The videotape covers various aspects of financial management for the Superfund Program. The importance of effective financial management and execution is discussed. The objectives and definitions of the Superfund Comprehensive Accomplishment Plan (SCAP) and the roles and responsibilities of Superfund personnel in the SCAP process are covered
The videotape is divided into three sections. Section 1 discusses the development and framework of CERCLA and the Superfund Program and outlines the implementing rules that guide Superfund site cleanups. The Superfund response actions - remedial, removal, and enforcement - are reviewed. Section 2 outlines On-Scene Coordinator's (OSC) and Remedial Project Manager's (RPM) roles and responsibilities in Superfund removal, remedial, and enforcement activities. The other players involved in Superfund response activities also are identified. Section 3 describes how EPA learns of potential Superfund sites and lists the authorities that determine the requirements for site discovery. The procedures used to prioritize the sites and to identify and select sites for remediation are discussed
The Carson River Mercury Site (CRMS) (Figure 1) is located in northwest Nevada and was designated a Superfund site in 1990 because of elevated mercury concentrations observed in surface water, sediments and biota inhabiting the site.
Report #2001-M-000015, June 15, 2001. We determined that EPA Region III did not have formal procedures in place to mitigate continuity problems caused by turnover of EPA personnel in the Superfund program.
This guidance is intended to help Superfund risk managers make ecological risk management decisions that are based on sound science, consistent across Regions, and present a characterization of site risks that is transparent to the public.
EPA recently reported to Congress on the status of the Superfund program. A review of the report reveals that Superfund is a costly, slow-moving juggernaut that consumes an ever-growing share of resources and threatens to overwhelm other, more pressing environmental issues. EPA was given a broad mandate to clean up hazardous-waste sites when Congress enacted the Comprehensive Environmental Response. Compensation, and Liability Act in 1980 and established a $1.6 billion appropriation for a Superfund. In 1986 Congress extended the program for another five years and added $8.5 billion to complete the job-an overly optimistic estimate, as we shall see. Superfund is a huge program; the inventory of potentially hazardous waste sites is large and growing quickly. By the end of fiscal year 1987, EPA's inventory listed 27,571 hazardous-waste sites,and this number is increasing steadily at a rate of about 2500 each year. The General Accounting Office suggests that there may be as many as 150,000 such sites
National Oceanic and Atmospheric Administration, Department of Commerce — This layer represents active Superfund Sites published by the Environmental Protection Agency (EPA). These data were extracted from the Superfund Enterprise...
U.S. Environmental Protection Agency — The Superfund Query allows users to retrieve data from the Comprehensive Environmental Response, Compensation, and Liability Information System (CERCLIS) database.
The Fernald Environmental Management Project (FEMP) attempted to address both RCRA and CERCLA requirements at the fire training facility (FTF) by integrating a CERCLA removal action work plan with a RCRA closure plan. While the regulatory agencies involved with the FTF cleanup agreed the integrated document was a good idea, implementation proved complicated, owing to disposition of clean debris from a Superfund site, treatment of contaminated media, duration of cleanup activities, and cleanup certification. While all the complications have not been resolved, solutions to all have been proposed to Ohio EPA and U.S. EPA. Both agencies have worked closely with FEMP to find the most effective fulfillment of RCRA and CERCLA requirements
Nearly ten years have passed since the enactment of the federal Comprehensive Response, Compensation, and Liability Act (CERCLA), usually referred to as open-quotes Superfundclose quotes. Nearly four years have passed since CERCLA's major overhaul through the Superfund Amendments and Reauthorization Act (SARA). Although much still remains to be done under Superfund, there is now enough experience to assess how effectively it is working. A study being undertaken by the University of Tennessee's Waste Management Research and Education Institute will supply a portion of that assessment. The study was completed in the fall of 1990. Our study examines two related issues: the resources that will be needed in the coming years to fulfill the mandate of Superfund and other hazardous waste remediation programs, and the site-level experience to date in implementing CERCLA and SARA. This chapter discusses only the open-quotes site-level experienceclose quotes effort, and only its methodological approach. The purpose of the open-quotes site-level experienceclose quotes effort is to explore what counts as a open-quotes successfulclose quotes site in the eyes of different stakeholders in a Superfund cleanup - e.g., the affected community, the potentially responsible parties (PRPs), state and local officials, and the US Environmental Protection Agency (EPA)
The Bunker Hill Mining and Metallurgical Complex Superfund Site includes all areas of the Coeur d’Alene Basin where mining-related contamination occurred and encompasses a 21-square mile “Box” along Interstate 90 surrounding the former smelter complex.
Cormier, J.; Horak, F.
It is no surprise to many of Superfund's practitioners that the law and its application are flawed. The South Valley Superfund Site in Albuquerque, New Mexico has not escaped Superfund's problems. The problems and issues arising out of the South Valley Superfund site have spurred the desire to seek a better way to administer and manage cleanup. This new method applies organizational and role changes that bring Superfund closer to an efficient business-like entity. This ''Reengineered'' Superfund strives for reorganization, contractor reduction, improved communication, reporting reduction, and teaming. In addition, modifications are made to the roles of regulators, potentially responsible parties (PRPs), and the public. Today the site encompasses roughly one square mile in area, includes six identified contaminant sources, and deals with solvent and petroleum by-product contamination
Weber, E.F.; Wilson, J.; Kirk, M.; Tochko, S.
A risk management approach at a former industrial waste disposal site in western Washington resulted in a selected remedy that is cost-effective and that meets the CERCLA threshold criterion of protecting human health and the environment. The proposed remedy, which addresses contamination in soil and groundwater, does not require an ARARs waiver and received state and community acceptance. By analyzing the current and potential risk at the site, a proposed remedy was chosen that would control the source and naturally attenuate the groundwater plume. Source control will include removal and treatment of some light nonaqueous phase liquid (LNAPL) and some soil, followed by isolation of the remaining soil and LNAPL within a slurry wall and beneath a multilayer cap. A contingent groundwater extraction and treatment system was included to address uncertainty in the risk characterization. Implementing source control is predicted to result in a steady decline in volatile organic compound levels in the drinking water aquifer through adsorption, degradation, and dispersion. Exposure to groundwater during the period of natural attenuation will be controlled by monitoring, institutional controls, and a thorough characterization of the plume and receptors. 7 figs., 1 tab
Author Guidelines. The Lagos Business School Management Review is published by management professionals for practising managers, without sacrificing academic standards. The Review welcomes articles that enhance knowledge about the process of managing an organisation as well as reflect techniques, trends and ...
U.S. Environmental Protection Agency — This asset includes data related to the Superfund Technical Assistance Grant program, including grant number, award amounts, award dates, period of performance,...
U.S. Environmental Protection Agency — This asset includes a number of individual data sets related to site-specific information for Superfund, which is governed under the Comprehensive Environmental...
The videotape is divided into 5 sections. Section 1 provides an overview of settlement activities including conducting an information exchange, issuing general notice letters, initiating special notice procedures, receiving good faith offers (GFO), negotiating and settlements, and pursuing enforcement actions. Section 2 covers the types of negotiations that commonly involve OSCs and RPMs. The characteristics of a negotiating style that satisfy all the parties as well as methods for preparing and conducting this type of negotiation are outlined. Section 3 deals with post-removal site control arrangements and other closeout requirements for a removal site, such as completing necessary paperwork. The remedial project closeout procedures also are covered, including the remedial closeout report, operation and maintenance (O ampersand M) arrangements, transfer of site responsibility, and deletion from the National Priorities List (NPL). Section 4 discusses the purpose, procedures, roles and responsibilities associated with records management under Superfund. Section 5 outlines the response authority provided by CERCLA to OCSs and RPMs
The issue of the Smart Moves in Superfund bulletin series provides an update on the revitalization effort, highlighting National Priorities List (NPL) construction completions, accelerating cleanup, the Superfund Accelerated Cleanup Model, risk assessment/risk management, contracts management, enforcement policy/equity, interagency cooperation, public forms, and state meetings
U.S. Environmental Protection Agency — The Comprehensive Environmental Response, Compensation and Liability Information System (CERCLIS) (Superfund) Public Access Database contains a selected set of...
This conference was held November 29--December 1, 1994 in Washington, D.C..The purpose of this conference was to provide a forum for exchange of state-of-the-art information on Superfund. Papers are included on the following topics: bioremediation; building decontamination; environmental policy issues; federal environmental restoration; groundwater remediation; innovative sampling and analytical technologies; laboratory methods; metals management; mixed wastes; PCB waste management; remediation technology and case studies; and risk assessment. Individual papers have been processed separately for inclusion in the appropriate data bases
Guidance on the primary considerations of remedy selection which are universally applicable at Superfund sites. Key guidance here include: Rules of Thumb for Superfund Remedy Selection and Role of the Baseline Risk Assessment.
Conducting a community relations effort in a community which is home to a Superfund site is a formidable challenge. Any education press, however appropriate, quickly falls victim to doubt, mistrust of fears of the very public intended to be served by the effort. While each site is uniquely different, the issues raised by affected communities in one part of the country are strikingly similar to those raised in other parts. Those most involved must join those most affected in seeking meaningful solutions and in building the trust that is so vital in moving forward with Superfund
The Environmental Protection Agency (EPA) Office of Solid Waste and Emergency Response is responsible for implementing two key US laws regulating waste management and cleanup: the Resource Conservation and Recovery Act, and the Comprehensive Environmental Response, Compensation and Liability Act, CERCLA, nicknamed ''Superfund''. The purpose of the Superfund programme is to protect human health and the environment over the long term from releases or potential releases of hazardous substances from abandoned or uncontrolled hazardous waste sites. The focus of this paper is on Superfund, including how radiation is addressed by the Superfund programme. This paper provides a brief overview of the approach used by EPA to conduct Superfund cleanups at contaminated sites, including those that are contaminated with radionuclides, to ensure protection of human health and the environment. The paper addresses how EPA Superfund determines if a site poses a risk to human health and the framework used to determine cleanup levels. The theme emphasized throughout the paper is that within the Superfund remediation framework, radioactive contamination is dealt with in the identical way as chemical contamination. (author)
U.S. Environmental Protection Agency — National Priorities List (NPL) Sites - The Comprehensive Environmental Response, Compensation and Liability Information System (CERCLIS) (Superfund) Public Access...
U.S. Environmental Protection Agency — The Comprehensive Environmental Response, Compensation and Liability Information System (CERCLIS) (Superfund) Public Access Database (CPAD) contains a selected set...
U.S. Environmental Protection Agency — This asset includes Superfund site-specific sampling information including location of samples, types of samples, and analytical chemistry characteristics of...
This report contains a review of the long-term groundwater monitoring network for the Permeable Reactive Barrier (PRB) and Soil Remedy Areas at the Clare Water Supply Superfund Site in Clare, Michigan.
The complexity of the industrial activities and the important mass of flows crossing the supply chain promotes the emergence of risks that must be considered in the decision process. For this reason, we have developed this paper to clarify the basics of risk management through a short new suggestion of literature review for risk management. Our justification of this attempt is that this area is the most discussed in our days and it is impossible to present all definition of the risk concept, ...
U.S. Environmental Protection Agency — A set of site boundaries for each site in EPA Region 1 (Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, and Vermont) on EPA's Superfund National...
Provisional Peer-Reviewed Toxicity Values (PPRTV) assessments are developed for use by the Agency’s Office of Land and Emergency Management (OLEM) to support informed decisions in the Superfund program and at hazardous waste sites when a values is not available in the Integrated ...
Provisional Peer-Reviewed Toxicity Values (PPRTV) assessments are developed for use by the Agency’s Office of Land and Emergency Management (OLEM) to support informed decisions in the Superfund program and at hazardous waste sites when a values is not available in the Integrated ...
Provisional Peer-Reviewed Toxicity Values (PPRTV) assessments are developed for use by the Agency’s Office of Land and Emergency Management (OLEM) to support informed decisions in the Superfund program and at hazardous waste sites when a values is not available in the Integrated ...
Pavetto, C.S.; Rubinton, D.S.
The need for cleaning up hazardous waste disposal sites was identified early in New York. In fact, New York's ''Superfund'' statute preceded the federal Superfund law thereby providing a model for CERCLA. Moreover, there are currently almost as many sites on New York's Registry of Inactive Hazardous Waste Disposal sites as there are sites on the National Priorities List. While New York's law served as a model for the federal CERCLA, CERCLA, in turn, has served as a model for other states' statutes. Similarly, lessons learned from the implementation of state Superfund statutes such as New York's can be instructive for those whose work involves dealing with CERCLA-type issues. This is because the problems associated with site restoration and cleanup, such as exceedingly complex site review and evaluation processes, high transaction costs, and difficulties in prioritizing sites for clean-up based upon the threat or risk of environmental harm, are universal
Study documents the long-term impacts of Superfund cleanup on property values in communities neighboring prominent Superfund sites, examining the sale prices of nearly 35,000 homes for up to a thirty-year period near six very large Superfund sites.
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.
International Journal of Development and Management Review ... social Development and Management practices and theories while providing an institutional ... The Igbo care for the elderly in contemporary times: an old testament evaluation ...
Prazeres, Ana R; Carvalho, Fátima; Rivas, Javier
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. Copyright © 2012 Elsevier Ltd. All rights reserved.
Claessens, B.J.C.; Eerde, van W.; Rutte, C.G.; Roe, R.A.
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
Claessens, B.J.C.; van Eerde, W.; Rutte, C.G.; Roe, R.A.
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
This report evaluates the performance of solidification as a method for treating solids from Superfund sites. Tests were conducted on four different artificially contaminated soils which are representative of soils found at the sites. Contaminated soils were solidified us...
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.
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
Carter, Launor F.; And Others
The mission of the ERIC Management Review Group was to examine the practices and procedures used by Central ERIC Management in their guidance and management of the 19 ERIC clearinghouses. The major topics covered in this report are: recommendations; the role of the clearinghouses; the bibliographic and documentation function; the interpretation…
Americans have used a range of narratives to make sense of their settlement and use of natural resources. This article focuses on narratives of environmental degradation after the United States passed legislation mandating the cleanup of toxic sites and provided a Superfund for that purpose. Thre...
Jensen, Anna Rose Vagn
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...
Langeron, Olivier; Amour, Julien; Vivien, Benoît; Aubrun, Frédéric
Difficulties or failure in airway management are still important factors in morbidity and mortality related to anesthesia and intensive care. A patent and secure airway is essential to manage anesthetized or critically ill patients. Oxygenation maintenance during tracheal intubation is the cornerstone of difficult airway management and is always emphasized in guidelines. The occurrence of respiratory adverse events has decreased in claims for injuries due to inadequate airway management mainly at induction of anesthesia. Nevertheless, claim reports emphasize that airway emergencies, tracheal extubation and/or recovery of anesthesia phases are still associated with death or brain damage, indicating that additional educational support and management strategies to improve patient safety are required. The present brief review analyses specific problems of airway management related to difficult tracheal intubation and to difficult mask ventilation prediction. The review will focus on basic airway management including preoxygenation, and on some oxygenation and tracheal intubation techniques that may be performed to solve a difficult airway. PMID:17184555
Langeron, Olivier; Amour, Julien; Vivien, Benoît; Aubrun, Frédéric
Difficulties or failure in airway management are still important factors in morbidity and mortality related to anesthesia and intensive care. A patent and secure airway is essential to manage anesthetized or critically ill patients. Oxygenation maintenance during tracheal intubation is the cornerstone of difficult airway management and is always emphasized in guidelines. The occurrence of respiratory adverse events has decreased in claims for injuries due to inadequate airway management mainly at induction of anesthesia. Nevertheless, claim reports emphasize that airway emergencies, tracheal extubation and/or recovery of anesthesia phases are still associated with death or brain damage, indicating that additional educational support and management strategies to improve patient safety are required. The present brief review analyses specific problems of airway management related to difficult tracheal intubation and to difficult mask ventilation prediction. The review will focus on basic airway management including preoxygenation, and on some oxygenation and tracheal intubation techniques that may be performed to solve a difficult airway.
Cook, Carly N; Possingham, Hugh P; Fuller, Richard A
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. © 2013 The Authors. Conservation Biology published by Wiley
H. Mevius; M. van Dijk (Monique); A. Numanoglu (Alp); A.B. van As (Àrjan Bastiaan)
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
U.S. Environmental Protection Agency — Contaminants at Comprehensive Environmental Response, Compensation and Liability Information System (CERCLIS) (Superfund) Sites - The CERCLIS Public Access Database...
U.S. Environmental Protection Agency — Responsible Parties at CERCLIS Sites - The Comprehensive Environmental Response, Compensation and Liability Information System (CERCLIS) (Superfund) Public Access...
U.S. Environmental Protection Agency — Non-NPL Sites - The Comprehensive Environmental Response, Compensation and Liability Information System (CERCLIS) (Superfund) Public Access Database contains a...
Brunicardi, F. C.; Hobson, F. L.
This article reviews the basic concepts and techniques of time management as they relate to a medical lifestyle. Essential tools are described to help the physician reassess and sharpen skills for handling intensifying demands and constraints of juggling patient care, research, teaching, and family responsibilities. The historical background and principles of time management for three popular "best selling" techniques are critiqued. In addition, a fourth technique, or model, of time management is introduced for physician use. PMID:8855650
R. Raudla (Ringa); R. Savi (Riin); T. Randma-Liiv (Tiina)
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
The Radium Chemical hazardous waste site in Queens, New York was contaminated with radium, posing a grave potential threat to the community. The US Environmental Protection Agency (EPA) used the Superfund program to design a long-term cleanup for the site using input from citizens and the business community. Superfund staff: Mobilized a quick cleanup action to remove 10,000 small containers of radium; Developed a streamlined approach to long-term cleanup; Secured the site to reduce the possibility of radiation exposure to the local residents; Cooperated with the community to design a well-organized emergency response plan; and Educated local citizens about site hazards, incorporating community concerns into the cleanup process. The Radium Chemical site is a clear example of EPA's effective management and problem-solving strategies at Superfund sites
Warnecke, E.; Bonne, A.
The Agency's peer review service for radioactive waste management - known as the Waste Management Assessment and Technical Review Programme (WATRP) - started in 1989, building upon earlier types of advisory programmes. WATRP's international experts today provide advice and guidance on proposed or ongoing radioactive waste management programmes; planning, operation, or decommissioning of waste facilities; or on legislative, organizational, and regulatory matters. Specific topics often cover waste conditioning, storage, and disposal concepts or facilities; or technical and other aspects of ongoing or planned research and development programmes. The missions can thus contributed to improving waste management systems and plans, and in raising levels of public confidence in them, as part of IAEA efforts to assist countries in the safe management of radioactive wastes. This article presents a brief overview of recent WATRP missions in Norway, Slovak Republic, Czech Republic and Finland
Greer, Lauren T; Gillern, Suzanne M; Vertrees, Amy E
The colon is the second most commonly injured intra-abdominal organ in penetrating trauma. Management of traumatic colon injuries has evolved significantly over the past 200 years. Traumatic colon injuries can have a wide spectrum of severity, presentation, and management options. There is strong evidence that most non-destructive colon injuries can be successfully managed with primary repair or primary anastomosis. The management of destructive colon injuries remains controversial with most favoring resection with primary anastomosis and others favor colonic diversion in specific circumstances. The historical management of traumatic colon injuries, common mechanisms of injury, demographics, presentation, assessment, diagnosis, management, and complications of traumatic colon injuries both in civilian and military practice are reviewed. The damage control revolution has added another layer of complexity to management with continued controversy.
Houck, M M; McAndrew, W P; Porter, M; Davies, B
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. Copyright © 2015 Central Police University.
Ellett, J.D.; Rieke, W.B.; Simpson, J.W.; Sullivan, P.E.
The uranium enrichment enterprise of the US Department of Energy (DOE) provides enriched nuclear fuel for private and government utilities domestically and abroad. The enterprise, in effect, provides a commercial service and represents a signficant business operation within the US government: more than $1 billion in revenues annually and future capital expenditures estimated at several billions of dollars. As a result, in May 1980, the Assistant Secretary for Resource Applications within DOE 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. The review group was specifically asked to focus on the management activities to which sound business practices could be applied. The group developed findings and recommendations in six areas: management of operations and construction; long-range planning; marketing of enrichment services; financial management; research and development; and general management. The chapters of this report present first the management review group's recommendations in the six areas evaluated and then the findings and issues in each area. An appendix provides the group's calendar of meetings. A list of major reference sources used in the course of the study is also included. 12 references
...-0276. FOR FURTHER INFORMATION CONTACT: Angelo Carasea, Assessment and Remediation Division, Office of Superfund Remediation and Technology Innovation, (5204P), Environmental Protection Agency, 1200 Pennsylvania... funds to a State, political subdivision, or Indian Tribe that assumes responsibility as the lead or...
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.
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.
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
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)
Amir Mohammad Colabi
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 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.
A study is being conducted by Electro-Pure Systems, Inc. (EPS) under the Emerging Technology portion of the U.S. Environmental Protection Agency's (EPA's) Superfund Innovative Technology Evaluation (SITE) Program to study alternating current electrocoagulation for Superfund site remediation. Alternating current electrocoagulation has proven to be effective in agglomerating and removing colloidal solids, metals and certain organic contaminants from surrogate soils prepared from the US EPA's Synthetic Soil Matrix. Treatments under a wide range of operating conditions have enabled the optimum parameter settings to be established for multiple phase separation. Electrocoagulation enables appreciably enhanced filtration and dewatering rates to be realized for metals- and diesel fuel-spiked surrogate soil slurries; such enhancements are prompted by growth in the mean particle size of the clays and particulates from typically < 10 microns to as much as 150 microns depending on the degree of electrocoagulation. Reduction in the total suspended solids content of clays in all slurries in excess of 90% can routinely be achieved. Bench-scale experiments of the metals-spiked surrogate soils indicate that electrocoagulation preferentially concentrates soluble metals into the sludge phase; excellent metals separation (Pb, Cr, Cu, Cd) can be realized. Experiments on surrogate wastes spiked with volatile organics suggest that this technology is not capable of effecting good volatile extractions from the aqueous phase. Reductions in excess of 80% in the total organic carbon (TOC) content of the diesel fuel-spiked surrogates can, however, be achieved
Lincoff, A.H. [US Environmental Protection Agency, San Francisco, CA (United States). Region IX; Costan, G.P.; Montgomery, M.S.; White, P.J. [Pacific Northwest Lab., Richland, WA (United States)
The United Heckathom Superfund Site in Richmond, California, was used to formulate pesticides from approximately 1947 to 1966. Soils at the site and sediments in the harbor were contaminated with various chlorinated pesticides, primarily DDT, as a result of these activities. The US Environmental Protection Agency listed the site on the Superfund National Priorities List in 1990. This document is part of the Remedial Investigation and Feasibility Study phase of the Superfund response, which will provide the basis for selection of a final remedy that will protect human health and the environment and achieve compliance with federal and state envirorunental laws.
The United Heckathom Superfund Site in Richmond, California, was used to formulate pesticides from approximately 1947 to 1966. Soils at the site and sediments in the harbor were contaminated with various chlorinated pesticides, primarily DDT, as a result of these activities. The US Environmental Protection Agency listed the site on the Superfund National Priorities List in 1990. This document is part of the Remedial Investigation and Feasibility Study phase of the Superfund response, which will provide the basis for selection of a final remedy that will protect human health and the environment and achieve compliance with federal and state envirorunental laws
Hood, Maureen N; Gugerty, Brian; Levine, Richard; Ho, Vincent B
The use of human subjects for medical research in most industrialized nations requires the scientific and ethical scrutiny of research proposals by a governing institutional review board (IRB) or its equivalent. As part of their primary charge to protect human subjects, IRBs are responsible for the regulatory oversight of not only the research protocol itself but also the research conduct of the investigators and, if applicable, the funding sponsor. This article will discuss the regulatory requirements for an accurate account of IRB protocols and investigators and present an overview of the general flow of information for an IRB protocol. The current and potential uses of information management systems by IRBs will also be reviewed and accompanied by a discussion of the potential advantages and disadvantages of various computerized information systems for management of clinical research.
Utility management is paying increasing attention to the broadening of regulatory commission prudency reviews to cover operating generating plants as well as those under construction. Utilities can expect a prudency review after a major outage, and should investigate the possibility for legal action against a third party or be prepared to defend itself. The Shoreham nuclear plant serves as a warning to utilities of the need for on-going documentation of cost-benefit analyses conducted during the construction period. Utility managers should demand a prudency standard from their regulators, and minority owners in large projects should make independent prudency findings. There is also a growing need for utilities to develop intelligent strategies for handling excess cash. Methods for handling cash flow include the financial investment, grid refurbishment, dividend payout, decapitalization, and diversification
Guizhong, Li; Feng, He; Guangling, Huang; Libo, Man; Kun, Liu; Yuming, Shen
Penile amputation is a rare injury. Although, in principle, penile replantation can be performed using a variety of methods, few, if any, standardized procedures exist to deal with this medical emergency. The value of the various microsurgical techniques for replantation of the penis remains uncertain. This article provides a review of the management of penile defects and complications. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.
Since the inception of cleanup for hazardous waste sites, estimating target cleanup levels has been the subject of considerable investigation and debate in the Superfund remediation process. Establishing formal procedures for assessing human health risks associated with hazardous waste sites has provided a conceptual framework for determining remediation goals and target cleanup levels (TCLs) based on human health and ecological risk consideration. This approach was once considered at variance with the concept of the pre-risk assessment period; that is, cleaning up to the background level, or using containment design or best available control technologies. The concept has been gradually adopted by the regulatory agencies and the parties responsible for cleanup. Evaluation of cleanup strategies at the outset of the planning stage will eventually benefit the parties responsible for cleanup and the oversight organizations, including regulatory agencies. Development of the strategies will provide an opportunity to promote an improvement in the pace and quality of many activities to be carried out. The strategies should help address the issues related to (1) improving remediation management activities to arrive at remediation as expeditiously as possible, (2) developing alternate remediation management activities, (3) identifying obstructing issues to management for resolution, (4) adapting the existing framework to correspond to the change in remediation statutes and guidelines, and (5) providing the basis for evaluating options for the record of decision process. This paper will discuss some of the issues and the research efforts that were addressed as part of the strategies requiring future discussion and comment
Maditati, Dhanavanth Reddy; Munim, Ziaul Haque; Schramm, Hans-Joachim
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...... the debate and hence identify future avenues in the on-going research. Practical implications: Managers and policy makers should not just focus on single actions but perceive GSCM as a comprehensive package, in order to achieve better value, as myopic actions results may lead to negative associations between...
Minick, D James; Anderson, Kim A
Superfund sites may be a source of polycyclic aromatic hydrocarbons (PAHs) to the surrounding environment. These sites can also act as PAH sinks from present-day anthropogenic activities, especially in urban locations. Understanding PAH transport across environmental compartments helps to define the relative contributions of these sources and is therefore important for informing remedial and management decisions. In the present study, paired passive samplers were co-deployed at sediment-water and water-air interfaces within the Portland Harbor Superfund Site and the McCormick and Baxter Superfund Site. These sites, located along the Willamette River (Portland, OR, USA), have PAH contamination from both legacy and modern sources. Diffusive flux calculations indicate that the Willamette River acts predominantly as a sink for low molecular weight PAHs from both the sediment and the air. The sediment was also predominantly a source of 4- and 5-ring PAHs to the river, and the river was a source of these same PAHs to the air, indicating that legacy pollution may be contributing to PAH exposure for residents of the Portland urban center. At the remediated McCormick and Baxter Superfund Site, flux measurements highlight locations within the sand and rock sediment cap where contaminant breakthrough is occurring. Environ Toxicol Chem 2017;36:2281-2289. © 2017 SETAC. © 2017 SETAC.
Prudencio, Liana; Null, Sarah E.
Researchers and water managers have turned to green stormwater infrastructure, such as bioswales, retention basins, wetlands, rain gardens, and urban green spaces to reduce flooding, augment surface water supplies, recharge groundwater, and improve water quality. It is increasingly clear that green stormwater infrastructure not only controls stormwater volume and timing, but also promotes ecosystem services, which are the benefits that ecosystems provide to humans. Yet there has been little synthesis focused on understanding how green stormwater management affects ecosystem services. The objectives of this paper are to review and synthesize published literature on ecosystem services and green stormwater infrastructure and identify gaps in research and understanding, establishing a foundation for research at the intersection of ecosystems services and green stormwater management. We reviewed 170 publications on stormwater management and ecosystem services, and summarized the state-of-the-science categorized by the four types of ecosystem services. Major findings show that: (1) most research was conducted at the parcel-scale and should expand to larger scales to more closely understand green stormwater infrastructure impacts, (2) nearly a third of papers developed frameworks for implementing green stormwater infrastructure and highlighted barriers, (3) papers discussed ecosystem services, but less than 40% quantified ecosystem services, (4) no geographic trends emerged, indicating interest in applying green stormwater infrastructure across different contexts, (5) studies increasingly integrate engineering, physical science, and social science approaches for holistic understanding, and (6) standardizing green stormwater infrastructure terminology would provide a more cohesive field of study than the diverse and often redundant terminology currently in use. We recommend that future research provide metrics and quantify ecosystem services, integrate disciplines to
This document sets forth EPA’s strategy (Strategy) for ensuring that institutional controls (ICs) are successfully implemented at Superfund sites, with an emphasis on evaluating ICs at sites where all construction of all remedies is complete (construction complete sites).
The Savage Municipal Water Supply Superfund Site, located on the western edge of Milford, New Hampshire, consists of a source area and an extended plume that is approximately 6,000 feet long and 2,500 feet wide.
SRI’s in-depth case studies explore Superfund reuse stories from start to finish. Their purpose is to see what redevelopment strategies worked, acknowledge reuse barriers and understand how communities overcame the barriers to create new reuse outcomes.
This Enforcement Superfund Tracking System (ESTS) collects publicly available information from the California Secretary of State on businesses. Learn how this data is collected, how it will be used, access to the data, and the purpose of data collection.
This memorandum revises the hierarchy of human health toxicity values generally recommended for use inr isk assessments, originally presented in Risk Assessment Guidance for Superfund Volume I, Part A.
Inglezakis, Vassilis J; Moustakas, Konstantinos
This paper deals with the waste stream of household hazardous waste (HHW) presenting existing management systems, legislation overview and other relevant quantitative and qualitative information. European Union legislation and international management schemes are summarized and presented in a concise manner by the use of diagrams in order to provide crucial information on HHW. Furthermore, sources and types, numerical figures about generation, collection and relevant management costs are within the scope of the present paper. The review shows that the term used to refer to hazardous waste generated in households is not clearly defined in legislation, while there is absence of specific acts regulating the management of HHW. The lack of obligation to segregate HHW from the household waste and the different terminology used makes it difficult to determine the quantities and composition of this waste stream, while its generation amount is relatively small and, therefore, is commonly overlooked in waste statistics. The paper aims to cover the gap in the related literature on a subject that is included within the crucial waste management challenges at world level, considering that HHW can also have impact on other waste streams by altering the redox conditions or causing direct reactions with other non hazardous waste substances. Copyright © 2014 Elsevier Ltd. All rights reserved.
