important aspects specific to the management of a pediatric patient with CM, highlighting the importance of a multidisciplinary approach to treatment.

  17. Economic evaluation of enhanced asthma management: a systematic review

    Directory of Open Access Journals (Sweden)

    Yong YV

    2014-12-01

    Full Text Available Objectives: To evaluate and compare full economic evaluation studies on the cost-effectiveness of enhanced asthma management (either as an adjunct to usual care or alone vs. usual care alone. Methods: Online databases were searched for published journal articles in English language from year 1990 to 2012, using the search terms ‘“asthma” AND (“intervene” OR “manage” AND (“pharmacoeconomics” OR “economic evaluation” OR “cost effectiveness” OR “cost benefit” OR “cost utility”’. Hand search was done for local publishing. Only studies with full economic evaluation on enhanced management were included (cost consequences (CC, cost effectiveness (CE, cost benefit (CB, or cost utility (CU analysis. Data were extracted and assessed for the quality of its economic evaluation design and evidence sources. Results: A total of 49 studies were included. There were 3 types of intervention for enhanced asthma management: education, environmental control, and self-management. The most cost-effective enhanced management was a mixture of education and self-management by an integrated team of healthcare and allied healthcare professionals. In general, the studies had a fair quality of economic evaluation with a mean QHES score of 73.7 (SD=9.7, and had good quality of evidence sources. Conclusion: Despite the overall fair quality of economic evaluations but good quality of evidence sources for all data components, this review showed that the delivered enhanced asthma managements, whether as single or mixed modes, were overall effective and cost-reducing. Whilst the availability and accessibility are an equally important factor to consider, the sustainability of the cost-effective management has to be further investigated using a longer time horizon especially for chronic diseases such as asthma.

  18. Increasing the Value of Age: Guidance in Employers' Age Management Strategies. Research Paper No 44

    Science.gov (United States)

    Cedefop - European Centre for the Development of Vocational Training, 2015

    2015-01-01

    The European active population is ageing. In the face of growing skills shortages, both national States and employers need to prolong the working lives of their most experienced workers. While enterprises strive to respond to this challenge, most still have not fully explored the potential of guidance activities in addressing age-related issues in…

  19. Using demand-side management to decrease transformer ageing

    NARCIS (Netherlands)

    van der Klauw, Thijs; Gerards, Marco Egbertus Theodorus; Hurink, Johann L.

    2016-01-01

    The introduction of local, often uncontrollable, generation units as well as larger loads such as electric vehicles (EVs) causes an increasing amount of stress on our energy supply chain, specifically on the distribution grids. Demand-side management (DSM) is often seen as a potential technology to

  20. Bulk Electrical Cable Non-Destructive Examination Methods for Nuclear Power Plant Cable Aging Management Programs

    Energy Technology Data Exchange (ETDEWEB)

    Glass, Samuel W. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Jones, Anthony M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Fifield, Leonard S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hartman, Trenton S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-09-01

    This Pacific Northwest National Laboratory milestone report describes progress to date on the investigation of nondestructive test methods focusing particularly on bulk electrical test methods that provide key indicators of cable aging and damage. The work includes a review of relevant literature as well as hands-on experimental verification of inspection capabilities. As nuclear power plants consider applying for second, or subsequent, license renewal to extend their operating period from 60 years to 80 years, it is important to understand how the materials installed in plant systems and components will age during that time and develop aging management programs to assure continued safe operation under normal and design basis events (DBE). Normal component and system tests typically confirm the cables can perform their normal operational function. The focus of the cable test program, however, is directed toward the more demanding challenge of assuring the cable function under accident or DBE. The industry has adopted 50% elongation at break (EAB) relative to the un-aged cable condition as the acceptability standard. All tests are benchmarked against the cable EAB test. EAB, however, is a destructive test so the test programs must apply an array of other nondestructive examination (NDE) tests to assure or infer the overall set of cable’s system integrity. Assessment of cable integrity is further complicated in many cases by vendor’s use of dissimilar material for jacket and insulation. Frequently the jacket will degrade more rapidly than the underlying insulation. Although this can serve as an early alert to cable damage, direct test of the cable insulation without violating the protective jacket becomes problematic. This report addresses the range of bulk electrical NDE cable tests that are or could be practically implemented in a field-test situation with a particular focus on frequency domain reflectometry (FDR). The FDR test method offers numerous advantages

  1. Youth with Behavioral Health Disorders Aging Out of Foster Care: a Systematic Review and Implications for Policy, Research, and Practice.

    Science.gov (United States)

    Kang-Yi, Christina D; Adams, Danielle R

    2017-01-01

    This systematic review aimed to (1) identify and summarize empirical studies on youth with behavioral health disorders aging out of foster care and (2) address implications for behavioral health policy, research, and practice. We identified previous studies by searching PubMed, PsycINFO, EBSCO, and ISI Citation Indexes and obtaining references from key experts in the child welfare field. A total of 28 full articles published between 1991 and 2014 were reviewed and summarized into the key areas including systems of care, disability type, transition practice area, study methods, study sample, transition outcome measures, study analysis, and study findings. Considering how fast youth who have behavioral health disorders fall through the crack as they exit foster care, one cannot understate the importance of incorporating timely and appropriate transition planning and care coordination for youth who have behavioral health disorders aging out of foster care into the usual case management performed by behavioral health systems and service providers.

  2. Down Syndrome and the aging process: a systematic review

    OpenAIRE

    Bruno de Sousa Lopes; Lucy Gomes Vianna; Clayton Franco Moraes; Gustavo de Azevedo Carvalho; Vicente Paulo Alves

    2015-01-01

    The study aimed to identify and update the knowledge about older people with Down Syndrome (DS), and to understand the peculiarities of the aging process in this population. Bibliographical research conducted by Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior and High Wire portal. Inclusion criteria were articles published in the last ten years with the words “Down Syndrome" and “Elderly”.  

  3. The Aging Military Aviator: A Review and Annotated Bibliography

    Science.gov (United States)

    1993-01-01

    aviation pilots. Very shortly thereafter, the International Civil Aviation Organization ( ICAO ) issued a similar policy affecting its member countries...lack of general methods of evaluating an individual’s monocular depth perception. If binocular vision is so vital to aviation, how does one explain...aged pilots with reduced binocular vision, or even monocular vision, accomplishing landings and other tasks requiring depth perception? Quite obviously

  4. Neonatal Abstinence Syndrome Management: A Review of Recent Evidence.

    Science.gov (United States)

    Grossman, Matthew; Seashore, Carl; Holmes, Alison Volpe

    2017-08-16

    The evaluation and management of infants with neonatal abstinence syndrome (NAS), the constellation of opioid withdrawal specific to newborns, has received renewed attention over the past decade during a new epidemic of opioid use, misuse, abuse, and dependence. Infants with NAS often endure long and costly hospital stays. We aim to review recent literature on the management and outcomes of infants with, and at risk for, opioid withdrawal. We reviewed articles indexed in PubMed over the past 5 years that examined interventions and/or outcomes related to the management of infants with NAS. Thirty-seven studies were included in our review comprising 8 categories: 1) identification of infants at risk for NAS, 2) prenatal factors, 3) evaluation of signs and symptoms, 4) non-pharmacologic care, including rooming-in and breastfeeding, 5) standardization of traditional protocols, 6) pharmacologic management, 7) alternative treatment approaches, and 8) long-term outcomes. Non-pharmacologic interventions, standardization of traditional protocols, and alternative treatment approaches were all associated with improved outcomes. Lengths of stay were generally lowest in the studies of non-pharmacologic interventions. Patients exposed to buprenorphine in utero tended to have better short-term outcomes than those exposed to methadone. Longer-term outcomes for infants with NAS appear to be worse than those of control groups. The current epidemic necessitates both continued research, and the application of new evidence-based practices in the assessment and treatment of newborns exposed to opioids in utero. Projects focused on non-pharmacologic interventions appear to hold the most promise. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  5. Model predictive control power management strategies for HEVs: A review

    Science.gov (United States)

    Huang, Yanjun; Wang, Hong; Khajepour, Amir; He, Hongwen; Ji, Jie

    2017-02-01

    This paper presents a comprehensive review of power management strategy (PMS) utilized in hybrid electric vehicles (HEVs) with an emphasis on model predictive control (MPC) based strategies for the first time. Research on MPC-based power management systems for HEVs has intensified recently due to its many inherent merits. The categories of the existing PMSs are identified from the latest literature, and a brief study of each type is conducted. Then, the MPC approach is introduced and its advantages are discussed. Based on the acquisition method of driver behavior used for state prediction and the dynamic model used, the MPC is classified and elaborated. Factors that affect the performance of the MPC are put forward, including prediction accuracy, design parameters, and solvers. Finally, several important issues in the application of MPC-based power management strategies and latest developing trends are discussed. This paper not only provides a comprehensive analysis of MPC-based power management strategies for HEVs but also puts forward the future and emphasis of future study, which will promote the development of energy management controller with high performance and low cost for HEVs.

  6. Stress management in dental students: a systematic review

    Directory of Open Access Journals (Sweden)

    Alzahem AM

    2014-05-01

    Full Text Available Abdullah M Alzahem,1 Henk T Van der Molen,2 Arwa H Alaujan,3 Benjamin J De Boer4 1King Abdullah International Medical Research Center, King Saud bin Abdulaziz University for Health Sciences, National Guard Health Affairs, Riyadh, Saudi Arabia; 2Institute of Psychology, Faculty of Social Sciences, Erasmus University, Rotterdam, the Netherlands; 3Dental Services, Central Region, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia; 4Clinical Psychology, Princess Nora University, Riyadh, Saudi Arabia Abstract: This study compared the effectiveness of stress management programs in dental education by systematic review of the literature. The number of studies concerning stress management programs for dental students is limited compared with studies discussing sources of stress. Several types of programs for stress management have been reported, and differ in their duration, content, and outcomes. Two main strategies have been used to help stressed students, ie, decreasing the number of stressors and increasing the ability to cope with stress. The first strategy includes several components, such as reducing fear of failure and workload pressure due to examinations and requirements. The second strategy includes coping techniques, such as deep breathing exercises. Although positive effects have been reported for most of the programs, these have mainly been evaluated using subjective self-report measures. There is a need for more research to identify the most effective stress management program. Keywords: students, dentistry, education, management, stress

  7. Facilities Management Practices in Malaysia: A Literature Review

    Directory of Open Access Journals (Sweden)

    Isa Nordiana Mohd

    2016-01-01

    Full Text Available Facilities management in Malaysia has been practiced for decades. The development of its formal practice parallels the improvement of the built environment in the nation. Involvement of the public and private sectors teaming up in arranging the National Asset and Facilities Management (NAFAM in demonstrates the vital collaboration in the facilities management area in Malaysia. Facilities management is seen distinctively as indicated by diverse geographical locations, interests and schools of thought. Facilities management is delegated a service-based industry which gives proficient counsel and administration of clients’ building facilities including residential, commercial, industrial, airports terminals and offices. The aim of this paper is to review the gaps that exist, especially on how FM is being practice in comparison with the published FM body of knowledge. Very relying upon literature, this paper discovered a gap that is an unclear description of current FM applications. This research aims to give new bits of knowledge to upgrade comprehension of FM execution in Malaysia.

  8. Residual limb volume change: Systematic review of measurement and management

    Directory of Open Access Journals (Sweden)

    Joan E. Sanders, PhD

    2011-10-01

    Full Text Available Management of residual limb volume affects decisions regarding timing of fit of the first prosthesis, when a new prosthetic socket is needed, design of a prosthetic socket, and prescription of accommodation strategies for daily volume fluctuations. This systematic review assesses what is known about measurement and management of residual limb volume change in persons with lower-limb amputation. Publications that met inclusion criteria were grouped into three categories: group I: descriptions of residual limb volume measurement techniques; group II: studies investigating the effect of residual limb volume change on clinical care in people with lower-limb amputation; and group III: studies of residual limb volume management techniques or descriptions of techniques for accommodating or controlling residual limb volume. We found that many techniques for the measurement of residual limb volume have been described but clinical use is limited largely because current techniques lack adequate resolution and in-socket measurement capability. Overall, limited evidence exists regarding the management of residual limb volume, and the evidence available focuses primarily on adults with transtibial amputation in the early postoperative phase. While we can draw some insights from the available research about residual limb volume measurement and management, further research is required.

  9. Review of Requirements Management Issues in Software Development

    Directory of Open Access Journals (Sweden)

    Muhammad Naeem Ahmed Khan

    2013-01-01

    Full Text Available A requirement is a capability to which a product or service should conform to. A meticulous consideration to requirements engineering acts as a backbone of software projects. Ambiguous and unrealistic requirements are major source of failure in the software-intensive systems. Requirements engineering processes are complex as most of the requirements engineering documentation is written in natural languages which are less formal and often distract the designers and developers. Requirements management is a continuous process throughout the project lifecycle and relates to documenting, analyzing, tracing and prioritizing requirements and then finally controlling changes. The main issues related to requirements management are usually social, political and cultural. Software requirement engineers who gather the requirements generally consider that such issues are beyond the scope of their profession as they deem them within the project management ambit. In this study, we highlight the management issues that arise in the requirements engineering process and explore the possibilities to tackle them amicably. The study is supplemented with a critical review of the existing methodologies for resolving and managing software requirements.

  10. ANSTO`s radioactive waste management policy. Preliminary environmental review

    Energy Technology Data Exchange (ETDEWEB)

    Levins, D.M.; Airey, P.; Breadner, B.; Bull, P.; Camilleri, A.; Dimitrovski, L.; Gorman, T.; Harries, J.; Innes, R.; Jarquin, E.; Jay, G.; Ridal, A.; Smith, A.

    1996-05-01

    For over forty years, radioactive wastes have been generated by ANSTO (and its predecessor, the AAEC) from the operation of nuclear facilities, the production of radioisotopes for medical and industrial use, and from various research activities. the quantities and activities of radioactive waste currently at Lucas Heights are very small compared to many other nuclear facilities overseas, especially those in countries with nuclear power program. Nevertheless, in the absence of a repository for nuclear wastes in Australia and guidelines for waste conditioning, the waste inventory has been growing steadily. This report reviews the status of radioactive waste management at ANSTO, including spent fuel management, treatment of effluents and environmental monitoring. It gives details of: relevant legislative, regulatory and related requirements; sources and types of radioactive waste generated at ANSTO; waste quantities and activities (both cumulative and annual arisings); existing practices and procedures for waste management and environmental monitoring; recommended broad strategies for dealing with radioactive waste management issues. Detailed proposals on how the recommendations should be implemented is the subject of a companion internal document, the Radioactive Waste Management Action Plan 1996-2000 which provides details of the tasks to be undertaken, milestones and resource requirements. 44 refs., 2 tabs., 18 figs.

  11. 5 CFR 10.3 - OPM authority to review personnel management programs and practices.

    Science.gov (United States)

    2010-01-01

    ... management programs and practices. 10.3 Section 10.3 Administrative Personnel OFFICE OF PERSONNEL MANAGEMENT CIVIL SERVICE RULES AGENCY ACCOUNTABILITY SYSTEMS; OPM AUTHORITY TO REVIEW PERSONNEL MANAGEMENT PROGRAMS (RULE X) § 10.3 OPM authority to review personnel management programs and practices. The Office of...

  12. Knowledge Management System in Health & Social Care: Review on 20 Practiced Knowledge Management

    Directory of Open Access Journals (Sweden)

    Muhammad Saiful Ridhwan

    2014-02-01

    Full Text Available The importance of managing medical information has become very critical in the healthcare delivery system. Medical information nowadays are optimized towards serving different areas such as; diagnosing of diseases, planning and administration, treatment and monitoring of patient outcomes, services and costs. This article provides a review into various Health and Social Care systems which encompasses the Knowledge Management value. For analysis, more than 30 systems that are related to Health and Social Care were gathered via Internet research, only 20 of these systems were finally selected based on recent system development and popularity of the system.Keywords: Health Care, Knowledge, Knowledge Management, Social Care, systemdoi:10.12695/ajtm.2013.6.2.4 How to cite this article:Ridhwan, M.S., and Oyefolahan, I.O. (2013. Knowledge Management System in Health & Social Care: Review on 20 Practiced Knowledge Management. The Asian Journal of Technology Management 6 (2: 92-101. Print ISSN: 1978-6956; Online ISSN: 2089-791X. doi:10.12695/ajtm.2013.6.2.4

  13. Hospital Management Between The Modern Image And Aging

    Science.gov (United States)

    Dadulescu, Ana-Maria

    2015-09-01

    Hospital management has experienced significant progress with the evolution of the Romanian health system reform, it has made strides in terms of resource allocation and cost control, new systems for classification, evaluation and monitoring (DRGs, SIUI, CaPeSaRo) were implemented, some taken from other countries and adapted to local conditions, but not always integrated with the other components and sometimes incompletely implemented and developed. This material does not offer definite solutions to current problems. It only briefly addresses the main aspects of hospital activity, and points out some failures with whom hospital managers are presently faced. Once the problems are identified it creates prerequisites for solving them, it opens channels of research and development of new methodologies or correlation of the existing deficient workflows that can be corrected.

  14. 47,XXY Klinefelter syndrome: clinical characteristics and age-specific recommendations for medical management.

    Science.gov (United States)

    Aksglaede, Lise; Link, Katarina; Giwercman, Aleksander; Jørgensen, Niels; Skakkebaek, Niels E; Juul, Anders

    2013-02-15

    47,XXY (Klinefelter syndrome) is the most frequent sex chromosomal disorder and affects approximately one in 660 newborn boys. The syndrome is characterized by varying degrees of cognitive, social, behavioral, and learning difficulties and in adulthood additionally primary testicular failure with small testes, hypergonadotropic hypogonadism, tall stature, and eunuchoid body proportions. The phenotype is variable ranging from "near-normal" to a significantly affected individual. In addition, newborns with Klinefelter syndrome generally present with a normal male phenotype and the only consistent clinical finding in KS is small testes, that are most often not identified until after puberty. Decreased awareness of this syndrome among health professionals and a general perception that all patients with 47,XXY exhibit the classic textbook phenotype results in a highly under-diagnosed condition with up to 75% of the patients left undetected. Typically, diagnosis is delayed with the majority of patients identified during fertility workup in adulthood, and only 10% of patients diagnosed prior to puberty. Early detection of this syndrome is recommended in order to offer treatment and intervention at the appropriate ages and stages of development for the purpose of preventing osteopenia/osteoporosis, metabolic syndrome, and other medical conditions related to hypogonadism and to the XXY as well as minimizing potential learning and psychosocial problems. The aim of this review is to present the clinical aspects of XXY and the age-specific recommendations for medical management. © 2013 Wiley Periodicals, Inc.

  15. A meta-analytic review of emotion recognition and aging: implications for neuropsychological models of aging.

    Science.gov (United States)

    Ruffman, Ted; Henry, Julie D; Livingstone, Vicki; Phillips, Louise H

    2008-01-01

    This meta-analysis of 28 data sets (N=705 older adults, N=962 younger adults) examined age differences in emotion recognition across four modalities: faces, voices, bodies/contexts, and matching of faces to voices. The results indicate that older adults have increased difficulty recognising at least some of the basic emotions (anger, sadness, fear, disgust, surprise, happiness) in each modality, with some emotions (anger and sadness) and some modalities (face-voice matching) creating particular difficulties. The predominant pattern across all emotions and modalities was of age-related decline with the exception that there was a trend for older adults to be better than young adults at recognising disgusted facial expressions. These age-related changes are examined in the context of three theoretical perspectives-positivity effects, general cognitive decline, and more specific neuropsychological change in the social brain. We argue that the pattern of age-related change observed is most consistent with a neuropsychological model of adult aging stemming from changes in frontal and temporal volume, and/or changes in neurotransmitters.

  16. The alliance managing talent in the networked age

    CERN Document Server

    Hoffman, Reid; Yeh, Chris

    2014-01-01

    Introducing the new, realistic loyalty pact between employer and employee. The employer-employee relationship is broken, and managers face a seemingly impossible dilemma: the old model of guaranteed long-term employment no longer works in a business environment defined by continuous change, but neither does a system in which every employee acts like a free agent. The solution? Stop thinking of employees as either family or as free agents. Think of them instead as allies. As a manager you want your employees to help transform the company for the future. And your employees want the company to help transform their careers for the long term. But this win-win scenario will happen only if both sides trust each other enough to commit to mutual investment and mutual benefit. Sadly, trust in the business world is hovering at an all-time low. We can rebuild that lost trust with straight talk that recognizes the realities of the modern economy. So, paradoxically, the alliance begins with managers acknowledging that ...

  17. Role of Age-Associated Alterations of the Dermal Extracellular Matrix Microenvironment in Human Skin Aging: A Mini-Review.

    Science.gov (United States)

    Quan, Taihao; Fisher, Gary J

    2015-01-01

    Human skin is largely composed of a collagen-rich connective tissue, which provides structural and functional support. The collagen-rich connective tissue is produced, organized, and maintained by dermal fibroblasts. During aging, dermal collagen fibrils undergo progressive loss and fragmentation, leading to thin and structurally weakened skin. Age-related alterations of collagen fibrils impairs skin structure and function and creates a tissue microenvironment that promotes age-related skin diseases, such as delayed wound healing and skin cancer development. This mini-review describes cellular mechanisms that give rise to self-perpetuating, collagen fibril fragmentation that creates an age-associated dermal microenvironment, which contributes to decline of human skin function.

  18. Down Syndrome and the aging process: a systematic review

    Directory of Open Access Journals (Sweden)

    Bruno Sousa Lopes

    2015-05-01

    Full Text Available The study aimed to identify and update the knowledge about older people with Down Syndrome (DS, and to understand the peculiarities of the aging process in this population. Bibliographical research conducted by Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior and High Wire portal. Inclusion criteria were articles published in the last ten years with the words “Down Syndrome" and “Elderly”.  

  19. Down Syndrome and the aging process: a systematic review

    OpenAIRE

    Lopes, Bruno Sousa; Universidade Católica de Brasília (UCB). Brasília (DF).; Vianna, Lucy Gomes; Universidade Católica de Brasília (UCB); Moraes, Clayton Franco; Universidade Católica de Brasília (UCB).; Carvalho, Gustavo de Azevedo; Universidade Católica de Brasília (UCB). Brasília (DF).; Alves, Vicente Paulo; Universidade Católica de Brasília (UCB). Brasília (DF).

