WorldWideScience

Sample records for unit recognition management

  1. Dystocia: recognition and management

    OpenAIRE

    Reichler, I M; Michel, E

    2009-01-01

    The morbidity and mortality of bitches and queens and their offspring at parturition is significantly reduced by optimum veterinary care. Usually, the patient's history already indicates that a parturition disorder may be present. If during physical examination a dystocia is confirmed, the cause of dystocia, the general condition of the dam and the fetal number and vitality are the cornerstones of the decision as to whether medical management or surgical therapy is indicated. A...

  2. Molecular Recognition Units: Design and diagnostic applications

    International Nuclear Information System (INIS)

    Alvarez, V.L.; Radcliffe, R.D.; Coughlin, D.J.; Lopes, A.D.; Rodwell, J.D.

    1992-01-01

    Molecular Recognition Units (MRUs), small peptides derived from complementarity-determining region (CDR) of IgM antibodies, can mimic the recognition site found in the antibody. One example of an MRU fusion peptide designed to image thrombi was derived from PAC 1.1, an IgM monoclonal antibody specific for the GPIIb/IIa receptor on platelets. The peptide sequence from the third CDR of the heavy chain was engineered for optimal binding activity and synthesized with a metal-binding peptide sequence. After labeling with 99m-Tc, the peptides were injected into either animal models of experimentally induced thrombi in order to determine their effectiveness in imaging model thrombi. Data are presented which demonstrate enhanced binding with open-quotes tandem repeatsclose quotes of the MRU domain and no loss of activity after incorporation of the metal-binding domain. These studies have led to a clinical candidate consisting of 17 amino acids. Extension of this concept to other MRUs and fusion peptides is also discussed

  3. Activity Recognition for Personal Time Management

    Science.gov (United States)

    Prekopcsák, Zoltán; Soha, Sugárka; Henk, Tamás; Gáspár-Papanek, Csaba

    We describe an accelerometer based activity recognition system for mobile phones with a special focus on personal time management. We compare several data mining algorithms for the automatic recognition task in the case of single user and multiuser scenario, and improve accuracy with heuristics and advanced data mining methods. The results show that daily activities can be recognized with high accuracy and the integration with the RescueTime software can give good insights for personal time management.

  4. Pulmonary manifestations of malaria : recognition and management.

    Science.gov (United States)

    Taylor, Walter R J; Cañon, Viviam; White, Nicholas J

    2006-01-01

    Lung involvement in malaria has been recognized for more than 200 hundred years, yet our knowledge of its pathogenesis and management is limited. Pulmonary edema is the most severe form of lung involvement. Increased alveolar capillary permeability leading to intravascular fluid loss into the lungs is the main pathophysiologic mechanism. This defines malaria as another cause of acute lung injury (ALI) and acute respiratory distress syndrome (ARDS).Pulmonary edema has been described most often in non-immune individuals with Plasmodium falciparum infections as part of a severe systemic illness or as the main feature of acute malaria. P.vivax and P.ovale have also rarely caused pulmonary edema.Clinically, patients usually present with acute breathlessness that can rapidly progress to respiratory failure either at disease presentation or, interestingly, after treatment when clinical improvement is taking place and the parasitemia is falling. Pregnant women are particularly prone to developing pulmonary edema. Optimal management of malaria-induced ALI/ARDS includes early recognition and diagnosis. Malaria must always be suspected in a returning traveler or a visitor from a malaria-endemic country with an acute febrile illness. Slide microscopy and/or the use of rapid antigen tests are standard diagnostic tools. Malaria must be treated with effective drugs, but current choices are few: e.g. parenteral artemisinins, intravenous quinine or quinidine (in the US only). A recent trial in adults has shown that intravenous artesunate reduces severe malaria mortality by a third compared with adults treated with intravenous quinine. Respiratory compromise should be managed on its merits and may require mechanical ventilation.Patients should be managed in an intensive care unit and particular attention should be paid to the energetic management of other severe malaria complications, notably coma and acute renal failure. ALI/ARDS may also be related to a coincidental bacterial

  5. Facial Action Units Recognition: A Comparative Study

    NARCIS (Netherlands)

    Popa, M.C.; Rothkrantz, L.J.M.; Wiggers, P.; Braspenning, R.A.C.; Shan, C.

    2011-01-01

    Many approaches to facial expression recognition focus on assessing the six basic emotions (anger, disgust, happiness, fear, sadness, and surprise). Real-life situations proved to produce many more subtle facial expressions. A reliable way of analyzing the facial behavior is the Facial Action Coding

  6. An Agent Framework for Recognition of Graphic Units in Drawings

    NARCIS (Netherlands)

    Achten, H.H.; Jessurun, A.J.; Koszewski, K.; Wrona, S.

    2002-01-01

    Architects use graphic conventions in their drawings that have meaningful content to the design task. In previous work, such well-defined sets of graphic entities have been identified and defined. These sets are called graphic units. In this paper, we discuss how graphic unit recognition in drawings

  7. [Recognition and management of Tourette syndrome].

    Science.gov (United States)

    Chao, Kuo-Yu; Wang, Huei-Shyong; See, Lai-Chu

    2009-10-01

    Tourette syndrome (TS) is a chronic tic disorder that occurs in childhood. Children with TS may have multiple tic incidents during a day, even many times per minute. Such sudden, rapid and short utterings or movements may influence sufferers' ability to perform daily activities and present barriers to normal interaction with others. Anger, depression and low self-esteem are commonly seen in many children with TS. Awareness of TS is not great in Taiwan, and so many pediatric patients fail to obtain an early diagnosis and / or are mistreated or punished due to disorder-related behaviors. Such results in elevated physical, psychological and social stresses for sufferers. In this paper, we briefly introduce TS symptoms, diagnosis, classification, prognosis, co-morbidity, related psycho-social stresses, and common treatments. In order to facilitate the effective management of TS, we provide suggestion for patient families and schools as well as recommendations on how to interact effectively with others. We hope this article is helpful for healthcare workers, patients, families and schools to improve the recognition and management of TS.

  8. An Investigation of the Role of Grapheme Units in Word Recognition

    Science.gov (United States)

    Lupker, Stephen J.; Acha, Joana; Davis, Colin J.; Perea, Manuel

    2012-01-01

    In most current models of word recognition, the word recognition process is assumed to be driven by the activation of letter units (i.e., that letters are the perceptual units in reading). An alternative possibility is that the word recognition process is driven by the activation of grapheme units, that is, that graphemes, rather than letters, are…

  9. Recognition and Management of Resistant Hypertension.

    Science.gov (United States)

    Braam, Branko; Taler, Sandra J; Rahman, Mahboob; Fillaus, Jennifer A; Greco, Barbara A; Forman, John P; Reisin, Efrain; Cohen, Debbie L; Saklayen, Mohammad G; Hedayati, S Susan

    2017-03-07

    Despite improvements in hypertension awareness and treatment, 30%-60% of hypertensive patients do not achieve BP targets and subsequently remain at risk for target organ damage. This therapeutic gap is particularly important to nephrologists, who frequently encounter treatment-resistant hypertension in patients with CKD. Data are limited on how best to treat patients with CKD and resistant hypertension, because patients with CKD have historically been excluded from hypertension treatment trials. First, we propose a consistent definition of resistant hypertension as BP levels confirmed by both in-office and out-of-office measurements that exceed appropriate targets while the patient is receiving treatment with at least three antihypertensive medications, including a diuretic, at dosages optimized to provide maximum benefit in the absence of intolerable side effects. Second, we recommend that each patient undergo a standardized, stepwise evaluation to assess adherence to dietary and lifestyle modifications and antihypertensive medications to identify and reduce barriers and discontinue use of substances that may exacerbate hypertension. Patients in whom there is high clinical suspicion should be evaluated for potential secondary causes of hypertension. Evidence-based management of resistant hypertension is discussed with special considerations of the differences in approach to patients with and without CKD, including the specific roles of diuretics and mineralocorticoid receptor antagonists and the current place of emerging therapies, such as renal denervation and baroreceptor stimulation. We endorse use of such a systematic approach to improve recognition and care for this vulnerable patient group that is at high risk for future kidney and cardiovascular events. Copyright © 2017 by the American Society of Nephrology.

  10. Recognition properties of receptors consisting of imidazole and indole recognition units towards carbohydrates

    Directory of Open Access Journals (Sweden)

    Monika Mazik

    2010-02-01

    Full Text Available Compounds 4 and 5, including both 4(5-substituted imidazole or 3-substituted indole units as the entities used in nature, and 2-aminopyridine group as a heterocyclic analogue of the asparagine/glutamine primary amide side chain, were prepared and their binding properties towards carbohydrates were studied. The design of these receptors was inspired by the binding motifs observed in the crystal structures of protein–carbohydrate complexes. 1H NMR spectroscopic titrations in competitive and non-competitive media as well as binding studies in two-phase systems, such as dissolution of solid carbohydrates in apolar media, revealed both highly effective recognition of neutral carbohydrates and interesting binding preferences of these acyclic compounds. Compared to the previously described acyclic receptors, compounds 4 and 5 showed significantly increased binding affinity towards β-galactoside. Both receptors display high β- vs. α-anomer binding preferences in the recognition of glycosides. It has been shown that both hydrogen bonding and interactions of the carbohydrate CH units with the aromatic rings of the receptors contribute to the stabilization of the receptor–carbohydrate complexes. The molecular modeling calculations, synthesis and binding properties of 4 and 5 towards selected carbohydrates are described and compared with those of the previously described receptors.

  11. Painting recognition with smartphones equipped with inertial measurement unit

    Science.gov (United States)

    Masiero, Andrea; Guarnieri, Alberto; Pirotti, Francesco; Vettore, Antonio

    2015-06-01

    Recently, several works have been proposed in the literature to take advantage of the diffusion of smartphones to improve people experience during museum visits. The rationale is that of substituting traditional written/audio guides with interactive electronic guides usable on a mobile phone. Augmented reality systems are usually considered to make the use of such electronic guides more effective for the user. The main goal of such augmented reality system (i.e. providing the user with the information of his/her interest) is usually achieved by properly executing the following three tasks: recognizing the object of interest to the user, retrieving the most relevant information about it, properly presenting the retrieved information. This paper focuses on the first task: we consider the problem of painting recognition by means of measure- ments provided by a smartphone. We assume that the user acquires one image of the painting of interest with the standard camera of the device. This image is compared with a set of reference images of the museum objects in order to recognize the object of interest to the user. Since comparing images taken in different conditions can lead to unsatisfactory recognition results, the acquired image is typically properly transformed in order to improve the results of the recognition system: first, the system estimates the homography between properly matched features in the two images. Then, the user image is transformed accordingly to the estimated homography. Finally, it is compared with the reference one. This work proposes a novel method to exploit inertial measurement unit (IMU) measurements to improve the system performance, in particular in terms of computational load reduction: IMU measurements are exploited to reduce both the computational burden required to estimate the transformation to be applied to the user image, and the number of reference images to be compared with it.

  12. Infectious Mononucleosis: Recognition and Management in Athletes.

    Science.gov (United States)

    Eichner, Edward R.

    1987-01-01

    Infectious mononucleosis strikes many young athletes. Considered here are its epidemiology, pathophysiology, diagnosis, natural course, complications, and management. The focus is on concerns of athletes with a perspective on personality, convalescence, and chronic fatigue. (Author/MT)

  13. Waste management units - Savannah River Site

    International Nuclear Information System (INIS)

    1989-10-01

    This report is a compilation of worksheets from the waste management units of Savannah River Plant. Information is presented on the following: Solid Waste Management Units having received hazardous waste or hazardous constituents with a known release to the environment; Solid Waste Management Units having received hazardous waste or hazardous constituents with no known release to the environment; Solid Waste Management Units having received no hazardous waste or hazardous constituents; Waste Management Units having received source; and special nuclear, or byproduct material only

  14. Management of planned unit outages

    International Nuclear Information System (INIS)

    Brune, W.

    1984-01-01

    Management of planned unit outages at the Bruno Leuschner Nuclear Power Plant is based on the experience gained with Soviet PWR units of the WWER type over a period of more than 50 reactor-years. For PWR units, planned outages concentrate almost exclusively on annual refuellings and major maintenance of the power plant facilities involved. Planning of such major maintenance work is based on a standardized basic network plan and a catalogue of standardized maintenance and inspection measures. From these, an overall maintenance schedule of the unit and partial process plans of the individual main components are derived (manually or by computer) and, in the temporal integration of major maintenance at every unit, fixed starting times and durations are determined. More than 75% of the maintenance work at the Bruno Leuschner Nuclear Power Plant is carried out by the plant's own maintenance personnel. Large-scale maintenance of every unit is controlled by a special project head. He is assisted by commissioners, each of whom is responsible for his own respective item. A daily control report is made. The organizational centre is a central office which works in shifts around the clock. All maintenance orders and reports of completion pass through this office; thus, the overall maintenance schedule can be corrected daily. To enforce the proposed operational strategy, suitable accompanying technical measures are required with respect to effective facility monitoring and technical diagnosis, purposeful improvement of particularly sensitive components and an increase in the effectiveness of maintenance work by special technologies and devices. (author)

  15. Management information systems. [United Kingdom

    Energy Technology Data Exchange (ETDEWEB)

    Hartley, D.; Spence, A.C.

    1985-02-01

    The successful application in the United Kingdom of the real time monitoring and control systems (MINOS) for underground mining operations, particularly in coal transport and the development of coalface monitoring (FIDO) in 1980 led naturally to the design of an operational data base for management. A User Group of experienced colliery managers produced a Management Information System (MIS) requirements specification and began the evolution of the systems of today. Twenty-four mines operate MIS in different ways from total dependency to a means of checking their manual reporting system. MIS collects useful data from all the major MINOS applications and provides a means of manually inputting other, relevant information. A wide variety of displays and reports are available to management, adjusted to meet individual requirements. The benefits from the use of MIS are difficult to quantify, since they become part of the management process. Further developments are taking place based on operational experience and requirements and taking advantage of the recent advances in computer technology. MIS is the modern management tool in British coal mining, collecting, storing, analysing and presenting accurate information upon which management decision making is based.

  16. Complications of decorative tattoos: recognition and management.

    Science.gov (United States)

    Simunovic, Carolina; Shinohara, Michi M

    2014-12-01

    Tattooing is an ancient practice that enjoys continued popularity. Although a modern, professionally performed tattoo is generally safe, complications can occur. A skin biopsy of all tattoo reactions is recommended as some tattoo reactions have systemic implications. Tattoo-related infections are seen days to decades after tattooing, and range from acute pyogenic infections to cutaneous tuberculosis. In particular, non-tuberculous mycobacterial infections happen in tattoos with increasing frequency and are introduced at the time of tattooing through contaminated ink or water used to dilute inks. Despite a transition in tattoo pigments from metal salts to industrial azo dyes, hypersensitivity reactions also persist, and include eczematous, granulomatous, lichenoid, and pseudoepitheliomatous patterns (among others). Granulomatous tattoo reactions can be a clue to cutaneous or systemic sarcoidosis, particularly in the setting of interferon use. Pseudoepitheliomatous tattoo reactions have substantial overlap with squamous cell carcinoma and keratoacanthoma, making diagnosis and management difficult. Other malignancies and their benign mimics can occur in tattoos, raising questions about the safety of tattoo ink and its role in carcinogenesis.

  17. New Public Management, Care and Struggles about Recognition

    DEFF Research Database (Denmark)

    Dahl, Hanne Marlene

    2009-01-01

    - of these two logics in two different Danish municipalities that are strategically chosen to illustrate differences along the continuum of NPM translations. It asks which logic the home helpers feel is most dominant and relates the results to feelings of recognition and misrecognition as well as to strategies......New Public Management (NPM) is usually perceived as a homogeneous discourse. However, when we examine it by looking at micro-politics in municipalities and understand its consequences drawing on the voices of home helpers, the picture is more complex and ambiguous. NPM is seen as disciplining paid...... of resistance. The analysis applies feminist theories of recognition and care, and its findings are based on focus group interviews and feminist discourse analysis...

  18. Recognition and management of perinatal depression and anxiety by general practitioners: a systematic review.

    Science.gov (United States)

    Ford, Elizabeth; Shakespeare, Judy; Elias, Fatin; Ayers, Susan

    2017-02-01

    Perinatal anxiety and depression are widespread, with up to 20% of women affected during pregnancy and after birth. In the UK, management of perinatal mental health falls under the remit of general practitioners (GPs). We reviewed the literature on GPs' routine recognition, diagnosis and management of anxiety and depression in the perinatal period. A systematic search of Embase, Medline, PsycInfo, Pubmed, Scopus and Web of Science was conducted. Studies were eligible if they reported quantitative measures of GPs' or Family Physicians' assessment, recognition and management of anxiety or depression in pregnancy or post-partum. Thirteen papers, reporting 10 studies, were identified from the United States, Australia, UK, Netherlands and Canada. All reported on depression; two included anxiety disorders. Reported awareness and ability to diagnose perinatal depression among GPs was high. GPs knew about and used screening tools in the UK but less so in US settings. Antidepressants were the first line of treatment, with various SSRIs considered safest. Counseling by GPs and referrals to specialists were common in the post-natal period, less so in pregnancy. Treatment choices were determined by resources, attitudes, knowledge and training. Data on GPs' awareness and management of perinatal depression were sparse and unlikely to be generalizable. Future directions for research are proposed; such as exploring the management of anxiety disorders which are largely missing from the literature, and understanding more about barriers to disclosure and recognition in primary care. More standardized training could help to improve recognition and management practices. © The Author 2016. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  19. The role of familiarity in associative recognition of unitized compound word pairs.

    Science.gov (United States)

    Ahmad, Fahad N; Hockley, William E

    2014-01-01

    This study examined the effect of unitization and contribution of familiarity in the recognition of word pairs. Compound words were presented as word pairs and were contrasted with noncompound word pairs in an associative recognition task. In Experiments 1 and 2, yes-no recognition hit and false-alarm rates were significantly higher for compound than for noncompound word pairs, with no difference in discrimination in both within- and between-subject comparisons. Experiment 2 also showed that item recognition was reduced for words from compound compared to noncompound word pairs, providing evidence of the unitization of the compound pairs. A two-alternative forced-choice test used in Experiments 3A and 3B provided evidence that the concordant effect for compound word pairs was largely due to familiarity. A discrimination advantage for compound word pairs was also seen in these experiments. Experiment 4A showed that a different pattern of results is seen when repeated noncompound word pairs are compared to compound word pairs. Experiment 4B showed that memory for the individual items of compound word pairs was impaired relative to items in repeated and nonrepeated noncompound word pairs, and Experiment 5 demonstrated that this effect is eliminated when the elements of compound word pairs are not unitized. The concordant pattern seen in yes-no recognition and the discrimination advantage in forced-choice recognition for compound relative to noncompound word pairs is due to greater reliance on familiarity at test when pairs are unitized.

  20. Hanford Site waste management units report

    International Nuclear Information System (INIS)

    1993-04-01

    The Hanford Site Waste Management Units Report was originated to provide information responsive to Section 3004(u) of the Hazardous and Solid Waste Amendments of the 1984. This report provides a comprehensive inventory of all types of waste management units at the Hanford Site, including a description of the units and the waste they contain. Waste management units in the report include: (1) Resource Conservation and Recovery Act of 1976 (RCRA) disposal units, (2) Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) disposal units, (3) unplanned releases, (4) inactive contaminated structures, (5) RCRA treatment, storage, and disposal (TSD) units, and (6) other storage areas. Because of the comprehensive nature of the units report, the list of units is more extensive than required by Section 3004(u) of Hazardous and Solid Waste Amendments of the 1984. In Sections 3.0 through 6.0 of this report, the four aggregate areas are subdivided into their operable units. The operable units are further divided into two parts: (1) those waste management units assigned to the operable unit that will be remediated as part of the Environmental Restoration Remedial Actions (ERRA) Program, and (2) those waste management units located within the operable unit boundaries but not assigned to the ERRA program. Only some operable unit sections contain the second part

  1. The Kozloduy project management unit

    International Nuclear Information System (INIS)

    Carnes, W.S.; Gros-Gean, P.; Demireva, E.

    2004-01-01

    The Project Management Unit (PMU) has been established in support to the Kozloduy NPP decommissioning department. It is comprised of a Consortium of the British Nuclear Group, EDF and subcontractor ENPRO Consult. It is responsible for the management of seven projects (a facility for dry storage of spent fuel; equipment to treat low activity liquid radioactive waste; provision of physical separation of the plant systems and areas to be decommissioned from the ones in operation; equipment to decontaminate and clean pools and large tanks; a facility to provide high volume reduction of solid radioactive wastes and retrieval and conditioning of ion exchange resins and other sorbents; equipment to provide measurement for the free-release of materials and components; a facility for personnel monitoring, decontamination and clothes changing for work outside of the normal radiological control areas) that will be used in support of the KNPP decommissioning process. The projects will be tendered in compliance with the European Bank for Reconstruction and Development requirements

  2. 7 CFR 275.6 - Management units.

    Science.gov (United States)

    2010-01-01

    ... FOOD STAMP AND FOOD DISTRIBUTION PROGRAM PERFORMANCE REPORTING SYSTEM Management Evaluation (ME... management unit; (iii) Food Stamp Program participation, including the number of persons and number of... 7 Agriculture 4 2010-01-01 2010-01-01 false Management units. 275.6 Section 275.6 Agriculture...

  3. Integrated Co-management of Lakes through Beach Management Units

    OpenAIRE

    Goverment of Uganda; Department for International Development (DFID) of the UK Government

    2007-01-01

    Metadata only record In 1999, the Integrated Co-management of Lakes through Beach Management Units project was started in an effort to implement a new approach to the management of lake resources in Uganda. The main components of this plan involved decentralization, local community management, and improving the livelihood of the poor. In order to finance the management of these areas, the Beach Management Units (BMU's) are charging user fees to those individuals who obtain benefit from the...

  4. Recognition

    DEFF Research Database (Denmark)

    Gimmler, Antje

    2017-01-01

    In this article, I shall examine the cognitive, heuristic and theoretical functions of the concept of recognition. To evaluate both the explanatory power and the limitations of a sociological concept, the theory construction must be analysed and its actual productivity for sociological theory mus...

  5. Hanford Site waste management units report

    International Nuclear Information System (INIS)

    1993-04-01

    The Hanford Site Waste Management Units Report was originated to provide information responsive to Section 3004(u) of the Hazardous and Solid Waste Amendments of the 1984. This report provides a comprehensive inventory of all types of waste management units at the Hanford Site, including a description of the units and the waste they contain. Waste management units in the report include: (1) Resource Conservation and Recovery Act of 1976 (RCRA) disposal units, (2) Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) disposal units, (3) unplanned releases, (4) inactive contaminated structures, (5) RCRA treatment, storage, and disposal (TSD) units, and (6) other storage areas. Because of the comprehensive nature of the units report, the list of units is more extensive than required by Section 3004(u) of Hazardous and Solid Waste Amendments of the 1984. In Sections 3.0 through 6.0 of this report, the four aggregate areas are subdivided into their operable units. The operable units are further divided into two parts: (1) those waste management units assigned to the operable unit that will be remediated as part of the Environmental Restoration Remedial Actions (ERRA) Program, and (2) those waste management units located within the operable unit boundaries but not assigned to the ERRA program. Only some operable unit sections contain the second part.Volume two contains Sections 4.0 through 6.0 and the following appendices: Appendix A -- acronyms and definition of terms; Appendix B -- unplanned releases that are not considered to be units; and Appendix C -- operable unit maps

  6. The quest for recognition: Brazilian immigrants in the United States.

    Science.gov (United States)

    Zubaran, Carlos

    2008-12-01

    'Hispanic' and 'Latino' are imprecise umbrella terms often used in the United States to designate nationals from Central and South America. The labelling of Brazilians in this manner generates inaccurate demographic information, including a significant undercount of the migrant population. Research data indicates that Brazilians object to being designated Hispanics, since Brazilians speak Portuguese and have no Spanish heritage. The labelling of ethnic groups has been criticized as a stereotypical and racist system, which primarily responds to non-scientific demands. This commentary appeals for reform in the way researchers and institutions refer to minority citizens as well as for continued research to investigate racism and ethnic prejudice. The development of new approaches and methodologies to examine social networks, migration and the geographic concentration of poverty is advocated.

  7. Pattern recognition in cyclic and discrete skills performance from inertial measurement units

    NARCIS (Netherlands)

    Seifert, Ludovic; L'Hermette, Maxime; Komar, John; Orth, Dominic; Mell, Florian; Merriaux, Pierre; Grenet, Pierre; Caritu, Yanis; Hérault, Romain; Dovgalecs, Vladislavs; Davids, Keith

    2014-01-01

    The aim of this study is to compare and validate an Inertial Measurement Unit (IMU) relative to an optic system, and to propose methods for pattern recognition to capture behavioural dynamics during sport performance. IMU validation was conducted by comparing the motions of the two arms of a

  8. Hanford Site Waste Managements Units reports

    International Nuclear Information System (INIS)

    1992-01-01

    The Hanford Site Waste Management Units Report (HSWMUR) was originated to provide information responsive to Section 3004(u) of the Hazardous and Solid Waste Amendments (HSWA) of the 1984 United States Code (USC 1984). This report provides a comprehensive inventory of all types of waste management units at the Hanford Site, including a description of the units and the waste they contain. Waste management units in this report include: (1) Resource Conservation and Recovery Act of 1976 (RCRA) disposal units, (2) Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) disposal units, (3) unplanned releases, (4) inactive contaminated structures, (5) RCRA treatment, storage, and disposal (TSD) units, and (6) other storage areas. Because of the comprehensive nature of this report, the listing of sites is more extensive than required by Section 3004(u) of HSWA. The information in this report is extracted from the Waste Information Data System (WIDS). The WIDS provides additional information concerning the waste management units contained in this report and is maintained current with changes to these units. This report is updated annually if determined necessary per the Hanford Federal Facility Agreement and Consent Order Order (commonly referred to as the Tri-Party Agreement, Ecology et al. 1990). This report identifies 1,414 waste management units. Of these, 1,015 units are identified as solid waste management units (SWMU), and 342 are RCRA treatment, storage, and disposal units. The remaining 399 are comprised mainly of one-time spills to the environment, sanitary waste disposal facilities (i.e., septic tanks), and surplus facilities awaiting decontamination and decommissioning

  9. Clinicians' recognition and management of emotions during difficult healthcare conversations.

    Science.gov (United States)

    Martin, Elliott B; Mazzola, Natalia M; Brandano, Jessica; Luff, Donna; Zurakowski, David; Meyer, Elaine C

    2015-10-01

    To examine the most commonly reported emotions encountered among healthcare practitioners when holding difficult conversations, including frequency and impact on care delivery. Interprofessional learners from a range of experience levels and specialties completed self-report questionnaires prior to simulation-based communication workshops. Clinicians were asked to describe up to three emotions they experienced when having difficult healthcare conversations; subsequent questions used Likert-scales to measure frequency of each emotion, and whether care was affected. 152 participants completed questionnaires, including physicians, nurses, and psychosocial professionals. Most commonly reported emotions were anxiety, sadness, empathy, frustration, and insecurity. There were significant differences in how clinicians perceived these different emotions affecting care. Empathy and anxiety were emotions perceived to influence care more than sadness, frustration, and insecurity. Most clinicians, regardless of clinical experience and discipline, find their emotional state influences the quality of their care delivery. Most clinicians rate themselves as somewhat to quite capable of recognizing and managing their emotions, acknowledging significant room to grow. Further education designed to increase clinicians' recognition of, reflection on, and management of emotion would likely prove helpful in improving their ability to navigate difficult healthcare conversations. Interventions aimed at anxiety management are particularly needed. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  10. Assessing the Performance of Business Unit Managers

    NARCIS (Netherlands)

    Bouwens, J.F.M.G.; van Lent, L.A.G.M.

    2006-01-01

    Using a sample of 140 managers, we investigate the use of various performance metrics in determining the periodic assessment, bonus decisions, and career paths of business unit managers.We show that the weight on accounting return measures is associated with the authority of these managers, and we

  11. Hanford Site Waste Management Units Report

    International Nuclear Information System (INIS)

    1991-01-01

    This Hanford Site Waste Management Units Report (HSWMUR) was originated to provide information responsive to Section 3004(u) of the Hazardous and Solid Waste Amendments (HSWA) of the 1984 United States Code (USC). The report provides a comprehensive inventory of all types of waste management units at the Hanford Site and consists of waste disposal units, including (1) Resource Conservation and Recovery Act of 1976 (RCRA) disposal units, (2) Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) disposal units, (3) unplanned releases, (4) inactive contaminated structure, (5) RCRA treatment and storage units, and (6) other storage areas. Because of the comprehensive nature of this report, the listing of sites is more extensive than required by Section 3004(u) of HSWA. In support of the Hanford RCRA permit, a field was added to designate whether the waste management unit is a solid waste management unit (SWMU). As SWMUs are identified, they will added to the Hanford Waste Information Data System (WIDS), which is the database supporting this report, and added to the report at its next annual update. A quality review of the WIDS was conducted this past year. The review included checking all data against their reference and making appropriate changes, updating the data elements using the most recent references, marking duplicate units for deletion, and addition additional information. 6 refs

  12. Hanford Site Waste Management Units Report

    International Nuclear Information System (INIS)

    1991-01-01

    This Hanford Site Waste Management Units Report (HSWMUR) was originated to provide information responsive to Section 3004(u) of the Hazardous and Solid Waste Amendments (HSWA) of the 1984 United States Code (USC). The report provides a comprehensive inventory of all types of waste management units at the Hanford Site and consists of waste disposal units, including (1) Resource Conservation and Recovery Act of 1976 (RCRA) disposal units, (2) Comprehensive Environmental Response, Compensation, and Liability Act of 1980 (CERCLA) disposal units, (3) unplanned releases, (4) inactive contaminated structures, (5) RCRA treatment and storage units, and (6) other storage areas. Because of the comprehensive nature of this report, the listing of sites is more extensive than required by Section 3004(u) of HSWA. In support of the Hanford RCRA permit, a field was added to designate whether the waste management unit is a solid waste management unit (SWMU). As SWMUs are identified, they will added to the Hanford Waste Information Data System (WIDS), which is the database supporting this report, and added to the report at its next annual update. A quality review of the WIDS was conducted this past year. The review included checking all data against their reference and making appropriate changes, updating the data elements using the most recent references, marking duplicate units for deletion, and adding additional information. 6 refs

  13. Evaluation and Effectiveness of Pain Recognition and Management Training for Staff Working in Learning Disability Services

    Science.gov (United States)

    Mackey, Ellen; Dodd, Karen

    2011-01-01

    Following Beacroft & Dodd's (2009) audit of pain recognition and management within learning disability services in Surrey, it was recommended that learning disability services should receive training in pain recognition and management. Two hundred and seventy-five services were invited to participate, of which 197 services in Surrey accepted…

  14. Recognition and management of stroke in young adults and adolescents

    Science.gov (United States)

    Biller, José; Elkind, Mitchell S.; Fullerton, Heather J.; Jauch, Edward C.; Kittner, Steven J.; Levine, Deborah A.; Levine, Steven R.