Young, Sam K
This paper presents a review of evidence-based management (EBM), exploring whether management activities within healthcare have been, or can be, subject to the same scientific framework as clinical practice. The evidence-based approach was initially examined, noting the hierarchy of evidence ranging from randomized control trials to clinical anecdote. The literature varied in its degree of criticism of this approach; the most common concern referring to the assumed superiority of positivism. However, evidence-based practice was generally accepted as the best way forward. Stewart (1998) offered the only detailed exposition of EBM, outlining a necessary 'attitude of mind' both for EBM and for the creation of a research culture. However, the term 'clinical effectiveness' emerged as a possible replacement buzz-word for EBM (McClarey 1998). The term appears to encompass the sentiments of the evidence-based approach, but with a concomitant concern for economic factors. In this paper the author has examined the divide between those who viewed EBM as an activity for managers to make their own practice accountable and those who believed it to be a facilitative practice to help clinicians with evidence-based practice. Most papers acknowledged the limited research base for management activities within the health service and offered some explanation such as government policy constraints and lack of time. Nevertheless, the overall emphasis is that ideally there should be a management culture firmly based in evidence.
Bowers, B.; McBee, K.; Lochmiller, R.; Burks, S.; Qualls, C.
Cotton rats (Sigmodon hispidus) were collected from an EPA Superfund site located on an abandoned oil refinery. Three trapping grids were located on the refinery and three similar grids were located at uncontaminated localities which served as reference sites. Bone marrow metaphase chromosome preparations were examined for chromosomal damage. For each individual, 50 cells were scored for six classes of chromosomal lesions. For the fall 1991 trapping period, mean number of aberrant cells per individual was 2.33, 0.85, and 1.50 for the three Superfund grids., Mean number of aberrant cells per individual was 2.55, 2.55, and 2.12 from the reference grids. Mean number of lesions per cell was 2.77, 0.86, and 1.9 from the Superfund grids, and 3.55, 2.77, and 2.50 from the reference grids. For the spring 1992 trapping period, more damage was observed in animals from both Superfund and reference sites; however, animals from Superfund grids had more damage than animals from reference grids. Mean number of aberrant cells per individual was 3.50, 3.25, and 3.70 from the Superfund grids, and 2.40, 2.11, and 1.40 from the reference grids. Mean number of lesions per cell was 4.80, 4.25, and 5.50 from the Superfund grids, and 2.60, 2.33, and 1.50 from the reference grids. These data suggest animals may be more susceptible to chromosomal damage during winter months, and animals from the Superfund grids appear to be more severely affected than animals from reference grids
... 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... the peer review process. ...
Rinckel, M.A.; Young, G.G.
Full text: United States nuclear power plants are initially licensed for a period of 40-years. The 40-year term, which was established by the Atomic Energy Commission in the 1950s, is believed to be based on engineering judgement and is consistent with the typical amortization schedule for purchasing fossil power plants. Under 10 CFR Part 54, the license renewal rule, additional terms of 20-years may be obtained through the preparation of a license renewal application that must be reviewed and approved by the Nuclear Regulatory Commission (NRC). The license renewal rule requires that applicants perform ageing management reviews on passive long-lived structures and components to demonstrate that ageing will be managed during the period of extended operation (i.e., additional 20 years of operation). ageing of active components, which are excluded from 10 CFR Part 54, is accomplished through the Maintenance Rule, 10 CFR Part 65, using performance-based monitoring. The license renewal rule, 10 CFR Part 54, was initially published in 1991. After significant interaction with the nuclear industry from 1991 through 1994, the NRC revised the rule in 1995 to focus on passive long-lived structures and components. In 1998, the first two applications for license renewal were submitted to the NRC by Baltimore Gas and Electric for the two-unit Calvert Cliffs nuclear power plant and by Duke Energy for the three-unit Oconee nuclear power plant. In March 2000, the NRC approved the application for the two-unit Calvert Cliffs nuclear power plant for an additional 20 years. Two months later, the NRC approved the renewal of the operating licenses for the three-unit Oconee nuclear station. The NRC completed these reviews in a timely, predictable, and stable manner. As of February 2002, the NRC has approved renewal of operating licenses for eight nuclear units and has applications under review for 15 more units. Twelve additional companies have notified the NRC of their intention to seek
In this lecture the screening approach for review of accident management programmes are presented. It contains objective trees for accident management: logic structure of the approach; objectives and safety functions for accident management; safety principles
NPL site POINT locations for the US EPA Region 9. NPL (National Priorities List) sites are hazardous waste sites that are eligible for extensive long-term cleanup under the Superfund program. Eligibility is determined by a scoring method called Hazard Ranking System. Sites with high scores are listed on the NPL. The majority of the locations are derived from polygon centroids of digitized site boundaries. The remaining locations were generated from address geocoding and digitizing. Area covered by this data set include Arizona, California, Nevada, Hawaii, Guam, American Samoa, Northern Marianas and Trust Territories. Attributes include NPL status codes, NPL industry type codes and environmental indicators. Related table, NPL_Contaminants contains information about contaminated media types and chemicals. This is a one-to-many relate and can be related to the feature class using the relationship classes under the Feature Data Set ENVIRO_CONTAMINANT.
During the summer of 1989, Maine Drilling and Blasting of Gardiner, Maine was contracted by Cayer Corporation of Harvard, Massachusetts to drill and blast an interceptor trench at the Nyanza Chemical Superfund Site in Ashland, Massachusetts. The interceptor trench was to be 1,365 feet long and to be blasted out of granite. The trench was to be 12 feet wide at the bottom with 1/1 slopes, the deepest cut being 30 feet deep. A French drain 12 feet wide by 15 to 35 feet deep was blasted below the main trench on a 2% slope from its center to each end. A French drain is an excavation where the rock is blasted but not dug. The trench would be used as a perimeter road with any ground water flow going through the French drain flowing to both ends of the trench. Being a Superfund project turned a simple blasting project into a regulatory nightmare. The US Environmental Protection Agency performed all the chemical related functions on site. The US Army Corps of Engineers was overseeing all related excavation and construction on site, as was the Massachusetts Department of Environmental Quality Engineering, the local Hazardous Wastes Council, and the local Fire Department. All parties had some input with the blasting and all issues had to be addressed. The paper outlines the project, how it was designed and completed. Also included is an outline of the blast plan to be submitted for approval, an outline of the Safety/Hazardous Waste training and a description of all the problems which arose during the project by various regulatory agencies
Full Text Available The move towards automated driving is gaining ground. This paper reviews the development process of self-driving technology and discusses the safety and efficiency advantages of autonomous vehicles. The discussion shows that the existing traffic management system, including transport infrastructures and regulations, should be changed accordingly to maximize the advantages of autonomous driving. Thus, this paper subsequently gives an insight of the traffic management from three aspects: fully self-driving traffic infrastructures, mixed traffic infrastructures and regulations. First, it is summarized in detail what should be adjusted in intersections, parking lots, pedestrian crossings, ramps, signs and markings. With the transformation of traffic infrastructures, the advantages of driverless car will be more pronounced on account of increased capacity, reduced delay and land use. Also, this paper indicates that the implementations of strict product liability for self-driving car manufacturers and no-fault tort liability for users are applicable to automated vehicle accidents.
Cheong, Ju Yong; Keshava, Anil
Traumatic colorectal injuries are common during times of military conflict, and major improvements in their care have arisen in such periods. Since World War II, many classification systems for colorectal trauma have been proposed, including (i) Flint Grading System; (ii) Penetrating Abdominal Trauma Index; (iii) Colonic/Rectal Injury Scale; and (iv) destructive/non-destructive colonic injuries. The primary goal of these classifications was to aid surgical management and, more particularly, to determine whether a primary repair or faecal diversion should be performed. Primary repair is now the preferred surgical option. Patients who have been identified as having destructive injuries have been found to have higher anastomotic leak rates after a primary repair. Damage control principles need to be adhered to in surgical decision-making. In this review, we discuss the mechanisms of injury, classifications, clinical presentation and current recommendations for the management of colorectal trauma. © 2017 Royal Australasian College of Surgeons.
Full Text Available Priapism is defined as a persistent and painful erection lasting longer than four hours without sexual stimulation. Based on episode history and pathophysiology, priapism is classified into three subtypes: ischemic (low-flow, non-ischemic (high-flow, and stuttering priapism. Ischemic priapism is characterized by a persistent, painful erection with remarkable rigidity of the corpora cavernosa caused by a disorder of venous blood outflow from this tissue mass, and is similar to penile compartment syndrome. Stuttering priapism is characterized by a self-limited, recurrent, and intermittent erection, frequently occurring in patients with sickle cell disease. Non-ischemic priapism is characterized by a painless, persistent nonsexual erection that is not fully rigid and is caused by excess arterial blood flow into the corpora cavernosa. Because ischemic and non-ischemic priapism differ based on emergency status and treatment options, appropriate discrimination of each type of priapism is required to initiate adequate clinical management. The goal of management of priapism is to achieve detumescence of the persistent penile erection and to preserve erectile function after resolution of the priapism. To achieve successful management, urologists should address this emergency clinical condition. In the present article, we review the diagnosis and clinical management of the three types of priapism.
COOK, CARLY N; POSSINGHAM, HUGH P; FULLER, RICHARD A
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
Today, the U.S. Environmental Protection Agency released the list of Superfund sites that Administrator Pruitt has targeted for immediate and intense attention. The Centredale Manor Restoration Project superfund site is one of the 21 sites on the list.
U.S. Environmental Protection Agency — This data layer provides access to Superfund National Priority List Sites as part of the CIMC web service. Superfund is a program administered by the EPA to locate,...
Harrison, David; Coughlin, Conor; Hogan, Dylan; Edwards, Deborah A; Smith, Benjamin C
The present paper describes a methodology for evaluating impacts of Superfund remedial alternatives on the regional economy in the context of a broader sustainability evaluation. Although economic impact methodology is well established, some applications to Superfund remedial evaluation have created confusion because of seemingly contradictory results. This confusion arises from failure to be explicit about 2 opposing impacts of remediation expenditures: 1) positive regional impacts of spending additional money in the region and 2) negative regional impacts of the need to pay for the expenditures (and thus forgo other expenditures in the region). The present paper provides a template for economic impact assessment that takes both positive and negative impacts into account, thus providing comprehensive estimates of net impacts. The paper also provides a strategy for identifying and estimating major uncertainties in the net impacts. The recommended methodology was applied at the Portland Harbor Superfund Site, located along the Lower Willamette River in Portland, Oregon, USA. The US Environmental Protection Agency (USEPA) developed remedial alternatives that it estimated would cost up to several billion dollars, with construction durations possibly lasting decades. The economic study estimated regional economic impacts-measured in terms of gross regional product (GRP), personal income, population, and employment-for 5 of the USEPA alternatives relative to the "no further action" alternative. Integr Environ Assess Manag 2018;14:32-42. © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC). © 2017 The Authors. Integrated Environmental Assessment and Management published by Wiley Periodicals, Inc. on behalf of Society of Environmental Toxicology & Chemistry (SETAC).
The Montclair/West Orange and Glen Ridge Superfund Sites, located in Essex County, NJ, are contaminated to varying degrees with radioactive materials. The waste originated from radium processing facilities prevalent in the area during the early 1900s. The design for remediation of these sites is managed by Bechtel National, Inc. on behalf of the United States Army Corps of Engineers, Kansas City District, which administers the project through an interagency agreement with the US Environmental Protection Agency (EPA). Design efforts for the project began in 1990. A portion of the scope, which is the topic of this article, was preparing the remediation costs estimates. These estimates were to be prepared from the detailed design packages; the Corps of Engineers required that the estimates were prepared using the Micro Computer-Aided Cost Estimating System (MCACES). This article discusses the design methods used, provides an overview of MCACES, and discusses the structure and preparation of the cost estimate and its uses. However, the main focus of the article is the methods used to generate the required project-specific cost estimate format for this project. 6 figs
... 10 Energy 3 2010-01-01 2010-01-01 false Initial review by manager. 473.22 Section 473.22 Energy... Certification of Grants, Cooperative Agreements, Contracts, and Projects § 473.22 Initial review by manager. (a) Upon expiration of the time for filing information under these regulations, the manager shall— (1...
... ENVIRONMENTAL PROTECTION AGENCY [FRL-9805-2; CERCLA-04-2013-3751] LWD, Inc. Superfund Site... costs concerning the LWD, Inc., Superfund Site located in Calvert City, Marshall County, Kentucky. The... V. Painter. Submit your comments by Site name LWD, Inc., Superfund Site by one of the following...
... ENVIRONMENTAL PROTECTION AGENCY [FRL 9788-2; CERCLA-04-2013-3754] Ward Transformer Superfund Site... Ward Transformer Superfund Site located in Raleigh, Wake County, North Carolina. Under the terms of the.... Submit your comments by Site name Ward Transformer Superfund Site by one of the following methods: [[Page...
Atkin, R.G.; Liedle, S.D.; Clemens, B.W.
With the promulgation of the Superfund Amendments and Reauthorization Act (SARA) federal facilities were required to comply with the Comprehensive Environmental Response Compensation and Liability Act (CERCLA) in the same manner as any non-government entity. This situation presented challenges for the Department of Energy (DOE) and other federal agencies involved in remedial action work because of the requirements under SARA that overlap other laws requiring DOE compliance, e.g., the National Environmental Policy Act (NEPA). This paper outlines options developed to comply with CERCLA and NEPA as part of an active, multi-site remedial action program. The program, the Formerly Utilized Sites Remedial Action Program (FUSRAP), was developed to identify, clean up, or control sites containing residual radioactive contamination resulting from the nation's early development of nuclear power. During the Manhattan Project, uranium was extracted from domestic and foreign ores and resulted in mill concentrates, purified metals, and waste products that were transported for use or disposal at other locations. Figure 1 shows the steps for producing uranium metal during the Manhattan Project. As a result of these activities materials equipment, buildings, and land became contaminated, primarily with naturally occurring radionuclides. Currently, FUSRAP includes 29 sites; three are on the Environmental Protection Agency's (EPA's) National Priorities List (NPL) of hazardous waste sites
Abattoir operations and waste management in Nigeria: A review of challenges ... Log in or Register to get access to full text downloads. ... militating against the establishment, operations and management of abattoirs are not given attention.
... ASSISTANCE STATE AND LOCAL ASSISTANCE Cooperative Agreements and Superfund State Contracts for Superfund Response Actions Personal Property Requirements Under A Cooperative Agreement § 35.6335 Property management... the property; (5) Provisions for financial control and accounting in the financial management system...
Lewis, N.M.; Barkley, N.P.; Williams, T.
The Superfund Innovative Technology Evaluation (SITE) Emerging Technology Program (ETP) has financially supported further development of bench- and pilot-scale testing and evaluation of innovative technologies for use at hazardous waste sites for five years. The ETP was established under the Superfund Amendments and Reauthorization Act (SARA) of 1986. The ETP complies with the goal of the SITE Program to promote, accelerate and make commercially available the development of alternative/innovative treatment technologies for use at Superfund sites. Technologies are submitted to the ETP through yearly solicitations for Preproposals. Applicants are asked to submit a detailed project proposal and a cooperative agreement application that requires Developer/EPA cost sharing. EPA co-funds selected Developers for one to two years. Second-year funding requires documentation of significant progress during the first year. Facilities, equipment, data collection, performance and development are monitored throughout the project. The US Department of Energy (DOE) and the US Air Force (USAF) are participants in the ETP. DOE has co-funded ETP projects since 1990 and the USAF since 1991. A goal of the ETP is to move developed technologies to the field-demonstration stage. A developer may be considered for participation in the SITE Demonstration Program if performance in the ETP indicates the technology is field-ready for evaluation. Six technology categories: biological, chemical, materials handling, physical, solidification/stabilization and thermal, are presently in the ETP. Technologies of primary interest to EPA are those that can treat complex mixtures of hazardous organic and inorganic contaminants and provide improved solids handling and/or pretreatment. An account of the background and progress of the ETP's first five years is presented in this paper. Technologies currently in the ETP are noted, and developers and EPA Project Managers, are listed. 4 refs., 11 figs., 6 tabs
International Atomic Energy Agency provides international peer review services in radioactive waste management to those Member States that have established radioactive waste management programmes. Such services are provided within Waste Management Assessment and Technical Review Programme (WATRP). The main objective of WATRP is to provide international expertise and information on a requested subject in the field of radioactive waste management and to validate that programmes and activities are sound and performing well. Refs, figs and tabs
interrelationships of the many aspects of management information systems (MIS); that is, with how analysis, design, operation, evaluation, and user considerations affect management information systems . (Author)
Ela, Wendell P; Sedlak, David L; Barlaz, Morton A; Henry, Heather F; Muir, Derek C G; Swackhamer, Deborah L; Weber, Eric J; Arnold, Robert G; Ferguson, P Lee; Field, Jennifer A; Furlong, Edward T; Giesy, John P; Halden, Rolf U; Henry, Tala; Hites, Ronald A; Hornbuckle, Keri C; Howard, Philip H; Luthy, Richard G; Meyer, Anita K; Sáez, A Eduardo; Vom Saal, Frederick S; Vulpe, Chris D; Wiesner, Mark R
This commentary evolved from a workshop sponsored by the National Institute of Environmental Health Sciences titled "Superfund Contaminants: The Next Generation" held in Tucson, Arizona, in August 2009. All the authors were workshop participants. Our aim was to initiate a dynamic, adaptable process for identifying contaminants of emerging concern (CECs) that are likely to be found in future hazardous waste sites, and to identify the gaps in primary research that cause uncertainty in determining future hazardous waste site contaminants. Superfund-relevant CECs can be characterized by specific attributes: They are persistent, bioaccumulative, toxic, occur in large quantities, and have localized accumulation with a likelihood of exposure. Although still under development and incompletely applied, methods to quantify these attributes can assist in winnowing down the list of candidates from the universe of potential CECs. Unfortunately, significant research gaps exist in detection and quantification, environmental fate and transport, health and risk assessment, and site exploration and remediation for CECs. Addressing these gaps is prerequisite to a preventive approach to generating and managing hazardous waste sites. A need exists for a carefully considered and orchestrated expansion of programmatic and research efforts to identify, evaluate, and manage CECs of hazardous waste site relevance, including developing an evolving list of priority CECs, intensifying the identification and monitoring of likely sites of present or future accumulation of CECs, and implementing efforts that focus on a holistic approach to prevention.
Murphy, Hamadi; Schroeder, Gregory D; Shi, Weilong J; Kepler, Christopher K; Kurd, Mark F; Fleischman, Andrew N; Kandziora, Frank; Chapman, Jens R; Benneker, Lorin M; Vaccaro, Alexander R
Traumatic spondylolisthesis of the axis, is a common cervical spine fracture; however, to date there is limited data available to guide the treatment of these injuries. The purpose of this review is to provide an evidence-based analysis of the literature and clinical outcomes associated with the surgical and nonsurgical management of hangman's fractures. A systematic literature search was conducted using PubMed (MEDLINE) and Scopus (EMBASE, MEDLINE, COMPENDEX) for all articles describing the treatment of hangman's fractures in 2 or more patients. Risk of nonunion, mortality, complications, and treatment failure (defined as the need for surgery in the nonsurgically managed patients and the need for revision surgery for any reason in the surgically managed patients) was compared for operative and nonoperative treatment methods using a generalized linear mixed model and odds ratio analysis. Overall, 25 studies met the inclusion criteria and were included in our quantitative analysis. Bony union was the principal outcome measure used to assess successful treatment. All studies included documented fracture union and were included in statistical analyses. The overall union rate for 131 fractures treated nonsurgically was 94.14% [95% confidence interval (CI), 76.15-98.78]. The overall union rate for 417 fractures treated surgically was 99.35% (95% CI, 96.81-99.87). Chance of nonunion was lower in those patients treated surgically (odds ratio, 0.12; 95% CI, 0.02-0.71). There was not a significant difference in mortality between patients treated surgically (0.16%; 95% CI, 0.01%-2.89%) and nonsurgically (1.04%; 95% CI, 0.08%-11.4%) (odds ratio, 0.15; 95% CI, 0.01-2.11). Treatment failure was less likely in the surgical treatment group (0.12%; 95% CI, 0.01%-2.45%) than the nonsurgical treatment group (0.71%; 95% CI, 0.28%-15.75%) (odds ratio 0.07; 95% CI, 0.01-0.56). Hangman's fractures are common injuries, and surgical treatment leads to an increase in the rate of
... NUCLEAR REGULATORY COMMISSION [NRC-2010-0242] Review of Management Directive 8.11 AGENCY: Nuclear... (NRC) is requesting public comment on Management Directive (MD) 8.11, ``Review Process for 10 CFR 2.206... members of the public and the NRC, the NRC is soliciting comments from the public, on what, if any...
... 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...
Reviewed by Dr. Adnan BOYACI
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
Lindenmayer, Jean-Pierre; Kaur, Amandeep
Schizoaffective disorder (SAD) is an incapacitating illness that presents clinicians with challenges in terms of both its diagnosis and its psychopharmacological management. Most studies conducted on the psychopharmacological treatment of SAD also include patients with schizophrenia or other psychotic illnesses, thereby providing an unspecific view to the clinician as to the best way of treating patients with SAD. The objective of this article is to review studies on evidence-based treatment of patients with SAD. We conducted a systematic literature search in MEDLINE/PubMed for full-text studies in the English language using the terms 'Schizoaffective and treatment' or 'antipsychotic schizoaffective'. Our review found relatively few studies with either an active comparator or placebo that examined the efficacy of antipsychotics for patients with SAD without an admixture of patients with schizophrenia. Only oral paliperidone extended release (ER), paliperidone long-acting injection (LAI), and risperidone have been shown to be effective and safe in reducing psychotic as well as affective components in acutely ill SAD patients in controlled studies. Paliperidone ER and LAI have also been shown to be efficacious in the maintenance treatment phase of SAD patients. While no supportive data exist, it is possible that other atypical antipsychotics may have similar efficacy to the two mentioned above. We conclude with a number of research recommendations for the study of treatment options for patients with SAD. First, there is a need for studies with patients specifically diagnosed with SAD for both the acute and the maintenance phase. The sample size needs to be adequate to allow a primary analysis of efficacy and to allow for analysis of the SAD subtypes: depressed and bipolar. Another recommendation is the need for studies of patients with SAD stratified into patients with and without mood stabilizers or antidepressants to allow the examination of the adjunctive role of
Yew, Bee K.
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…
The Douglas Road Landfill Superfund Site is located in St. Joseph County just north of Mishawaka,Indiana. The site consists of a 16-acre capped landfill located on an approximately 32-acre lot (includingthe land purchased in 1999 for a wetlands...
This study examines the decision-making process of the remedial design (RD) phase of on-site incineration projects conducted at Superfund sites. Decisions made during RD affect the cost and schedule of remedial action (RA). Decision analysis techniques are used to determine the...
This review of the disturbance ecology literature, and how it pertains to forest management, is a resource for forest managers and researchers interested in disturbance theory, specific disturbance agents, their interactions, and appropriate methods of inquiry for specific geographic regions. Implications for the future of disturbance ecology-based management are...
... 31 Money and Finance: Treasury 2 2010-07-01 2010-07-01 false Cash management planning and review. 206.6 Section 206.6 Money and Finance: Treasury Regulations Relating to Money and Finance (Continued) FISCAL SERVICE, DEPARTMENT OF THE TREASURY FINANCIAL MANAGEMENT SERVICE MANAGEMENT OF FEDERAL AGENCY...
Langeron, Olivier; Amour, Julien; Vivien, Benoît; Aubrun, Frédéric
Difficulties or failure in airway management are still important factors in morbidity and mortality related to anesthesia and intensive care. A patent and secure airway is essential to manage anesthetized or critically ill patients. Oxygenation maintenance during tracheal intubation is the cornerstone of difficult airway management and is always emphasized in guidelines. The occurrence of respiratory adverse events has decreased in claims for injuries due to inadequate airway management mainl...
Craft, H. G., Jr.
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.
Williams, A; Biffen, A; Pilkington, N; Arrick, L; Williams, R J; Smith, M E; Smith, M; Birchall, J
The management of epistaxis requires an understanding of haematological factors that may complicate its treatment. This systematic review includes six distinct reviews examining the evidence supporting epistaxis-specific management strategies relating to warfarin, direct oral anticoagulants, heparin, antiplatelet agents, tranexamic acid and transfusion. A systematic review of the literature was performed using a standardised methodology and search strategy. Limited numbers of articles were identified in each systematic review, with level 1 evidence only regarding the use of tranexamic acid. No studies met the inclusion criteria within the heparin, direct oral anticoagulants or transfusion systematic reviews. Many studies were limited by small sample sizes and significant risk of bias. The management of major bleeding and transfusion practice is well documented in national guidance from multiple sources. The guidelines include advice on anticoagulants, antiplatelet agents and tranexamic acid. In the absence of more specific evidence, these guidelines should be applied in the management of epistaxis.
Brown, Charlotte; Milke, Mark; Seville, Erica
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.
Brown, Charlotte; Milke, Mark; Seville, Erica
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.
Mara Solange Gomes Dellaroza
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.
Annals of Medical and Health Sciences Research | Mar-Apr 2014 | Vol 4 | Issue 2 |. Address for ... More efforts are needed to fill this large gap in the correct management of osteoporosis related fractures .... Systematic review: Comparative.
... a review of the disease, management strategies and future research directions. ... Plants are infected either by insects through the inflorescence or by ... wilt is not fully understood but its impact on food security in the region is very significant.
Background: A systematic review was conducted of randomized trials of workplace weight management interventions, including trials with dietary, physical activity, environmental, behavioral and incentive based components. Main outcomes were defined as change in weight-related measures. Methods: Key w...
Pérez Salazar, María del Rosario; Aguilar Laserre, Alberto Alfonso; Cedillo-Campos, Miguel Gastón; Hernández González, José Carlos
Purpose: The aim of this paper is to examine the state of knowledge management research in supply chain management from three standpoints, methodological approach, supply chain management area, and knowledge management processes. Design/methodology/approach: To achieve this, a systematic review is conducted over the period 2000-2014 on the basis of a qualitative content analysis. Findings: Major results showed that knowledge management can be viewed as a leverage mechanism f...
Duan Hongwei; Li Juan; Wang Jing; Zhang Hui; Wang Yanqi; Tian Feng
According to the nuclear safety regulations and guidelines in China, the information of the IAEA and the NRC, this paper discusses the origin, purpose, method and report of the management review, the basic concepts and requirements. In order to identify the difference between the management review and the internal quality assurance audit, the paper also compares their purpose, nature, the pursuant documents, and etc. (authors)
2008) ... The Effects of Bureaucracy and its Implications for Adhocracy in the Workplace: A Study ... A Review of the Conflict between Environmental Rights and Human Rights: A ... Emerging Pattern of Forest Bio-Diversity in South West Nigeria: A ...
Review of pension schemes of Ukraine and Argentina in comparison with Nigeria's 2014 pension reform act · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. JO Nweke, 81-94 ...
...). The lessons learned from the 1997 Quadrennial Defense Review (QDR 1997) included the need for leadership guidance and integration of analytic activities to sort through the myriad issues that are always confronting the Department of Defense...
The Environmental Protection Agency (EPA) Office of Superfund Remediation and Technology Innovation (OSRTI) is responsible for implementing the long-term (non-emergency) portion of a key U.S. law regulating cleanup: the Comprehensive Environmental Response, Compensation and Liability Act, CERCLA, nicknamed 'Superfund'. The purpose of the Superfund program is to protect human health and the environment over the long term from releases or potential releases of hazardous substances from abandoned or uncontrolled hazardous waste sites. The focus of this paper is on Superfund, including how radiation is addressed by the Superfund program. This paper provides a brief overview of the approach used by EPA to conduct Superfund cleanups at contaminated sites, including those that are contaminated with radionuclides, to ensure protection of human health and the environment. The paper addresses how EPA Superfund determines if a site poses a risk to human health and the framework used to determine cleanup levels. The theme emphasized throughout the paper is that within the Superfund remediation framework, radioactive contamination is dealt with in a consistent manner as with chemical contamination, except to account for the technical differences between radionuclides and chemicals. This consistency is important since at every radioactively contaminated site being addressed under Superfund's primary program for long-term cleanup, the National Priorities List (NPL), chemical contamination is also present. (author)
U.S. Environmental Protection Agency — Point geospatial dataset representing locations of CERCLA (Superfund) Removal sites. CERCLA (Comprehensive Environmental Response, Compensation, and Liability Act)...
Lalit K Makhija
Full Text Available Introduction: Vascular anomalies are congenital lesions broadly categorised into vascular tumour (haemangiomas and vascular dysmorphogenesis (vascular malformation. The management of these difficult problems has lately been simplified by the biological classification and multidisciplinary approach. To standardise the treatment protocol, an algorithm has been devised. The study aims to validate the algorithm in terms of its utility and presents our experience in managing vascular anomalies. Materials and Methods: The biological classification of Mulliken and Glowacki was followed. A detailed algorithm for management of vascular anomalies has been devised in the department. The protocol is being practiced by us since the past two decades. The data regarding the types of lesions and treatment modality used were maintained. Results and Conclusion: This study was conducted from 2002 to 2012. A total of 784 cases of vascular anomalies were included in the study of which 196 were haemangiomas and 588 were vascular malformations. The algorithmic approach has brought an element of much-needed objectivity in the management of vascular anomalies. This has helped us to define the management of particular lesion considering its pathology, extent and aesthetic and functional consequences of ablation to a certain extent.
Dibapile, Waitshega Tefo Smitta
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…
A systematic literature review was conducted to identify and synthesise the relevant literature on the epidemiology, presentation, assessment and management of Munchausen's Syndrome by Proxy (MSP). This included collating information from published and unpublished sources. The purpose of the review was to provide ...
B.S. Kuipers (Ben); M.J. Higgs (Malcolm); W.J.M. Kickert (Walter); L.G. Tummers (Lars); J. Grandia (Jolien); J. van der Voet (Joris)
textabstractThis article presents a review of the recent literature on change management in public organisations and sets out to explore the extent to which this literature has responded to earlier critiques regarding the lack of (public) contextual factors. The review includes 133 articles
... FURTHER INFORMATION CONTACT: Mary Beth Pultz, Director, Executive Resources Team, Human Resources Services... DEPARTMENT OF EDUCATION Office of Management; Performance Review Board Membership AGENCY... Department of Education for 2010 is composed of career and non-career senior executives. The PRB reviews and...
The Storm Water Management Model (SWMM) is a widely used tool for urban drainage design and planning. Hundreds of peer-reviewed articles and conference proceedings have been written describing applications of SWMM. This review focused on collecting information on model performanc...
Batterink, M.H.; Omta, S.W.F.; Wubben, E.F.M.
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
Diego Fernando Macías
Full Text Available This review examines studies in the area of classroom management in foreign language education. It is organized into three large areas: The first area focuses on the distinctive characteristics of foreign language instruction that are more likely to impact classroom management in foreign language classes. The second area provides a description of classroom management issues that foreign language teachers usually encounter in their practice; and the third area centers on the different alternatives to reduce the negative impact of classroom management on foreign language classes. Conclusions suggest a need for more research particularly on the relationship between classroom management and aspects such as target language use and teaching methods.
Macías, Diego Fernando
This review examines studies in the area of classroom management in foreign language education. It is organized into three large areas: The first area focuses on the distinctive characteristics of foreign language instruction that are more likely to impact classroom management in foreign language classes. The second area provides a description of…
Hanley Nadeau, Ellen; Toronto, Coleen E.
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…
Terborg, James R.
This paper reviews the literature on the psychological and social processes involved in the integration of women into management positions. The author concentrates on two areas. First is the entry of women into management (including women's career choices, choice of organization, and the effects of these choices on the organization. These effects…
Boscari, Stefania; Bortolotti, Thomas; Netland, Torbjorn; Rich, Nicholas
National culture has received a substantial amount of interest in the operations management literature. We present the first structured review of articles studying national culture in operations management. Our search returned 51 papers published in ten leading journals between 2000 and 2017. We
Background: Rabies is still a cause of death among children in our environment. We undertook a 10-year retrospective review to evaluate the aetiology and outcome of management of childhood rabies in our setting. Methodology: This was a 10-year retrospective study of rabies cases managed in the Paediatrics Unit of the ...