    2015-01-01

    The study aimed to identify and update the knowledge about older people with Down Syndrome (DS), and to understand the peculiarities of the aging process in this population. Bibliographical research conducted by Portal de Periódicos da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior and High Wire portal. Inclusion criteria were articles published in the last ten years with the words “Down Syndrome" and “Elderly”.   O estudo teve como objetivo identificar e atualizar os conheci...

  20. Digital asthma self-management interventions: a systematic review.

    Science.gov (United States)

    Morrison, Deborah; Wyke, Sally; Agur, Karolina; Cameron, Euan J; Docking, Robert I; Mackenzie, Alison M; McConnachie, Alex; Raghuvir, Vandana; Thomson, Neil C; Mair, Frances S

    2014-02-18

    Many people with asthma tolerate symptoms and lifestyle limitations unnecessarily by not utilizing proven therapies. Better support for self-management is known to improve asthma control, and increasingly the Internet and other digital media are being used to deliver that support. Our goal was to summarize current knowledge, evidenced through existing systematic reviews, of the effectiveness and implementation of digital self-management support for adults and children with asthma and to examine what features help or hinder the use of these programs. A comprehensive search strategy combined 3 facets of search terms: (1) online technology, (2) asthma, and (3) self-management/behavior change/patient experience. We undertook searches of 14 databases, and reference and citation searching. We included qualitative and quantitative systematic reviews about online or computerized interventions facilitating self-management. Title, abstract, full paper screening, and quality appraisal were performed by two researchers independently. Data extraction was undertaken using standardized forms. A total of 3810 unique papers were identified. Twenty-nine systematic reviews met inclusion criteria: the majority were from the United States (n=12), the rest from United Kingdom (n=6), Canada (n=3), Portugal (n=2), and Australia, France, Spain, Norway, Taiwan, and Greece (1 each). Only 10 systematic reviews fulfilled pre-determined quality standards, describing 19 clinical trials. Interventions were heterogeneous: duration of interventions ranging from single use, to 24-hour access for 12 months, and incorporating varying degrees of health professional involvement. Dropout rates ranged from 5-23%. Four RCTs were aimed at adults (overall range 3-65 years). Participants were inadequately described: socioeconomic status 0/19, ethnicity 6/19, and gender 15/19. No qualitative systematic reviews were included. Meta-analysis was not attempted due to heterogeneity and inadequate information

  1. Millennial fandom: Television audiences in the transmedia age, by Louisa Ellen Stein [book review

    Directory of Open Access Journals (Sweden)

    Helena Louise Dare-Edwards

    2016-09-01

    Full Text Available Review of Louisa Ellen Stein, Millennial fandom: Television audiences in the transmedia age. Iowa City: University of Iowa Press, 2015, paperback, $24 (224p ISBN 978-1609383558; e-book, $24, ISBN 978-1609383565.

  2. Spondyloarthropathy presenting at a young age: case report and review

    Energy Technology Data Exchange (ETDEWEB)

    Hartman, Golda H.; Renaud, Deborah L.; Reed, Ann M. [Mayo Clinic and Mayo Foundation, Department of Pediatrics, Rochester, MN (United States); Sundaram, Murali [Mayo Clinic and Mayo Foundation, Department of Pediatrics, Rochester, MN (United States); Cleveland Clinic, Cleveland, OH (United States)

    2007-02-15

    The diagnosis of juvenile spondyloarthritis (JSA) is rarely entertained in young children who present with back and leg pain. We present a case of a 6-year-old male who presented with a 3-year history of severe back and leg pain and a positive Gower's sign, and was given a presumed diagnosis of muscular dystrophy. Presenting serologic evaluation included a mildly elevated sedimentation rate and C-reactive protein (CRP). Computed tomography of the pelvis demonstrated large erosions affecting both sacro-iliac joints. Despite the unusually young age of this patient, ankylosing spondylitis seemed the most plausible diagnosis. Following rheumatological evaluation and treatment for JSA, he showed significant clinical improvement. His disease, however, has not entirely remitted with signs of enthesitis at the Achilles tendon and knees. We present this case to illustrate that JSA could account for symptoms at an early age and not considering it could lead to multiple medical visits and diagnoses. To our knowledge, based on a search of the World literature, this would appear to be the youngest case of JSA reported with demonstrable severe sacroiliitis. (orig.)

  3. Thyroid function in small for gestational age newborns: a review.

    Science.gov (United States)

    Franco, Bagnoli; Laura, Farmeschi; Sara, Nappini; Salvatore, Grosso

    2013-01-01

    Several studies have shown that small for gestational age (SGA) babies have a different hormonal profile than those born with a birth weight appropriate for gestational age (AGA). Thyroid hormones play an important role in growth and neurocognitive development. Only few studies analyzed the concentrations of thyroid-stimulating hormone (TSH) and thyroxine (T4) during fetal and extrauterine life in SGA and AGA newborns, and the existing data on the possible alterations of these hormones in postnatal life are controversial. It remains to be established whether SGA newborns have different blood concentrations of thyroid hormones as compared with AGA infants and if so, whether these findings play a role in the development of obesity, short stature, hypertension, and diabetes--disorders, already known to be related with SGA birth. It has also not yet been established whether and when substitutive therapy with levothyroxine (LT4) should be initiated in preterm and full-term SGA newborns. Further trials are needed to determine the thyroid hormone profile in both preterm and full-term SGA newborns and also to evaluate the effectiveness and safety of LT4 treatment in these infants.

  4. Titan II. Reliability and Aging Surveillance Program (RASP) Management Plan

    Science.gov (United States)

    1974-12-02

    following organizations: SAC OGDEN ALC * LGBT *MMER XPQM *MMCO BM MMCP V DEFS MMCR DOKM MMCT DOTM MMEW ~- V -~ -DOXX S • ,. _ X PQ T * Indicates...age and service on the Titan II Weapon System. This responsibility includes publication and dissemina- tion of reports and information. CINCSAC/ LGBT ...semiannually by the scheduling subcommittee composed of CINCSAC/ LGBT and Ogden ALC/ MMCO and MMER. LGBT will have primary responsibility for scheduling

  5. The aesthetic jaw line: management of the aging jowl.

    Science.gov (United States)

    Reece, Edward M; Rohrich, Rod J

    2008-01-01

    The lower third of the face is often an afterthought in aesthetic plastic surgery. Aging across the mandibular border may be described by several mechanisms: fat atrophy and volume loss; shifting of subcutaneous fat compartments; and mandibular septum dehiscence with submandibular fat hypertrophy. Accurate diagnosis of the apparent mechanism of jaw line aging is critical to successful facial rejuvenation. Diagnosis directs the plastic surgeon as to which key anatomic components in this region to manipulate to optimize rejuvenation. The senior author's technique for facial rejuvenation across the mandibular border is described with an algorithm for facial rejuvenation of the jaw line. Several consistent patterns of facial aging are apparent and a theory of their mechanism is suggested: (1) patients with thin skin and minimal jowling resulting from fat atrophy; (2) jowl ptosis with normal skin and loss of submalar hollow and midface fullness, caused by displacement of fat compartments; and (3) cascading confluent fat over the mandible, produced by septum dehiscence. Fat atrophy is treated with fat replacement, either injectable or autologous fat. Jowl ptosis is treated with septum release and superficial musculoaponeurotic system elevation to restore jaw line definition. Confluent fat is treated by septum release, superficial musculoaponeurotic system elevation, and direct excision of fat over the mandible. Application of techniques without proper analysis and definition may lead to an operated look with a swept jaw line. Undertreatment may not achieve jaw line definition.

  6. Clinical effectiveness of transdiagnostic health management interventions for older people with multimorbidity: a quantitative systematic review.

    Science.gov (United States)

    Crowe, Marie; Jordan, Jennifer; Burrell, Beverley; Jones, Virginia; Gillon, Deborah; Harris, Shirley; Wilkinson, Amanda

    2016-10-01

    The aim of this study was to evaluate the clinical effectiveness (improvement in health status and/or functioning and use of health services) of transdiagnostic health management interventions for people aged 65 years and older. The care of older people with multimorbidity is of increasing concern for nurses. A transdiagnostic approach to health management interventions (promote self-management or lifestyle) may be apposite for providing older people with the skills to manage symptoms that may or may not be disease-specific. Quantitative systematic review. Cochrane methods using Cochrane's Effective Practice and Organization of Care Methods (EPOC) for assessing risk of bias and the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) for assessing the weight of evidence. Medline, CINAHL, PubMed and PsycINFO 1999-2014. Twelve studies were included in the review (n = 10,393). All 12 studies provided results for health outcomes (health status and functioning) and six provided results for health outcomes and health service utilization. Ten studies reported statistically significant improvements in health outcomes but of these studies only two were of low risk of bias. Three studies identified some statistically significant reductions in health service utilization. The weight of evidence for the health management interventions included in the review, were low/moderate for improvements in health status and low for improvements in health service utilization. While there is some very preliminary evidence suggesting that structured transdiagnostic health management interventions may be clinically effective for older people with multimorbidity the effect sizes are small and the quality of this evidence is generally low. © 2016 John Wiley & Sons Ltd.

  7. Distribution of Age and Location of Chordoma in 39 Cases and Review of Treatment Options

    Directory of Open Access Journals (Sweden)

    Alireza Khoshnevisan

    2012-02-01

    Full Text Available Introduction:Skull base chordomas are rare neoplasms arising from the notochord.Although histologically benign, these tumors are locally aggressive and present significant management challenges. There are some studies on chordoma cases but there was no study about Iranian cases.In this study we evaluated the location, age and gender of the patients with Chordoma in two referral centers in Tehran. Methods: A database of patients with chordoma tumors referred to two centers (Shariati and Imam Hospitals, Tehran from 2001 to 2011 was retrospectively reviewed. Results: In our subjects tumors affect men nearly twice as frequently as women, and they are most commonly diagnosed in middle-aged (mean age was 50.6. Tumors typically occur in the axial skeleton and have a tendency for the spheno-occipital region of the skull base and sacral region. In adults 33.3% of chordomas involve the sacrococcygeal region, 53% occured at the base of the skull near the spheno-occipital area, and near 14% were found in the vertebral column. The cranial nerves mostly affected were abducens, oculomotor and trochlear, with some overlaps. All patients were treated with surgery and some cases referred for gamma-knife radiosurgery (GKS.Discussion:Findings of this study showed more involvement of males compare to females; that is different from other studies, however, few studies reported more male to female ratio. Despite the progress in current surgical techniques and some encouraging results with the use of targeted therapy, disease control and long-term prognosis of patients are still poor.

  8. BOOK REVIEW: HUMAN RESOURCES MANAGEMENT CHALLENGES: LEARNING & DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Valerij DERMOL

    2015-10-01

    Full Text Available The book titled Human Resources Management Challenges: Learning & Development focus on a variety of issues related to diversity of workforce and diversity management. As many researchers claim, the diversity relates to the factors that differentiate employees, such as age, gender, marital status, social status, level of disability, sexual orientation, religion, personality, physical and mental capabilities, moral values, culture, religion, even outlook. Nevertheless, the concept of diversity is not based only on differentiation related to workers’ attributes, but also on other issues, such as relationships between the organisation and workers, interests of organisations’ stakeholders etc. Diversity management is, on the other hand, perceived as an opportunity to increase the competitiveness of enterprises. Organizations might gain competitive advantage through the use of diverse workforce potential and by implementing proper structures and processes with the goal of maximising the ability of the employees to contribute to organizational objectives and to achieve the full potential unhindered by the group identities such as gender, race, nationality, age and departmental affiliation.

  9. Age-related macular degeneration: prevention and treatment. A review

    Directory of Open Access Journals (Sweden)

    K. A. Mirzabekova

    2014-07-01

    Full Text Available Age-related macular degeneration (AMD is a multifactorial disease. Age, light exposure, smoking, melanin levels and low-antioxidant diet are contributed to AMD development and progression. Cardiovascular disorders are of considerable importance as well. In macula, photoreceptor outer segments that are rich in polyunsaturated fatty acids (FA, particularly, docosahexaenoic acid (DHA, are susceptible to free radicals damage. High blood flow velocity and oxygen partial pressure as well as direct sunlight exposure induce oxidative processes. The source of free radicals in photoreceptor cells and retinal pigment epithelium (RPE is an extensive mitochondrial metabolism, photoreceptor outer segments phagocytosis, lipofuscin phototoxic activity and hemoglobin or protoporphyrin precursors photosensitization. Oxidative stress is considered as an universal component of cell depth in necrosis, apoptosis and toxic damage. Antioxidant protective system consists of enzymes (superoxide dismutase, glutathione peroxidase and catalase and non-enzymatic factors (ascorbic acid, alpha tocopherol, retinol, carotenoids. Specific antioxidant food supplement containing ascorbic acid (500 mg, vitamin E (400 IU and beta carotene (15 mg coupled with zinc (80 mg of zinc oxide and copper (2 mg of copper oxide results in 25 % decrease in late-stage AMD development rate. Amongst the agents that can protect retina from oxidative stress and AMD development, carotenoids are of special importance. Lutein and zeaxanthin containing in retina and lens screen blue light from central area of the retina. They also absorb blue light and inhibit free radicals generation thus preventing polyunsaturated FA light destruction. Association between lutein and zeaxanthin intake and late-stage AMD risk was revealed. Amongst the most important factors which deficiency favors macular degeneration are omega-3 FAs, i.e., DHA. DHA is the key component of visual pigment rhodopsin transformation. It

  10. Age-related macular degeneration: prevention and treatment. A review

    Directory of Open Access Journals (Sweden)

    K. A. Mirzabekova

    2014-01-01

    Full Text Available Age-related macular degeneration (AMD is a multifactorial disease. Age, light exposure, smoking, melanin levels and low-antioxidant diet are contributed to AMD development and progression. Cardiovascular disorders are of considerable importance as well. In macula, photoreceptor outer segments that are rich in polyunsaturated fatty acids (FA, particularly, docosahexaenoic acid (DHA, are susceptible to free radicals damage. High blood flow velocity and oxygen partial pressure as well as direct sunlight exposure induce oxidative processes. The source of free radicals in photoreceptor cells and retinal pigment epithelium (RPE is an extensive mitochondrial metabolism, photoreceptor outer segments phagocytosis, lipofuscin phototoxic activity and hemoglobin or protoporphyrin precursors photosensitization. Oxidative stress is considered as an universal component of cell depth in necrosis, apoptosis and toxic damage. Antioxidant protective system consists of enzymes (superoxide dismutase, glutathione peroxidase and catalase and non-enzymatic factors (ascorbic acid, alpha tocopherol, retinol, carotenoids. Specific antioxidant food supplement containing ascorbic acid (500 mg, vitamin E (400 IU and beta carotene (15 mg coupled with zinc (80 mg of zinc oxide and copper (2 mg of copper oxide results in 25 % decrease in late-stage AMD development rate. Amongst the agents that can protect retina from oxidative stress and AMD development, carotenoids are of special importance. Lutein and zeaxanthin containing in retina and lens screen blue light from central area of the retina. They also absorb blue light and inhibit free radicals generation thus preventing polyunsaturated FA light destruction. Association between lutein and zeaxanthin intake and late-stage AMD risk was revealed. Amongst the most important factors which deficiency favors macular degeneration are omega-3 FAs, i.e., DHA. DHA is the key component of visual pigment rhodopsin transformation. It

  11. The importance of preventive dental visits from a young age: systematic review and current perspectives

    Directory of Open Access Journals (Sweden)

    Bhaskar V

    2014-03-01

    Full Text Available Vaishnavi Bhaskar,1 Kathleen A McGraw,2 Kimon Divaris3 1Department of Health Policy and Management, Gillings School of Global Public Health, 2Health Sciences Library, 3Department of Pediatric Dentistry, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA Background: Dental caries, the most common childhood chronic disease, disproportionately affects vulnerable parts of the population and confers substantial impacts to children, families, and health systems. Because efforts directed toward oral health promotion and disease prevention are fundamentally superior to dental rehabilitation secondary to disease development, early preventive dental visits (EPDVs are widely advocated by professional and academic stakeholders. The aim of this comprehensive review was to critically review and summarize available evidence regarding the effectiveness of EPDVs in improving children's oral health outcomes. Materials and methods: A systematic literature search of the PubMed and Embase electronic databases was undertaken to identify peer-reviewed publications investigating the effectiveness of EPDVs on oral health outcomes, including clinical, behavioral, and cost end points up to October 30, 2013. Outcomes of the identified studies were abstracted and summarized independently by two investigators. Results: Four manuscripts met the inclusion criteria and were included in the review. All studies were conducted in the US and employed a retrospective cohort study design using public insurance-claims data, whereas one study matched claims files with kindergarten state dental surveillance data. That study found no benefit of EPDVs in future clinically determined dental caries levels in kindergarten. The other three studies found mixed support for an association of EPDVs with subsequent more preventive and fewer nonpreventive visits and lower nonpreventive service-related expenditures. Selection bias and a problem-driven dental care

  12. Bulk Electrical Cable Non-Destructive Examination Methods for Nuclear Power Plant Cable Aging Management Programs

    Energy Technology Data Exchange (ETDEWEB)

    Glass, Samuel W. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Jones, Anthony M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Fifield, Leonard S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hartman, Trenton S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2016-09-01

    This Pacific Northwest National Laboratory milestone report describes progress to date on the investigation of nondestructive test methods focusing particularly on bulk electrical test methods that provide key indicators of cable aging and damage. The work includes a review of relevant literature as well as hands-on experimental verification of inspection capabilities. As nuclear power plants consider applying for second, or subsequent, license renewal to extend their operating period from 60 years to 80 years, it is important to understand how the materials installed in plant systems and components will age during that time and develop aging management programs to assure continued safe operation under normal and design basis events (DBE). Normal component and system tests typically confirm the cables can perform their normal operational function. The focus of the cable test program, however, is directed toward the more demanding challenge of assuring the cable function under accident or DBE. The industry has adopted 50% elongation at break (EAB) relative to the un-aged cable condition as the acceptability standard. All tests are benchmarked against the cable EAB test. EAB, however, is a destructive test so the test programs must apply an array of other nondestructive examination (NDE) tests to assure or infer the overall set of cable’s system integrity. Assessment of cable integrity is further complicated in many cases by vendor’s use of dissimilar material for jacket and insulation. Frequently the jacket will degrade more rapidly than the underlying insulation. Although this can serve as an early alert to cable damage, direct test of the cable insulation without violating the protective jacket becomes problematic. This report addresses the range of bulk electrical NDE cable tests that are or could be practically implemented in a field-test situation with a particular focus on frequency domain reflectometry (FDR). The FDR test method offers numerous advantages

  13. Product Cost Management Structures: a review and neural network modelling

    Directory of Open Access Journals (Sweden)

    P. Jha

    2003-11-01

    Full Text Available This paper reviews the growth of approaches in product costing and draws synergies with information management and resource planning systems, to investigate potential application of state of the art modelling techniques of neural networks. Increasing demands on costing systems to serve multiple decision-making objectives, have made it essential to use better techniques for analysis of available data. This need is highlighted in the paper. The approach of neural networks, which have several analogous facets to complement and aid the information demands of modern product costing, Enterprise Resource Planning (ERP structures and the dominant-computing environment (for information management in the object oriented paradigm form the domain for investigation. Simulated data is used in neural network applications across activities that consume resources and deliver products, to generate information for monitoring and control decisions. The results in application for feature extraction and variation detection and their implications are presented in the paper.

  14. A review of mechanochemistry applications in waste management.

    Science.gov (United States)

    Guo, Xiuying; Xiang, Dong; Duan, Guanghong; Mou, Peng

    2010-01-01

    Mechanochemistry is defined to describe the chemical and physicochemical transformation of substances during the aggregation caused by the mechanical energy. Mechanochemical technology has several advantages, such as simple process, ecological safety and the possibility of obtaining a product in the metastable state. It potentially has a prospective application in pollution remediation and waste management. Therefore, this paper aims to give an overall review of the mechanochemistry applications in waste management and the related mechanisms. Based on our study, the modification of fly ash and asbestos-containing wastes (ACWs) can be achieved by mechanochemical technology. Waste metal oxides can be transformed into easily recyclable sulfide by mechanochemical sulfidization. Besides, the waste plastics and rubbers, which are usually very difficult to be recycled, can also be recycled by mechanochemical technology.

  15. Management of Root Resorption Using Chemical Agents: A Review

    Science.gov (United States)

    Mohammadi, Zahed; C. Cehreli, Zafer; Shalavi, Sousan; Giardino, Luciano; Palazzi, Flavio; Asgary, Saeed

    2016-01-01

    Root resorption (RR) is defined as the loss of dental hard tissues because of clastic activity inside or outside of tooth the root. In the permanent dentition, RR is a pathologic event; if untreated, it might result in the premature loss of the affected tooth. Several hypotheses have been suggested as the mechanisms of root resorption such as absence of the remnants of Hertwig's epithelial root sheath (HERS) and the absence of some intrinsic factors in cementum and predentin such as amelogenin or osteoprotegerin (OPG). It seems that a barrier is formed by the less-calcified intermediate cementum or the cementodentin junction that prevents external RR. There are several chemical strategies to manage root resorption. The purpose of this paper was to review several chemical agents to manage RR such as tetracycline, sodium hypochlorite, acids (citric acid, phosphoric acid, ascorbic acid and hydrochloric acid), acetazolamide, calcitonin, alendronate, fluoride, Ledermix and Emdogain. PMID:26843869

  16. General review of tinnitus: prevalence, mechanisms, effects, and management.

    Science.gov (United States)

    Henry, James A; Dennis, Kyle C; Schechter, Martin A

    2005-10-01

    Tinnitus is an increasing health concern across all strata of the general population. Although an abundant amount of literature has addressed the many facets of tinnitus, wide-ranging differences in professional beliefs and attitudes persist concerning its clinical management. These differences are detrimental to tinnitus patients because the management they receive is based primarily on individual opinion (which can be biased) rather than on medical consensus. It is thus vitally important for the tinnitus professional community to work together to achieve consensus. To that end, this article provides a broad-based review of what is presently known about tinnitus, including prevalence, associated factors, theories of pathophysiology, psychological effects, effects on disability and handicap, workers' compensation issues, clinical assessment, and various forms of treatment. This summary of fundamental information has relevance to both clinical and research arenas.