    2013-01-01

    Approximately 15% of all ischemic strokes (IS) occur in young adults and adolescents. To date, only limited prior public health and research efforts have specifically addressed stroke in the young. Early diagnosis remains challenging because of the lack of awareness and the relative infrequency of stroke compared with stroke mimics. Moreover, the causes of IS in the young are heterogeneous and can be relatively uncommon, resulting in uncertainties about diagnostic evaluation and cause-specific management. Emerging data have raised public health concerns about the increasing prevalence of traditional vascular risk factors in young individuals, and their potential role in increasing the risk of IS, stroke recurrence, and poststroke mortality. These issues make it important to formulate and enact strategies to increase both awareness and access to resources for young stroke patients, their caregivers and families, and health care professionals. The American Academy of Neurology recently convened an expert panel to develop a consensus document concerning the recognition, evaluation, and management of IS in young adults and adolescents. The report of the consensus panel is presented herein. PMID:23946297

  15. Computer versus paper system for recognition and management of sepsis in surgical intensive care.

    Science.gov (United States)

    Croft, Chasen A; Moore, Frederick A; Efron, Philip A; Marker, Peggy S; Gabrielli, Andrea; Westhoff, Lynn S; Lottenberg, Lawrence; Jordan, Janeen; Klink, Victoria; Sailors, R Matthew; McKinley, Bruce A

    2014-02-01

    A system to provide surveillance, diagnosis, and protocolized management of surgical intensive care unit (SICU) sepsis was undertaken as a performance improvement project. A system for sepsis management was implemented for SICU patients using paper followed by a computerized system. The hypothesis was that the computerized system would be associated with improved process and outcomes. A system was designed to provide early recognition and guide patient-specific management of sepsis including (1) modified early warning signs-sepsis recognition score (MEWS-SRS; summative point score of ranges of vital signs, mental status, white blood cell count; after every 4 hours) by bedside nurse; (2) suspected site assessment (vascular access, lung, abdomen, urinary tract, soft tissue, other) at bedside by physician or extender; (3) sepsis management protocol (replicable, point-of-care decisions) at bedside by nurse, physician, and extender. The system was implemented first using paper and then a computerized system. Sepsis severity was defined using standard criteria. In January to May 2012, a paper system was used to manage 77 consecutive sepsis encounters (3.9 ± 0.5 cases per week) in 65 patients (77% male; age, 53 ± 2 years). In June to December 2012, a computerized system was used to manage 132 consecutive sepsis encounters (4.4 ± 0.4 cases per week) in 119 patients (63% male; age, 58 ± 2 years). MEWS-SRS elicited 683 site assessments, and 201 had sepsis diagnosis and protocol management. The predominant site of infection was abdomen (paper, 58%; computer, 53%). Recognition of early sepsis tended to occur more using the computerized system (paper, 23%; computer, 35%). Hospital mortality rate for surgical ICU sepsis (paper, 20%; computer, 14%) was less with the computerized system. A computerized sepsis management system improves care process and outcome. Early sepsis is recognized and managed with greater frequency compared with severe sepsis or septic shock. The system

  16. Waste management regroups units into Rust International

    International Nuclear Information System (INIS)

    Kirschner, E.

    1992-01-01

    Three Waste Management (Oak Brook, IL) subsidiaries have proposed merging units from Chemical Waste Management (CWM) and Wheelabrator Technologies with the Brand Companies (Park Ridge, IL). Waste Management says the new company, to be called Rust International, will become one of the US's largest environmental consulting and infrastructure organizations and will include design and construction services. Waste Management expects the merged company's 1993 revenues to reach $1.8 billion. It will be based in Birmingham, AL and have 12,000 employees

  17. Intensive Care Unit Nurses' Beliefs About Delirium Assessment and Management.

    Science.gov (United States)

    Oosterhouse, Kimberly J; Vincent, Catherine; Foreman, Marquis D; Gruss, Valerie A; Corte, Colleen; Berger, Barbara

    2016-10-01

    Delirium, the most frequent complication of hospitalized older adults, particularly in intensive care units (ICUs), can result in increased mortality rates and length of stay. Nurses are neither consistently identifying nor managing delirium in these patients. The purpose of this study was to explore ICU nurses' identification of delirium, actions they would take for patients with signs or symptoms of delirium, and beliefs about delirium assessment and management. In this cross-sectional study using qualitative descriptive methods guided by the theory of planned behavior, 30 ICU nurses' responses to patient vignettes depicting different delirium subtypes were explored. Descriptive and content analyses revealed that nurses did not consistently identify delirium; their actions varied in different vignettes. Nurses believed that they needed adequate staffing, balanced workload, interprofessional collaboration, and established policy and protocols to identify and manage delirium successfully. Research is needed to determine if implementing these changes increases recognition and decreases consequences of delirium. ©2016 American Association of Critical-Care Nurses.

  18. Evidence for view-invariant face recognition units in unfamiliar face learning.

    Science.gov (United States)

    Etchells, David B; Brooks, Joseph L; Johnston, Robert A

    2017-05-01

    Many models of face recognition incorporate the idea of a face recognition unit (FRU), an abstracted representation formed from each experience of a face which aids recognition under novel viewing conditions. Some previous studies have failed to find evidence of this FRU representation. Here, we report three experiments which investigated this theoretical construct by modifying the face learning procedure from that in previous work. During learning, one or two views of previously unfamiliar faces were shown to participants in a serial matching task. Later, participants attempted to recognize both seen and novel views of the learned faces (recognition phase). Experiment 1 tested participants' recognition of a novel view, a day after learning. Experiment 2 was identical, but tested participants on the same day as learning. Experiment 3 repeated Experiment 1, but tested participants on a novel view that was outside the rotation of those views learned. Results revealed a significant advantage, across all experiments, for recognizing a novel view when two views had been learned compared to single view learning. The observed view invariance supports the notion that an FRU representation is established during multi-view face learning under particular learning conditions.

  19. Market Response toward Accrual Earnings Management, Real Transactions, and Strategic Revenue Recognition - Earnings Management1

    Directory of Open Access Journals (Sweden)

    Windy Puspita Dewi

    2015-01-01

    Full Text Available This study investigates how the capital market response to a variety of earnings management tools i.e., accrual-based earnings management, real transaction activities, and strategic revenue recognition. We measure the market response to the information content of earnings by the earnings response coefficient (ERC. By using pooled-OLS regression from 748 firm-years data of public listed companies on the Indonesian Stock Exchange (IDX in 2004-2009, we find some evidence of a negative association between earnings response coefficients and information content of earnings that contained earnings management. Our study find that real transactions earnings management in operating activities has negative association with earnings response coefficient, but we do not find any evidence from the other earnings management tools. The findings of this study imply that the market participants are able to capture a certain kind of earnings management behaviour that may reduce the earnings response coefficient.

  20. Managing Natural Resources for Sustainable Livelihoods: Uniting ...

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

    2003-07-31

    Jul 31, 2003 ... Management of local resources has a greater chance of a ... Managing Natural Resources for Sustainable Livelihoods: Uniting Science and Participation ... innovative approaches for establishing and sustaining participation and ... A new IDRC-supported project will help improve water conservation and ...

  1. Hanford Site Waste Management Units Report

    Energy Technology Data Exchange (ETDEWEB)

    Shearer, Jeffrey P. [Hanford Site (HNF), Richland, WA (United States)

    2012-02-29

    The Hanford Site Waste Management Units Report (HSWMUR) has been created to meet the requirements of the Tri-Party Agreement (TPA) Action Plan, Section 3.5, which states: “The Hanford Site Waste Management Units Report shall be generated, in a format agreed upon by the Parties, as a calendar year report and issued annually by the DOE by the end of February of each year, and posted electronically for regulator and public access. This report shall reflect all changes made in waste management unit status during the previous year.” This February 2012 version of the HSWMUR contains a comprehensive inventory of the 3389 sites and 540 subsites in the Waste Information Data System (WIDS). The information for each site contains a description of each unit and the waste it contains, where applicable. The WIDS database provides additional information concerning the sites contained in this report and is maintained with daily changes to these sites.

  2. Hanford Site Waste Management Units Report

    Energy Technology Data Exchange (ETDEWEB)

    Shearer, Jeffrey P. [Hanford Site (HNF), Richland, WA (United States)

    2013-02-13

    The Hanford Site Waste Management Units Report (HSWMUR) has been created to meet the requirements of the Tri-Party Agreement (TPA) Action Plan, Section 3.5, which states: “The Hanford Site Waste Management Units Report shall be generated, in a format agreed upon by the Parties, as a calendar year report and issued annually by the DOE by the end of February of each year, and posted electronically for regulator and public access. This report shall reflect all changes made in waste management unit status during the previous year.” This February 2013 version of the HSWMUR contains a comprehensive inventory of the 3427 sites and 564 subsites in the Waste Information Data System (WIDS). The information for each site contains a description of each unit and the waste it contains, where applicable. The WIDS database provides additional information concerning the sites contained in this report and is maintained with daily changes to these sites.

  3. Hanford Site Waste Management Units Report

    Energy Technology Data Exchange (ETDEWEB)

    Shearer, Jeffrey P. [Hanford Site (HNF), Richland, WA (United States)

    2014-02-19

    The Hanford Site Waste Management Units Report (HSWMUR) has been created to meet the requirements of the Tri-Party Agreement (TPA) Action Plan, Section 3.5, which states: “The Hanford Site Waste Management Units Report shall be generated, in a format agreed upon by the Parties, as a calendar year report and issued annually by the DOE by the end of February of each year, and posted electronically for regulator and public access. This report shall reflect all changes made in waste management unit status during the previous year.” This February 2013 version of the HSWMUR contains a comprehensive inventory of the 3438 sites and 569 subsites in the Waste Information Data System (WIDS). The information for each site contains a description of each unit and the waste it contains, where applicable. The WIDS database provides additional information concerning the sites contained in this report and is maintained with daily changes to these sites.

  4. Management units radio physics hospital clinic: New management model?

    International Nuclear Information System (INIS)

    Iborra Oquendo, M.; Angulo Pain, E.; Castro Ramirez, I.; Quinones Rodriguez, L. A.; Urena Llinares, A.; Richarter Reina, J. M.; Lupiani Castellanos, J.; Ramos Caballero, L. I.

    2011-01-01

    Clinical management in the Andalusian Health Service is a process of organizational design that allows professionals to incorporate the management of resources used in their own clinical practice. In the Clinical Management Units activity develops according to different objectives, among them: encourage the involvement of health professionals in managing the centers, enhance continuity of care between the two levels of care, improve work organization and raise patient satisfaction.

  5. Enhanced iris recognition method based on multi-unit iris images

    Science.gov (United States)

    Shin, Kwang Yong; Kim, Yeong Gon; Park, Kang Ryoung

    2013-04-01

    For the purpose of biometric person identification, iris recognition uses the unique characteristics of the patterns of the iris; that is, the eye region between the pupil and the sclera. When obtaining an iris image, the iris's image is frequently rotated because of the user's head roll toward the left or right shoulder. As the rotation of the iris image leads to circular shifting of the iris features, the accuracy of iris recognition is degraded. To solve this problem, conventional iris recognition methods use shifting of the iris feature codes to perform the matching. However, this increases the computational complexity and level of false acceptance error. To solve these problems, we propose a novel iris recognition method based on multi-unit iris images. Our method is novel in the following five ways compared with previous methods. First, to detect both eyes, we use Adaboost and a rapid eye detector (RED) based on the iris shape feature and integral imaging. Both eyes are detected using RED in the approximate candidate region that consists of the binocular region, which is determined by the Adaboost detector. Second, we classify the detected eyes into the left and right eyes, because the iris patterns in the left and right eyes in the same person are different, and they are therefore considered as different classes. We can improve the accuracy of iris recognition using this pre-classification of the left and right eyes. Third, by measuring the angle of head roll using the two center positions of the left and right pupils, detected by two circular edge detectors, we obtain the information of the iris rotation angle. Fourth, in order to reduce the error and processing time of iris recognition, adaptive bit-shifting based on the measured iris rotation angle is used in feature matching. Fifth, the recognition accuracy is enhanced by the score fusion of the left and right irises. Experimental results on the iris open database of low-resolution images showed that the

  6. Comorbid Conditions in Idiopathic Pulmonary Fibrosis: Recognition and Management

    Directory of Open Access Journals (Sweden)

    Justin M. Oldham

    2017-08-01

    Full Text Available Idiopathic pulmonary fibrosis (IPF, a fibrosing interstitial pneumonia of unknown etiology, primarily affects older adults and leads to a progressive decline in lung function and quality of life. With a median survival of 3–5 years, IPF is the most common and deadly of the idiopathic interstitial pneumonias. Despite the poor survivorship, there exists substantial variation in disease progression, making accurate prognostication difficult. Lung transplantation remains the sole curative intervention in IPF, but two anti-fibrotic therapies were recently shown to slow pulmonary function decline and are now approved for the treatment of IPF in many countries around the world. While the approval of these therapies represents an important first step in combatting of this devastating disease, a comprehensive approach to diagnosing and treating patients with IPF remains critically important. Included in this comprehensive assessment is the recognition and appropriate management of comorbid conditions. Though IPF is characterized by single organ involvement, many comorbid conditions occur within other organ systems. Common cardiovascular processes include coronary artery disease and pulmonary hypertension (PH, while gastroesophageal reflux and hiatal hernia are the most commonly encountered gastrointestinal disorders. Hematologic abnormalities appear to place patients with IPF at increased risk of venous thromboembolism, while diabetes mellitus (DM and hypothyroidism are prevalent metabolic disorders. Several pulmonary comorbidities have also been linked to IPF, and include emphysema, lung cancer, and obstructive sleep apnea. While the treatment of some comorbid conditions, such as CAD, DM, and hypothyroidism is recommended irrespective of IPF, the benefit of treating others, such as gastroesophageal reflux and PH, remains unclear. In this review, we highlight common comorbid conditions encountered in IPF, discuss disease-specific diagnostic

  7. Performance Recognition for Sulphur Flotation Process Based on Froth Texture Unit Distribution

    Directory of Open Access Journals (Sweden)

    Mingfang He

    2013-01-01

    Full Text Available As an important indicator of flotation performance, froth texture is believed to be related to operational condition in sulphur flotation process. A novel fault detection method based on froth texture unit distribution (TUD is proposed to recognize the fault condition of sulphur flotation in real time. The froth texture unit number is calculated based on texture spectrum, and the probability density function (PDF of froth texture unit number is defined as texture unit distribution, which can describe the actual textual feature more accurately than the grey level dependence matrix approach. As the type of the froth TUD is unknown, a nonparametric kernel estimation method based on the fixed kernel basis is proposed, which can overcome the difficulty when comparing different TUDs under various conditions is impossible using the traditional varying kernel basis. Through transforming nonparametric description into dynamic kernel weight vectors, a principle component analysis (PCA model is established to reduce the dimensionality of the vectors. Then a threshold criterion determined by the TQ statistic based on the PCA model is proposed to realize the performance recognition. The industrial application results show that the accurate performance recognition of froth flotation can be achieved by using the proposed method.

  8. Facial Action Unit Recognition under Incomplete Data Based on Multi-label Learning with Missing Labels

    KAUST Repository

    Li, Yongqiang

    2016-07-07

    Facial action unit (AU) recognition has been applied in a wild range of fields, and has attracted great attention in the past two decades. Most existing works on AU recognition assumed that the complete label assignment for each training image is available, which is often not the case in practice. Labeling AU is expensive and time consuming process. Moreover, due to the AU ambiguity and subjective difference, some AUs are difficult to label reliably and confidently. Many AU recognition works try to train the classifier for each AU independently, which is of high computation cost and ignores the dependency among different AUs. In this work, we formulate AU recognition under incomplete data as a multi-label learning with missing labels (MLML) problem. Most existing MLML methods usually employ the same features for all classes. However, we find this setting is unreasonable in AU recognition, as the occurrence of different AUs produce changes of skin surface displacement or face appearance in different face regions. If using the shared features for all AUs, much noise will be involved due to the occurrence of other AUs. Consequently, the changes of the specific AUs cannot be clearly highlighted, leading to the performance degradation. Instead, we propose to extract the most discriminative features for each AU individually, which are learned by the supervised learning method. The learned features are further embedded into the instance-level label smoothness term of our model, which also includes the label consistency and the class-level label smoothness. Both a global solution using st-cut and an approximated solution using conjugate gradient (CG) descent are provided. Experiments on both posed and spontaneous facial expression databases demonstrate the superiority of the proposed method in comparison with several state-of-the-art works.

  9. Facial Action Unit Recognition under Incomplete Data Based on Multi-label Learning with Missing Labels

    KAUST Repository

    Li, Yongqiang; Wu, Baoyuan; Ghanem, Bernard; Zhao, Yongping; Yao, Hongxun; Ji, Qiang

    2016-01-01

    Facial action unit (AU) recognition has been applied in a wild range of fields, and has attracted great attention in the past two decades. Most existing works on AU recognition assumed that the complete label assignment for each training image is available, which is often not the case in practice. Labeling AU is expensive and time consuming process. Moreover, due to the AU ambiguity and subjective difference, some AUs are difficult to label reliably and confidently. Many AU recognition works try to train the classifier for each AU independently, which is of high computation cost and ignores the dependency among different AUs. In this work, we formulate AU recognition under incomplete data as a multi-label learning with missing labels (MLML) problem. Most existing MLML methods usually employ the same features for all classes. However, we find this setting is unreasonable in AU recognition, as the occurrence of different AUs produce changes of skin surface displacement or face appearance in different face regions. If using the shared features for all AUs, much noise will be involved due to the occurrence of other AUs. Consequently, the changes of the specific AUs cannot be clearly highlighted, leading to the performance degradation. Instead, we propose to extract the most discriminative features for each AU individually, which are learned by the supervised learning method. The learned features are further embedded into the instance-level label smoothness term of our model, which also includes the label consistency and the class-level label smoothness. Both a global solution using st-cut and an approximated solution using conjugate gradient (CG) descent are provided. Experiments on both posed and spontaneous facial expression databases demonstrate the superiority of the proposed method in comparison with several state-of-the-art works.

  10. Decommissioning project management unit started its activities

    International Nuclear Information System (INIS)

    Medeliene, D.

    2002-01-01

    The Decommissioning Project Management Unit team comprises western experts as well as experts from INPP Decommissioning Service who all work as a single team. The DPMU will develop the Final Decommissioning Plan and a more detailed Decommissioning Project, which will describe how the plant will be removed from service and safely decommissioned

  11. Pattern recognition for cache management in distributed medical imaging environments.

    Science.gov (United States)

    Viana-Ferreira, Carlos; Ribeiro, Luís; Matos, Sérgio; Costa, Carlos

    2016-02-01

    Traditionally, medical imaging repositories have been supported by indoor infrastructures with huge operational costs. This paradigm is changing thanks to cloud outsourcing which not only brings technological advantages but also facilitates inter-institutional workflows. However, communication latency is one main problem in this kind of approaches, since we are dealing with tremendous volumes of data. To minimize the impact of this issue, cache and prefetching are commonly used. The effectiveness of these mechanisms is highly dependent on their capability of accurately selecting the objects that will be needed soon. This paper describes a pattern recognition system based on artificial neural networks with incremental learning to evaluate, from a set of usage pattern, which one fits the user behavior at a given time. The accuracy of the pattern recognition model in distinct training conditions was also evaluated. The solution was tested with a real-world dataset and a synthesized dataset, showing that incremental learning is advantageous. Even with very immature initial models, trained with just 1 week of data samples, the overall accuracy was very similar to the value obtained when using 75% of the long-term data for training the models. Preliminary results demonstrate an effective reduction in communication latency when using the proposed solution to feed a prefetching mechanism. The proposed approach is very interesting for cache replacement and prefetching policies due to the good results obtained since the first deployment moments.

  12. Medical leadership and management in the United Kingdom.

    Science.gov (United States)

    Kyratsis, Yiannis; Armit, Kirsten; Zyada, Azra; Lees, Peter

    2016-06-01

    This article aims to outline the historical development of medical leadership in the United Kingdom (UK), present recent advances, and discuss professional development and future prospects. With increasing involvement of medical professionals in top managerial roles in the UK over the last 30 years, leadership development initiatives have been growing steadily and there is increasing recognition of the need for leadership and management skills for doctors. Such skills can help to greatly improve patient care as well as enhance organisational effectiveness and productivity. The central involvement of professional bodies such as the UK Faculty of Medical Leadership and Management, and the establishment of medical fellowship schemes, have provided a solid foundation for a new generation of aspiring medical leaders but there is still a long way to go to achieve a higher degree of professionalism for clinical leadership in the UK. The evidence base is weak such that integrated efforts by clinicians and management academics have much to offer in achieving the vision of socially responsible, clinically relevant and research informed medical leadership training. © The Royal Australian and New Zealand College of Psychiatrists 2016.

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

    DEFF Research Database (Denmark)

    Lee, Yih-Teen; Paunova, Minna

    2017-01-01

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

  14. Hanford Site Waste management units report

    International Nuclear Information System (INIS)

    1992-01-01

    This report summarizes the operable units in several areas of the Hanford Site Waste Facility. Each operable unit has several waste units (crib, ditch, pond, etc.). The operable units are summarized by describing each was unit. Some of the descriptions are unit name, unit type, waste category start data, site description, etc. The descriptions will vary for each waste unit in each operable unit and area of the Hanford Site

  15. Early phacoemulsification in diabetic cataract for early recognition and management of diabetic macular oedema

    International Nuclear Information System (INIS)

    Wahab, S.; Rab, K. F. U.; Hargun, L. D.

    2013-01-01

    Objective: To get optimal visualization of fundus by early phacoemulsification in diabetic cataract for early recognition and management of diabetic macular oedema. Study Design: Interventional study. Place and Duration of Study: Ophthalmology Unit III, Sindh Government Lyari General Hospital and Dow University of Health Sciences and Al-Noor Eye Hospital, Karachi, from July 2008 to June 2009. Methodology: Patients with uncontrolled type-II diabetes mellitus of more than 10 years of duration were selected. Patients with clinical significant macular oedema (CSME), non-proliferative diabetic retinopathy (NPDR) and proliferative diabetic retinopathy (PDR) were excluded. Follow-up was done on day 1, 1 week, 1 month, 3 months and 6 months. Results: The male to female ratio was 1:1.44. Out of 218 patients; 129 (59.2%) were males and 89 (40.8%) were females. CSME was found in 82 patients (37.6%) at first postoperative week which declined to 29 cases (13.3%) at first month follow-up. Three subjects developed mild to moderate NPDR. In majority of the subjects, best corrected visual acuity (BCVA) gradually improved in each subsequent follow-up visit. Conclusion: Early phacoemulsification in diabetic cataract offers optimal posterior pole visualization and clears the ambiguity of decreased vision either caused by cataract or macular oedema. Uncomplicated phacoemulsification does not accelerate diabetic macular oedema or retinopathy provided glycemic control and co-morbids are well addressed. (author)

  16. Role of pattern recognition receptors of the neurovascular unit in inflamm-aging.

    Science.gov (United States)

    Wilhelm, Imola; Nyúl-Tóth, Ádám; Kozma, Mihály; Farkas, Attila E; Krizbai, István A

    2017-11-01

    Aging is associated with chronic inflammation partly mediated by increased levels of damage-associated molecular patterns, which activate pattern recognition receptors (PRRs) of the innate immune system. Furthermore, many aging-related disorders are associated with inflammation. PRRs, such as Toll-like receptors (TLRs) and nucleotide-binding oligomerization domain-like receptors (NLRs), are expressed not only in cells of the innate immune system but also in other cells, including cells of the neurovascular unit and cerebral vasculature forming the blood-brain barrier. In this review, we summarize our present knowledge about the relationship between activation of PRRs expressed by cells of the neurovascular unit-blood-brain barrier, chronic inflammation, and aging-related pathologies of the brain. The most important damage-associated molecular pattern-sensing PRRs in the brain are TLR2, TLR4, and NLR family pyrin domain-containing protein-1 and pyrin domain-containing protein-3, which are activated during physiological and pathological aging in microglia, neurons, astrocytes, and possibly endothelial cells and pericytes. Copyright © 2017 the American Physiological Society.

  17. Management of inpatient aggression in forensic mental health nursing : the application of the Early Recognition Method

    NARCIS (Netherlands)

    Fluttert, F.A.J.

    2011-01-01

    Management of Inpatient Aggression in Forensic Mental Health Nursing. The application of the Early Recognition Method. Forensic mental health nurses take care of forensic patients convicted for an offense for which they were assessed not to be fully accountable due to their psychiatric disorder. For

  18. Institutional Development to Build a Succesfull Local Collective Action in Forest Management from Arau Watershed Unit

    Directory of Open Access Journals (Sweden)

    Nursidah Nursidah

    2012-04-01

    Full Text Available The study was aimed to build institution model of sustainable forest management, through analysis of action arena, community attributes and forest management rules in Arau Watershed Unit Management Area.  To achieve sustainable forest management, recognition and incorporation of local institutions in forest policy formulation is very important because it had great potential for collective action and had characteristics of common pools resources sustainable management needed.  To achieve a successful local collective action, the institution must be had: the rules in use suitable with local community norms; the organization has power to give reward and punishment as well as recognized and respected by society; specific management according location; rules of the game was made participatory; there are economic incentives for owners and users; there is an instrument for controlling sustainable use; and conflict resolution through negotiations to reach an concencus agreement.  The finding of institutional models  analysis  show  that  co-management  model  between government and local communities, called Nagari Forest Management Model is more suitable, because it gives greater opportunities for indigenous rights recognition to communal forest, until the capacity of villages get better, then the choice of forest management can be shifted into Nagari Community Based Forest Management Model.Keywords: sustainable forest management, institution, collective action, nagari

  19. Recognition and management of seizures in children in emergency departments.

    Science.gov (United States)

    Caplan, Edward; Dey, Indranil; Scammell, Andrea; Burnage, Katy; Paul, Siba Prosad

    2016-09-01

    Seizure is defined as 'a sudden surge of electrical activity in the brain, which usually affects how a person appears or acts for a short time'. Children who have experienced seizures commonly present to emergency departments (EDs), and detailed history taking will usually help differentiate between epileptic and non-epileptic events. ED nurses are often the first health professionals to manage children with seizures, and this is best done by following the ABCDE approach. Treatment involves termination of seizures with anticonvulsants, and children may need other symptomatic management. Seizures in children can be an extremely distressing experience for parents, who should be supported and kept informed by experienced ED nurses. Nurses also play a vital role in educating parents on correct administration of anticonvulsants and safety advice. This article discusses the aetiology, clinical presentation, diagnosis and management of children with seizures, with particular emphasis on epilepsy. It includes two reflective case studies to highlight the challenges faced by healthcare professionals managing children who present with convulsions.

  20. Risk Management: Earning Recognition with an Automated Safety Program

    Science.gov (United States)

    Lansberry, Linden; Strasburger, Tom

    2012-01-01

    Risk management is a huge task that requires diligent oversight to avoid penalties, fines, or lawsuits. Add in the burden of limited resources that schools face today, and the challenge of meeting the required training, reporting, compliance, and other administrative issues associated with a safety program is almost insurmountable. Despite an…

  1. Recognition and management of Tourette's syndrome and tic disorders.

    Science.gov (United States)

    Bagheri, M M; Kerbeshian, J; Burd, L

    1999-04-15

    Tic disorders and Tourette's syndrome are conditions that primary care physicians are likely to encounter. Up to 20 percent of children have at least a transient tic disorder at some point. Once believed to be rare, Tourette's syndrome is now known to be a more common disorder that represents the most complex and severe manifestation of the spectrum of tic disorders. Tourette's syndrome is a chronic familial disorder with a fluctuating course; the long-term outcome is generally favorable. Although the exact underlying pathology has yet to be determined, evidence indicates a disorder localized to the frontal-subcortical neural pathways. Tourette's syndrome is commonly associated with attention-deficit/hyperactivity disorder, obsessive-compulsive disorder, behavior problems and learning disabilities. These comorbid conditions make the management of Tourette's syndrome more challenging. Management of Tourette's syndrome should include timely and accurate diagnosis, education, and behavior or pharmacologic interventions. Use of neuroleptic medications and dopamine D2 antagonist drugs can be effective but may be associated with significant side effects.

  2. Organisation Development through Management Development: The United Biscuits Example.

    Science.gov (United States)

    Campbell, Andrew; Winterburn, Den

    1988-01-01

    The success of the strategic management program developed by United Biscuits (United Kingdom) for senior managers resulted from (1) tailoring the program to organizational and individual needs; (2) using company-specific material; (3) involving top management; and (4) using a follow-up program. (JOW)

  3. The death of marriage? The effects of new forms of legal recognition on marriage rates in the United States.

    Science.gov (United States)

    Dillender, Marcus

    2014-04-01

    Some conservative groups argue that allowing same-sex couples to marry reduces the value of marriage to opposite-sex couples. This article examines how changes in U.S. legal recognition laws occurring between 1995 and 2010 designed to include same-sex couples have altered marriage rates in the United States. Using a difference-in-differences strategy that compares how marriage rates change after legal recognition in U.S. states that alter legal recognition versus states that do not, I find no evidence that allowing same-sex couples to marry reduces the opposite-sex marriage rate. Although the opposite-sex marriage rate is unaffected by same-sex couples marrying, it decreases when domestic partnerships are available to opposite-sex couples.

  4. Digital management of an electron microscope unit

    International Nuclear Information System (INIS)

    Elea, N.; Dickson, M.; Munroe, P.

    2002-01-01

    Full text: Electron microscope units, especially those such as ours, which operate as a central infrastructural facility are increasingly asked to provide more service, over more instruments with decreasing, or limited, financial resources. We believe that staff time is best used performing electron microscopy, assisting users and maintaining instrumentation rather than in the pursuit of red tape. One solution to this problem has been the creation of a control system which performs all routine acts of data management, such as the archiving and accessing of digital data, providing access to bookings, and most importantly in the era of user pays services, logging time and billing users. The system we have created, developed and expanded allows the users themselves to access our server through any web-browser and make their own bookings or access and manipulate their data. Users themselves must log on to a microscope through swipecard readers before it can be used and log-off after use. Their time is logged precisely and an exquisitely fair user pays systems can be operated by transferring logged usage time to spreadsheets to calculate charges. Furthermore, this system acts as a method of user authentication and can be used to bar incompetent or unauthorised users. The system has recently been upgraded to increase its utility to include sensors that monitor the electron microscope operating environment, such as magnetic field, room temperature, water flow etc, so that if these parameters depart significantly from optimum levels electron microscope unit staff may be alerted. In this presentation the structure of our system will be described and the advantages and disadvantages of such a system will be discussed. Copyright (2002) Australian Society for Electron Microscopy Inc

  5. Implementing a Nurse Manager Profile to Improve Unit Performance.

    Science.gov (United States)

    Krugman, Mary E; Sanders, Carolyn L

    2016-06-01

    Nurse managers face significant pressures in the rapidly changing healthcare environment. Staying current with multiple sources of data, including reports that detail institutional and unit performance outcomes, is particularly challenging. A Nurse Manager Customized Profile was developed at a western academic hospital to provide a 1-page visual of pertinent data to help managers and director supervisors focus coaching to improve unit performance. Use of the Decisional Involvement Scale provided new insights into measuring manager performance.

  6. 50 CFR 600.320 - National Standard 3-Management Units.

    Science.gov (United States)

    2010-10-01

    .... Wherever practicable, an FMP should seek to manage interrelated stocks of fish. (c) Unity of management... management exits or is planned for a separate geographic area or for a distinct use of the stocks, or if the... stock of fish shall be managed as a unit throughout its range, and interrelated stocks of fish shall be...

  7. Recognition and management of idiopathic systemic capillary leak syndrome: an evidence-based review.

    Science.gov (United States)

    Baloch, Noor Ul-Ain; Bikak, Marvi; Rehman, Abdul; Rahman, Omar

    2018-05-01

    Idiopathic systemic capillary leak syndrome (SCLS) is a unique disorder characterized by episodes of massive systemic leak of intravascular fluid leading to volume depletion and shock. A typical attack of SCLS consists of prodromal, leak and post-leak phases. Complications, such as compartment syndrome and pulmonary edema, usually develop during the leak and post-leak phases respectively. Judicious intravenous hydration and early use of vasopressors is the cornerstone of management in such cases. Areas covered: The purpose of the present review is to provide an up-to-date, evidence-based review of our understanding of SCLS and its management in the light of currently available evidence. Idiopathic SCLS was first described in 1960 and, since then, more than 250 cases have been reported. A large number of cases have been reported over the past one decade, most likely due to improved recognition. In the acute care setting, most patients with SCLS are managed as per the Surviving Sepsis guidelines and receive aggressive volume resuscitation - which is not the optimal management strategy for such patients. There is a need to raise awareness amongst physicians and clinicians in order to improve recognition of this disorder and ensure its appropriate management.

  8. Characteristics of the nurse manager's recognition behavior and its relation to sense of coherence of staff nurses in Japan.