Marc Hanewinkel; Susan Hummel; Axel Albrecht
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...
Management style is a major factor in the successful accomplishment of the many tasks required of an educational administrator. An administrator's leadership style develops in proportion to his adaptation to organizational structure, his personality and value system, his concept of personal success, experiences both in and out of his managerial…
Conegundes De Jesus, Camila Kiyomi; Salerno, Mario Sergio
Patents and patent portfolios are gaining attention in the last decades, from the called 'pro-patent era' to the recent billionaire transactions involving patent portfolios. The field is growing in importance, both theoretically and practically and despite having substantial literature on new product development portfolio management, we have not found an article relating this theory to patent portfolios. Areas covered: The paper develops a systematic literature review on patent portfolio management to organize the evolution and tendencies of patent portfolio management, highlighting distinctive features of patent portfolio management. Interview with IP manager of three life sciences companies, including a leading multinational group provided relevant information about patent portfolio management. Expert opinion: Based on the systematic literature review on portfolio management, more specifically, on new product development portfolio theory, and interview the paper proposes the paper proposes a reference model to manage patent portfolios. The model comprises four stages aligned with the three goals of the NPD portfolio management: 1 - Linking strategy of the Company's NPD Portfolio to Patent Portfolio; 2 - Balancing the portfolio in buckets; 3 - Patent Valuation (maximizing valuation); 4 - Regularly reviewing the patent portfolio.
The fact sheet describes what various actions the EPA can take to clean up hazardous wastes sites. Explanations of how the criteria for environmental and public health risk assessment are determined and the role of state and local governments in site remediation are given. The fact sheet is one in a series providing reference information about Superfund issues and is intended for readers with no formal scientific training
... administration on an ongoing basis by reviewing financial reports, audit reports, food orders, inventory reports... the State agency do to ensure that local agencies meet program requirements and objectives? The State..., and other agencies conducting program activities meet program requirements and objectives. As part of...
Stormwater management can be a challenge in any environment, but it is especially difficult in karst terrain. The characteristic dissolution of bedrock creates depressions in topography as well as voids in the subsurface, resulting in problems such as collapse sinkhole development, groundwater cont...
Customer relationship management and performance in the paint industry: a study of selected paint manufacturing firms in Lagos State, Nigeria · EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Kenneth C. Nwekpa, Ewans Chukwuma, Nancy Agha, 184-192 ...
This manual of practice is geared toward a technical audience but the first four chapters can be understood by anyone interested in stormwater issues and the use of best management practices (BMPs) to mitigate urban stormwater effects. These chapters outline the stormwater probl...
Shujahat, Muhammad; Hussain, Saddam; Javed, Sammar; Muhammad, Imran Malik; Thursamy, Ramayah; Ali, Junaid
Purpose:\\ud First purpose of this study is to discuss the synergic and separate use of knowledge and\\ud intelligence, via knowledge management and competitive intelligence, in each stage of strategic\\ud management process. Second purpose is to discuss the implications of each stage of strategic\\ud management process for knowledge management and competitive intelligence and vice versa.\\ud Methodology/Design/Approach:\\ud A systematic literature review was performed within timeframe of 2000 to 2...
J.C. Moreki; S.C. Chiripasi
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. Giv...
Luis Paulo Sant'ana; Taynara Cristina Cordeiro
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 co...
Mourshed, Monjur; Masud, Mahadi Hasan; Rashid, Fazlur; Joardder, Mohammad Uzzal Hossain
The plastic-derived product, nowadays, becomes an indispensable commodity for different purposes. A huge amount of used plastic causes environmental hazards that turn in danger for marine life, reduces the fertility of soil, and contamination of ground water. Management of this enormous plastic waste is challenging in particular for developing countries like Bangladesh. Lack of facilities, infrastructure development, and insufficient budget for waste management are some of the prime causes of improper plastic management in Bangladesh. In this study, the route of plastic waste production and current plastic waste management system in Bangladesh have been reviewed extensively. It emerges that no technical and improved methods are adapted in the plastic management system. A set of the sustainable plastic management system has been proposed along with the challenges that would emerge during the implementation these strategies. Successful execution of the proposed systems would enhance the quality of plastic waste management in Bangladesh and offers enormous energy from waste.
Wood, Matthew D; Bostrom, Ann; Bridges, Todd; Linkov, Igor
Risk managers are increasingly interested in incorporating stakeholder beliefs and other human factors into the planning process. Effective risk assessment and management requires understanding perceptions and beliefs of involved stakeholders, and how these beliefs give rise to actions that influence risk management decisions. Formal analyses of risk manager and stakeholder cognitions represent an important first step. Techniques for diagramming stakeholder mental models provide one tool for risk managers to better understand stakeholder beliefs and perceptions concerning risk, and to leverage this new understanding in developing risk management strategies. This article reviews three methodologies for assessing and diagramming stakeholder mental models--decision-analysis-based mental modeling, concept mapping, and semantic web analysis--and assesses them with regard to their ability to address risk manager needs. © 2012 Society for Risk Analysis.
Md Nazmul Kayes
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.
Awasthi, Abhishek Kumar; Wang, Mengmeng; Wang, Zhishi; Awasthi, Mrigendra Kumar; Li, Jinhui
Environmental deterioration and health risk due to improper e-waste management has become a serious issue in India. The major portion of e-waste reaches an unorganized e-waste recycling sector and is then treated by using crude methods. This review article presents a brief highlight on e-waste management status, legislation, and technology uses in India. The present e-waste management needs to be more focused on environmentally sound management, by more active support from all the participants involved in the e-waste flow chain in India.
Almost, Joan; Wolff, Angela C; Stewart-Pyne, Althea; McCormick, Loretta G; Strachan, Diane; D'Souza, Christine
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.
Wei-Whua Loa; Suan Chen; Wei-Chu Yu
Regulations on radioactive waste disposal are now in urgent need due to our increasing consumption of electric power from nuclear origin. It is set forth that actually applying the regulations to evaluate the license application of new repositories for interim storage and final disposal of High-Level Waste and Low-Level Waste before the year of 2000. In the mean time, it is expected to establish the basis for the decision on issuing the license. The license review procedure can be very complicated, because too many factors must be taken into consideration. For the time being, licensing review is as much an art as it is a science. The authority usually faces three major problems; (1) the availability of domain expert, (2) maintaining of high quality and consistent reviews, and (3) the documentation of the review process. However, to maintain a more efficient, accurate, and systematic review procedure, and at the same time to reduce costs, the Artificial Intelligence (AI) techniques may be used. An expert system is designed as a radioactive waste management licensing review aid for the staff those are in charge of the license application. Tasks such as completeness checking, functional areas of review distribution, participation confirmation, knowledge acquisition, review comment collection, weighting calculation, and degree of satisfaction are considered. In this paper we will discuss the development of the radioactive waste management licensing review assistant
Sadeghi-Bazargani, Homayoun; Azami-Aghdash, Saber; Kazemi, Abdolhassan; Ziapour, Behrad
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. Data needed for this systematic review were collected through searching PubMed, EMBASE and SID databases, for the period from 2003 to 2011. Keywords included earthquake, Iran and Bam earthquake. The data were summarized and were analyzed using Content Analysis. Out of 422 articles, 25 articles were included in the study. Crisis Management aspects and existing pitfalls were classified into seven categories including planning and organization, human resource management, management of logistics, international humanitarian aids, field performance of the military and security forces, health and medical service provision, and information management. Positive aspects and major pitfalls of crisis management have been introduced in all the mentioned categories. The available evidence indicated poor crisis management during Bam earthquake that resulted in aggravating the losses as well as diminishing the effect of interventions. Thus, concerning the importance of different aspects of the crisis management and the high prevalence of disasters in Iran, the observed vulnerability in disaster management process should be addressed.
The subject of radioactive waste management and burial is a subject that raises strong emotional and political issues and generates sharp technical differences of opinion. The overall problem can be subdivided into the three major categories of (1) credibility and emotionalism, (2) technology, and (3) nuclear waste isolation and containment. An area of concern desperately in need of attention is that of proper public education on all aspects of the high-level radioactive-waste (rad-waste) burial problem. A major problem related to the rad-waste issue is the apparent lack of an official, all-encompassing U.S. policy for nuclear waste management, burial, isolation, and regulation. It is clear from all past technical reports that disposal of rad wastes in an appropriate geologic horizon is the best ultimate solution to the waste problem. After 25 y of dealing with the high-level radioactive waste problem, the difficulty is that no proposed plan has to date been tested properly. It is this indecision and reaction that has contributed in no small way to the public perception of inability to solve the problem. One major change that has occurred in the last few years was the enactment of the Nuclear Waste Policy Act of 1982. This act mandates deadlines, guidelines, and state involvement. It is time that strong differences of opinions be reconciled. One must get on with the difficult job of selecting the best means of isolating and burying these wastes before the task becomes impossible
... 40 Protection of Environment 1 2010-07-01 2010-07-01 false How many groups can receive a TAG at one Superfund site? 35.4040 Section 35.4040 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY... Eligible? § 35.4040 How many groups can receive a TAG at one Superfund site? (a) Only one TAG may be...
This data layer provides access to Base Realignment and Closure (BRAC) Superfund Sites as part of the CIMC web service. EPA works with DoD to facilitate the reuse and redevelopment of BRAC federal properties. When the BRAC program began in the early 1990s, EPA worked with DoD and the states to identify uncontaminated areas and these parcels were immediately made available for reuse. Since then EPA has worked with DoD to clean up the contaminated portions of bases. These are usually parcels that were training ranges, landfills, maintenance facilities and other past waste-disposal areas. Superfund is a program administered by the EPA to locate, investigate, and clean up worst hazardous waste sites throughout the United States. EPA administers the Superfund program in cooperation with individual states and tribal governments. These sites include abandoned warehouses, manufacturing facilities, processing plants, and landfills - the key word here being abandoned.This data layer shows Superfund Sites that are located at BRAC Federal Facilities. Additional Superfund sites and other BRAC sites (those that are not Superfund sites) are included in other data layers as part of this web service.BRAC Superfund Sites shown in this web service are derived from the epa.gov website and include links to the relevant web pages within the attribute table. Data about BRAC Superfund Sites are located on their own EPA web pages, and CIMC links to those pages. The CIMC web service
Under the Superfund Innovative Technology Evaluation or SITE Program, an evaluation was made of the Shirco Pilot-Scale Infrared Incineration System during 17 separate test runs under varying operating conditions. The tests were conducted at the Demode Road Superfund site in Ros...
... ENVIRONMENTAL PROTECTION AGENCY [CERCLA-04-2012-3763; FRL 9637-7] Anniston PCB Superfund Site... past response costs concerning the Anniston PCB Superfund Site located in Anniston, Calhoun County.... Submit your comments by Site name Anniston PCB by one of the following methods: www.epa.gov/region4...
...-2012- 3766; CERCLA-04-2012-3765] Florida Petroleum Reprocessors Superfund Site; Davie, Broward County... costs concerning the Florida Petroleum Reprocessors Superfund Site located in Davie, Broward County.... Painter. Submit your comments by Site name Florida Petroleum Reprocessors by one of the following methods...
... ENVIRONMENTAL PROTECTION AGENCY [FRL-9767-6; CERCLA-04-2012-3780] Ellman Battery Superfund Site; Orlando, Orange County, FL; Notice of Settlement AGENCY: Environmental Protection Agency (EPA). ACTION... Action at the Ellman Battery Superfund Site located in Orlando, Orange County, Florida. DATES: The Agency...
Pereira, Aline Garcia; Vergara, Lizandra Garcia Lupi; Merino, Eugenio Andrés Díaz; Wagner, Adriano
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.
Aline Garcia Pereira
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.
Pereira, Aline Garcia; Vergara, Lizandra Garcia Lupi; Merino, Eugenio Andrés Díaz; Wagner, Adriano
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
Kokkonen, Kaija; Rissanen, Sari; Hujala, Anneli
Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents. This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents. The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents. Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers' and policymakers' scientific literacy needs to be enhanced.
The Hazard Ranking System (HRS) training course is a four and ½ day, intermediate-level course designed for personnel who are required to compile, draft, and review preliminary assessments (PAs), site inspections (SIs), and HRS documentation records/packag
Krudys, Kevin; Li, Fang; Florian, Jeffry; Tornoe, Christoffer; Chen, Ying; Bhattaram, Atul; Jadhav, Pravin; Neal, Lauren; Wang, Yaning; Gobburu, Joga; Lee, Peter I D
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.
Roger E. Thomas
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.
Pihlainen, Vuokko; Kivinen, Tuula; Lammintakanen, Johanna
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.
Srinivasan, V.; Cohen, M.; Akudago, J.; Keith, D.; Palaniappan, M.
The diversity of water resources endowments and the societal arrangements to use, manage, and govern water makes defining a single paradigm or lens through which to define, prioritize and evaluate interventions in the water sector particularly challenging. Integrated Water Resources Management (IWRM) emerged as the dominant intervention paradigm for water sector interventions in the early 1990s. Since then, while many successful implementations of IWRM have been demonstrated at the local, basin, national and trans-national scales, IWRM has also been severely criticized by the global water community as "having a dubious record that has never been comprehensively analyzed", "curiously ambiguous", and "ineffective at best and counterproductive at worst". Does IWRM hold together as a coherent paradigm or is it a convenient buzzword to describe a diverse collection of water sector interventions? We analyzed 184 case study summaries of IWRM interventions on the Global Water Partnership (GWP) website. The case studies were assessed to find the nature, scale, objectives and outcomes of IWRM. The analysis does not suggest any coherence in IWRM as a paradigm - but does indicate distinct regional trends in IWRM. First, IWRM was done at very different scales in different regions. In Africa two-thirds of the IWRM interventions involved creating national or transnational organizations. In contrast, in Asia and South America, almost two-thirds were watershed, basin, or local body initiatives. Second, IWRM interventions involved very different types of activities in different regions. In Africa and Europe, IWRM entailed creation of policy documents, basin plans and institution building. In contrast, in Asia and Latin America the interventions were much more likely to entail new technology, infrastructure or watershed measures. In Australia, economic measures, new laws and enforcement mechanisms were more commonly used than anywhere else.
Ogundare, F O
The management of radioactive waste in Nigeria from early 1960 to date is reviewed. As in many developing countries, waste management in Nigeria has been shown to be ineffective. The factors that are responsible for this ineffectiveness are identified and discussed. The steps being taken by and the opportunities available to the newly established Nigerian Nuclear Regulatory Authority towards addressing this problem of ineffectiveness are discussed. The efforts of this newly set up body towards managing the resultant radioactive wastes that will be generated during the use of a reactor and an accelerator that will soon be commissioned in Nigeria are also mentioned. Likely ways of further addressing the problems militating against waste management in developing countries are suggested. (review)
Crockett, Matthew; Aherne, Emily; O'Reilly, Michael; Sugrue, Gavin; Cashman, James; Kavanagh, Eoin
Groin pain is a common symptom in athletes, particularly in sports requiring sudden changes in speed and direction and those involving kicking. Despite a high prevalence of groin pain in this patient cohort, the diagnosis and management of the underlying pathological processes remains a challenge for surgeons and radiologists alike. The aim of this paper is to review the imaging findings and management of the common pathological processes which produce groin pain in athletes. The anatomy of the groin region will be defined as a basis for further discussion. The common pathological processes underlying groin pain such as adductor dysfunction, rectus abdominus injury, osteitis pubis, and femuro-acetabular impingement will then be reviewed and correlating radiological imaging findings presented. Current management options will also be considered. This paper will aid surgeons and radiologists in navigating the challenging diagnostic and management dilemma of groin pain in athletes.
de Vet, Renée; van Luijtelaar, Maurice J. A.; Brilleslijper-Kater, Sonja N.; Vanderplasschen, Wouter; Beijersbergen, Mariëlle D.
We reviewed the literature on standard case management (SCM), intensive case management (ICM), assertive community treatment (ACT), and critical time intervention (CTI) for homeless adults. We searched databases for peer-reviewed English articles published from 1985 to 2011 and found 21 randomized controlled trials or quasi-experimental studies comparing case management to other services. We found little evidence for the effectiveness of ICM. SCM improved housing stability, reduced substance use, and removed employment barriers for substance users. ACT improved housing stability and was cost-effective for mentally ill and dually diagnosed persons. CTI showed promise for housing, psychopathology, and substance use and was cost-effective for mentally ill persons. More research is needed on how case management can most effectively support rapid-rehousing approaches to homelessness. PMID:23947309
Jada, Ajit; Mackel, Charles E; Hwang, Steven W; Samdani, Amer F; Stephen, James H; Bennett, James T; Baaj, Ali A
Adolescent idiopathic scoliosis (AIS) is a 3D spinal deformity affecting children between the ages of 11 and 18, without an identifiable etiology. The authors here reviewed the available literature to provide spine surgeons with a summary and update on current management options. Smaller thoracic and thoracolumbar curves can be managed conservatively with observation or bracing, but corrective surgery may be indicated for rapidly growing or larger curves. The authors summarize the atypical features to look for in patients who may warrant further investigation with MRI during diagnosis and review the fundamental principles of the surgical management of AIS. Patients with AIS can be managed very well with a combination of conservative and surgical options. Outcomes for these children are excellent with sustained longer-term results.
The McCormick and Baxter Creosoting Company, Portland Plant, Superfund Site is located adjacent tothe Willamette River in Portland, Oregon and addresses contamination of soil, groundwater, and riversediments stemming from creosoting operations...
Lock, P.J.; Wakerley, M.W.
Data on the nature, radioactive content and management options used for I-125 wastes that are produced in England and Wales and fall within the provisions of the Radioactive Substances Act 1960 have been collated. The options for, and impacts of the disposal of these wastes have been reviewed and discussed. In addition storage for decay has been reviewed. The necessary storage requirements and methods of storage for the various waste forms have been examined. Conclusions are drawn with respect to the potential/suitability of the various waste management options. (author)
Wreathall, J.; Schurman, D.; Modarres, M.; Mosleh, A.; Anderson, N.; Reason, J.
The purpose of this project is to develop a methodology for amalgamating performance indicators to provide an overall perspective on plant safety, as one input to Nuclear Regulatory Commission's (NRC) senior management reviews of plant safety. These reviews are used to adjust the level of oversight by NRC. Work completed to date includes the development of frameworks for relating indicator measures to safety, a classification scheme for performance indicators, and a mapping process to portray indicators in the frameworks
Irma Elia Damian
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.
There is obvious need to have the safest working environments and the best quality of health care delivery to patients by nurses working in the hospitals. Effective stress management and coping strategies is one very important step towards this goal. This research aims to identify the major stressors for nurses and the most effective management and coping strategies as contained in literature. This involved excellent review of relevant articles in addition to deductive content analysis of the...
... DEPARTMENT OF THE TREASURY 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...
... DEPARTMENT OF THE TREASURY 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...
Background Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents. Methods This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents. Results The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents. Conclusions Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers’ and policymakers’ scientific literacy needs to be enhanced. PMID:23137416
Full Text Available Abstract Background Elderly care practice and its management together with policy and research play a crucial role in responding to increasing challenges in institutional care for elderly people. Successful dialogue between these is necessary. The purpose of this systematic literature review is to compare how institutional elderly care management research meets the care challenges currently emphasized in international long-term care policy documents. Methods This paper was based on a systematic literature review. After screening 1971 abstracts using inclusion/exclusion criteria, 58 refereed articles published between 2000 and 2010 remained for analysis. The articles were analyzed using theory-based content analysis by comparing the results to the framework based on analysis of international long-term care management policy documents. Results The current challenges of long-term care management identified from policy documents were Integrated Care Management, Productivity Management, Quality Management, Workforce Management and ICT Management. The research on institutional elderly care management responded somewhat to the challenges mentioned in policy documents. However, some of the challenges were studied broadly and some were paid only minor attention. Further, only few studies focused on the core items of challenges addressed in policy documents. Conclusions Institutional care management research needs to focus more on challenges in integrated care, productivity, ICT and division of labor. Managers, researchers and policy-makers should assume more active collaborative roles in processes of research, policymaking and policy implementation. In addition managers’ and policymakers’ scientific literacy needs to be enhanced.
Walker, Marjorie M; Ludvigsson, Jonas F; Sanders, David S
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.
Higgins, Angela; O'Halloran, Peter; Porter, Sam
The increasing impact and costs of long term sickness absence have been well documented. However, the diversity and complexity of interventions and of the contexts in which these take place makes a traditional review problematic. Therefore, we undertook a systematic realist review to identify the dominant programme theories underlying best practice, to assess the evidence for these theories, and to throw light on important enabling or disabling contextual factors. A search of the scholarly literature from 1950 to 2011 identified 5,576 articles, of which 269 formed the basis of the review. We found that the dominant programme theories in relation to effective management related to: early intervention or referral by employers; having proactive organisational procedures; good communication and cooperation between stakeholders; and workplace-based occupational rehabilitation. Significant contextual factors were identified as the level of support for interventions from top management, the size and structure of the organisation, the level of financial and organisational investment in the management of long-term sickness absence, and the quality of relationships between managers and staff. Consequently, those with responsibility for managing absence should bear in mind the contextual factors that are likely to have an impact on interventions, and do what they can to ensure stakeholders have at least a mutual understanding (if not a common purpose) in relation to their perceptions of interventions, goals, culture and practice in the management of long term sickness absence.
Lowry, Glenn R.
The derivation of the concept of participative management from a variety of complementary managerial and motivational theories, and its acceptance and use as a managerial technique in library administration are reviewed in detail. The major contributions to the development of the concept of participative management, including Maslow's hierarchy of…
The European Union of Medical Specialists, founded in 1958, is the largest and oldest european medical organization. It includes 39 member states (of the European Union and others), and represents a total of 1.600.000 medical specialists. The main objective of the UEMS is to influence european healthcare politics by promoting the interests of the european medical specialists, establishing high standards in practice and training, as well as continuing medical education and professional development, and guaranteeing quality in specialist practice. The UEMS is developing several projects to face current and future challenges related to surgical training, education, acreditation, revalidation and professional development: i.- First, the UEMS is developing homogeneous requisites for European Training (ETRs), ii.- To manage the quality control process of the ETRs and evaluation of the organization, the UEMS has created the Council of european specialized medial evaluations (CESMA), iii.- The UEMS has been greatly involved in the acreditation process of training centres in all of Europe, iv.- in relation to continuing medical education, the European Accreditation Council for Continuing Medical Education (EACCME) is the main project of the UEMS for the accreditation of educational events and v.- the UEMS has established the Network of Accredited Clinical Skills Centres of Europe (UEMS-NASCE), that facilitates the accreditation and cooperation of training centres in Europe. In conclusion, with the great support of National Surgical Societies of the UEMS and the Surgery Section a series of solid projects have been established to support the professional development of the collective in Europe. This process constitutes a continuous effort that is very gratifying, with the aim to set the standards for a brilliant future for surgery students and specialized surgeons. Copyright © 2017. Publicado por Elsevier España, S.L.U.
This draft report is one of several prepared under contract to the Massachusetts Ocean Partnership (MOP) to support the Massachusetts Executive Office of Energy and Environmental Affairs (EOEEA) in its development of the integrated coastal ocean management plan mandated by the Massachusetts Oceans Act of 2008. The purpose of this report was to inventory and review ocean management and integrated resource management programs from around the world, including the United States, Europe, Australia...
Hanley Nadeau, Ellen; Toronto, Coleen E
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 the school setting. Findings revealed multiple barriers school nurses encounter in managing asthma. Six themes emerged that included lack of resources and support, insufficient time, communication challenges, limited knowledge, and lack of awareness of school nurses' expertise. Students, parents, primary care physicians, school administration, staff, and school nurses themselves all play a role in constructing barriers to asthma management. There is a need for school nurses and school nurse leaders to focus efforts to develop strategies to overcome barriers to ensure evidence-based, best practice management of asthma in the school setting. © The Author(s) 2015.
Rocha, Elyrose Sousa Brito; Nagliate, Patricia; Furlan, Claudia Elisangela Bis; Rocha, Kerson; Trevizan, Maria Auxiliadora; Mendes, Isabel Amélia Costa
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%).
Experiments comparing different systems of grazing management on natural pastures in various parts of the world are reviewed. In experiments in which various rotational systems were tested against continuous grazing, fewer than half revealed pasture improvement relative to continuous grazing. In the majority of ...
De Raad, B; Kokkonen, M
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
Abidi, H.; de Leeuw, S.L.J.M.; Klumpp, M.
Design/methodology/approach - A literature review has been conducted using a structured method based on Denyer and Tranfield (2009) and Rousseau et al. (2008). The state of the art on humanitarian supply chain performance management with a focus on measurement frameworks and indicators and their
Research in South African temporarily open/closed estuaries that includes studies on the hydrodynamics, sediment dynamics, macronutrients, microalgae, macrophytes, zoobenthos, hyperbenthos, zooplankton, ichthyoplankton, fishes and birds is used as a basis to review the ecology and management of this estuary type ...
Urethral stricture management is a challenging surgery. Multiplicity of techniques means that none of them is ideal. No single technique is appropriate for all situations and the successful surgeon should have a store of operations to choose from according to each specific case. This review aims to provide an update on the ...
Broek, A.M. van den; Feenstra, L.; Baat, C. de
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
Papanthymou, Anastasia; Darra, Maria
This paper is a review which presents a summary of 52 studies from 2006 to 2016 in Quality Management (QM) within Higher Education Institutes (HEIs). The aim of this paper is to submit evidence regarding the level of QM in HEIs, particularly in developing countries, and also to enhance the research in the field of QM. The findings reveal that from…
Contreras, Ivan; Vehi, Josep
Artificial intelligence methods in combination with the latest technologies, including medical devices, mobile computing, and sensor technologies, have the potential to enable the creation and delivery of better management services to deal with chronic diseases. One of the most lethal and prevalent chronic diseases is diabetes mellitus, which is characterized by dysfunction of glucose homeostasis. The objective of this paper is to review recent efforts to use artificial intelligence techniques to assist in the management of diabetes, along with the associated challenges. A review of the literature was conducted using PubMed and related bibliographic resources. Analyses of the literature from 2010 to 2018 yielded 1849 pertinent articles, of which we selected 141 for detailed review. We propose a functional taxonomy for diabetes management and artificial intelligence. Additionally, a detailed analysis of each subject category was performed using related key outcomes. This approach revealed that the experiments and studies reviewed yielded encouraging results. We obtained evidence of an acceleration of research activity aimed at developing artificial intelligence-powered tools for prediction and prevention of complications associated with diabetes. Our results indicate that artificial intelligence methods are being progressively established as suitable for use in clinical daily practice, as well as for the self-management of diabetes. Consequently, these methods provide powerful tools for improving patients' quality of life. ©Ivan Contreras, Josep Vehi. Originally published in the Journal of Medical Internet Research (http://www.jmir.org), 30.05.2018.
Information on the current status of reproduction and gamete management of the African Catfish, Clarias gariepinus (Burchell) a highly appreciated culturable fish species in Nigeria were reviewed. Natural and artificial reproductive behaviour as well as gonadal maturation rhythm in the highly fecund fish were documented.
Wilson, Bridget H; Nelson, Jessica
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.
Vanessa Lin Lin Lee
Full Text Available Metabolic epilepsy is a metabolic abnormality which is associated with an increased risk of epilepsy development in affected individuals. Commonly used antiepileptic drugs are typically ineffective against metabolic epilepsy as they do not address its root cause. Presently, there is no review available which summarizes all the treatment options for metabolic epilepsy. Thus, we systematically reviewed literature which reported on the treatment, therapy and management of metabolic epilepsy from four databases, namely PubMed, Springer, Scopus and ScienceDirect. After applying our inclusion and exclusion criteria as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines, we reviewed a total of 43 articles. Based on the reviewed articles, we summarized the methods used for the treatment, therapy and management of metabolic epilepsy. These methods were tailored to address the root causes of the metabolic disturbances rather than targeting the epilepsy phenotype alone. Diet modification and dietary supplementation, alone or in combination with antiepileptic drugs, are used in tackling the different types of metabolic epilepsy. Identification, treatment, therapy and management of the underlying metabolic derangements can improve behavior, cognitive function and reduce seizure frequency and/or severity in patients.
Managing a nuclear plant might well be the toughest industrial job in the United States today. Everyday, nuclear plant managers must deal with the twin concerns of producing megawatts reliably and protecting the safety of the plant personnel and the public. A nuclear plant manager must possess a combination of special technical and managerial skills to do his job well. He also must be supported fully and actively by his utility's corporate management and organization. For more than five years, INPO teams have observed nuclear plant performance and on-site management. For nearly three years, we have been looking at corporate management support. The authors review the results of these plant and corporate evaluations from a management standpoint. More specifically, they look at two areas: One, how and why INPO evaluates plant performance and plant and corporate management, and two, what INPO evaluators have been during these evaluations. Or, to put it another way, what are the characteristics of good management at the best plants we've visited, and what are the areas for improvement that INPO sees most often
Renault Berenger Y.
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.
Choi, Mona; Yang, You Lee; Lee, Sun-Mi
The purpose of this study was to review evaluation studies of nursing management information systems (NMISs) and their outcome measures to examine system effectiveness. For the systematic review, a literature search of the PubMed, CINAHL, Embase, and Cochrane Library databases was conducted to retrieve original articles published between 1970 and 2014. Medical Subject Headings (MeSH) terms included informatics, medical informatics, nursing informatics, medical informatics application, and management information systems for information systems and evaluation studies and nursing evaluation research for evaluation research. Additionally, manag(*) and admin(*), and nurs(*) were combined. Title, abstract, and full-text reviews were completed by two reviewers. And then, year, author, type of management system, study purpose, study design, data source, system users, study subjects, and outcomes were extracted from the selected articles. The quality and risk of bias of the studies that were finally selected were assessed with the Risk of Bias Assessment Tool for Non-randomized Studies (RoBANS) criteria. Out of the 2,257 retrieved articles, a total of six articles were selected. These included two scheduling programs, two nursing cost-related programs, and two patient care management programs. For the outcome measurements, usefulness, time saving, satisfaction, cost, attitude, usability, data quality/completeness/accuracy, and personnel work patterns were included. User satisfaction, time saving, and usefulness mostly showed positive findings. The study results suggest that NMISs were effective in time saving and useful in nursing care. Because there was a lack of quality in the reviewed studies, well-designed research, such as randomized controlled trials, should be conducted to more objectively evaluate the effectiveness of NMISs.
Jacelon, Cynthia S; Gibbs, Molly A; Ridgway, John Ve
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.
Loa, W.W.; Chen, S.; Yu, W.C.; Peng, C.M.; Huang, C.L.; Lin, C.