  17. Towards an Ultimate Battery Thermal Management System: A Review

    Directory of Open Access Journals (Sweden)

    Mohammad Rezwan Khan

    2017-03-01

    Full Text Available The prevailing standards and scientific literature offer a wide range of options for the construction of a battery thermal management system (BTMS. The design of an innovative yet well-functioning BTMS requires strict supervision, quality audit and continuous improvement of the whole process. It must address all the current quality and safety (Q&S standards. In this review article, an effective battery thermal management is sought considering the existing battery Q&S standards and scientific literature. The article contains a broad overview of the current existing standards and literature on a generic compliant BTMS. The aim is to assist in the design of a novel compatible BTMS. Additionally, the article delivers a set of recommendations to make an effective BTMS.

  18. Cognitive Functioning in Middle and Old Age Adults. A Review of Research Based on Piaget's Theory

    Science.gov (United States)

    Papalia, D. E.; Bielby, D. Del Vento

    1974-01-01

    A review of literature on Piagetian cognitive functioning generally noted lower levels of functioning for elderly subjects than for comparison groups of adults. Several possible interpretations for these age differences were offered. The effects of certain demographic variables on performance were also reviewed and inconsistent results were noted.…

  19. The management of the painful bipartite patella: a systematic review.

    Science.gov (United States)

    McMahon, Samuel E; LeRoux, Johannes A; Smith, Toby O; Hing, Caroline B

    2016-09-01

    This study aimed to identify the most effective method for the treatment of the symptomatic bipartite patella. A systematic review of the literature was completed, and all studies assessing the management of a bipartite patella were included. Owing to the paucity of randomised controlled trials, a narrative review of 22 studies was completed. A range of treatments were assessed: conservative measures, open and arthroscopic fixation or excision and soft tissue release and excision. All of the methods provided results ranging from good to excellent, with acceptable complication rates. This is a poorly answered treatment question. No firm guidance can be given as to the most appropriate method of treating the symptomatic bipartite patella. This study suggests that there are a number of effective treatments with acceptable complication rates and it may be that treatments that conserve the patella are more appropriate for larger fragments. IV.

  20. Sustainable supply chain management: Review and research opportunities

    Directory of Open Access Journals (Sweden)

    Sudheer Gupta

    2011-12-01

    Full Text Available Anthropogenic emissions likely pose serious threat to the stability of our environment; immediate actions are required to change the way the earth’s resources are consumed. Among the many approaches to mitigation of environmental deterioration being considered, the processes for designing, sourcing, producing and distributing products in global markets play a central role. Considerable research effort is being devoted to understanding how organisational initiatives and government policies can be structured to facilitate incorporation of sustainability into design and management of entire supply chain. In this paper, we review the current state of academic research in sustainable supply chain management, and provide a discussion of future direction and research opportunities in this field. We develop an integrative framework summarising the existing literature under four broad categories: (i strategic considerations; (ii decisions at functional interfaces; (iii regulation and government policies; and (iv integrative models and decision support tools. We aim to provide managers and industry practitioners with a nuanced understanding of issues and trade-offs involved in making decisions related to sustainable supply chain management. We conclude the paper by discussing environmental initiatives in India and the relevance of sustainability discussions in the context of the Indian economy.

  1. Caesarean scar pregnancy: a review of management options.

    Science.gov (United States)

    Litwicka, Katarzyna; Greco, Ermanno

    2013-12-01

    The current review aims to provide an overview of the already available and emerging treatment modalities for caesarean scar pregnancy (CSP). CSP is a type of ectopic gestation associated with a high risk of serious complications. The cause of this condition and the best management are still unclear. However, some medical and surgical treatment modalities have been suggested. The main objectives in the clinical management of CSP should be the prevention of massive blood loss and the conservation of the uterus to maintain further fertility, women's health and quality of life. Current data suggest that expectant management should not be recommended, whereas there are accumulating data suggesting that early diagnosis offers single or combined medical and surgical treatment options avoiding uterine rupture and haemorrhage, thus preserving the uterus and fertility. No universal treatment guidelines for management of CSP have been published up to now. The lack of data on the best evidence should encourage any individual case report and further multicentre studies for recommendation establishment.

  2. Uncertainty and risk in wildland fire management: a review.

    Science.gov (United States)

    Thompson, Matthew P; Calkin, Dave E

    2011-08-01

    Wildland fire management is subject to manifold sources of uncertainty. Beyond the unpredictability of wildfire behavior, uncertainty stems from inaccurate/missing data, limited resource value measures to guide prioritization across fires and resources at risk, and an incomplete scientific understanding of ecological response to fire, of fire behavior response to treatments, and of spatiotemporal dynamics involving disturbance regimes and climate change. This work attempts to systematically align sources of uncertainty with the most appropriate decision support methodologies, in order to facilitate cost-effective, risk-based wildfire planning efforts. We review the state of wildfire risk assessment and management, with a specific focus on uncertainties challenging implementation of integrated risk assessments that consider a suite of human and ecological values. Recent advances in wildfire simulation and geospatial mapping of highly valued resources have enabled robust risk-based analyses to inform planning across a variety of scales, although improvements are needed in fire behavior and ignition occurrence models. A key remaining challenge is a better characterization of non-market resources at risk, both in terms of their response to fire and how society values those resources. Our findings echo earlier literature identifying wildfire effects analysis and value uncertainty as the primary challenges to integrated wildfire risk assessment and wildfire management. We stress the importance of identifying and characterizing uncertainties in order to better quantify and manage them. Leveraging the most appropriate decision support tools can facilitate wildfire risk assessment and ideally improve decision-making.

  3. Aging Management Guideline for commercial nuclear power plants: Electrical switchgear. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Toman, G.; Gazdzinski, R.; Schuler, K. [Ogden Environmental and Energy Services Co., Inc., Blue Bell, PA (United States)

    1993-07-01

    This Aging Management Guideline (AMG) provides recommended methods for effective detection and mitigation of age-related degradation mechanisms in BWR and PWR commercial nuclear power plant electrical switchgear important to license renewal. The latent of this AMG to assist plant maintenance and operations personnel in maximizing the safe, useful life of these components. It also supports the documentation of effective aging management programs required under the License Renewal Rule 10 CFR Part 54. This AMG is presented in a manner which allows personnel responsible for performance analysis and maintenance, to compare their plant-specific aging mechanisms (expected or already experienced) and aging management program activities to the more generic results and recommendations presented herein.

  4. Aging management guideline for commercial nuclear power plants-stationary batteries. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Berg, R.; Shao, J.; Krencicki, G.; Giachetti, R. [Multiple Dynamics Corp., Southfield, MI (United States)

    1994-03-01

    The Aging Management Guideline (AMG) describes recommended methods for effective detection and mitigation of age-related degradation mechanisms in BWR and PWR commercial nuclear power plant stationary batteries important to license renewal. The intent of this AMG is to assist plant maintenance and operations personnel in maximizing the safe, useful life of these components. It also supports the documentation of effective aging management programs required under the License Renewal Rule 10 CFR Part 54. This AMG is presented in a manner that allows personnel responsible for performance analysis and maintenance to compare their plant-specific aging mechanisms (expected or already experienced) and aging management program activities to the more generic results and recommendations presented herein.

  5. Aging Management Guideline for commercial nuclear power plants: Power and distribution transformers

    Energy Technology Data Exchange (ETDEWEB)

    Toman, G.; Gazdzinski, R. [Sandia National Labs., Albuquerque, NM (United States)

    1994-05-01

    This Aging Management Guideline (AMG) provides recommended methods for effective detection and mitigation of age-related degradation mechanisms in power and distribution transformers important to license renewal in commercial nuclear power plants. The intent of this AMG to assist plant maintenance and operations personnel in maximizing the safe, useful life of these components. It also supports the documentation of effective aging management programs required under the License Renewal Rule 10 CFR Part 54. This AMG is presented in a manner which allows personnel responsible for performance analysis and maintenance to compare their plant-specific aging mechanisms (expected or already experienced) and aging management program activities to the more generic results and recommendations presented herein.

  6. Aging Management Guideline for commercial nuclear power plants: Motor control centers; Final report

    Energy Technology Data Exchange (ETDEWEB)

    Toman, G.; Gazdzinski, R.; O`Hearn, E. [Ogden Environmental and Energy Services Co., Inc., Blue Bell, PA (United States)

    1994-02-01

    This Aging Management Guideline (AMG) provides recommended methods for effective detection and mitigation of age-related degradation mechanisms in Boiling Water Reactor (BWR) and Pressurized Water Reactor (PWR) commercial nuclear power plant motor control centers important to license renewal. The intent of this AMG is to assist plant maintenance and operations personnel in maximizing the safe, useful life of these components. It also supports the documentation of effective aging management programs required under the License Renewal Rule 10 CFR Part 54. This AMG is presented in a manner that allows personnel responsible for performance analysis and maintenance to compare their plant-specific aging mechanisms (expected or already experienced) and aging management program activities to the more generic results and recommendations presented herein.

  7. Aging management guideline for commercial nuclear power plants - tanks and pools

    Energy Technology Data Exchange (ETDEWEB)

    Blocker, E.; Smith, S.; Philpot, L.; Conley, J.

    1996-02-01

    Continued operation of nuclear power plants for periods that extend beyond their original 40-year license period is a desirable option for many U.S. utilities. U.S. Nuclear Regulatory Commission (NRC) approval of operating license renewals is necessary before continued operation becomes a reality. Effective aging management for plant components is important to reliability and safety, regardless of current plant age or extended life expectations. However, the NRC requires that aging evaluations be performed and the effectiveness of aging management programs be demonstrated for components considered within the scope of license renewal before granting approval for operation beyond 40 years. Both the NRC and the utility want assurance that plant components will be highly reliable during both the current license term and throughout the extended operating period. In addition, effective aging management must be demonstrated to support Maintenance Rule (10 CFR 50.65) activities.

  8. Traditional chinese medicine and temporomandibular disorders management: A literature review

    Directory of Open Access Journals (Sweden)

    Larry C.F. Li

    2012-01-01

    Conclusions: The most common TCM treatment modalities in treating TMDs include acupuncture,moxibustion with or without acupuncture and medicated compress. A review of these TCM treatment modalities showed that possible beneficialeffects existed in TMDs management. Acupuncture seems to be the most evidenced based treatment modality among the three and being investigated the most. However,due to a lack of evidence based studies, more scientific and rigorous randomised controlled clinical trials are needed to further evaluate TCM′s safety,efficacy and effectiveness.

  9. Management of uveal tract melanoma: A comprehensive review

    Directory of Open Access Journals (Sweden)

    Akhil Kapoor

    2016-06-01

    Full Text Available Uveal tract melanoma is the most common primary intraocular malignancy in adults, accounting for about 5–10% of all the melanomas. Since there are no lymphatic vessels in the eye, uveal melanoma can only spread hematogenously leading to liver metastasis. A wide variety of treatment modalities are available for its management, leading to dilemma in selecting the appropriate therapy. This article reviews the diagnostic and therapeutic modalities available and thus, can help to individualize the treatment plan for each patient.

  10. Can Systematic Reviews Inform GMO Risk Assessment and Risk Management?

    Science.gov (United States)

    Kohl, Christian; Frampton, Geoff; Sweet, Jeremy; Spök, Armin; Haddaway, Neal Robert; Wilhelm, Ralf; Unger, Stefan; Schiemann, Joachim

    2015-01-01

    Systematic reviews represent powerful tools to identify, collect, synthesize, and evaluate primary research data on specific research questions in a highly standardized and reproducible manner. They enable the defensible synthesis of outcomes by increasing precision and minimizing bias whilst ensuring transparency of the methods used. This makes them especially valuable to inform evidence-based risk analysis and decision making in various topics and research disciplines. Although seen as a “gold standard” for synthesizing primary research data, systematic reviews are not without limitations as they are often cost, labor and time intensive and the utility of synthesis outcomes depends upon the availability of sufficient and robust primary research data. In this paper, we (1) consider the added value systematic reviews could provide when synthesizing primary research data on genetically modified organisms (GMO) and (2) critically assess the adequacy and feasibility of systematic review for collating and analyzing data on potential impacts of GMOs in order to better inform specific steps within GMO risk assessment and risk management. The regulatory framework of the EU is used as an example, although the issues we discuss are likely to be more widely applicable. PMID:26322307

  11. Can systematic reviews inform GMO risk assessment and risk management?

    Directory of Open Access Journals (Sweden)

    Christian eKohl

    2015-08-01

    Full Text Available Systematic reviews represent powerful tools to identify, collect, synthesize and evaluate primary research data on specific research questions in a highly standardized and reproducible manner. They enable the defensible synthesis of outcomes by increasing precision and minimizing bias whilst ensuring transparency of the methods used. This makes them especially valuable to inform evidence-based risk analysis and decision making in various topics and research disciplines. Although seen as a gold standard for synthesizing primary research data, systematic reviews are not without limitations as they are often cost, labor and time intensive and the utility of synthesis outcomes depends upon the availability of sufficient and robust primary research data. In this paper we 1 consider the added value systematic reviews could provide when synthesizing primary research data on genetically modified organisms (GMO and 2 critically assess the adequacy and feasibility of systematic review for collating and analyzing data on potential impacts of GMOs in order to better inform specific steps within GMO risk assessment and risk management. The regulatory framework of the EU is used as an example, although the issues we discuss are likely to be more widely applicable.

  12. Traditional herbal medicine for weight management: A Review

    Directory of Open Access Journals (Sweden)

    E. Valizadeh

    2016-11-01

    Full Text Available The prevalence of obesity is increasing at an alarming rate in recent years. Many drugs for weight managing are available in the market; however their adverse effects and hazards have not been thoroughly evaluated, therefore herbal medicines are being proposed as an efficient, inexpensive and safe alternative. This review will address the current advances in using traditional herbal plants in obese and overweight humans and animals. Searching data bases were PubMed, Scopus, Google Scholar and Science direct, reported between 1990 and 2014. Articles were screened and selected by two researchers. Based on the available literature, abstract/full randomized clinical trials (RCTs, evidence studies, reviews, systematic reviews and books were surveyed. Studies with LI85008F, Itrifal Saghir, Hunteria umbellate, Morus alba, Melissa officinalis, and Artemisia capillarie, pomegranate leaf (PLE, NT (rhubarb, ginger, astragulus, red sage, and turmeric combined with gallic acid (GA, ephedrine, caffeine, salicin, Adlay seed crude extract (ACE, Bufo-tsusho-san (BF and Stimulant-free supplement (glucomannan, chitosan, fenugreek, Gymnema sylvestre, and vitamin C show significant decreases in body weight. Only, NT (rhubarb, ginger, astragulus, red sage, turmeric caused dose-limiting gastrointestinal toxicity. Additionally, Ma Huang and Guarana (ephedrine alkaloid and caffeine caused mouth dryness, insomnia and headache. No other significant adverse effects were reported in all 31 trials included in this article. This review highlights the need for higherquality randomized, controlled trials to confirm the results.

  13. Can Systematic Reviews Inform GMO Risk Assessment and Risk Management?

    Science.gov (United States)

    Kohl, Christian; Frampton, Geoff; Sweet, Jeremy; Spök, Armin; Haddaway, Neal Robert; Wilhelm, Ralf; Unger, Stefan; Schiemann, Joachim

    2015-01-01

    Systematic reviews represent powerful tools to identify, collect, synthesize, and evaluate primary research data on specific research questions in a highly standardized and reproducible manner. They enable the defensible synthesis of outcomes by increasing precision and minimizing bias whilst ensuring transparency of the methods used. This makes them especially valuable to inform evidence-based risk analysis and decision making in various topics and research disciplines. Although seen as a "gold standard" for synthesizing primary research data, systematic reviews are not without limitations as they are often cost, labor and time intensive and the utility of synthesis outcomes depends upon the availability of sufficient and robust primary research data. In this paper, we (1) consider the added value systematic reviews could provide when synthesizing primary research data on genetically modified organisms (GMO) and (2) critically assess the adequacy and feasibility of systematic review for collating and analyzing data on potential impacts of GMOs in order to better inform specific steps within GMO risk assessment and risk management. The regulatory framework of the EU is used as an example, although the issues we discuss are likely to be more widely applicable.

  14. Approaching the concept of self-managing illness in long term illness. A review of literature.

    Directory of Open Access Journals (Sweden)

    Stavrou V

    2014-04-01

    Full Text Available Abstract: The management of long term illness is globally challenging and the common concerns are mainly found in developed, developing and transitory countries as the increase in the ageing of the population deteriorates the problems. For patients who are suffering from long term illnesses, there is an interest for programs of self managing the disease, which highlight the core essence of educating patients on managing the disease. Purpose: The purpose of the current study is to a present the basic definitions of self managing the disease, b identify the current situation and c discuss and support nursing staff in educating the patient on self managing the illness. Materials- Methods: A review of relevant articles was conducted on the electronic database Medline/ Pubmed as well as through Scholar Google search engine and a secondary search on the references found on the articles. This occurred irrespective of the publication time.Conclusions The role of the nurse as a member of the interdisciplinary group is important because it helps the patient to develop skills of self care. Complete programs of self-managing the illness with the participation of the nurses in the planning, application and evaluation of the results, will contribute significantly to the patient, notwithstanding the professional benefit for the nurses.

  15. High Availability Solution: Resource Usage Management in Virtualized Software Aging

    Directory of Open Access Journals (Sweden)

    Aye Myat Myat Paing

    2012-07-01

    Full Text Available As businesses increasingly rely on IT for their mission-critical operations, continuous availability is auniversal concern. Nowadays, virtualized platform has become the popular option to deploy complexenough services. Deployed services are expected to be always, available, but these long running servicesare especially sensitive to suffer from software aging phenomenon. Software aging of virtual machinemonitors (VMMs is becoming critical because performance degradation or crash failure of a VMM affectsall virtual machines (VMs on it. To counteract this issue, we deploy software rejuvenation methodology.To eliminate the service outage during software rejuvenation process, we combine the rejuvenation withlive migration technology. Live VM migration enables a running VM on a host serer to move onto the otherhost server with very small interruption of the execution. Live VM migration depends on VMs placementand efficient resource available is required. The idea behind our paper is two-fold. First, we present theoptimization of the resource usage as accepting as many services as in virtualized environment whichsupport of VM live migration. Second, to demonstrate how much it can improve system availability, thestochastic Petri nets model a virtualized server system in case of using time based software rejuvenation forVMM is presented. Finally, we perform the numerical analysis to evaluate the model.

  16. Critical study of Jara (aging) and its management.

    Science.gov (United States)

    Parmar, Nisha; Vyas, Mahesh; Vyas, Hitesh

    2012-04-01

    Jara Avastha (stage of old age) is the later phase of life in which maximum decline of bodily elements is observed. Paramanuvibhaga (cell division) takes place at every moment; particularly in old age, it will be fast in comparison with other phases of life. Some organ related changes also take place during this period, which are the decades of Balya, Vridhhi, Chhavi, Medha, Twak, etc., In this study, applied aspects of Medha Hani, Twak Hani, and Drishti Hani were evaluated subjectively as well as objectively. Patients were selected from the OPD of Department of Basic Principles, I.P.G.T. and R.A., Gujarat Ayurved University, Jamnagar, irrespective of their sex, caste, religion, etc., and randomly divided into two groups. Patients in Group A were treated with Panchagavya Ghrita and Group B with plain Go Ghrita for 90 days and the dose of drug was 10 g/day at Nirannakala (early morning with empty stomach). Both groups showed significant results, the difference in between the groups is statistically insignificant.

  17. Related activities on management of ageing of Dalat Research Reactor

    Energy Technology Data Exchange (ETDEWEB)

    Pham Van Lam [Reactor Dept., Nuclear Research Institute, Dalat (Viet Nam)

    1998-10-01

    The Dalat Nuclear Research Reactor (DNRR) is a pool type research reactor which was reconstructed in 1982 from the previous 250 kW TRIGA-MARK II reactor. The reactor core, the control and instrumentation system, the primary and secondary cooling systems as well as other associated systems were newly designed and installed. The renovated reactor reached its initial criticality in November 1983 and attained its nominal power of 500 kW in February 1984. Since then DNRR has been operated safely. Retained structures of the former reactor such as the reactor aluminum tank, the graphite reflector, the thermal column, the horizontal beam tubes and the radiation concrete shielding are 35 years old. During the recent years, in-service inspection has been carried out, the reactor control and instrumentation system were renovated due to ageing and obsolescence of its components, reactor general inspection and refurbishment were performed. Efforts are being made to cope with ageing of old reactor components to maintain safe operation of the DNRR. (author)

  18. The Assessment of Metacognition in Children Aged 4-16 Years: A Systematic Review

    Science.gov (United States)

    Gascoine, Louise; Higgins, Steve; Wall, Kate

    2017-01-01

    This article presents the results of a systematic review of methods that have been used to measure or assess metacognition in children aged 4-16 years over a 20-year period (1992-2012). It includes an overview of the types of tool and methods used linked with the ages of the participants targeted and how metacognition and associated concepts are…

  19. The Assessment of Metacognition in Children Aged 4-16 Years: A Systematic Review

    Science.gov (United States)

    Gascoine, Louise; Higgins, Steve; Wall, Kate

    2017-01-01

    This article presents the results of a systematic review of methods that have been used to measure or assess metacognition in children aged 4-16 years over a 20-year period (1992-2012). It includes an overview of the types of tool and methods used linked with the ages of the participants targeted and how metacognition and associated concepts are…

  20. FOREX - an expert system for managing even-aged upland oak forests on steep terrain

    Science.gov (United States)

    Chris B. LeDoux; B. Gopalakrishnan; K. Lankalapalli

    1995-01-01

    An expert system, FOREX, was developed to access the data from the database management provided by MANAGE. For a specific site index, the user of FOREX can obtain information on present net worth, optimal thinning entry timing, optimal stand rotation age, diameter at breast height, volume by grade and value of the trees harvested, and based on the cable yarder used,...

  1. Ethics and Retail Management Professionals: An Examination of Age, Education, and Experience Variables

    Science.gov (United States)

    Mujtaba, Bahaudin G.; Cavico, Frank J.; McCartney, Timothy O.; DiPaolo, Peter T.

    2009-01-01

    Ethical maturity and behavior are of great concern to all educators, firms, and investors, and even more so in a recession. This research surveyed managers and employees in the retail environment to measure their Personal Business Ethics Scores (PBES) to see if age, education, and management experience makes a difference in making more ethical…

  2. Managing HCV infection in pediatric age group: Suggested recommendations

    Directory of Open Access Journals (Sweden)

    Danish Fazal

    2010-01-01

    Full Text Available Hepatitis C virus (HCV infection in children is different from the adult infection in many ways, like natural course of the disease; duration, therapeutic response and side effects profile of the drug therapy; and prognosis. Special considerations include consideration on what could be the appropriate time to investigate a suspected child, when to institute drug therapy and how to prevent vertical transmission. Although over the past one decade many landmark studies have greatly increased our insight on this subject, yet we are far from developing a consensus statement. In this article, a concise yet comprehensive review of HCV infection in children - diagnosis and treatment - is given, followed by suggested recommendations at the end. It is hoped that these recommendations will help develop local guidelines on this subject.