    Science.gov (United States)

    Miyata, Chiharu; Arai, Hidenori; Suga, Sawako

    2015-01-01

    The recognition behaviors strongly influence the job satisfaction of staff nurses and an extremely important factor for the prevention of burnout and the promotion of retention. Additionally, among internal factors that may affect worker's mental health, a sense of coherence (SOC) is an important concept from the view of the salutogenic theory and stress recognition style. Individual's SOC increases in relation to recognition behavior. However, in Japan, few studies have examined the effect of recognition behaviors on the SOC of staff nurses. The purpose of this study was to investigate how staff nurses perceive recognition behaviors of the nurse manager and to determine the relationship between recognition behaviors and the staff nurses' SOC. This quantitative, cross-sectional study involved 10 hospitals in Japan. A total of 1425 nurses completed the questionnaire. As a result, the perceptions of nurse manager's recognition behaviors by staff nurses were evaluated by presentation and report, individual value and the transfer of responsibility, and professional development. The median score of staff nurse SOC-13 was 50 (IQR; 45-55). Significant differences in SOC scores were found in marital status, age, years of experience, and mental and physical health condition. In conclusion, recognition behaviors by the nurse manager can improve staff nurse's SOC and effectively support the mental health of the staff nurse.

  9. Forest carbon management in the United States: 1600-2100

    Science.gov (United States)

    Richard A. Birdsey; Kurt Pregitzer; Alan Lucier

    2006-01-01

    This paper reviews the effects of past forest management on carbon stocks in the United States, and the challenges for managing forest carbon resources in the 21st century. Forests in the United States were in approximate carbon balance with the atmosphere from 1600-1800. Utilization and land clearing caused a large pulse of forest carbon emissions during the 19th...

  10. Target-context unitization effect on the familiarity-related FN400: a face recognition exclusion task.

    Science.gov (United States)

    Guillaume, Fabrice; Etienne, Yann

    2015-03-01

    Using two exclusion tasks, the present study examined how the ERP correlates of face recognition are affected by the nature of the information to be retrieved. Intrinsic (facial expression) and extrinsic (background scene) visual information were paired with face identity and constituted the exclusion criterion at test time. Although perceptual information had to be taken into account in both situations, the FN400 old-new effect was observed only for old target faces on the expression-exclusion task, whereas it was found for both old target and old non-target faces in the background-exclusion situation. These results reveal that the FN400, which is generally interpreted as a correlate of familiarity, was modulated by the retrieval of intra-item and intrinsic face information, but not by the retrieval of extrinsic information. The observed effects on the FN400 depended on the nature of the information to be retrieved and its relationship (unitization) to the recognition target. On the other hand, the parietal old-new effect (generally described as an ERP correlate of recollection) reflected the retrieval of both types of contextual features equivalently. The current findings are discussed in relation to recent controversies about the nature of the recognition processes reflected by the ERP correlates of face recognition. Copyright © 2015 Elsevier B.V. All rights reserved.

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

    Science.gov (United States)

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

    2014-04-04

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

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

    Directory of Open Access Journals (Sweden)

    Mokgadi C. Matlakala

    2014-04-01

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

  13. The United Kingdom's School Asset Management Plans.

    Science.gov (United States)

    Jones, Alan

    1999-01-01

    Examines the U.K.'s Asset Management Plans (AMPs) designed to help Local Education Authorities (LEAs) identify and address the most important priorities in their school capital programs, and to help in their longer term planning and management of the school estate. Discusses AMP objectives, the stages of developing an AMP, and how the Department…

  14. Managing Natural Resources for Sustainable Livelihoods: Uniting ...

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

    31 juil. 2003 ... Management of local resources has a greater chance of a sustainable outcome when there is partnership between local people and external agencies, and agendas relevant to their aspirations and circumstances. Managing Natural Resources for Sustainable Livelihoods analyses and extends this premise ...

  15. The recognition and management of sepsis and septic shock: a guide for non-intensivists.

    Science.gov (United States)

    Keeley, Alexander; Hine, Paul; Nsutebu, Emmanuel

    2017-10-01

    Sepsis is common, often fatal and requires rapid interventions to improve outcomes. While the optimal management of sepsis in the intensive care setting is the focus of extensive research interest, the mainstay of the recognition and initial management of sepsis will occur outside the intensive care setting. Therefore, it is key that institutions and clinicians remain well informed of the current updates in sepsis management and continue to use them to deliver appropriate and timely interventions to enhance patient survival. This review discusses the latest updates in sepsis care including the new consensus definition of sepsis, the outcome of the proCESS, ProMISe and ARISE trials of early goal directed therapy (EGDT), and the most recent guidelines from the Surviving Sepsis Campaign. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  16. United nations Supported principles for Responsible Management Education

    DEFF Research Database (Denmark)

    Godemann, Jasmin; Moon, Jeremy; Haertle, Jonas

    2014-01-01

    and various ecological system crises. The United Nations supported Principles for Responsible Management Education (PRME) initiative is an important catalyst for the transformation of management education and a global initiative to change and reform management education in order to meet the increasing......The expectation that management education institutions should be leading thought and action on issues related to corporate responsibility and sustainability has been reinforced in the light of their association with business leaders' failings, including corporate corruption, the financial crisis...

  17. Radioactive waste management in the United Kingdom

    International Nuclear Information System (INIS)

    Hill, J.

    1976-01-01

    The principles to be followed in the processing and disposal of radioactive wastes are summarized and the procedures practiced in the United Kingdom for different types of wastes are reviewed to illustrate how these principles are being observed. The objectives for the future in modification of current practices are discussed

  18. Animal health management practices in zero grazing dairy units in ...

    African Journals Online (AJOL)

    Animal health management practices in zero grazing dairy units in Arusha City, Tanzania. ... African Journal of Food, Agriculture, Nutrition and Development ... findings, majority (84.6%) of the cow's enclosures were of poor hygiene.

  19. An Appraisal Of The Operation And Management Of Unit Trust ...

    African Journals Online (AJOL)

    An Appraisal Of The Operation And Management Of Unit Trust Schemes In Nigeria. ... Open Access DOWNLOAD FULL TEXT ... instead of being invested in shares or in money market instruments as a result of widespread financial illiteracy.

  20. Using sense-making theory to aid understanding of the recognition, assessment and management of pain in patients with dementia in acute hospital settings.

    Science.gov (United States)

    Dowding, Dawn; Lichtner, Valentina; Allcock, Nick; Briggs, Michelle; James, Kirstin; Keady, John; Lasrado, Reena; Sampson, Elizabeth L; Swarbrick, Caroline; José Closs, S

    2016-01-01

    The recognition, assessment and management of pain in hospital settings is suboptimal, and is a particular challenge in patients with dementia. The existing process guiding pain assessment and management in clinical settings is based on the assumption that nurses follow a sequential linear approach to decision making. In this paper we re-evaluate this theoretical assumption drawing on findings from a study of pain recognition, assessment and management in patients with dementia. To provide a revised conceptual model of pain recognition, assessment and management based on sense-making theories of decision making. The research we refer to is an exploratory ethnographic study using nested case sites. Patients with dementia (n=31) were the unit of data collection, nested in 11 wards (vascular, continuing care, stroke rehabilitation, orthopaedic, acute medicine, care of the elderly, elective and emergency surgery), located in four NHS hospital organizations in the UK. Data consisted of observations of patients at bedside (170h in total); observations of the context of care; audits of patient hospital records; documentary analysis of artefacts; semi-structured interviews (n=56) and informal open conversations with staff and carers (family members). Existing conceptualizations of pain recognition, assessment and management do not fully explain how the decision process occurs in clinical practice. Our research indicates that pain recognition, assessment and management is not an individual cognitive activity; rather it is carried out by groups of individuals over time and within a specific organizational culture or climate, which influences both health care professional and patient behaviour. We propose a revised theoretical model of decision making related to pain assessment and management for patients with dementia based on theories of sense-making, which is reflective of the reality of clinical decision making in acute hospital wards. The revised model recognizes the

  1. Care management in nursing within emergency care units

    OpenAIRE

    Roberta Juliane Tono de Oliveira; Patrícia Madalena Vieira Hermida; Fernanda Hannah da Silva Copelli; José Luís Guedes dos Santos; Alacoque Lorenzini Erdmann; Selma Regina de Andrade

    2015-01-01

    Objective.Understand the conditions involved in the management of nursing care in emergency care units. Methodology. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Results. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency se...

  2. Nurse management skills required at an emergency care unit

    OpenAIRE

    Montezeli, Juliana Helena; Peres, Aida Maris; Bernardino, Elizabeth

    2013-01-01

    Objective: To identify the management skills needed for this professional at an emergency care unit. Method: An exploratory descriptive qualitative study conducted with eight nurses in which semi-structured interviews with nonparticipating systematic observation were conducted; the data was processed by content analysis. Results: The categories which emerged from the content analysis served as a list of management skills necessary to their work at the emergency care unit: leadership, decision...

  3. Management accounting in an area. [United Kingdom

    Energy Technology Data Exchange (ETDEWEB)

    Cheney, G.H.

    1985-01-01

    The role of a chief accountant in a mining Area, in particular the management accounting aspect, is demonstrated by considering: cash flow; cost control; functional costing; capital expenditure appraisal; budgetary control and zero base budgeting. The above subject headings and their needs are also considered in the light of the current economic situation. 4 references.

  4. Radioactive waste management in the United States

    International Nuclear Information System (INIS)

    Smiley, J.L.

    1985-01-01

    In the United States, efforts to dispose of the nation's high- and low-level radioactive wastes are based on somewhat different approaches.The individual States are responsible for disposing of low-level wastes with the Federal Government providing technical and financial support to help the States in the early phases of their efforts. The Federal Government has responsibility for developing facilities for the disposal of high-level waste. However, both efforts show a common need to meet national objectives while satisfying the concerns of the public. (author)

  5. Development of a practical guide for the early recognition for malignant melanoma of the foot and nail unit

    Directory of Open Access Journals (Sweden)

    de Berker David AR

    2010-09-01

    Full Text Available Abstract Background Malignant melanoma is a rare but potentially lethal form of cancer which may arise on the foot. Evidence suggests that due to misdiagnosis and later recognition, foot melanoma has a poorer prognosis than cutaneous melanoma elsewhere. Methods A panel of experts representing podiatry and dermatologists with a special interest in skin oncology was assembled to review the literature and clinical evidence to develop a clinical guide for the early recognition of plantar and nail unit melanoma. Results A systematic review of the literature revealed little high quality data to inform the guide. However a significant number of case reports and series were available for analysis. From these, the salient features were collated and summarised into the guide. Based on these features a new acronym "CUBED" for foot melanoma was drafted and incorporated in the guide. Conclusions The use of this guide may help clinicians in their assessment of suspicious lesions on the foot (including the nail unit. Earlier detection of suspicious pedal lesions may facilitate earlier referral for expert assessment and definitive diagnosis. The guide is currently being field tested amongst practitioners.

  6. Identification of management units using population genetic data

    NARCIS (Netherlands)

    Palsboll, Per J.; Berube, Martine; Allendorf, Fred W.

    The identification of management units (MUs) is central to the management of natural populations and is crucial for monitoring the effects of human activity upon species abundance. Here, we propose that the identification of MUs from population genetic data should be based upon the amount of genetic

  7. AREVA Logistics Business Unit Transportation Risk Management Initiative

    International Nuclear Information System (INIS)

    Anne, C.

    2009-01-01

    A safe, secure and reliable transportation organization is a key component for the success of the nuclear industry. With the forecasted increase of radioactive material transport flows in future and the changing environment, AREVA Logistic Business Unit (L-BU) must ensure that safety and security risks are minimized but also ensure of the chain supply for its various facilities (mines, conversion, enrichment, fuel manufacturing, reprocessing, etc). AREVA L-BU Unit is implementing a transportation risk management initiative for the radioactive shipments of the AREVA group across all the Business Unit involved in shipments of radioactive and nuclear materials. The paper will present the four main components of the risk management. (authors)

  8. Care management in nursing within emergency care units

    Directory of Open Access Journals (Sweden)

    Roberta Juliane Tono de Oliveira

    2015-12-01

    Full Text Available Objective.Understand the conditions involved in the management of nursing care in emergency care units. Methodology. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Results. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. Conclusion. Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.

  9. Care management in nursing within emergency care units.

    Science.gov (United States)

    Tono de Oliveira, Roberta Juliane; Vieira Hermida, Patrícia Madalena; da Silva Copelli, Fernanda Hannah; Guedes Dos Santos, José Luís; Lorenzini Erdmann, Alacoque; Regina de Andrade, Selma

    2015-12-01

    Understand the conditions involved in the management of nursing care in emergency care units. Qualitative research using the methodological framework of the Grounded Theory. Data collection occurred from September 2011 to June 2012 through semi-structured interviews with 20 participants of the two emergency care units in the city of Florianopolis, Brazil. Hindering factors to care management are: lack of experience and knowledge of professionals in emergency services; inadequate number of professionals; work overload of emergency care units in the urgent care network; difficulty in implementing nursing care systematization, and need for team meetings. Facilitating factors are: teamwork; importance of professionals; and confidence of the nursing technicians in the presence of the nurse. Whereas the hindering factors in care management are related to the organizational aspects of the emergency care units in the urgency care network, the facilitating ones include specific aspects of teamwork.

  10. The effectiveness of education in the recognition and management of deteriorating patients: A systematic review.

    Science.gov (United States)

    Connell, Clifford J; Endacott, Ruth; Jackman, Jennifer A; Kiprillis, Noelleen R; Sparkes, Louise M; Cooper, Simon J

    2016-09-01

    Survival from in-hospital cardiac arrest is poor. Clinical features, including abnormal vital signs, often indicate patient deterioration prior to severe adverse events. Early warning systems and rapid response teams are commonly used to assist the health profession in the identification and management of the deteriorating patient. Education programs are widely used in the implementation of these systems. The effectiveness of the education is unknown. The aims of this study were to identify: (i) the evidence supporting educational effectiveness in the recognition and management of the deteriorating patient and (ii) outcome measures used to evaluate educational effectiveness. A mixed methods systematic review of the literature was conducted using studies published between 2002 and 2014. Included studies were assessed for quality and data were synthesized thematically, while original data are presented in tabular form. Twenty-three studies were included in the review. Most educational programs were found to be effective reporting significant positive impacts upon learners, patient outcomes and organisational systems. Outcome measures related to: i learners, for example knowledge and performance, ii systems, including activation and responses of rapid response teams, and iii patients, including patient length of stay and adverse events. All but one of the programs used blended teaching with >87% including medium to high fidelity simulation. In situ simulation was employed in two of the interventions. The median program time was eight hours. The longest program lasted 44h however one of the most educationally effective programs was based upon a 40min simulation program. Educational interventions designed to improve the recognition and management of patient deterioration can improve learner outcomes when they incorporate medium to high-fidelity simulation. High-fidelity simulation has demonstrated effectiveness when delivered in brief sessions lasting only forty minutes

  11. [Management of postoperative pain in surgical units].

    Science.gov (United States)

    Delbos, A

    1998-01-01

    In order to improve the management of postoperative pain many publications insist on progressive changes in care organization. The following list outlines steps to be taken for implementation of these changes: 1) an initial analysis of management of post-operative pain allows awareness of reforms to be proposed; 2) participation of health teams in special training in order to use evaluation tools and collect data (use of analgesics, adverse effects); 3) establishing policies and procedures: recovery room, guidelines for analgesic use and adverse effects; 4) notifying patient about the various procedures to be used in postoperative period--discussion with the patient during the preoperative interview; 5) current use of standard patient-controlled analgesia (PCA) and locoregional analgesia; 6) use of combined techniques in order to achieve a balanced analgesia; 7) implementing a quality assurance programme which should include analgesic effectiveness, patient satisfaction and prevention of complications; and 8) planning of an Acute Pain Service based on a clinical nurse co-ordinator which offers highly effective forms of postsurgical analgesia.

  12. Health care units and human resources management trends.

    Science.gov (United States)

    André, Adriana Maria; Ciampone, Maria Helena Trench; Santelle, Odete

    2013-02-01

    To identify factors producing new trends in basic health care unit management and changes in management models. This was a prospective study with ten health care unit managers and ten specialists in the field of Health in São Paulo, Southeastern Brazil, in 2010. The Delphi methodology was adopted. There were four stages of data collection, three quantitative and the fourth qualitative. The first three rounds dealt with changing trends in management models, manager profiles and required competencies, and the Mann-Whitney test was used in the analysis. The fourth round took the form of a panel of those involved, using thematic analysis. The main factors which are driving change in basic health care units were identified, as were changes in management models. There was consensus that this process is influenced by the difficulties in managing teams and by politics. The managers were found to be up-to-date with trends in the wider context, with the arrival of social health organizations, but they are not yet anticipating these within the institutions. Not only the content, but the professional development aspect of training courses in this area should be reviewed. Selection and recruitment, training and assessment of these professionals should be guided by these competencies aligned to the health service mission, vision, values and management models.

  13. Strategies to address management challenges in larger intensive care units.

    Science.gov (United States)

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

    2015-10-01

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

  14. The management of animal bites in the United kingdom.

    Science.gov (United States)

    Evgeniou, E; Markeson, D; Iyer, S; Armstrong, A

    2013-01-01

    Animal bites represent a significant global health issue. The evidence in the literature regarding their management in many areas is conflicting and unclear. This project attempts to identify current evidence in the literature on the management of animal bites and assess if current practice in the United Kingdom is evidence based. A literature review on the management of animal bites was performed, and a national UK survey was contacted using a questionnaire based on the available evidence in the literature. The results from this survey show that 98% of plastic surgery units routinely use prophylactic antibiotics in all animal bite wounds; 58% close low-risk injuries primarily after initial washout, and there are conflicting opinions regarding the management of associated fractures and soft tissue injuries. The available data in the literature suggest that appropriate wound management is the most important factor for prevention of infection in animal bites. Antibiotic prophylaxis should only be given in high-risk wounds and primary closure should be performed in low-risk wounds. The management protocols of many plastic surgery units often diverge from the available evidence within the literature. On the basis of a thorough literature review, a guideline for the management of animal bites is presented. Future studies should investigate the management of associated fractures and soft tissue injuries.

  15. Unit costs of waste management operations

    International Nuclear Information System (INIS)

    Kisieleski, W.E.; Folga, S.M.; Gillette, J.L.; Buehring, W.A.

    1994-04-01

    This report provides estimates of generic costs for the management, disposal, and surveillance of various waste types, from the time they are generated to the end of their institutional control. Costs include monitoring and surveillance costs required after waste disposal. Available data on costs for the treatment, storage, disposal, and transportation of spent nuclear fuel and high-level radioactive, low-level radioactive, transuranic radioactive, hazardous, mixed (low-level radioactive plus hazardous), and sanitary wastes are presented. The costs cover all major elements that contribute to the total system life-cycle (i.e., ''cradle to grave'') cost for each waste type. This total cost is the sum of fixed and variable cost components. Variable costs are affected by operating rates and throughput capacities and vary in direct proportion to changes in the level of activity. Fixed costs remain constant regardless of changes in the amount of waste, operating rates, or throughput capacities. Key factors that influence cost, such as the size and throughput capacity of facilities, are identified. In many cases, ranges of values for the key variables are presented. For some waste types, the planned or estimated costs for storage and disposal, projected to the year 2000, are presented as graphics

  16. Practitioner Perceptions of Adaptive Management Implementation in the United States

    Directory of Open Access Journals (Sweden)

    Melinda Harm. Benson

    2013-09-01

    Full Text Available Adaptive management is a growing trend within environment and natural resource management efforts in the United States. While many proponents of adaptive management emphasize the need for collaborative, iterative governance processes to facilitate adaptive management, legal scholars note that current legal requirements and processes in the United States often make it difficult to provide the necessary institutional support and flexibility for successful adaptive management implementation. Our research explores this potential disconnect between adaptive management theory and practice by interviewing practitioners in the field. We conducted a survey of individuals associated with the Collaborative Adaptive Management Network (CAMNet, a nongovernmental organization that promotes adaptive management and facilitates in its implementation. The survey was sent via email to the 144 participants who attended CAMNet Rendezvous during 2007-2011 and yielded 48 responses. We found that practitioners do feel hampered by legal and institutional constraints: > 70% of respondents not only believed that constraints exist, they could specifically name one or more examples of a legal constraint on their work implementing adaptive management. At the same time, we found that practitioners are generally optimistic about the potential for institutional reform.

  17. A multi-professional full-scale simulation course in the recognition and management of deteriorating hospital patients

    DEFF Research Database (Denmark)

    Fuhrmann, Lone; Østergaard, Doris; Lippert, Anne

    2009-01-01

    INTRODUCTION: Recognition and management of deteriorating patients is often suboptimal, resulting in adverse events that may be avoided if a unified understanding of the signs and needs of deteriorating patients is secured through the education of staff. This paper describes the planning...

  18. Survey of Thai Physicians Regarding Recognition and Management of Inflammatory Back Pain and Spondyloarthritis.

    Science.gov (United States)

    Tangrungruengkit, Mintra; Srinonprasert, Varalak; Chiowchanwisawakit, Praveena

    2016-01-01

    To assess recognition and management of inflammatory back pain (IBP) and spondyloarthritis (SpA) among non-rheumatologists (NRs) and rheumatologists in Thailand. A cross-sectional survey was conducted among physicians in Thailand A questionnaire designed to evaluate knowledge regarding IBP and SpA was sent to 1,336 NRs. A different questionnaire regarding SpA management in practice was sent to 112 rheumatologists. Of 1,448 questionnaires distributed, 367 (25.3%) questionnaires were returned (NRs: 321 [24.0%] and included rheumatologists, 46 [41.1%]). Among NRs, 26.6%, 20.9%, and 9.4% recognized all features of IBP according to Calin, Assessment of SpondyloArthritis International Society, and Berlin criteria, respectively. In the presence of typical features of ankylosing spondylitis, 57.8% of NRs made the correct diagnosis. Regarding related clinical skills and involvement, 43.8%, 53.6%, and 37.3% of NRs lacked confidence in distinguishing IBP from mechanical back pain, performing musculoskeletal examination, and interpretation of plain radiography, respectively. Expensive biologic agents (31.2%) and advanced disease stage at diagnosis (27.1%) were the main problems reported by rheumatologists. Problems in diagnosis and management of SpA patients among NRs in Thailand included lack of knowledge and lack of associated clinical skills. Issues reported by rheumatologists centered on case management limitations. In order to improve overall quality of care for SpA patients, focused strategies should be implemented for both NRs and rheumatologists that consider the needs of patients, clinicians, and policy makers.

  19. Status of native fishes in the western United States and issues for fire and fuels management

    Science.gov (United States)

    Rieman, B.; Lee, D.; Burns, D.; Gresswell, Robert E.; Young, M.; Stowell, R.; Rinne, J.; Howell, P.

    2003-01-01

    Conservation of native fishes and changing patterns in wildfire and fuels are defining challenges for managers of forested landscapes in the western United States. Many species and populations of native fishes have declined in recorded history and some now occur as isolated remnants of what once were larger more complex systems. Land management activities have been viewed as one cause of this problem. Fires also can have substantial effects on streams and riparian systems and may threaten the persistence of some populations of fish, particularly those that are small and isolated. Despite that, major new efforts to actively manage fires and fuels in forests throughout the region may be perceived as a threat rather than a benefit to conservation of native fishes and their habitats. The management of terrestrial and aquatic resources has often been contentious, divided among a variety of agencies with different goals and mandates. Management of forests, for example, has generally been viewed as an impact on aquatic systems. Implementation of the management-regulatory process has reinforced a uniform approach to mitigate the threats to aquatic species and habitats that may be influenced by management activities. The problems and opportunities, however, are not the same across the landscapes of interest. Attempts to streamline the regulatory process often search for generalized solutions that may oversimplify the complexity of natural systems. Significant questions regarding the influence of fire on aquatic ecosystems, changing fire regimes, and the effects of fire-related management remain unresolved and contribute to the uncertainty. We argue that management of forests and fishes can be viewed as part of the same problem, that of conservation and restoration of the natural processes that create diverse and productive ecosystems. We suggest that progress toward more integrated management of forests and native fishes will require at least three steps: (1) better

  20. Sustainable energy development material management team report. Fossil business unit

    International Nuclear Information System (INIS)

    Bird, P.; Keller, P.; Manning, P.; Nolan, M.; Ricci, A.; Turnbull, F.; Varadinek, H.

    1995-01-01

    Report of the Material Management Sustainable Energy Development (SED) Team was presented, outlining strategic directions and initiative for embedding SED principles in the materials management function. Six principles underlying SED were prescribed, accompanied by a framework for analysis. Excerpts from position papers used in the formulation of SED recommendations and initiatives were provided. The general theme of the recommendations was: (1) materials management activities should be review to ensure consistency with SED, (2) strategic alliances should be developed where appropriate and (3) staff in the Fossil Business Unit should promote SED among industry suppliers

  1. Management of Tracheostomy: A Survey of Dutch Intensive Care Units

    NARCIS (Netherlands)

    Veelo, Denise P.; Schultz, Marcus J.; Phoa, Kai Y. N.; Dongelmans, Dave A.; Binnekade, Jan M.; Spronk, Peter E.

    2008-01-01

    OBJECTIVE: To determine tracheostomy-management practices in Dutch intensive care units (ICUs) and post-ICU step-down facilities. METHODS: We surveyed the physician medical directors of all Dutch nonpediatric ICUs that have : 5 beds suitable for mechanical ventilation. The survey asked for

  2. An Update on Asset Management Plans in the United Kingdom.

    Science.gov (United States)

    Patel, Mukund

    1999-01-01

    Describes a current project in the United Kingdom designed to improve school buildings. The use of Asset Management Plans (AMPs) in providing the means through which likely future needs are assessed, criteria for prioritization are set, and informed decisions on local spending are made are examined. (GR)

  3. The holistic leadership model and the nurse unit manager ...

    African Journals Online (AJOL)

    Effective leadership is arguably one of the most relevant indicators of a profession's advancement or lack thereof. The purpose of this article is to share the authors' personal views on the leadership competencies necessary for the nurse unit manager transitioning into the role for the first time. To identify these leadership ...

  4. Primary care clinicians' recognition and management of depression: a model of depression care in real-world primary care practice.

    Science.gov (United States)

    Baik, Seong-Yi; Crabtree, Benjamin F; Gonzales, Junius J

    2013-11-01

    Depression is prevalent in primary care (PC) practices and poses a considerable public health burden in the United States. Despite nearly four decades of efforts to improve depression care quality in PC practices, a gap remains between desired treatment outcomes and the reality of how depression care is delivered. This article presents a real-world PC practice model of depression care, elucidating the processes and their influencing conditions. Grounded theory methodology was used for the data collection and analysis to develop a depression care model. Data were collected from 70 individual interviews (60 to 70 min each), three focus group interviews (n = 24, 2 h each), two surveys per clinician, and investigators' field notes on practice environments. Interviews were audiotaped and transcribed for analysis. Surveys and field notes complemented interview data. Seventy primary care clinicians from 52 PC offices in the Midwest: 28 general internists, 28 family physicians, and 14 nurse practitioners. A depression care model was developed that illustrates how real-world conditions infuse complexity into each step of the depression care process. Depression care in PC settings is mediated through clinicians' interactions with patients, practice, and the local community. A clinician's interactional familiarity ("familiarity capital") was a powerful facilitator for depression care. For the recognition of depression, three previously reported processes and three conditions were confirmed. For the management of depression, 13 processes and 11 conditions were identified. Empowering the patient was a parallel process to the management of depression. The clinician's ability to develop and utilize interactional relationships and resources needed to recognize and treat a person with depression is key to depression care in primary care settings. The interactional context of depression care makes empowering the patient central to depression care delivery.

  5. 8 CFR 292.2 - Organizations qualified for recognition; requests for recognition; withdrawal of recognition...

    Science.gov (United States)

    2010-01-01

    ...; requests for recognition; withdrawal of recognition; accreditation of representatives; roster. 292.2...; withdrawal of recognition; accreditation of representatives; roster. (a) Qualifications of organizations. A non-profit religious, charitable, social service, or similar organization established in the United...

  6. Application of Business Process Management to drive the deployment of a speech recognition system in a healthcare organization.

    Science.gov (United States)

    González Sánchez, María José; Framiñán Torres, José Manuel; Parra Calderón, Carlos Luis; Del Río Ortega, Juan Antonio; Vigil Martín, Eduardo; Nieto Cervera, Jaime

    2008-01-01

    We present a methodology based on Business Process Management to guide the development of a speech recognition system in a hospital in Spain. The methodology eases the deployment of the system by 1) involving the clinical staff in the process, 2) providing the IT professionals with a description of the process and its requirements, 3) assessing advantages and disadvantages of the speech recognition system, as well as its impact in the organisation, and 4) help reorganising the healthcare process before implementing the new technology in order to identify how it can better contribute to the overall objective of the organisation.

  7. [Continuing training plan in a clinical management unit].

    Science.gov (United States)

    Gamboa Antiñolo, Fernando Miguel; Bayol Serradilla, Elia; Gómez Camacho, Eduardo

    2011-01-01

    Continuing Care Unit (UCA) focused the attention of frail patients, polypathological patients and palliative care. UCA attend patients at home, consulting, day unit, telephone consulting and in two hospitals of the health area. From 2002 UCA began as a management unit, training has been a priority for development. Key elements include: providing education to the workplace, including key aspects of the most prevalent health care problems in daily work, directing training to all staff including organizational aspects of patient safety and the environment, improved working environment, development of new skills and knowledge supported by the evidence-based care for the development of different skills. The unit can be the ideal setting to undertake the reforms necessary conceptual training of professionals to improve the quality of care. 2010 SESPAS. Published by Elsevier Espana. All rights reserved.

  8. 76 FR 28954 - International Conservation and Management Measures Recognized by the United States

    Science.gov (United States)

    2011-05-19

    ... International Conservation and Management Measures Recognized by the United States AGENCY: National Marine... international conservation and management measures recognized by the United States. To fulfill this requirement, a list of agreements resulting in international conservation and management measures was first...

  9. Nursing management and organizational ethics in the intensive care unit.

    Science.gov (United States)

    Wlody, Ginger Schafer

    2007-02-01

    This article describes organizational ethics issues involved in nursing management of an intensive care unit. The intensive care team and medical center management have the dual responsibility to create an ethical environment in which to provide optimum patient care. Addressing organizational ethics is key to creating that ethical environment in the intensive care unit. During the past 15-20 yrs, increasing costs in health care, competitive markets, the effect of high technology, and global business changes have set the stage for business and healthcare organizational conflicts that affect the ethical environment. Studies show that critical care nurses experience moral distress and are affected by the ethical climate of both the intensive care unit and the larger organization. Thus, nursing moral distress may result in problems related to recruitment and retention of staff. Other issues with organizational ethics ramifications that may occur in the intensive care unit include patient safety issues (including those related to disruptive behavior), intensive care unit leadership style, research ethics, allocation of resources, triage, and other economic issues. Current organizational ethics conflicts are discussed, a professional practice model is described, and multidisciplinary recommendations are put forth.

  10. Do critical care units play a role in the management of gynaecological oncology patients? The contribution of gynaecologic oncologist in running critical care units.

    Science.gov (United States)

    Davidovic-Grigoraki, Miona; Thomakos, Nikolaos; Haidopoulos, Dimitrios; Vlahos, Giorgos; Rodolakis, Alexandros

    2017-03-01

    Routine post-operative care in high dependency unit (HDU), surgical intensive care unit (SICU) and intensive care unit (ICU) after high-risk gynaecological oncology surgical procedures may allow for greater recognition and correct management of post-operative complications, thereby reducing long-term morbidity and mortality. On the other hand, unnecessary admissions to these units lead to increased morbidity - nosocomial infections, increased length of hospital stay and higher hospital costs. Gynaecological oncology surgeons continue to look after their patient in the HDU/SICU and have the final role in decision-making on day-to-day basis, making it important to be well versed in critical care management and ensure the best care for their patients. Post-operative monitoring and the presence of comorbid illnesses are the most common reasons for admission to the HDU/SICU. Elderly and malnutritioned patients, as well as, bowel resection, blood loss or greater fluid resuscitation during the surgery have prolonged HDU/SICU stay. Patients with ovarian cancer have a worse survival outcome than the patients with other types of gynaecological cancer. Dependency care is a part of surgical management and it should be incorporated formally into gynaecologic oncology training programme. © 2016 John Wiley & Sons Ltd.