Regulations on radioactive waste disposal are now in urgent need due to our increasing consumption of electric power from nuclear origin. It is set forth that actually applying the regulations to evaluate the license application of new repositories for interim storage and final disposal fo High-Level Waste and Low-Level Waste before the year of 2000. In the mean time, it is expected to establish the basis for the decision on issuing the license. The license review procedure can be very complicated because too many factors must be taken into consideration. However, to maintain a more efficient, accurate, and systematic review procedure, and at the same time to reduce costs, the Artificial Intelligence (AI) techniques may be used. An expert system is designed as a radioactive waste management licensing review aid for the staff those are in charge of the license application. Tasks such as completeness checking, functional areas of review distribution, participation confirmation, knowledge acquisition, review comment collection, weighting calculation, and degree of satisfaction are considered. In this paper the authors will discuss the development of the radioactive waste management licensing review assistant
King, Jennifer Renae; Lachica, Ruben; Lee, Richard H; Montoro, Martin; Mestman, Jorge
Hyperthyroidism has important implications for pregnancy, affecting both mother and fetus. Appropriate maternal and fetal management iscritical to avoiding adverse pregnancy outcomes and requires a multidisciplinary approach. To describe maternal diagnosis and management of hyperthyroidism, across all stages of pregnancy. In addition, to review clinical signs of fetal thyroid dysfunction due to maternal Graves disease and discuss management considerations. Review of published articles on PubMed and guidelines by recognized governing organizations regarding the diagnostic and management considerations for hyperthyroidism in pregnancy, from preconception to the postpartum period. Diagnosis of maternal hyperthyroidism involves both clinical symptoms and laboratory findings. Antithyroid medications are the mainstay of therapy, with trimester-specific pregnancy goals. Hyperthyroidism due to Graves disease has important diagnostic and management considerations for the fetus and neonate. Hyperthyroidism in pregnancy affects mother, fetus, and neonate. Interpretation of thyroid tests and understanding the appropriate use of antithyroid drugs are fundamental. Proper education of physicians providing care to women with hyperthyroidism is essential and starts before pregnancy. Postpartum follow-up is an essential part of the care. A systematic approach to management will ensure optimal pregnancy outcomes.
Christmann, Corinna A; Bleser, Gabriele
Background 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. Objective 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. Methods 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. Results 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). Conclusions 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. PMID:28592397
Alzahem, Abdullah M; Van der Molen, Henk T; Alaujan, Arwa H; De Boer, Benjamin J
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. PMID:24904226
Vaillant, Ludovic; Bataille, Céline
This article proposes a review of past and current ICRP publications dealing with the management of radon exposures. Its main objective is to identify and discuss the driving factors that have been used by the Commission during the last 50 years so as to better appreciate current issues regarding radon exposure management. The analysis shows that major evolutions took place in very recent years. As far as the management of radon exposures is concerned, ICRP recommended, until ICRP Publication 103 (ICRP 2007 ICRP Publication 103; Ann. ICRP 37), to use action levels and to consider only exposures above these levels. The Commission has reviewed its approach and now proposes to manage any radon exposure through the application of the optimisation principle and associated reference levels. As far as the assessment of the radon risk is concerned, it appears that the successive changes made by ICRP did not have a strong impact on the values of radon gas concentration recommended as action levels either in dwellings or in workplaces. The major change occurred in late 2009 with the publication of the ICRP Statement on Radon, which acknowledged that the radon risk has been underestimated by a factor of 2, thus inducing a major revision of radon reference levels. (review)
Albana Berisha Qehaja
Full Text Available This paper is one of the few studies to review the empirical literature on strategic management tools and techniques usage. There are many techniques, tools and methods, models, frameworks, approaches and methodologies, available to support strategic managers in decision making. They are developed and designed to support managers in all stages of strategic management process to achieve better performance. Management schools provide knowledge of these tools. But their use in organizations should be seen in practice‑based context. Consequently, some questions arise: Do they use these strategic tools and techniques in their workplace? Which strategic tools and techniques are used more in organizations? To answer these questions we have made a review of empirical studies using textual narrative synthesis method. Initially, this study presents a tabulation with a summary of empirical research for the period 1990–2015. The included studies are organized clustering them by enterprise size and sector and by country level development. A synopsis of the ten most used strategic tools and techniques worldwide resulted as follows: SWOT analysis, benchmarking, PEST analysis, “what if” analysis, vision and mission statements, Porter’s five forces analysis, business financial analysis, key success factors analysis, cost‑benefit analysis and customer satisfaction.
Guntzburger, Yoann; Pauchant, Thierry C; Tanguy, Philippe A
Risk management is certainly one of the most important professional responsibilities of an engineer. As such, this activity needs to be combined with complex ethical reflections, and this requirement should therefore be explicitly integrated in engineering education. In this article, we analyse how this nexus between ethics and risk management is expressed in the engineering education research literature. It was done by reviewing 135 articles published between 1980 and March 1, 2016. These articles have been selected from 21 major journals that specialize in engineering education, engineering ethics and ethics education. Our review suggests that risk management is mostly used as an anecdote or an example when addressing ethics issues in engineering education. Further, it is perceived as an ethical duty or requirement, achieved through rational and technical methods. However, a small number of publications do offer some critical analyses of ethics education in engineering and their implications for ethical risk and safety management. Therefore, we argue in this article that the link between risk management and ethics should be further developed in engineering education in order to promote the progressive change toward more socially and environmentally responsible engineering practices. Several research trends and issues are also identified and discussed in order to support the engineering education community in this project.
Nascimento, Luciana da Silva; de Gutierrez, Maria Gaby Rivero; De Domenico, Edvane Birelo Lopes
The objective was to identify definitions and/or explanations of the term self-management in educative programs that aim its development. The authors also aimed to describe the educative plans and results of the educative programs analyzed. As a methodology we used integrative review, with 15 published articles (2002 the 2007). The inclusion criteria was: the occurrence of the term self-management; the existence of an educative program for the development of self-management; to be related to the area of the health of the adult. Self-management means the improvement or acquisition of abilities to solve problems in biological, social and affective scopes. The review pointed to different educational methodologies. However, it also showed the predominance of traditional methods, with conceptual contents and of physiopathological nature. The learning was evaluated as favorable, with warns in relation to the application in different populations and contexts and to the increase of costs of the educative intervention. It was concluded that research has evidenced the importance of the education for self-management, but lacked in strength for not relating the biopsychosocial demands of the chronic patient and for not describing in detail the teaching and evaluation methodologies employed.
Hulburt, D.A.; Berkey, B.D.
The US Department of Energy has issued an Order, DOE 5481.1, which establishes uniform requirements for the preparation and review of Safety Analysis for DOE Operations. The Management Implementation Plan specified herein establishes the administrative procedures and technical requirements for implementing DOE 5481.1 to Operations under the cognizance of the Pittsburgh Energy Technology Center. This Implementation Plan is applicable to all present and future Operations under the cognizance of PETC. The Plan identifies those Operations for which DOE 5481.1 is applicable and those Operations for which no further analysis is required because the initial determination and review has concluded that DOE 5481.1 does not apply
Pirani, Sanaa I; Arafat, Hassan A
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.
Carr, G.; BlöSchl, G.; Loucks, D. P.
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.
Ali, Faheem; Boks, Casper; Bey, Niki
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...... of development and implementation of design for sustainability tools.......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...
Rikhardsson, Pall M.; Rohde, C.; Rom, A.
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...... done so far primarily addresses the relationship between management control and ES based on a limited number of methodologies and approaches. We argue that there seems to be a need for more research done from functionalistic and critical perspectives, as well which employs a greater variety...
Gieringer, Matthias; Gosepath, Jan; Naim, Ramin
Radiation therapy is a major therapeutic modality in the management of cancer patients. Over 60% of these patients receive radiotherapy at some point during their course of treatment and over 90% will develop skin reactions after therapy. Problematic wound healing in radiation-damaged tissue constitutes a major surgical difficulty and despite all efforts, irradiated skin remains a therapeutic challenge. This review provides an overview of the fundamental principles of radiation therapy with regards to the wound healing in normal and irradiated skin. Furthermore, it presents techniques that describe how to prevent and manage skin side effects as well as prospects that may improve cutaneous wound repair in general and in irradiated skin.
Anandan Sundaram Shanmuga
Full Text Available Due to rapid growth in semiconductor technology, there is a continuous increase of the system power and the shrinkage of size. This resulted in inevitable challenges in the field of thermal management of electronics to maintain the desirable operating temperature. The present paper reviews the literature dealing with various aspects of cooling methods. Included are papers on experimental work on analyzing cooling technique and its stability, numerical modeling, natural convection, and advanced cooling methods. The issues of thermal management of electronics, development of new effective cooling schemes by using advanced materials and manufacturing methods are also enumerated in this paper. .
Ian O’ Boyle
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.
The report presents a concise summary of the Programme of Radioactive Waste Management Research carried out by the Agency in the period 1996 to 2001. It not only provides information, which is relevant to the Agency's responsibilities, but also offers an input to the government's development of a policy for managing solid radioactive waste in the UK. The research projects have included laboratory and field scientific studies, reviews of existing scientific data and understanding, development of assessment methodologies, and development of technical support software and databases. The Agency has participated widely in internationally-supported projects and on jointly-funded projects amongst UK regulators, advisory bodies and industry
Garcia Nunez, Hernan
International guidelines for management of basal cell carcinoma are reviewed and analyzed for decision-making in the appropriate therapeutic behavior for patients. The different therapies for the treatment of basal cell carcinoma are described. Different therapies are evaluated according to the risk (low or high) of recurrence to determine the appropriate treatment. According to the evidence, low-risk tumors have responded to topical therapy, curettage and electrodesiccation, cryotherapy or simple resection, and high-risk tumors are managed with surgery, radiotherapy or Mohs' micrographic surgery [es
Pérez-Salazar, María del Rosario; Lasserre, Alberto Alfonso Aguilar; Cedillo-Campos, Miguel Gastón; González, José Carlos Hernández
The aim of this paper is to examine the state of knowledge management research in supply chain management from three standpoints, methodological approach, supply chain management area, and knowledge management processes. Design/methodology/approach: To achieve this, a systematic review is conducted over the period 2000-2014 on the basis of a qualitative content analysis. Findings: Major results showed that knowledge management can be viewed as a leverage mechanism for: (i) supply chain integration; (ii) the enhancement of intra and inter-relations across the supply chain; (iii) supply chain strategy alignment; and (iv) the reinforcement of knowledge transfer in product development. Some supply chain management areas such as reverse logistics, inventory management, forecasting/demand planning, outsourcing, and risk management have been explored only to some extent. Furthermore, knowledge transfer is being studied in the majority of the articles, mainly by both case study and survey approach; mathematical models and simulation techniques are used in very limited articles. Findings concerning theoretical perspectives and managerial issues are also described. Research limitations/implications: The limitation of our study encompasses the aspects of search period (2000-2014), selection of search databases (Web of Science and SCOPUS and language selection (English). Practical implications: The exhibition of the KM processes within the SC context may help practitioners and managers interested in implementing KM initiatives to replicate the methodologies in order to increase the possibilities of a successful KM adoption. Originality/value: The systematic review will contribute to the understanding of the present state of research in the knowledge management theory, with focus on the supply chain, as there are no state-of-knowledge studies that report a systematic literature review approach.
Pérez-Salazar, María del Rosario; Lasserre, Alberto Alfonso Aguilar; Cedillo-Campos, Miguel Gastón; González, José Carlos Hernández
The aim of this paper is to examine the state of knowledge management research in supply chain management from three standpoints, methodological approach, supply chain management area, and knowledge management processes. Design/methodology/approach: To achieve this, a systematic review is conducted over the period 2000-2014 on the basis of a qualitative content analysis. Findings: Major results showed that knowledge management can be viewed as a leverage mechanism for: (i) supply chain integration; (ii) the enhancement of intra and inter-relations across the supply chain; (iii) supply chain strategy alignment; and (iv) the reinforcement of knowledge transfer in product development. Some supply chain management areas such as reverse logistics, inventory management, forecasting/demand planning, outsourcing, and risk management have been explored only to some extent. Furthermore, knowledge transfer is being studied in the majority of the articles, mainly by both case study and survey approach; mathematical models and simulation techniques are used in very limited articles. Findings concerning theoretical perspectives and managerial issues are also described. Research limitations/implications: The limitation of our study encompasses the aspects of search period (2000-2014), selection of search databases (Web of Science and SCOPUS and language selection (English). Practical implications: The exhibition of the KM processes within the SC context may help practitioners and managers interested in implementing KM initiatives to replicate the methodologies in order to increase the possibilities of a successful KM adoption. Originality/value: The systematic review will contribute to the understanding of the present state of research in the knowledge management theory, with focus on the supply chain, as there are no state-of-knowledge studies that report a systematic literature review approach.
María del Rosario Pérez-Salazar
Full Text Available Purpose: The aim of this paper is to examine the state of knowledge management research in supply chain management from three standpoints, methodological approach, supply chain management area, and knowledge management processes. Design/methodology/approach: To achieve this, a systematic review is conducted over the period 2000-2014 on the basis of a qualitative content analysis. Findings: Major results showed that knowledge management can be viewed as a leverage mechanism for: (i supply chain integration; (ii the enhancement of intra and inter-relations across the supply chain; (iii supply chain strategy alignment; and (iv the reinforcement of knowledge transfer in product development. Some supply chain management areas such as reverse logistics, inventory management, forecasting/demand planning, outsourcing, and risk management have been explored only to some extent. Furthermore, knowledge transfer is being studied in the majority of the articles, mainly by both case study and survey approach; mathematical models and simulation techniques are used in very limited articles. Findings concerning theoretical perspectives and managerial issues are also described. Research limitations/implications: The limitation of our study encompasses the aspects of search period (2000-2014, selection of search databases (Web of Science and SCOPUS and language selection (English. Practical implications: The exhibition of the KM processes within the SC context may help practitioners and managers interested in implementing KM initiatives to replicate the methodologies in order to increase the possibilities of a successful KM adoption. Originality/value: The systematic review will contribute to the understanding of the present state of research in the knowledge management theory, with focus on the supply chain, as there are no state-of-knowledge studies that report a systematic literature review approach.
This fact sheet summarizes key aspects of effective management for operating pump and treat (P&T) systems based on lessons learned from conducting optimization evaluations at 20 Superfund-financed P&T systems.
Section 70.58, ''Fundamental Nuclear Material Controls,'' of 10 CFR Part 70, ''Special Nuclear Materials,'' requires, in paragraph 70.58(c), that certain licensees authorized to possess more than one effective kilogram of special nuclear material establish a management system to provide for the development, revision, implementation, and enforcement of nuclear material control and accounting procedures. Such a system must provide for a review of the nuclear material control system at least every 12 months. This guide describes the purpose and scope, personnel qualifications, depth of detail, and procedures that are acceptable to the NRC staff for the management review of nuclear material control systems required under paragraph 70.58(c) of 10 CFR Part 70. (U.S.)
Iwamuro, Masaya; Okada, Hiroyuki; Matsueda, Kazuhiro; Inaba, Tomoki; Kusumoto, Chiaki; Imagawa, Atsushi; Yamamoto, Kazuhide
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. PMID:25901212
Greenwood, Deborah A; Gee, Perry M; Fatkin, Kathy J; Peeples, Malinda
Since the introduction of mobile phones, technology has been increasingly used to enable diabetes self-management education and support. This timely systematic review summarizes how currently available technology impacts outcomes for people living with diabetes. A systematic review of high quality review articles and meta analyses focused on utilizing technology in diabetes self-management education and support services was conducted. Articles were included if published between January 2013 and January 2017. Twenty-five studies were included for analysis. The majority evaluated the use of mobile phones and secure messaging. Most studies described healthy eating, being active and metabolic monitoring as the predominant self-care behaviors evaluated. Eighteen of 25 reviews reported significant reduction in A1c as an outcome measure. Four key elements emerged as essential for improved A1c: (1) communication, (2) patient-generated health data, (3) education, and (4) feedback. Technology-enabled diabetes self-management solutions significantly improve A1c. The most effective interventions incorporated all the components of a technology-enabled self-management feedback loop that connected people with diabetes and their health care team using 2-way communication, analyzed patient-generated health data, tailored education, and individualized feedback. The evidence from this systematic review indicates that organizations, policy makers and payers should consider integrating these solutions in the design of diabetes self-management education and support services for population health and value-based care models. With the widespread adoption of mobile phones, digital health solutions that incorporate evidence-based, behaviorally designed interventions can improve the reach and access to diabetes self-management education and ongoing support.
Preeti Devnani; Racheal Fernandes
Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment behavior resulting from a loss of REM skeletal muscle atonia. The neurobiology of REM sleep and the characteristic features of REM atonia have an important basis for understanding the aggravating etiologies the proposed pharmacological interventions in its management. This review outlines the evidence for behavioral and therapeutic measures along with evidence-based guidelines for their implementation, ...
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.
No Abstract Available LBS Management Review Vol.4(2) 1999: 135-147. Full Text: EMAIL FULL TEXT EMAIL FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT · http://dx.doi.org/10.4314/lbsmr.v4i2.24462 · AJOL African Journals Online. HOW TO USE AJOL... for Researchers · for Librarians · for Authors ...
Katy Cooper, PhD
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.
BRADY RAAP, M.C.
This document provides the results of an internal management review of the Tank Waste Remediation System (TWRS) criticality safety program, performed in advance of the DOE/RL assessment for closure of the TWRS Nuclear Criticality Safety Issue, March 1994. Resolution of the safety issue was identified as Hanford Federal Facility Agreement and Consent Order (Tri-Party Agreement) Milestone M-40-12, due September 1999
Mendenhall, William M.; Friedman, William A.; Amdur, Robert J.; Foote, Kelly D.
The optimal management of benign meningiomas of the skull base is reviewed. Elderly patients with small, asymptomatic tumors can be observed and treatment can be initiated if and when progression occurs. Patients with tumors that appear to be amenable to complete resection with an acceptable rate of morbidity are optimally treated with surgery. Decompression of more extensive tumors through conservative subtotal resection and preservation of the involved cranial nerves may result in improved ...
Kapoor, A.; Kumar, H.S.; Beniwal, V.; Beniwal, S.; Mathur, H.
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
Sustainability has become a subject of increasing concern to academics and practitioners in recent years. Increasing demand for environmentally and socially responsible products and services encouraged supply chains to put increasing emphasis on sustainability. The purpose of this paper is to review research in Sustainable Supply Chain Management (SSCM) and to identify gaps in the current body of knowledge. Future research directions are also provided which may help to stimulate more intensiv...
Chafen, Jennifer J Schneider; Newberry, Sydne J; Riedl, Marc A; Bravata, Dena M; Maglione, Margaret; Suttorp, Marika J; Sundaram, Vandana; Paige, Neil M; Towfigh, Ali; Hulley, Benjamin J; Shekelle, Paul G
There is heightened interest in food allergies but no clear consensus exists regarding the prevalence or most effective diagnostic and management approaches to food allergies. To perform a systematic review of the available evidence on the prevalence, diagnosis, management, and prevention of food allergies. Electronic searches of PubMed, Cochrane Database of Systematic Reviews, Cochrane Database of Abstracts of Reviews of Effects, and Cochrane Central Register of Controlled Trials. Searches were limited to English-language articles indexed between January 1988 and September 2009. Diagnostic tests were included if they had a prospective, defined study population, used food challenge as a criterion standard, and reported sufficient data to calculate sensitivity and specificity. Systematic reviews and randomized controlled trials (RCTs) for management and prevention outcomes were also used. For foods where anaphylaxis is common, cohort studies with a sample size of more than 100 participants were included. Two investigators independently reviewed all titles and abstracts to identify potentially relevant articles and resolved discrepancies by repeated review and discussion. Quality of systematic reviews and meta-analyses was assessed using the AMSTAR criteria, the quality of diagnostic studies using the QUADAS criteria most relevant to food allergy, and the quality of RCTs using the Jadad criteria. A total of 12,378 citations were identified and 72 citations were included. Food allergy affects more than 1% to 2% but less than 10% of the population. It is unclear if the prevalence of food allergies is increasing. Summary receiver operating characteristic curves comparing skin prick tests (area under the curve [AUC], 0.87; 95% confidence interval [CI], 0.81-0.93) and serum food-specific IgE (AUC, 0.84; 95% CI, 0.78-0.91) to food challenge showed no statistical superiority for either test. Elimination diets are the mainstay of therapy but have been rarely studied
Baaki Timothy Kurannen
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
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.
Ali, Mustafa; Wang, Wenping; Chaudhry, Nawaz; Geng, Yong
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.
Rosko, Andrew J; Vankoevering, Kyle K; McLean, Scott A; Johnson, Timothy M; Moyer, Jeffrey S
The incidence of melanoma is increasing, with 76 380 new cases of invasive melanoma and 68 480 new cases of melanoma in situ expected in 2016. To review the contemporary management of early-stage melanoma. We searched PubMed, MEDLINE, and the Cochrane Database of Systematic Reviews databases from January 1, 2011, to May 1, 2016, yielding 966 articles. We focused our search on early-stage (melanoma in situ, stage I, and stage II) cutaneous melanoma. After excluding articles, 41 articles were manually reviewed. A review of the bibliographies of selected articles generated additional references. While the majority of recent advances have been in the treatment of advanced melanoma, surgical excision with margins based on the presence and depth of invasion continues to be the cornerstone of management. Sentinel lymph node biopsy plays a central role in the staging and treatment of melanoma. Accurate diagnosis and adequate surgical excision are critical in reducing local recurrences and improving outcomes. Sentinel lymph node biopsy is useful in staging the regional nodal basin and guiding treatment in appropriately selected patients.
Maria Jose Marques
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.
Full Text Available The last two decades food logistics systems have seen the transition from a focus on traditional supply chain management to food supply chain management, and successively, to sustainable food supply chain management. The main aim of this study is to identify key logistical aims in these three phases and analyse currently available quantitative models to point out modelling challenges in sustainable food logistics management (SFLM. A literature review on quantitative studies is conducted and also qualitative studies are consulted to understand the key logistical aims more clearly and to identify relevant system scope issues. Results show that research on SFLM has been progressively developing according to the needs of the food industry. However, the intrinsic characteristics of food products and processes have not yet been handled properly in the identified studies. The majority of the works reviewed have not contemplated on sustainability problems, apart from a few recent studies. Therefore, the study concludes that new and advanced quantitative models are needed that take specific SFLM requirements from practice into consideration to support business decisions and capture food supply chain dynamics.
Bentz, E.J. Jr.; Bentz, C.B.; O'Hora, T.D.; Chen, S.Y.
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
Tawfic, Qutaiba A
Ketamine is a noncompetitive antagonist of N-methyl-d-aspartate receptor. It has been widely used in anesthesia and pain management. Ketamine has been administered via the intravenous, intramuscular, subcutaneous, oral, rectal, topical, intranasal, sublingual, epidural, and caudal routes. Ketamine improves postoperative and posttrauma pain scores and reduces opioid consumption. It has special indication for patients with opioid tolerance, acute hyperalgesia, and neuropathic pain. It also has a role in the management of chronic pain including both cancer and noncancer pain. Recreational use of ketamine is increasing as well through different routes of administration like inhalation, smoking, or intravenous injection. Long-time exposure to ketamine, especially in the abusers, may lead to serious side effects. This review is trying to define the role of ketamine in pain management.
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
Gil, C.S.; Glinatsis, G.; Hesketh, K.; Iwamoto, O.; Okajima, S.; Tsujimoto, K.; Jacqmin, R.; Khomyakov, Y.; Kochetkov, A.; Kormilitsyn, M.; Palmiotti, G.; Salvatores, M.; Perret, G.; Rineiski, A.; Romanello, V.; Sweet, D.
Spent nuclear fuel contains minor actinides (MAs) such as neptunium, americium and curium, which require careful management. This becomes even more important when mixed oxide (MOX) fuel is being used on a large scale since more MAs will accumulate in the spent fuel. One way to manage these MAs is to transmute them in nuclear reactors, including in light water reactors, fast reactors or accelerator-driven subcritical systems. The transmutation of MAs, however, is not straightforward, as the loading of MAs generally affects physics parameters, such as coolant void, Doppler and burn-up reactivity. This report focuses on nuclear data requirements for minor actinide management, the review of existing integral data and the determination of required experimental work, the identification of bottlenecks and possible solutions, and the recommendation of an action programme for international co-operation. (authors)
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.
A review of game theory approach to cyber security risk management. ... This paper presents a review of game theoretic-based model for cyber security risk management. Specifically, issues on ... AJOL African Journals Online. HOW TO USE ...
Memorandum recommends strategies to encourage PRPs to enter into a settlement using the model RD/RA Consent Decree; discusses the current model UAO; and suggests practical alternatives to expedite Superfund settlements and the cleanup process.
EPA released the list of Superfund sites that Administrator Pruitt has targeted for intense and immediate attention, including the Quendall Terminals Site, a former creosote facility on the shore of Lake Washington in Renton, Washington.
The memorandum requests regional offices to re-examine existing Superfund State Contracts (SSCs) for Fund-financed remedial actions to verify that they adequately reflect incurred and projected remedial action costs
U.S. Environmental Protection Agency — This data layer provides access to Base Realignment and Closure (BRAC) Superfund Sites as part of the CIMC web service. EPA works with DoD to facilitate the reuse...
...- traditional communication methods to make the significance and applicability of SRP-funded research... and Social Sciences Research, and National Institute of Biomedical Imaging and Bioengineering. [cir... Superfund Hazardous Substance Research and Training Program Strategic Plan; Request for Comments ACTION...
U.S. Environmental Protection Agency — Federal facilities are properties owned by the federal government. This data layer provides access to Federal facilities that are Superfund sites as part of the CIMC...
Ela, Wendell P.; Sedlak, David L.; Barlaz, Morton A.; Henry, Heather F.; Muir, Derek C.G.; Swackhamer, Deborah L.; Weber, Eric J.; Arnold, Robert G.; Ferguson, P. Lee; Field, Jennifer A.; Furlong, Edward T.; Giesy, John P.; Halden, Rolf U.; Henry, Tala; Hites, Ronald A.; Hornbuckle, Keri C.; Howard, Philip H.; Luthy, Richard G.; Meyer, Anita K.; Saez, A. Eduardo; vom Saal, Frederick S.; Vulpe, Chris D.; Wiesner, Mark R.
Background This commentary evolved from a workshop sponsored by the National Institute of Environmental Health Sciences titled "Superfund Contaminants: The Next Generation" held in Tucson, Arizona, in August 2009. All the authors were workshop participants.
Hoffmann, Alexandra; Christmann, Corinna A; Bleser, Gabriele
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. ©Alexandra Hoffmann, Corinna A Christmann, Gabriele Bleser. Originally published in JMIR Serious Games (http://games.jmir.org), 07.06.2017.
National Priority List (NPL) sites, or more commonly called Superfund sites, are hazardous waste sites (HWS) deemed by the Environmental Protection Agency (EPA) to impose the greatest risks to human health or welfare or to the environment. HWS are placed and ranked for cleanup on the NPL based on a score derived from the Hazard Ranking System (HRS), which is a scientific assessment of the health and environmental risks posed by HWS. A concern of the HRS is that the rank of sites is not based on benefit-cost analysis. The main objective of this dissertation is to develop a method for estimating the local area economic damages associated with Superfund waste sites. Secondarily, the model is used to derive county-level damage estimates for use in ranking the county level damages from Superfund sites. The conceptual model used to describe the damages associated with Superfund sites is a household-firm location decision model. In this model assumes that households and firms make their location choice based on the local level of wages, rents and amenities. The model was empirically implemented using 1980 census microdata on households and workers in 253 counties across the US. The household sample includes data on the value and structural characteristics of homes. The worker sample includes the annual earnings of workers and a vector worker attributes. The microdata was combined with county level amenity data, including the number of Superfund sites. The hedonic pricing technique was used to estimate the effect of Superfund sites on average annual wages per household and on monthly expenditures on housing. The results show that Superfund sites impose statistically significant damages on households. The annual county damages from Superfund sites for a sample of 151 counties was over 14 billion dollars. The ranking of counties using the damage estimates is correlated with the rank of counties using the HRS
Full Text Available Energy efficiency represents a key resource for economic and social development, providing substantial benefits to different stakeholders, ranging from the entities which develop energy efficient measures to everyone in society. In addition to cost savings, multiple benefits can be achieved by supporting a better alignment between energy issues and strategic business priorities: e.g., improved competitiveness, profitability, quality, etc. Thus, energy efficiency can be a strategic advantage, not just a marginal issue, for companies. However, most firms, especially small and medium enterprises (SMEs, face many problems and, in some cases, hostility when trying to effectively implement energy efficiency actions. The most dominant barriers are the access to capital and the lack of awareness (especially in terms of life cycle cost effects. The supply chain viewpoint represents one of the main opportunities for overcoming those barriers and improving energy performance even for weaker companies. Since the current literature on energy efficiency and practical approaches to ensure energy efficiency mainly focus on energy performance on a single-firm basis, this paper aims to provide a systematic review of papers on the integration of energy efficiency in supply chain design and management published in academic journal, thereby defining potential research streams to close the gaps in the literature. A number of literature reviews have been published focusing on specific aspects of sustainable or on green supply chain management; however, to the best of our knowledge, no review has focused on the energy efficiency issue. Firstly, the present paper shows how considering energy consumption in supply chain management can contribute to more energy-efficient processes from a systemic point of view. Then, the review methodology used is defined and the sampled papers are analyzed and categorized based on the different approaches they propose. From these
Escoffery, Cam; McGee, Robin; Bidwell, Jonathan; Sims, Christopher; Thropp, Eliana Kovitch; Frazier, Cherise; Mynatt, Elizabeth D
Mobile health app developers increasingly are interested in supporting the daily self-care of people with chronic conditions. The purpose of this study was to review mobile applications (apps) to promote epilepsy self-management. It investigates the following: 1) the available mobile apps for epilepsy, 2) how these apps support patient education and self-management (SM), and 3) their usefulness in supporting management of epilepsy. We conducted the review in Fall 2017 and assessed apps on the Apple App Store that related to the terms "epilepsy" and "seizure". Inclusion criteria included apps (adult and pediatric) that, as follows, were: 1) developed for patients or the community; 2) made available in English, and 3) less than $5.00. Exclusion criteria included apps that were designed for dissemination of publications, focused on healthcare providers, or were available in other languages. The search resulted in 149 apps, of which 20 met the selection criteria. A team reviewed each app in terms of three sets of criteria: 1) epilepsy-specific descriptions and SM categories employed by the apps and 2) Mobile App Rating Scale (MARS) subdomain scores for reviewing engagement, functionality, esthetics, and information; and 3) behavioral change techniques. Most apps were for adults and free. Common SM domains for the apps were treatment, seizure tracking, response, and safety. A number of epilepsy apps existed, but many offered similar functionalities and incorporated few SM domains. The findings underline the need for mobile apps to cover broader domains of SM and behavioral change techniques and to be evaluated for outcomes. Copyright © 2017 Elsevier Inc. All rights reserved.
Basuroy, R; Srirajaskanthan, R; Prachalias, A; Quaglia, A; Ramage, J K
Gastric carcinoids (GCs) or neuroendocrine tumours (NETs) are increasingly identified at endoscopy, and account for 0.6-2% of all gastric polyps identified. The SEER database in the US has demonstrated a rising incidence of gastric NETs amongst all NETs; from 2.2% between 1950 and 1969 to 6.0% between 2000 and 2007. To review the literature and assist clinicians in managing patients with GCs. A literature search was conducted through MEDLINE using search terms: gastric, carcinoid, neuroendocrine tumour, therapy, endoscopy, mucosal resection, submucosal dissection. Relevant articles were identified through manual review. The reference lists of these articles were reviewed to include further appropriate articles. There are three types of GCs with important epidemiological, pathophysiological, histological and endoscopic differences that affect prognosis and management. Type 1 and 2 GCs develop in the context of hypergastrinaemia that originates from achlorhydria in atrophic gastritis and a gastrinoma, respectively. Type 3 GCs occur sporadically and independent of gastrin. The histological type, grade and Ki67 index are used to determine prognosis and direct clinical management. Type 1 GCs >1 cm in size and type 2 GCs should be assessed for invasion beyond the submucosa with EUS prior to endoscopic resection with EMR or ESD. Type 3 GCs should be managed as per recommendations for gastric adenocarcinoma. The treatment of advanced disease is multimodal. Patients with gastric carcinoids should be discussed in a specialist neuroendocrine tumour multidisciplinary meeting to ensure all treatment options are explored in localised and advanced disease. Areas of controversy exist that need further research. © 2014 John Wiley & Sons Ltd.