  3. Prevention, management, and outcomes of macrosomia: a systematic review of literature and meta-analysis.

    Science.gov (United States)

    Rossi, A Cristina; Mullin, Patrick; Prefumo, Federico

    2013-10-01

    Macrosomia represents an obstetric challenge, and when suspected, there is no general consensus as to whether expectant management, induction of labor, or elective cesarean delivery are the best option. This review article was aimed to discuss literature published in the last decade about the identification, management, and outcomes of macrosomia. The identification of macrosomia remains uncertain, mainly because of the high heterogeneity across studies because of different definitions of macrosomia, gestational age at time of assessment, and fetal weight formulas. With regard to management and outcomes of macrosomia, 12,212 macrosomic neonates can be pooled from 17 articles. Compared with neonates with normal birth weight, the odds ratio of emergency cesarean delivery increases from 1.92 (1.53-2.42) to 2.24 (1.42-3.56) and 5.20 (3.47-7.79) for macrosomia 4000 g or greater, 4500 g or greater, and 5000 g or greater, respectively. The odds ratios of shoulder dystocia are 7.18 (2.06-25.00), 7.33 (5.13-10.48), and 16.16 (7.62-34.26) for macrosomia 4000 g or greater, 4500 g or greater, and 5000 g or greater, respectively. Three birth traumas were reported after cesarean delivery. Perinatal mortality is similar between macrosomic and neonates with normal birth weight at each cutoff of macrosomia. Nonetheless, limitations of current literature, which are also discussed in this review, do not allow to drive definitive conclusion about the management of macrosomia.

  4. TQM (Total Quality Management) SPARC (Special Process Action Review Committees) Handbook

    Science.gov (United States)

    1989-08-01

    improvement; Logistics information; Process analysis; Quality control; Quality assurance; Total Quality Management ; Statistical processes; Management Planning and control; Management training; Management information systems.... Quality Management (TQM). It includes concepts and definitions, checklists, sample formats, and assessment criteria. Keywords: Continuous process...This document describes the techniques used to support and guide the Special Process Action Review Committees for accomplishing their goals for Total

  5. 76 FR 74834 - Interim Staff Guidance on Aging Management Program for Steam Generators

    Science.gov (United States)

    2011-12-01

    ... COMMISSION Interim Staff Guidance on Aging Management Program for Steam Generators AGENCY: Nuclear Regulatory Commission. ACTION: Interim staff guidance; issuance. SUMMARY: The U.S. Nuclear Regulatory Commission (NRC) is issuing License Renewal Interim Staff Guidance (LR-ISG), LR-ISG-2011-02, ``Aging...

  6. Age-dependent changes in ecosystem carbon fluxes in managed forests in Northern Wisconsin, USA

    Science.gov (United States)

    Asko Noormets; Jiquan Chen; Thomas R. Crow

    2007-01-01

    The age-dependent variability of ecosystem carbon (C) fluxes was assessed by measuring the net ecosystem exchange of C (NEE) in five managed forest stands in northern Wisconsin, USA. The study sites ranged in age from 3-year-old clearcut to mature stands (65 years). All stands, except the clearcut, accumulated C over the study period from May to October 2002. Seasonal...

  7. Gaseous emissions from management of solid waste: a systematic review.

    Science.gov (United States)

    Pardo, Guillermo; Moral, Raúl; Aguilera, Eduardo; Del Prado, Agustín

    2015-03-01

    The establishment of sustainable soil waste management practices implies minimizing their environmental losses associated with climate change (greenhouse gases: GHGs) and ecosystems acidification (ammonia: NH3 ). Although a number of management strategies for solid waste management have been investigated to quantify nitrogen (N) and carbon (C) losses in relation to varied environmental and operational conditions, their overall effect is still uncertain. In this context, we have analyzed the current scientific information through a systematic review. We quantified the response of GHG emissions, NH3 emissions, and total N losses to different solid waste management strategies (conventional solid storage, turned composting, forced aerated composting, covering, compaction, addition/substitution of bulking agents and the use of additives). Our study is based on a meta-analysis of 50 research articles involving 304 observations. Our results indicated that improving the structure of the pile (waste or manure heap) via addition or substitution of certain bulking agents significantly reduced nitrous oxide (N2 O) and methane (CH4 ) emissions by 53% and 71%, respectively. Turned composting systems, unlike forced aerated composted systems, showed potential for reducing GHGs (N2 O: 50% and CH4 : 71%). Bulking agents and both composting systems involved a certain degree of pollution swapping as they significantly promoted NH3 emissions by 35%, 54%, and 121% for bulking agents, turned and forced aerated composting, respectively. Strategies based on the restriction of O2 supply, such as covering or compaction, did not show significant effects on reducing GHGs but substantially decreased NH3 emissions by 61% and 54% for covering and compaction, respectively. The use of specific additives significantly reduced NH3 losses by 69%. Our meta-analysis suggested that there is enough evidence to refine future Intergovernmental Panel on Climate Change (IPCC) methodologies from solid waste

  8. Assessment of Managed Aquifer Recharge through Modeling—A Review

    Directory of Open Access Journals (Sweden)

    Jana Ringleb

    2016-12-01

    Full Text Available Managed aquifer recharge (MAR is the purposeful recharge of an aquifer for later recovery or environmental benefits and represents a valuable method for sustainable water resources management. Models can be helpful tools for the assessment of MAR systems. This review encompasses a survey and an analysis of case studies which apply flow and transport models to evaluate MAR. The observed modeling objectives include the planning or optimization of MAR schemes as well as the identification and quantification of geochemical processes during injection, storage and recovery. The water recovery efficiency and the impact of the injected water on the ambient groundwater are further objectives investigated in the reviewed studies. These objectives are mainly solved by using groundwater flow models. Unsaturated flow models, solute transport models, reactive geochemical models as well as water balance models are also frequently applied and often coupled. As each planning step to setup a new MAR facility requires cost and time investment, modeling is used to minimize hazard risks and assess possible constraints of the system such as low recovery efficiency, clogging and geochemical processes.

  9. A review of current progress in acquired cholesteatoma management.

    Science.gov (United States)

    Kuo, Chin-Lung; Liao, Wen-Huei; Shiao, An-Suey

    2015-12-01

    The aim of this study was to review recent advances in the management of acquired cholesteatoma. All papers referring to acquired cholesteatoma management were identified in Medline via OVID (1948 to December 2013), PubMed (to December 2013), and Cochrane Library (to December 2013). A total of 86 papers were included in the review. Cholesteatoma surgery can be approached using either a canal wall up (CWU) or canal wall down (CWD) mastoidectomy with or without reconstruction of the middle ear cleft. In recent decades, a variety of surgical modifications have been developed including various "synthesis" techniques that combine the merits of CWU and CWD. The application of transcanal endoscopy has also recently gained popularity; however, difficulties associated with this approach remain, such as the need for one-handed surgery, the inability to provide continuous irrigation/suction, and limitations regarding endoscopic accessibility to the mastoid cavity. Additionally, several recent studies have reported successes in the application of laser-assisted cholesteatoma surgery, which overcomes the conflicting goals of eradicating disease and the preservation of hearing. Nevertheless, the risk of residual disease remains a challenge. Each of the techniques examined in this study presents pros and cons regarding final outcomes, such that any pronouncements regarding the superiority of one technique over another cannot yet be made. Flexibility in the selection of surgical methods according to the context of individual cases is essential in optimizing the outcomes.

  10. A review of web based interventions for managing tobacco use

    Directory of Open Access Journals (Sweden)

    Yatan Pal Singh Balhara

    2014-01-01

    Full Text Available Web based interventions (WBIs have been developed for various health conditions. These include interventions for various psychoactive substance use disorders including tobacco and alcohol. Tobacco use has remained the single largest preventable cause of global mortality and morbidity for many years. It is responsible for around 6 million deaths annually world-wide. Ironically, most of the tobacco users reside in resource poor low and middle-income countries. The article reviews the existing literature on WBIs for management of tobacco use. The literature search was performed using MedLine, PubMed, PsycINFO, Embase and Cochrane Review for relevant English language articles published from 1998 up to 2013. There is limited support for effectiveness of WBIs for managing tobacco use among adolescents. Although most of the trials among adults found WBIs to be more effective at short term follow-up (a few days to weeks, the benefits failed to extend beyond 3 months in most of the studies. All but one interventions studied in a randomized controlled trial is for smoking forms.

  11. Managing Anxiety Related to Anaphylaxis in Childhood: A Systematic Review

    Directory of Open Access Journals (Sweden)

    Katharina Manassis

    2012-01-01

    Full Text Available Objectives. This paper reviews the relationship between anxiety and anaphylaxis in children and youth, and principles for managing anxiety in the anaphylactic child and his or her parents. Methods. A review of the medical literature (Medline was done using the keywords “anxiety,” “anaphylaxis,” and “allergy,” limited to children and adolescents. Findings were organized into categories used in the treatment of childhood anxiety disorders, then applied to managing anxiety in the anaphylactic child. Results. Twenty-four relevant papers were identified. These varied widely in methodology. Findings emphasized included the need to distinguish anxiety-related and organic symptoms, ameliorate the anxiety-related impact of anaphylaxis on quality of life, and address parental anxiety about the child. Conclusion. Children with anaphylaxis can function well despite anxiety, but the physical, cognitive, and behavioral aspects of anxiety associated with anaphylactic risk must be addressed, and parents must be involved in care in constructive ways.

  12. Weight Management, Energy Metabolism, and Endocrine Hor¬mones- Review Article

    Directory of Open Access Journals (Sweden)

    Seyed-Ali MOSTAFAVI

    2015-10-01

    Full Text Available Energy expenditure is determined by basal metabolic rate, physical activity, and Thermic Effect of Foods (TEF. Some endocrine hormones have role in basal metabolism and hence in human energy expenditure. And some foods pose more thermic effects on the total body energy expenditure and therefore can influence body weight. This review was performed to discuss factors which may affect body metabolism and body weight. Latest medical databases and nutrition and metabolism books were reviewed. We used the following keywords in online databases: "Weight Management" and "Hormones"; "Energy Metabolism" and "dietary factors"; "Weight Management" and "dietary factors"; "Endocrine Hormones" and "energy expenditure"; "Basal Energy Expenditure" and "dietary factors"; " Thermic Effect of Foods" and "dietary factors". The best designed articles were used to perform this review. The results are presented bellow. Spicy foods, Caffeine, and alcohol are some dietary factors and Body Size, Body Composition, Age and Gender are the non-dietary factors which may affect the metabolism. Diet composition can also slightly influence the metabolism. This effect depends on how efficient a dietary component is metabolized in the body. Regular dietary pattern also can slightly increase TEF comparing with irregular dietary pattern. Thyroid hormones, Ghrelin, Epinephrine, Cortisol, Steroid hormones, Leptin, Growth hormone, and insulin are among the most important hormones which may influence on metabolism and body weight. Energy expenditure is the basis for measuring human energy requirement and is crucial for weight management. Various hormonal, dietary and non-dietary factors are engaged in total body energy expenditure and are important for weight management. Keywords: Weight Management, Energy Metabolism, Dietary factors, Endocrine Hormones

  13. Practical intelligence at work: relationship between aging and cognitive efficiency among managers in a bank environment.

    Science.gov (United States)

    Colonia-Willner, R

    1998-03-01

    A study was conducted to determine which better predicts performance among bank managers: tacit practical knowledge as assessed by the Tacit Knowledge Inventory for Managers (TKIM) or 2 psychometric measures of reasoning, the Raven's Advanced Progressive Matrices (Raven's) and the Verbal Reasoning subtest of the Differential Aptitude Test (DAT). Two hundred bank managers (43 experts and 157 nonexperts), ages 24-59 years old, participated. Increased age was associated with lower performance in Raven's and the DAT but less so in the TKIM; best performing older managers on average had high levels of tacit knowledge, although they scored lower on psychometric reasoning measures; TKIM predicted managerial skill; DAT and Raven's did not. These results suggest that stabilization of some aspects of intelligence may occur in old age. Implications of the findings for the study of practical intelligence, expertise, and compensatory abilities are discussed.

  14. Therapeutic targeting of the complement system in age-related macular degeneration: a review.

    Science.gov (United States)

    Troutbeck, Robyn; Al-Qureshi, Salmaan; Guymer, Robyn H

    2012-01-01

    The last decade has produced pivotal change in our understanding of the molecular mechanisms underlying age-related macular degeneration (AMD), a leading cause of global blindness. In this time, the complement system has featured as a unifying theme for several elements of new evidence: initially, the discovery of complement proteins within drusen and subsequently, the association between AMD and mutations in various complement pathway genes, most notably complement factor H. Increasingly, a wealth of data are pointing towards a role for chronic local inflammation and complement activation in the patho-aetiology of AMD. These findings have paved the way for the exploration of a new paradigm of therapy in AMD management; targeting of specific molecular constituents in the complement pathway thus producing dampening or inhibition of the inflammatory response. Such an approach has the potential to intervene earlier in the disease process and ideally before vision is compromised. In this review we discuss the role of the complement system in AMD, novel therapies in preclinical evaluation and clinical trial, and whether these have a part to play in reducing the burden of disease.

  15. Internet delivered diabetes self-management education: a review.

    Science.gov (United States)

    Pereira, Katherine; Phillips, Beth; Johnson, Constance; Vorderstrasse, Allison

    2015-01-01

    Diabetes self-management education is a cornerstone of successful diabetes management. Various methods have been used to reach the increasing numbers of patients with diabetes, including Internet-based education. The purpose of this article is to review various delivery methods of Internet diabetes education that have been evaluated, as well as their effectiveness in improving diabetes-related outcomes. Literature was identified in the Cumulative Index to Nursing and Allied Health Literature (CINAHL), PubMed, Medline, EBSCO, the Cochrane Library, and the Web of Science databases through searches using the following terms: "type 2 diabetes AND internet/web based AND education" and "type 2 diabetes AND diabetes self-management education (DSME) AND web-based/internet OR technology assisted education." The search was limited to English language articles published in the last 10 years. The search yielded 111 articles; of these, 14 met criteria for inclusion in this review. Nine studies were randomized controlled trials, and study lengths varied from 2 weeks to 24 months, for a total of 2,802 participants. DSME delivered via the Internet is effective at improving measures of glycemic control and diabetes knowledge compared with usual care. In addition, results demonstrate that improved eating habits and increased attendance at clinic appointments occur after the online DSME, although engagement and usage of Internet materials waned over time. Interventions that included an element of interaction with healthcare providers were seen as attractive to participants. Internet-delivered diabetes education has the added benefit of easier access for many individuals, and patients can self-pace themselves through materials. More research on the cost-benefits of Internet diabetes education and best methods to maintain patient engagement are needed, along with more studies assessing the long-term impact of Internet-delivered DSME.

  16. A multidisciplinary systematic literature review on frailty: Overview of the methodology used by the Canadian Initiative on Frailty and Aging

    Directory of Open Access Journals (Sweden)

    Bergman Howard

    2009-10-01

    Full Text Available Abstract Background Over the past two decades, there has been a substantial growth in the body of literature on frailty in older persons. However, there is no consensus on its definition or the criteria used to identify frailty. In response to this lack of consensus, the Canadian Initiative on Frailty and Aging carried out a set of systematic reviews of the literature in ten areas of frailty research: biological basis; social basis; prevalence; risk factors; impact; identification; prevention and management; environment and technology; health services; health and social policy. This paper describes the methodology that was developed for the systematic reviews. Methods A Central Coordination Group (CCG was responsible for developing the methodology. This involved the development of search strategies and keywords, article selection processes, quality assessment tools, and guidelines for the synthesis of results. Each review was conducted by two experts in the content area, with the assistance of methodologists and statisticians from the CCG. Results Conducting a series of systematic literature reviews involving a range of disciplines on a concept that does not have a universally accepted definition posed several conceptual and methodological challenges. The most important conceptual challenge was determining what would qualify as literature on frailty. The methodological challenges arose from our goal of structuring a consistent methodology for reviewing literature from diverse fields of research. At the outset, certain methodological guidelines were deemed essential to ensure the validity of all the reviews. Nevertheless, it was equally important to permit flexibility in the application of the proposed methodology to capture the essence of frailty research within the given fields. Conclusion The results of these reviews allowed us to establish the status of current knowledge on frailty and promote collaboration between disciplines. Conducting

  17. Pain management in Guillain-Barre syndrome: a systematic review.

    Science.gov (United States)

    Peña, L; Moreno, C B; Gutierrez-Alvarez, A M

    2015-09-01

    Pain is a common symptom in patients with Guillain-Barre syndrome. Intensity is moderate to severe in most cases and pain may persist after resolution of the disease. Identify the most appropriate analgesic therapy for pain management in patients with Guillain-Barre syndrome. Systematic review and selection of scientific articles on treatment of pain in Guillain-Barre syndrome patients, published between January 1985 and December 2012. We included only randomised, double-blind, controlled trials assessing the effectiveness of drugs for pain management in these patients. Four articles met the inclusion criteria. One evaluated the use of gabapentin, another evaluated carbamazepine, a third compared gabapentin to carbamazepine, and the last evaluated use of methylprednisolone. Both carbamazepine and gabapentin were useful for pain management. Patients experienced lower-intensity pain with gabapentin treatment in the study comparing that drug to carbamazepine. Methylprednisolone was not shown to be effective for reducing pain. The published data did not permit completion of a meta-analysis. There is no robust evidence at present that would point to a single treatment option for this disorder. Further clinical studies of larger patient samples and with a longer duration are needed to characterise types of pain for each patient and measure pain intensity in an objective way. Copyright © 2013 Sociedad Española de Neurología. Published by Elsevier España, S.L.U. All rights reserved.

  18. A Review : Benefits and Critical Factors of Customer Relationship Management

    Directory of Open Access Journals (Sweden)

    Vijay Pal Dhaka

    2014-07-01

    Full Text Available Customer Relationship Management (CRM is a technical jargon which is a blend of methodologies, software and internet, which are used by a company to achieve its goal through the identification and satisfaction of customer’s stated and unstated needs and wants. This software addresses customer life cycle management. This system manages company interactions with current and future customers. It involves technology to organize, automate and synchronize business processes. CRM application is an essential tool for a company to grow and help to increase the satisfaction of customers. There are many benefits of CRM; those make the market environment customer centric. In this paper, we reviewed previous studies and identify those benefits which affect customers and company both. But CRM has many problems also because of them CRM gets failure. Its failure rate is more than its success rate. We also elaborated its failure factors and along with them its critical success factors which help in making CRM a successful project for a company, however implementation of CRM is a complex task.

  19. Diagnosis and management of right colonic diverticular disease: A review.

    Science.gov (United States)

    Ferrara, Francesco; Bollo, Jesús; Vanni, Letizia V; Targarona, Eduardo M

    2016-12-01

    The aim of this narrative review is to define the clinical-pathological characteristics and to clarify the management of right colonic diverticular disease. It is rare in Europe, USA and Australia and more common in Asia. In the recent years its incidence has increased in the West, with various distributions among populations. Many studies have reported that it is difficult to differentiate the presenting symptoms of this disease from those of appendicitis before surgery, because the signs and symptoms are similar, so misdiagnosis is not infrequent. With accurate imaging studies it is possible to reach a precise preoperative diagnosis, in order to assess an accurate treatment strategy. Currently the management of this disease is not well defined, no clear guidelines have been proposed and it is not known whether the guidelines for left colonic diverticular disease can also be applied for it. Several authors have stated that conservative management is the best approach, even in case of recurrence, and surgery should be indicated in selected cases. Copyright © 2016. Publicado por Elsevier España, S.L.U.

  20. Short bowel syndrome: a review of management options.

    Science.gov (United States)

    Seetharam, Prasad; Rodrigues, Gabriel

    2011-01-01

    Extensive resection of the intestinal tract frequently results in inadequate digestion and/or absorption of nutrients, a condition known as short bowel syndrome (SBS). This challenging condition demands a dedicated multidisciplinary team effort to overcome the morbidity and mortality in these patients. With advances in critical care management, more and more patients survive the immediate morbidity of massive intestinal resection to present with SBS. Several therapies, including parenteral nutrition (PN), bowel rehabilitation and surgical procedures to reconstruct bowel have been used in these patients. Novel dietary approaches, pharmacotherapy and timely surgical interventions have all added to the improved outcome in these patients. However, these treatments only partially correct the underlying problem of reduced bowel function and have limited success resulting in 30% to 50% mortality rates. However, increasing experience and encouraging results of intestinal transplantation has added a new dimension to the management of SBS. Literature available on SBS is exhaustive but inconclusive. We conducted a review of scientific literature and electronic media with search terms 'short bowel syndrome, advances in SBS and SBS' and attempted to give a comprehensive account on this topic with emphasis on the recent advances in its management.

  1. Breast cancer pain management - A review of current & novel therapies

    Directory of Open Access Journals (Sweden)

    Aanchal Satija

    2014-01-01

    Full Text Available Breast cancer is one of the most prevalent cancers amongst women in the world. Unfortunately, even after adequate treatment, some patients experience severe pain either due to disease progression or due to treatment related side effects. The persistent pain causes a negative physical and psychosocial impact on patients′ lives. Current rational pain management is patient-centred and requires a thorough psychological assessment. Usually adequate analgesia is achieved by adopting the WHO′s three step analgesic ladder. As the disease progresses, the pain experienced by the patient also increases. This necessitates the administration of opioids and adjuvant analgesics to the breast cancer patients experiencing severe pain. However, opioid use is associated with intolerable side effects like constipation, nausea, vomiting, fear of dependence, and tolerance. Concomitant medications are required to combat these unacceptable side effects. Adjuvant analgesics need to be added to provide adequate and satisfactory analgesia. These factors worsen the psychological state of patients and deteriorate their quality of life. Hence, there is a need to develop therapeutic modalities to provide adequate analgesia with minimum side effects. This review article focuses on the current treatments available for cancer pain management, their limitations, and novel targets and non-pharmacological measures under investigation which have the potential to produce a radical change in pain management measures for the breast cancer patients.