  11. Recognition and management of iatrogenically induced opioid dependence and withdrawal in children.

    Science.gov (United States)

    Galinkin, Jeffrey; Koh, Jeffrey Lee

    2014-01-01

    Opioids are often prescribed to children for pain relief related to procedures, acute injuries, and chronic conditions. Round-the-clock dosing of opioids can produce opioid dependence within 5 days. According to a 2001 Consensus Paper from the American Academy of Pain Medicine, American Pain Society, and American Society of Addiction Medicine, dependence is defined as "a state of adaptation that is manifested by a drug class specific withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood level of the drug, and/or administration of an antagonist." Although the experience of many children undergoing iatrogenically induced withdrawal may be mild or goes unreported, there is currently no guidance for recognition or management of withdrawal for this population. Guidance on this subject is available only for adults and primarily for adults with substance use disorders. The guideline will summarize existing literature and provide readers with information currently not available in any single source specific for this vulnerable pediatric population.

  12. Takotsubo Cardiomyopathy in Intensive Care Unit: Prevention, Diagnosis and Management

    Directory of Open Access Journals (Sweden)

    Hannah Masoud

    2016-01-01

    Full Text Available Accurate diagnosis of Takotsubo Cardiomyopathy has substantial prognostic implications in an intensive care unit, given its increased mortality risk and association with life-threatening complications. This report seeks to discuss diagnostic modalities that can be useful in accurately differentiating Takotsubo Cardiomyopathy from Acute Coronary Syndrome, and also briefly discuss prevention and management of this cardiomyopathy in an intensive care unit. For critically ill Takotsubo patients, intensive clinicians can consider establishment of diagnosis by specific electrocardiograph changes, distinctive marked release of cardiac enzymes, characteristic echocardiograph findings, as well as invasive coronary angiography or noninvasive cardiac magnetic imaging.

  13. The United States initiative for international radioactive source management (ISRM)

    International Nuclear Information System (INIS)

    Naraine, N.; Karhnak, J.

    1999-01-01

    The United States takes seriously the potential problems from uncontrolled radioactive sources. To address these problems, the United States Department of State is leading the development of an initiative for International Radioactive Source Management (ISRM). The Department of State, through a number of Federal and state agencies, regulatory bodies and private industry, will endeavor to provide coordinated support to the international community, particularly through IAEA, to assist in the development and implementation of risk-based clearance levels to support import/export of radioactive contaminated metals and the tracking, management, identification, remediation, and disposition of 'lost sources' entering nation states and targeted industries. The United States believes that the international control of radioactive sources is critical in avoiding wide-spread contamination of the world metal supply. Thus the initiative has four objectives: (1) Protect sources from becoming lost (Tracking management); (2) Identify primary locations where sources have been lost (Stop future losses); (3) Locate lost sources (monitor and retrieve); and (4) Educate and train (deploy knowledge and technology). A number of efforts already underway in the United States support the overall initiative. The EPA has provided a grant to the Conference of Radiation Program Control Directors (CRCPD) to develop a nation-wide program for the disposition of orphaned radioactive sources. This program now has internet visibility and a toll-free telephone number to call for assistance in the disposal of sources. The Nuclear Regulatory Commission (NRC), the Department of Energy (DOE), and other government agencies as well as private companies are assisting CRCPD in this program. The NRC has begun a program to improve control of radioactive sources in the United States, and also intends to promulgate a regulation defining conditions for the release of materials from licensed facilities. The DOE is

  14. [Job satisfaction of nurses in the clinical management units].

    Science.gov (United States)

    Martínez Lara, Concepción; Praena Fernández, Juan Manuel; Gil García, Eugenia

    2013-01-01

    Clinical Management Unit (CMU) is currently set in the Andalusian health institutions as the model reference management. This management model aims to make all healthcare professionals a powerful idea: the best performance of health resources is performed to drive clinical practice using the least number of diagnostic and therapeutic resources. The CMU not only aims at saving money, in the Clinical Management Agreement [1] are measured all the dimensions that make up the UGC: research, training, clinical process, the portfolio of services, objectives, financial management and indicators to control and security. The CMU is to transfer more responsibilities to Health Care Professionals, involving them in the management of the Unit. The CMU sets new approaches that directly affect health professionals and presents advantages and disadvantages for the Doctors and the Nurses, involved in achieving excellence in care work. Nurse Practitioners shows expectant before the changes are generated in health institutions and appears a discussion of skills derived from the CMU. Some Nurses believe that the bur, den of care to which they are subjected in public institutions has increased since the onset of the CMU and yet others believe that they are motivated and rewarded for the results obtained with this model of management. In health institutions, some professionals are more motivated than others and this is found in the outcome of health care activity [2]. Given the positive and negative perceptions that arise in the CMU Professional Nurses, it is considered appropriate to focus the objective of this work in the search for factors that influence job satisfaction of nurses in the CMU. There are few studies about the CMU [3] but are absent when linked with nursing, so the pursuit of scientific knowledge related to nursing management model based on Clinical and Quality Care can lead to establish new concepts around the nursing profession, a profession in which major changes are

  15. An overview of the corrective action management unit and temporary unit regulations

    International Nuclear Information System (INIS)

    Green, D.R.; Corathers, L.; Coalgate, J.

    1995-01-01

    In February 1993, the US Environmental Protection Agency (EPA) promulgated the corrective action management unit (CAMU) and temporary unit (TU) regulations as 40 CFR Part 264, Subpart S. These regulations are intended to foster the selection of protective and cost-effective remedies for the restoration of sites contaminated by hazardous substances, hazardous wastes, and hazardous waste constituents by removing certain regulatory impediments to implementing those remedies, most notably those of the land disposal restrictions (LDRs). This paper provides a brief overview of the CAMU and TU regulations

  16. Managing sepsis: Electronic recognition, rapid response teams, and standardized care save lives.

    Science.gov (United States)

    Guirgis, Faheem W; Jones, Lisa; Esma, Rhemar; Weiss, Alice; McCurdy, Kaitlin; Ferreira, Jason; Cannon, Christina; McLauchlin, Laura; Smotherman, Carmen; Kraemer, Dale F; Gerdik, Cynthia; Webb, Kendall; Ra, Jin; Moore, Frederick A; Gray-Eurom, Kelly

    2017-08-01

    Sepsis can lead to poor outcomes when treatment is delayed or inadequate. The purpose of this study was to evaluate outcomes after initiation of a hospital-wide sepsis alert program. Retrospective review of patients ≥18years treated for sepsis. There were 3917 sepsis admissions: 1929 admissions before, and 1988 in the after phase. Mean age (57.3 vs. 57.1, p=0.94) and Charlson Comorbidity Scores (2.52 vs. 2.47, p=0.35) were similar between groups. Multivariable analyses identified significant reductions in the after phase for odds of death (OR 0.62, 95% CI 0.39-0.99, p=0.046), mean intensive care unit LOS (2.12days before, 95%CI 1.97, 2.34; 1.95days after, 95%CI 1.75, 2.06; p<0.001), mean overall hospital LOS (11.7days before, 95% CI 10.9, 12.7days; 9.9days after, 95% CI 9.3, 10.6days, p<0.001), odds of mechanical ventilation use (OR 0.62, 95% CI 0.39, 0.99, p=0.007), and total charges with a savings of $7159 per sepsis admission (p=0.036). There was no reduction in vasopressor use (OR 0.89, 95% CI 0.75, 0.1.06, p=0.18). A hospital-wide program utilizing electronic recognition and RRT intervention resulted in improved outcomes in patients with sepsis. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. How the United States exports managed care to developing countries.

    Science.gov (United States)

    Waitzkin, H; Iriart, C

    2001-01-01

    As their expansion slows in the United States, managed care organizations will continue to enter new markets abroad. Investors view the opening of managed care in Latin America as a lucrative business opportunity. As public-sector services and social security funds are cut back, privatized, and reorganized under managed care, with the support of international lending agencies such as the World Bank, the effects of these reforms on access to preventive and curative services will hold great importance throughout the developing world. Many groups in Latin America are working on alternative projects that defend health as a public good, and similar movements have begun in Africa and Asia. Increasingly, this organizing is being recognized not only as part of a class struggle but also as part of a struggle against economic imperialism--which has now taken on the new appearance of rescuing less developed countries from rising health care costs and inefficient bureaucracies through the imposition of neoliberal managed-care solutions exported from the United States.

  18. Habitat Demonstration Unit Project Leadership and Management Strategies

    Science.gov (United States)

    Kennedy, Kriss J.

    2011-01-01

    This paper gives an overview of the National Aeronautics and Space Administration (NASA) led multi-center Habitat Demonstration Unit (HDU) project leadership and management strategies. The HDU project team constructed and tested an analog prototype lunar surface habitat/laboratory called the Pressurized Excursion Module (PEM) during 2010. The prototype unit subsystems were integrated in a short amount of time, utilizing a tiger team approach that brought together over 20 habitation-related technologies and innovations from a variety of NASA centers. This paper describes the leadership and management strategies as well as lessons learned pertaining to leading and managing a multi-center diverse team in a rapid prototype environment. The PEM configuration went from a paper design to an operational surface habitat demonstration unit in less than 12 months. The HDU project is part of the strategic plan from the Exploration Systems Mission Directorate (ESMD) Directorate Integration Office (DIO) and the Exploration Mission Systems Office (EMSO) to test destination elements in analog environments. The 2011 HDU-Deep Space Habitat (DSH) configuration will build upon the PEM work, and emphasize validity of crew operations (remote working and living), EVA operations, mission operations, logistics operations, and science operations that might be required in a deep space context for Near Earth Object (NEO) exploration mission architectures. The 2011 HDU-DSH will be field-tested during the 2011 Desert Research and Technologies Studies (DRaTS) field tests. The HDU project is a "technology-pull" project that integrates technologies and innovations from multiple NASA centers. This project will repurpose the HDU 2010 demo unit that was field tested in the 2010 DRaTS, adding habitation functionality to the prototype unit. This paper will describe the strategy of establishing a multi-center project management team that put in place the key multi-center leadership skills and

  19. Syncope management unit: evolution of the concept and practice implementation.

    Science.gov (United States)

    Shen, Win K; Traub, Stephen J; Decker, Wyatt W

    2013-01-01

    Syncope, a clinical syndrome, has many potential causes. The prognosis of a patient experiencing syncope varies from benign outcome to increased risk of mortality or sudden death, determined by the etiology of syncope and the presence of underlying disease. Because a definitive diagnosis often cannot be established immediately, hospital admission is frequently recommended as the "default" approach to ensure patient's safety and an expedited evaluation. Hospital care is costly while no studies have shown that clinical outcomes are improved by the in-patient practice approach. The syncope unit is an evolving practice model based on the hypothesis that a multidisciplinary team of physicians and allied staff with expertise in syncope management, working together and equipped with standard clinical tools could improve clinical outcomes. Preliminary data have demonstrated that a specialized syncope unit can improve diagnosis in a timely manner, reduce hospital admission and decrease the use of unnecessary diagnostic tests. In this review, models of syncope units in the emergency department, hospital and outpatient clinics from different practices in different countries are discussed. Similarities and differences of these syncope units are compared. Outcomes and endpoints from these studies are summarized. Developing a syncope unit with a standardized protocol applicable to most practice settings would be an ultimate goal for clinicians and investigators who have interest, expertise, and commitment to improve care for this large patient population. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Risk assessment and management approaches on mental health units.

    Science.gov (United States)

    Woods, P

    2013-11-01

    This exploratory and descriptive study took place in one Canadian province. The study aimed to: (1) to identify and describe the nature and extent of current risk assessment and management approaches used in the adult inpatient mental health and forensic units; and (2) to identify good practice and shortfalls in the nature and extent of the approaches currently utilized. Data were collected from 48 participants through nine focus groups. Participants reported that they used a clinical approach to risk assessment. They had also not considered risk assessment and management as a proactive structured process. Education and training was also limited and skills were developed over time through practice. Five keys issues are discussed as important: reliance on clinical judgement alone is not the best choice to make; the need to consider risk as a whole concept; risk management being more reactive than proactive; education and training; and client involvement in risk assessment. © 2012 John Wiley & Sons Ltd.

  1. [Management of malnutrition in geriatric hospital units in Germany].

    Science.gov (United States)

    Smoliner, C; Volkert, D; Wirth, R

    2013-01-01

    Elderly hospitalized patients have a high risk for developing malnutrition. The causes for an impaired nutritional status in old age are various and the impact is far-reaching. Malnutrition is a comorbidity that is well treatable and various studies show the favorable effect of nutrition therapy on nutritional status and prognosis. In the past few years, several guidelines have been developed to improve nutritional management and to ensure standardized procedures to identify patients at nutritional risk who will benefit from nutrition therapy. However, it is still not clear to what extent nutrition management has been implemented in geriatric wards in Germany. This survey is intended to give an overview on the situation of the current diagnosis and therapy of malnutrition and nutritional management in geriatric hospital units for acute and rehabilitative care. In 2011, the task force of the German Geriatric Society ("Deutsche Gesellschaft für Geriatrie", DGG) developed a questionnaire which was sent out to 272 directors of geriatric hospital and rehabilitational units. Included were questions regarding the size and staffing of the hospital and wards, food provision, diagnosis and therapy of malnutrition, as well as communication of malnutrition and nutrition therapy in the doctor's letter. A total of 38% of the questioned units answered. The following information was compiled: 31% of the geriatric facilities employed a doctor with training in clinical nutrition, 42% employ dieticians or nutritional scientists, and 90% speech and language pathologists. In 36% of the wards, a so-called geriatric menu is offered (small portions, rich in energy and/or protein, easy to chew). In 89% of the wards, snacks are available between meals. Diagnosis of malnutrition is mainly done by evaluation of weight and BMI. Validated and established screening tools are only used in 40% of the geriatric wards. Food records are carried out in 64% of the units when needed. Diagnosed

  2. Integrated Waste Treatment Unit GFSI Risk Management Plan

    International Nuclear Information System (INIS)

    W. A. Owca

    2007-01-01

    This GFSI Risk Management Plan (RMP) describes the strategy for assessing and managing project risks for the Integrated Waste Treatment Unit (IWTU) that are specifically within the control and purview of the U.S. Department of Energy (DOE), and identifies the risks that formed the basis for the DOE contingency included in the performance baseline. DOE-held contingency is required to cover cost and schedule impacts of DOE activities. Prior to approval of the performance baseline (Critical Decision-2) project cost contingency was evaluated during a joint meeting of the Contractor Management Team and the Integrated Project Team for both contractor and DOE risks to schedule and cost. At that time, the contractor cost and schedule risk value was $41.3M and the DOE cost and schedule risk contingency value is $39.0M. The contractor cost and schedule risk value of $41.3M was retained in the performance baseline as the contractor's management reserve for risk contingency. The DOE cost and schedule risk value of $39.0M has been retained in the performance baseline as the DOE Contingency. The performance baseline for the project was approved in December 2006 (Garman 2006). The project will continue to manage to the performance baseline and change control thresholds identified in PLN-1963, ''Idaho Cleanup Project Sodium-Bearing Waste Treatment Project Execution Plan'' (PEP)

  3. The management of household hazardous waste in the United Kingdom.

    Science.gov (United States)

    Slack, R J; Gronow, J R; Voulvoulis, N

    2009-01-01

    Waste legislation in the United Kingdom (UK) implements European Union (EU) Directives and Regulations. However, the term used to refer to hazardous waste generated in household or municipal situations, household hazardous waste (HHW), does not occur in UK, or EU, legislation. The EU's Hazardous Waste Directive and European Waste Catalogue are the principal legislation influencing HHW, although the waste categories described are difficult to interpret. Other legislation also have impacts on HHW definition and disposal, some of which will alter current HHW disposal practices, leading to a variety of potential consequences. This paper discusses the issues affecting the management of HHW in the UK, including the apparent absence of a HHW-specific regulatory structure. Policy and regulatory measures that influence HHW management before disposal and after disposal are considered, with particular emphasis placed on disposal to landfill.

  4. 7 CFR 275.18 - Project area/management unit corrective action plan.

    Science.gov (United States)

    2010-01-01

    ... 7 Agriculture 4 2010-01-01 2010-01-01 false Project area/management unit corrective action plan... SYSTEM Corrective Action § 275.18 Project area/management unit corrective action plan. (a) The State agency shall ensure that corrective action plans are prepared at the project area/management unit level...

  5. DRUG MANAGEMENT REVIEWS IN DISTRICT DRUG MANAGEMENT UNIT AND GENERAL HOSPITAL

    Directory of Open Access Journals (Sweden)

    Max Joseph Herman

    2009-12-01

    Full Text Available Drug is one of the essential elements in healthcare that should be effectively and efficiently managed. Following thedecentralization in 2001 in Indonesia, drug management has changed in district drug management units and also in District General Hospitals. Certainly this condition influences the sustainability of drug access in primary health care such as in Community Health Center and District General Hospital, especially in drug financing policy. A cross sectional descriptive study to obtain information on drug management in public healthcare in district had been carried out between July and December 2006 in 10 District Public Drug Management Units from 10 district health offices and 9 district general hospitals as samples. Data were collected by interviewing heads of Drug Section in District Health Offices and heads of Hospital Pharmacies using structured questionnaires and observing drug storage in District Drug Management Units, Community Health Centers, and Hospital Pharmacies. Results of the study show that drug planning in District Health Offices and General Hospitals did not meet the basic real need in some districts nor District Hospitals. The minimum health service standards had no been achieved yet. Furthermore, drug procurement, storage and recording as well as reporting was not good enough either, such as shown by the existence of expired drugs. Lead time for drug delivery to community health centers in some districts was longer than the average of lead time in the past 3 years.

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

    International Nuclear Information System (INIS)

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

    2002-01-01

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

  7. Radioactive waste management and decommissioning in The United States

    International Nuclear Information System (INIS)

    Raymont, J.M.

    2005-01-01

    With their missions and access to disposal sites changing over the last decade, radioactive waste management and decommissioning practice in the U.S. commercial and federal nuclear markets has evolved to keep pace. This paper reviews the changes that have occurred and the differing waste management practices that have resulted depending on whether a nuclear facility is situated on federally owned or privately owned property in the United States, confirming that the cost of disposal generally dictates waste management and decommissioning practices. Of the 123 utility-owned licensed commercial reactors in U.S., 19 are undergoing decomissioning, with the balance of 104 reactors focusing on plant life extension, power upgrades, and power generation. As a result, almost all of the approximately dollar 400 million in annual expenditures on waste processing and disposal comes from waste generated from operations. In contrast, the U.S. Department of Energy (DOE), under its Environmental Management (EM) program, is focused on decommissioning the facilities, tanks, and ground contamination resulting from 50-years of Cold War activities and spending about dollar 7 billion a year on these activities. Other than spent fuel, U.S. federal law precludes disposal of commercial nuclear power plant radioactive wastes at DOE disposal sites. In contrast to the commercial disposal market, which must go through extensive public hearings and decision-making, the DOE has a much freer hand in siting new disposal capacity on federal land. As a result, the DOE has ample disposal capacity, 'routinely' opens new disposal sites, and enjoys disposal pricing well below the commercial market. Waste composition, volume, and activity levels drive disposal costs, which is the key life cycle parameter in determining radioactive waste management practice. Differences in these parameters drive the differences in how radioactive waste management practice is performed in the commercial and DOE markets

  8. Epidemiology, Patterns of Care, and Mortality for Patients With Acute Respiratory Distress Syndrome in Intensive Care Units in 50 Countries

    NARCIS (Netherlands)

    Bellani, Giacomo; Laffey, John G.; Pham, Tài; Fan, Eddy; Brochard, Laurent; Esteban, Andres; Gattinoni, Luciano; van Haren, Frank; Larsson, Anders; McAuley, Daniel F.; Ranieri, Marco; Rubenfeld, Gordon; Thompson, B. Taylor; Wrigge, Hermann; Slutsky, Arthur S.; Pesenti, Antonio; Francois, Guy M.; Rabboni, Francesca; Madotto, Fabiana; Conti, Sara; Sula, Hektor; Nunci, Lordian; Cani, Alma; Zazu, Alan; Dellera, Christian; Insaurralde, Carolina S.; Alejandro, Risso V.; Daldin, Julio; Vinzio, Mauricio; Fernandez, Ruben O.; Cardonnet, Luis P.; Bettini, Lisandro R.; Bisso, Mariano Carboni; Osman, Emilio M.; Setten, Mariano G.; Lovazzano, Pablo; Alvarez, Javier; Villar, Veronica; Pozo, Norberto C.; Grubissich, Nicolas; Plotnikow, Gustavo A.; Vasquez, Daniela N.; Ilutovich, Santiago; Tiribelli, Norberto; Chena, Ariel; Pellegrini, Carlos A.; Saenz, María G.; Estenssoro, Elisa; Simonis, Fabienne D.; Schultz, Marcus J.

    2016-01-01

    IMPORTANCE Limited information exists about the epidemiology, recognition, management, and outcomes of patients with the acute respiratory distress syndrome (ARDS). OBJECTIVES To evaluate intensive care unit (ICU) incidence and outcome of ARDS and to assess clinician recognition, ventilation

  9. An ethical leadership program for nursing unit managers.

    Science.gov (United States)

    Jeon, Sang Hee; Park, Mihyun; Choi, Kyungok; Kim, Mi Kyoung

    2018-03-01

    The aims of this study were to evaluate the effect of an ethical leadership program (ELP) on ethical leadership, organizational citizenship behavior (OCB), and job outcomes of nursing unit managers (UMs) and to examine changes in staff nurses' perception about UMs' EL, OCB, job outcomes, and ethical work environments (EWEs) post-ELP. A quasi-experimental (pre- and post-test design) study conducted six-month intervention (ELP) using self-reported UM survey (n=44), and staff nurses (n=158) were randomly extracted by two steps. The Korean version of Ethical Leadership at Work for UMs' self-ethical leadership, the Ethical Leadership Scale for staff nurses' perceived ethical leadership, a 19-item OCB scale, and six dimensions of the medium-sized Copenhagen Psychosocial Questionnaire II for job outcomes and EWEs were administered at baseline and post-intervention. UMs' ethical leadership scores differed significantly over time in people orientation (p=0.041) and concern for ethical leadership sustainability (p=0.002) adjusting for UM experience duration and nursing unit type. Total mean and level of power-sharing of ethical leadership among UMs with leadership, OCB, job outcomes, and EWEs, significant improvement over time appeared only in EWEs' work influence level (p=0.007). This study provides useful information for clinical ELP development and examining the program's effect on leadership skills and followers' outcomes. Program facilitation relies on practical training methods, participant motivation, and assessment outcome designs by controlling clinical confounding factors. Findings have implications as an attempt for intervention to promote competencies related to ethical leadership of nursing unit managers. Copyright © 2017 Elsevier Ltd. All rights reserved.

  10. The current acceptance, accessibility and recognition of Chinese and Ayurvedic medicine in the United States in the public, governmental, and industrial sectors.

    Science.gov (United States)

    Park, Jongbae J; Beckman-Harned, Selena; Cho, Gayoung; Kim, Duckhee; Kim, Hangon

    2012-06-01

    To assess the current level of acceptance in the United States of complementary and alternative medicine, recent research into the prevalence, acceptance, accessibility, and recognition of complementary and alternative therapies were reviewed. Several signs point to an increasing acceptance of complementary and alternative medicine in the United States; the use of complementary and alternative medicine is significantly increasing, many aspects of Chinese medicine and Ayurveda are becoming mainstream, practitioners in the United States are beginning to be licensed, and insurance companies are beginning to cover some complementary and alternative therapies. Remaining challenges to true acceptance include the restrictive Western mindset, the absence of published studies, a lack of consistent manufacturing processes and quality standards, and a fear of adulteration. Although the field still faces many challenges, alternative and complementary medicine, including Chinese medicine and Ayurvedic medicine, is becoming more accepted and accessible in the United States.

  11. The recognition unit of FIBCD1 organizes into a noncovalently linked tetrameric structure and uses a hydrophobic funnel (S1) for acetyl group recognition

    DEFF Research Database (Denmark)

    Thomsen, Theresa; Moeller, Jesper B; Schlosser, Anders

    2010-01-01

    We have recently identified FIBCD1 (Fibrinogen C domain containing 1) as a type II transmembrane endocytic receptor located primarily in the intestinal brush border. The ectodomain of FIBCD1 comprises a coiled coil, a polycationic region, and a C-terminal FReD (fibrinogen-related domain) that ass......We have recently identified FIBCD1 (Fibrinogen C domain containing 1) as a type II transmembrane endocytic receptor located primarily in the intestinal brush border. The ectodomain of FIBCD1 comprises a coiled coil, a polycationic region, and a C-terminal FReD (fibrinogen-related domain......) that assembles into disulfide-linked homotetramers. The FIBCD1-FReD binds Ca(2+) dependently to acetylated structures like chitin, N-acetylated carbohydrates, and amino acids. FReDs are present in diverse innate immune pattern recognition proteins including the ficolins and horseshoe crab TL5A. Here, we use...... combined with site-directed mutagenesis to define the binding site involved in the interaction of FIBCD1 with acetylated structures. We show that mutations of central residues (A432V and H415G) in the hydrophobic funnel (S1) abolish the binding of FIBCD1 to acetylated bovine serum albumin and chitin...

  12. Produced water volumes and management practices in the United States.

    Energy Technology Data Exchange (ETDEWEB)

    Clark, C. E.; Veil, J. A. (Environmental Science Division)

    2009-09-01

    Produced water volume generation and management in the United States are not well characterized at a national level. The U.S. Department of Energy (DOE) asked Argonne National Laboratory to compile data on produced water associated with oil and gas production to better understand the production volumes and management of this water. The purpose of this report is to improve understanding of produced water by providing detailed information on the volume of produced water generated in the United States and the ways in which produced water is disposed or reused. As the demand for fresh water resources increases, with no concomitant increase in surface or ground water supplies, alternate water sources, like produced water, may play an important role. Produced water is water from underground formations that is brought to the surface during oil or gas production. Because the water has been in contact with hydrocarbon-bearing formations, it contains some of the chemical characteristics of the formations and the hydrocarbons. It may include water from the reservoir, water previously injected into the formation, and any chemicals added during the production processes. The physical and chemical properties of produced water vary considerably depending on the geographic location of the field, the geologic formation, and the type of hydrocarbon product being produced. Produced water properties and volume also vary throughout the lifetime of a reservoir. Produced water is the largest volume by-product or waste stream associated with oil and gas exploration and production. Previous national produced water volume estimates are in the range of 15 to 20 billion barrels (bbl; 1 bbl = 42 U.S. gallons) generated each year in the United States (API 1988, 2000; Veil et al. 2004). However, the details on generation and management of produced water are not well understood on a national scale. Argonne National Laboratory developed detailed national-level information on the volume of produced

  13. Risk management solutions for Cernavoda Unit #2 NPP completion

    International Nuclear Information System (INIS)

    Chirica, T.; Pall, S.

    2002-01-01

    The greatest risk facing today's electric utilities is change. Utility risk managers are being challenged to address the changes of deregulation, new technologies and changing work force. The utilities must be more aware of where all its costs are located to face with the challenge of competition, forcing them to respond with lower prices and innovative services. For completion of large projects, like Cernavoda NPP, Unit 2, the utilities are facing also with certain specific risks: politic, economic, social. The natural perils or machinery breakdown are common risks for operation as well as for construction-commissioning projects. Beyond the explicit challenges associated with the completion of a nuclear power plant in a transition economy environment, the utilities are facing with new risk factors such as professional liability, political risk, product warranty and liability, international exposure, etc. Changes in other governmental policies are also affecting large projects, mentioning healthcare, workplace safety, workers' compensation, environmental clean up, etc.(author)

  14. Self-organization comprehensive real-time state evaluation model for oil pump unit on the basis of operating condition classification and recognition

    Science.gov (United States)

    Liang, Wei; Yu, Xuchao; Zhang, Laibin; Lu, Wenqing

    2018-05-01

    In oil transmission station, the operating condition (OC) of an oil pump unit sometimes switches accordingly, which will lead to changes in operating parameters. If not taking the switching of OCs into consideration while performing a state evaluation on the pump unit, the accuracy of evaluation would be largely influenced. Hence, in this paper, a self-organization Comprehensive Real-Time State Evaluation Model (self-organization CRTSEM) is proposed based on OC classification and recognition. However, the underlying model CRTSEM is built through incorporating the advantages of Gaussian Mixture Model (GMM) and Fuzzy Comprehensive Evaluation Model (FCEM) first. That is to say, independent state models are established for every state characteristic parameter according to their distribution types (i.e. the Gaussian distribution and logistic regression distribution). Meanwhile, Analytic Hierarchy Process (AHP) is utilized to calculate the weights of state characteristic parameters. Then, the OC classification is determined by the types of oil delivery tasks, and CRTSEMs of different standard OCs are built to constitute the CRTSEM matrix. On the other side, the OC recognition is realized by a self-organization model that is established on the basis of Back Propagation (BP) model. After the self-organization CRTSEM is derived through integration, real-time monitoring data can be inputted for OC recognition. At the end, the current state of the pump unit can be evaluated by using the right CRTSEM. The case study manifests that the proposed self-organization CRTSEM can provide reasonable and accurate state evaluation results for the pump unit. Besides, the assumption that the switching of OCs will influence the results of state evaluation is also verified.

  15. Corn rootworm area-wide management across the United States

    International Nuclear Information System (INIS)

    Chandler, Laurence D.; Coppedge, James R.; Richard Edwards, C.; Tollefson, Jon J.; Wilde, Gerald E.

    2000-01-01

    The western corn rootworm, Diabrotica virgifera virgifera LeConte, northern corn rootworm, D. barberi Smith and Lawrence, and Mexican corn rootworm, D. virgifera zeae Krysan and Smith are among the most economically and environmentally important pests of United States maize (Zea mays L.) production systems (Metcalf 1986). Annually, 8 to 10 million hectares of maize are treated with soil applied insecticides to protect the crop from larval feeding damage. Crop rotation, however, is also widely used to minimise the need for soil insecticide applications. Insecticides for adult rootworm management are also frequently used. Numerous problems are currently associated with corn rootworm management approaches. Soil insecticides are normally used to protect maize roots from larval feeding damage. However, they are ineffective in controlling the management of corn rootworm populations (Gray et al. 1992, Sutter et al. 1991). It is not uncommon for large numbers of rootworms to develop within treated fields. Thus, when maize is grown in the same field year after year (continuous cropping), soil insecticide applications must be used to protect the plant. These applications are generally made without knowledge (prophylactic) of the rootworm population levels within the field due to the difficulty of sampling for immature life stages. Western corn rootworm resistance to chlorinated hydrocarbon insecticides has been extensively documented (Ball and Weekman 1962). Recently, two distinct populations of western corn rootworms in Nebraska were found to be resistant to carbaryl and methyl parathion which are commonly used for adult control (Meinke et al. 1998). Although the occurrence of resistance has not spread outside of these areas, the potential for increased tolerance of western corn rootworm populations to carbamate and organophosphate insecticides across the region does exist. In response to many of the management problems discussed above, scientists with the USDA Agricultural

  16. Managing Forest Conflicts: Perspectives of Indonesia’s Forest Management Unit Directors

    Directory of Open Access Journals (Sweden)

    Larry A. Fisher

    2017-04-01

    Full Text Available Recent expansion of the forestry and plantation sectors in Indonesia has intensified agrarian and natural resource conflicts, and created increased awareness of the social, economic and environmental impacts of these disputes. Addressing these disputes is a critical issue in advancing Indonesia’s commitment to sustainable forest management. The Forest Management Units (Kesatuan Pengelolaan Hutan, or KPH, have become the pivotal structural element for managing all state forests at the local level, with responsibility for conventional forest management and policy implementation (establishing management boundaries, conducting forest inventory, and developing forest management plans, as well as the legal mandate to communicate and work with indigenous people and local communities. This paper presents the results of a national survey of all currently functioning KPH units, the first of its kind ever conducted with KPH leadership, to obtain a system-wide perspective of the KPHs’ role, mandate, and capacity for serving as effective intermediaries in managing forest conflicts in Indonesia. The survey results show that the KPHs are still in a very initial stage of development, and are struggling with a complex and rapidly evolving policy and institutional framework. The most common conflicts noted by respondents included forest encroachment, tenure disputes, boundary conflicts, and illegal logging and land clearing. KPH leadership views conflict resolution as among their primary duties and functions, and underscored the importance of more proactive and collaborative approaches for addressing conflict, many seeing themselves as capable facilitators and mediators. Overall, these results juxtapose a generally constructive view by KPH leadership over their role and responsibility in addressing forest management conflicts, with an extremely challenging social, institutional, and political setting. The KPHs can certainly play an important role as local

  17. Investigation of thermal management materials for automotive electronic control units

    International Nuclear Information System (INIS)

    Mallik, Sabuj; Ekere, Ndy; Best, Chris; Bhatti, Raj

    2011-01-01

    Today's electronics packages are smaller and more powerful than ever before. This leads to ever increasing thermal challenges for the systems designer. The automotive electronic control unit (ECU) package faces the same challenge of thermal management as the industry in general. This is coupled with the latest European Union legislation (Euro 6 standard) which forced the ECU manufacturers to completely re-design their ECU platform with improved hardware and software capability. This will result in increased power densities and therefore, the ability to dissipate heat will be a key factor. A higher thermal conductivity (TC) material for the ECU housing (than the currently used Aluminium) could improve heat dissipation from the ECU. This paper critically reviews the state-of-the-art in thermal management materials which may be applicable to an automotive ECU. This review shows that of the different materials currently available, the Al/SiC composites in particular have very good potential for automotive ECU application. In terms of metal composites processing, the liquid metal infiltration process is recommended as it has a lower processing cost and it also has the ability to produce near net-shape materials.