Chokshi, Krunal; Desai, Sachin; Malu, Rahul; Chokshi, Achala
Introduction Oral Lichen Planus (OLP) is a chronic inflammatory, T-cell-mediated autoimmune oral mucosal disease with unclear aetiology. The clinical management of OLP poses considerable difficulties to the oral physician. Aim The aim was to assess the efficacy of any form of intervention used to medically manage OLP. Materials and Methods We searched and analysed the following databases (from January 1990 to December 2014):- Cochrane Oral Health Group Trials Register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE and EMBASE. All Randomised Controlled Trials (RCTs) for the medical management of OLP which compared active treatment with placebo or between active treatments were considered in this systematic review. Participants of any age, gender or race having symptomatic OLP (including mixed forms), unconnected to any identifiable cause (e.g. lichenoid drug reactions) and confirmed by histopathology have been included. Interventions of all types, including topical treatments or systemic drugs of variable dosage, duration & frequency of delivery have been considered. All the trials identified were appraised by five review authors and the data for all the trials were synthesised using specifically designed data extraction form. Binary data has been presented as risk ratios (RR) with 95% confidence intervals (CI) and continuous data as mean differences (MD) with 95% CIs. Results A total of 35 RCTs were included in this systematic review on medical management of OLP. No strong evidence suggesting superiority of any specific intervention in reducing pain and clinical signs of OLP were shown by the RCTs included here. Conclusion Future RCTs on a larger scale, adopting standardized outcome assessing parameters should be considered. PMID:27042598
The Department of Energy, Richland Operations Office (RL) Manual Environmental Restoration Program Quality System Requirements (QSR) for the Hanford Site, defines all quality requirements governing Hanford Environmental Restoration (ER) Program activities. The QSR requires that ER Program participants develop Quality Management Plans (QMPs) that describe how the QSR requirements will be implemented for their assigned scopes of work. This standard review plan (SRP) describes the ER program participant responsibilities for submittal of QMPs to the RL Environmental Restoration Division for review and the RL methodology for performing the reviews of participant QMPS. The SRP serves the following functions: acts as a guide in the development or revision of QMPs to assure that the content is complete and adequate; acts as a checklist to be used by the RL staff in their review of participant QMPs; acts as an index or matrix between the requirements of the QSR and implementing methodologies described in the QMPs; decreases the time and subjectivity of document reviews; and provides a formal, documented method for describing exceptions, modifications, or waivers to established ER Program quality requirements
Isa Nordiana Mohd
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.
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.
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.
Full Text Available Sustainability in project operations such as financial, social and environmental sustainability is one of the most prominent issues of the present times to address. The increased focus on sus-tainable business operations has changed the viewpoint of researchers and corporate community towards the project management. Today sustainability in business operations along with sustain-ability of natural and environmental resources are of paramount significance which has further caused a huge impact on conception, planning, scheduling and execution of the project manage-ment activities. In this paper, a literature review between 1987 and 2018 on different issues af-fecting the sustainability in project management is carried out. The present study also identifies and discusses the future possibilities to apply computational procedures in order to estimate and optimize the sustainability issues in the management of projects, for example the computational evolutionary algorithms can be applied to formulate the multi-objective decision-making problem after considering critical factors of sustainability in the projects and then yielding optimized solu-tions for the formulated problem to achieve sustainability in the projects. A new integrated framework with the inclusion of feedback function for assessment of each decision and actions taken towards the sustainability of the projects is also identified and presented.
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
Hussain, Saddam; Peng, Shaobing; Fahad, Shah; Khaliq, Abdul; Huang, Jianliang; Cui, Kehui; Nie, Lixiao
Global warming is one of the gravest threats to crop production and environmental sustainability. Rice, the staple food of more than half of the world's population, is the most prominent cause of greenhouse gas (GHG) emissions in agriculture and gives way to global warming. The increasing demand for rice in the future has deployed tremendous concerns to reduce GHG emissions for minimizing the negative environmental impacts of rice cultivation. In this review, we presented a contemporary synthesis of existing data on how crop management practices influence emissions of GHGs in rice fields. We realized that modifications in traditional crop management regimes possess a huge potential to overcome GHG emissions. We examined and evaluated the different possible options and found that modifying tillage permutations and irrigation patterns, managing organic and fertilizer inputs, selecting suitable cultivar, and cropping regime can mitigate GHG emissions. Previously, many authors have discussed the feasibility principle and the influence of these practices on a single gas or, in particular, in the whole agricultural sector. Nonetheless, changes in management practices may influence more than one gas at the same time by different mechanisms or sometimes their effects may be antagonistic. Therefore, in the present attempt, we estimated the overall global warming potential of each approach to consider the magnitude of its effects on all gases and provided a comprehensive assessment of suitable crop management practices for reducing GHG emissions in rice culture.
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.
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
Muhammad Saiful Ridhwan
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
Bair, E Scott; Metheny, Maura A
Remediation of ground water and soil contamination at the Wells G & H Superfund Site, Woburn, Massachusetts, uses technologies that reflect differences in hydrogeologic settings, concentrations of volatile organic compounds (VOCs), and costs of treatment. The poorly permeable glacial materials that overlie fractured bedrock at the W.R. Grace property necessitate use of closely spaced recovery wells. Contaminated ground water is treated with hydrogen peroxide and ultraviolet (UV) oxidation. At UniFirst, a deep well completed in fractured bedrock removes contaminated ground water, which is treated by hydrogen peroxide, UV oxidation, and granular activated carbon (GAC). The remediation system at Wildwood integrates air sparging, soil-vapor extraction, and ground water pumping. Air stripping and GAC are used to treat contaminated water; GAC is used to treat contaminated air. New England Plastics (NEP) uses air sparging and soil-vapor extraction to remove VOCs from the unsaturated zone and shallow ground water. Contaminated air and water are treated using separate GAC systems. After nine years of operation at W.R. Grace and UniFirst, 30 and 786 kg, respectively, of VOCs have been removed. In three years of operation, 866 kg of VOCs have been removed at Wildwood. In 15 months of operation, 36 kg of VOCs were removed at NEP. Characterization work continues at the Olympia Nominee Trust, Whitney Barrel, Murphy Waste Oil, and Aberjona Auto Parts properties. Risk assessments are being finalized that address heavy metals in the floodplain sediments along the Aberjona River that are mobilized from the Industri-Plex Superfund Site located a few miles upstream.
Boluyt, Nicole; van der Lee, Johanna H.; Moyer, Virginia A.; Brand, Paul L. P.; Offringa, Martin
OBJECTIVE: Our goal was to evaluate clinical, methodologic, and reporting aspects of systematic reviews on the management of acute asthma in children. METHODS: We undertook a systematic review of systematic reviews on acute asthma management in children. We identified eligible reviews by searching
... review and the information required in a request for review. In the event that we place an article of...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment... Management and Budget (OMB) for review and clearance under the Paperwork Reduction Act of 1995. DATES: Fax...
Devnani, Preeti; Fernandes, Racheal
Rapid eye movement (REM) sleep behavior disorder (RBD) is characterized by dream enactment behavior resulting from a loss of REM skeletal muscle atonia. The neurobiology of REM sleep and the characteristic features of REM atonia have an important basis for understanding the aggravating etiologies the proposed pharmacological interventions in its management. This review outlines the evidence for behavioral and therapeutic measures along with evidence-based guidelines for their implementation, impact on falls, and effect on polysomnography (PSG) while highlighting the non-motor, autonomic, and cognitive impact of this entity. PubMed databases were reviewed upto May 2013 in peer-reviewed scientific literature regarding the pathophysiology and management of RBD in adults. The literature was graded according to the Oxford centre of evidence-based Medicine Levels. An early intervention that helps prevent consequences such as falls and provides a base for intervention with neuroprotective mechanisms and allocates a unique platform that RBD portrays with its high risk of disease conversion with a sufficiently long latency. RBD provides a unique platform with its high risk of disease conversion with a sufficiently long latency, providing an opportunity for early intervention both to prevent consequences such as falls and provide a base for intervention with neuroprotective mechanisms.
Full Text Available Rapid eye movement (REM sleep behavior disorder (RBD is characterized by dream enactment behavior resulting from a loss of REM skeletal muscle atonia. The neurobiology of REM sleep and the characteristic features of REM atonia have an important basis for understanding the aggravating etiologies the proposed pharmacological interventions in its management. This review outlines the evidence for behavioral and therapeutic measures along with evidence-based guidelines for their implementation, impact on falls, and effect on polysomnography (PSG while highlighting the non-motor, autonomic, and cognitive impact of this entity. PubMed databases were reviewed upto May 2013 in peer-reviewed scientific literature regarding the pathophysiology and management of RBD in adults. The literature was graded according to the Oxford centre of evidence-based Medicine Levels. An early intervention that helps prevent consequences such as falls and provides a base for intervention with neuroprotective mechanisms and allocates a unique platform that RBD portrays with its high risk of disease conversion with a sufficiently long latency. RBD provides a unique platform with its high risk of disease conversion with a sufficiently long latency, providing an opportunity for early intervention both to prevent consequences such as falls and provide a base for intervention with neuroprotective mechanisms.
Shojaei, Mir Hatef; Alavinia, Seyed Mohammad; Craven, B Catharine
Individuals with chronic spinal cord injury (SCI) are susceptible to central and visceral obesity and it's metabolic consequences; consensus based guidelines for obesity management after SCI have not yet been stablished. To identify and compare effective means of obesity management among SCI individuals. This systematic review included English and non-English articles, published prior to April 2017 found in the PubMed/Medline, Embase, CINAHL Psychinfo and Cochrane databases. Studies evaluating any obesity management strategy, alone or in combination, including: diet therapy, voluntary and involuntary exercise such as neuro-muscular electric stimulation (NMES), pharmacotherapy, and surgery, among individuals with chronic SCI were included. Outcomes of interest were reductions in waist circumference, body weight (BW), body mass index (BMI) and total fat mass (TFM) and increases in total lean body mass (TLBM) from baseline. From 3,553 retrieved titles and abstracts, 34 articles underwent full text review and 23 articles were selected for data abstraction. Articles describing weight loss due to inflammation, cancer or B12 deficiency were excluded. The Downs and Black reported poor to moderate quality of the studies. Bariatric surgery produced the greatest permanent weight reduction and BMI correction followed by combinations of physical exercise and diet therapy. Generally, NMES and pharmacotherapy improved TLBM and reduced TFM but not weight. The greatest weight reduction and BMI correction was produced by bariatric surgery, followed by a combination of physical exercise and diet therapy. NMES and pharmacologic treatment did not reduce weight or TFM but increased in TLBM.
..., Management (Chief Financial Officer). Alfred J. Kopec, Assistant Commissioner, Business Architecture. Sheryl... DEPARTMENT OF THE TREASURY Fiscal Service Senior Executive Service; Financial Management Service Performance Review Board (PRB) AGENCY: Financial Management Service, Fiscal Service, Treasury. ACTION: Notice...
Tara T. T. Tran
Full Text Available BackgroundDiabetic ketoacidosis (DKA is an endocrine emergency with associated risk of morbidity and mortality. Despite this, DKA management lacks strong evidence due to the absence of large randomised controlled trials (RCTs.ObjectiveTo review existing studies investigating inpatient DKA management in adults, focusing on intravenous (IV fluids; insulin administration; potassium, bicarbonate, and phosphate replacement; and DKA management protocols and impact of DKA resolution rates on outcomes.MethodsOvid Medline searches were conducted with limits “all adult” and published between “1973 to current” applied. National consensus statements were also reviewed. Eligibility was determined by two reviewers’ assessment of title, abstract, and availability.ResultsA total of 85 eligible articles published between 1973 and 2016 were reviewed. The salient findings were (i Crystalloids are favoured over colloids though evidence is lacking. The preferred crystalloid and hydration rates remain contentious. (ii IV infusion of regular human insulin is preferred over the subcutaneous route or rapid acting insulin analogues. Administering an initial IV insulin bolus before low-dose insulin infusions obviates the need for supplemental insulin. Consensus-statements recommend fixed weight-based over “sliding scale” insulin infusions although evidence is weak. (iii Potassium replacement is imperative although no trials compare replacement rates. (iv Bicarbonate replacement offers no benefit in DKA with pH > 6.9. In severe metabolic acidosis with pH < 6.9, there is lack of both data and consensus regarding bicarbonate administration. (v There is no evidence that phosphate replacement offers outcome benefits. Guidelines consider replacement appropriate in patients with cardiac dysfunction, anaemia, respiratory depression, or phosphate levels <0.32 mmol/L. (vi Upon resolution of DKA, subcutaneous insulin is recommended with IV insulin infusions
The decision document presents the selected remedial action for the mining wastes at Operable Unit No. 07 of the Galena Subsite, which is part of the Cherokee County Superfund Site in Cherokee County, Kansas. The selected remedy includes actions for residential soils impacted by mining wastes and includes: Excavation and disposal of residential soils impacted by mining wastes; Health education for the general community and medical professionals; Institutional controls to guide future development in residential areas impacted by mining wastes; Treatability studies to evaluate the effectiveness of phosphate stabilization as a future alternative; and Operation and maintenance of all remedy aspects including, but not limited to, health education, institutional controls, and long-term monitoring.
Horodytska, O; Valdés, F J; Fullana, A
Plastic flexible films are increasingly used in many applications due to their lightness and versatility. In 2014, the amount of plastic films represented 34% of total plastic packaging produced in UK. The flexible film waste generation rises according to the increase in number of applications. Currently, in developed countries, about 50% of plastics in domestic waste are films. Moreover, about 615,000 tonnes of agricultural flexible waste are generated in the EU every year. A review of plastic films recycling has been conducted in order to detect the shortcomings and establish guidelines for future research. This paper reviews plastic films waste management technologies from two different sources: post-industrial and post-consumer. Clean and homogeneous post-industrial waste is recycled through closed-loop or open-loop mechanical processes. The main differences between these methods are the quality and the application of the recycled materials. Further research should be focused on closing the loops to obtain the highest environmental benefits of recycling. This could be accomplished through minimizing the material degradation during mechanical processes. Regarding post-consumer waste, flexible films from agricultural and packaging sectors have been assessed. The agricultural films and commercial and industrial flexible packaging are recycled through open-loop mechanical recycling due to existing selective waste collection routes. Nevertheless, the contamination from the use phase adversely affects the quality of recycled plastics. Therefore, upgrading of current washing lines is required. On the other hand, household flexible packaging shows the lowest recycling rates mainly because of inefficient sorting technologies. Delamination and compatibilization methods should be further developed to ensure the recycling of multilayer films. Finally, Life Cycle Assessment (LCA) studies on waste management have been reviewed. A lack of thorough LCA on plastic films waste
Szmigielski, Wojciech; Kumar, Rajendra; Al Hilli, Shatha; Ismail, Mostafa
The purpose of this review is to illustrate and discuss the spectrum of imaging findings, particularly computed tomography (CT), of blunt and penetrating renal trauma, based on our own materials, according to the American Association for Surgery of Trauma (AAST) renal injury grading scale. The article also indicates the conditions in which interventional radiology procedures can be applied for the management of renal trauma. Cases for this pictorial review were selected from the imaging material collected at the Radiology Department of Hamad Medical Corporation during a 14-year period from 1999 to 2012. The material includes 176 cases (164 males and 12 females) with confirmed blunt or penetrating renal trauma. Following abdominal trauma, all patients had a CT examination performed on admission to the hospital and/or during hospitalization. The most representative and illustrative cases of renal trauma were reviewed according to CT findings and were categorized according to the AAST grading system. The review describes a spectrum of imaging presentations with special emphasis on the 5 grades of renal injury on a CT according to the AAST scale. The most representative cases were illustrated and discussed with indications of possible interventional radiology treatment. Two groups of patients not included in the AAST grading system were presented separately: those with preexisting renal abnormalities and those with sustained iatrogenic renal injury. Proper application of renal trauma grading scale is essential for selecting the patients for conservative treatment, surgery or interventional radiology procedure
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.
Kohl, Christian; Frampton, Geoff; Sweet, Jeremy; Spök, Armin; Haddaway, Neal Robert; Wilhelm, Ralf; Unger, Stefan; Schiemann, Joachim
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.
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.
Liu, Qi; Kong, Fanmin; Zhou, Jianping; Dong, Ming; Dong, Qi
Gastrointestinal stromal tumors (GISTs) are relatively common mesenchymal tumors. They originate from the wall of hollow viscera and may be found in any part of the digestive tract. The prognosis of patients with stromal tumors depends on various risk factors, including size, location, presence of mitotic figures, and tumor rupture. Emergency surgery is often required for stromal tumors with hemorrhage. The current literature suggests that stromal tumor hemorrhage indicates poor prognosis. Although the optimal treatment options for hemorrhagic GISTs are based on surgical experience, there remains controversy with regard to optimum postoperative management as well as the classification of malignant potential. This article reviews the biological characteristics, diagnostic features, prognostic factors, treatment, and postoperative management of GISTs with hemorrhage.
Guo Xiuying; Xiang Dong; Duan Guanghong; Mou Peng
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.
Full Text Available Context Atopic dermatitis is a chronic, relapsing skin disorder that affects all ages including infancy and childhood. There are many proved and unproved treatments for atopic dermatitis. Evidence Acquisition Data sources of this narrative review included studies about pediatric atopic dermatitis with the following keywords, pediatric, atopic dermatitis, immunity, acute, chronic, pruritic inflammatory skin disorder, infancy, childhood, diagnosis, management and treatment. All of the articles were written in English language with full text on management or treatment. Results Innate and adaptive immune system involved atopic dermatitis. Major characteristics of atopic dermatitis include pruritus, chronic or relapsing lesions and personal or family history of atopic disease. There is no specific treatment for atopic dermatitis. The treatment included rehydration, emollients, topical steroid, calcineurin inhibitors and immunosuppressant. Crisaborole topical ointment, a PDE4 anti-inflammatory topical agent (phase three of the research could be effective in atopic dermatitis. Conclusions Avoidance from trigger factors and emollients are basic treatments of atopic dermatitis.
Nussbaum, E S
Since its introduction in the 1950s, carotid endarterectomy has become one of the most frequently performed operations in the United States. The tremendous appeal of a procedure that decreases the risk of stroke, coupled with the large number of individuals in the general population with carotid stenosis, has contributed to its popularity. To provide optimal patient care, the practicing physician must have a firm understanding of the proper evaluation and management of carotid stenosis. Nevertheless, because of the large number of clinical trials performed over the last decade addressing the treatment of stroke and carotid endarterectomy, the care of patients with carotid stenosis remains a frequently misunderstood topic. This review summarizes the current evaluation and treatment options for carotid stenosis and provides a rational management algorithm for this prevalent disease process.
Larmer, Peter J; Reay, Nicholas D; Aubert, Elizabeth R; Kersten, Paula
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
Progress over the previous year in the nuclear fuel waste management program is reviewed. Universities, industry and consultants have become increasingly involved, and the work is being overseen by a Technical Advisory Committee. The program has also been investigated by Ontario's Porter Commission and Select Committe on Ontario Hydro Affairs. A public information program has been extended to cover most of the Canadian Shield region of Ontario. Ontario Hydro is studying spent fuel storage and transportation, while AECL is covering immobilization of spent fuel or processing wastes, geotechnical and geochemical research in the laboratory and in the field, design of disposal facilities, and environmental and safety assessments. (L.L.)
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.
Ivanov, Stanislav; Zhechev, Vladimir
The paper presents a literature review of the main concepts of hotel revenue management (RM) and current state-of-the-art of its theoretical research. The article emphasises on the different directions of hotel RM research and is structured around the elements of the hotel RM system and the stages of RM process. The elements of the hotel RM system discussed in the paper include hotel RM centres (room division, F&B, function rooms, spa & fitness facilities, golf courses, casino and gambling fa...
Carey, Pat; Walker, Stuart
This paper describes the Superfund program's statutory requirements for community involvement. It also discusses the efforts the Superfund program has made that go beyond these statutory requirements to involve communities. The Environmental Protection Agency (EPA) implements the Superfund program under the authority of the Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA), as amended by the Superfund Amendments and Reauthorization Act of 1986 (SARA). From the beginning of the Superfund program, Congress envisioned a role for communities. This role has evolved and expanded during the implementation of the Superfund program. Initially, the CERCLA statute had community involvement requirements designed to inform surrounding communities of the work being done at a site. CERCLA's provisions required 1) development of a community relations plan for each site, 2) establishment of information repositories near each site where all publicly available materials related to the site would be accessible for public inspection, 3) opportunities for the public to comment on the proposed remedy for each site and 4) development of a responsiveness summary responding to all significant comments received on the proposed remedy. In recognition of the need for people living near Superfund sites to be well-informed and involved with decisions concerning sites in their communities, SARA expanded Superfund's community involvement activities in 1986. SARA provided the authority to award Technical Assistance Grants (TAGs) to local communities enabling them to hire independent technical advisors to assist them in understanding technical issues and data about the site. The Superfund Community Involvement Program has sought to effectively implement the statutory community involvement requirements, and to go beyond those requirements to find meaningful ways to involve citizens in the cleanup of sites in their communities. We've structured our program around
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.
Burton, A Kim; Kendall, Nicholas A S; Pearce, Brian G; Birrell, Lisa N; Bainbridge, L Christopher
Upper limb disorders (ULDs) are clinically challenging and responsible for considerable work loss. There is a need to determine effective approaches for their management. To determine evidence-based management strategies for work-relevant ULDs and explore whether a biopsychosocial approach is appropriate. Literature review using a best evidence synthesis. Data from articles identified through systematic searching of electronic databases and citation tracking were extracted into evidence tables. The information was synthesized into high-level evidence statements, which were ordered into themes covering classification/diagnosis, epidemiology, associations/risks and management/treatment, focusing on return to work or work retention and taking account of distinctions between non-specific complaints and specific diagnoses. Neither biomedical treatment nor ergonomic workplace interventions alone offer an optimal solution; rather, multimodal interventions show considerable promise, particularly for occupational outcomes. Early return to work, or work retention, is an important goal for most cases and may be facilitated, where necessary, by transitional work arrangements. The emergent evidence indicates that successful management strategies require all the players to be on side and acting in a coordinated fashion; this requires engaging employers and workers to participate. The biopsychosocial model applies: biological considerations should not be ignored, but psychosocial factors are more influential for occupational outcomes. Implementation of interventions that address the full range of psychosocial issues will require a cultural shift in the way the relationship between upper limb complaints and work is conceived and handled. Dissemination of evidence-based messages can contribute to the needed cultural shift.
Terrence D. Lewis
Full Text Available Uterine leiomyomata are the most common benign tumors of the gynecologic tract impacting up to 80% of women by 50 years of age. It is well established that these tumors are the leading cause for hysterectomy with an estimated total financial burden greater than $30 billion per year in the United States. However, for the woman who desires future fertility or is a poor surgical candidate, definitive management with hysterectomy is not an optimal management plan. Typical gynecologic symptoms of leiomyoma include infertility, abnormal uterine bleeding (AUB/heavy menstrual bleeding (HMB and/or intermenstrual bleeding (IMB with resulting iron-deficiency anemia, pelvic pressure and pain, urinary incontinence, and dysmenorrhea. The morbidity caused by these tumors is directly attributable to increases in tumor burden. Interestingly, leiomyoma cells within a tumor do not rapidly proliferate, but rather the increase in tumor size is secondary to production of an excessive, stable, and aberrant extracellular matrix (ECM made of disorganized collagens and proteoglycans. As a result, medical management should induce leiomyoma cells toward dissolution of the extracellular matrix, as well as halting or inhibiting cellular proliferation. Herein, we review the current literature regarding the medical management of uterine leiomyoma.
At the request of the NASA Administrator a team was formed to review the Space Shuttle Program and propose a new management system that could significantly reduce operating costs. Composed of a group of people with broad and extensive experience in spaceflight and related areas, the team received briefings from the NASA organizations and most of the supporting contractors involved in the Shuttle Program. In addition, a number of chief executives from the supporting contractors provided advice and suggestions. The team found that the present management system has functioned reasonably well despite its diffuse structure. The team also determined that the shuttle has become a mature and reliable system, and--in terms of a manned rocket-propelled space launch system--is about as safe as today's technology will provide. In addition, NASA has reduced shuttle operating costs by about 25 percent over the past 3 years. The program, however, remains in a quasi-development mode and yearly costs remain higher than required. Given the current NASA-contractor structure and incentives, it is difficult to establish cost reduction as a primary goal and implement changes to achieve efficiencies. As a result, the team sought to create a management structure and associated environment that enables and motivates the Program to further reduce operational costs. Accordingly, the review team concluded that the NASA Space Shuttle Program should (1) establish a clear set of program goals, placing a greater emphasis on cost-efficient operations and user-friendly payload integration; (2) redefine the management structure, separating development and operations and disengaging NASA from the daily operation of the space shuttle; and (3) provide the necessary environment and conditions within the program to pursue these goals.
Williams, G.; Durham, L.
Custom visualization analysis programs were developed and used to analyze contaminant transport calculations from a three-dimensional numerical groundwater flow model developed for a Department of Energy Superfund site. The site hydrogeology, which is highly heterogenous, includes both fractured limestone and dolomite and alluvium deposits. Three-dimensional interactive visualization techniques were used to understand and analyze the three-dimensional, double-porosity modeling results. A graphical object oriented programming environment was applied to efficiently develop custom visualization programs in a coarse-grained data structure language. Comparisons were made, using the results from the three-dimensional, finite-difference model, between traditional two-dimensional analyses (contour and vector plots) and interactive three-dimensional techniques. Subjective comparison areas include the accuracy of analysis, the ability to understand the results of three-dimensional contaminant transport simulation, and the capability to transmit the results of the analysis to the project management. In addition, a quantitative comparison was made on the time required to develop a thorough analysis of the modeling results. The conclusions from the comparative study showed that the visualization analysis provided an increased awareness of the contaminant transport mechanisms, provided new insights into contaminant migration, and resulted in a significant time savings
Williams, G. [Northwestern Univ., Evanston, IL (United States); Durham, L. [Argonne National Lab., IL (United States)
Custom visualization analysis programs were developed and used to analyze contaminant transport calculations from a three-dimensional numerical groundwater flow model developed for a Department of Energy Superfund site. The site hydrogeology, which is highly heterogenous, includes both fractured limestone and dolomite and alluvium deposits. Three-dimensional interactive visualization techniques were used to understand and analyze the three-dimensional, double-porosity modeling results. A graphical object oriented programming environment was applied to efficiently develop custom visualization programs in a coarse-grained data structure language. Comparisons were made, using the results from the three-dimensional, finite-difference model, between traditional two-dimensional analyses (contour and vector plots) and interactive three-dimensional techniques. Subjective comparison areas include the accuracy of analysis, the ability to understand the results of three-dimensional contaminant transport simulation, and the capability to transmit the results of the analysis to the project management. In addition, a quantitative comparison was made on the time required to develop a thorough analysis of the modeling results. The conclusions from the comparative study showed that the visualization analysis provided an increased awareness of the contaminant transport mechanisms, provided new insights into contaminant migration, and resulted in a significant time savings.
Andromalos, K.B.; Ameel, M.E.
The Geiger (C and M Oil) Superfund Site is the first US Army Corps of Engineers managed soil remediation project which utilized the in-situ stabilization/solidification technique to remediate the soil. This project involved the remediation of approximately 23,000 cubic yards of contaminated soil. Contaminants of concern included chromium, lead, PCB'S, toluene, benzene, and other organic compounds. Clean-up criteria for the stabilized material was equal to the National Primary Drinking Water Regulations, when tested using the TCLP leachate extraction method. Chromium, lead, and toluene were the main contaminants of concern, with TCLP clean-up goals of 150, 15 and 1,000 parts per billion (ppb), respectively. This National Priorities List (NPL) site is located near Charleston, SC and was an abandoned old waste oil facility that utilized unlined shallow trenches for the storage of waste oil. This paper summarizes the initial testing programs and the final production work at the site. Extensive testing was performed throughout all phases of the project. This testing was performed for the purpose of mix optimization, quality assurance, and verification testing. Specific parameters tested included: TCLP testing of organics, metals and PCBs, permeability testing, and unconfirmed compression strength
The US Department of Energy (DOE) is committed to conducting its operations. In a safe and environmentally sound manner. High priorities for the Department are identifying and correcting environmental problems at DOE facilities that resulted from past operations, and preventing environmental problems from occurring during present and future operations. In this regard, the Department is committed to the 30-year goal of cleanup of all facilities by the year 2019. DOE has issued an Order and guidance establishing policy and procedures for activities conducted under the Comprehensive Environmental Response, Compensation, and Liability Act (CERCLA), as amended by the Superfund Amendments and Reauthorization Act (SARA), and has developed a Five-Year Plan, updated annually, that integrates planing for corrective activities, environmental restoration, and waste management operations at its facilities. During Calendar Year 1991 and early 1992, DOE made significant progress in reaching agreements with regulatory entities, undertaking cleanup actions, and initiating preventive measures designed to eliminate future environmental problems. These accomplishments are described
Xia, Guodong; Cao, Lei; Bi, Guanglong
The global issues of energy crisis and air pollution have offered a great opportunity to develop electric vehicles. However, so far, cycle life of power battery, environment adaptability, driving range and charging time seems far to compare with the level of traditional vehicles with internal combustion engine. Effective battery thermal management (BTM) is absolutely essential to relieve this situation. This paper reviews the existing literature from two levels that are cell level and battery module level. For single battery, specific attention is paid to three important processes which are heat generation, heat transport, and heat dissipation. For large format cell, multi-scale multi-dimensional coupled models have been developed. This will facilitate the investigation on factors, such as local irreversible heat generation, thermal resistance, current distribution, etc., that account for intrinsic temperature gradients existing in cell. For battery module based on air and liquid cooling, series, series-parallel and parallel cooling configurations are discussed. Liquid cooling strategies, especially direct liquid cooling strategies, are reviewed and they may advance the battery thermal management system to a new generation.
Whurr, Renata; Lorch, Marjorie
The recent literature on spasmodic dysphonia is reviewed with regard to pathogenesis, differential diagnosis, treatment options, audits, and current methods of management. Advances in technology have enabled clinicians to better understand the connection between brain and laryngeal function and dysfunction. Refinements in imaging and genetic investigation techniques have led to advances in the understanding of the underlying mechanism of this neurolaryngeal disorder. Development of diagnostic assessment tools and measures of quality of life hold the potential to improve treatment and care. Fifty articles published between 2014 and 2015 were selected for this review. The sources were drawn from several clinical specialties: 54% come under the scope of laryngology, 32% from neurology, and 14% from other areas. It remains poorly understood, misdiagnosed, and underdiagnosed. Its identification, diagnosis, treatment selection, and coordination of care require an expert specialist multidisciplinary team. More training is required to help people who have this chronic and psychosocially disabling voice disorder, which impinges on all aspects of their lives. Spasmodic dysphonia is now classified as a 'rare' disease in the United States. This designation will assist in international standards of diagnosis, assessment, treatment, and management.
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.
Mendoza, G.; Diaz, A.; Viais, J.; Carmona, M.; Santander, L.