  2. Clinical diagnosis and management in early Huntington's disease: a review

    Directory of Open Access Journals (Sweden)

    Schiefer J

    2015-03-01

    Full Text Available Johannes Schiefer,1,* Cornelius J Werner,1,* Kathrin Reetz1,2 1Euregional Huntington Center, 2Jülich Aachen Research Alliance (JARA – Translational Brain Medicine, Department of Neurology, RWTH Aachen University, Aachen, Germany *These authors contributed equally to this work Abstract: This review focuses on clinical diagnosis and both pharmacological and nonpharmacological therapeutic options in early stages of the autosomal dominant inherited neurodegenerative Huntington's disease (HD. The available literature has been reviewed for motor, cognitive, and psychiatric alterations, which are the three major symptom domains of this devastating progressive disease. From a clinical point of view, one has to be aware that the HD phenotype can vary highly across individuals and during the course of the disease. Also, symptoms in juvenile HD can differ substantially from those with adult-onset of HD. Although there is no cure of HD and management is limited, motor and psychiatric symptoms often respond to pharmacotherapy, and nonpharmacological approaches as well as supportive care are essential. International treatment recommendations based on study results, critical statements, and expert opinions have been included. This review is restricted to symptomatic and supportive approaches since all attempts to establish a cure for the disease or modifying therapies have failed so far. Keywords: Neurodegeneration, clinical picture, early symptoms, therapy, treatment

  3. 77 FR 24961 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

    Science.gov (United States)

    2012-04-26

    ... Office of Management and Budget Review; Comment Request; Prescription Drug Product Labeling: Medication... Management and Budget (OMB) for review and clearance under the Paperwork Reduction Act of 1995 (the PRA... INFORMATION CONTACT: Juanmanuel Vilela, Office of Information Management, Food and Drug Administration,...

  4. 76 FR 6621 - Agency Information Collection Activities; Submission for Office of Management and Budget Review...

    Science.gov (United States)

    2011-02-07

    ... Office of Management and Budget Review; Comment Request; Guidance for Industry on Pharmacogenomic Data... Management and Budget (OMB) for review and clearance under the Paperwork Reduction Act of 1995. DATES: Fax... collection of information to OMB for review and clearance. Guidance for Industry on Pharmacogenomic...

  5. Management of childhood fever by parents: literature review.

    Science.gov (United States)

    Walsh, Anne; Edwards, Helen

    2006-04-01

    This paper reports a review which draws together findings from studies targeting parents' temperature-taking, antipyretic administration, attitudes, practices and information-seeking behaviours. Parents' concerns about the harmful effects of fever have been reported for more than two decades. These concerns remain despite successful educational interventions. Medline, CINAHL, PsycINFO, PsycARTICLES and Web of Science databases were searched from 1980 to 2004 during November 2004. The search terms were fever, child, parent, education, knowledge, belief, concern, temperature, antipyretic and information, and combinations of these. In the 1980s, studies were mainly descriptive of small single site samples of parents with a febrile child seeking assistance from healthcare professionals. From 1990, sample sizes increased and multi-site studies were reported. Educational interventions were designed to increase knowledge and reduce unnecessary use of health services. One 2003 study targeted knowledge and attitudes. Parental knowledge about normal body temperature and the temperature that indicates fever is poor. Mild fever is misclassified by many as high, and they actively reduce mild fever with incorrect doses of antipyretics. Although some parents acknowledge the benefits of mild fever, concerns about brain damage, febrile convulsions and death from mild to moderate fever persist irrespective of parental education or socio-economic status. Many base their fever management practices on inaccurate temperature readings. Increased use of antipyretics to reduce fever and waking sleeping febrile children for antipyretics or sponging reflects heightened concern about harmful effects of fever. Educational interventions have reduced unnecessary use of healthcare services, improved knowledge about fever and when to implement management strategies, and reduced incorrect parental accuracy of antipyretic dosing. Information-seeking behaviours in fever management differ according to

  6. Research data management in academic institutions: A scoping review.

    Science.gov (United States)

    Perrier, Laure; Blondal, Erik; Ayala, A Patricia; Dearborn, Dylanne; Kenny, Tim; Lightfoot, David; Reka, Roger; Thuna, Mindy; Trimble, Leanne; MacDonald, Heather

    2017-01-01

    The purpose of this study is to describe the volume, topics, and methodological nature of the existing research literature on research data management in academic institutions. We conducted a scoping review by searching forty literature databases encompassing a broad range of disciplines from inception to April 2016. We included all study types and data extracted on study design, discipline, data collection tools, and phase of the research data lifecycle. We included 301 articles plus 10 companion reports after screening 13,002 titles and abstracts and 654 full-text articles. Most articles (85%) were published from 2010 onwards and conducted within the sciences (86%). More than three-quarters of the articles (78%) reported methods that included interviews, cross-sectional, or case studies. Most articles (68%) included the Giving Access to Data phase of the UK Data Archive Research Data Lifecycle that examines activities such as sharing data. When studies were grouped into five dominant groupings (Stakeholder, Data, Library, Tool/Device, and Publication), data quality emerged as an integral element. Most studies relied on self-reports (interviews, surveys) or accounts from an observer (case studies) and we found few studies that collected empirical evidence on activities amongst data producers, particularly those examining the impact of research data management interventions. As well, fewer studies examined research data management at the early phases of research projects. The quality of all research outputs needs attention, from the application of best practices in research data management studies, to data producers depositing data in repositories for long-term use.

  7. Research data management in academic institutions: A scoping review

    Science.gov (United States)

    Ayala, A. Patricia; Dearborn, Dylanne; Kenny, Tim; Lightfoot, David; Reka, Roger; Thuna, Mindy; Trimble, Leanne

    2017-01-01

    Objective The purpose of this study is to describe the volume, topics, and methodological nature of the existing research literature on research data management in academic institutions. Materials and methods We conducted a scoping review by searching forty literature databases encompassing a broad range of disciplines from inception to April 2016. We included all study types and data extracted on study design, discipline, data collection tools, and phase of the research data lifecycle. Results We included 301 articles plus 10 companion reports after screening 13,002 titles and abstracts and 654 full-text articles. Most articles (85%) were published from 2010 onwards and conducted within the sciences (86%). More than three-quarters of the articles (78%) reported methods that included interviews, cross-sectional, or case studies. Most articles (68%) included the Giving Access to Data phase of the UK Data Archive Research Data Lifecycle that examines activities such as sharing data. When studies were grouped into five dominant groupings (Stakeholder, Data, Library, Tool/Device, and Publication), data quality emerged as an integral element. Conclusion Most studies relied on self-reports (interviews, surveys) or accounts from an observer (case studies) and we found few studies that collected empirical evidence on activities amongst data producers, particularly those examining the impact of research data management interventions. As well, fewer studies examined research data management at the early phases of research projects. The quality of all research outputs needs attention, from the application of best practices in research data management studies, to data producers depositing data in repositories for long-term use. PMID:28542450

  8. Mobile Apps for Weight Management: A Scoping Review.

    Science.gov (United States)

    Rivera, Jordan; McPherson, Amy; Hamilton, Jill; Birken, Catherine; Coons, Michael; Iyer, Sindoora; Agarwal, Arnav; Lalloo, Chitra; Stinson, Jennifer

    2016-07-26

    Obesity remains a major public health concern. Mobile apps for weight loss/management are found to be effective for improving health outcomes in adults and adolescents, and are pursued as a cost-effective and scalable intervention for combating overweight and obesity. In recent years, the commercial market for 'weight loss apps' has expanded at rapid pace, yet little is known regarding the evidence-based quality of these tools for weight control. To characterize the inclusion of evidence-based strategies, health care expert involvement, and scientific evaluation of commercial mobile apps for weight loss/management. An electronic search was conducted between July 2014 and July 2015 of the official app stores for four major mobile operating systems. Three raters independently identified apps with a stated goal of weight loss/management, as well as weight loss/management apps targeted to pediatric users. All discrepancies regarding selection were resolved through discussion with a fourth rater. Metadata from all included apps were abstracted into a standard assessment criteria form and the evidence-based strategies, health care expert involvement, and scientific evaluation of included apps was assessed. Evidence-based strategies included: self-monitoring, goal-setting, physical activity support, healthy eating support, weight and/or health assessment, personalized feedback, motivational strategies, and social support. A total of 393 apps were included in this review. Self-monitoring was most common (139/393, 35.3%), followed by physical activity support (108/393, 27.5%), weight assessment (100/393, 25.4%), healthy eating support (91/393, 23.2%), goal-setting (84/393, 21.4%), motivational strategies (28/393, 7.1%), social support (21/393, 5.3%), and personalized feedback (7/393, 1.8%). Of apps, 0.8% (3/393) underwent scientific evaluation and 0.3% (1/393) reported health care expert involvement. No apps were comprehensive in the assessment criteria, with the majority

  9. Developing a Computerized Aging Management System for Concrete Structures in Finnish Nuclear Power Plants

    Directory of Open Access Journals (Sweden)

    Hradil P.

    2013-07-01

    Full Text Available Finland has four nuclear reactors units in two power plants. The first unit started operation in 1977 and in the early 1980's all four units were in use. During the last few years the aging management of the Nuclear Power Plant's (NPP concrete structures has grown an important issue because the existing structures are reaching the end of their licensed operating lifetime (about 40 years. Therefore the nuclear power companies are developing aging management systems to avoid premature degradation of NPP facilities and to be able to extend their operating lifetime. This paper is about the development of a computerized ageing management system for the nuclear power plants concrete structures. The computerized ageing management system is built upon central database and implementation applications. It will assist the personnel of power companies to implement the aging management activities at different phases of the lifetime of a power plant. It will provide systematic methods for planning, surveillance, inspection, monitoring, condition assessment, maintenance and repair of structures.

  10. Developing a Computerized Aging Management System for Concrete Structures in Finnish Nuclear Power Plants

    Science.gov (United States)

    Al-Neshawy, F.; Piironen, J.; Sistonen, E.; Vesikari, E.; Tuomisto, M.; Hradil, P.; Ferreira, M.

    2013-07-01

    Finland has four nuclear reactors units in two power plants. The first unit started operation in 1977 and in the early 1980's all four units were in use. During the last few years the aging management of the Nuclear Power Plant's (NPP) concrete structures has grown an important issue because the existing structures are reaching the end of their licensed operating lifetime (about 40 years). Therefore the nuclear power companies are developing aging management systems to avoid premature degradation of NPP facilities and to be able to extend their operating lifetime. This paper is about the development of a computerized ageing management system for the nuclear power plants concrete structures. The computerized ageing management system is built upon central database and implementation applications. It will assist the personnel of power companies to implement the aging management activities at different phases of the lifetime of a power plant. It will provide systematic methods for planning, surveillance, inspection, monitoring, condition assessment, maintenance and repair of structures.

  11. Optimizing any-aged management of mixed boreal forest under residual basal area constraints

    Institute of Scientific and Technical Information of China (English)

    Timo Pukkala; Erkki Lähde; Olavi Laiho

    2014-01-01

    The current trend of forest management in many countries is reduced use of clear-felling and planting, and increased use of continuous cover management. In Finland, the new forest act of 2014 made all types of cuttings equally allowable on the condition that if the post-cutting residual stand basal area is too low, the stand must be regenerated within certain time frame. Forest landowner can freely choose between even-and uneven-aged management. This study developed a method for opti-mizing the timing and type of cuttings without the need to categorize the management system as either even-aged or uneven-aged. A management system that does not set any requirements on the sequence of post-cutting diameter distributions is called any-aged management. Planting or sow-ing was used when stand basal area fell below the required minimum basal area and the amount of advance regeneration was less than required in the regulations. When the cuttings of 200 stands managed earlier with even-aged silviculture were optimized with the developed system, final felling followed by artificial regeneration was selected for almost 50%of stands. Reduction of the minimum basal area limit greatly decreased the use of artificial regeneration but improved profitability, suggesting that the truly optimal management would be to use natural regeneration in financially mature stands. The optimal type of thinning was high thinning in 97-99%of cases. It was calculated that the minimum basal area re-quirement reduced the mean net present value of the stands by 12-16%when discount rate was 3-5%.

  12. Impact on diabetes management of General Practice Management Plans, Team Care Arrangements and reviews.

    Science.gov (United States)

    Wickramasinghe, Leelani K; Schattner, Peter; Hibbert, Marienne E; Enticott, Joanne C; Georgeff, Michael P; Russell, Grant M

    2013-08-19

    To investigate whether General Practice Management Plans (GPMPs), Team Care Arrangements (TCAs) and reviews of these improve the management and outcomes of patients with diabetes when supported by cdmNet, a web-based chronic disease management system; and to investigate adherence to the annual cycle of care (ACOC), as recommended in diabetes guidelines. A before-and-after study to analyse prospectively collected data on 577 patients with type 1 or 2 diabetes mellitus who were managed with a GPMP created using cdmNet between June 2008 and November 2012. Completion of the clinical tests in the ACOC (process outcome) and values of six of these clinical measurements (clinical outcomes). Significant improvements were seen after creation of a GPMP in the proportion of ACOC clinical tests completed (57.9% v 74.8%, P < 0.001), total cholesterol level (P < 0.01), low-density lipoprotein (LDL) cholesterol level (P < 0.001) and body mass index (BMI) (P < 0.01). Patients using GPMPs and TCAs also improved their glycated haemoglobin (HbA1c) level (P < 0.05). Patients followed up with irregular reviews had significant improvements in the proportion of ACOC clinical tests completed (59.2% v 77.6%, P < 0.001), total cholesterol level (P < 0.05), and BMI (P < 0.01), but patients with regular reviews had greater improvements in the proportion of ACOC clinical tests completed (58.9% v 85.0%, P < 0.001), HbA(1c) level (57.7 v 53.0 mmol/mol, P < 0.05), total cholesterol level (4.8 v 4.5 mmol/L, P < 0.05), LDL cholesterol level (2.8 v 2.4 mmol/L, P < 0.01) and diastolic blood pressure (76.0 v 74.0 mmHg, P < 0.05). There were significant improvements in process and clinical outcomes for patients on a GPMP or a GPMP and TCA, particularly when these were followed up by regular reviews. Patients using cdmNet were four times more likely to have their GPMP or TCA followed up through regular reviews than the national average.

  13. Importance and performance of managerial skills in the Australian aged care sector - a middle managers' perspective.

    Science.gov (United States)

    Meissner, Ellen; Radford, Katrina

    2015-09-01

    This study examined the importance and performance of middle managers' skills to provide a starting point for a sector-wide leadership and management framework. There is an increasing consensus that the quality of management, leadership and performance of any organisation is directly linked to the capabilities of its middle managers and the preparation and on-going training they receive. A total of 199 middle managers from three aged care organisations in Australia participated in a questionnaire conducted during 2010-2011. This study found that middle managers perceived the need to develop their communication skills, self-awareness, change management, conflict resolution and leadership skills. Middle managers perceive a discrepancy between performance and importance of various managerial skills. This study demonstrated that provision of training needs to go beyond clinical skills development and further investigation into managers' needs is necessary, particularly considering the diversity of this critical group in organisations. Future training opportunities provided to middle managers need to address the 'softer' skills (e.g. communication) rather than 'technical' skills (e.g. clinical skills). The provision of training in these skills may improve their performance, which may also lead to increased job satisfaction, continuity in leadership and management and ultimately improvements in the quality of care provided. © 2014 John Wiley & Sons Ltd.

  14. A contemporary review of management and prognostic factors of upper tract urothelial carcinoma.

    Science.gov (United States)

    Leow, Jeffrey J; Orsola, Anna; Chang, Steven L; Bellmunt, Joaquim

    2015-04-01

    Upper tract urothelial carcinoma (UTUC) accounts for management and potentially improve outcomes. This article systematically reviews current literature on prognostic factors and management options for UTUC. A comprehensive literature search was performed to identify all studies examining prognostic factors and management options for UTUC. The search included the Medline, Embase, Cochrane Central Register of Controlled Trials databases, and abstracts from the American Society of Clinical Oncology meetings up to November 2014. An updated systematic review was performed. Preoperative prognostic factors for UTUC patients include age, race, performance status, obesity, smoking status, elevated fibrinogen levels, hydronephrosis, tumor size, multi-focality, location, clinical grade and previous/synchronous bladder cancer. Postoperative variables include tumor stage/grade, multifocality, nodal involvement, lympho-vascular invasion, initial ureteral location, necrosis, sessile architecture, variant histologies and presence of tissue ALDH1 and SOX2. Curative treatment of choice is NU, with lymphadenectomy conferring survival benefits. Minimally invasive surgery has equivalent oncologic and better peri-operative outcomes compared to open surgery. Conservative therapy includes adjuvant BCG and intravesical mitomycin C. Two randomized trials investigating postoperative instillation of mitomycin C suggest bladder recurrence benefits. Adjuvant chemo-radiotherapy may be useful for patients with advanced T3/4 and/or N+ disease. Gold-standard treatment for UTUC remains NU, increasingly performed using minimally invasive surgery. Nomograms including pre- and post-operative variables can aid prognostication and guide further therapy. Copyright © 2015 Elsevier Ltd. All rights reserved.

  15. Reviewing CSR management and marketing communication research: A discourse approach

    DEFF Research Database (Denmark)

    Nielsen, Anne Ellerup; Thomsen, Christa

    context (Matten & Moon 2008). Many corporations today are concerned with gaining legitimacy through integrating the expectations of their stakeholders (employees, customers, NGOs, activists, government institutions, institutions of international governance) in the overall company strategy. This also...... of institutions’ pressure on companies to adopt similar practices in a given societal context (DiMaggio & Powel 1983). Considering CSR communication under the lens of insitutional theory opens for understanding the diversity and dynamics of CSR (Brammer et al. 2012).Moreover, the institutionalizing processes...... for CSR researchers and practitioners and to examine the underlying institutional context of CSR communication to explain this. The data for study are based on international peer-reviewed articles on CSR management and marketing communication research papers published during the last 10 years and drawn...

  16. Current management of bronchiectasis: review and 3 case studies.

    Science.gov (United States)

    Silverman, Enid; Ebright, Linda; Kwiatkowski, Marianne; Cullina, Joanne

    2003-01-01

    Bronchiectasis is the abnormal, irreversible dilatation of diseased bronchi. Permanently dilated airways, usually in the medium-sized bronchi, are inflamed and often obstructed with thick, purulent secretions. Known causative factors include postinfection bronchial damage, postinhalation injury, hypersensitivity reactions, and congenital airway obstructive disorders. Typical symptoms include sputum overproduction, fever, pleurisy, dyspnea, and chronic cough. Diagnosis involves radiographic studies and pulmonary function testing. Treatment includes oral, aerosolized, or intravenous antibiotic therapy according to the severity of the exacerbation, and mucus clearance by means of bronchial hygiene assistive devices, chest physiotherapy, postural drainage, and high-frequency chest compression. We present a review of bronchiectasis and offer 3 case studies illustrating current management of different presentations, including use of aerosolized antibiotics for patients infected with Pseudomonas aeruginosa. Although an adjunctive program of pulmonary rehabilitation may be useful for patients with bronchiectasis, no confirming studies have been performed to date, and additional research in this area is warranted.

  17. Management of inappropriate sexual behaviors in dementia: a literature review.

    Science.gov (United States)

    Tucker, Inese

    2010-08-01

    This paper reviews published literature on the pharmacological and non-pharmacological treatment of inappropriate sexual behavior in dementia. A literature search of Psychinfo and Cochrane databases was performed and data from case reports and case series were analyzed. No randomized controlled trials exist for any treatment of sexual disinhibition in dementia and there are no trials comparing different pharmacological agents. Case reports and case series report a wide range of pharmacotherapies as efficacious in the treatment of inappropriate sexual behaviors in dementia. There is only one case report of non-pharmacological strategies to manage inappropriate sexual behavior. Inappropriate sexual behaviors in dementia can be difficult to treat. Frequently, multiple psychoactive medications are used and many pharmacotherapies are trialed prior to finding an effective agent. More research is needed to clarify the usefulness of these medications and to identify non-pharmacological strategies to prevent unnecessary use of medications.

  18. An Insight into Sweet Potato Weevils Management: A Review

    Directory of Open Access Journals (Sweden)

    Seow-Mun Hue

    2015-01-01

    Full Text Available Sweet potato is an important food crop that is grown widely in tropical and subtropical regions. Sweet potato weevil is the most disastrous pest affecting sweet potato plantations, causing millions of dollars losses annually. An effective integrated pest management (IPM method will help to prevent economic losses, and it is crucial to understand the factors that contribute to weevil infestation and strategies that are available to overcome them. This review summarizes the (1 mechanisms of action of weevil on sweet potato and (2 contributing factors in weevil infestation, followed by (3 discussion on current IPM practices used in the different regions, including intercropping, entomopathogenic fungi and bacteria, sex pheromones, and pesticides. Lastly, it also focuses on (4 applications of advanced biotechnology and genomics strategies towards reducing weevil’s infestation in sweet potato plantation.

  19. Management and Complications of Short Bowel Syndrome: an Updated Review.

    Science.gov (United States)

    Carroll, Robert E; Benedetti, Enrico; Schowalter, Joseph P; Buchman, Alan L

    2016-07-01

    Short bowel syndrome (SBS) is defined as loss of bowel mass from surgical resection, congenital defects, or disease. Intestinal failure (IF) includes the subset of SBS unable to meet nutrition needs with enteral supplements and requires parenteral nutrition (PN). The parenteral treatment of SBS is now a half-century old. Recent pharmacologic treatment (GLP-2 analogues) has begun to make a significant impact in the care and ultimate management of these patients such that the possibility of reducing PN requirements in formerly PN-dependent patients is a now a real possibility. Finally, newer understanding and possible treatment for some of the complications related to IF have more recently evolved and will be an emphasis of this report. This review will focus on developments over the last 10 years with the goal of updating the reader to new advances in our understanding of the care and feeding of the SBS patient.

  20. Review and management of 46,XY disorders of sex development.

    Science.gov (United States)

    Massanyi, Eric Z; Dicarlo, Heather N; Migeon, Claude J; Gearhart, John P

    2013-06-01

    Disorders of sex development (DSD) among 46,XY individuals are rare and challenging conditions. Abnormalities of karyotype, gonadal formation, androgen synthesis, and androgen action are responsible for the multiple disorders that result in undervirilization during development. Phenotypic appearance and timing of presentation are quite variable. The focus of treatment has shifted from early gender assignment and corrective surgery to careful diagnosis, proper education of patients and their families, and individualized treatment by a multi-disciplinary team. The modern management of these patients is difficult and controversial. Conflicting data on long-term outcomes of these individuals have been reported in the literature. The various etiologies of 46,XY DSD, current approaches to diagnosis and treatment, and reported long-term results are reviewed.