  18. Legislative framework for sediment management in the United States

    Directory of Open Access Journals (Sweden)

    P. A. Garcia-Chevesich

    2018-04-01

    Full Text Available Sediment erosion is a serious issue, with approximately 75 billion tons of soil is eroded annually around the world (Pimentel and Kounang, 1998. Although erosion is a natural process, it can accelerate due to human activity and land use changes. Increasing soil erosion beyond its natural threshold can result in significant environmental degradation and decreased economic productivity. Implementing sediment management laws and practices is critical to significantly decrease soil erosion and preserve environmental resources. In the United States, there is a comprehensive system of laws and regulations at national, state, county, and city level that govern erosion and sediment control. The laws and voluntary incentives outlined in our paper have significantly reduced the negative impacts of sediment carried in urban and storm-generated runoff, have reduced chemical and biological pollutants in sediment transported in aquatic ecosystems, and have improved the air quality in several cities with air pollution problems. Having a multi-faceted approach to monitoring erosion and improving soil management is important for a healthy, productive environment and economy.

  19. Recognition of management structure and spatial planning in Tehran metropolitan area

    Directory of Open Access Journals (Sweden)

    Manijeh Lalehpour

    2016-06-01

    Full Text Available Metropolitan areas are concentrated and dense areas filled settlements and include a central urban region with its surrounding residences. Severity and complexity of issues in metropolitan areas along with intricacy and quantity of influential factors in these areas necessitate novel approaches and innovative solutions for comprehensive strategies and management coordination of land use in these regions. The present study has taken this approach to investigate management structure and spatial planning in Tehran metropolitan area. The study takes parameters like political and management decentralization, elements affecting urban management based on the sources of power and province and finally spatial domain of urban management into account. Findings revealed that decentralization in national management and political structure has limited tasks and authority of urban management. In this regard, a closer look at management structure and spatial planning of Tehran metropolitan are demonstrates that the government and its element dominate policy making, planning and spatial management of the city and inherent position of municipality and city council suffer weaknesses in their role as urban management. Results from investigating official tasks in urban management elements and their spatial domain reveals lack of coordination and Fragmentation in management structure and spatial planning in the region. The paper attempts to discuss these Fragmentation in the fields of management, function, politics and domains.

  20. Project No. 7 - Decommissioning unit at Ignalina NPP. (Engineering and project management)

    International Nuclear Information System (INIS)

    2000-01-01

    In order to manage decommissioning process at Ignalina NPP, a new unit should be established in the framework of the Ignalina NPP organizational structure. The on-site Engineering Project Management Unit (PMU) will adopt an integrated approach to project management , engineering design, planning, procurement, safety and licensing activities at Ignalina NPP site. The PMU will assist the Ignalina NPP management in the development of an integrated decommissioning and waste management strategy

  1. Intraurethral knot in a very-low-birth-weight infant: radiological recognition, surgical management and prevention

    International Nuclear Information System (INIS)

    Lodha, Abhay; Ly, Linh; McNamara, Patrick J.; Brindle, Mary; Daneman, Alan

    2005-01-01

    We report a case where a knot developed in a urinary catheter and became lodged within the urethra of a very-low-birth-weight (VLBW) preterm infant. The catheter was removed with the assistance of a urologist. We recommend using caution when placing urinary catheters in VLBW infants and question the appropriateness of feeding tubes as catheters. Recognition on radiographs of malpositioned bladder catheters is vital to the care of these patients. All staff involved in the insertion, maintenance or removal of these catheters should be suitably trained to minimize the risk of knots and related complications. (orig.)

  2. Phases of Recognition and Management of Financial Crisis in Public Organizations.

    Science.gov (United States)

    Jones, L. R.

    Based in part on interviews conducted in 32 municipalities, this paper is intended to provide information to public managers, policy analysts, and others on methods for improving the management of retrenchment. A model summarizes how public organizations recognize and attempt to manage financial crises and prolonged financial stress. Some cutback…

  3. Nurses’ Experiences of Managing and Management in a Critical Care Unit

    Directory of Open Access Journals (Sweden)

    K. Robyn Ogle

    2014-05-01

    Full Text Available In this article, we describe the major findings of an ethnographic study undertaken to investigate nurses’ experiences of managing nurses and being managed by nurses in an Australian critical care unit. Our purpose was to valorize and make space for nurses to speak of their experiences and investigate the cultural practices and knowledges that comprised nursing management discourses. Subjugated practices, knowledges, and discourses were identified, revealing how nurses were inscribed by, or resisted, the discourses, including their multiple mobile subject positions. Informed by critical, feminist, and postmodern perspectives, nine mobile subject positions were identified. Direct participant observation, participant interviews, and reflective field notes were analyzed for dominant and subjugated discourses. The major finding described is the subject position of “junior novice.” Nurses informed by dominant patriarchal and organizational discourses participated in constructing and reinscribing their own submissive identity reflected in interprofessional relations that lacked individual valuing and undermined their self-esteem.

  4. Nurses’ Experiences of Managing and Management in a Critical Care Unit

    Science.gov (United States)

    Ogle, K. Robyn; Glass, Nel

    2014-01-01

    In this article, we describe the major findings of an ethnographic study undertaken to investigate nurses’ experiences of managing nurses and being managed by nurses in an Australian critical care unit. Our purpose was to valorize and make space for nurses to speak of their experiences and investigate the cultural practices and knowledges that comprised nursing management discourses. Subjugated practices, knowledges, and discourses were identified, revealing how nurses were inscribed by, or resisted, the discourses, including their multiple mobile subject positions. Informed by critical, feminist, and postmodern perspectives, nine mobile subject positions were identified. Direct participant observation, participant interviews, and reflective field notes were analyzed for dominant and subjugated discourses. The major finding described is the subject position of “junior novice.” Nurses informed by dominant patriarchal and organizational discourses participated in constructing and reinscribing their own submissive identity reflected in interprofessional relations that lacked individual valuing and undermined their self-esteem. PMID:28462287

  5. The Gordian knot: managing herring (Clupea harengus) bridging across populations, fishery units, management areas, and politics

    DEFF Research Database (Denmark)

    Worsøe Clausen, Lotte; Mosegaard, Henrik; Berg, Casper Willestofte

    2012-01-01

    –24) and the North Sea (Division IIIa) by various EU—and in the latter case also non‐EU—fishing fleets. For the two separate management areas, TACs are set at different times in the yearly TACsetting process by the EU and negotiating counties, which often result in conflicts over quota allocations among different......The management of western Baltic spring spawning (WBSS) herring is challenged by the highly complex stock structure with a temporal and geographical distribution leading to conflicting interests among different stakeholder groups. The stock is exploited in the Baltic Sea (Subdivisions 22...... management units. The WBSS herring stock spawns in the western Baltic Sea and migrates into the Kattegat and Skagerrak areas, where it mixes with North Sea autumn spawning (NSAS) herring. Recent development of otolith shape analysis has enabled a high‐resolution separation of herring stocks in these waters...

  6. Depression, Help-Seeking and Self-Recognition of Depression among Dominican, Ecuadorian and Colombian Immigrant Primary Care Patients in the Northeastern United States

    Directory of Open Access Journals (Sweden)

    Susan Caplan

    2015-08-01

    Full Text Available Latinos, the largest minority group in the United States, experience mental health disparities, which include decreased access to care, lower quality of care and diminished treatment engagement. The purpose of this cross-sectional study of 177 Latino immigrants in primary care is to identify demographic factors, attitudes and beliefs, such as stigma, perceived stress, and ethnic identity that are associated with depression, help-seeking and self-recognition of depression. Results indicated that 45 participants (25% had depression by Patient Health Questionnaire (PHQ-9 criteria. Factors most likely to be associated with depression were: poverty; difficulty in functioning; greater somatic symptoms, perceived stress and stigma; number of chronic illnesses; and poor or fair self-rated mental health. Fifty-four people endorsed help-seeking. Factors associated with help-seeking were: female gender, difficulty in functioning, greater somatic symptoms, severity of depression, having someone else tell you that you have an emotional problem, and poor or fair self-rated mental health. Factors most likely to be associated with self-recognition were the same, but also included greater perceived stress. This manuscript contributes to the literature by examining attitudinal factors that may be associated with depression, help-seeking and self-recognition among subethnic groups of Latinos that are underrepresented in research studies.

  7. Policy Adoption of Forest Management Unit: A Knowledge Diffusion Analysis

    Directory of Open Access Journals (Sweden)

    Julijanti

    2014-08-01

    Full Text Available Within the policy adoption process of Forest Management Unit (FMU concept, there has been disagreement of stakeholders on FMUs concept. This disagreement is caused by the exchange of knowledge, information, and perception among stakeholders involved. The results of these interactions could speed up, slow down, and prevent the adoption process of FMU policy. The study objective was analyzing process of knowledge diffusion of FMUs development policy and stakeholders interaction in PFMU Batutegi and PFMU Kotaagung Utara, Indonesia. Adoption process was analyzed by the logical diffusion technique based on knowledge time of FMUs concept received and its interaction space. Social interaction among stakeholders was analyzed using method developed by International Development Studies analysis, i.e. interaction among discourse/narrative, actors/networks and politics/interests. The results showed that knowledge diffusion of FMUs concept in both PFMU tends to cascade diffusion. Factors was affecting of it process were network, role of opinion leaders, willingness to know, and understand on FMUs concept. Indicative strategy is needed as anticipating and overcoming an obstacle in its internalization process, i.e. harmonization of legislative and executive relationship, building an opinion the importance of FMU, and optimalizing network for bureaucratic problems.

  8. Status of spent fuel management in the United Kingdom

    International Nuclear Information System (INIS)

    Dodds, R.

    1996-01-01

    Nuclear generating capacity in the UK is static with no units currently under construction following the completion of the Sizewell B PWR. The Government's reviews of nuclear energy policy and radioactive waste management policy have been published following a public consultation procedure, largely with an endorsement of current policies. Nuclear Electric plc (NE) and Scottish Nuclear Limited's (SNL) AGR and PWR stations are to be privatised as two subsidiaries of a holding company, and it is planned that the Magnox stations and their liabilities will be kept in the public sector, initially in a stand alone company but ultimately integrated with BNFL. Prompt reprocessing of all Magnox fuel will continue. NE and SNL have signed contracts for extensive reprocessing of AGR fuel. In addition, SNL has agreed contractual arrangements with BNFL for long term storage of its remaining overlife arisings of AGR fuel and has therefore on commercial ground opted not to dry store their fuel at the reactor site. NE have not yet made a decision on the fate of their AGR fuel not covered by existing reprocessing contracts. No option selection has taken place for PWR fuel. Following the closure of the Dounreay PFR and the withdrawal from the EFR project, the option of recycle of plutonium in fast reactors has been suspended. (author)

  9. Configuration management and change control at Cernavoda NPP Unit 1

    International Nuclear Information System (INIS)

    Gheorghiu, Virgil

    1998-01-01

    Effective configuration management requires that: 1. the design basis of station structures, systems, equipment and components be maintained at all times; 2. only accurate and approved technical, operational and maintenance information is available for performance of station activities; 3. correct operating manuals, flowsheets, operating sequences, operating task and training manuals are prepared and maintained currently. Design Engineering at Cernavoda NPP is primarily the responsibility of the Engineering Services Department supported if necessary by the Technical Unit. The key elements needed to achieve excellence in design engineering support for station operation, including design process and implementation of modification are investigated by answering the questions: 1. What is the station expectation for design change control?; 2. How is this provided?. Concerning design, the following aspects are stressed: Detailed Design Development; Design Verification; Design Change Implementation. The present design process is auditable and well documented. It consists of detailed design development, and design output documents such as applicable drawings, procurement specifications, installation and test requirement and the results of design and safety reviews. The design change implementation does not proceed until an Inspection Test Plan has been developed and approved as required. (author)

  10. Investigation and management of gastro-oesophageal reflux in United Kingdom neonatal intensive care units.

    Science.gov (United States)

    Rossor, Thomas; Andradi, Gwendolyn; Bhat, Ravindra; Greenough, Anne

    2018-01-01

    In 2004, wide variation in the investigation and management of gastro-oesophageal reflux (GOR) of infants on UK major neonatal units was demonstrated. Our aim was to resurvey neonatal practitioners to determine current practice and whether it was now evidence based. A questionnaire was sent to all 207 UK neonatal units. Responses were obtained from 84% of units. The most frequent 'investigation' was a trial of therapy (83% of units); pH studies were used in 38%, upper GI contrast studies in 19% and multichannel intraluminal impedance (MII)/pH studies in 5%. Only six units suggested a threshold for an abnormal pH study and two units for an abnormal MII study. Infants were commenced on antireflux medication without investigation always in 32% of units, often in 29%, occasionally in 19% and only never in 1%. Gaviscon was used as first line treatment in 60% of units, and other medications included ranitidine in 53%, thickening agents in 27%, proton pump inhibitors in 23%, domperidone in 22% and erythromycin in 6%. There remains a wide variation in diagnostic and treatment strategies for infants with suspected GOR on neonatal intensive care units, emphasising the need for randomised trials to determine appropriate GOR management. ©2017 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.

  11. A study on work life balance amongst managers of garment units in Tamilnadu State, India

    OpenAIRE

    Kalaiselvi Kandampalayam Thulasimani; Muruganandam Duraisamy; Sakthi Suganya Rathinasabapathi

    2010-01-01

    Work life balance plays an important role now a day. Employees want it, managers need it, and organization cannot afford to ignore it! Managers need to take work-life balance seriously particularly in garment units. The more overworked and overloaded, the higher the demands or the expectations on the department or the work unit, the more the managers have to rely on their employees to produce at the highest possible level of efficiency, effectiveness, and quality. If managers are out of balan...

  12. WIPP Facility Work Plan for Solid Waste Management Units

    Energy Technology Data Exchange (ETDEWEB)

    Washington TRU Solutions LLC

    2001-02-25

    This 2001 Facility Work Plan (FWP) has been prepared as required by Module VII, Section VII.M.1 of the Waste Isolation Pilot Plant (WIPP) Hazardous Waste Facility Permit, NM4890139088-TSDF (the Permit); (NMED, 1999a), and incorporates comments from the New Mexico Environment Department (NMED) received on December 6, 2000 (NMED, 2000a). This February 2001 FWP describes the programmatic facility-wide approach to future investigations at Solid Waste Management Units (SWMUs) and Areas of Concern (AOCs) specified in the Permit. The permittees are evaluating data from previous investigations of the SWMUs and AOCs against the newest guidance proposed by the NMED. Based on these data, the permittees expect that no further sampling will be required and that a request for No Further Action (NFA) at the SWMUs and AOCs will be submitted to the NMED. This FWP addresses the current Permit requirements. It uses the results of previous investigations performed at WIPP and expands the investigations as required by the Permit. As an alternative to the Resource Conservation and Recovery Act (RCRA) Facility Investigation (RFI) specified in Module VII of the Permit, current NMED guidance identifies an Accelerated Corrective Action Approach (ACAA) that may be used for any SWMU or AOC (NMED, 1998). This accelerated approach is used to replace the standard RFI Work Plan and Report sequence with a more flexible decision-making approach. The ACAA process allows a Facility to exit the schedule of compliance contained in the Facility’s Hazardous and Solid Waste Amendments (HSWA) permit module and proceed on an accelerated time frame. Thus, the ACAA process can be entered either before or after an RFI Work Plan. According to the NMED's guidance, a facility can prepare an RFI Work Plan or Sampling and Analysis Plan (SAP) for any SWMU or AOC (NMED, 1998). Based on this guidance, a SAP constitutes an acceptable alternative to the RFI Work Plan specified in the Permit.

  13. Praise matters: the influence of nurse unit managers' praise on nurses' practice, work environment and job satisfaction: a questionnaire study.

    Science.gov (United States)

    Sveinsdóttir, Herdís; Ragnarsdóttir, Erla Dögg; Blöndal, Katrín

    2016-03-01

    The aim of this study was to investigate the associations between praise from nurse unit managers and job satisfaction, professional practice, workload, work climate and organizational commitment of nurses caring for surgical patients. Praise influences experiences of employees. Web-based, cross-sectional explorative survey design. A structured questionnaire was used to measure praise given by nurse unit managers as perceived by nurses (n = 383; 49% response rate) working with surgical patients. Data were collected between December 2009-January 2010. Several variables assessed the major concepts under study. Binary logistic regression analysis was employed to compare nurses who receive praise very rarely/rarely as compared with very often/rather often. Praise was received often/very often by 31·6% of participants. Compared with nurses receiving praise rarely/very rarely those who received it often/rather showed more job satisfaction, stated they had more opportunities to practice professionally, described a more positive work climate and were more committed to the organization such as being proud to work at and willing to make effort for the unit and hospital. There was no difference between the groups regarding workload. Main findings of the regression analysis were that nurses display their organizational commitment by not thinking about leaving the current workplace and those who value professional recognition are likelier to receive praise than their counterparts. Nurse unit managers should praise their staff in a realistic fashion. Such praise is cost-effective, takes short time, produces positive influences on members of their staff and may improve patient safety. © 2015 John Wiley & Sons Ltd.

  14. [AIDS and pain management-a survey of German AIDS and pain management units.].

    Science.gov (United States)

    Zech, D; Radbruch, L; Grond, S; Heise, W

    1994-06-01

    The number of AIDS patients is steadily increasing. According to the literature these patients are often in severe pain. We evaluated pain diagnoses and treatments with two almost identical questionnaires for AIDS treatment units (ATU) and pain management units (PMU). Questions dealt with unit type and size, number of patients treated per year and the proportion of intravenous drug users. The units were also asked to give an estimate of pain aetiologies, pain types and localizations and treatment modalities offered. Completed questionnaires were returned by 38 of 235 ATU and 85 of 127 PMU. In the ATU, 16% of the patients (estimated at 580 patients per year) had pain requiring treatment. In 26 of the PMU approximately 120 AIDS patients per year were treated, while 59 PMU had not yet seen any AIDS patients. Pain was caused mainly by opportunistic infections and by neurological syndromes connected with AIDS. Pain aetiologies could not be differentiated in the ATU in 22% of patients (PMU 9%), and pain types in 33% (PMU 9%). Neuropathic pain (ATU 38%, PMU 89%) was more frequent than nociceptive pain (ATU 29%, PMU 36%). The treatment modalities were systemic pharmacotherapy in 76% of ATU and 73% of PMU and nerve blocks in 37% of ATU and 42% of PMU. In 82% of ATU the staff thought their analgesic therapy was adequate, and in 92% staff were interested in closer cooperation with PMU such as was currently practised in only 6 of the 38 units (16%) that responded. The high incidence of complicated neuropathic pain syndromes in AIDS patients requires a sophisticated therapeutic approach. Closer cooperation between AIDS specialists and pain specialists, comparable to that already existing for other patient groups, is therefore desirable.

  15. Unconventional wisdom [Entergy's economic management of five disparate nuclear units

    International Nuclear Information System (INIS)

    Wood, J.

    1996-01-01

    The conventional wisdom is that a competitive nuclear power programme requires standard plants, multi-unit sites and economies of scale. Entergy Operations, Inc (EOI) in the USA has five nuclear units of two reactor types, acquired from five vendors and located on four sites separated by hundreds of miles. EOI set two bench marks in its aim to deliver electricity at the market price from each of its nuclear units while meeting the costs of O and M, fuel, capital investment and overheads. The first was to become the best operator of each type of its differently designed units. The second was to combine the sense of ownership and expertise of single unit operators with the flexibility and efficiency of multi-unit sites. In order to achieve this, EOI aims to operate the five units as though they were on one site. Central to this plan is a set of peer groups, each of which deals with an aspect of plant operation, sharing good practice across all the units. Building on this, increasingly during outages, employees are brought in from other units rather than employing outside contractors. Although EOI employees are more expensive on an hourly basis they are two to three times more efficient than outside contractors. The peer group concept is also leading to rationalisation of expertise as groups become identified with particular specialisations which back-up teams working on other units. (U.K.)

  16. Closed-loop control for cardiopulmonary management and intensive care unit sedation using digital imaging

    Science.gov (United States)

    Gholami, Behnood

    This dissertation introduces a new problem in the delivery of healthcare, which could result in lower cost and a higher quality of medical care as compared to the current healthcare practice. In particular, a framework is developed for sedation and cardiopulmonary management for patients in the intensive care unit. A method is introduced to automatically detect pain and agitation in nonverbal patients, specifically in sedated patients in the intensive care unit, using their facial expressions. Furthermore, deterministic as well as probabilistic expert systems are developed to suggest the appropriate drug dose based on patient sedation level. Patients in the intensive care unit who require mechanical ventilation due to acute respiratory failure also frequently require the administration of sedative agents. The need for sedation arises both from patient anxiety due to the loss of personal control and the unfamiliar and intrusive environment of the intensive care unit, and also due to pain or other variants of noxious stimuli. In this dissertation, we develop a rule-based expert system for cardiopulmonary management and intensive care unit sedation. Furthermore, we use probability theory to quantify uncertainty and to extend the proposed rule-based expert system to deal with more realistic situations. Pain assessment in patients who are unable to verbally communicate is a challenging problem. The fundamental limitations in pain assessment stem from subjective assessment criteria, rather than quantifiable, measurable data. The relevance vector machine (RVM) classification technique is a Bayesian extension of the support vector machine (SVM) algorithm which achieves comparable performance to SVM while providing posterior probabilities for class memberships and a sparser model. In this dissertation, we use the RVM classification technique to distinguish pain from non-pain as well as assess pain intensity levels. We also correlate our results with the pain intensity

  17. 78 FR 69363 - Lake Tahoe Basin Management Unit, California, Heavenly Mountain Resort Epic Discovery Project

    Science.gov (United States)

    2013-11-19

    ... DEPARTMENT OF AGRICULTURE Forest Service Lake Tahoe Basin Management Unit, California, Heavenly Mountain Resort Epic Discovery Project AGENCY: Lake Tahoe Basin Management Unit, Forest Service, USDA...: The Epic Discovery Project is intended to enhance summer activities in response to the USDA Forest...

  18. 76 FR 34271 - Hewlett Packard, Global Parts Supply Chain, Global Product Life Cycles Management Unit, Including...

    Science.gov (United States)

    2011-06-13

    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,671] Hewlett Packard, Global Parts Supply Chain, Global Product Life Cycles Management Unit, Including Teleworkers Reporting to... Supply Chain, Global Product Life Cycles Management Unit, including teleworkers reporting to Houston...

  19. 76 FR 41525 - Hewlett Packard Global Parts Supply Chain, Global Product Life Cycles Management Unit Including...

    Science.gov (United States)

    2011-07-14

    ... Parts Supply Chain, Global Product Life Cycles Management Unit Including Teleworkers Reporting to... workers of Hewlett Packard, Global Parts Supply Chain, Global Product Life Cycles Management Unit...). Since eligible workers of Hewlett Packard, Global Parts Supply Chain, Global Product Life Cycles...

  20. Big Game Management Units, New Mexico Department of Game and Fish 2010

    Data.gov (United States)

    Earth Data Analysis Center, University of New Mexico — GMUs are based on New Mexico Department of Game and Fish Big Game Management Units and Game Management Sub-units as described in Title 19 Chapter 30 Part 4 ofThe New...

  1. Management and control aimed at reducing potential exposure of cobalt irradiation units

    International Nuclear Information System (INIS)

    Yan Yukui

    2003-01-01

    This paper is intended to address the problems of the management and control of potential exposure of cobalt irradiation units and analyze both the current situation and the resultant accident reasons associated with irradiation units, with the necessary control measures provided to reduce potential exposure. The concepts of defense in depth and excellent engineering practice are introduced in design to provide the units with sufficient redundancy. In the course of scientific management, the qualified applicants or registers devoted, strictly and effectively, their oversight, monitoring and regulation to the irradiation units. The effective management and control are achieved through safety analysis and assessment, reasonable regulatory system and source decommissioning system. (authors)

  2. The control Unit of radiopharmacie: the solution of radioplarmacies management

    International Nuclear Information System (INIS)

    Jimenez, R.; Oyarzabal, I.

    2002-01-01

    Nuclear Medicine Departments administer unit doses of radiopharmaceuticals to patients. There unit doses are prepared in radio pharmacies either in the Hospital or in centralized radio pharmacies capable of servicing several Hospitals. This article describes the characteristics of centralized radio pharmacies and their advantages over units in Hospitals as well as the technological features that Molypharma has added to their own centralized radio pharmacies. (Author)

  3. Recognition and management of eating disorders in children and young people.

    Science.gov (United States)

    Oakley, Thomas James; Dey, Indranil; Discombe, Sandra; Fitzpatrick, Lynn; Paul, Siba Prosad

    2017-10-25

    Eating disorders form a group of mental health conditions characterised by abnormal eating habits and are associated with high mortality rates. This article provides nurses working in various settings with evidence-based strategies to identify, manage and refer children and young people with eating disorders. It explores what eating disorders are, and their association with physical and psychiatric co-morbidities. Eating disorders have a significant effect on children and young people's health and development, and nurses have a vital role in managing them. This article presents a case study that illustrates some of the challenges nurses may experience when managing children and young people with eating disorders. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  4. Toxic alcohol ingestion: prompt recognition and management in the emergency department [digest].

    Science.gov (United States)

    Beauchamp, Gillian A; Valento, Matthew; Kim, Jeremy

    2016-09-22

    Identifying patients with potential toxic alcohol exposure and initiating appropriate management is critical to avoid significant patient morbidity. Sources of toxic alcohol exposure include ethylene glycol, methanol, diethylene glycol, propylene glycol, and isopropanol. Treatment considerations include the antidotes fomepizole and ethanol, and hemodialysis for removal of the parent compound and its toxic metabolites. Additional interventions include adjunctive therapies that may improve acidosis and enhance clearance of the toxic alcohol or metabolites. This issue reviews common sources of alcohol exposure, basic mechanisms of toxicity, physical examination and laboratory findings that may guide rapid assessment and management, and indications for treatment. [Points & Pearls is a digest of Emergency Medicine Practice].

  5. Intelligent Tutor with Emotion Recognition and Student Emotion Management for Math Performance

    Directory of Open Access Journals (Sweden)

    Mari­a Luci­a Barron Estrada

    2014-10-01

    Full Text Available This research presents the development, implementation, and testing of an Intelligent Tutoring System for math in third grade elementary students, it identifies and manages the emotional state of the student; it produces affective feedback for the student during the course that also it is part of a social network. Emotions are recognized via facial expressions by means of an artificial neural network. The social network and the intelligent tutoring system with affective management have been tested in public and private elementary schools with very satisfying results.

  6. Developing standardized strategic response categories for fire management units

    Science.gov (United States)

    Matthew P. Thompson; Crystal S. Stonesifer; Robert C. Seli; Marlena Hovorka

    2013-01-01

    Federal wildland fire policy requires that publicly owned lands with burnable vegetation have a fire management plan (FMP); this applies to the five primary Federal fire agencies (Bureau of Indian Affairs, Bureau of Land Management, National Park Service, U.S. Fish and Wildlife Service, and Forest Service). FMPs are based on land and resource management plans and are...

  7. State Decision-Makers Guide for Hazardous Waste Management: Defining Hazardous Wastes, Problem Recognition, Land Use, Facility Operations, Conceptual Framework, Policy Issues, Transportation.

    Science.gov (United States)

    Corson, Alan; And Others

    Presented are key issues to be addressed by state, regional, and local governments and agencies in creating effective hazardous waste management programs. Eight chapters broadly frame the topics which state-level decision makers should consider. These chapters include: (1) definition of hazardous waste; (2) problem definition and recognition; (3)…

  8. Experiencing nature: The recognition of the symbolic environment within research and management of visitor flows

    NARCIS (Netherlands)

    Marwijk, van R.; Elands, B.H.M.; Lengkeek, J.

    2007-01-01

    Insight in and understanding of visitor use, including temporal and spatial distributions, is necess­ary for sustainable recreational use and effective park management. A visitor uses the physical environment of e.g. a National Park, however, his behaviour is not only a result of the objective or

  9. Criteria for the recognition and correlation of sandstone units in the Precambrian and Paleozoic-Mesozoic clastic sequence in the near east

    Science.gov (United States)

    Weissbrod, T.; Perath, I.

    A systematic study of the Precambrian and Paleozoic-Mesozoic clastic sequences (Nubian Sandstone) in Israel and Sinai, and a comparative analysis of its stratigraphy in neighbouring countries, has shown that besides the conventional criteria of subdivision (lithology, field appearance, photogeological features, fossil content), additional criteria can be applied, which singly or in mutual conjuction enable the recognition of widespread units and boundaries. These criteria show lateral constancy, and recurrence of a similar vertical sequence over great distances, and are therefore acceptable for the identification of synchronous, region-wide sedimentary units (and consequently, major unconformities). They also enable, once the units are established, to identify detached (not in situ) samples, samples from isolated or discontinous outcrops, borehole material or archive material. The following rock properties were tested and found to be usefuls in stratigraphic interpretation, throughout large distribution areas of the clastic sequence: Landscape, which is basically the response of a particular textural-chemic al aggregate to atmospheric weathering. Characteristic outcrop feature — styles of roundness or massivity, fissuring or fliatin, slope profile, bedding — express a basic uniformity of these platform-type clastics. Colors are often stratigraphically constant over hundreds of kilometers, through various climates and topographies, and express some intrinsic unity of the rock bodies. Grain size and sorting, when cross-plotted, enable to differentiate existing unit. The method requires the analysis of representative numbers of samples. Vertical trends of median grain size and sorting show reversals, typically across unconformities. Feldstar content diminishes from 15-50% in Precambrian-Paleozoic rocks to a mere 5% or less in Mesozoic sandstones — a distinctive regionwide time trend. Dominance of certain feldstar types characterizes Precambrian and Paleozoic

  10. Forest management and water in the United States [Chapter 13

    Science.gov (United States)

    Daniel G. Neary

    2017-01-01

    This chapter outlines a brief history of the United States native forests and forest plantations. It describes the past and current natural and plantation forest distribution (map, area, main species), as well as main products produced (timber, pulp, furniture, etc.). Integrated into this discussion is a characterization of the water resources of the United States and...

  11. 40 CFR 264.552 - Corrective Action Management Units (CAMU).

    Science.gov (United States)

    2010-07-01

    ..., tanks, or other non-land-based units found above ground, unless the wastes are first placed in the tanks, containers or non-land-based units as part of cleanup, or the containers or tanks are excavated during the... drainage and minimize erosion or abrasion of the cover; (4) Accommodate settling and subsidence so that the...