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)
Pardo, Guillermo; Moral, Raúl; Aguilera, Eduardo; Del Prado, Agustín
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
Pardo, Guillermo; Moral, Raúl; Aguilera, Eduardo; del Prado, Agustín
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 (N2O) and methane (CH4) emissions by 53% and 71%, respectively. Turned composting systems, unlike forced aerated composted systems, showed potential for reducing GHGs (N2O: 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
... OFFICE OF MANAGEMENT AND BUDGET Collection of Information Under Review by Office of Management and Budget AGENCY: Office of Management and Budget, Office of Federal Financial Management. ACTION: Notice....), the Office of Management and Budget (OMB) invites the general public and Federal agencies to comment...
Full Text Available Purpose: This review was intended to discuss the various possible modifications suggested in the literature for prosthetic steps and surgical corrective procedures in nonresponding or complicated cases during rehabilitation of patients with restricted mouth opening. Material and Methods: Medline, PubMed, and Google were searched electronically for articles using keywords: microstomia and treatment options for restricted mouth opening. The various articles on prosthodontic rehabilitation in microstomia were segregated. From these, various modifications in the prosthetic steps were reviewed. Results: Oral hygiene maintenance is difficult for patient either due to limited access or due to associated lack of manual dexterity, so dental decay and periodontal problems are more extensive in such patients; hence, tooth loss is a common finding. All prosthetic procedures require wide mouth opening to carry out various steps, starting from tray placement during impression making to the final prosthesis insertion, especially removable prosthesis. Various prosthetic modifications given by authors are included in this review for each step in prosthodontic management. A total of eight stock tray designs, 12 custom tray designs, and 17 removable prosthesis designs are discussed along with fixed (either tooth-supported or implant-supported and maxillofacial prosthesis. However, some patients require surgical intervention also for the correction of microstomia either for function or for esthetic purpose before prosthetic rehabilitation and are also enumerated here. Conclusion: Among all prosthetic restorative options, removable prosthesis is most difficult for dentist to fabricate as conventional methods are either very difficult or impossible to apply. To get a more accurate final prosthesis, we need to modify these steps according to the existing case. Several modifications available are discussed here which can help while managing these patients.
Kumar, Bhushan; Fernandes, Aquaviva; Sandhu, Prabhdeep Kaur
This review was intended to discuss the various possible modifications suggested in the literature for prosthetic steps and surgical corrective procedures in nonresponding or complicated cases during rehabilitation of patients with restricted mouth opening. Medline, PubMed, and Google were searched electronically for articles using keywords: microstomia and treatment options for restricted mouth opening. The various articles on prosthodontic rehabilitation in microstomia were segregated. From these, various modifications in the prosthetic steps were reviewed. Oral hygiene maintenance is difficult for patient either due to limited access or due to associated lack of manual dexterity, so dental decay and periodontal problems are more extensive in such patients; hence, tooth loss is a common finding. All prosthetic procedures require wide mouth opening to carry out various steps, starting from tray placement during impression making to the final prosthesis insertion, especially removable prosthesis. Various prosthetic modifications given by authors are included in this review for each step in prosthodontic management. A total of eight stock tray designs, 12 custom tray designs, and 17 removable prosthesis designs are discussed along with fixed (either tooth-supported or implant-supported) and maxillofacial prosthesis. However, some patients require surgical intervention also for the correction of microstomia either for function or for esthetic purpose before prosthetic rehabilitation and are also enumerated here. Among all prosthetic restorative options, removable prosthesis is most difficult for dentist to fabricate as conventional methods are either very difficult or impossible to apply. To get a more accurate final prosthesis, we need to modify these steps according to the existing case. Several modifications available are discussed here which can help while managing these patients.
The Shirco Pilot-Scale Infrared Incineration System was evaluated during a series of seventeen test runs under varied operating conditions at the Demode Road Superfund Site located in Rose Township, Michigan. The tests sought to demonstrate the effectiveness of the unit and the t...
Pereira, Katherine; Phillips, Beth; Johnson, Constance; Vorderstrasse, Allison
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.
Riazi, H; Larijani, B; Langarizadeh, M; Shahmoradi, L
To review published evidences about using information technology interventions in diabetes care and determine their effects on managing diabetes. Systematic review of information technology based interventions. MEDLINE®/PubMed were electronically searched for articles published between 2004/07/01 and 2014/07/01. A comprehensive, electronic search strategy was used to identify eligible articles. Inclusion criteria were defined based on type of study and effect of information technology based intervention in relation to glucose control and other clinical outcomes in diabetic patients. Studies must have used a controlled design to evaluate an information technology based intervention. A total of 3613 articles were identified based on the searches conducted in MEDLINE from PubMed. After excluding duplicates (n = 6), we screened titles and abstracts of 3607 articles based on inclusion criteria. The remaining articles matched with inclusion criteria (n = 277) were reviewed in full text, and 210 articles were excluded based on exclusion criteria. Finally, 67 articles complied with our eligibility criteria and were included in this study. In this study, the effect of various information technology based interventions on clinical outcomes in diabetic patients extracted and measured from selected articles is described and compared to each other. Information technology based interventions combined with the usual care are associated with improved glycemic control with different efficacy on various clinical outcomes in diabetic patients.
Mahadi Hasan Miraz
Full Text Available The purpose of this paper is to present the state of the art of research in Information Technology (IT in Change Management (CM. Initial studies indicate that investments into CM in IT often do not add the predictable value, neither to the CM division himself nor to the association supported by the CM section. A basis for further study into this complex and inter disciplinary area is therefore needed. This literature review will contribute to this basis. Based on a Systematic Literature Review (SLR method, journal articles, with a focus on CM in IT were found. Relevant articles were organized in categories according to focus on Technology, IT layer, CM process and theory, research method applied and type of findings. Finally research gaps were identified. There seems to be a general belief in technology combinations as a way to speed up the rather slow IT diffusion process in CM. It is documented that current research into CM in IT has an unbalanced focus on few specific technologies, IT layers and CM processes, and that further research should focus more on the IT implementation process and use. Knowledge from application and use could be fed back into (and strengthen conceptualization and progress, thereby adding more value to CM. Only the search engine Scopus is used. This is the first review paper focusing on CM in general in IT, giving an overview of the area and delivering a basis for further research.
Lädermann, Alexandre; Denard, Patrick J; Burkhart, Stephen S
Importance Recurrent tear after rotator cuff repair (RCR) is common. Conservative, and open and arthroscopic revisions, have been advocated to treat these failures. Aim or objective The purpose of this systematic review was to evaluate the different options for managing recurrent rotator cuff tears. Evidence review A search was conducted of level I through 4 studies from January 2000 to October 2015, to identify studies reporting on failed RCR. 10 articles were identified. The overall quality of evidence was very low. Findings Mid-term to long-term follow-up of patients treated conservatively revealed acceptable results; a persistent defect is a well-tolerated condition that only occasionally requires subsequent surgery. Conservative treatment might be indicated in most patients, particularly in case of posterosuperior involvement and poor preoperative range of motion. Revision surgery might be indicated in a young patient with a repairable lesion, a 3 tendon tear, and in those with involvement of the subscapularis. Conclusions and relevance The current review indicates that arthroscopic revision RCR can lead to improvement in functional outcome despite a high retear rate. Further studies are needed to develop specific rehabilitation in the case of primary rotator cuff failure, to better understand the place of each treatment option, and, in case of repair, to optimise tendon healing. PMID:27134759
Konkani, Avinash; Oakley, Barbara; Bauld, Thomas J
Increasing noise in hospital environments, especially in intensive care units (ICUs) and operating rooms (ORs), has created a formidable challenge for both patients and hospital staff. A major contributing factor for the increasing noise levels in these environments is the number of false alarms generated by medical devices. This study focuses on discovering best practices for reducing the number of false clinical alarms in order to increase patient safety and provide a quiet environment for both work and healing. The researchers reviewed Pub Med, Web of Knowledge and Google Scholar sources to obtain original journal research and review articles published through January 2012. This review includes 27 critically important journal articles that address different aspects of medical device alarms management, including the audibility, identification, urgency mapping, and response time of nursing staff and different solutions to such problems. With current technology, the easiest and most direct method for reducing false alarms is to individualize alarm settings for each patient's condition. Promoting an institutional culture change that emphasizes the importance of individualization of alarms is therefore an important goal. Future research should also focus on the development of smart alarms.
Nadel, M.V.; Kerwin, C.M.
This report is part of a larger project designed to assist the NRC in its responsibilities for assessing the management and organization of utilities applying for an operating license for a nuclear power plant. This report reviews the processes and criteria used by other organizations that conduct management and organization audits and evaluations. It was undertaken in order to provide data and a basis for future analysis by taking a comparative perspective. When considering changes in criteria and procedures as the NRC is doing, a standard benchmark is the performance of other organizations that are similarly situated. It was our goal to directly inform the NRC about the activities of other organizations so that a reconsideration of NRC activities could benefit from the perspective of organizations with a longer, broader, and different experience than the NRC has in the management and organization area. Data collected for this report has provided useful information in designing organization and administration guidelines and assessment procedures for consideration by the NRC
Peña, L; Moreno, C B; Gutierrez-Alvarez, A M
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.
Ferrara, Francesco; Bollo, Jesús; Vanni, Letizia V; Targarona, Eduardo M
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 Â© 2016. Publicado por Elsevier España, S.L.U.
Cholette, Jill M; Faraoni, David; Goobie, Susan M; Ferraris, Victor; Hassan, Nabil
Efforts to reduce blood product transfusions and adopt blood conservation strategies for infants and children undergoing cardiac surgical procedures are ongoing. Children typically receive red blood cell and coagulant blood products perioperatively for many reasons, including developmental alterations of their hemostatic system, and hemodilution and hypothermia with cardiopulmonary bypass that incites inflammation and coagulopathy and requires systemic anticoagulation. The complexity of their surgical procedures, complex cardiopulmonary interactions, and risk for inadequate oxygen delivery and postoperative bleeding further contribute to blood product utilization in this vulnerable population. Despite these challenges, safe conservative blood management practices spanning the pre-, intra-, and postoperative periods are being developed and are associated with reduced blood product transfusions. This review summarizes the available evidence regarding anemia management and blood transfusion practices in the perioperative care of these critically ill children. The evidence suggests that adoption of a comprehensive blood management approach decreases blood transfusions, but the impact on clinical outcomes is less well studied and represents an area that deserves further investigation.
Isozaki, Kazunori; Ogawa, To-ru; Nishino, Kazunari
Periodic safety review (Review of the aging management) which consisted of ''Technical review on aging for the safety related structures, systems and components'' and ''Establishment a long term maintenance program'' was carried out up to April 2005. 1. Technical review on aging for the safety related structures, systems and components. It was technically confirmed to prevent the loss of function of the safety related structures, systems and components due to aging phenomena, which (1) irradiation damage, (2) corrosion, (3) abrasion and erosion, (4) thermal aging, (5) creep and fatigue, (6) Stress Corrosion Cracking, (7) insulation deterioration and (8) general deterioration, under the periodic monitoring or renewal of them. 2. Establishment of long term maintenance program. The long term maintenance during JFY2005 to 2014 were established based on the technical review on aging for the safety related structures, systems and components. It was evaluated that the inspection and renewal based on the long term maintenance program, in addition to the spontaneous inspection of the long term voluntary long-term inspection plan, could prevent the loss of function of the safety related structures, systems and components. (author)
Abstract The purpose of this report is to review and evaluate available infor- mation regarding reservoir operation strategies for management of...12 3 Operations Management Examples ............................................................................ 16...report is to review and evaluate available information regarding reservoir operation strategies for management of harmful algal ERDC/EL TR-17-11 2
... 7 Agriculture 15 2010-01-01 2010-01-01 false Initial review of Applicant's management team's...'s management team's qualifications. The Secretary will review the information submitted by the Applicant concerning the qualifications of the Applicant's management team to determine in his or her sole...
Full Text Available 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.
... ENVIRONMENTAL PROTECTION AGENCY [FRL-9843-3; CERCLA-04-2013-3759] Ore Knob Mine Superfund Site; Laurel Springs, Ashe County, North Carolina; Notice of Settlement AGENCY: Environmental Protection Agency... settlement with Herbert N. Francis concerning the Ore Knob Mine Superfund Site located in Laurel Springs...
Rivera, Jordan; McPherson, Amy; Hamilton, Jill; Birken, Catherine; Coons, Michael; Iyer, Sindoora; Agarwal, Arnav; Lalloo, Chitra; Stinson, Jennifer
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
Wickramasinghe, Leelani K; Schattner, Peter; Hibbert, Marienne E; Enticott, Joanne C; Georgeff, Michael P; Russell, Grant M
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.
Labidi, Asma; Serghini, Meriem; Karoui, Sami; Boubaker, Jalel; Filali, Azza
Refractory celiac disease is defined by persisting malabsorptive symptoms in spite of a strict gluten free diet for at least 6 to 12 months. Alternatives to gluten free diet seem to be still controversial. To describe the clinical and epidemiologic aspects of refractory celiac disease, and to identify therapeutic options in this condition. Systematic review and critical analysis of observational studies, clinical trials and case reports that focused on diagnosis and management of refractory celiac disease. Refractory celiac disease can be classified as type 1 or type 2 according to the phenotype of intraepithelial lymphocytes. Great complications such as enteropathy-associated T-cell lymphoma may occur in a subgroup of these patients mainly in refractory celiac disease type 2. Curative therapies are still lacking. Refractory celiac disease remains a diagnosis of exclusion. Its prognosis remains still dismal by the absence yet of curative therapies. However, some new treatments seem to hold promise during few cohort-studies.
Kwame Ofori Adjepong
Full Text Available An estimated 30 million people worldwide have sickle cell disease (SCD. Emergent and non-emergent surgical procedures in SCD have been associated with relatively increased risks of peri-operative mortality, vaso-occlussive (painful crisis, acute chest syndrome, post-operative infections, congestive heart failure, cerebrovascular accident and acute kidney injury. Pre-operative assessment must include careful review of the patient’s known crisis triggers, baseline hematologic profile, usual transfusion requirements, pre-existing organ dysfunction and narcotic use. Use of preoperative blood transfusions should be selective and decisions individualized based on the baseline hemoglobin, surgical procedure and anticipated volume of blood loss. Intra- and post-operative management should focus on minimizing hypoxia, hypothermia, acidosis, and intravascular volume depletion. Pre- and post-operative incentive spirometry use should be encouraged.
Full Text Available Phytotherapy has long been a source of medicinal products and over the years there have been many attempts to use herbal medicines for the treatment of diabetes. Several medicinal plants and their preparations have been demonstrated to act at key points of glucidic metabolism. The most common mechanisms of action found include the inhibition of α-glucosidase and of AGE formation, the increase of GLUT-4 and PPARs expression and antioxidant activity. Despite the large amount of literature available, the actual clinical effectiveness of medicinal plants in controlling diabetes-related symptoms remains controversial and there is a crucial need for stronger evidence-based data. In this review, an overview of the medicinal plants, which use in the management of diabetes is supported by authoritative monographs, is provided. References to some species which are currently under increasing clinical investigation are also reported.
Silverman, Enid; Ebright, Linda; Kwiatkowski, Marianne; Cullina, Joanne
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.
Mileto, Achille; Itani, Malak; Katz, Douglas S; Siebert, Joseph R; Dighe, Manjiri K; Dubinsky, Theodore J; Moshiri, Mariam
Common fetal anomalies of the kidneys and urinary tract encompass a complex spectrum of abnormalities that can be detected prenatally by ultrasound. Common fetal anomalies of the kidneys and urinary tract can affect amniotic fluid volume production with the development of oligohydramnios or anhydramnios, resulting in fetal pulmonary hypoplasia and, potentially, abnormal development of other fetal structures. We provide an overview of common fetal anomalies of the kidneys and urinary tract with an emphasis on sonographic patterns as well as pathologic and postnatal correlation, along with brief recommendations for postnatal management. Of note, we render an updated classification of fetal abnormalities of the kidneys and urinary tract based on the presence or absence of associated urinary tract dilation. In addition, we review the 2014 classification of urinary tract dilation based on the Linthicum multidisciplinary consensus panel.
Boyko, Tatiana V.; Longaker, Michael T.; Yang, George P.
Significance: The incidence of pressure ulcers is increasing due to our aging population and the increase in the elderly living with disability. Learning how to manage pressure ulcers appropriately is increasingly important for all professionals in wound care. Recent Advances: Many new dressings and treatment modalities have been developed over the recent years and the goal of this review is to highlight their benefits and drawbacks to help providers choose their tools appropriately. Critical Issues: Despite an increased number of therapies available on the market, none has demonstrated any clear benefit over the others and pressure ulcer treatment remains frustrating and time-consuming. Future Directions: Additional research is needed to develop products more effective in prevention and treatment of pressure ulcers. PMID:29392094
Lozano, Reymundo; Azarang, Atoosa; Wilaisakditipakorn, Tanaporn; Hagerman, Randi J
Summary The fragile X mental retardation 1 gene, which codes for the fragile X mental retardation 1 protein, usually has 5 to 40 CGG repeats in the 5′ untranslated promoter. The full mutation is the almost always the cause of fragile X syndrome (FXS). The prevalence of FXS is about 1 in 4,000 to 1 in 7,000 in the general population although the prevalence varies in different regions of the world. FXS is the most common inherited cause of intellectual disability and autism. The understanding of the neurobiology of FXS has led to many targeted treatments, but none have cured this disorder. The treatment of the medical problems and associated behaviors remain the most useful intervention for children with FXS. In this review, we focus on the non-pharmacological and pharmacological management of medical and behavioral problems associated with FXS as well as current recommendations for follow-up and surveillance. PMID:27672537
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.
Koelling, M.A.; Kovac, C.P.; Norris, J.E.
Design considerations and construction aspects are presented for the installation of a vertical barrier wall system for the Boeing Company at a Superfund Site near Seattle, WA. The construction was performed during 1996. The vertical barrier wall system included: (1) a soil-bentonite (SB) slurry wall, approximately 670 meters (2200 feet) in length, ranging from 12 to 21 meters (40 to 70 feet) in depth; (2) expansion of a cover system over the area enclosed by the SB wall; and (3) surface drainage improvements. Design and construction of the system addressed requirements of a Consent Decree for the site issued in 1993. The paper discusses the development of the design to meet remedial performance goals of preventing migration of contaminants in the soil/groundwater system and aiding aquifer restoration. Secondly, the paper details installation of the SB wall, highlighting the more significant construction issues, which included excavation of the wall through glacially deposited cobbles/boulders/till as well as addressing the severe elevation changes along the wall alignment. Thirdly, the paper presents Quality Assurance (QA) monitoring and testing performed during the construction phase
Mittal, Ravi; Banerjee, Sumit
Purpose The purpose of this study was to review the principles involved in the management of proximal femoral fractures as reported in the literature. Methods: A medical literature search in the MEDLINE (PubMed) and Cochrane database was undertaken to review strategies and principles in proximal femoral fracture treatment. Randomized control trials and meta analysis were given preference while case reports/small series were rejected. Results and conclusions: Early anatomical reduction and surgical fixation remains the best option to reduce the risk of complications like non-union and avascular necrosis in treating fracture neck femurs. Cancellous screws continue to be the preferred treatment for fixation of neck femur fractures in younger population until the benefit of using sliding hip screws is validated by large multicentric studies. In the geriatric age group, early prosthetic replacement brings down the mortality and morbidity associated with neck femur fractures. Sliding hip screw (DHS) is the best available option for stable inter trochanteric fractures. The use of intramedullary nails e.g. PFN is beneficial in treating inter trochanteric fractures with comminution and loss of lateral buttress. Intramedullary implants have been proven to have increased success rates in subtrochanteric fractures and should be preferred over extramedullary plate fixation systems. PMID:25983451
de Jong, M B; Kokke, M C; Hietbrink, F; Leenen, L P H
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.
Swords, C; Patel, A; Smith, M E; Williams, R J; Kuhn, I; Hopkins, C
There is variation regarding the use of surgery and interventional radiological techniques in the management of epistaxis. This review evaluates the effectiveness of surgical artery ligation compared to direct treatments (nasal packing, cautery), and that of embolisation compared to direct treatments and surgery. A systematic review of the literature was performed using a standardised published methodology and custom database search strategy. Thirty-seven studies were identified relating to surgery, and 34 articles relating to interventional radiology. For patients with refractory epistaxis, endoscopic sphenopalatine artery ligation had the most favourable adverse effect profile and success rate compared to other forms of surgical artery ligation. Endoscopic sphenopalatine artery ligation and embolisation had similar success rates (73-100 per cent and 75-92 per cent, respectively), although embolisation was associated with more serious adverse effects (risk of stroke, 1.1-1.5 per cent). No articles directly compared the two techniques. Trials comparing endoscopic sphenopalatine artery ligation to embolisation are required to better evaluate the clinical and economic effects of intervention in epistaxis.
Boese, Christoph Kolja; Hackl, Michael; Müller, Lars Peter; Ruchholtz, Steffen; Frink, Michael; Lechler, Philipp
Nonoperative management (NOM) has become the standard treatment in hemodynamically stable patients with blunt hepatic injuries. While the reported overall success rates of NOM are excellent, there is a lack of consensus regarding the risk factors predicting the failure of NOM. The aim of this systematic review was to identify the incidence and prognostic factors for failure of NOM in adult patients with blunt hepatic trauma. Prospective studies reporting prognostic factors for the failure of nonoperative treatment of blunt liver injuries were identified by searching MEDLINE and the Cochrane Central Register of Controlled Trials. We screened 798 titles and abstracts, of which 8 single-center prospective observational studies, reporting 410 patients, were included in the qualitative and quantitative synthesis. No randomized controlled trials were found. The pooled failure rate of NOM was 9.5% (0-24%). Twenty-six prognostic factors predicting the failure of NOM were reported, of which six reached statistical significance in one or more studies: blood pressure (p hepatic injuries. Systematic review, level III.
Eshragh, Faezeh; Pooyandeh, Majeed; Marceau, Danielle J
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. Copyright © 2015 Elsevier Ltd. All rights reserved.
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.
Karamitri, Ioanna; Talias, Michael A; Bellali, Thalia
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. Copyright © 2015 John Wiley & Sons, Ltd.
Rupali D Bhalerao
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.
Dwi Iryaning Handayani
Full Text Available Supply Chain Risk Management merupakan risiko yang terjadi pada aliran produk, informasi, bahan baku sampai pengiriman produk akhir yang mengancam keseluruhan supply chain dari pemasok awal hingga sampai konsumen. Sedangkan Supply chain disruptions (gangguan rantai pasok adalah peristiwa tak terencana yang terjadi dalam rantai pasok yang bisa mempengaruhi aliran bahan dan komponen. Kejadian risiko yang terjadi didalam supply chain telah banyak dilakukan oleh beberapa peneliti sehingga perlu dilakukan review untuk mengetahui potensi risiko yang terjadi pada supply chain. Risiko yang terjadi pada supply chain berdasarkan hasil penelitian sebelumya terdapat 120 jenis risiko. Kesamaan risiko yang terjadi pada supply chain menghasilkan 17 jenis risiko yang sama pada supply chain dan terdapat 3 risiko yang sering terjadi yaitu risiko demand, keterlambatan bahan baku, Bencana alam (discruption, sedangkan 14 risiko lainnya yaitu , kwalitas supplier, kwalitas produk, sistem informasi, harga, suplai, produk rusak digudang, finansial, ketergantungan supplier, penundaan, kapasitas produksi, persediaan, kekurangan bahan baku, selisih stok dan politik. Adapun mitigasi yang dapat dilakukan dalam mengatasi gangguan supply chain ada 9 strategi yaitu: postponement, strategy stock, flexible supply base. make and buy, economic supply incentives, flexible transportation. revenue management via dynamic pricing and promotion, assortment planning. silent product rollover.
Burkitt, M D; Pritchard, D M
Gastric carcinoid tumours are rare, but are increasing in incidence. To discuss tumour pathogenesis and outline current approaches to patient management. Review of published articles following a Pubmed search. Although interest in gastric carcinoids has increased since it was recognized that they are associated with achlorhydria, to date there is no definite evidence that humans taking long-term acid suppressing medication are at increased risk. Type I tumours are associated with autoimmune atrophic gastritis and hypergastrinaemia, type II are associated with Zollinger-Ellison syndrome, multiple endocrine neoplasia-1 and hypergastrinaemia and sporadic type III carcinoids are gastrin-independent and carry the worst prognosis. Careful investigation of these patients is required, particularly to identify the tumour type, the source of hypergastrinaemia and the presence of metastases. Treatment can be directed at the source of hypergastrinaemia if type I or II tumours are still gastrin responsive and not growing autonomously. Type III tumours should be treated surgically. Advances in our understanding of the pathogenesis of gastric carcinoids have led to recent improvements in investigation and management. Challenges remain in identifying the genetic and environmental factors, in addition to hypergastrinaemia, that are responsible for tumour development in susceptible patients.
Full Text Available Jakob Nielsen, Karsten Fogh Department of Dermatology, Aarhus University Hospital, Aarhus, Denmark Background: The management of chronic wounds is a significant medical burden associated with large health care expenditures. Since the establishment of moist wound healing in the 1960s, several types of wound dressings have been developed. However, the evidence for effectiveness when comparing various types of wound dressings is limited. Objectives: The purpose of this review is 1 to provide a general description of the role of foam in wound therapy and 2 to evaluate the evidence for effectiveness of foam dressings compared to other frequently used products. Summary and conclusion: Foam has a significant role in the clinical management of chronic wounds and in moist wound healing. There are only a few randomized controlled trials, which in general, show no significant difference in the healing effect of different dressing types. The choice of wound dressing should therefore be based on clinical evaluation of the wound and the periwound skin. Keywords: foam dressing, chronic wounds, comparative effectiveness, healing, periwound skin, ulcers
Yeh, William W.-G.
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.
Imran, H M; Akib, Shatirah; Karim, Mohamed Rehan
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.
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.
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.
This primer outlines key concepts and expectations of a Transportation Management Area (TMA) Planning Certification Review. Reflecting on the collective experiences of past Certification Reviews, this includes references to relevant laws and regulati...
Blake, Alexia; Wan, Bo Angela; Malek, Leila; DeAngelis, Carlo; Diaz, Patrick; Lao, Nicholas; Chow, Edward; O'Hearn, Shannon
Insufficient management of cancer-associated chronic and neuropathic pain adversely affects patient quality of life. Patients who do not respond well to opioid analgesics, or have severe side effects from the use of traditional analgesics are in need of alternative therapeutic op-tions. Anecdotal evidence suggests that medical cannabis has potential to effectively manage pain in this patient population. This review presents a selection of representative clinical studies, from small pilot studies conducted in 1975, to double-blind placebo-controlled trials conducted in 2014 that evaluated the efficacy of cannabinoid-based therapies containing tetrahydrocannabinol (THC) and cannabidiol (CBD) for reducing cancer-associated pain. A review of literature published on Medline between 1975 and 2017 identified five clinical studies that evaluated the effect of THC or CBD on controlling cancer pain, which have been reviewed and summarised. Five studies that evaluated THC oil capsules, THC:CBD oromucosal spray (nabiximols), or THC oromucosal sprays found some evidence of cancer pain reduction associated with these therapies. A variety of doses ranging from 2.7-43.2 mg/day THC and 0-40 mg/day CBD were administered. Higher doses of THC were correlated with increased pain relief in some studies. One study found that significant pain relief was achieved in doses as low as 2.7-10.8 mg THC in combination with 2.5-10.0 mg CBD, but there was conflicting evidence on whether higher doses provide superior pain relief. Some reported side effects include drowsiness, hypotension, mental clouding, and nausea and vomiting. There is evidence suggesting that medical cannabis reduces chronic or neu-ropathic pain in advanced cancer patients. However, the results of many studies lacked statistical power, in some cases due to limited number of study subjects. Therefore, there is a need for the conduct of further double-blind, placebo-controlled clinical trials with large sample sizes in order to
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
Julius Simoni Leere
Full Text Available IntroductionPrimary hyperparathyroidism is increasingly an asymptomatic disease at diagnosis, but the recognized guidelines for management are based on evidence obtained from studies on patients with symptomatic disease, and surgery is not always indicated. Other patients are unable to undergo surgery, and thus a medical treatment is warranted. This systematic review provides an overview of the existing literature on contemporary pharmaceutical options available for the medical management of primary hyperparathyroidism.MethodsDatabases of medical literature were searched for articles including terms for primary hyperparathyroidism and each of the included drugs. Data on s-calcium, s-parathyroid hormone, bone turnover markers, bone mineral density (BMD and hard endpoints were extracted and tabulated, and level of evidence was determined. Changes in s-calcium were estimated and a meta-regression analysis was performed.ResultsThe 1,999 articles were screened for eligibility and 54 were included in the review. Weighted mean changes calculated for each drug in s-total calcium (mean change from baseline ± SEM were pamidronate (0.31 ± 0.034 mmol/l; alendronate (0.07 ± 0.05 mmol/l; clodronate (0.20 ± 0.040 mmol/l; mixed bisphosphonates (0.16 ± 0.049 mmol/l; and cinacalcet (0.37 ± 0.013 mmol/l. The meta-analysis revealed a significant decrease of effect on s-calcium with time for the bisphosphonates (Coef. −0.049 ± 0.023, p = 0.035, while cinacalcet proved to maintain its effect on s-calcium over time. Bisphosphonates improved BMD while cinacalcet had no effect.DiscussionThe included studies demonstrate advantages and drawbacks of the available pharmaceutical options that can prove helpful in the clinical setting. The great variation in how primary hyperparathyroidism is manifested requires that management should rely on an individual evaluation when counseling patients. Combining resorptive agents with
Anderson, Neil O.; Flash, Pamela
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…
... Information Collection Activity Under OMB Review: TSA Claims Management Program AGENCY: Transportation... Security Administration (TSA) has forwarded the Information Collection Request (ICR), Office of Management... the nature of the information collection and its expected burden. TSA published a Federal Register...
... Fishery Management Council (Council); Work Session To Review Proposed Salmon Methodology Changes AGENCY.... ACTION: Notice of a public meeting. SUMMARY: The Pacific Fishery Management Council's Salmon Technical Team (STT), Scientific and Statistical Committee (SSC) Salmon Subcommittee, and Model Evaluation...
... Fishery Management Council; Public Meeting; Work Session To Review Proposed Salmon Methodology Changes...), Commerce. ACTION: Notice of a public meeting. SUMMARY: The Pacific Fishery Management Council's Salmon Technical Team (STT), Scientific and Statistical Committee (SSC) Salmon Subcommittee, and Model Evaluation...
Durach, Christian F.; Wieland, Andreas; Kembro, Joakim
methodological developments in the application systematic literature reviews in supply chain management. It analyzes what approaches researchers in supply chain management have taken to follow the requirements of a systematic review, identifies issues in the approaches and provides authors, reviewers and editors...... with suggestions to better craft, disseminate, evaluate and select systematic literature reviews in supply chain management. This paper applies a systematic literature review approach to identify and analyze 31 articles published in core supply chain journals. It is the first research to map these developments......, since three seminal methodology papers on systematic reviews in management research have been published between 2003-2009. This research shows that there is still a need for more transparency in the approaches taken. Systematic literature reviews have a high potential to advance the field...