  1. Prognostics and Health Management in Nuclear Power Plants: A Review of Technologies and Applications

    Energy Technology Data Exchange (ETDEWEB)

    Coble, Jamie B.; Ramuhalli, Pradeep; Bond, Leonard J.; Hines, Wes; Upadhyaya, Belle

    2012-07-17

    This report reviews the current state of the art of prognostics and health management (PHM) for nuclear power systems and related technology currently applied in field or under development in other technological application areas, as well as key research needs and technical gaps for increased use of PHM in nuclear power systems. The historical approach to monitoring and maintenance in nuclear power plants (NPPs), including the Maintenance Rule for active components and Aging Management Plans for passive components, are reviewed. An outline is given for the technical and economic challenges that make PHM attractive for both legacy plants through Light Water Reactor Sustainability (LWRS) and new plant designs. There is a general introduction to PHM systems for monitoring, fault detection and diagnostics, and prognostics in other, non-nuclear fields. The state of the art for health monitoring in nuclear power systems is reviewed. A discussion of related technologies that support the application of PHM systems in NPPs, including digital instrumentation and control systems, wired and wireless sensor technology, and PHM software architectures is provided. Appropriate codes and standards for PHM are discussed, along with a description of the ongoing work in developing additional necessary standards. Finally, an outline of key research needs and opportunities that must be addressed in order to support the application of PHM in legacy and new NPPs is presented.

  2. Exercise induced laryngeal obstruction: a review of diagnosis and management.

    Science.gov (United States)

    Liyanagedara, Savinda; McLeod, Robert; Elhassan, Hassan A

    2017-04-01

    Exercise induced laryngeal obstruction (EILO) is a condition where inappropriate vocal cord or glottic closure occurs during exercise. This review of the literature provides an overview of the current understanding of the definition, epidemiology, diagnosis and management of EILO. Using The Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) guidelines the Cochrane, Embase, Ovid MEDLINE and PubMed databases were searched. Four search domains "exercise", "induced", "laryngeal" and "obstruction" were used. Primary searching found 469 records, 308 were excluded following screening of titles and citation. 100 were duplicates, a further 47 studies were excluded after applying inclusion and exclusion criteria. Two studies were identified following cross-referencing. A total of 15 studies were included. The last search date was 6/06/15. Average prevalence in the general adolescent population and athletes was 7.1 and 35.2 %, respectively. Dyspnoea was reported in 96.5, 99 and 100 % of three EILO patient cohorts. Two studies (n = 107) reported continuous laryngoscopy during exercise (CLE) testing could differentiate between patients and controls. In two studies (n = 33) the visual analogue scale (VAS) showed a beneficial effect of endoscopic supraglottoplasty (ES). Thirty-eight out of 43 patients who received two or more laryngeal control therapy sessions (LCT) had improvement or resolution of EILO symptoms. Exercise induced dyspnoea is the most common EILO symptom. EILO has a high occurrence in adolescents and athletes. The CLE test is the current gold standard for EILO diagnostics. Management of EILO includes both surgical and non-surgical interventions.

  3. Diagnosis and management of chronic pruritus: An expert consensus review

    Directory of Open Access Journals (Sweden)

    Murlidhar Rajagopalan

    2017-01-01

    Full Text Available The aim of this study is to formulate the best clinical practice in the diagnosis and management of chronic pruritus (CP. We searched PubMed, EMBASE, Scopus, Web of Science, and the WHO's regional databases, for studies on “Diagnosis and management of chronic pruritus” from January 1, 2014, to July 31, 2015. We included programmatic reports and hand-searched references of published reviews and articles. Two independent reviewers screened articles and extracted data. We screened 87 of 95 studies that contained qualitative data. Avoid: Dry climate, heat, alcohol compress, ice packs, frequent bathing and washing, intake of very hot and spicy food, intake of alcohol, contact with irritant substances, excitement, strain and stress, and allergens. Using: Mild nonalkaline soaps, moisturizers, bathing oils, lukewarm water while bathing, soft cotton clothing and night creams/lotions, relaxation therapy, autogenic training, psychosocial education, educating patients to cope with itching and scratching, and educational programs. Especially use of moisturizers is considered important. In addition, symptomatic treatment options include systemic H1 antihistamines and topical corticosteroids. Symptomatic therapy directed toward the cause (hepatic, renal, atopic, polycythemia, etc.. If refractory or cause is unknown, consider capsaicin, calcineurin inhibitors for localized pruritus and naltrexone, pregabalin, ultraviolet therapy, Cyclosporine for generalized itching. CP is quite frequent finding associated with skin and systemic diseases in the overall population. It is known to significantly affect quality life score of an individual and also adds burden on the health-care cost. A specific recommendation for treatment of CP is difficult as a result of varied and diverse possibility of underlying diseases associated with CP.

  4. A single center series highlights on incidence and management of gastric neuroendocrine tumours with literature review

    Directory of Open Access Journals (Sweden)

    Fahmy WF

    2015-06-01

    Full Text Available Neuroendocrine tumours of the digestive system (GEP-NET are relatively rare. Nevertheless, their diagnoses is rising as seen from studies in the US and elsewhere. Gastric neuroendocrine tumours (Gastric NETs vary through a wide clinical spectrum, from asymptomatic cases to functioning tumours. Gastrointestinal specialists need to be aware and pursue these lesions as they are indolent with a malignant variant and a potential for metastasis. A computerised search through our pathology laboratory data base, using codes for gastric, carcinoid and neuroendocrine tumour/ hyperplasia, was used to identify cases from January 2008 to September 2014. Medical charts were retrieved, examined. Eleven cases were identified and re-examined by one consultant pathologist. There were 5 females - mean age of 50 years (39-59 and 6 males - mean age of 57 years (41-73. Mean follow up period was 4.5 years (1-9. Gastric NETs fall into Type I, II and III (WHO Classification. Our series showed eight cases of Type I managed by biopsy/ endoscopic mucosal resection (EMR. No Type II cases were identified and one case of Type III had a subtotal gastrectomy and lymphadenectomy. Two neuroendocrine hyperplasia cases were managed by biopsy only. Cases were followed up (except one who refused with regular upper endoscopy and imaging as indicated. A literature review of managing Gastric NETs was discussed. We aim to alert gastrointestinal specialists by presenting a retrospective study of Gastric NETs from a single teaching institution.

  5. Uncertainty in age-specific harvest estimates and consequences for white-tailed deer management

    Science.gov (United States)

    Collier, B.A.; Krementz, D.G.

    2007-01-01

    Age structure proportions (proportion of harvested individuals within each age class) are commonly used as support for regulatory restrictions and input for deer population models. Such use requires critical evaluation when harvest regulations force hunters to selectively harvest specific age classes, due to impact on the underlying population age structure. We used a stochastic population simulation model to evaluate the impact of using harvest proportions to evaluate changes in population age structure under a selective harvest management program at two scales. Using harvest proportions to parameterize the age-specific harvest segment of the model for the local scale showed that predictions of post-harvest age structure did not vary dependent upon whether selective harvest criteria were in use or not. At the county scale, yearling frequency in the post-harvest population increased, but model predictions indicated that post-harvest population size of 2.5 years old males would decline below levels found before implementation of the antler restriction, reducing the number of individuals recruited into older age classes. Across the range of age-specific harvest rates modeled, our simulation predicted that underestimation of age-specific harvest rates has considerable influence on predictions of post-harvest population age structure. We found that the consequence of uncertainty in harvest rates corresponds to uncertainty in predictions of residual population structure, and this correspondence is proportional to scale. Our simulations also indicate that regardless of use of harvest proportions or harvest rates, at either the local or county scale the modeled SHC had a high probability (>0.60 and >0.75, respectively) of eliminating recruitment into >2.5 years old age classes. Although frequently used to increase population age structure, our modeling indicated that selective harvest criteria can decrease or eliminate the number of white-tailed deer recruited into older

  6. Age-Related Changes in Performance and Recovery Kinetics in Masters Athletes: A Narrative Review.

    Science.gov (United States)

    Borges, Nattai; Reaburn, Peter; Driller, Matthew; Argus, Christos

    2016-01-01

    Despite increasing participation rates in masters sport and extensive research examining age-related changes in performance, little is known about the effect of age on recovery kinetics in masters athletes. This narrative review focuses on the relationship between aging and sport participation, and the effect on both performance and recovery following an exercise bout. Current research suggests the effect of age on performance and recovery may be smaller than originally suggested and that increasing sedentary lifestyles appear to play a larger role in any observed decrements in performance and recovery in masters athletes. Currently, it appears that performance decrements are inevitable with age. However, performance capacities can be maintained through systematic physical training. Moreover, the limited current research suggests there may be an age effect on recovery kinetics following an exercise bout, although further research is required to understand the acute and chronic recovery processes in the masters athlete.

  7. 77 FR 43355 - Agency Information Collection Activities: Submitted for Office of Management and Budget Review...

    Science.gov (United States)

    2012-07-24

    ... Office of Natural Resources Revenue Agency Information Collection Activities: Submitted for Office of Management and Budget Review, Comment Request AGENCY: Office of Natural Resources Revenue, Interior. ACTION... information from Indian beneficiaries. ONRR performs the minerals revenue management functions for...

  8. Complications Related to Pectus Carinatum Correction: Lessons Learned from 15 Years' Experience. Management and Literature Review.

    Science.gov (United States)

    Del Frari, Barbara; Sigl, Stephan; Schwabegger, Anton H

    2016-08-01

    Various methods of corrective thoracoplasty for pectus carinatum deformity have been described, but to date no studies describe a review of complications and how to manage them. Complications are dependent not only on the technique used and the patient's age, but also on the experience of the treating surgeon. The authors present their 15 years' experience with surgical correction of pectus carinatum and the complications that have occurred. A literature review regarding complications with pectus carinatum surgery is performed. A retrospective review of 95 patients (mean age, 19 years) was performed. One hundred four surgical procedures for repair of pectus carinatum were performed from July of 2000 to July of 2015 using a modified Ravitch technique, bioabsorbable material, postoperative bracing, and in some cases a diced rib cartilage graft technique. Intraoperative and postoperative complications were evaluated. The mean patient follow-up was 13.6 months (range, 4 months to 9.75 years). Intraoperative complications were pleura lesion and laceration of the internal mammary vein. Postoperative complications were recurrent mild protrusion, persistent protrusion of one or two costal cartilages, minor wound healing delay, skin ulcer, hypertrophic scar, transient intercostal dysesthesia, marginal pneumothorax, seroma, meningitis, and epidural hematoma. In our reported series of pectus carinatum repair, increasing experience and progressively less extensive techniques have resulted in fewer complications, low morbidity, and early return to activity. Complications were observed in the early period of application, predominantly because of a lack of experience, and usually subsided with increasing numbers of patients and frequency of surgery. Therapeutic, IV.

  9. Quality of life in age-related macular degeneration: a review of the literature

    OpenAIRE

    Mitchell, Jan; Bradley, Clare

    2006-01-01

    The Age-related Macular Degeneration Alliance International commissioned a review of the literature on quality of life (QoL) in macular degeneration (MD) with a view to increasing awareness of MD, reducing its impact and improving services for people with MD worldwide. Method: A systematic review was conducted using electronic databases, conference proceedings and key journal hand search checks. The resulting 'White Paper' was posted on the AMD Alliance website and is reproduced here. ...

  10. Age- and stroke-related skeletal muscle changes: a review for the geriatric clinician.

    Science.gov (United States)

    Sions, Jaclyn Megan; Tyrell, Christine M; Knarr, Brian A; Jancosko, Angela; Binder-Macleod, Stuart A

    2012-01-01

    Independently, aging and stroke each have a significant negative impact on skeletal muscle, but the potential cumulative effects of aging and stroke have not been explored. Optimal interventions for individuals post stroke may include those that specifically target skeletal muscle. Addressing changes in muscles may minimize activity limitations and enhance participation post stroke. This article reviews the impact of aging and stroke on muscle morphology and composition, including fiber atrophy, reductions in muscle cross-sectional area, changes in muscle fiber distributions, and increases in intramuscular fat. Relationships between changes in muscle structure, muscle function, and physical mobility are reviewed. Clinical recommendations that preserve and enhance skeletal muscle in the aging adult and individuals post stroke are discussed. Future research directions that include systematic comparison of the differences in skeletal muscle between younger and older adults who have sustained a stroke are suggested.

  11. Causes of dysphagia among different age groups: a systematic review of the literature.

    Science.gov (United States)

    Roden, Dylan F; Altman, Kenneth W

    2013-12-01

    Dysphagia is a common problem that has the potential to result in severe complications such as malnutrition and aspiration pneumonia. Based on the complexity of swallowing, there may be many different causes. This article presents a systematic literature review to assess different comorbid disease associations with dysphagia based on age. The causes of dysphagia are different depending on age, affecting between 1.7% and 11.3% of the general population. Dysphagia can be a symptom representing disorders pertinent to any specialty of medicine. This review can be used to aid in the diagnosis of patients presenting with the complaint of dysphagia. Copyright © 2013 Elsevier Inc. All rights reserved.

  12. Managing reservoir sedimentation by venting turbidity currents:A review

    Institute of Scientific and Technical Information of China (English)

    Sabine Chamoun; Giovanni De Cesare; Anton J. Schleiss

    2016-01-01

    Reservoir sedimentation is an issue that dam operators are increasingly facing as dams are aging. Not only does it reduce a reservoir's capacity but it also affects its outlet structures such as bottom outlets and powerhouse intakes. Sedimentation may also impoverish downstream ecosystems. For these reasons, several strategies for sediment management are being investigated and applied worldwide. Among these methods, venting of turbidity currents reaching the dam can be very beneficial and economical. This measure helps in preserving a certain continuity of sediment transport in rivers obstructed by dams. However, several practical but also theoretical challenges hamper this technique, rendering its use less common and its aspects rela-tively unknown. The present paper aims to gather the actual state-of-the-art concerning turbidity currents venting and to present an outlook for future development and research in this field.

  13. Gouty Arthritis: A Review of Acute Management and Prevention.

    Science.gov (United States)

    Wilson, Liza; Saseen, Joseph J

    2016-08-01

    Gouty arthritis is one of the most common rheumatic diseases. The clinical burden of gouty arthritis has historically been well recognized; however, gout is often misdiagnosed and mismanaged. The prevalence of gout is rising and is likely attributed to several factors including increased incidence of comorbidities, lifestyle factors, and increased use of causative medications. With the increasing prevalence, there have been several innovations and evidence-based updates related to the diagnosis and management of gout. Acute gouty arthritis should be treated with nonsteroidal antiinflammatory drugs (NSAIDs), colchicine, or corticosteroids, or a combination of two agents. Xanthine oxidase inhibitor therapy remains the consensus first-line treatment option for the prevention of recurrent gout. Add-on therapies that reduce serum urate concentration include traditional uricosuric agents and a novel uric acid reabsorption inhibitor. Prophylaxis of acute gout with NSAIDs, colchicine, or corticosteroids is universally recommended when initiating any urate-lowering therapy in order to prevent acute gouty arthritis for a period of at least 6 months. In this review, we discuss the epidemiology and risk factors for gouty arthritis and evaluate diagnostic strategies and therapeutic regimens for the management of gout, including a new drug approval.

  14. Review: Optimization methods for groundwater modeling and management

    Science.gov (United States)

    Yeh, William W.-G.

    2015-09-01

    Optimization methods have been used in groundwater modeling as well as for the planning and management of groundwater systems. This paper reviews and evaluates the various optimization methods that have been used for solving the inverse problem of parameter identification (estimation), experimental design, and groundwater planning and management. Various model selection criteria are discussed, as well as criteria used for model discrimination. The inverse problem of parameter identification concerns the optimal determination of model parameters using water-level observations. In general, the optimal experimental design seeks to find sampling strategies for the purpose of estimating the unknown model parameters. A typical objective of optimal conjunctive-use planning of surface water and groundwater is to minimize the operational costs of meeting water demand. The optimization methods include mathematical programming techniques such as linear programming, quadratic programming, dynamic programming, stochastic programming, nonlinear programming, and the global search algorithms such as genetic algorithms, simulated annealing, and tabu search. Emphasis is placed on groundwater flow problems as opposed to contaminant transport problems. A typical two-dimensional groundwater flow problem is used to explain the basic formulations and algorithms that have been used to solve the formulated optimization problems.

  15. Permeable pavement and stormwater management systems: a review.

    Science.gov (United States)

    Imran, H M; Akib, Shatirah; Karim, Mohamed Rehan

    2013-01-01

    Uncontrolled stormwater runoff not only creates drainage problems and flash floods but also presents a considerable threat to water quality and the environment. These problems can, to a large extent, be reduced by a type of stormwater management approach employing permeable pavement systems (PPS) in urban, industrial and commercial areas, where frequent problems are caused by intense undrained stormwater. PPS could be an efficient solution for sustainable drainage systems, and control water security as well as renewable energy in certain cases. Considerable research has been conducted on the function of PPS and their improvement to ensure sustainable drainage systems and water quality. This paper presents a review of the use of permeable pavement for different purposes. The paper focuses on drainage systems and stormwater runoff quality from roads, driveways, rooftops and parking lots. PPS are very effective for stormwater management and water reuse. Moreover, geotextiles provide additional facilities to reduce the pollutants from infiltrate runoff into the ground, creating a suitable environment for the biodegradation process. Furthermore, recently, ground source heat pumps and PPS have been found to be an excellent combination for sustainable renewable energy. In addition, this study has identified several gaps in the present state of knowledge on PPS and indicates some research needs for future consideration.

  16. Automated negotiation in environmental resource management: Review and assessment.

    Science.gov (United States)

    Eshragh, Faezeh; Pooyandeh, Majeed; Marceau, Danielle J

    2015-10-01

    Negotiation is an integral part of our daily life and plays an important role in resolving conflicts and facilitating human interactions. Automated negotiation, which aims at capturing the human negotiation process using artificial intelligence and machine learning techniques, is well-established in e-commerce, but its application in environmental resource management remains limited. This is due to the inherent uncertainties and complexity of environmental issues, along with the diversity of stakeholders' perspectives when dealing with these issues. The objective of this paper is to describe the main components of automated negotiation, review and compare machine learning techniques in automated negotiation, and provide a guideline for the selection of suitable methods in the particular context of stakeholders' negotiation over environmental resource issues. We advocate that automated negotiation can facilitate the involvement of stakeholders in the exploration of a plurality of solutions in order to reach a mutually satisfying agreement and contribute to informed decisions in environmental management along with the need for further studies to consolidate the potential of this modeling approach.

  17. Homoeopathy in the management of Dyslipidemia: A short review

    Directory of Open Access Journals (Sweden)

    Rupali D Bhalerao

    2015-01-01

    Full Text Available The importance of high serum total cholesterol and high level of low-density lipoprotein cholesterol, as a risk factor for coronary artery diseases is well established. Statin is the first-line of treatment for dyslipidemia and there are known side effects of statin therapy. This study reviews the existing information available in Homoeopathy (research and traditional knowledge for managing dyslipidemia. No rigid inclusion has been kept due to scarcity of evidence-based literature. Preclinical and clinical studies (case records to controlled trials are included. A comprehensive search from major biomedical databases including National Medical Library (PubMed, AYUSH PORTAL, EMBASE, and the Cochrane Library was conducted using the search term “dyslipidemia,” “atherosclerosis,” “arteriosclerosis,” “atheroma” along with “Homoeopathy.” In addition, efforts were made to search authoritative texts of authors, such homoeopathic Materia Medica, repertory, etc. Relevant research was categorized by study type and appraised according to study type and design. Four preclinical, three observational studies, and two case records were identified. From literary search, medicines commonly used in Materia Medica and drugs of Indian origin were noted. There are positive leads in managing patients suffering from dyslipidemia. However, more well-designed studies are warranted to generate effectiveness/efficacy of Homoeopathy.

  18. Knowledge management practices in healthcare settings: a systematic review.

    Science.gov (United States)

    Karamitri, Ioanna; Talias, Michael A; Bellali, Thalia

    2017-01-01

    Knowledge is an intangible asset in Organizations, and provides a comparative advantage to those who possess it. Hospitals are complex organizations with unique characteristics because of the heterogeneity of health professionals' orientation, the composite networking and the decision-making processes. A deeper understanding of knowledge management (KM) could streamline productivity and coordinate the use of resources more efficient. We conducted a systematic literature search of peer-reviewed papers that described key elements of KM using three databases (Medline, Cinahl and Health Source: nursing/academic edition) for a 10-year period (1/1/2004-25/11/2014). The included articles were subjected to qualitative content analysis. We retrieved 604 articles of which 20 articles were eligible for analysis. Most of the studies (n=13) used a qualitative methodology. The total sample size was 2155 participants. The key elements that arose were as follows: perceptions of KM, synthesis, dissemination, collaboration, means of KM and leadership. Moreover, this study identified barriers for KM implementation, like time restrictions and limited skills. Healthcare managers ought to cultivate a knowledge environment, operate as role models, provide the tools for KM and reward people who act as knowledge brokers. Opportunities for collaboration and knowledge sharing should be encouraged. Successful KM should be patient-centered to gain its maximum value. Copyright © 2015 John Wiley & Sons, Ltd.

  19. Best herbs for managing diabetes: a review of clinical studies

    Directory of Open Access Journals (Sweden)

    Ahmad Ghorbani

    2013-09-01

    Full Text Available Diabetes mellitus is a public health problem which leads to serious complications over time. Experimentally, many herbs have been recommended for treating diabetes. In most cases, however, the recommendations are based on animal studies and limited pieces of evidence exist about their clinical usefulness. This review focused on the herbs, the hypoglycemic actions of which have been supported by three or more clinical studies. The search was done in Google Scholar, Medline and Science Direct databases using the key terms diabetes, plants, herbs, glucose and patients. According to the clinical studies, Aegle marmelos, Allium cepa, Gymnema sylvestre, Momordica charantia, Ocimum sanctum, Nigella sativa, Ocimum sanctum, Panax quinquefolius, Salacia reticulate, Silybum marianum and Trigonella foenum-graecum have shown hypoglycemic and, in some cases, hypolipidemic activities in diabetic patients. Among them, Gymnema sylvestre, Momordica charantia, Silybum marianum and Trigonella foenum-graecum have acquired enough reputation for managing diabetes. Thus, it seems that physicians can rely on these herbs and advise for the patients to improve management of diabetes.