  12. WIPP Facility Work Plan for Solid Waste Management Units

    International Nuclear Information System (INIS)

    2000-01-01

    This Facility Work Plan (FWP) has been prepared as required by Module VII,Section VII.M.1 of the Waste Isolation Pilot Plant (WIPP) Hazardous Waste Permit, NM4890139088-TSDF (the Permit); (NMED, 1999a). This work plan describes the programmatic facility-wide approach to future investigations at Solid Waste Management Units (SWMUs) and Areas of Concern (AOCs) specified in the Permit. This FWP addresses the current Permit requirements. It uses the results of previous investigations performed at WIPP and expands the investigations as required by the Permit. As an alternative to the Resource Conservation and Recovery Act (RCRA) Facility Investigation (RFI) specified in Module VII of the Permit, current New Mexico Environment Department (NMED) guidance identifies an Accelerated Corrective Action Approach (ACAA) that may be used for any SWMU or AOC (NMED, 1998). This accelerated approach is used to replace the standard RFI Work Plan and Report sequence with a more flexible decision-making approach. The ACAA process allows a Facility to exit the schedule of compliance contained in the Facility's's Hazardous and Solid Waste Amendments (HSWA) permit module and proceed on an accelerated time frame. Thus, the ACAA process can be entered either before or after an RFI Work Plan. According to NMED's guidance, a facility can prepare an RFI Work Plan or Sampling and Analysis Plan (SAP) for any SWMU or AOC (NMED, 1998). Based on this guidance, a SAP constitutes an acceptable alternative to the RFI Work Plan specified in the Permit. The scope of work for the RFI Work Plan or SAP is being developed by the Permittees. The final content of the RFI Work Plan or SAP will be coordinated with the NMED for submittal on May 24, 2000. Specific project-related planning information will be included in the RFI Work Plan or SAP. The SWMU program at WIPP began in 1994 under U.S. Environmental Protection Agency (EPA) regulatory authority. NMED subsequently received regulatory authority from EPA. A

  13. WIPP Facility Work Plan for Solid Waste Management Units

    Energy Technology Data Exchange (ETDEWEB)

    Washington TRU Solutions LLC

    2000-02-25

    This Facility Work Plan (FWP) has been prepared as required by Module VII,Section VII.M.1 of the Waste Isolation Pilot Plant (WIPP) Hazardous Waste Permit, NM4890139088-TSDF (the Permit); (NMED, 1999a). This work plan describes the programmatic facility-wide approach to future investigations at Solid Waste Management Units (SWMUs) and Areas of Concern (AOCs) specified in the Permit. This FWP addresses the current Permit requirements. It uses the results of previous investigations performed at WIPP and expands the investigations as required by the Permit. As an alternative to the Resource Conservation and Recovery Act (RCRA) Facility Investigation (RFI) specified in Module VII of the Permit, current New Mexico Environment Department (NMED) guidance identifies an Accelerated Corrective Action Approach (ACAA) that may be used for any SWMU or AOC (NMED, 1998). This accelerated approach is used to replace the standard RFI Work Plan and Report sequence with a more flexible decision-making approach. The ACAA process allows a Facility to exit the schedule of compliance contained in the Facility’s Hazardous and Solid Waste Amendments (HSWA) permit module and proceed on an accelerated time frame. Thus, the ACAA process can be entered either before or after an RFI Work Plan. According to NMED’s guidance, a facility can prepare an RFI Work Plan or Sampling and Analysis Plan (SAP) for any SWMU or AOC (NMED, 1998). Based on this guidance, a SAP constitutes an acceptable alternative to the RFI Work Plan specified in the Permit. The scope of work for the RFI Work Plan or SAP is being developed by the Permittees. The final content of the RFI Work Plan or SAP will be coordinated with the NMED for submittal on May 24, 2000. Specific project-related planning information will be included in the RFI Work Plan or SAP. The SWMU program at WIPP began in 1994 under U.S. Environmental Protection Agency (EPA) regulatory authority. NMED subsequently received regulatory authority from EPA

  14. Managing Workplace Conflict in the United States and Hong Kong.

    Science.gov (United States)

    Tinsley, Catherine H.; Brett, Jeanne M.

    2001-07-01

    We propose that managers have norms (standards of appropriate behavior) for resolving conflict, that these norms are culturally based, and that they explain cultural differences in conflict management outcomes. We confirm that the traditionally American norms of discussing parties' interests and synthesizing multiple issues were exhibited more strongly by American managers than by their Hong Kong Chinese counterparts. In addition, we confirm that the traditionally Chinese norms of concern for collective interests and concern for authority appeared more strongly among Hong Kong Chinese managers than among their American counterparts. American managers were more likely than Hong Kong Chinese managers, to resolve a greater number of issues and reach more integrative outcomes, while Hong Kong Chinese managers were more likely to involve higher management in conflict resolution. Culture had a significant effect on whether parties selected an integrative outcome rather than an outcome that involved distribution, compromise, higher management, or no resolution at all. Conflict norms explained the cultural differences that existed between reaching an integrative outcome and reaching an outcome involving distribution, compromise, or higher management; however, conflict norms did not fully explain the cultural differences that existed between reaching an integrative outcome and reaching no resolution. Copyright 2001 Academic Press.

  15. An Analysis of United States Marine Corps Enlisted Entry-Level Training Using Supply Chain and Operations Management

    Science.gov (United States)

    2010-12-01

    An Analysis of United States Marine Corps Enlisted Entry-Level Training Using Supply Chain and Operations Management ______________________________________ By...Report 4. TITLE AND SUBTITLE: An Analysis of United States Marine Corps Enlisted Entry-Level Training Using Supply Chain and Operations Management 6...Level Training; United States Marine Corps; Operations Management ; Supply Chain Management; Process Analysis 16. PRICE CODE 17. SECURITY

  16. Lumen apposing metal stents for pancreatic fluid collections: Recognition and management of complications.

    Science.gov (United States)

    DeSimone, Michael L; Asombang, Akwi W; Berzin, Tyler M

    2017-09-16

    For patients recovering from acute pancreatitis, the development of a pancreatic fluid collection (PFC) predicts a more complex course of recovery, and introduces difficult management decisions with regard to when, whether, and how the collection should be drained. Most PFCs resolve spontaneously and drainage is indicated only in pseudocysts and walled-off pancreatic necrosis when the collections are causing symptoms and/or local complications such as biliary obstruction. Historical approaches to PFC drainage have included surgical (open or laparoscopic cystgastrostomy or pancreatic debridement), and the placement of percutaneous drains. Endoscopic drainage techniques have emerged in the last several years as the preferred approach for most patients, when local expertise is available. Lumen-apposing metal stents (LAMS) have recently been developed as a tool to facilitate potentially safer and easier endoscopic drainage of pancreatic fluid collections, and less commonly, for other indications, such as gallbladder drainage. Physicians considering LAMS placement must be aware of the complications most commonly associated with LAMS including bleeding, migration, buried stent, stent occlusion, and perforation. Because of the patient complexity associated with severe pancreatitis, management of pancreatic fluid collections can be a complex and multidisciplinary endeavor. Successful and safe use of LAMS for patients with pancreatic fluid collections requires that the endoscopist have a full understanding of the potential complications of LAMS techniques, including how to recognize and manage expected complications.

  17. Special Needs Dentistry: Interdisciplinary Management of Medically-Complex Patients at Hospital-Based Dental Units in Tasmania, Australia

    Directory of Open Access Journals (Sweden)

    Lim

    2017-06-01

    Full Text Available Background: Increasing awareness of the interactions between oral and general health has led to the establishment of Special Needs Dentistry as a dental specialty in many countries. This specialty assists with the interdisciplinary management of patients between the medical and dental professions particularly those with complex medical problems, intellectual and physical impairments, and psychiatric conditions that may affect their oral health or the manner in which they receive treatment. However, little is known about the utilisation of specialised services provided to facilitate individuals with these needs. Aim: The aim of this study was to understand current utilisation of hospital-based dental services established to provide medically-necessary dental care. Methods: A retrospective review of the demographics and medical status of patients treated at referral hospital-based dental clinics in the state of Tasmania was completed for the month of August 2015. Results: Patients treated at these units had a variety of medical backgrounds. Most (46.4% were referred from medical professionals within the hospital. On average, patients treated at these units had 2.56 medical conditions and were taking 3.59 medications each. Many of these were chronic medical conditions known to have an interaction with oral health. Conclusions: Our results demonstrate the growing recognition of dynamic interactions between oral and general health and the importance of these hospitalbased units and interprofessional relationships in providing timely and holistic health care to these patients.

  18. Planning for a smooth transition: evaluation of a succession planning program for prospective nurse unit managers.

    Science.gov (United States)

    Manning, Vicki; Jones, Alan; Jones, Pamela; Fernandez, Ritin S

    2015-01-01

    The current and projected nurse workforce shortage has created significant pressure on health care organizations to examine their approach to managing talent. This includes the need for strategic development of new formal leaders. This article reports on a succession planning program for prospective nursing unit managers. Eight prospective management candidates participated in a Future Nursing Unit Managers program. The effectiveness of the program was measured through a comparison of pre- and postprogram surveys relating to participants' perception of personal managerial and leadership skills. Significant differences in scores from baseline to 6-month follow-up surveys were observed in the participants' confidence in undertaking the nursing unit manager role and in their management skills. Investment in structured programs to prepare nurses for leadership roles is strongly recommended as a management workforce strategy.

  19. United States Department of Energy Automated Transportation Management System

    International Nuclear Information System (INIS)

    Portsmouth, J.H.

    1992-01-01

    At the US Department of Energy (DOE) 80 transportation facilities, each contractor's transportation management operation has different internal and site specific procedures, and reports to a DOE regional Field Office Traffic Manager (FOTM). The DOE Transportation Management Program (TMP) has the responsibility to manage a transportation program for safe, efficient, and economical transportation of DOE-owned materials. The TMP develops and administers transportation/traffic operations management policies and programs for materials; including radioactive materials, other hazardous materials, hazardous substances, and hazardous wastes, pursuant to applicable federal regulations, such as the Code of Federal Register, Sections 40 and 49. Transportation management has become an increasingly critical primarily because of transportation issues regarding the shipment of radioactive materials and hazardous wastes that are frequently the focus of public concerns. A large shipments and requiring millions of business transactions necessitates the establishment of automated systems, programs, procedures, and controls to ensure that the transportation management process in being handled in a safe, efficient, and economical manner. As the mission of many DOE facilities changes from production of special nuclear materials for defense purposes to environmental restoration and waste management, the role of transportation management will become even more important to the safe and efficient movement of waste materials to prescribed locations. In support of this role, the Automated Transportation Management System (ATMS) was conceived to assist the DOE and its contractors in the performance of their day-to-day transportation management activities. The ATMS utilizes the latest in technology and will supply state-of-the-art automated transportation management for current and future DOE transportation requirements

  20. Integrating concerns about wood production and sustainable forest management in the United States.

    Science.gov (United States)

    R.W. Haynes

    2007-01-01

    The implementation of Sustainable Forest Management (SFM) in the United States is strongly influenced by U.S. forest products markets and the numerous management decisions made by individual landowners and managers. These decisions are influenced by a mix of market incentives and regulatory actions reducing predictability in assessing progress towards SFM and causing...

  1. Site Specific Waste Management Instruction for the 116-F-4 soil storage unit

    International Nuclear Information System (INIS)

    Hopkins, G.G.

    1996-08-01

    This Site Specific Waste Management Instruction provides guidance for management of waste generated during the excavation and remediation of soil and debris from the 116-4 soil storage unit located at the Hanford Site in Richland, Washington. This document outlines the waste management practices that will be performed in the field to implement federal, state, and US Department of Energy requirements

  2. United States Japan Industry and Technology Management Training

    National Research Council Canada - National Science Library

    Gercik, Patricia

    2001-01-01

    .... The intellectual focus of the Program is to integrate the research methodologies of the social sciences, the humanities, and technology to approach issues confronting the United States and Japan...

  3. Health care in the United States: organization, management, and policy

    National Research Council Canada - National Science Library

    Greenwald, Howard P

    2010-01-01

    "Health Care in the United States discusses the basic structures and operations of the U.S. health system. This resource includes examples, tables, and a glossary with key terms and acronyms to help understand important concepts...

  4. CFL Labeling Harmonization in the United States, China, Brazil andELI Member Countries: Specifications, Testing, and MutualRecognition

    Energy Technology Data Exchange (ETDEWEB)

    Fridley, David; Lin, Jiang; Denver, Andrea; Biermayer, Peter; Dillavou, Tyler

    2005-07-20

    This report examines critical differences among energy-efficient labeling programs for CFLs in Brazil, China, the United States, and the seven members of the international Efficient Lighting Initiative (ELI) in terms of technical specifications and test procedures, and review issues related to international harmonization of these standards.

  5. Septris: a novel, mobile, online, simulation game that improves sepsis recognition and management.

    Science.gov (United States)

    Evans, Kambria H; Daines, William; Tsui, Jamie; Strehlow, Matthew; Maggio, Paul; Shieh, Lisa

    2015-02-01

    Annually affecting over 18 million people worldwide, sepsis is common, deadly, and costly. Despite significant effort by the Surviving Sepsis Campaign and other initiatives, sepsis remains underrecognized and undertreated. Research indicates that educating providers may improve sepsis diagnosis and treatment; thus, the Stanford School of Medicine has developed a mobile-accessible, case-based, online game entitled Septris (http://med.stanford.edu/septris/). Septris, launched online worldwide in December 2011, takes an innovative approach to teaching early sepsis identification and evidence-based management. The free gaming platform leverages the massive expansion over the past decade of smartphones and the popularity of noneducational gaming.The authors sought to assess the game's dissemination and its impact on learners' sepsis-related knowledge, skills, and attitudes. In 2012, the authors trained Stanford pregraduate (clerkship) and postgraduate (resident) medical learners (n = 156) in sepsis diagnosis and evidence-based practices via 20 minutes of self-directed game play with Septris. The authors administered pre- and posttests. By October 2014, Septris garnered over 61,000 visits worldwide. After playing Septris, both pre- and postgraduate groups improved their knowledge on written testing in recognizing and managing sepsis (P game scores with sepsis knowledge.

  6. Control system design specification of advanced spent fuel management process units

    Energy Technology Data Exchange (ETDEWEB)

    Ahn, S. H.; Kim, S. H.; Yoon, J. S

    2003-06-01

    In this study, the design specifications of instrumentation and control system for advanced spent fuel management process units are presented. The advanced spent fuel management process consists of several process units such as slitting device, dry pulverizing/mixing device, metallizer, etc. In this study, the control and operation characteristics of the advanced spent fuel management mockup process devices and the process devices developed in 2001 and 2002 are analysed. Also, a integral processing system of the unit process control signals is proposed, which the operation efficiency is improved. And a redundant PLC control system is constructed which the reliability is improved. A control scheme is proposed for the time delayed systems compensating the control performance degradation caused by time delay. The control system design specification is presented for the advanced spent fuel management process units. This design specifications can be effectively used for the detail design of the advanced spent fuel management process.

  7. [Emotional climate and internal communication in a clinical management unit compared with two traditional hospital services].

    Science.gov (United States)

    Alonso, E; Rubio, A; March, J C; Danet, A

    2011-01-01

    The aim of this study is to compare the emotional climate, quality of communication and performance indicators in a clinical management unit and two traditional hospital services. Quantitative study. questionnaire of 94 questions. 83 health professionals (63 responders) from the clinical management unit of breast pathology and the hospital services of medical oncology and radiation oncology. descriptive statistics, comparison of means, correlation and linear regression models. The clinical management unit reaches higher values compared with the hospital services about: performance indicators, emotional climate, internal communication and evaluation of the leadership. An important gap between existing and desired sources, channels, media and subjects of communication appear, in both clinical management unit and traditional services. The clinical management organization promotes better internal communication and interpersonal relations, leading to improved performance indicators. Copyright © 2011 SECA. Published by Elsevier Espana. All rights reserved.

  8. Pattern recognition

    CERN Document Server

    Theodoridis, Sergios

    2003-01-01

    Pattern recognition is a scientific discipline that is becoming increasingly important in the age of automation and information handling and retrieval. Patter Recognition, 2e covers the entire spectrum of pattern recognition applications, from image analysis to speech recognition and communications. This book presents cutting-edge material on neural networks, - a set of linked microprocessors that can form associations and uses pattern recognition to ""learn"" -and enhances student motivation by approaching pattern recognition from the designer's point of view. A direct result of more than 10

  9. Four-Year Turfgrass Management Programs in the United States: II. Organization and Content of Introductory Turfgrass Management Courses.

    Science.gov (United States)

    Karnok, Keith J.; And Others

    1993-01-01

    A survey of 32 land-grant institutions was conducted to determine format, topical content, and teaching methods of introductory turfgrass management courses of 4-year turfgrass management programs in the United States. Required courses included a basic soils class and a course in biology or botany, usually transmitted by the lecture method. (MDH)

  10. Bench-to-bedside review: leadership and conflict management in the intensive care unit.

    Science.gov (United States)

    Strack van Schijndel, Rob J M; Burchardi, Hilmar

    2007-01-01

    In the management of critical care units, leadership and conflict management are vital areas for the successful performance of the unit. In this article a practical approach to define competencies for leadership and principles and practices of conflict management are offered. This article is, by lack of relevant intensive care unit (ICU) literature, not evidence based, but it is the result of personal experience and a study of literature on leadership as well on conflicts and negotiations in non-medical areas. From this, information was selected that was recognisable to the authors and, thus, also seems to be useful knowledge for medical doctors in the ICU environment.

  11. Clinical recognition and management of amyotrophic lateral sclerosis: the nurse's role.

    Science.gov (United States)

    Clarke, Kathie; Levine, Todd

    2011-08-01

    Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, causes a progressive wasting and loss of the upper and lower motor neurons that facilitate the movement of body parts. At onset, ALS patients may show symptoms such as muscle weakness, atrophy, hyperreflexia, or bulbar symptoms such as dysphagia or dysarthria. Deterioration progresses rapidly, and the later stages of ALS are characterized by severely limited mobility and respiratory failure, which is the primary cause of death. There is no specific diagnostic test for ALS, and there are a number of other conditions that may resemble ALS, making a diagnosis difficult. The variability of the initial presentation combined with the broad differential diagnosis may result in significant delays in diagnosis or, in some cases, misdiagnosis, which in turn have a negative impact on patient outcomes. There is no cure for ALS; however, many of the symptoms are treatable, and the physical and psychological symptoms are best managed through the efforts of a coordinated, multidisciplinary team. Nurses play a critical role in the clinical management of ALS and may be involved in coordinating the activities of the team, facilitating treatment, and helping patients and caregivers in making informed treatment and end-of-life decisions. Drug therapy for ALS is currently limited to riluzole; however, patients may be treated with a number of nonpharmacologic methods on the basis of their symptoms. A number of other treatment modalities, such as stem-cell-based therapy or gene therapy, and an array of neuroprotective clinical trials are currently under development for the treatment of ALS. Nurses may also have a key role in these various ALS studies.

  12. Lifetime management of the nuclear units in France

    International Nuclear Information System (INIS)

    Combes, J-P.; Godin, R.

    1994-01-01

    A systematic design study entitled 'Lifetime Project' has been initiated at Electricite de France, to estimate, plan, and maximize the life span of the French PWR plants. It is estimated that the present units will have a lifetime of 30 to 50 years. The life of a unit will be determined by that of its components, by economic considerations (whether it is cheaper to repair or replace the unit), and by safety considerations, which may be affected by changing safety standards. A 'periodic safety reassessment' takes place about every ten years. A list of 18 critical components can be summarized by saying that the main concerns are: radiation embrittlement of and within the reactor vessel, the steam generators, the concrete containment (which can not be replaced), instrumentation and control. Examination of samples from decommissioned plants, such as Chooz A, will provide valuable evidence of mechanisms of degradation due to aging

  13. The main objectives of lifetime management of reactor unit components

    International Nuclear Information System (INIS)

    Dragunov, Y.; Kurakov, Y.

    1998-01-01

    The main objectives of the work concerned with life management of reactor components in Russian Federation are as follows: development of regulations in the field of NPP components ageing and lifetime management; investigations of ageing processes; residual life evaluation taking into account the actual state of NPP systems, real loading conditions and number of load cycles, results of in-service inspections; development and implementation of measures for maintaining/enhancing the NPP safety

  14. Outpatient evaluation, recognition, and initial management of pediatric overweight and obesity in U.S. military medical treatment facilities.

    Science.gov (United States)

    Dickey, Wayne; Arday, David R; Kelly, Joseph; Carnahan, Col David

    2017-02-01

    As childhood obesity is a concern in many communities, this study investigated outpatient evaluation and initial management of overweight and obese pediatric patients in U.S. military medical treatment facilities (MTFs). Samples of 579 overweight and 341 obese patients (as determined by body mass index [BMI]) aged 3-17 years were drawn from MTFs. All available FY2011 outpatient records were searched for documentation of BMI assessment, overweight/obesity diagnosis, and counseling. Administrative data for these patients were merged to assess coded diagnostic and counseling rates and receipt of recommended laboratory screenings. Generic BMI documentation was high, but BMI percentile assessments were found among fewer than half the patients. Diagnostic recording or recognition totaled 10.9% of overweight and 32.0% of obese. Counseling rates were higher, with 46.4% and 61.0% of overweight and obese patients, respectively, receiving weight related counseling. Among patients 10 years of age or older, rates of recommended lab screenings for diabetes, liver abnormality, and dyslipidemia were not greater than 33%. BMI percentile recording was strongly associated with diagnostic recording, and diagnostic recording was strongly associated with counseling. Improvements to electronic health records or implementation of local procedures to facilitate better diagnostic recording would likely improve adherence to clinical practice guidelines. ©2016 American Association of Nurse Practitioners.

  15. Accounting principles, revenue recognition, and the profitability of pharmacy benefit managers.

    Science.gov (United States)

    McLean, Robert A; Garis, Robert I

    2005-03-01

    To contrast pharmacy benefit management (PBM) companies' measured profitability by using two accounting standards. The first accounting standard is that which, under Generally Accepted Accounting Principles (GAAP), PBMs are currently allowed to employ. The second accounting standard, seemingly more congruent with the PBM business model, treats the PBM as an agent of the plan sponsor. Financial Accounting Standards Board (FASB) Emerging Issues Task Force Issue 99-19, U.S. Securities and Exchange 10-K filings and financial accounting literature. Under GAAP record keeping, the PBM industry profitability appears modest. Using currently applied GAAP, the PBM treats all payment from the plan sponsor as revenue and all payment to the pharmacy as revenue. However, the PBM functions, in practice, as an entity that passes-through money collected from one party (the sponsor) to other parties (dispensing pharmacies). Therefore, it would seem that the nature of PBM cash flows would be more accurately recorded as a pass-through entity. When the PBM is evaluated using an accounting method that recognizes the pass-through nature of its business, the PBM profit margin increases dramatically. Current GAAP standards make traditional financial statement analysis of PBMs unrevealing, and may hide genuinely outstanding financial performance. Investors, regulators, pharmacies, and the FASB all have an interest in moving to clarify this accounting anomaly.

  16. A Conceptual Model for Delineating Land Management Units (LMUs Using Geographical Object-Based Image Analysis

    Directory of Open Access Journals (Sweden)

    Deniz Gerçek

    2017-06-01

    Full Text Available Land management and planning is crucial for present and future use of land and the sustainability of land resources. Physical, biological and cultural characteristics of land can be used to define Land Management Units (LMUs that aid in decision making for managing land and communicating information between different research and application domains. This study aims to describe the classification of ecologically relevant land units that are suitable for land management, planning and conservation purposes. Relying on the idea of strong correlation between landform and potential landcover, a conceptual model for creating Land Management Units (LMUs from topographic data and biophysical information is presented. The proposed method employs a multi-level object-based classification of Digital Terrain Models (DTMs to derive landform units. The sensitivity of landform units to changes in segmentation scale is examined, and the outcome of the landform classification is evaluated. Landform classes are then aggregated with landcover information to produce ecologically relevant landform/landcover assemblages. These conceptual units that constitute a framework of connected entities are finally enriched given available socio-economic information e.g., land use, ownership, protection status, etc. to generate LMUs. LMUs attached to a geographic database enable the retrieval of information at various levels to support decision making for land management at various scales. LMUs that are created present a basis for conservation and management in a biodiverse area in the Black Sea region of Turkey.

  17. Nurses' knowledge and barriers regarding pain management in intensive care units.

    Science.gov (United States)

    Wang, Hsiang-Ling; Tsai, Yun-Fang

    2010-11-01

    To explore nurses' knowledge and barriers regarding pain management in intensive care units. Pain is a common and treatable condition among intensive care patients. Quality care of these patients depends on the pain knowledge and pain management skills of critical care nurses. However, no single study has explored these nurses' knowledge of and perceived barriers to pain management in Taiwan. A cross-sectional study. Intensive care unit nurses (n = 370) were recruited from 16 hospitals chosen by stratified sampling across Taipei County in Taiwan. Data were collected on nurses' knowledge of pain management using the Nurses' Knowledge and Attitudes Survey-Taiwanese version, on perceived barriers to pain management using a researcher-developed scale and on background information. The overall average correct response rate for the knowledge scale was 53.4%, indicating poor knowledge of pain management. The top barrier to managing pain identified by these nurses was 'giving proper pain prescription needs doctor's approval; can't depend on me'. Knowledge of pain management was significantly and negatively related to perceived barriers to pain management. In addition, scores for knowledge and perceived barriers differed significantly by specific intensive care unit. Knowledge also differed significantly by nurses' education level, clinical competence level (nursing ladder) and hospital accreditation category. Our results indicate an urgent need to strengthen pain education by including case analysis for intensive care nurses in Taiwan. Pain education should target knowledge deficits and barriers to changing pain management approaches for Taiwanese nurses in intensive care units. © 2010 Blackwell Publishing Ltd.

  18. Development of a software tool for the management of quality control in a helical tomotherapy unit

    International Nuclear Information System (INIS)

    Garcia Repiso, S.; Hernandez Rodriguez, J.; Martin Rincon, C.; Ramos Pacho, J. A.; Verde Velasco, J. M.; Delgado Aparacio, J. M.; Perez Alvarez, M. e.; Gomez Gonzalez, N.; Cons Perez, V.; Saez Beltran, M.

    2013-01-01

    The large amount of data and information that is managed in units of external radiotherapy quality control tests makes necessary the use of tools that facilitate, on the one hand, the management of measures and results in real time, and on other tasks of management, file, query and reporting of stored data. This paper presents an application of software of own development which is used for the integral management of the helical TomoTherapy unit in the aspects related to the roles and responsibilities of the hospital Radiophysics. (Author)

  19. AN OPERATIONAL MANAGEMENT MODEL FOR A COAL MINING PRODUCTION UNIT

    Directory of Open Access Journals (Sweden)

    R. Visser

    2012-01-01

    Full Text Available

    ENGLISH ABSTRACT: The coal mining industry faces increased pressure for higher quality coal at lower cost and increased volumes. To satisfy these requirements the industry needs technically skilled first line supervisors with operational management skills. Most first line supervisors possess the necessary technical, but not the required operational management skills. Various operational management philosophies, describing world-class operational management practices exist; however, it is not possible to implement these philosophies as-is in a mining environment due to the various differences between manufacturing and mining. The solution is to provide an operational management model, adapted from these philosophies, to first line supervisors in the coal mining industry.

    AFRIKAANSE OPSOMMING: Die steenkoolmynbedryf ervaar groeiende druk van die mark vir hoër gehalte steenkool, laer koste en verhoogde volumes. Om hierdie behoefte te bevredig benodig die myn tegniesgeskoolde eerstelyntoesighouers met bedryfsbestuursvaardighede. Ongelukkig beskik die meeste toesighouers wel oor die nodige tegniese kennis, maar nie die nodige bedryfsbestuursvaardighede nie. Daar bestaan verskeie bedryfsbestuursfilosofieë wat wêreldklas bedryfsbestuurspraktyke omskryf. Dit is egter nie moontlik om die filisofieë net so in die mynbedryf te implimenteer nie a.g.v. die verskille tussen vervaardiging en mynbou. Die oplossing is om ‘n bedryfsbestuurmodel wat op hierdie filosofieë geskoei is, aan eerstelyntoesighouers in die steenkoolbedryf te verskaf.

  20. Reconsidering information management roles and capabilities in disaster response decision-making units

    NARCIS (Netherlands)

    Bharosa, N.; Janssen, M.F.W.H.A.

    2009-01-01

    When disaster strikes, the emerging task environment requires relief agencies to transform from autonomous mono-disciplinary organizations into interdependent multidisciplinary decision-making units. Evaluation studies reveal that adaptation of information management to the changing task environment

  1. United States of America Department of Energy Environmental Management Advisory Committee Public Meeting

    Energy Technology Data Exchange (ETDEWEB)

    1993-12-01

    This reports contains documentation of presentations given at the United States of America Department of Energy Environmental Management Advisory Committee Public Meeting held December 14--15, 1993 in Alexandria, Virginia.

  2. Review of radioactive waste management programs in the United Kingdom

    International Nuclear Information System (INIS)

    Keen, N.J.; Duncan, A.G.

    1982-01-01

    The paper reports progress by the Department of Environment and the nuclear industry in developing and implementing a strategy for the management of radioactive waste in the UK. It outlines the range of possible disposal facilities required to deal with all classes of waste arising from nuclear power generation. The present practices for waste management and the main lines of development by the main waste producers of the plant needed in future are outlined, together with a summary of some of the more generic R and D devoted to treatment, packaging and transport of wastes

  3. Observation unit management of acute decompensated heart failure.

    Science.gov (United States)

    Schrock, Jon W; Emerman, Charles L

    2009-01-01

    Acute decompensated heart failure (ADHF) is a common illness presenting to the emergency department (ED) that is amenable to observation unit (OU) treatment. As the number of baby boomers continues to grow and the incidence of heart failure increases, the financial implications of ADHF treatment will become more prominent. Obtaining institutional support and developing a good working relationship with cardiology colleagues is vital to creating workable ADHF protocols for whichever type of OU an institution decides to use.

  4. Molecular recognition at methyl methacrylate/n-butyl acrylate (MMA/nBA) monomer unit boundaries of phospholipids at p-MMA/nBA copolymer surfaces.

    Science.gov (United States)

    Yu, Min; Urban, Marek W; Sheng, Yinghong; Leszczynski, Jerzy

    2008-09-16

    Lipid structural features and their interactions with proteins provide a useful vehicle for further advances in membrane proteins research. To mimic one of potential lipid-protein interactions we synthesized poly(methyl methacrylate/ n-butyl acrylate) (p-MMA/nBA) colloidal particles that were stabilized by phospholipid (PLs). Upon the particle coalescence, PL stratification resulted in the formation of surface localized ionic clusters (SLICs). These entities are capable of recognizing MMA/nBA monomer interfaces along the p-MMA/nBA copolymer backbone and form crystalline SLICs at the monomer interface. By utilizing attenuated total reflectance Fourier transform infrared (ATR FT-IR) spectroscopy and selected area electron diffraction (SAD) combined with ab initio calculations, studies were conducted that identified the origin of SLICs as well as their structural features formed on the surface of p-MMA/nBA copolymer films stabilized by 1,2-dilauroyl-sn-glycero-3-phosphocholine (DLPC) PL. Specific entities responsible for SLIC formation are selective noncovalent bonds of anionic phosphate and cationic quaternary ammonium segments of DLPC that interact with two neighboring carbonyl groups of nBA and MMA monomers of the p-MMA/nBA polymer backbone. To the best of our knowledge this is the first example of molecular recognition facilitated by coalescence of copolymer colloidal particles and the ability of PLs to form SLICs at the boundaries of the neighboring MMA and nBA monomer units of the p-MMA/nBA chain. The dominating noncovalent bonds responsible for the molecular recognition is a combination of H-bonding and electrostatic interactions.

  5. National Project Management Corp (United States). [Technical and regulatory aspects

    International Nuclear Information System (INIS)

    DeBor, Joseph

    2013-01-01

    Studies of the VHTR fuel cycle which involves: (i) use of light water cooled reactor (LWR) spent fuel as kernel feedstock; (ii) recycle of spent VHTR fuel; (iii) use of the VHTR in the management of transuranics (TRU); and, (iv) the geologic storage performance of spent VHTR fuel

  6. Examining the relationships between span of control and manager job and unit performance outcomes.

    Science.gov (United States)

    Wong, Carol A; Elliott-Miller, Pat; Laschinger, Heather; Cuddihy, Michael; Meyer, Raquel M; Keatings, Margaret; Burnett, Camille; Szudy, Natalie

    2015-03-01

    Our aim was to examine the combination of frontline manager (FLM) personal characteristics and span of control (SOC) on their job and unit performance outcomes. Healthcare downsizing and reform have contributed to larger spans for FLMs in Canadian hospitals and increased concerns about manager workload. Despite a heightened awareness of SOC issues among decision makers, there is limited empirical evidence related to the effects of SOC on outcomes. A non-experimental predictive survey design was used to examine FLM SOC in 14 Canadian academic hospitals. Managers (n = 121) completed an online survey of work characteristics and The Ottawa Hospital (TOH) SOC tool. Unit turnover data were collected from organisational databases. The combination of SOC and core self-evaluation significantly predicted role overload, work control and job satisfaction, but only SOC predicted unit adverse outcomes and neither significantly predicted unit turnover. The findings contribute to an understanding of connections between the combination of SOC and core self-evaluation and manager job and unit performance outcomes. Organisational strategies to create manageable FLM SOC are essential to ensure exemplary job and unit outcomes. Core self-evaluation is a personality characteristic that may enhance manager performance in the face of high spans of control. © 2013 John Wiley & Sons Ltd.