Akhtar, Nahid; Haqqi, Tariq M
Osteoarthritis (OA) is a progressive degenerative joint disease that has a major impact on joint function and quality of life. Nutraceuticals and dietary supplements derived from herbs have long been used in traditional medicine and there is considerable evidence that nutraceuticals may play an important role in inflammation and joint destruction in OA. We review the biological effects of some medicinal fruits and herbs - pomegranate, green tea, cat's claw, devil's claw, ginger, Indian olibaum, turmeric and ananas - in an attempt to understand the pivotal molecular targets involved in inflammation and the joint destruction process and to summarize their toxicities and efficacy for OA management. So far there is insufficient reliable evidence on the effectiveness of ginger, turmeric and ananas. Pomegranate and green tea only have preclinical evidence of efficacy due to the lack of clinical data. In vivo and clinical studies are required to understand their targets and efficacy in OA. Limited in vitro and in vivo evidence is available for cat's claw and Indian olibaum. More extensive studies are required before long-term controlled trials of whole cat's claw and Indian olibaum extracts, or isolated active compounds, are carried out in patients with OA to determine their long-term efficacy and safety. Devil's claw has not been rigorously tested to determine its antiarthritic potential in in vitro and in vivo models. There is strong clinical evidence of the effectiveness of devil's claw in pain reduction. However, high-quality clinical trials are needed to determine its effectiveness. No serious side effects have been reported for any fruits and herbs. Overall, these studies identify and support the use of nutraceuticals to provide symptomatic relief to patients with OA and to be used as adjunct therapy for OA management. More high-quality trials are needed to provide definitive answers to questions related to their efficacy and safety for OA prevention and
Elhennawy, Karim; Schwendicke, Falk
We systematically reviewed treatment modalities for MIH-affected molars and incisors. Trials on humans with ≥1 MIH molar/incisor reporting on various treatments were included. Two authors independently searched and extracted records. Sample-size-weighted annual failure rates were estimated where appropriate. The risk of bias was assessed using the Newcastle-Ottawa scale. Electronic databases (PubMed, Embase, Cochrane CENTRAL, Google Scholar) were screened, and hand searches and cross-referencing performed. Fourteen (mainly observational) studies were included. Ten trials (381 participants) investigated MIH-molars, four (139) MIH-incisors. For molars, remineralization, restorative or extraction therapies had been assessed. For restorative approaches, mean (SD) annual failure rates were highest for fissure sealants (12%) and glass-ionomer restorations (12%), and lowest for indirect restorations (1%), preformed metal crowns (1.3 [2.1]%) and composite restorations (4%). Ony study assessed extraction of molars in young patients (median age 8.2 years), the majority of them without malocclusions, but third molars in development. Spontaneous alignment of second molars was more frequent in the maxilla (55%) than the mandible (47%). For incisors, desensitizing agents successfully managed hypersensitivity. Micro-abrasion and composite veneers improved aesthetics. Few, mainly moderate to high-risk-studies investigated treatment of MIH. Remineralization or sealants seem suitable for MIH-molars with limited severity and/or hypersensitivity. For severe cases, restorations with composites or indirect restorations or preformed metal crowns seem suitable. Prior to tooth extraction as last resort factors like the presence of a general malocclusion, patients' age and the status of neighboring teeth should be considered. No recommendations can be given for MIH-incisors. Dentists need to consider the specific condition of each tooth and the needs and expectations of
Hussein, K; Bitterman, R; Shofty, B; Paul, M; Neuberger, A
Infections complicating neurosurgery pose unacceptable mortality and morbidity. To summarize what is known about the epidemiology, diagnosis and treatment of post-neurosurgical meningitis (PNM). PubMed, references of identified studies and reviews, and personal experience when evidence was lacking. The incidence and pathogen distribution of PNM is highly variable. A shift towards Gram-negative bacteria has been observed with use of antibiotic prophylaxis and antibiotic-coated devices directed mainly against Gram-positive bacteria. However, knowledge of the local epidemiology is necessary to treat PNM. The diagnosis of PNM is difficult because, unlike community-acquired meningitis, symptoms are less specific; patients are ill at baseline and many neurosurgical conditions mimic meningitis and cause cerebrospinal fluid (CSF) abnormalities. Pivotal CSF findings for diagnosis of PNM are the CSF glucose, CSF lactate and Gram stain. CSF leucocyte counts are not specific in PNM. Current diagnostic capabilities leave a non-negligible category of patients with microbiologically negative, uncertain diagnosis of PNM. There is no high-quality evidence on several cardinal issues in PNM management, including the effectiveness of intraventricular or intrathecal (IV/IT) antibiotics, effectiveness of dual antibiotic therapy for multidrug-resistant Gram-negative bacteria; clinical benefit of routine therapeutic drug monitoring; and safest timing of shunt replacement. Some data point to a potential benefit of IV/IT antibiotic treatment, mainly for PNM caused by carbapenem-resistant Gram-negative bacteria. Carbapenem-colistin combination therapy is suggested for PNM caused by carbapenem-resistant Gram-negative bacteria with a carbapenem MIC ≤8 mg/L. Guiding the optimal management of PNM will necessitate collaborative multicentre efforts and unique study designs. Copyright © 2017 European Society of Clinical Microbiology and Infectious Diseases. Published by Elsevier Ltd. All rights
Kohn, Nancy P; Evans, Nathan R
This report represents Phase I of a multi-phase approach to a source investigation of DDT at the Heckathorn Superfund Site, Richmond, California, the former site of a pesticide packaging plant, and the adjacent waterway, the Lauritzen Channel. Potential identified sources of contamination were from sloughed material from undredged areas (such as side banks) and from outfall pipes. Objectives of Phase I included the (1) evaluation of pesticide concentrations associated with discharge from outfalls, (2) identification of additional outfalls in the area, (3) identification of type, quantity, and distribution of sediment under the Levin pier, (4) quantification of pesticide concentrations in sediment under the pier, and (5) evaluation of sediment structure and slope stability under the pier. Field operations included the collection of sediment directly from inside the mouths of outfall pipes, when possible, or the deployment of specially designed particle traps where direct sampling was problematic. Passive water samplers were placed at the end of known outfall pipes and analyzed for DDT and other pesticides of concern. Underwater dive surveys were conducted beneath the Levin pier to document type, slope, and thickness of sediment. Samples were collected at locations of interest and analyzed for contaminants. Also sampled was soil from bank areas, which were suspected of potentially contributing to continued DDT contamination of the Lauritzen Channel through erosion and groundwater leaching. The Phase I Source Investigation was successful in identifying significant sources of DDT contamination to Lauritzen Channel sediment. Undredged sediment beneath the Levin pier that has been redistributed to the channel is a likely source. Two outfalls tested bear further investigation. Not as well-defined are the contributions of bank erosional material and groundwater leaching. Subsequent investigations will be based on the results of this first phase.
Full Text Available Gina Cosentino,1 Ariane O Conrad,2 Gabriel I Uwaifo1 1Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Louisiana State University Health Sciences Center, New Orleans, LA, USA; 2Xavier University of Louisiana College of Pharmacy, New Orleans, LA, USA Abstract: 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
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
Joo, J Y; Liu, M F
This qualitative systematic review aimed to identify and synthesize recent qualitative studies to improve understanding of the experiences and perceptions of case management interventions that individuals with chronic illnesses and their caregivers have. Case management has been shown to be effective at improving quality of care and lowering costs for individuals with chronic illnesses. However, no qualitative review has been synthesized with recent qualitative studies about case management experiences by individual with chronic illnesses. This qualitative systematic review uses a thematic synthesis method to review 10 qualitative studies published within the last 10 years, from 2007 to 2016, thereby identifying and discussing the understandings that individuals with chronic illnesses and their caregivers have about case management. From this synthesis, three themes were identified as facilitators of case management (access to healthcare resources, health status supports and emotional aid) and two themes were identified as barriers to it (low information about case management and time constraints). This is the first qualitative systematic review of the perceptions and experiences that individuals with chronic illnesses and their caregivers have about case management. The facilitators of case management can be employed to inform patients about the benefits of case management and to improve population health. The findings about barriers to case management can be used to reform case management for populations with chronic illnesses. These factors should be considered by nursing researchers and healthcare policymakers when implementing case management. © 2018 International Council of Nurses.
Shaukat, Aasma; Levitt, Michael D; Taylor, Brent C; MacDonald, Roderick; Shamliyan, Tatyana A; Kane, Robert L; Wilt, Timothy J
Lactose intolerance resulting in gastrointestinal symptoms is a common health concern. Diagnosis and management of this condition remain unclear. To assess the maximum tolerable dose of lactose and interventions for reducing symptoms of lactose intolerance among persons with lactose intolerance and malabsorption. Multiple electronic databases, including MEDLINE and the Cochrane Library, for trials published in English from 1967 through November 2009. Randomized, controlled trials of individuals with lactose intolerance or malabsorption. Three investigators independently reviewed articles, extracted data, and assessed study quality. 36 unique randomized studies (26 on lactase- or lactose-hydrolyzed milk supplements, lactose-reduced milk, or tolerable doses of lactose; 7 on probiotics; 2 on incremental lactose administration for colonic adaptation; and 1 on another agent) met inclusion criteria. Moderate-quality evidence indicated that 12 to 15 g of lactose (approximately 1 cup of milk) is well tolerated by most adults. Evidence was insufficient that lactose-reduced solution or milk with a lactose content of 0 to 2 g, compared with greater than 12 g, is effective in reducing symptoms of lactose intolerance. Evidence for probiotics, colonic adaptation, and other agents was also insufficient. Most studies evaluated persons with lactose malabsorption rather than lactose intolerance. Variation in enrollment criteria, outcome reporting, and the composition and dosing of studied agents precluded pooling of results and limited interpretation. Most individuals with presumed lactose intolerance or malabsorption can tolerate 12 to 15 g of lactose. Additional studies are needed to determine the effectiveness of lactose intolerance treatment.
Full Text Available Aquaponics (AP, the integrated multi-trophic fish and plants production in quasi-closed recirculating system, is one of the newest sustainable food production systems. The hydroponic component of the AP directly influences water quality (in turn influencing fish growth and health, and water consumption (through evapotranspiration of the entire system. In order to assess the role of the design and the management of the hydroponic component on the overall performance, and water consumption of the aquaponics, 122 papers published from 1979 to 2017 were reviewed. Although no unequivocal results were found, the nutrient film technique appears in several aspects less efficient than medium-based or floating raft hydroponics. The best system performance in terms of fish and plant growth, and the highest nutrient removal from water was achieved at water flow between 0.8 L min–1 and 8.0 L min–1. Data on water consumption of aquaponics are scarce, and no correlation between the ratio of hydroponic unit surface/fish tank volume and the system water loss was found. However, daily water loss was positively correlated with the hydroponic surface/fish tank volume ratio if the same experimental conditions and/or systems were compared. The plant species grown in hydroponics influenced the daily water loss in aquaponics, whereas no effect was exerted by the water flow (reciprocating flood/drain cycle or constant flow or type (medium-based, floating or nutrient film technique of hydroponics.
Nomakhosi, Mpofana; Heidi, Abrahamse
A blemish free, even-toned skin is universally associated with healthy skin. This reasoning makes people desire to have a flawless skin. Melanin is a naturally occurring pigment in humans. This pigment is responsible for skin, hair, and eye color, therefore determines our race and phenotypic appearance. On darker skin types, it is common that melanin production processes malfunctions. These malfunctions often lead to overproduction and secretion of melanin. As a result, unwanted pigmentary problems such melasma occur. Due to unknown etiology and its recurrence in nature, melasma is challenging to treat. The current available melasma treatment options often produce undesired side effects and suboptimum results. First-line topical treatments usually involve hydroquinone or topical steroids. Apart from the irritant reactions, this treatment mode is not suitable for all skin types. Skin care specialists are in search of an effective long-term cosmetics and cosmeceuticals to address hypermelanosis problems. Understanding of naturally occurring depigmenting agents provides an opportunity for more effective ways to manage melasma in all skin types. This review considers the benefits of naturally occurring ingredients which could help address skin pigmentation problems and broaden the choice for skin-lightening treatments.
Dennis, Elizabeth A; Flack, Kyle D; Davy, Brenda M
Total energy consumption among United States adults has increased in recent decades, and energy-containing beverages are a significant contributor to this increase. Because beverages are less satiating than solid foods, consumption of energy-containing beverages may increase energy intake and lead to weight gain; trends in food and beverage consumption coinciding with increases in overweight and obesity support this possibility. The purpose of this review is to present what is known about the effect of beverage consumption on short-term (i.e., meal) energy intake, as well as longer-term effects on body weight. Specific beverages addressed include water, other energy-free beverages (diet soft drinks, coffee and tea), and energy-containing beverages (soft drinks, juices and juice drinks, milk and soy beverages, alcohol). Existing evidence, albeit limited, suggests that encouraging water consumption, and substituting water and other energy-free beverages (diet soft drinks, coffee and tea) for energy-containing beverages may facilitate weight management. Energy-containing beverages acutely increase energy intake, however long-term effects on body weight are uncertain. While there may be health benefits for some beverage categories, additional energy provided by beverages should be compensated for by reduced consumption of other foods in the diet.
...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment Request; Experimental Study of Consumer Response to Health Claims and Disclaimers About the Relationship... has been submitted to the Office of Management and Budget (OMB) for review and clearance under the...
...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment... Document; Automated Blood Cell Separator Device Operating by Centrifugal or Filtration Separation Principle... Management and Budget (OMB) for review and clearance under the Paperwork Reduction Act of 1995. DATES: Fax...
Manfredini, D.; Ahlberg, J.; Winocur, E.; Lobbezoo, F.
This paper updates the bruxism management review published by Lobbezoo et al. in 2008 (J Oral Rehabil 2008; 35: 509-23). The review focuses on the most recent literature on management of sleep bruxism (SB) in adults, as diagnosed with polysomnography (PSG) with audio-video (AV) recordings, or with
... intended goals. The PDUFA V Commitment Letter specifies that the assessments be conducted by an independent...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment... Management and Budget (OMB) for review and clearance under the Paperwork Reduction Act of 1995. DATES: Fax...
...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment Request; Medical Device User Fee Cover Sheet--Form FDA 3601 AGENCY: Food and Drug Administration, HHS... of information has been submitted to the Office of Management and Budget (OMB) for review and...
...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment Request; Medical Device User Fee Cover Sheet, Form FDA 3601 AGENCY: Food and Drug Administration, HHS... of information has been submitted to the Office of Management and Budget (OMB) for review and...
...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment Request; Animal Drug User Fee Cover Sheet, Form 3546 AGENCY: Food and Drug Administration, HHS. ACTION... information has been submitted to the Office of Management and Budget (OMB) for review and clearance under the...
... 32 National Defense 2 2010-07-01 2010-07-01 false Internal Management Control Review Checklist B... B to Part 327—Internal Management Control Review Checklist (a) Task: Personnel and/or Organization... See footnote 2 to this Appendix B. (1) I attest that the above listed internal controls provide...
... Federal Hazardous Substances Act, and the Flammable Fabrics Act, as amended by the Consumer Product Safety... of Management and Budget Review; Comment Request; Procedures for Export of Noncomplying Goods AGENCY... Office of Management and Budget (``OMB'') for review and clearance under the Paperwork Reduction Act of...
...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment Request; Petition to Request an Exemption From 100 Percent Identity Testing of Dietary Ingredients... Management and Budget (OMB) for review and clearance under the Paperwork Reduction Act of 1995. DATES: Fax...
... identified in FDA's official establishment inventory plus 1,220 very small apple juice manufacturers and 230...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment... Management and Budget (OMB) for review and clearance under the Paperwork Reduction Act of 1995. DATES: Fax...
The article reviews the book "Current Issues in International Human Resource Management and Strategy Research," edited by Marion Festing and Susanne Royer.......The article reviews the book "Current Issues in International Human Resource Management and Strategy Research," edited by Marion Festing and Susanne Royer....
...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment... information has been submitted to the Office of Management and Budget (OMB) for review and clearance under the... advertisements. Section 904(a)(1) of the act, as amended by the Tobacco Control Act, requires each tobacco...
...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment Request; Prescription Drug Advertisements AGENCY: Food and Drug Administration, HHS. ACTION: Notice... has been submitted to the Office of Management and Budget (OMB) for review and clearance under the...
...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment... of information has been submitted to the Office of Management and Budget (OMB) for review and... warnings be displayed on packaging and advertising for each brand of smokeless tobacco ``in accordance with...
...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment... of information has been submitted to the Office of Management and Budget (OMB) for review and... as to whether the device could be corrected by labeling, change of labeling, change of advertising...
...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment... of information has been submitted to the Office of Management and Budget (OMB) for review and... specified health warning label statements required to appear in advertising and packaging. FDA is required...
Graves, Rachel L; Goldshear, Jesse; Perrone, Jeanmarie; Ungar, Lyle; Klinger, Elissa; Meisel, Zachary F; Merchant, Raina M
To characterize Yelp reviews about pain management and opioids. We manually coded and applied natural language processing to 836 Yelp reviews of US hospitals mentioning an opioid medication. Yelp reviews by patients and caregivers describing experiences with pain management and opioids had lower ratings compared with other reviews. Negative descriptions of pain management and opioid-related experiences were more commonly described than positive experiences, and the number of themes they reflected was more diverse. Yelp reviews offer insights into pain management and opioid use that are not assessed by traditional surveys. As a free, highly utilized source of unstructured narratives, Yelp may allow ongoing assessment of policies related to pain management and opioid use.
The Lee Chemical Superfund Site (site) is located along Missouri Highway 210 in Liberty, Missouri, approximately 15 miles east of Kansas City, Missouri. Currently, the site is a vacant lot of approximately2.5 acres in a flat alluvial plain.
Martin, K.; Walker, St.
This paper describes the EPA Superfund program's statutory requirements for community involvement. It also discusses the efforts the Superfund program has made that go beyond these statutory requirements to involve communities, and what lessons have been learned by EPA when trying to conduct meaningful community involvement at sites. In addition, it discusses tools that EPA has designed to specifically enhance community involvement at radioactively contaminated Superfund sites. In summary, the Superfund program devotes substantial resources to involving the local community in the site cleanup decision making process. We believe community involvement provides us with highly valuable information that must be available to carefully consider remedial alternatives at a site. We also find our employees enjoy their jobs more. Rather than fighting with an angry public they can work collaboratively to solve the problems created by the hazardous waste sites. We have learned the time and resources we devote at the beginning of a project to developing relationships with the local community, and learning about their issues and concerns is time and resources well spent. We believe the evidence shows this up-front investment helps us make better cleanup decisions, and avoids last minute efforts to work with a hostile community who feels left out of the decision-making process. (authors)
This process involves incorporating lead-contaminated Superfund waste with the regular feed to a secondary lead smelter. Since secondary lead smelters already recover lead from recycled automobile batteries, it seems likely that this technology could be used to treat waste from ...
Superfund allows the government either to clean up a site and recover its cost from the potentially responsible parties (PRPs) or to require the PRPs to undertake the cleanup themselves. This study examines private-sector expenditures and transaction-costs
Susan Charnley; Bruce. Engelbert
This article discusses an 8-year, ongoing project that evaluates the Environmental Protection Agency's Superfund community involvement program. The project originated as a response to the Government Performance and Results Act, which requires federal agencies to articulate program goals, and evaluate and report their progress in meeting those goals. The evaluation...
... ENVIRONMENTAL PROTECTION AGENCY [Docket EPA-RO4-SFUND-2010-1053, FRL-9243-2] Ward Transformer... entered into a five settlements for reimbursement of past response costs concerning the Ward Transformer... Docket ID No. EPA-RO4- SFUND-2010-1053 or Site name Ward Transformer Superfund Site by one of the...
... ENVIRONMENTAL PROTECTION AGENCY [FRL-9644-2; CERCLA-04-2012-3763] Anniston PCB Superfund Site... FR 11533 (FRL-9637-7), EPA posted a Notice of Amended Settlement concerning the Anniston PCB... the settlement are available from Ms. Paula V. Painter. Submit your comments by Site name Anniston PCB...
... Paul's Tank Cleaning Service Superfund Site, Burlington County, New Jersey AGENCY: Environmental.... (``Settling Party''). The Settling Party is a potentially responsible party, pursuant to Section 107(a) of CERCLA, and thus is potentially liable for response costs incurred at or in connection Paul's Tank...
Saslow Gomez, Sarah A.; Faurie-Wisniewski, Danielle; Parsa, Arlen; Spitz, Jeff; Spitz, Jennifer Amdur; Loeb, Nancy C.; Geiger, Franz M.
The classroom exercise outlined here is a self-directed assignment that connects students to the environmental contamination problem surrounding the DePue Superfund site. By connecting chemistry knowledge gained in the classroom with a real-world problem, students are encouraged to personally connect with the problem while simultaneously…
... superfund cleanup remediation efforts. This RNA will prohibit activities that would disturb the seabed, such... or capped are arsenic, copper, lead, mercury, zinc, PAHs and PCBs. The metal contaminants were... installed in the designated regulated navigation area, pursuant to the remediation efforts of the U.S...
The Tutu Wellfield Superfund Site is a 1.5 square mile site located on the eastern end of St. Thomas, U.S. Virgin Islands (USVI) within the upper Turpentine Run surface drainage basin in the Anna’s Retreat area.
... ENVIRONMENTAL PROTECTION AGENCY [Docket EPA-RO4-SFUND-2010-0729, FRL-9196-1] Florida Petroleum... entered into a settlement for reimbursement of past response costs concerning the Florida Petroleum... No. EPA-RO4- SFUND-2010-0729 or Site name Florida Petroleum Reprocessors Superfund Site by one of the...
Kertz, A F; Hill, T M; Quigley, J D; Heinrichs, A J; Linn, J G; Drackley, J K
The first calf paper, published in the May 1919 issue of the Journal of Dairy Science (JDS), described factors affecting birth body weight of different breeds of calves. Other studies were done on nonmilk ingredients, growth charts were developed, and early weaning was followed to conserve milk fed to calves. Calf papers did not report use of statistics to control or record variation or to determine whether treatment means were different. Many experiments were more observational than comparative. Typically fewer than 5 calves, and sometimes 1 or 2 calves, were used per treatment. During the next 20 yr, calf studies increased and included colostrum feeding, milk and milk replacer feeding, minerals and vitamins, and fats and oils. Many concepts fundamental to current knowledge and understanding of digestion, rumen development, and milk replacer formulation were developed during this period. In addition, the concept of using antibiotic growth promoters in dairy calf diets was first evaluated and developed during the 1950s. During the 20-yr period of January 1957 through December 1976, a large number of universities in the United States and 1 in Canada contributed almost 150 papers on a variety of calf-related topics. These topics included genetics, physiology of the calf, review of calf immunity, antibiotic feeding, and milk replacer ingredients. This became the golden era of calf rumen development studies, which also engendered studies of calf starter rations and ingredients. A classic review of management, feeding, and housing studies summarized research related to calf feeding and management systems up to that point with an emphasis on maintaining calf growth and health while reducing labor and feed costs. It was also during this period that metric measurements replaced English units. In the 20-yr period from 1977 to 1996, more than 400 articles on calf nutrition and management were published in JDS. With the growing research interest in calves, a paper outlining
Yao Xuefen; Zhang Luoping
Along with the industrial development, adverse impacts on the natural environment become more serious, and ecosystem health and ecological security have also been deteriorated.The traditional environment management focused on the shortterm and economic benefits. Such managing pattern is not accommodating to the new situation of increasingly global environment problems and large scale marine environment problems.This paper introduces the advance and definition of a new managing pattern-ecosystem management. Meanwhile, the connotation of ecosystem management was summarized as seven points: Sustainability; Human is an important aspect of ecosystem management; Cooperation is the foundation of ecosystem management; Maintain health and security of ecosystem; Ecological diversity protection characters ecosystem management; Maintain the integrity of ecosystem; Ecosystem management must be founded on scientific theories and precise information. Somebody said Ecosystem Management is "a new label of old ideas". However, there is an essential difference between ecosystem management and traditional environmental management. In the last part of this paper, the differences of the approaches between ecosystem management and traditional environmental management are compared.
Huang, Shaojun; Wu, Qiuwei; Liu, Zhaoxi
This paper reviews the existing congestion management methods for distribution networks with high penetration of DERs documented in the recent research literatures. The congestion management methods for distribution networks reviewed can be grouped into two categories – market methods and direct...... control methods. The market methods consist of dynamic tariff, distribution capacity market, shadow price and flexible service market. The direct control methods are comprised of network reconfiguration, reactive power control and active power control. Based on the review of the existing methods...
Hansen, Anders Peder Lysholm
This paper presents a systematic literature review of scientific papers on cross-functional sourcing teams in top journals within Purchasing and Supply Management. The review identifies four common research topics within the field; Determining factors of sourcing team success, Performance...... management/goals of sourcing teams, Behavior and decisions in sourcing teams and Involvement of purchasing in sourcing teams. Further research on Performance Management and how to create a holistic, teams based perspective in cross-functional sourcing teams is suggested....
Al-Motowa, Saeed A.; Chaudhry, Imtiaz A.
To review the salient features of periocular capillary hemangioma, provide the ophthalmologist with clinical, diagnostic and histological features characteristic of the tumor and discuss various methods of management. Methods were literature review of periocular capillary hemangioma, diagnostic evaluation with emphasis on treatment through the presentation of illustrative clinical cases. Capillary hemangioma is the most common benign vascular tumor found on the head and neck area including eyelids and orbit. The lesion typically manifests within the first few weeks of life, grows rapidly in the first year during the proliferative phase, then invariably and slowly regresses over the next 4 to 5 years during the involutional phase. The lesion may resolve without leaving any significant cosmetic sequelae in vast majority of patients, however, the functional defects in the form of amblyopia, squint, facial disfigurement and rarely optic atrophy may persist long after complete resolution of the tumor. The diagnosis of the capillary hemangioma requires a combination of clinical and imaging studies such as ultrasonography, computerized tomography, magnetic resonance imaging and angiography in selected cases. With the advent of less invasive diagnostic techniques, the need for biopsy in capillary hemangioma has decreased. Nevertheless, it should be differentiated from other periocular tumors such as rhabdomyosarcoma, lymphangioma, chloroma, neuroblastoma, orbital cyst, and orbital cellulites. Treatment is indicated to prevent amblyopia or cosmetic disfigurement. If indicated, intra-lesional corticosteroids may be used to enhance resolution of the tumor. Other forms of treatment tried with variable success include systematic and topical corticosteroids, radiation, surgical excision and intravenous embolization of the tumor. Indecent years, laser ablation of the tumor has been found effective in some cases. Interferon-u has been utilized effectively in cases of capillary
Wouters, M.; Morales, S.; Grollmuss, S.; Scheer, M.
Purpose The paper provides an overview of research published in the innovation and operations management (IOM) literature on 15 methods for cost management in new product development, and it provides a comparison to an earlier review of the management accounting (MA) literature (Wouters & Morales,
... of Facilities Management and Program Services; Submission for OMB Review; Background Investigations for Child Care Workers AGENCY: Office of Facilities Management and Program Services, Public Building... Act, the Regulatory Secretariat will be submitting to the Office of Management and Budget (OMB) a...
... Manager. 515.6 Section 515.6 Indians NATIONAL INDIAN GAMING COMMISSION, DEPARTMENT OF THE INTERIOR GENERAL PROVISIONS PRIVACY ACT PROCEDURES § 515.6 Review of request for amendment of record by the Records Manager. (a) The Records Manager shall, not later than ten (10) days (excluding Saturdays, Sundays and Federal...
Bull Schaefer, Rebecca A.
Although the annual performance review has received much criticism from practitioners and researchers alike, organizations continue to use coaching and/or reviews to maximize employee effectiveness and minimize liabilities. A semester class is a great context to practice skills relating to tracking and reviewing performance. This article describes…
Hong, C.H.L.; Hu, S.; Haverman, T.M.; Stokman, M.; Napeñas, J.J.; Bos-den Braber, J.; Gerber, E.; Geuke, M.; Vardas, E.; Waltimo, T.; Jensen, S.B.; Saunders, D.P.
Introduction: This systematic review aims to update on the prevalence of odontogenic-related infections and the efficacy of dental strategies in preventing dental-related complications in cancer patients since the 2010 systematic review. Review method: A literature search was conducted in the
Hong, Catherine H L; Hu, Shijia; Haverman, Thijs; Stokman, Monique; Napeñas, Joel J; Braber, Jacolien Bos-den; Gerber, Erich; Geuke, Margot; Vardas, Emmanouil; Waltimo, Tuomas; Jensen, Siri Beier; Saunders, Deborah P
INTRODUCTION: This systematic review aims to update on the prevalence of odontogenic-related infections and the efficacy of dental strategies in preventing dental-related complications in cancer patients since the 2010 systematic review. REVIEW METHOD: A literature search was conducted in the
Ratna Reddy, V.; Saharawat, Yashpal Singh; George, Biju
Watershed management (WSM) is the most widely adopted technology in developed as well as developing countries due to its suitability across climatic conditions. Watershed technology is suitable to protect and enhance soil fertility, which is deteriorating at an alarming rate with agricultural intensification in high as well as low rainfall regions. Of late, WSM is considered as an effective poverty alleviation intervention in the rain fed regions in countries like India. This paper aims at providing a basic watershed policy and implementation framework based on a critical review of experiences of WSM initiatives across South Asia. The purpose is to provide cross learnings within South Asia and other developing countries (especially Africa) that are embarking on WSM in recent years. Countries in the region accord differential policy priority and are at different levels of institutional arrangements for implementing WSM programmes. The implementation of watershed interventions is neither scientific nor comprehensive in all the countries limiting the effectiveness (impacts). Implementation of the programmes for enhancing the livelihoods of the communities need to strengthen both technical and institutional aspects. While countries like India and Nepal are yet to strengthen the technical aspects in terms of integrating hydrogeology and biophysical aspects into watershed design, others need to look at these aspects as they move towards strengthening the watershed institutions. Another important challenge in all the countries is regarding the distribution of benefits. Due to the existing property rights in land and water resources coupled with the agrarian structure and uneven distribution and geometry of aquifers access to sub-surface water resources is unevenly distributed across households. Though most of the countries are moving towards incorporating livelihoods components in order to ensure benefits to all sections of the community, not much is done in terms of
Owusu Obeng, Aniwaa; Hamadeh, Issam; Smith, Michael
Opioid analgesics are the standards of care for the treatment of moderate to severe nociceptive pain, particularly in the setting of cancer and surgery. Their analgesic properties mainly emanate from stimulation of the μ receptors, which are encoded by the OPRM1 gene. Hepatic metabolism represents the major route of elimination, which, for some opioids, namely codeine and tramadol, is necessary for their bioactivation into more potent analgesics. The highly polymorphic nature of the genes coding for phase I and phase II enzymes (pharmacokinetics genes) that are involved in the metabolism and bioactivation of opioids suggests a potential interindividual variation in their disposition and, most likely, response. In fact, such an association has been substantiated in several pharmacokinetic studies described in this review, in which drug exposure and/or metabolism differed significantly based on the presence of polymorphisms in these pharmacokinetics genes. Furthermore, in some studies, the observed variability in drug exposure translated into differences in the incidence of opioid-related adverse effects, particularly nausea, vomiting, constipation, and respiratory depression. Although the influence of polymorphisms in pharmacokinetics genes, as well as pharmacodynamics genes (OPRM1 and COMT) on response to opioids has been a subject of intense research, the results have been somehow conflicting, with some evidence insinuating for a potential role for OPRM1. The Clinical Pharmacogenetics Implementation Consortium guidelines provide CYP2D6-guided therapeutic recommendations to individualize treatment with tramadol and codeine. However, implementation guidelines for other opioids, which are more commonly used in real-world settings for pain management, are currently lacking. Hence, further studies are warranted to bridge this gap in our knowledge base and ultimately ascertain the role of pharmacogenetic markers as predictors of response to opioid analgesics. © 2017
The purpose of this project is to obtain a better understanding of operations-level asset management by examining the specific case of signal systems. Key products will include: a synthesis of existing signal systems asset management practices; a gen...