  20. Management of hereditary angioedema in pregnant women: a review

    Directory of Open Access Journals (Sweden)

    Caballero T

    2014-09-01

    Full Text Available Teresa Caballero,1,2 Julio Canabal,1 Daniela Rivero-Paparoni,1 Rosario Cabañas1 1Hospital La Paz Institute for Health Research, (IdiPaz 2Biomedical Research Network on Rare Diseases-U754 (CIBERER, Madrid, Spain Abstract: Three types of hereditary angioedema (HAE have been described: two are due to C1 inhibitor (C1-INH deficiency (C1-INH-HAE types I and II and one is characterized by normal C1-INH (nC1-INH-HAE. The management of pregnancy in patients with HAE is often a clinical challenge owing to potential worsening of the disease in relation to the physiological increase in estrogens and the limited treatment options. This review addresses the potential influence of pregnancy on the clinical severity of hereditary angioedema and the management of this disease during pregnancy with currently available treatments. Keywords: hereditary angioedema, pregnancy, female, treatment, C1 inhibitor concentrate, tranexamic acid

  1. Malheur National Wildlife Refuge wildlife and habitat management review : November 13-17, 2000

    Data.gov (United States)

    US Fish and Wildlife Service, Department of the Interior — This report summarizes the findings and recommendations of a wildlife and habitat management review conducted by a review team during November 13-17, 2000 at the...

  2. [The efficacy of e-health management on weight control in adolescents: a systematic review].

    Science.gov (United States)

    Su, Mei-Chen; Lin, Chia-Ling; Tsao, Lee-Ing

    2014-02-01

    Advances during the past decade have made it feasible to apply e-health methods to chronic disease management. Researchers have recently begun applying these methods to weight control. The application of e-health management methods to weight control in adolescents has yet to be investigated empirically. This study conducted a systematic review of reports discussing the weight-control effects of e-health management in adolescents. Researchers searched 6 electronic databases for relevant articles published between 1995 and April 2013. Data were collected using inclusion and exclusion criteria. A modified Jadad Scale was used to evaluate the quality of the identified articles. Seven studies met the inclusion criterion of targeting adolescent subject populations. A total of 3728 adolescents and 1394 parents participated in these studies. The majority of participants were overweight girls and median participant ages ranged from 12.52 (SD = 3.15) to 15.31 (SD = 0.69). All studies reported that e-health management reduced body mass index and body fat percentage. Four studies indicate that e-health management may improve physical activity knowledge and skills. However, diet control outcomes among the seven studies varied. Empirical results demonstrate that e-health management significantly affects weight control. However, the effectiveness of log-in versus primary outcome indicators was inconclusive. Future studies should consider the use of incentives, reminder systems, and other strategies to enhance website usage. The development of an Internet-based, computer-tailored weight-management intervention for overweight adolescents and the development of an appropriate care model are recommended.

  3. Perioperative Pain Management Strategies for Amputation: A Topical Review.

    Science.gov (United States)

    Kent, Michael L; Hsia, Hung-Lun John; Van de Ven, Thomas J; Buchheit, Thomas E

    2017-03-01

    To review acute pain management strategies in patients undergoing amputation with consideration of preoperative patient factors, pharmacologic/interventional modalities, and multidisciplinary care models to alleviate suffering in the immediate post-amputation setting. Regardless of surgical indication, patients undergoing amputation suffer from significant residual limb pain and phantom limb pain in the acute postoperative phase. Most studies have primarily focused on strategies to prevent persistent pain with inclusion of immediate postoperative outcomes as secondary measures. Pharmacologic agents, including gabapentin, ketamine, and calcitonin, and interventional modalities such as neuraxial and perineural catheters, have been examined in the perioperative period. Focused Literature Review. Pharmacologic agents (gabapentin, ketamine, calcitonin) have not shown consistent efficacy. Neuraxial analgesia has demonstrated both an opioid sparing and analgesic benefit while results have been mixed regarding perineural catheters in the immediate post-amputation setting. However, several early studies of perineural catheters employed sub-optimal techniques (distal surgical placement), and prolonged use of perineural catheters may provide a sustained benefit. Regardless of analgesic technique, a multidisciplinary approach is necessary for optimal care. Patient-tailored analgesic regimens utilizing catheter-based techniques are essential in the acute post-amputation phase and should be implemented in all patients undergoing amputation. Future research should focus on improved measurement of acute pain and comparisons of effective analgesic regimens instead of single techniques.

  4. Outcome of Keratoconus Management: Review of the Past 20 Years' Contemporary Treatment Modalities.

    Science.gov (United States)

    Mandathara, Preeji S; Stapleton, Fiona J; Willcox, Mark D P

    2017-05-01

    To describe the past 20 years' contemporary management modalities for keratoconus (KC) and their outcomes and failures and to propose recommendations in reporting their outcomes. A systematic review of the literature on KC management options for the last 20 years was performed. Original articles that reported the outcome of any form of KC management other than full-thickness or lamellar corneal graft were reviewed to collect information on their outcomes and complications and the level of scientific evidence of the study. A total of 1,147 articles retrieved and of those, 241 satisfied the inclusion criteria, and 41.1% of them were prospective case series. The higher level of evidence studies, that is, randomized controlled trials (RCTs), were limited to only one intervention, that is, corneal collagen cross-linking (CXL). However, the quality of most RCTs was limited because of performance and detection bias. Contact lenses (CLs) remain the mainstream of KC management and were associated with reversible and non-sight-threatening complications. Surgical options such as intracorneal segment implantation and phakic intraocular lens are considered in the visual rehabilitation of CL intolerants, and CXL is the only available option to stop or delay the disease progression. Generally, these surgical procedures are associated with transient inflammatory events and permanent sequelae. The published studies on KC management options varied significantly with respect to the study population, age of participants, severity of KC, clinical outcome measurements, and follow-up period. High-quality longer follow-up RCTs are required to evaluate the long-term effects of KC interventions.

  5. Management of the aging of critical safety-related concrete structures in light-water reactor plants

    Energy Technology Data Exchange (ETDEWEB)

    Naus, D.J.; Oland, C.B. (Oak Ridge National Lab., TN (USA)); Arndt, E.G. (Nuclear Regulatory Commission, Washington, DC (USA))

    1990-01-01

    The Structural Aging Program has the overall objective of providing the USNRC with an improved basis for evaluating nuclear power plant safety-related structures for continued service. The program consists of a management task and three technical tasks: materials property data base, structural component assessment/repair technology, and quantitative methodology for continued-service determinations. Objectives, accomplishments, and planned activities under each of these tasks are presented. Major program accomplishments include development of a materials property data base for structural materials as well as an aging assessment methodology for concrete structures in nuclear power plants. Furthermore, a review and assessment of inservice inspection techniques for concrete materials and structures has been complete, and work on development of a methodology which can be used for performing current as well as reliability-based future condition assessment of concrete structures is well under way. 43 refs., 3 tabs.

  6. Moving beyond resistance to restraint minimization: a case study of change management in aged care.

    Science.gov (United States)

    Johnson, Susan; Ostaszkiewicz, Joan; O'Connell, Beverly

    2009-01-01

    This case study describes a quality initiative to minimize restraint in an Australian residential aged care facility. The process of improving practice is examined with reference to the literature on implementation of research into practice and change management. The differences between planned and emergent approaches to change management are discussed. The concepts of resistance and attractors are explored in relation to our experiences of managing the change process in this initiative. The importance of the interpersonal interactions that were involved in facilitating the change process is highlighted. Recommendations are offered for dealing with change management processes in clinical environments, particularly the need to move beyond an individual mind-set to a systems-based approach for quality initiatives in residential aged care.

  7. Phentermine and topiramate for the management of obesity: a review.

    Science.gov (United States)

    Cosentino, Gina; Conrad, Ariane O; Uwaifo, Gabriel I

    2013-01-01

    Obesity is now a major public health concern worldwide with increasing prevalence and a growing list of comorbidities and complications. The morbidity, mortality and reduced productivity associated with obesity and its complications result in a major burden to health care costs. Obesity is a complex chronic medical syndrome often with multiple different etiologic factors in individual patients. The long term successful management of obesity remains particularly challenging and invariably requires a multifaceted approach including lifestyle and behavioral modification, increased physical activity, and adjunctive pharmacotherapy. Bariatric surgery remains a last resort though at present it has the best results for achieving sustained robust weight loss. Obesity pharmacotherapy has been very limited in its role for long term obesity management because of the past history of several failed agents as well as the fact that presently available agents are few, and generally utilized as monotherapy. The recent FDA approval of the fixed drug combination of phentermine and extended release topiramate (topiramate-ER) (trade name Qsymia™) marks the first FDA approved combination pharmacotherapeutic agent for obesity since the Phen-Fen combination of the 1990s. This review details the history and clinical trial basis for the use of both phentermine and topiramate in obesity therapeutics as well as the results of clinical trials of their combination for obesity treatment in humans. The initial clinical approval trials offer evidence that this fixed drug combination offers synergistic potential for effective, robust and sustained weight loss with mean weight loss of at least 10% of baseline achieved and sustained for up to 2 years in over 50% of subjects treated. It is anticipated that this agent will be the first in a new trend of multi-agent combination therapy for the chronic adjunctive management of obesity.

  8. Triple therapy for the management of COPD: a review.

    Science.gov (United States)

    Gaebel, Kathryn; McIvor, R Andrew; Xie, Feng; Blackhouse, Gord; Robertson, Diana; Assasi, Nazila; Hernandez, Paul; Goeree, Ron

    2011-06-01

    Triple therapy for COPD consists of a long-acting anti-cholinergic bronchodilator, a long-acting beta-agonist bronchodilator, and an inhaled corticosteroid. Guidelines from the Canadian Thoracic Society advocate triple therapy for some patients with moderate-to-severe COPD. The objective of this review was to evaluate the evidence based clinical efficacy of triple therapy compared to dual bronchodilator therapy (long-acting anti-cholinergic bronchodilator + beta-agonist bronchodilator) or long-acting anti-cholinergic bronchodilator monotherapy for managing COPD. A systematic literature search was conducted to identify relevant clinical evaluations of triple therapy in the management of moderate to severe COPD. Databases searched included: Medline; EMBASE; CINAHL and PubMed (non-Medline records only). Of 2,314 publications, 4 articles evaluated triple therapy for the management of COPD. Hospitalization rates for COPD exacerbations, reported in 2 trials, were significantly reduced with triple therapy compared to long-acting anti-cholinergic bronchodilator monotherapy, with reported relative risks of 0.53 (95% CI: 0.33, 0.86, p = 0.01) and 0.35 (95% CI: 0.16-0.78, p = 0.011). Exacerbation data is inconsistent between the two trials reporting this outcome. Lung function, dyspnea and quality of life data show statistical significant changes with triple therapy compared to long-acting anti-cholinergic bronchodilator monotherapy but the changes do not reach clinical importance. Triple therapy does decrease the number of hospitalizations for severe/acute COPD exacerbations compared with long-acting anti-cholinergic bronchodilator monotherapy. There is insufficient evidence to determine if triple therapy is superior to dual bronchodilator therapy.

  9. Disaster management and the critical thinking skills of local emergency managers: correlations with age, gender, education, and years in occupation.

    Science.gov (United States)

    Peerbolte, Stacy L; Collins, Matthew Lloyd

    2013-01-01

    Emergency managers must be able to think critically in order to identify and anticipate situations, solve problems, make judgements and decisions effectively and efficiently, and assume and manage risk. Heretofore, a critical thinking skills assessment of local emergency managers had yet to be conducted that tested for correlations among age, gender, education, and years in occupation. An exploratory descriptive research design, using the Watson-Glaser Critical Thinking Appraisal-Short Form (WGCTA-S), was employed to determine the extent to which a sample of 54 local emergency managers demonstrated the critical thinking skills associated with the ability to assume and manage risk as compared to the critical thinking scores of a group of 4,790 peer-level managers drawn from an archival WGCTA-S database. This exploratory design suggests that the local emergency managers, surveyed in this study, had lower WGCTA-S critical thinking scores than their equivalents in the archival database with the exception of those in the high education and high experience group. © 2013 The Author(s). Journal compilation © Overseas Development Institute, 2013.

  10. Carotid stenosis management: a review for the internist.

    Science.gov (United States)

    Carmo, Gabriel Assis Lopes; Calderaro, Daniela; Gualandro, Danielle Menosi; Casella, Ivan Benaduce; Yu, Pai Ching; Marques, André Coelho; Caramelli, Bruno

    2014-03-01

    Stroke is one of the most important causes of mortality and morbidity worldwide and, for a long time, was the leading cause of death in developed countries. Atherothrombotic carotid stenosis is one of the most important etiologies behind this event. If properly recognized and treated, lives can be saved, as well as long-term disabilities prevented. With population aging and improvements in surgical and clinical care, patients with several comorbidities will be referred for revascularization procedures more frequently, posing a challenge for physicians. The purpose of this review is to provide internists and clinicians with information based on several studies so they can offer to their patients, the best evidence-based care, indicating appropriate medical therapy, as well as referral to a vascular surgeon, or what contraindicates endarterectomy or angioplasty, depending on individual characteristics.

  11. What is the difference in concussion management in children as compared with adults? A systematic review.

    Science.gov (United States)

    Davis, Gavin A; Anderson, Vicki; Babl, Franz E; Gioia, Gerard A; Giza, Christopher C; Meehan, William; Moser, Rosemarie Scolaro; Purcell, Laura; Schatz, Philip; Schneider, Kathryn J; Takagi, Michael; Yeates, Keith Owen; Zemek, Roger

    2017-06-01

    To evaluate the evidence regarding the management of sport-related concussion (SRC) in children and adolescents. The eight subquestions included the effects of age on symptoms and outcome, normal and prolonged duration, the role of computerised neuropsychological tests (CNTs), the role of rest, and strategies for return to school and return to sport (RTSp). Systematic review. MEDLINE (OVID), Embase (OVID) and PsycInfo (OVID). Studies were included if they were original research on SRC in children aged 5 years to 18 years, and excluded if they were review articles, or did not focus on childhood SRC. A total of 5853 articles were identified, and 134 articles met the inclusion criteria. Some articles were common to multiple subquestions. Very few studies examined SRC in young children, aged 5-12 years. This systematic review recommends that in children: child and adolescent age-specific paradigms should be applied; child-validated symptom rating scales should be used; the widespread routine use of baseline CNT is not recommended; the expected duration of symptoms associated with SRC is less than 4 weeks; prolonged recovery be defined as symptomatic for greater than 4 weeks; a brief period of cognitive and physical rest should be followed with gradual symptom-limited physical and cognitive activity; all schools be encouraged to have a concussion policy and should offer appropriate academic accommodations and support to students recovering from SRC; and children and adolescents should not RTSp until they have successfully returned to school, however early introduction of symptom-limited physical activity is appropriate. PROSPERO 2016:CRD42016039184. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  12. The Application of Genetic Risk Scores in Age-Related Macular Degeneration: A Review

    Directory of Open Access Journals (Sweden)

    Jessica N. Cooke Bailey

    2016-03-01

    Full Text Available Age-related macular degeneration (AMD, a highly prevalent and impactful disease of aging, is inarguably influenced by complex interactions between genetic and environmental factors. Various risk scores have been tested that assess measurable genetic and environmental contributions to disease. We herein summarize and review the ability and utility of these numerous models for prediction of AMD and suggest additional risk factors to be incorporated into clinically useful predictive models of AMD.

  13. Towards interprofessional networking in medication management of the aged: current challenges and potential solutions in Finland.

    Science.gov (United States)

    Kallio, Sonja; Kumpusalo-Vauhkonen, Anne; Järvensivu, Timo; Mäntylä, Antti; Pohjanoksa-Mäntylä, Marika; Airaksinen, Marja

    2016-12-01

    The Finnish Medicines Agency (Fimea) initiated a programme in 2012 for enhancing interprofessional networking in the medication management of the aged. The goal is to develop national guidelines for interprofessional collaboration with respect to medication management. This study aims to explore the challenges and potential solutions experienced by existing health care teams in managing medication of the aged: (1) at the individual and team level (micro level), (2) organisational level (meso level) and (3) structural level (macro level). Group discussions (n = 10), pair (n = 3) and individual interviews (n = 2). Abductive content analysis combining data and theory was applied. Networking was used as a theoretical framework. Meetings (n = 15) organised by Fimea in the formation phase of the interprofessional network in 2012. Health care professionals (n = 55). Challenges and solutions in the medication management of the aged at the micro, meso and macro levels. Challenges in interprofessional collaboration, problems with patient record systems, and the organisation of work and lack of resources were present at all the levels contributing to patients' medication problems. Participants suggested multiple potential solutions to improve interprofessional collaboration, sharing of tasks and responsibilities, better exploitation of pharmaceutical knowledge and developing tools as being the most commonly mentioned. Optimising medication use of the aged requires new systemic solutions within and between different system levels. The main challenges can be solved by clarifying responsibilities, enhancing communication and applying operational models that involve pharmacists and the use of information technology in medication management. KEY POINTS An interprofessional team approach has been suggested as a solution to promote rational medicine use among the aged. Fragmented health care system and lack of coordinated patient care are reasons for medication

  14. Making electronic health records support quality management: A narrative review.

    Science.gov (United States)

    Triantafillou, Peter

    2017-08-01

    Since the 1990s many hospitals in the OECD countries have introduced electronic health record (EHR) systems. A number of studies have examined the factors impinging on EHR implementation. Others have studied the clinical efficacy of EHR. However, only few studies have explored the (intermediary) factors that make EHR systems conducive to quality management (QM). Undertake a narrative review of existing studies in order to identify and discuss the factors conducive to making EHR support three dimensions of QM: clinical outcomes, managerial monitoring and cost-effectiveness. A narrative review of Web of Science, Cochrane, EBSCO, ProQuest, Scopus and three Nordic research databases. most studies do not specify the type of EHR examined. 39 studies were identified for analysis. 10 factors were found to be conducive to make EHR support QM. However, the contribution of EHR to the three specific dimensions of QM varied substantially. Most studies (29) included clinical outcomes. However, only half of these reported EHR to have a positive impact. Almost all the studies (36) dealt with the ability of EHR to enhance managerial monitoring of clinical activities, the far majority of which showed a positive relationship. Finally, only five dealt with cost-effectiveness of which two found positive effects. The findings resonates well with previous reviews, though two factors making EHR support QM seem new, namely: political goals and strategies, and integration of guidelines for clinical conduct. Lacking EHR type specification and diversity in study method imply that there is a strong need for further research on the factors that may make EHR may support QM. Copyright © 2017 Elsevier B.V. All rights reserved.

  15. A SYSTEMATIC REVIEW ON EFFICACY OF KINESIOTAPING IN PAIN MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Jaspreet Kaur

    2016-06-01

    Full Text Available Background: Most common complaint of an individual is pain, which can be with or without injury. It is the key that enables human being to figure out disease ordisorders that is interfering normal life. Pain can be because of numerous reasons but known pathways for pain can be physiological, nociceptive, neuropathic or mixed, which may be experienced as aching pain, burning pain, stabbing pain, etc. Although there are various clinical methods to reduce pain but the main objective of present study was to find if taping can reduce pain be it musculoskeletal or neurological pain. Also to summarise all evaluated work done in various studies. Methods: various studies have been taken from pub med, Google scholar that includes relief of pain with application of taping irrespective to technique used. Study selection, data extraction, and assessment of methodological quality and clinical relevance were performed independently by two reviewers. All the data extracted from randomised controlled trials included in the review has been used to synthesise the results. Therefore the results are based on facts laid down by the articles included. Results: Pedro scoring has been used to asses various studies which show the use of taping for relief of pain on various musculoskeletal disorders and neurological disorders. Conclusions: Although there are various modalities which can help in reducing pain but present review shows that taping can be used as very useful tool for reducing pain. Further it is cheap, less time consuming and easy to manage with excellent results. taping can be used as an adjunct to modalities present to reduce pain.

  16. Management of Thoracic Empyema: Review of 112 Cases

    Directory of Open Access Journals (Sweden)

    Ommolbanin Abed

    2012-03-01

    Full Text Available To review our experience in treatment of patients with thoracic empyema at a teaching hospital chart of patients were retrospectively reviewed over a 72-month period. A total of 112 patients (94 men, 18 women, mean age: 39, range: 6-89 years underwent therapeutic procedures for thoracic empyema between 2001-2006. The causes of empyema included parapneumonic empyema (60.7%, thoracic trauma (20.5%, surgical procedures (7.1% and seeding from an extra-pulmonary source (11.7%. Multiloculated empyemas were documented in 45 patients (40%. Insertion of chest tube was the first procedure in 103 patients (92%. Nineteen patients (17% were treated by thoracotomy, ten patients (8.9% had fibrinolytic therapy, eight patients (7.2% underwent video assisted thoracic surgery (VATS and sixteen patients (14.3% had subsequent radiologic-guided drainage. Thoracotomy-Decortication was successful in 90% of patients undergoing surgery and the least successful intervention was tube thoracostomy alone. Twelve of 112 patients (10.7% died in the hospital including one patient in the thoracotomy group. Long-term follow-up was available in 67 patients including all of patients requiring surgery and fibrinolytic therapy. Thirty four patients (50% obtained complete functional recovery. Simple drainage as the first procedure for the treatment of thoracic empyema has a high failure rate. Selection of a therapeutic option should be based on age, underlying disease, stage of the empyema, state of the loculation, local expertise and availability. Surgical procedures such as VATS or thoracotomy are recommended as the first procedure in elderly patients and advanced empyema.