  7. Low Energy Technology. A Unit of Instruction in Florida Agriculture. Crop Protection with Integrated Pest Management.

    Science.gov (United States)

    Florida Univ., Gainesville. Inst. of Food and Agricultural Sciences.

    This unit of instruction on integrated pest management was designed for use by agribusiness and natural resources teachers in Florida high schools and by agricultural extension agents as they work with adults and students. It is one of a series of 11 instructional units (see note) written to help teachers and agents to educate their students and…

  8. Science, Society, and America's Nuclear Waste: The Waste Management System, Unit 4. Teacher Guide. Second Edition.

    Science.gov (United States)

    Department of Energy, Washington, DC. Office of Civilian Radioactive Waste Management, Washington, DC.

    This guide is Unit 4 of the four-part series, Science, Society, and America's Nuclear Waste, produced by the U.S. Department of Energy's Office Civilian Radioactive Waste Management. The goal of this unit is to explain how transportation, a geologic repository, and the multi-purpose canister will work together to provide short-term and long-term…

  9. Myasthenic crisis patients who require intensive care unit management.

    Science.gov (United States)

    Sakaguchi, Hideya; Yamashita, Satoshi; Hirano, Teruyuki; Nakajima, Makoto; Kimura, En; Maeda, Yasushi; Uchino, Makoto

    2012-09-01

    The purpose of this report was to investigate predictive factors that necessitate intensive care in myasthenic crisis (MC). We retrospectively reviewed MC patients at our institution and compared ICU and ward management groups. Higher MG-ADL scale scores, non-ocular initial symptoms, infection-triggered findings, and higher MGFA classification were observed more frequently in the ICU group. In patients with these prognostic factors, better outcomes may be obtained with early institution of intensive care. Copyright © 2012 Wiley Periodicals, Inc.

  10. United States-Russia: Environmental management activities. Summer 1998

    International Nuclear Information System (INIS)

    1998-01-01

    A Joint Coordinating Committee for Environmental Restoration and Waste Management (JCCEM) was formed between the US and Russia. This report describes the areas of research being studied under JCCEM, namely: Efficient separations; Contaminant transport and site characterization; Mixed wastes; High level waste tank remediation; Transuranic stabilization; Decontamination and decommissioning; and Emergency response. Other sections describe: Administrative framework for cooperation; Scientist exchange; Future actions; Non-JCCEM DOE-Russian activities; and JCCEM publications

  11. United States-Russia: Environmental management activities, Summer 1998

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1998-09-01

    A Joint Coordinating Committee for Environmental Restoration and Waste Management (JCCEM) was formed between the US and Russia. This report describes the areas of research being studied under JCCEM, namely: Efficient separations; Contaminant transport and site characterization; Mixed wastes; High level waste tank remediation; Transuranic stabilization; Decontamination and decommissioning; and Emergency response. Other sections describe: Administrative framework for cooperation; Scientist exchange; Future actions; Non-JCCEM DOE-Russian activities; and JCCEM publications.

  12. Connectionist Reinforcement Learning for Intelligent Unit Micro Management in StarCraft

    NARCIS (Netherlands)

    Shantia, Amirhosein; Begue, Eric; Wiering, Marco

    2011-01-01

    Real Time Strategy Games are one of the most popular game schemes in PC markets and offer a dynamic environment that involves several interacting agents. The core strategies that need to be developed in these games are unit micro management, building order, resource management, and the game main

  13. Corrective Action Management Unit Report of Post-Closure Care Activities Calendar Year 2016.

    Energy Technology Data Exchange (ETDEWEB)

    Ziock, Robert [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Little, Bonnie Colleen [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-02-01

    The Corrective Action Management Unit (CAMU) at Sandia National Laboratories, New Mexico (SNL/NM) consisted of a containment cell, two treatment systems, four associated waste staging and storage areas, and support areas; all were used for management of remediation wastes between 1997 and 2003.

  14. Brief introduction to project management of full scope simulator for Qinshan 300 MW Nuclear Power Unit

    International Nuclear Information System (INIS)

    Chen Jie

    1996-01-01

    The key points in development and engineering project management of full scope simulator for Qinshan 300 MW Nuclear Power Unit are briefly introduced. The Gantt chart, some project management methods and experience are presented. The key points analysis along with the project procedure will be useful to the similar project

  15. Management of Energy Flows in Low-temperature Separation Units

    Directory of Open Access Journals (Sweden)

    Trishyn F.A.

    2018-04-01

    Full Text Available . The aim of this work is to study the effect of medium and low power ultrasound on the crystallization and separation processes. A thesis about the importance of using thermal energy converters in separation units has been suggested. The prospects of desalination freezing units and ways of their improvement have been justified. Based on the system analysis, the energy flows in an ice recycling facility have been considered. For the first time, the overall energy efficiency estimation technique based on the hypothesis of direct and reverse energy flows has been proposed. The new results on the effect of ultrasonic fields on the separation and crystallization process have been obtained. It has been proved that the use of ultrasonic field is effective in controlling the energy flows during block freezing. It has been established that the salt content in the ice block is reduced by 2-3 times. The relationship between the ice block separation kinetics and the power and frequency has been determined. The similarity theory methods have been used to summarize the experimental data obtained. The criterion models have been presented to calculate the block porosity and the filtration rate. It has been established that the Euler wavenumber modified by the authors successfully generalizes the databases of the experimental findings. Using the numerical simulation methods, the thermal field in the block which depends on its porosity has been established. The results of the simulation have been presented in the form of a nomogram.

  16. Analysis of the Marine Corps Supply Management Unit’s Internal Operations and Effect on the Warfighter

    Science.gov (United States)

    2016-12-01

    centered on the Marine Corps’ forward deployed supply chain management for expeditionary logistics . He used a fictitious case study to stress the...also maintenance, maintenance management , and logistics chain management at the retail supply level and maintenance activities at all levels. (DON...11 Figure 2. United States Marine Corps Supply Management Unit Global Locations

  17. Improved recognition of ineffective chest compressions after a brief Crew Resource Management (CRM) training: a prospective, randomised simulation study.

    Science.gov (United States)

    Haffner, Leopold; Mahling, Moritz; Muench, Alexander; Castan, Christoph; Schubert, Paul; Naumann, Aline; Reddersen, Silke; Herrmann-Werner, Anne; Reutershan, Jörg; Riessen, Reimer; Celebi, Nora

    2017-03-03

    Chest compressions are a core element of cardio-pulmonary resuscitation. Despite periodic training, real-life chest compressions have been reported to be overly shallow and/or fast, very likely affecting patient outcomes. We investigated the effect of a brief Crew Resource Management (CRM) training program on the correction rate of improperly executed chest compressions in a simulated cardiac arrest scenario. Final-year medical students (n = 57) were randomised to receive a 10-min computer-based CRM or a control training on ethics. Acting as team leaders, subjects performed resuscitation in a simulated cardiac arrest scenario before and after the training. Team members performed standardised overly shallow and fast chest compressions. We analysed how often the team leader recognised and corrected improper chest compressions, as well as communication and resuscitation quality. After the CRM training, team leaders corrected improper chest compressions (35.5%) significantly more often compared with those undergoing control training (7.7%, p = 0.03*). Consequently, four students have to be trained (number needed to treat = 3.6) for one improved chest compression scenario. Communication quality assessed by the Leader Behavior Description Questionnaire significantly increased in the intervention group by a mean of 4.5 compared with 2.0 (p = 0.01*) in the control group. A computer-based, 10-min CRM training improved the recognition of ineffective of chest compressions. Furthermore, communication quality increased. As guideline-adherent chest compressions have been linked to improved patient outcomes, our CRM training might represent a brief and affordable approach to increase chest compression quality and potentially improve patient outcomes.

  18. Introduction of construction management system for preparation work of Shimane Nuclear Power Station Unit-3

    International Nuclear Information System (INIS)

    Sasaki, Yutaka; Tsumura, Isamu; Hayashi, Minoru; Nakamoto, Kenji

    2005-01-01

    The construction management system aims to have information on the construction management between the Chugoku Electric Power Co. Inc. and each contractor, and to work efficiently. The system has been operating during about half year. The system manages the manufacturing process, safety and quality. The aims, development process, characteristics, network construction of the system are reported. As outline of the construction management system, functions and construction management of each process, safety and quality and ITV camera are explained. The system will be used at construction of Shimane nuclear power station unit-3. (S.Y.)

  19. Defining management units for cetaceans by combining genetics, morphlogy, acoustics and satellite tracking

    DEFF Research Database (Denmark)

    Sveegaard, Signe; Galatius, Anders; Dietz, Rune

    2015-01-01

    Managing animal units is essential in biological conservation and requires spatial and temporal identification of such units. Since even neighbouring populations often have different conservation status and face different levels of anthropogenic pressure, detailed knowledge of population structure......, seasonal range and overlap with animals from neighbouring populations is required to manage each unit separately. Previous studies on genetic structure and morphologic separation suggests three distinct populations of harbour porpoises with limited geographic overlap in the North Sea (NS), the Belt Sea (BS...... with the least overlap between populations and thus the least error when abundance and population status is estimated. Discriminant analysis of the satellite tracking data from the BS and NS populations showed that the best fit of the management unit border during the summer months was an east-west line from...

  20. Implementing the Environmental Management System ISO 14001 at the Cernavoda NPP Unit 1

    International Nuclear Information System (INIS)

    Jelev, Adrian

    2003-01-01

    An environmental management plan (EMP) has been developed for the Cernavoda NPP Unit 1. It contains the necessary components for identification and management of the environmental aspects of NPP. The environmental policy of the 'Nuclearelectrica' National Society and the associated EMP are the basis for the Environment Management System that will be implemented at Cernavoda NPP. The final step of this process will be the ISO 14001 certification. This paper points out to the main aspects concerning the implementation of the ISO 14001 system at Cernavoda NPP Unit 1. (author)

  1. Nurse manager perspective of staff participation in unit level shared governance.

    Science.gov (United States)

    Cox Sullivan, Sheila; Norris, Mitzi R; Brown, Lana M; Scott, Karen J

    2017-11-01

    To examine the nurse manager perspective surrounding implementation of unit level shared governance in one Veterans Health Administration facility. Nursing shared governance is a formal model allowing nursing staff decision-making input into clinical practice, quality improvement, evidence-based practice and staff professional development. Unit level shared governance is a management process where decision authority is delegated to nursing staff at the unit level. Convenience sampling was used to recruit ten nurse managers who participated in face-to-face semi-structured interviews. Data were analysed using content analysis and constant comparison techniques. Demographic data were described using descriptive statistics. The participants included seven female and three male nurse managers with seven Caucasian and three African American. Participant quotes were clustered to identify sub-themes that were then grouped into four global themes to describe unit level shared governance. The global themes were: (1) motivation, (2) demotivation, (3) recommendations for success, and (4) outcomes. These research findings resonate with previous studies that shared governance may be associated with increased nurse empowerment, self-management, engagement, and satisfaction. These findings reflect the need for nurse managers to promote and recognize staff participation in unit level shared governance. © 2017 John Wiley & Sons Ltd.

  2. Environmental remediation and waste management in the United States

    International Nuclear Information System (INIS)

    Muntzing, L.M.; Person, J.C.

    1994-01-01

    Environmental remediation of radioactively and chemically contaminated sites represents one of the most complex challenges of our age. It is currently a problem at nuclear weapons sites in the United States, but as the civilian nuclear industry everywhere deals with decommissioning and decontamination, the lessons learned from these early activities will be influential. The task is challenging for several reasons. First, standards governing remedial action are complex and constantly evolving. Second, unless contaminated material is to be stabilized in place, it must be removed and sent to another facility for storage and ultimate disposal. Third the task is technically demanding. Those who undertake the challenge must be technically sophisticated, creative, and innovative. Fourth, the challenge is a risky one. Those who seek to remediate past contamination may find themselves exposed to expanding and unfair allegations of liability for that very contamination. Finally, there is often a basic crisis of public confidence regarding remediation efforts

  3. Sustaining the pivotal organizational outcome: magnet recognition.

    Science.gov (United States)

    Parsons, Mickey L; Cornett, Patricia A

    2011-03-01

    To identify the facilitators and barriers for health-care organizations to sustain Magnet Recognition, the exemplar of a professional practice environment and quality care. Recognition as a Magnet Hospital is the gold standard for acknowledging excellence in nursing. However, limited evidence exists to inform nursing management practices for sustainability. This qualitative study was conducted using a national convenience sample of 15 Chief Nursing Officers of Magnet Recognized hospitals in the USA. Key macrosystem facilitators included executive management and leadership themes about quality, people, education, and the nurse executive's commitment and intent. Barriers were executive management turnover and financial challenges. Infrastructure supports and resources for empowerment and quality and unit leadership practices were found to be essential for quality outcomes. The key theme at the microsystem level was moving nursing practice to managing outcomes from tasks; barriers were challenges with unit management turnover and development. Multiple factors at system levels were found to contribute to sustainability. Further research is needed on the concept of sustainability. The findings contribute to executives' armamentarium to inform management practice for the design of evidenced based organizational systems and programs for nursing excellence. © 2011 The Authors. Journal compilation © 2011 Blackwell Publishing Ltd.

  4. Speech Recognition

    Directory of Open Access Journals (Sweden)

    Adrian Morariu

    2009-01-01

    Full Text Available This paper presents a method of speech recognition by pattern recognition techniques. Learning consists in determining the unique characteristics of a word (cepstral coefficients by eliminating those characteristics that are different from one word to another. For learning and recognition, the system will build a dictionary of words by determining the characteristics of each word to be used in the recognition. Determining the characteristics of an audio signal consists in the following steps: noise removal, sampling it, applying Hamming window, switching to frequency domain through Fourier transform, calculating the magnitude spectrum, filtering data, determining cepstral coefficients.

  5. Environmental remediation and waste management in the United States

    International Nuclear Information System (INIS)

    Muntzing, L.M.; Person, J.C.

    1994-01-01

    Environmental remediation of radioactively and chemically contaminated sites represents one of the most complex challenges of our age. It is currently a problem at nuclear weapons sites in the Unites States, but as the civilian nuclear industry everywhere deals with decommissioning and decontamination, the lessons learned from these early activities will be influential. The task is challenging for several reasons. First, standards governing remedial action are complex and constantly evolving. Second, unless contaminated material is to be stabilized in place, it must be removed and sent to another facility for storage and ultimate disposal. Third, the task is technically demanding. Those who undertake the challenge must be technically sophisticated, creative, and innovative. Fourth, the challenge is a risky one. Those who seek to remediate past contamination may find themselves exposed to expanding and unfair allegations of liability for that very contamination. Finally, there is often a basic crisis of public confidence regarding remediation efforts. This paper briefly outlines some of the liabilities surrounding environmental contracting and ways to minimize risks

  6. Status of United States civilian waste management program

    International Nuclear Information System (INIS)

    Lawrence, M.J.

    1984-01-01

    The Nuclear Waste Policy Act of 1982 confirms the Federal responsibility for nuclear waste management and provides for unprecedented involvement by States, Indian tribes and the public. The Act provides a comprehensive framework for disposing of spent nuclear fuel and high-level radioactive wastes of domestic origin generated by civilian nuclear power reactors. It establishes detailed schedules and procedures for selecting and developing geologic repositories; provides a mechanism for financing the cost of disposal; and sets forth other provisions relating to nuclear waste disposal. The other provisions of the Act include provision for a user-financed federal interim storage facility with time and quantity limitations, as well as strict Nuclear Regulatory Commission-prescribed eligibility criteria; a proposal for a Federally-owned and operated monitored retrievable storage (MRS) facility for the interim period prior to operation of a permanent repository; and provision for a Test and Evaluation Facility (TEF). This paper centers on the schedule and current status and siting of the first two geologic repositories

  7. Human resource management and unit performance in knowledge-intensive work.

    Science.gov (United States)

    Kehoe, Rebecca R; Collins, Christopher J

    2017-08-01

    To clarify the potential value of a targeted system of human resource (HR) practices, we explore the unique effects of a relationship-oriented HR system and the more commonly studied high commitment HR system on unit performance in the context of knowledge-intensive work. We develop theoretical arguments suggesting that the high commitment HR system contributes to unit performance through its positive effects on employees' collective organizational commitment, general and firm-specific human capital, and access to knowledge. We argue that the relationship-oriented HR system contributes to unit performance through its positive effects on employees' collective access to knowledge by fostering a social context and interpersonal exchange conditions which support employees' ongoing access to knowledge flows within and outside their unit and broader organization. Based on unit-level data collected from a matched sample of employees and managers in 128 units in the science and engineering division of a large hydroelectric power organization, our results suggest that the targeted, relationship-oriented HR system is related to firm performance and may complement a broader, high commitment approach to managing knowledge workers. Specifically, the positive relationship between the high commitment HR system and unit performance is mediated by employees' collective organizational commitment, firm-specific human capital, and access to knowledge in other organizational units; whereas the positive relationship between the relationship-oriented HR system and unit performance is mediated by units' access to knowledge within the unit, in other units, and outside the organization. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  8. Defining management units for cetaceans by combining genetics, morphology, acoustics and satellite tracking

    Directory of Open Access Journals (Sweden)

    Signe Sveegaard

    2015-01-01

    Full Text Available Managing animal units is essential in biological conservation and requires spatial and temporal identification of such units. Since even neighbouring populations often have different conservation status and face different levels of anthropogenic pressure, detailed knowledge of population structure, seasonal range and overlap with animals from neighbouring populations is required to manage each unit separately. Previous studies on genetic structure and morphologic separation suggests three distinct populations of harbour porpoises with limited geographic overlap in the North Sea (NS, the Belt Sea (BS and the Baltic Proper (BP region. In this study, we aim to identify a management unit for the BS population of harbour porpoises. We use Argos satellite data and genetics from biopsies of tagged harbour porpoises as well as acoustic data from 40 passive acoustic data loggers to determine management areas with the least overlap between populations and thus the least error when abundance and population status is estimated. Discriminant analysis of the satellite tracking data from the BS and NS populations showed that the best fit of the management unit border during the summer months was an east–west line from Denmark to Sweden at latitude 56.95°N. For the border between BS and BP, satellite tracking data indicate a sharp decline in population density at 13.5°E, with 90% of the locations being west of this line. This was supported by the acoustic data with the average daily detection rate being 27.5 times higher west of 13.5°E as compared to east of 13.5°E. By using this novel multidisciplinary approach, we defined a management unit for the BS harbour porpoise population. We recommend that these boundaries are used for future monitoring efforts of this population under the EU directives. The boundaries may also be used for conservation efforts during the summer months, while seasonal movements of harbour porpoises should be considered during

  9. The impact of municipal solid waste management on greenhouse gas emissions in the United States.

    Science.gov (United States)

    Weitz, Keith A; Thorneloe, Susan A; Nishtala, Subba R; Yarkosky, Sherry; Zannes, Maria

    2002-09-01

    Technological advancements, environmental regulations, and emphasis on resource conservation and recovery have greatly reduced the environmental impacts of municipal solid waste (MSW) management, including emissions of greenhouse gases (GHGs). This study was conducted using a life-cycle methodology to track changes in GHG emissions during the past 25 years from the management of MSW in the United States. For the baseline year of 1974, MSW management consisted of limited recycling, combustion without energy recovery, and landfilling without gas collection or control. This was compared with data for 1980, 1990, and 1997, accounting for changes in MSW quantity, composition, management practices, and technology. Over time, the United States has moved toward increased recycling, composting, combustion (with energy recovery) and landfilling with gas recovery, control, and utilization. These changes were accounted for with historical data on MSW composition, quantities, management practices, and technological changes. Included in the analysis were the benefits of materials recycling and energy recovery to the extent that these displace virgin raw materials and fossil fuel electricity production, respectively. Carbon sinks associated with MSW management also were addressed. The results indicate that the MSW management actions taken by U.S. communities have significantly reduced potential GHG emissions despite an almost 2-fold increase in waste generation. GHG emissions from MSW management were estimated to be 36 million metric tons carbon equivalents (MMTCE) in 1974 and 8 MMTCE in 1997. If MSW were being managed today as it was in 1974, GHG emissions would be approximately 60 MMTCE.

  10. Salamander chytrid fungus (Batrachochytrium salamandrivorans) in the United States—Developing research, monitoring, and management strategies

    Science.gov (United States)

    Grant, Evan H. Campbell; Muths, Erin L.; Katz, Rachel A.; Canessa, Stefano; Adams, Michael J.; Ballard, Jennifer R.; Berger, Lee; Briggs, Cheryl J.; Coleman, Jeremy; Gray, Matthew J.; Harris, M. Camille; Harris, Reid N.; Hossack, Blake R.; Huyvaert, Kathryn P.; Kolby, Jonathan E.; Lips, Karen R.; Lovich, Robert E.; McCallum, Hamish I.; Mendelson, Joseph R.; Nanjappa, Priya; Olson, Deanna H.; Powers, Jenny G.; Richgels, Katherine L. D.; Russell, Robin E.; Schmidt, Benedikt R.; Spitzen-van der Sluijs, Annemarieke; Watry, Mary Kay; Woodhams, Douglas C.; White, C. LeAnn

    2016-01-20

    The recently (2013) identified pathogenic chytrid fungus, Batrachochytrium salamandrivorans (Bsal), poses a severe threat to the distribution and abundance of salamanders within the United States and Europe. Development of a response strategy for the potential, and likely, invasion of Bsal into the United States is crucial to protect global salamander biodiversity. A formal working group, led by Amphibian Research and Monitoring Initiative (ARMI) scientists from the U.S. Geological Survey (USGS) Patuxent Wildlife Research Center, Fort Collins Science Center, and Forest and Rangeland Ecosystem Science Center, was held at the USGS Powell Center for Analysis and Synthesis in Fort Collins, Colorado, United States from June 23 to June 25, 2015, to identify crucial Bsal research and monitoring needs that could inform conservation and management strategies for salamanders in the United States. Key findings of the workshop included the following: (1) the introduction of Bsal into the United States is highly probable, if not inevitable, thus requiring development of immediate short-term and long-term intervention strategies to prevent Bsal establishment and biodiversity decline; (2) management actions targeted towards pathogen containment may be ineffective in reducing the long-term spread of Bsal throughout the United States; and (3) early detection of Bsal through surveillance at key amphibian import locations, among high-risk wild populations, and through analysis of archived samples is necessary for developing management responses. Top research priorities during the preinvasion stage included the following: (1) deployment of qualified diagnostic methods for Bsal and establishment of standardized laboratory practices, (2) assessment of susceptibility for amphibian hosts (including anurans), and (3) development and evaluation of short- and long-term pathogen intervention and management strategies. Several outcomes were achieved during the workshop, including development

  11. Nurses' perception of their manager's leadership style and unit climate: are there generational differences?

    Science.gov (United States)

    Farag, Amany A; Tullai-McGuinness, Susan; Anthony, Mary K

    2009-01-01

    To describe and compare how nurses representing four age cohorts perceive their manager's leadership style and unit climate. The current workforce consists of nurses representing four generational cohorts. Nursing literature suggests that nurses from each age cohort think, behave and approach work differently. Limited empirical evidence, however, exists about how nurses from each age cohort perceive two aspects of their work environment: their managers' leadership style and unit climate. This cross-sectional, descriptive survey was conducted using a convenience sample of 475 registered nurses working in different inpatient units in three community non-magnet hospitals. Only nurses from Boomer and Gen-Xers had sufficient representation to be included in the data analysis. Nurses from the two main age cohorts did not differ in their perceptions of their manager's leadership style. Significant differences were found in two unit climate dimensions. The Gen-Xers had a less favourable perception of their unit climate related to warmth and belonging and administrative support. Nurse manager's might reflect on how they interact with different age cohorts; and to involve nurses from various age cohorts in the development of policies to create a flexible work environment.

  12. Using Lean principles to manage throughput on an inpatient rehabilitation unit.

    Science.gov (United States)

    Chiodo, Anthony; Wilke, Ruste; Bakshi, Rishi; Craig, Anita; Duwe, Doug; Hurvitz, Edward

    2012-11-01

    Performance improvement is a mainstay of operations management and maintenance of certification. In this study at a University Hospital inpatient rehabilitation unit, Lean management techniques were used to manage throughput of patients into and out of the inpatient rehabilitation unit. At the start of this process, the average admission time to the rehabilitation unit was 5:00 p.m., with a median time of 3:30 p.m., and no patients received therapy on the day of admission. Within 8 mos, the mean admission time was 1:22 p.m., 50% of the patients were on the rehabilitation unit by 1:00 p.m., and more than 70% of all patients received therapy on the day of admission. Negative variance from this performance was evaluated, the identification of inefficient discharges holding up admissions as a problem was identified, and a Lean workshop was initiated. Once this problem was tackled, the prime objective of 70% of patients receiving therapy on the date of admission was consistently met. Lean management tools are effective in improving throughput on an inpatient rehabilitation unit.

  13. The Development Strategies for the Management Models of the Electronic Documents and Records in the United States, United Kingdom and Australia

    Directory of Open Access Journals (Sweden)

    Chiu-Yen Lin

    2015-06-01

    Full Text Available The trend toward electronic government has espoused a large quantity of electronic records, which challenge the existing records management models in the modern countries. This paper describes and compares the development and transition toward electronic records management in the United States, United Kingdom, and Australia to show how the three advanced countries evolved the government records management practices. The analysis emphasized on the holistic policy initiative perspective and compared the directives and regulations, research and development programs and plans, the emerging structures of governance, staffing and professional training, and risk management provisions. The comparison may shed lights on the government electronic management in the other countries. [Article content in Chinese

  14. Effect of CRAC units layout on thermal management of data center

    International Nuclear Information System (INIS)

    Nada, S.A.; Said, M.A.

    2017-01-01

    Highlights: • CFD study of thermal management in data centers. • Effects of layout arrangements of the CRACs units relative to the racks array on data center performance. • Design guide liens for data centers energy efficiency improvements. - Abstract: Comprehensive numerical studies of thermal management of data centers were presented by several investigators for different geometric and operating conditions of data centers. In the present work, a technical note regarding the effect of the computer room air conditioning (CRAC) units layout arrangements is presented. Two arrangements of CRAC units layouts are investigated; namely locating CRACs units in line with the racks row and locating the CRACs units perpendicular to the rack row. Temperature distributions, air flow characteristics particularly air recirculation and bypass and thermal management in data centers are evaluated in terms of the measureable overall performance parameters: supply/return heat indices (SHI/RHI) and return temperature indices (RTI). The results showed that locating CRAC units perpendicular to the racks row has the following effects: (i) enhances the uniformity of the air flow from the perforated tiles along the rack row, (ii) reduces the hot air recirculation at the ends racks of the row and the cold air bypass at the middle rack of the row and (iii) enhances the data center performance parameters RTI, SHI and RHI.

  15. Effect of stress management interventions on job stress among nurses working in critical care units.

    Science.gov (United States)

    Light Irin, C; Bincy, R

    2012-01-01

    Stress in nurses affects their health and increases absenteeism, attrition rate, injury claims, infection rates and errors in treating patients. This in turn significantly increases the cost of employment in healthcare units. Proper management of stress ensures greater efficiency at work place and improved wellbeing of the employee. Therefore, a pre-experimental study was conducted among 30 Critical Care Unit nurses working inMedical College Hospital, Thiruvananthapuram, (Kerala) to assess the effect of stress management interventions such as Job Stress Awareness, Assertiveness Training, Time Management, andProgressive Muscle Relaxation on job stress. The results showed that caring for patients, general job requirements and workload were the major sources of stress for the nurses. The level of severe stress was reduced from 60 percent to 20 percent during post-test. The Stress Management Interventions were statistically effective in reducing the stress of nurses at p<0.001 level.

  16. Science, society, and America's nuclear waste: Unit 4, The waste management system

    International Nuclear Information System (INIS)

    1992-01-01

    This is the teachers guide to unit 4, (The Waste Management System), of a four-unit secondary curriculum. It is intended to provide information about scientific and societal issues related to the management of spent nuclear fuel from generation of electricity at nuclear powerplants and high-level radioactive waste from US national defense activities. The curriculum, supporting classroom activities, and teaching materials present a brief discussion of energy and electricity generation, including that produced at nuclear powerplants; information on sources, amounts, location, and characteristics of spent nuclear fuel and high-level radioactive waste; sources, types and effects of radiation; US policy for managing and disposing of spent nuclear fuel and high-level radioactive waste and what other countries are doing; and the components of the nuclear waste management system

  17. Science, society, and America's nuclear waste: Unit 4, The waste management system

    International Nuclear Information System (INIS)

    1992-01-01

    This is unit 4 (The Waste Management System) in a four-unit secondary curriculum. It is intended to provide information about scientific and societal issues related to the management of spent nuclear fuel from generation of electricity at nuclear powerplants and high-level radioactive waste from US national defense activities. The curriculum, supporting classroom activities, and teaching materials present a brief discussion of energy and electricity generation, including that produced at nuclear powerplants; information on sources, amounts, location, and characteristics of spent nuclear fuel and high-level radioactive waste; sources, types and effects of radiation; US policy for managing and disposing of spent nuclear fuel and high-level radioactive waste and what other countries are doing; and the components of the nuclear waste management system

  18. Organizational and safety culture in Canadian intensive care units: relationship to size of intensive care unit and physician management model.

    Science.gov (United States)

    Dodek, Peter M; Wong, Hubert; Jaswal, Danny; Heyland, Daren K; Cook, Deborah J; Rocker, Graeme M; Kutsogiannis, Demetrios J; Dale, Craig; Fowler, Robert; Ayas, Najib T

    2012-02-01

    The objectives of this study are to describe organizational and safety culture in Canadian intensive care units (ICUs), to correlate culture with the number of beds and physician management model in each ICU, and to correlate organizational culture and safety culture. In this cross-sectional study, surveys of organizational and safety culture were administered to 2374 clinical staff in 23 Canadian tertiary care and community ICUs. For the 1285 completed surveys, scores were calculated for each of 34 domains. Average domain scores for each ICU were correlated with number of ICU beds and with intensivist vs nonintensivist management model. Domain scores for organizational culture were correlated with domain scores for safety culture. Culture domain scores were generally favorable in all ICUs. There were moderately strong positive correlations between number of ICU beds and perceived effectiveness at recruiting/retaining physicians (r = 0.58; P organizational and safety culture. Differences in perceptions between staff in larger and smaller ICUs highlight the importance of teamwork across units in larger ICUs. Copyright © 2012 Elsevier Inc. All rights reserved.

  19. Site-specific waste management instruction for the 100-KR-4 Operable Unit drilling

    International Nuclear Information System (INIS)

    Hadley, J.T.

    1996-07-01

    This site-specific waste management instruction provides guidance for the management of waste generated as a result of groundwater well installations in the 100-KR-4 Operable Unit (OU). The well installations are necessary to implement the Remedial Action (RA) option (pump-and-treat using ion exchange) to prevent discharge of hexavalent chromium at levels above those considered protective of aquatic life in the Columbia River and riverbed sediments

  20. Site-specific waste management instruction for the 100-KR-4 Operable Unit drilling. Revision 1

    International Nuclear Information System (INIS)

    Hadley, J.T.