Background: International osteoporosis foundation described severe or established osteoporosis as an osteoporotic individual with a fragility fracture. Orthopaedic surgeons frequently manage fractures, but we believe that large gaps are prevalent in the medical management of osteoporosis after fractures are fixed.
Through a wide range of information and topics, Integrated Watershed Management Principles and Practice shows how involved the watershed management planning process can be. The book is informative, and the author obviously has researched the subject thoroughly. The book's case...
Soysal, M.; Bloemhof, J.M.; Meuwissen, M.P.M.; Vorst, van der J.G.A.J.
The last two decades food logistics systems have seen the transition from a focus on traditional supply chain management to food supply chain management, and successively, to sustainable food supply chain management. The main aim of this study is to identify key logistical aims in these three phases
...) SUPERFUND, EMERGENCY PLANNING, AND COMMUNITY RIGHT-TO-KNOW PROGRAMS COMPREHENSIVE ENVIRONMENTAL RESPONSE... importance of the response activity when compared with competing demands on the Fund; (3) Whether there is... management, project management, financial management and documentation procedures; (12) Whether the applicant...
Hansen, Lars; Kræmmergaard, Pernille
There is more to IT portfolio management than top-management making the right decisions: A review of the IT PPM literature. Organizations experience ongoing challenges in managing their portfolio of InformationTechnology (IT) as IT expenses are becoming a major part of the budget. Hence......, organizations implement a wide range of IT portfolio management (IT PPM) arrangements to increase value from IT. The literature vastly emphasizes the organizational benefits of establishing IT PPM, but only a minor part of the literature emphasizes the unintended and negative consequences of IT PPM....
This manuscript presents the history and evolution of the U.S. Environmental Protection Agency's (EPA) Superfund Innovative Technology Evaluation (SITE) Monitoring and Measurement Technology (MMT) Program. This includes a discussion of how the fundamental concepts of a performanc...
Full Text Available Self-management has received growing attention as an effective approach for long-term condition management. Little is known about which outcomes of supported self-management are valued by patients, their families, health professionals and those who commission self-management services. This study systematically reviewed published empirical evidence in accordance with PRISMA guidelines to determine the outcomes of self-management valued by these key stakeholder groups, using three prominent exemplar conditions: colorectal cancer, diabetes and stroke.To systematically review the literature to identify which generic outcomes of self-management have been targeted and are considered important using three exemplar conditions (colorectal cancer, diabetes and stroke, which collectively have a range of features that are likely to be representative of generic self-management issues.Systematic searching of nine electronic databases was conducted in addition to hand searches of review articles. Abstracts were identified against inclusion criteria and appraised independently by two reviewers, using a critical appraisal tool. Synthesis of findings was conducted using mixed research synthesis.Over 20,536 abstracts were screened. 41 studies which met the review criteria were fully retrieved and appraised. The majority of evidence related to diabetes. Few studies directly focussed on stakeholders' views concerning desired self-management outcomes; the majority of evidence was derived from studies focusing upon the experience of self-management. The views of health care commissioners were absent from the literature. We identified that self-management outcomes embrace a range of indicators, from knowledge, skills, and bio-psychosocial markers of health through to positive social networks.Patients', families', health professionals' and commissioners' views regarding which outcomes of self-management are important have not been clearly elicited. The extent to which
Alshikho, Mohamad J; Talas, Joud M; Noureldine, Salem I; Zazou, Saf; Addas, Aladdin; Kurabi, Haitham; Nasser, Mahmoud
BACKGROUND Intestinal lymphangiectasia (IL) is a rare disease characterized by a dilatation of the intestinal lymphatics and loss of lymph fluid into the gastrointestinal tract leading to hypoproteinemia, edema, lymphocytopenia, hypogammaglobinemia, and immunological abnormalities. Iron, calcium, and other serum components (e.g., lipids, fat soluble vitamins) may also be depleted. A literature search revealed more than 200 reported cases of IL. Herein, we report our observations of a patient diagnosed with IL; we also present our conclusion for our review of the published literature. CASE REPORT A 24-year-old male was admitted to Aleppo University Hospital with the complaints of abdominal pain, headache, arthralgia, fever, and rigors. His past medical history was remarkable for frequent episodes of diarrhea, recurrent infections, and swelling in the lower limbs. In addition, he had been hospitalized several times in non-academic hospitals due to edema in his legs, cellulitis, and recurrent infections. In the emergency department, a physical examination revealed a patient in distress. He was weak, dehydrated, pale, and had a high-grade fever. His lower extremities were edematous, swollen, and extremely tender to touch. The overlying skin was erythematous and warm. Moreover, the patient was tachycardic, tacypneic, and moderately hypotensive. The patient was resuscitated with IV fluids, and Tylenol was administered to bring the temperature down. Blood tests showed anemia and high levels of inflammatory markers. The patient's white blood cell count was elevated with an obvious left shift. However, subsequent investigations showed that the patient had IL. Suitable diet modification plans were applied as a long-term management plan. CONCLUSIONS IL is a rare disease of challenging nature due to its systematic effects and lack of comprehensive studies that can evaluate the effectiveness of specific treatments in a large cohort of patients. MCT (medium-chain triglyceride
Logistics Air Force Institute of Technology, WAFB, OH I1. CONTROLLING OFFICE N-34E AND ADDRESS 12. REPORT DATE Department of Communication and Humanities...First, upper level managers sometimes fail to accurately translate their understanding of corporate objectives and goals into the technical envi...could also be classified as a "style" of management. A management technique according to John Argenti is "a recognized method of analyzing or solving a
Vijay Pal Dhaka; Pooja Nahar
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 ...
Indratmo, J; Vassileva, Julita
Personal information management (PIM) covers a large area of research fragmented into separate sub-areas such as file management, web bookmark organization, and email management. Consequently, it is hard to obtain a unified view of the various approaches to PIM developed in these different sub-areas. In this article, we synthesize and classify existing research on PIM based on the approach used to organize information items. We classify the organizational structures into five categories: hier...
Zullina H. Shaari; Amzairi Amar; M. Radzi Zainol; Azamudin Badri Harun
Two models of corporate brand or reputation management include ¡°leadership and success¡± as a dimension that influences reactions of multiple stakeholders to organisations. Primary groups of stakeholders such as shareholders/investors, employees, and customers, often associate leadership of organisations with Chief Executive Officers (CEOs) or managing directors. This paper proposes that if CEOs are to be capitalised as part of corporate brand management, their leadership should be projected...
Gorelick, Steven M.
Models which solve the governing groundwater flow or solute transport equations in conjunction with optimization techniques, such as linear and quadratic programing, are powerful aquifer management tools. Groundwater management models fall in two general categories: hydraulics or policy evaluation and water allocation. Groundwater hydraulic management models enable the determination of optimal locations and pumping rates of numerous wells under a variety of restrictions placed upon local drawdown, hydraulic gradients, and water production targets. Groundwater policy evaluation and allocation models can be used to study the influence upon regional groundwater use of institutional policies such as taxes and quotas. Furthermore, fairly complex groundwater-surface water allocation problems can be handled using system decomposition and multilevel optimization. Experience from the few real world applications of groundwater optimization-management techniques is summarized. Classified separately are methods for groundwater quality management aimed at optimal waste disposal in the subsurface. This classification is composed of steady state and transient management models that determine disposal patterns in such a way that water quality is protected at supply locations. Classes of research missing from the literature are groundwater quality management models involving nonlinear constraints, models which join groundwater hydraulic and quality simulations with political-economic management considerations, and management models that include parameter uncertainty.
Labrague, Leodoro J; McEnroe-Petitte, Denise M
Nurse education plays a critical role in the achievement of conflict management skills in nursing students. However, a wider perspective on this concept has not been explored. This paper is a report of a review appraising and synthesizing existing empirical studies describing conflict management styles among nursing students. An integrative review method guided this review. Five (5) bibliographic databases (CINAHL, Medline, Psych Info, Embase and SCOPUS) were searched to locate relevant articles. An electronic database search was performed in December 2016 to locate studies published from 2007 onwards. The search words included: 'conflict', 'management resolution', 'management style', 'management strategy', 'nursing', 'student'. Thirteen (13) articles met the inclusion criteria. Nursing students preferred 'constructive/positive conflict management styles' when handling conflicts. However, more studies are needed to identify factors that may affect their choice of styles. Further, this review emphasizes the need for empirical studies to identify appropriate interventions that would effectively enhance nursing students' skills in managing conflicts using rigorous methods. Nursing faculty play a critical role in teaching, training, and modeling constructive conflict resolution styles in nursing students. Simulation scenarios, reflective exercises, and role playing may be useful to facilitate such learning in choosing constructive conflict management styles. Structured training programme on conflict management will assist nursing students develop positive conflict management styles. Copyright © 2017 Elsevier Ltd. All rights reserved.
Davidson, Benjamin; Nassiri, Farshad; Mansouri, Alireza; Badhiwala, Jetan H; Witiw, Christopher D; Shamji, Mohammed F; Peng, Philip W; Farb, Richard I; Bernstein, Mark
Spontaneous intracranial hypotension (SIH) is a condition of low cerebrospinal fluid volume and pressure caused by a leak of cerebrospinal fluid through a dural defect. Diagnosis and management can be difficult, often requiring coordination between multiple disciplines for myelography, blood patching, and possible surgical repair. Patients should be monitored closely, because they can deteriorate into a coma or even death. There are no widely accepted guidelines for the management of SIH. We review the existing SIH literature, illustrate management challenges via a case review, and propose an algorithm developed by neurosurgeons, radiologists, and anesthesiologists intended to simplify and streamline the management of SIH. Copyright © 2017 Elsevier Inc. All rights reserved.
... 7 Agriculture 10 2010-01-01 2010-01-01 false Has the Office of Management and Budget reviewed the... COMMODITIES General Information § 1484.11 Has the Office of Management and Budget reviewed the paperwork and... by this part have been submitted to the Office of Management and Budget (OMB) for emergency review...
... 7 Agriculture 10 2010-01-01 2010-01-01 false Has the Office of Management and Budget reviewed the... Compliance § 1486.512 Has the Office of Management and Budget reviewed the paperwork and record keeping... been submitted to the Office of Management and Budget (OMB) for review and under the Paperwork...
Adnexal masses in different age groups may need different management approaches. By elimination of the type of mass that is less likely in a specific age group one can identify the most prevalent group which can guide management. Most important of all, the probability of malignancy must either be identified or ruled out.
Medical management of ectopic pregnancies is a safe and effective management option, as proven by international data, but at Tygerberg Hospital the safety of this treatment modality cannot be guaranteed because of poor follow-up. Improvement in patient selection with consideration of predictors of success and thorough ...
Takwate, Kwaji Tizhe
This paper examines the concept of management of diversification at tertiary education level in view of the growth of national secondary education system which vested high scramble for tertiary education was made in relation to question of access and expansion. This paper examines management of diversification at tertiary education level as a…
Van Ruijven, T.W.J.
Serious games and virtual environments are increasingly used for emergency management training and research. The development of these technologies seems to contribute to a solution to some problems in the existing literature on emergency management which is mainly based on case study research.
The Integrated Management of Childhood Illness (IMCI) strategy is the primary child-care approach of choice for South Africa.1,2 IMCI training was introduced into ... by nurse practitioner and doctor alike in empowering them to make easy, evidence-based decisions in the management of sick children at first contact level.
Background: Management of burn continues to be a great challenge. Dressing and ... The state of depression was assessed using Beck classification of ... depression. Conclusion: Conservative management of burns is associated with more wound complications. Sudan Joural of Medical Studies Vol. 2 (1) 2007: pp. 25-28 ...
for fertility services in the HIV-positive population has thus increased and may be employed for management of infertility and protection from transmission or acquisition of HIV infection. As such, preconception counseling, sexual health and fertility screening have become routine in the management of HIV-positive couples.
Dou Yikang; He Yinbiao; Xu Xuelian; Zhang Ming; Liang Xingyun
According to the requirements of NNSA, for Chinese operational NPPs periodical safety review (PSR) should be carried out every 10 years. Ageing management is one of the important safety factors to be reviewed. Entrusted by Qinshan Nuclear Power Plant (QNPP), Shanghai Nuclear Engineering Research and Design Institute (SNERDI) carried out the ageing management review (AMR), as a part of the first PSR of QNPP, from 2001 to 2003. This paper summarizes the methodology of the AMR process, including screening of critical components and structures, identification of main ageing mechanisms and their indicators and the tabulated review process, etc. 15 components and structures, hereafter referred as equipment, were selected as review objects based on their significance of safety, replaceability and cost-benefit considerations. To these objects, the main ageing mechanisms and relevant ageing indicators were identified according to specific working and environmental condition, design and manufacture information, operation and maintenance history, etc. The review can be divided into two parallel parts, the review for specific equipment and the review for overall management procedures and their implementation. To typical components, such as RPV and SG, fatigue analysis based on operational transient accounting was carried out to observe the actual safety margins. Through the review, the weaknesses in ageing management and potential threats to structural integrity were identified and thus continued improvement can be made in the next period of 10 years. (authors)
Effective and efficient caseload management requires extensive skills to ensure that patients receive the right care by the right person at the right time. District nursing caseloads are continually increasing in size and complexity, which requires specialist district nursing knowledge and skills. This article reviews the literature related to caseload management with the aim of identifying the most effective method for district nursing teams. The findings from this review are that there are different styles and methods of caseload management. The literature review was unable to identify a single validated tool or method, but identified themes for implementing effective caseload management, specifically caseload analysis; workload measurement; work allocation; service and practice development and workforce planning. This review also identified some areas for further research.
Managing Osteoarthritis Pain With Medicines A Review of the Research for Adults Is This Summary Right for Me? Yes, if: A doctor* said you have osteoarthritis (pronounced ah-stee-oh- arth-RYE-tis). Osteoarthritis ...
Lee, Yong Hee; Lee, Jung Woon
This technical report describes a result of reviews on the risk management terminology for the use in standards. Experiences in related technical fields and their definitions are reviewed according to the concepts and operational definitions of risk terminologies. It results into a draft standard for KS in the fields of product safety. Quality Assurance, Industrial and Occupational Safety, Financial Management and Risk Management, and others may show many different definitions for their own technical purpose. A draft KS standard for risk terminology must be revised and enhanced to be adopted to the product safety. However, this review does not provide a strict guide for use in the operational definitions of risk terms, but does provide a common base among application areas. The result of this review is submitted to Korea Standard Association in form of a draft KS standards, KS X 0000 : 2001 (ISO TBD : 1999), titled as ' Risk management terminology - Guidelines for use in standards '
EPA is proposing to approve a revision to the Butte County Air Quality Management District (BCAQMD) portion of the California SIP concerning the District's New Source Review (NSR) permitting program for new and modified sources of air pollution.
Glaser, J P
The article presents and discusses a graduate course in managing information systems in health care delivery organizations. The article presents the course content, assignments, and syllabus and reviews the strengths and weaknesses of the course.
Horvath, Clara, Ed.; And Others
This special issue includes reviews of 32 books on the following topics: management, human resources, and organizational development; career counseling, guidance, and assessment; job search; resumes; careers in specific fields; careers for special populations; career transitions; and finding balance. (SK)
... its expert judgment about consumer behavior, perceptions, and similar information related to consumer... CONSUMER PRODUCT SAFETY COMMISSION [Docket No. CPSC-2010-0046] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment Request; Consumer Focus Groups...
Kamman, Arnoud V.; de Beaufort, Hector W. L.; van Bogerijen, Guido H W; Nauta, FJH; Heijmen, Robin H.; Moll, Frans L.; van Herwaarden, Joost A.; Trimarchi, Santi
Background Currently, the optimal management strategy for chronic type B aortic dissections (CBAD) is unknown. Therefore, we systematically reviewed the literature to compare results of open surgical repair (OSR), standard thoracic endovascular aortic repair (TEVAR) or branched and fenestrated TEVAR
Cheng, Adam; Donoghue, Aaron; Gilfoyle, Elaine; Eppich, Walter
To review the essential elements of crisis resource management and provide a resource for instructors by describing how to use simulation-based training to teach crisis resource management principles in pediatric acute care contexts. A MEDLINE-based literature source. OUTLINE OF REVIEW: This review is divided into three main sections: Background, Principles of Crisis Resource Management, and Tools and Resources. The background section provides the brief history and definition of crisis resource management. The next section describes all the essential elements of crisis resource management, including leadership and followership, communication, teamwork, resource use, and situational awareness. This is followed by a review of evidence supporting the use of simulation-based crisis resource management training in health care. The last section provides the resources necessary to develop crisis resource management training using a simulation-based approach. This includes a description of how to design pediatric simulation scenarios, how to effectively debrief, and a list of potential assessment tools that instructors can use to evaluate crisis resource management performance during simulation-based training. Crisis resource management principles form the foundation for efficient team functioning and subsequent error reduction in high-stakes environments such as acute care pediatrics. Effective instructor training is required for those programs wishing to teach these principles using simulation-based learning. Dissemination and integration of these principles into pediatric critical care practice has the potential for a tremendous impact on patient safety and outcomes.
Hong, Catherine H L; Hu, Shijia; Haverman, Thijs
INTRODUCTION: This systematic review aims to update on the prevalence of odontogenic-related infections and the efficacy of dental strategies in preventing dental-related complications in cancer patients since the 2010 systematic review. REVIEW METHOD: A literature search was conducted in the dat....../treatment protocols. The use of chlorhexidine, fluoride mouth rinses as well as composite resin, resin-modified glass ionomer cement (GIC), and amalgam restorations over conventional GIC in post head and neck radiation patients who are compliant fluoride users is recommended....
Full Text Available We present a literature review on quality and operations management problems in food supply chains. In food industry, the quality of the food products declines over time and should be addressed in the supply chain operations management. Managing food supply chains with operations management methods not only generates economic benefit, but also contributes to environmental and social benefits. The literature on this topic has been burgeoning in the past few years. Since 2005, more than 100 articles have been published on this topic in major operations research and management science journals. In this literature review, we concentrate on the quantitative models in this research field and classify the related articles into four categories, that is, storage problems, distribution problems, marketing problems, and food traceability and safety problems. We hope that this review serves as a reference for interested researchers and a starting point for those who wish to explore it further.
Goetzel, Ron Z; Ozminkowski, Ronald J; Villagra, Victor G; Duffy, Jennifer
The results of 44 studies investigating financial impact and return on investment (ROI) from disease management (DM) programs for asthma, congestive heart failure (CHF), diabetes, depression, and multiple illnesses were examined. A positive ROI was found for programs directed at CHF and multiple disease conditions. Some evidence suggests that diabetes programs may save more than they cost, but additional studies are needed. Results are mixed for asthma management programs. Depression management programs cost more than they save in medical expenses, but may save money when considering productivity outcomes.
Borshch, Viktoriya I.; Huz, V. V.
This article provides a deep research about the most known gurus of management: Henri Fayol, who invented the basic 14 Principles of Management, Michael Porter and his competition concept, at last Peter Drucker, the inventor of MBO system. Nowadays society is still using Fayol’s Porter’s and Drucker’s discoveries.Research subject of this article is knowledge from the management founders. The objective of the article is to determine the main issues, which they tried to explain and solve. There...
Ganbat, Tsenguun; Chong, Heap-Yih; Liao, Pin-Chao; Wu, You-Di
International construction is complicated and involves high risks. However, with the development of technological innovation, Building Information Modeling (BIM) emerged and seems to be able to address certain risks. To understand BIM applications in risk management for international construction, a state-of-the-art review is required. Therefore, this paper aims to identify the research trends and opportunities for risk management in BIM-enabled international construction by reviewing 526 pee...
Fatima Sheikh Shoaie; Mehdi Husseini
The present study investigates the software used in scientific journals for content management and peer review, in order to identify the essential features. These softwares are analyzed and presented in tabular format. A questionnaire was prepared and submitted to a panel composed of 15 referees, editor in chief, software designers and researchers. The essential features for a software managing the review process were divided into three groups with populations of 10-15, 5-10 and 0-5 respect...
South African Gastroenterology Review. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 2, No 2 (2004) >. Log in or Register to get access to full text downloads.
Azri, Suhaibah; Ujang, Uznir; Anton, François
Pressure on land development in urban areas causes progressive efforts in spatial planning and management. The physical expansion of urban areas to accommodate rural migration implies a massive impact to social, economical and political situations of major cities. Most of the models used...... in managing urban areas are moving towards sustainable urban development in order to fulfill current necessities while preserving the resources for future generations. However, in order to manage large amounts of urban spatial data, an efficient spatial data constellation method is needed. With the ease...... of three dimensional (3D) spatial data usage in urban areas as a new source of data input, practical spatial data indexing is necessary to improve data retrieval and management. Current two dimensional (2D) spatial indexing approaches seem not applicable to the current and future spatial developments...
... address the deficiencies and prevent their future recurrence. (iii) If the corrective action plan is... needed. Compliance buys can be required if, during FNS management evaluations by regional offices, a...
The University of Alabama (UA) researchers worked with Alabama Department of Transportation (ALDOT) managers to investigate various mechanisms to provide quality control of data collection and interpretation for pavements, and to target the data resu...
Hunt, Caralise W
Technology can be used to supplement healthcare provider diabetes care by providing both educational and motivational support. Education can be provided using technology allowing patients to learn new practices and routines related to diabetes management. Technology can support daily diabetes self-management activities including blood glucose monitoring, exercising, healthy eating, taking medication, monitoring for complications, and problem-solving. This article describes an integrative revi...
Duran, Cem; Uray, Nimet
Purpose - Nowadays, customers expectfrom the brands to build customized and long term relationships with them.Hence, it has become evident thatmanagerial approaches like Customer Relationship Management are important, butnot sufficient to understand and manage the relationships with customers. It has been well recognizedthat companies need something more than keeping,analyzing the data on customer behavior and determine strategies accordingly. Anew concept and deeper approach to understand an...
Iwan Vanany; Suhaiza Zailani; Nyoman Pujawan
Supply chain risk management has increasingly becoming a more popular research area recently. Various papers, with different focus and approaches, have been published since a few years ago. This paper aims to survey supply chain risk management (SCRM) literature. Paper published in relevant journals from 2000 to 2007 are analysed and classified into five categories: conceptual, descriptive, empirical, exploratory cross-sectional, and exploratory longitudinal. We also looked at the papers in t...
Zhu, Shangzhen; Gao, Hetong; Duan, Lunbo
Since a large amount of food supplying is provided as a basic line measuring increasing residents’ life standard, food waste has become progressively numeral considerable. Much attention has been drawn to this problem. This work gave an overview on latest researches about anaerobic digestion, composting, generalized management and other developments on management of food waste. Different technologies were introduced and evaluated. Further views on future research in such a field were proposed.
Full Text Available this instrument was never utilised. Limited waste policy and regulation emerged between 1989 and 2007. With the publishing of the 1st National Waste Management Strategy (NWMS)  and the White Paper on Integrated Pollution and Waste Management (IP&WM) [4..., classification and disposal of waste, was developed with funding and technical support from the Danish Cooperation for Environment and Development (DANCED). The Minimum Requirements were replaced by “National Norms and Standards for the Assessment of Waste...
In recent years, a growing body of literature in portfolio management has devoted a great deal of attention for this subject. The theoretical foundation to portfolio management was offered by Harry Markowitz at the beginning of the 1950s. The limitations of the original Markowitz model have stimulated the occurrence of extended or modified models – two of the best known (and criticized) being the equilibrium models: CAPM (capital asset pricing model) and APT (arbitrage pricing theory). Altern...
AlSaif, K. M
The physical, chemical and antibacterial properties of saliva provide protection to human dentition against dental diseases, Therefore, salivary deficiency has to be managed carefully. The causes of saliva deficiency are many and varied. It is worth mentioning that saliva flow rate is normally affected by physiologic condition, such as eating, resting, sleeping, cold or hot season etc. In this paper the protective role of saliva, etiologiy of saliva deficiency and its clinical management are discussed. (author
Wilson, Houston; Daane, Kent M
Grape growers in California utilize a variety of biological, cultural, and chemical approaches for the management of insect and mite pests in vineyards. This combination of strategies falls within the integrated pest management (IPM) framework, which is considered to be the dominant pest management paradigm in vineyards. While the adoption of IPM has led to notable and significant reductions in the environmental impacts of grape production, some growers are becoming interested in the use of an explicitly non-pesticide approach to pest management that is broadly referred to as ecologically-based pest management (EBPM). Essentially a subset of IPM strategies, EBPM places strong emphasis on practices such as habitat management, natural enemy augmentation and conservation, and animal integration. Here, we summarize the range and known efficacy of EBPM practices utilized in California vineyards, followed by a discussion of research needs and future policy directions. EBPM should in no way be seen in opposition, or as an alternative to the IPM framework. Rather, the further development of more reliable EBPM practices could contribute to the robustness of IPM strategies available to grape growers.
Lee, How; Cummings, Greta G
The purpose of this study was to systematically review the research literature that examined the determinants of front line nurse managers' job satisfaction. Front line managers are the vital link between senior management and clinical nurses. They influence organizational culture and outcomes for patients and staff so their job satisfaction and ultimately retention is of importance. A review of research articles that examined the determinants of front line nurse managers' job satisfaction was conducted. These managers supervise staff nurses and have direct responsibility for the management of a nursing unit or team in any type of healthcare facility. Fourteen studies were included in the final analysis. Evidence of significant positive relationships were found between span of control, organizational support, empowerment and the job satisfaction of front line nurse managers. The review suggests that job satisfaction of front line managers may be improved by addressing span of control and workload, increasing organizational support from supervisors and empowering managers to participate in decision-making. Healthcare organizations may enhance the recruitment, retention and sustainability of future nursing leadership by addressing the factors that influence job satisfaction of front line managers.
Gawel, James E.; Hemond, Harold F.
Characterizing the spatial extent of groundwater metal contamination traditionally requires installing sampling wells, an expensive and time-consuming process in urban areas. Moreover, extrapolating biotic effects from metal concentrations alone is problematic, making ecological risk assessment difficult. Our study is the first to examine the use of phytochelatin measurements in tree leaves for delimiting biological metal stress in shallow, metal-contaminated groundwater systems. Three tree species (Rhamnus frangula, Acer platanoides, and Betula populifolia) growing above the shallow groundwater aquifer of the Aberjona River watershed in Woburn, Massachusetts, display a pattern of phytochelatin production consistent with known sources of metal contamination and groundwater flow direction near the Industri-Plex Superfund site. Results also suggest the existence of a second area of contaminated groundwater and elevated metal stress near the Wells G and H Superfund site downstream, in agreement with a recent EPA ecological risk assessment. Possible contamination pathways at this site are discussed
Shigaki, Helena Belintani; Patrus, Roberto
In a productivist culture, marked by the appreciation of the publication of scientific papers, the subject of peer review becomes relevant. The aim of this study was to reflect on how productivism is seen by the reviewers of scientific papers in the area of Administration, in the light of three specific objectives: to identify the motivations and external influences that teachers act as reviewers, to understand their assessment about the peer review system in Brazil, and to identify the possi...
Brink-Huis, Anita; van Achterberg, Theo; Schoonhoven, Lisette
This paper reports a review of the literature conducted to identify organisation models in cancer pain management that contain integrated care processes and describe their effectiveness. Pain is experienced by 30-50% of cancer patients receiving treatment and by 70-90% of those with advanced disease. Efforts to improve pain management have been made through the development and dissemination of clinical guidelines. Early improvements in pain management were focussed on just one or two single processes such as pain assessment and patient education. Little is known about organisational models with multiple integrated processes throughout the course of the disease trajectory and concerning all stages of the care process. Systematic review. The review involved a systematic search of the literature, published between 1986-2006. Subject-specific keywords used to describe patients, disease, pain management interventions and integrated care processes, relevant for this review were selected using the thesaurus of the databases. Institutional models, clinical pathways and consultation services are three alternative models for the integration of care processes in cancer pain management. A clinical pathway is a comprehensive institutionalisation model, whereas a pain consultation service is a 'stand-alone' model that can be integrated in a clinical pathway. Positive patient and process outcomes have been described for all three models, although the level of evidence is generally low. Evaluation of the quality of pain management must involve standardised measurements of both patient and process outcomes. We recommend the development of policies for referrals to a pain consultation service. These policies can be integrated within a clinical pathway. To evaluate the effectiveness of pain management models standardised outcome measures are needed.
Castillo, Felipe Aravena; Hallinger, Philip
The purpose of this systematic review was to further our understanding of educational leadership and management (EDLM) knowledge production in Latin America. We conducted a "topographical review" of 48 articles from Latin America published in eight "core" EDLM journals published between 1991 and 2017. Data analysis focused on…
Scholars throughout the world are working to diversify the knowledge base in educational leadership and management (EDLM). In concert with this effort, this article reports the results of a systematic review of research on EDLM in Africa. The goals of the review were to describe trends with respect to the volume of journal publications, national…
Bush, Tony; Glover, Derek
Purpose: The purpose of this paper is to provide a systematic review of the literature on school leadership and management in South Africa, linked to the 20th anniversary of democratic government and integrated education. Design/Methodology/Approach: The authors conducted a systematic review of all published work since 2007 with a more selective…
Moore, Paula; Karr-Kidwell, PJ
This paper presents a relevant literary review and then develops a behavior-management program within schools encompassing social-skills training for all children. Both the literary review and this program can be used to educate administrators, educators, parents, and students about behaviors and warning signs associated with violent children. The…
Doherty, Alison J.; Jones, Stephanie P.; Chauhan, Umesh; Gibson, Josephine M. E.
Background: Obesity is more prevalent in people with intellectual disabilities and increases the risk of developing serious medical conditions. UK guidance recommends multicomponent weight management interventions (MCIs), tailored for different population groups. Methods: An integrative review utilizing systematic review methodology was conducted…
Eales, J.; Lenoir-Wijnkoop, I.; King, S.; Wood, H.; Kok, F.J.; Shamir, R.; Prentice, A.; Edwards, M.; Glanville, J.; Atkinson, R.L.
Background:Yoghurt is part of the diet of many people worldwide and is commonly recognised as a 'health food'. Epidemiological studies suggest that yoghurt may be useful as part of weight management programs. In the absence of comprehensive systematic reviews, this systematic review investigated
....282(a)(1)(i) through (a)(1)(iii)). In the event that an article of food has been refused admission... in a request for review. In the event that an article of food has been placed under hold under...] Agency Information Collection Activities; Submission for Office of Management and Budget Review; Comment...
Zhang, Xuan; van Donk, Dirk Pieter; van der Vaart, Taco
Purpose - The purpose of this paper is to review and classify survey-based research connecting information and communication technology (ICT), supply chain management (SCM), and supply chain (SC) performance. The review evaluates present empirical results and aims at detecting explanations for
Havermans, B.M.; Schelvis, R.M.C.; Boot, C.R.L.; Brouwers, E.P.M.; Anema, J.R.; Beek, A.J. van der
Objectives This systematic review aimed to explore which process variables are used in stress management intervention (SMI) evaluation research. Methods A systematic review was conducted using seven electronic databases. Studies were included if they reported on an SMI aimed at primary or secondary
Pallis, A.A.; Vitsounis, T.K.; Langen, de P.W.
This paper reviews research in port economics, policy and management during the period 1997-2008. In an increasingly international economy, research interest in ports is gradually emerging. This paper examines the developments, themes and characteristics of this research, by reviewing a
Havermans, B.M.; Schlevis, Roosmarijn Mc; Boot, Cécile Rl; Brouwers, E.P.M.; Anema, Johannes R; van der Beek, Allard J
OBJECTIVES: This systematic review aimed to explore which process variables are used in stress management intervention (SMI) evaluation research. METHODS: A systematic review was conducted using seven electronic databases. Studies were included if they reported on an SMI aimed at primary or
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