  17. The Power of Peer Reviewing to Enhance Writing in Horticulture: Greenhouse Management

    Science.gov (United States)

    Anderson, Neil O.; Flash, Pamela

    2014-01-01

    Peer review is not included in undergraduate horticultural curricula. Our research objectives in an 8- year study, which ranged from 2000 to 2007 in two sections (2000-2002 non-peer reviewed and 2003-2007 peer-reviewed) of Greenhouse Management students at the University of Minnesota were to determine whether iterative peer reviews would result in…

  18. Clinical manifestations and managements in jellyfish envenomation A systematic review

    Directory of Open Access Journals (Sweden)

    Negar Taheri

    2013-11-01

    Full Text Available Background: The phylum Cnidarians have over nine thousand species that approximately, one hundred species are dangerous for humans. Annually, a large number of deaths were reported due to jellyfish stings. The manifestations depend on their species and kind of venoms, and include the local and systemic manifestations. A number of methods and compounds were used and under investigation for management of injuries with jellyfishes. Due to the lack of an integrated systematic review, the current study was done. Materials and Methods: The PubMed data bank was searched for the term “Jellyfish”. A total of 1677 papers were found. These papers were divided into three categories: medical, biomedical and biotechnological fields. The medical category was further divided into three subcategories comprising systemic manifestations, cutaneous manifestations and treatments for the stings of jellyfishes. The biomedical category was further subdivided into genomics, proteomics, and biology of venoms, mechanisms of actions and products of biomedical significance. In this part of systematic review, the medical aspects of injuries with jellyfishes were evaluated. Results: The clinical manifestations in jellyfish envenomation depend on their species and the nature of venoms. The most common clinical manifestations of jellyfish stings are cutaneous presentations like urticasia, erythema, swelling, vesicles and severe dermonectoric manifestations. Systemic manifestations were seen in the stings of box jellyfishes, Portuguese man-of-war and in Irukandji syndrome. The most common recommendations for jellyfish envenomation managements include decreasing the local effects of venom, prevention of the venomous nematocysts release, and Controlling of systemic reactions. Application of commercial vinegar (4 - 6% acetic acid, hot water immersion (HWI (42 ° C for 20 minutes, ice packs, sea water rinsing for inactivating nematocysts, administration of topical and parenteral

  19. Ischemic stroke management in West Scotland: a chart review

    Science.gov (United States)

    Verpillat, Patrice; Dorey, Julie; Guilhaume-Goulant, Chantal; Dabbous, Firas; Aballéa, Samuel

    2015-01-01

    Background Little information is available about the long-term management of ischemic stroke (IS) in West Scotland. In this study we aim to describe the management of IS at onset, admission, and during follow-up among patients who survived an IS event. Methods General practitioners (GPs) (n=20) were randomly selected to recruit IS patients and extract data about patient characteristics, hospitalizations, discharge, and ambulatory care from GP databases, hospital letters, and direct contact with patients and their relatives. Descriptive analyses were conducted. Results One hundred and one patients were included, with a mean age of 65.6±13.4. About half of the patients contacted their GPs at the time of onset (45.4%). Cardiovascular history was prevalent in 29.7% of cases, and 14% of all cases were recurrences. Of the patients, 89 (88%) were hospitalized with mean length of stay (LOS) 11.8 days. Treatment was administered on average within 12.9 hours of admission and 23.6% of the admitted patients received thrombolytic treatment. During the 1-year follow-up period, 33.6% of patients were rehospitalized and the mean LOS was 15.1±29.5 days. Further, patients on average sought nursing care (10.9%), physical therapy (45.5%), occupational therapy (27.7%), speech therapy (12.9%), and professional caregivers (12%). Conclusion The health-care resource utilization of IS patients is a major driver of economic burden. PMID:27123179

  20. The management of dog bite injuries of genitalia in paediatric age

    Directory of Open Access Journals (Sweden)

    Mirko Bertozzi

    2013-01-01

    Full Text Available Dog bite injuries are common in children and represent an important health-care problem. Most dog bite injuries involve the face or an extremity. Victims tend to seek medical care quickly. Dog bites to the external genitalia are rarely reported, but they potentially result in morbidity if improperly managed. Morbidity is also directly related to the severity of initial wound. Guidelines for the management of dog bites include irrigation, dιbridment, antibiotic therapy, consideration of tetanus and rabies immunisation and suture of wounds or surgical reconstruction. Literature review was conducted and focused to analyze the management of dog bite lesions involving external genitalia.

  1. The effects of riparian forest management on the freshwater environment: a literature review of best management practice

    Directory of Open Access Journals (Sweden)

    S. Broadmeadow

    2004-01-01

    Full Text Available National Forests and Water Guidelines require the establishment of riparian buffers to help protect the freshwater environment from disturbance by silvicultural operations on the adjacent land. The main functions of the riparian buffer are considered to be sediment removal and erosion control, protection of water quality, moderation of shade and water temperature, maintenance of habitat structural diversity and ecological integrity, and improvement of landscape quality. This review paper assesses how these functions are affected by the design and management of the riparian forest zone, with a focus on the width of the buffer, the structure of the vegetation and species choice. It is not possible to specify a definitive riparian buffer width that will protect the freshwater environment from every potential threat. Forestry agencies usually recommend widths between 10 and 30 m. Buffer widths towards the lower end of this scale tend to protect the physical and chemical characteristics of a stream, while the maintenance of ecological integrity requires widths at the upper end. In terms of structure and species, the benefits are greatest where the riparian buffer replicates native riparian woodland with an open canopy of mixed species of varied age class. The optimum level of shade is difficult to quantify but limited work suggests that a good balance is achieved where around 50% of the stream surface is open to sunlight and the remainder covered by dappled shade. Within the management of riparian woodland there is a need to consider a stream’s sensitivity and intrinsic value. Some sites will benefit from active intervention such as thinning, coppicing or pollarding, while others will be favoured by a hands-off approach. Long-term continuity of management is important to ensure that the potential benefits to the freshwater environment are realised. Keywords: riparian woodland, riparian buffer, woodland management, freshwater environment, water

  2. Management and organisational barriers in the acquisition of computer usage skills by mature age workers.

    Science.gov (United States)

    Keogh, Mark

    2009-09-01

    To investigate workplace cultures in the acquisition of computer usage skills by mature age workers. Data were gathered through focus groups conducted at job network centres in the Greater Brisbane metropolitan region. Participants who took part were a mixture of workers and job-seekers. The results suggest that mature age workers can be exposed to inappropriate computer training practices and age-insensitive attitudes towards those with low base computer skills. There is a need for managers to be observant of ageist attitudes in the work place and to develop age-sensitive strategies to help mature age workers learn computer usage skills. Mature age workers also need to develop skills in ways which are practical and meaningful to their work.

  3. Effect of age, sex, area and management practices on cattle mortality in Rajshahi division, Bangladesh

    Directory of Open Access Journals (Sweden)

    Md. Reazul Islam

    2016-03-01

    Full Text Available Objective: The aim of the present study was to evaluate the effect of age, sex, location and management on cattle mortality rate in Rajshahi division of Bangladesh. Materials and methods: The study was conducted in 8 districts of Rajshahi division during July 2011 to June 2012. A total of 17,982 cattle heads were investigated based on age, sex, area. Data were collected from the cattle owners using a closed structured questionnaire. Tentative cause of cattle mortality was identified based on clinical signs, laboratory tests, history, ante-mortem and postmortem reports. Management practices of the cattle were also investigated. Results: Out of 17,982 cattle heads, 549 were found to be dead by various diseases, and an average mortality rate was 3.05%. Age-wise mortality rate of cattle revealed that the maximum mortality rate was found in the age group of 0.05 between the cattle mortality rate in Natore district (2.84% and Joypurhat districts (2.84%. Conclusion: The overall mortality rate of cattle in Rajshahi division was found comparatively low. This might be due to improved management practices, better veterinary services, and awareness among farmers. However, cattle mortality rate in the age group <2-year is alarming due to bad management practices and disease. [J Adv Vet Anim Res 2016; 3(1.000: 13-17

  4. Management and health issues in women with epilepsy - a review.

    Science.gov (United States)

    Salawu, F K; Moruppa, J Y; Danburam, A; Olokoba, A B

    2011-12-01

    Although epilepsy affects men and women equally, there are special implications for women, especially during their childbearing years, and particularly when pregnancy is contemplated. This review summarisesthe complexity and multifaceted nature of health issues affecting women with epilepsy (WWE) in general and epilepsy in women beyond childbearing age. The female sex hormones and their cyclic as well as age-related variations certainly influence seizure activity and epilepsy in women. Catamenial epilepsy is a multifaceted neuroendocrine condition in which seizures are clustered around specific points in the menstrual cycle, most often around perimenstrual or periovulatory period. There are special concerns for women of child bearing years with regard to contraception, pregnancy and teratogenicity that should be considered during counseling and selection of appropriate treatment.Although the majority of pregnant WWE experience normal pregnancies and deliveries, their children have a higher risk of birth defects. Individualised treatment coupling antiepileptic drug use (AED) and the specific phase of impact of the reproductive cycle must be considered in treatment selection. As the number of available treatment options for epilepsy increases, the optimal goal for the general practitioner is to work as a team with obstetricians and gynaecologists, and neurologists in an effort to ensure the best treatment of WWE

  5. The aging gut and the role of prebiotics, probiotics, and synbiotics: A review

    Directory of Open Access Journals (Sweden)

    Pragnesh J. Patel, MD

    2014-03-01

    Full Text Available The United States (US Census Bureau estimates the current US population at 301 million with elderly people (>65 years old accounting for 36 million. Within this group, the fastest growing segment of the population is >85 years of age, which currently numbers ∼5 million and is expected to rise to ∼20 million by 2050. Over the decades there has been speculation that gastrointestinal structure and function decline with age. Therefore, the physiological changes in the gut with aging and their clinical implications have become important topics for discussion. This review also attempts to document the role of probiotics in enhancing gut activity in older persons.

  6. Ascorbic acid: new role of an age-old micronutrient in the management of periodontal disease in older adults.

    Science.gov (United States)

    Alagl, Adel S; Bhat, Subraya Giliyar

    2015-03-01

    To review the new role of an age-old micronutrient - ascorbic acid - in the management of periodontal disease. Articles pertaining to the topic were searched in PubMed and other search engines from year 1974 to April 2014 with the following key words: "ascorbic acid," "ascorbate," "vitamin C," "periodontal disease," "gingivitis," "periodontitis," "anti-oxidants" and "elderly." Balanced nutrition is an essential factor in the elderly. Modification of nutritional requirement is important to overcome the effect of an unbalanced diet in older individuals as a result of several external and internal host-associated factors. Micronutrient requirements as aging advances could change, and require due attention. Ascorbic acid and its relationship with periodontal disease are very well known. However, recent changes in the concept of understanding the pathogenicity has led to a new path of therapeutic intervention with ascorbic acid in many chronic diseases. Oxidative stress with its associated burden might alter the disease process. In the era of "periodontal medicine," the impact of remote tissue changes on systemic disease has to be taken into serious consideration. Deficiency of nutritional impact on the host, with micronutrient vitamin C detailed in this review with sources, absorption, interaction and its relationship with systemic disease, and thereby the impact on periodontal disease. Ascorbic acid plays an important role in the aging process, and in the maintenance of periodontal health in the elderly. © 2014 Japan Geriatrics Society.

  7. State of the Art Assessment of NDE Techniques for Aging Cable Management in Nuclear Power Plants FY2015

    Energy Technology Data Exchange (ETDEWEB)

    Glass, Samuel W. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Fifield, Leonard S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Dib, Gerges [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Tedeschi, Jonathan R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Jones, Anthony M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Hartman, Trenton S. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-09-08

    This milestone report presents an update on the state-of-the-art review and research being conducted to identify key indicators of in-containment cable aging at nuclear power plants (NPPs), and devise in-situ measurement techniques that are sensitive to these key indicators. The motivation for this study stems from the need to address open questions related to nondestructive evaluation (NDE) of aging cables for degradation detection and estimation of condition-based remaining service life. These questions arise within the context of a second round of license extension for NPPs that would extend the operating license to 60 and 80 years. Within the introduction, a review of recently published U.S. and international research and guidance for cable aging management programs including NDE technologies is provided. As with any “state-of-the-art” report, the observations are deemed accurate as of the publication date but cannot anticipate evolution of the technology. Moreover, readers are advised that research and development of cable NDE technology is an ongoing issue of global concern.

  8. The potential effects of meditation on age-related cognitive decline: a systematic review.

    Science.gov (United States)

    Gard, Tim; Hölzel, Britta K; Lazar, Sara W

    2014-01-01

    With a rapidly aging society it becomes increasingly important to counter normal age-related decline in cognitive functioning. Growing evidence suggests that cognitive training programs may have the potential to counteract this decline. On the basis of a growing body of research that shows that meditation has positive effects on cognition in younger and middle-aged adults, meditation may be able to offset normal age-related cognitive decline or even enhance cognitive function in older adults. In this paper, we review studies investigating the effects of meditation on age-related cognitive decline. We searched the Web of Science (1900 to present), PsycINFO (1597 to present), MEDLINE (1950 to present), and CABI (1910 to present) to identify original studies investigating the effects of meditation on cognition and cognitive decline in the context of aging. Twelve studies were included in the review, six of which were randomized controlled trials. Studies involved a wide variety of meditation techniques and reported preliminary positive effects on attention, memory, executive function, processing speed, and general cognition. However, most studies had a high risk of bias and small sample sizes. Reported dropout rates were low and compliance rates high. We conclude that meditation interventions for older adults are feasible, and preliminary evidence suggests that meditation can offset age-related cognitive decline.

  9. Prevalence of asymptomatic carotid artery stenosis according to age and sex systematic review and metaregression analysis

    NARCIS (Netherlands)

    de Weerd, M.; Greving, J.P.; de Jong, A.W.F.; Buskens, E.; Bots, M.L.

    2009-01-01

    Background and Purpose-In the discussion on the value of population-wide screening for asymptomatic carotid artery stenosis (ACAS), reliable prevalence estimates are crucial. We set out to provide reliable age- and sex-specific prevalence estimates of ACAS through a systematic literature review and

  10. A Systematic Review of Common Physiotherapy Interventions in School-Aged Children with Cerebral Palsy

    Science.gov (United States)

    Martin, Liz; Baker, Richard; Harvey, Adrienne

    2010-01-01

    This systematic review focused on the common conventional physiotherapy interventions used with children with cerebral palsy (CP), aged 4 to 18 years, and critically appraised the recent evidence of each of these interventions using the Oxford Centre for Evidence-Based Medicine Levels of Evidence. The search strategy yielded 34 articles after…

  11. A Review and New Look at Ethical Suicide in Advanced Age.

    Science.gov (United States)

    Carpenter, Brian D.

    1993-01-01

    Notes that suicide is common in old age, but public opinion remains negative. Following a review of theories of suicide and summary of arguments against suicide, constructs argument for why elderly have unique claim to an ethical, unobstructed suicide. Claim rests on their "developmental autonomy," based on experience and wisdom of the elderly.…

  12. A Systematic Review of Common Physiotherapy Interventions in School-Aged Children with Cerebral Palsy

    Science.gov (United States)

    Martin, Liz; Baker, Richard; Harvey, Adrienne

    2010-01-01

    This systematic review focused on the common conventional physiotherapy interventions used with children with cerebral palsy (CP), aged 4 to 18 years, and critically appraised the recent evidence of each of these interventions using the Oxford Centre for Evidence-Based Medicine Levels of Evidence. The search strategy yielded 34 articles after…

  13. Current Management of Penile Fracture: An Up-to-Date Systematic Review.

    Science.gov (United States)

    Falcone, Marco; Garaffa, Giulio; Castiglione, Fabio; Ralph, David J

    2017-09-02

    Because of the low incidence of penile fracture, many aspects of the diagnostic process and of the surgical and functional outcomes are rarely reported. To systematically review the current literature on the surgical management of penile fracture, focusing on etiology, diagnosis, functional outcomes, and postoperative complications. The present review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) declaration standards for systematic reviews. A systematic search for the terms penile fracture, fracture of penis, trauma of penis, rupture of corpora cavernosa, and immediate management of penile fracture was been carried out in the PubMed, EMBASE, Cochrane, SCOPUS, and Science Citation Index databases. Etiology of penile fracture, clinical presentation, types of radiologic investigations and their accuracy, surgical approach, suture material used for tunica repair, timing of surgical exploration, intraoperative findings, surgical complications, and functional outcomes. The total number of patients analyzed was 438, and the patients' an average age was 36 years. The most frequent reported cause of penile fracture was sexual intercourse (80% of cases). The most common finding at examination was a penile hematoma (97.5%). Although operator dependent, in experienced hands, ultrasonography was found to be a useful tool in confirming the location of the albuginea tear and identifying the presence of any concomitant urethral injury, helping the surgeon to choose the best surgical approach. Early surgical repair of a penile fracture was found to be a safe procedure, although long-term complications are not uncommon. Tertiary referral centers that managed a larger number of cases seemed to obtain more satisfactory long-term results with a significantly smaller number of complications. A low incidence of postoperative complications and full satisfactory functional outcomes are reported when early repair is

  14. Review article: review of behavioral operations experimental studies of newsvendor problems for operating room management.

    Science.gov (United States)

    Wachtel, Ruth E; Dexter, Franklin

    2010-06-01

    Operating room (OR) managers must plan staffing in the face of uncertain demand for OR time. Planning too much staffing results in underutilized OR time. Planning too little staffing causes overutilized time, which is approximately twice as expensive as underutilized time. Deciding how much staffing to plan for an OR is analogous to the classic newsvendor problem in operations research. A newsvendor must decide how much product to order based on its cost c and sales price p, plus estimates of the uncertain future demand for the product. The newsvendor problem has a simple mathematical solution. The correct amount of product to order is the (p - c)/p quantile of the demand for the product. This optimal order quantity is analogous mathematically to the number of hours of OR time for which staffing should be planned. We performed a systematic review of the behavioral operations experimental literature on newsvendor problems relevant to OR management. Student volunteers participating in experimental studies have great difficulty knowing how much product to order, given c, p, and the demand distribution. Decision making is only modestly improved by more frequent feedback. Even scores of rounds of ordering are insufficient for much learning to occur. Suboptimal decisions result from innate psychological biases. Students anchor on mean demand, make insufficient adjustments, and rely disproportionately on the most recent demand values. The behavior of OR managers who plan staffing for the OR is analogous to that of students participating in a newsvendor experiment. Month after month, an OR manager will plan too little staffing for the surgeon who consistently ends the day late and too much staffing for the surgeon who consistently does not fill an OR. Experimental studies of the newsvendor problem provide mechanistic insights into the reasons that OR managers make poor decisions when planning OR staffing. The students face no organizational factors or personality issues

  15. Theory of mind and cognitive processes in aging and Alzheimer type dementia: a systematic review.

    Science.gov (United States)

    Sandoz, Mélanie; Démonet, Jean-François; Fossard, Marion

    2014-09-01

    Theory of mind (ToM) performance in aging and dementia of the Alzheimer type (DAT) has been a growing interest of researchers and recently, theoretical trends in ToM development have led to a focus on determining the cognitive skills involved in ToM performance. The aim of the present review is to answer three main questions: How is ToM assessed in aging and DAT? How does ToM performance evolve in aging and DAT? Do cognitive processes influence ToM performance in aging and DAT? A systematic review was conducted to provide a targeted overview of recent studies relating ToM performance with cognitive processes in aging and DAT. RESULTS suggest a decrease in ToM performance, more pronounced in complex ToM tasks. Moreover, the review points up the strong involvement of executive functions, especially inhibition, and reasoning skills in ToM task achievement. Current data suggest that the structure of ToM tasks itself could lead to poor performance, especially in populations with reduced cognitive abilities.

  16. Modern management of pyogenic hepatic abscess: a case series and review of the literature.

    LENUS (Irish Health Repository)

    Heneghan, Helen M

    2012-01-31

    BACKGROUND: Pyogenic hepatic abscesses are relatively rare, though untreated are uniformly fatal. A recent paradigm shift in the management of liver abscesses, facilitated by advances in diagnostic and interventional radiology, has decreased mortality rates. The aim of this study was to review our experience in managing pyogenic liver abscess, review the literature in this field, and propose guidelines to aid in the current management of this complex disease. METHODS: Demographic and clinical details of all patients admitted to a single institution with liver abscess over a 5 year period were reviewed. Clinical presentation, aetiology, diagnostic work-up, treatment, morbidity and mortality data were collated. RESULTS: Over a 5 year period 11 patients presented to a single institution with pyogenic hepatic abscess (55% males, mean age 60.3 years). Common clinical features at presentation were non-specific constitutional symptoms and signs. Aetiology was predominantly gallstones (45%) or diverticular disease (27%). In addition to empiric antimicrobial therapy, all patients underwent radiologically guided percutaneous drainage of the liver abscess at diagnosis and only 2 patients required surgical intervention, including one 16-year old female who underwent hemi-hepatectomy for a complex and rare Actinomycotic abscess. There were no mortalities after minimum follow-up of one year. CONCLUSIONS: Pyogenic liver abscesses are uncommon, and mortality has decreased over the last two decades. Antimicrobial therapy and radiological intervention form the mainstay of modern treatment. Surgical intervention should be considered for patients with large, complex, septated or multiple abscesses, underlying disease or in whom percutaneous drainage has failed.

  17. 77 FR 41457 - Aging Management Associated With Wall Thinning Due to Erosion Mechanisms

    Science.gov (United States)

    2012-07-13

    ... COMMISSION Aging Management Associated With Wall Thinning Due to Erosion Mechanisms AGENCY: Nuclear... Interim Staff Guidance (LR-ISG), LR-ISG-2012-01, ``Wall Thinning Due to Erosion Mechanisms.'' The draft LR... erosion mechanisms for piping and components within the scope of the Requirements for Renewal of Operating...

  18. In search for suitable age management practices for lifelong employability and career success

    NARCIS (Netherlands)

    van der Heijde, C.M.; van der Heijden, B.I.J.M.; Rocco, T.S.; Thijssen, J.G.L.

    2006-01-01

    Despite an increasing dependence of the market on older workers, organizations still do not pay enough attention to their (broad) development. In this study, potential factors of age management are explored, specifically with regard to the development of specific and broad competences

  19. INTRODUCTION: COMPARATIVE PERFORMANCE MANAGEMENT AND ACCOUNTABILITY IN THE AGE OF AUSTERITY

    DEFF Research Database (Denmark)

    Grossi, Giuseppe; Hansen, Morten Balle; Johanson, Jan-Erik

    2016-01-01

    The five articles in this symposium examine the issues of comparative performance management and accountability in the age of austerity from different vantage points. Brusca and Montesinos carry out an international comparison of 17 countries studying key issues in the implementation of performance...

  20. Aging Workforce Management in the Automobile Industry : Defining the Concept and its Constituting Elements

    NARCIS (Netherlands)

    Streb, Christoph; Voelpel, Sven; Leibold, Marius

    2009-01-01

    This paper presents the results of a grounded theory study on the automobile industry aimed at developing a concept of aging workforce management by identifying and constructing its constituting elements. Through an in-depth research investigation, it answers the question of how the challenge of an