    1996-08-01

    This site-specific waste management instruction provides guidance for the management of waste generated as a result of groundwater well installations in the 100-KR-4 Operable Unit (OU). The well installations are necessary to implement the Remedial Action (RA) option (pump-and-treat using ion exchange) to prevent discharge of hexavalent chromium at levels above those considered protective of aquatic life in the Columbia River and riverbed sediments

  1. The Moderation of Cultural Difference on Consumer Relationship Management in Belgium, the United States, and China

    OpenAIRE

    He, Xun

    2017-01-01

    Customer relationship management (CRM) is a strategic approach aiming to create and improve shareholder value by creating and managing suitable relationships with their corresponding customer segments. As national culture is one of the fundamental factors that distinguishes customers from one country to another, the objective of this study is to explore how cultural factors influence CRM. Empirically, this study tests how different cultural dimensions from Belgium, the United States, and Chin...

  2. Achieving compliance with healthcare waste management regulations : empirical evidence from small European healthcare units

    OpenAIRE

    Botelho, Anabela

    2011-01-01

    Healthcare units generate substantial amounts of hazardous or potentially hazardous wastes as by-products of their medical services. The inappropriate management of these wastes poses significant risks to people and the environment. In Portugal, as in other EU countries, the collection, storage, treatment and disposal of healthcare waste is regulated by law. Although legal provisions covering the safe management of healthcare waste date back to the 1990s, little is known about the compliance ...

  3. The reality of waste management in primary health care units in Brazil.

    Science.gov (United States)

    Alves, Sergiane B; e Souza, Adenícia C S; Tipple, Anaclara F V; Rezende, Keyti C A D; de Resende, Fabiana R; Rodrigues, Érika G; Pereira, Milca S

    2014-09-01

    A large number of users are serviced in primary health care units in Brazil, both in health facilities and in households. These services generate waste that must be managed safely, but there is no legislation that regulates this type of waste management in Brazil. The objective of this study was to analyse the production and management of waste in primary health care. A direct observation was performed of the stages in the handling and weighing of waste generated in primary health care units in the municipality of Goiânia (Brazil). The units generated infectious, chemical, and common waste, as well as sharp objects. The generation of waste ranged between 0.027 and 0.075 kg user-day. The generated waste was classified mostly as common and recyclable. Flaws were observed in the management of all types of waste. The critical point is segregation. Only 34.1% of the waste disposed of as infectious actually belonged to this group, the rest was ordinary waste. Flaws at this stage increase the volume of infectious waste, the occupational and environmental risks, and associated costs. Intervention to change this reality is needed and it requires the careful preparation of a waste management plan, corroborating structural changes to the implementation of this plan, and professional training and public policies to guide waste management in primary care, especially those generated in households. © The Author(s) 2014.

  4. Barriers to implementation of risk management for federal wildland fire management agencies in the United States

    Science.gov (United States)

    Dave Calkin; Matthew P. Thompson; Alan A. Ager; Mark Finney

    2010-01-01

    In this presentation we review progress towards the implementation of a risk-based management framework for U.S. Federal wildland fire policy and operations. We first describe new developments in wildfire simulation technology that catalyzed the development of risk-based decision support systems for strategic wildfire management. These systems include new analytical...

  5. Functioning of primary health care in opinion of managers of primary health care units.

    Science.gov (United States)

    Bojar, I; Wdowiak, L; Kwiatosz-Muc, M

    2006-01-01

    The aim of the research is to get to know opinions of primary health care managers concerning working of primary health care and concerning quality of medical services offered by family doctors out-patient clinics. The research among managers of primary health care units took place in all out-patient clinics in Lublin province. Research instrument was survey questionnaire of authors own construction. Results were statistically analyzed. From 460 surveys sent, 108 questionnaires were accepted to analysis. Majority of managers of out-patient clinics of primary health care is satisfied with the way and the quality of work of employed staff. In opinion of 71.3% of managers access to family doctor services is very good. Availability of primary health care services is better estimated by managers of not public units. The occupied local provide comfortable work for the staff in opinion of 78.5% of surveyed managers of out-patient clinics. Managers estimate the level of their services as very good (37.96%) and good (37.96%) comparing to other such a subjects present in the market. Internal program of improving quality is run in 22% of out-patient clinics, which were investigated. Managers of primary health care units assess the quality of their services as good and very good. They estimate positively the comfort and politeness in serving patients as well as technical status of equipment and the lodging. They assess availability of their services as very good. Large group of managers of family doctors practices recognizes neighborhood practices as a competitors.

  6. Genetic specificity of face recognition.

    Science.gov (United States)

    Shakeshaft, Nicholas G; Plomin, Robert

    2015-10-13

    Specific cognitive abilities in diverse domains are typically found to be highly heritable and substantially correlated with general cognitive ability (g), both phenotypically and genetically. Recent twin studies have found the ability to memorize and recognize faces to be an exception, being similarly heritable but phenotypically substantially uncorrelated both with g and with general object recognition. However, the genetic relationships between face recognition and other abilities (the extent to which they share a common genetic etiology) cannot be determined from phenotypic associations. In this, to our knowledge, first study of the genetic associations between face recognition and other domains, 2,000 18- and 19-year-old United Kingdom twins completed tests assessing their face recognition, object recognition, and general cognitive abilities. Results confirmed the substantial heritability of face recognition (61%), and multivariate genetic analyses found that most of this genetic influence is unique and not shared with other cognitive abilities.

  7. [Analysis of the safety culture in a Cardiology Unit managed by processes].

    Science.gov (United States)

    Raso-Raso, Rafael; Uris-Selles, Joaquín; Nolasco-Bonmatí, Andreu; Grau-Jornet, Guillermo; Revert-Gandia, Rosa; Jiménez-Carreño, Rebeca; Sánchez-Soriano, Ruth M; Chamorro-Fernández, Carlos I; Marco-Francés, Elvira; Albero-Martínez, José V

    2017-04-04

    Safety culture is one of the requirements for preventing the occurrence of adverse effects. However, this has not been studied in the field of cardiology. The aim of this study is to evaluate the safety culture in a cardiology unit that has implemented and certified an integrated quality and risk management system for patient safety. A cross-sectional observational study was conducted in 2 consecutive years, with all staff completing the Spanish version of the questionnaire, "Hospital Survey on Patient Safety Culture" of the "Agency for Healthcare Research and Quality", with 42 items grouped into 12 dimensions. The percentage of positive responses in each dimension in 2014 and 2015 were compared, as well as national data and United States data, following the established rules. The overall assessment out of a possible 5, was 4.5 in 2014 and 4.7 in 2015. Seven dimensions were identified as strengths. The worst rated were: staffing, management support and teamwork between units. The comparison showed superiority in all dimensions compared to national data, and in 8 of them compared to American data. The safety culture in a Cardiology Unit with an integrated quality and risk management patient safety system is high, and higher than nationally in all its dimensions and in most of them compared to the United States. Copyright © 2017 Instituto Nacional de Cardiología Ignacio Chávez. Publicado por Masson Doyma México S.A. All rights reserved.

  8. Behavioral Management Leads to Reduction in Aggression in a Child and Adolescent Psychiatric Inpatient Unit

    Science.gov (United States)

    Dean, Angela J.; Duke, Suzanne G.; George, Michelle; Scott, James

    2007-01-01

    Objective: Aggression is common in children and adolescents admitted to psychiatric inpatient units. Few interventions for reducing aggressive behaviors have been identified. This study aimed to evaluate the impact of a milieu-based behavioral management program on the frequency of aggressive behaviors in a child and adolescent mental health…

  9. Smoke modeling in support of management of forest landscapes in the eastern United States

    Science.gov (United States)

    Gary L. Achtemeier

    2009-01-01

    The impact of smoke from forest burning on air quality is a threat to the use of prescribed fire to manage woodlands in the eastern United States. Population shifts from urban centers to the wildland/urban interface have increased human exposures to smoke. Tighter national ambient air quality standards restrict the amount of smoke released over an area. This article...

  10. The Moral Reasoning of Sports Management Students in the United States and Italy

    Science.gov (United States)

    Forte, Almerinda

    2013-01-01

    The researcher analyzed the moral reasoning ability of Sports Management students in the United States and Italy. The researcher statistically analyzed data collected through a survey questionnaire designed to measure moral reasoning. The Defining Issues Test (DIT) developed by James Rest using Kohlberg's six stages of moral judgment was used in…

  11. A tool for the auto-management of Units of Learning: the Link Tool

    NARCIS (Netherlands)

    Pérez-Sanagustín, Mar; Cherian, Roy; Hernández-Leo, Davinia; Griffiths, Dai; Blat, Josep

    2009-01-01

    Pérez-Sanagustín, M., Cherian, R., Hernández-Leo, D., Griffiths, D., & Blat, J. (2010). A tool for the auto-management of Units of Learning: the Link Tool. In D. Griffiths, & R. Koper (Eds.), Rethinking Learning and Employment at a Time of Economic Uncertainty. Proceedings of the 6th TENCompetence

  12. Litter Control, Waste Management, and Recycling Resource Unit, K-6. Bulletin 1722.

    Science.gov (United States)

    Louisiana State Dept. of Education, Baton Rouge.

    This unit provides elementary teachers with ideas for assisting their students in developing an understanding and appreciation of sound resource use. It contains projects and activities that focus on both the litter problem and on waste management solutions. These materials can be adapted and modified to accommodate different grade levels and…

  13. The development of the portfolio management for the unit investment funds

    OpenAIRE

    Sergeeva, Irina; Nikiforova, Vera

    2012-01-01

    The paper analyses common Russian practice of assessment of the effectiveness of the unit investment fund portfolio management based on the risk/return tradeoff. The paper identifies characteristics, advantages and disadvantages of various portfolio risk measures, and introduces the approach to risk assessment based on the analytical coefficient calculations.

  14. An emerging paradigm for managing protected areas with examples from Europe and the United States

    Science.gov (United States)

    James Absher; Carsten Mann

    2010-01-01

    Parks and Protected Areas (PPA) have become increasingly important for societal well-being in Europe and the United States. Urbanization, detachment from nature, and demographic changes are fostering discussions about strengthening the social and cultural dimensions of management. The complexities and subtleties of incorporating PPAs into existing government and...

  15. 40 CFR 264.101 - Corrective action for solid waste management units.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 25 2010-07-01 2010-07-01 false Corrective action for solid waste management units. 264.101 Section 264.101 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE TREATMENT, STORAGE, AND DISPOSAL FACILITIES Releases From Soli...

  16. Crew resource management training in the intensive care unit. A multisite controlled before–after study

    NARCIS (Netherlands)

    Kemper, Peter F.; de Bruijne, Martine; van Dyck, C.; Wagner, Cordula

    Introduction There is a growing awareness today that adverse events in the intensive care unit (ICU) are more often caused by problems related to non-technical skills than by a lack of technical, or clinical, expertise. Team training, such as crew resource management (CRM), aims to improve these

  17. Crew resource management training in the intensive care unit: a multisite controlled before-after study.

    NARCIS (Netherlands)

    Kemper, P.F.; Bruijne, M. de; Dyck, C. van; So, R.L.; Tangkau, P.; Wagner, C.

    2016-01-01

    Introduction There is a growing awareness today that adverse events in the intensive care unit (ICU) are more often caused by problems related to non-technical skills than by a lack of technical, or clinical, expertise. Team training, such as crew resource management (CRM), aims to improve these

  18. Firefighters United for Safety, Ethics, and Ecology (FUSEE): Torchbearers for a new fire management paradigm

    Science.gov (United States)

    Timothy Ingalsbee; Joseph Fox; Patrick Withen

    2007-01-01

    Firefighters United for Safety, Ethics, and Ecology (FUSEE) is a nonprofit organization promoting safe, ethical, ecological wildland fire management. FUSEE believes firefighter and community safety are ultimately interdependent with ethical public service, wildlands protection, and ecological restoration of fire-adapted ecosystems. Our members include current, former,...

  19. Management of infections in critically ill returning travellers in the intensive care unit-II

    DEFF Research Database (Denmark)

    Rello, Jordi; Manuel, Oriol; Eggimann, Philippe

    2016-01-01

    This position paper is the second ESCMID Consensus Document on this subject and aims to provide intensivists, infectious disease specialists, and emergency physicians with a standardized approach to the management of serious travel-related infections in the intensive care unit (ICU) or the emerge...

  20. Annosus Root Disease Hazard Rating, Detection, and Management Strategies in the Southeastern United States

    Science.gov (United States)

    S. A. Alexander

    1989-01-01

    Annosus root disease (ARD), is the major root disease of pines in the southeastern United States where severely affected trees exhibit growth loss. Assessing the potential damage of ARD is essential for making effective disease control and management decisions. A soil hazard rating system developed to identify potential for tree mortality is described. The Annosus...

  1. Geographic considerations for fire management in the Eastern United States: geomorphology and topography, soils, and climate

    Science.gov (United States)

    Barton D. Clinton; James M. Vose; Erika C. Cohen

    2012-01-01

    Across the Eastern United States, there is on average an estimated 36 MT ha–1 (16 tons ac–1) of dead woody fuel (Chojnacky and others 2004). Variations in fuel type, size, and flammability make the selection of treatment options critical for effective fuels management. The region is a complex landscape characterized by...

  2. Why business unit controllers bias accounting figures: Involvement in management, social pressure and Machiavellianism

    NARCIS (Netherlands)

    Maas, V.S.; Hartmann, F.G.H.

    2009-01-01

    This paper investigates why some business unit controllers are more likely to deliberately bias accounting data than others. Different from the existing literature, we argue that involvement in management and social pressure are neither necessary, nor sufficient conditions for biasing behavior.

  3. Effect of Conceptual Change Texts for Overcoming Misconceptions in "People and Management" Unit

    Science.gov (United States)

    Dagdelen, Orhan; Kosterelioglu, Ilker

    2015-01-01

    This study aimed to investigate the effects of conceptual change texts in teaching concepts in the "People and Management" Unit of a Social Studies Course. The working group of the study was composed of 4th graders in a primary school in Çorum, assigned as control (n = 23) and experimental (n = 23) groups. Non-equivalent control group…

  4. A distributed control algorithm for internal flow management in a multi-zone climate unit

    NARCIS (Netherlands)

    Persis, C. De; Jessen, J.J.; Izadi-Zamanabadi, R.; Schiøler, H.

    2008-01-01

    We examine a distributed control problem for internal flow management in a multi-zone climate unit. The problem consists of guaranteeing prescribed indoor climate conditions in a cascade connection of an arbitrarily large number of communicating zones, in which air masses are exchanged to redirect

  5. The Role of an Academic Development Unit in Supporting Institutional VET Learning and Teaching Change Management

    Science.gov (United States)

    Fotinatos, Nina

    2016-01-01

    The aim of this paper is to examine the role and impact of a central academic development unit (ADU) within an institutional strategic and operational change management project. The primary goal of this project was to improve vocational education and training (VET) learning and teaching practice in an Australian dual-sector regional university.…

  6. Innovative solutions: sample financial management business plan: neurosurgical intensive care unit.

    Science.gov (United States)

    Villanueva-Baldonado, Analiza; Barrett-Sheridan, Shirley E

    2010-01-01

    This article describes one institution's intention to implement a financial management business plan for a neurosurgical intensive care unit in a level I trauma center. The financial objective of this proposed business plan includes a service increase in the patient population requiring critical care in a way that will help control costs.

  7. A Methodology for Building Faculty Support for the United Nations Principles for Responsible Management Education

    Science.gov (United States)

    Maloni, Michael J.; Smith, Shane D.; Napshin, Stuart

    2012-01-01

    Evidence from extant literature indicates that faculty support is a critical driver for implementing the United Nations Principles for Responsible Management Education (PRME), particularly for schools pursuing an advanced, cross-disciplinary level of sustainability integration. However, there is limited existing research offering insight into how…

  8. Closure of hazardous and mixed radioactive waste management units at DOE facilities

    International Nuclear Information System (INIS)

    1990-06-01

    This is document addresses the Federal regulations governing the closure of hazardous and mixed waste units subject to Resource Conservation and Recovery Act (RCRA) requirements. It provides a brief overview of the RCRA permitting program and the extensive RCRA facility design and operating standards. It provides detailed guidance on the procedural requirements for closure and post-closure care of hazardous and mixed waste management units, including guidance on the preparation of closure and post-closure plans that must be submitted with facility permit applications. This document also provides guidance on technical activities that must be conducted both during and after closure of each of the following hazardous waste management units regulated under RCRA

  9. Communication received from the United States of America concerning its policies regarding the management of plutonium

    International Nuclear Information System (INIS)

    2002-01-01

    The Secretariat has received a letter dated 9 May 2002 from the Permanent Mission of the United States of America to the IAEA in which the Government of the United States in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, makes available an annual statement of its national holdings of civil unirradiated plutonium and of plutonium contained in spent civil reactor fuel, as of 31 December 2000. In the light of the request expressed by the United States in its note verbale of 1 December 1997, concerning its policies regarding the management of plutonium (INFCIRC/549 of 16 March 1998), the texts of the enclosure of the letter of 9 May 2002 are attached for the information of all Member States

  10. Communication Received from the United States of America Concerning its Policies Regarding the Management of Plutonium

    International Nuclear Information System (INIS)

    2014-01-01

    The Secretariat has received a note verbale dated 14 March 2014 from the Permanent Mission of the United States of America to the IAEA in the enclosures of which the Government of the United States of America, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the “Guidelines”), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2012. In light of the request expressed by the Government of the United States of America in its note verbale of 1 December 1997 concerning its policies regarding the management of plutonium (INFCIRC/549 of 16 March 1998), the note verbale of 14 March 2014 and the enclosures therewith are attached for the information of all Member States

  11. Communication received from the United States of America concerning its policies regarding the management of plutonium

    International Nuclear Information System (INIS)

    2003-01-01

    The Secretariat has received a letter, dated 15 September 2003, from the Permanent Mission of the United States of America in the enclosures of which the Government of the United States of America, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2002. In light of the request expressed by the Government of the United States of America in its Note Verbale of 1 December 1997 concerning its policies regarding the management of plutonium (INFCIRC/549 of 16 March 1998), the enclosures of the letter of 15 September 2003 are attached for the information of all Member States

  12. Communication received from the United States of America concerning its policies regarding the management of plutonium

    International Nuclear Information System (INIS)

    2005-01-01

    The Secretariat has received a letter dated 24 May 2005 from the Permanent Mission of the United States of America to the IAEA in the enclosures of which the Government of the United States of America, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2003. In light of the request expressed by the Government of the United States of America in its Note Verbale of 1 December 1997 concerning its policies regarding the management of plutonium (INFCIRC/549 of 16 March 1998), the enclosures of the letter of 24 May 2005 are attached for the information of all Member States

  13. Communication received from the United States of America concerning its policies regarding the management of plutonium

    International Nuclear Information System (INIS)

    2005-01-01

    The Secretariat has received a letter dated 28 September 2005 from the Permanent Mission of the United States of America to the IAEA in the enclosures of which the Government of the United States of America, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2004. In light of the request expressed by the Government of the United States of America in its Note Verbale of 1 December 1997 concerning its policies regarding the management of plutonium (INFCIRC/549 of 16 March 1998), the enclosures of the letter of 28 September 2005 are attached for the information of all Member States

  14. [Therapeutic restraint management in Intensive Care Units: Phenomenological approach to nursing reality].

    Science.gov (United States)

    Acevedo-Nuevo, M; González-Gil, M T; Solís-Muñoz, M; Láiz-Díez, N; Toraño-Olivera, M J; Carrasco-Rodríguez-Rey, L F; García-González, S; Velasco-Sanz, T R; Martínez-Álvarez, A; Martin-Rivera, B E

    2016-01-01

    To identify nursing experience on physical restraint management in Critical Care Units. To analyse similarities and differences in nursing experience on physical restraint management according to the clinical context that they are involved in. A multicentre phenomenological study was carried out including 14 Critical Care Units in Madrid, classified according to physical restraint use: Common/systematic use, lacking/personalised use, and mixed use. Five focus groups (23 participants were selected following purposeful sampling) were convened, concluding in data saturation. Data analysis was focused on thematic content analysis following Colaizzi's method. Six main themes: Physical restraint meaning in Critical Care Units, safety (self-retreat vital devices), contribution factors, feelings, alternatives, and pending issues. Although some themes are common to the 3 Critical Care Unit types, discourse differences are found as regards to indication, feelings, systematic use of pain and sedation measurement tools. In order to achieve real physical restraint reduction in Critical Care Units, it is necessary to have a deep understanding of restraints use in the specific clinical context. As self-retreat vital devices emerge as central concept, some interventions proposed in other settings could not be effective, requiring alternatives for critical care patients. Discourse variations laid out in the different Critical Care Unit types could highlight key items that determine the use and different attitudes towards physical restraint. Copyright © 2015 Elsevier España, S.L.U. y SEEIUC. All rights reserved.

  15. Sustainable Materials Management (SMM) - Materials and Waste Management in the United States Key Facts and Figures

    Data.gov (United States)

    U.S. Environmental Protection Agency — Each year EPA produces a report called Advancing Sustainable Materials Management: Facts and Figures. It includes information on municipal solid waste (MSW)...

  16. [Managing the basic health unit in tuberculosis control: a field of challenges].

    Science.gov (United States)

    Protti, Simone Teresinha; da Silva, Laís Mara Caetano; Palha, Pedro Fredemir; Villa, Tereza Cristina Scatena; Ruffino-Neto, Antonio; Nogueira, Jordana de Almeida; de Sá, Lenilde Duarte

    2010-09-01

    In this study we analyzed the management of Basic Health Units in terms of Tuberculosis (TB) control in a city in the interior of São Paulo state. Fourteen managers participated in the study. A closed questionnaire was administered and an open question was also applied. The interview was carried out after obtaining free and informed consent. Data analysis was performed using the Statsoft software Statistica 8.0 and thematic content analysis was used for the qualitative data. It was found there is a clear technical-bureaucratic management, deficient in the activity planning and organization dimensions at the BHU. Hence, health care managers in this study should include management aspects of planning and organization as ways to make TB control feasible.

  17. [Investigation of doctors' and nurses' perceptions and implementation of delirium management in intensive care unit].

    Science.gov (United States)

    Luo, H B; Wang, X T; Tang, B; Zhu, Z N; Guo, H L; Li, Z Z; Sun, J H; Liu, D W

    2017-12-01

    Objective: To investigate doctors' and nurses' perceptions and implementation of delirium management in intensive care unit. Methods: A total of 197 doctors and nurses in 2 general ICUs and 3 special ICUs at Peking Union Medical College Hospital finished a self-designed questionnaire of delirium management. Results: There were 47 males and 150 females, 43 doctors and 154 nurses who participated in the survey.One hundred and twenty five participators were from general ICU and the others from special ICU. The ICU staff had a significant difference on the perceptions and implementation of delirium management( P delirium assessment" ( P delirium management,especially in special ICUs. Delirium management should be included as a routine care in ICU to improve patients' outcome.

  18. [IMPLEMENTATION OF A QUALITY MANAGEMENT SYSTEM IN A NUTRITION UNIT ACCORDING TO ISO 9001:2008].

    Science.gov (United States)

    Velasco Gimeno, Cristina; Cuerda Compés, Cristina; Alonso Puerta, Alba; Frías Soriano, Laura; Camblor Álvarez, Miguel; Bretón Lesmes, Irene; Plá Mestre, Rosa; Izquierdo Membrilla, Isabel; García-Peris, Pilar

    2015-09-01

    the implementation of quality management systems (QMS) in the health sector has made great progress in recent years, remains a key tool for the management and improvement of services provides to patients. to describe the process of implementing a quality management system (QMS) according to the standard ISO 9001:2008 in a Nutrition Unit. the implementation began in October 2012. Nutrition Unit was supported by Hospital Preventive Medicine and Quality Management Service (PMQM). Initially training sessions on QMS and ISO standards for staff were held. Quality Committee (QC) was established with representation of the medical and nursing staff. Every week, meeting took place among members of the QC and PMQM to define processes, procedures and quality indicators. We carry on a 2 months follow-up of these documents after their validation. a total of 4 processes were identified and documented (Nutritional status assessment, Nutritional treatment, Monitoring of nutritional treatment and Planning and control of oral feeding) and 13 operating procedures in which all the activity of the Unit were described. The interactions among them were defined in the processes map. Each process has associated specific quality indicators for measuring the state of the QMS, and identifying opportunities for improvement. All the documents associated with requirements of ISO 9001:2008 were developed: quality policy, quality objectives, quality manual, documents and records control, internal audit, nonconformities and corrective and preventive actions. The unit was certified by AENOR in April 2013. the implementation of a QMS causes a reorganization of the activities of the Unit in order to meet customer's expectations. Documenting these activities ensures a better understanding of the organization, defines the responsibilities of all staff and brings a better management of time and resources. QMS also improves the internal communication and is a motivational element. Explore the satisfaction

  19. Integrated pest management and weed management in the United States and Canada.

    Science.gov (United States)

    Owen, Micheal D K; Beckie, Hugh J; Leeson, Julia Y; Norsworthy, Jason K; Steckel, Larry E

    2015-03-01

    There is interest in more diverse weed management tactics because of evolved herbicide resistance in important weeds in many US and Canadian crop systems. While herbicide resistance in weeds is not new, the issue has become critical because of the adoption of simple, convenient and inexpensive crop systems based on genetically engineered glyphosate-tolerant crop cultivars. Importantly, genetic engineering has not been a factor in rice and wheat, two globally important food crops. There are many tactics that help to mitigate herbicide resistance in weeds and should be widely adopted. Evolved herbicide resistance in key weeds has influenced a limited number of growers to include a more diverse suite of tactics to supplement existing herbicidal tactics. Most growers still emphasize herbicides, often to the exclusion of alternative tactics. Application of integrated pest management for weeds is better characterized as integrated weed management, and more typically integrated herbicide management. However, adoption of diverse weed management tactics is limited. Modifying herbicide use will not solve herbicide resistance in weeds, and the relief provided by different herbicide use practices is generally short-lived at best. More diversity of tactics for weed management must be incorporated in crop systems. © 2014 Society of Chemical Industry.

  20. Notes on critical care-review of seminal management and leadership papers in the United Kingdom.

    Science.gov (United States)

    Coombs, Maureen

    2009-06-01

    Review of recent critical care provision reveals substantial changes in clinical unit operating, and policy drivers influencing international critical care delivery. Practitioners who have worked in healthcare environments over this time, will have witnessed substantial shifts in healthcare policy, changes in professional body guidance and greater service evaluation have impacted on critical care management and leadership. This paper offers a personal perspective on seminal management and leadership papers published in the critical care literature over the past decade. Presenting a range of national and international work that utilise diverse approaches, ten key papers are highlighted that have impacted in the United Kingdom setting. Through this, the influence of the modernisation agenda, the increasing significance of outcome studies, and the need for flexible, interdependent practice emerges. A key message to surface from this paper is the need for all in critical care to engage with, and understand the wider implications of management and leadership change for critical care delivery.

  1. Acute stroke unit improves stroke management-four years on from INASC.

    Science.gov (United States)

    Shanahan, E; Keenan, R; Cunningham, N; O'Malley, G; O'Connor, M; Lyons, D; Peters, C

    2015-02-01

    The Irish Heart Foundation carried out the Irish National Audit of Stroke Care (INASC) in 2008. Management practices were significantly poorer than those in the UK Sentinel audits. Since then an acute stroke unit has been established in University Hospital Limerick. A stroke database was established. 12 key indicators of stroke management audited by INASC were identified. Results were compared to those in INASC. 89 stroke patients were admitted. 8 of the 12 key indicators scored significantly better than in INASC. 92.5% had a brain scan within 24hrs (INASC-40%, p = strokes received anti-thrombotics (INASC-85%, p = 0.001). 94% had rehab goals agreed by MDT (22% in INASC p = 0.0000). 55% were treated in stroke unit (2% in INASC, p = 0.0000). MDT input improved with regard to physiotherapy (87% vs 43% in INASC, p = Stroke management has significantly improved from 2008, however some deficiencies remain.

  2. Project Management Unit for decommissioning of NPP Bohunice VI (2003-2014)

    International Nuclear Information System (INIS)

    Gonzalez Fernandez-conde, A.; Brochet, I.; Ferreira, A.

    2015-01-01

    From October 2003 until december 2014 the Consortium consisting of Iberdrola Engineering and Construction (leader). Empresarios Agrupados Internacional, and Indra Sistemas has carried out the project Project Management Unit ((PMU) for the decommissioning of Bohunice V1 NPP (units 1 and 2), type VVER-440/V-230 in Slovakia. during the first phase (2003-2007) EdF was also part of the Consortium. The project is funded by the Bohunice International Decommissioning Support Fund (BIDSF) administered by the RBRD. The main objective of the project is to provide the necessary engineering and resources of project management for planning, execution, management, coordination and monitoring of all tasks in support of the decommissioning. (Author)

  3. Risk Management in Csr Unit of Shams Hospital Using FMEA Technique -Tabriz

    Directory of Open Access Journals (Sweden)

    Mohammad Saadati

    2015-08-01

    Full Text Available Background and Objectives : Since one of the effective ways to prevent infections is the proper sterilization of instruments, CSR is one of the most important units in hospitals. Thus, risk management has a high priority in CSR. The aim of this study was to identify and prevent potential risks in CSR unit in Shams Hospital using FMEA technique. Material and Methods : This is a descriptive and interventional study. Using FMEA technique, potential risks were identified. Risks were prioritized and corrective interventions were implemented to reduce risks. Results : The current study identified 69 risks that 10 risks were marked as high priority. Corrective activities were suggested by risk management teams which were applied. Conclusion : The results showed that flaws in safety policies, equipment and physical conditions were the most important risk factors. Implementing risk management plan and clear safety policies could be useful. ​

  4. Leadership skills for nursing unit managers to decrease intention to leave

    Directory of Open Access Journals (Sweden)

    Roche MA

    2015-05-01

    Full Text Available Michael A Roche,1 Christine Duffield,1,2 Sofia Dimitrelis,1 Belinda Frew1 1Centre for Health Services Management, Faculty of Health, University of Technology, Sydney, NSW, 2Clinical Nursing and Midwifery Research Centre, School of Nursing and Midwifery, Edith Cowan University, Joondalup, WA, Australia Aim: To examine specific elements of nursing leadership linked to intention to leave, in public acute care hospitals. Background: Nurse turnover is a global issue receiving widespread attention due to prolonged and projected workforce shortages. Nurse management and leadership qualities have been associated with intention to leave and turnover of nurses. The role of the nurse unit managers in the retention of nurses is becoming increasingly important, particularly because of their strong influence on the quality and stability of the work environment. Methods: Data were collected from 62 medical, surgical, and mixed units across eleven public acute care hospitals in three Australian states (September 2008 to August 2010. A total of 1,673 nurses completed a nurse survey that included measures of intention to leave and leadership aspects of the practice environment. Analyses explored specific leadership characteristics that were associated with turnover intent. Results: The role of nursing unit managers was confirmed to be a major factor in nurses’ intention to remain or leave their current workplace. Nurses valued “human” skills more highly than other leadership characteristics, including their manager’s connection with nurses’ concerns, clarity, participation in decisions, and encouragement. Conclusion: Strong leadership qualities in the nursing unit manager have been associated with greater job satisfaction, reduced turnover intention among nursing staff, and improved patient outcomes. Nurse leaders need to be supported in an effort to retain nurses given ongoing workforce issues and to ensure high-quality patient care. Keywords: nurse

  5. Communication Received from the United States of America Concerning Its Policies Regarding the Management of Plutonium

    International Nuclear Information System (INIS)

    2010-01-01

    The Secretariat has received a letter dated 13 October 2010 from the Permanent Mission of the United States of America to the IAEA in the enclosures of which the Government of the United States of America, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2009. The Permanent Mission of the United States has also communicated in its letter that there have been recent changes in its plutonium and fuel cycle policy to replace the statement, and has included a Revised Plutonium and Fuel Cycle Policy Statement provided with the report submitted by the United States for 2007 [es

  6. Communication Received from the United States of America Concerning Its Policies Regarding the Management of Plutonium

    International Nuclear Information System (INIS)

    2010-01-01

    The Secretariat has received a letter dated 13 October 2010 from the Permanent Mission of the United States of America to the IAEA in the enclosures of which the Government of the United States of America, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2009. The Permanent Mission of the United States has also communicated in its letter that there have been recent changes in its plutonium and fuel cycle policy to replace the statement, and has included a Revised Plutonium and Fuel Cycle Policy Statement provided with the report submitted by the United States for 2007

  7. Are wildfire management resources in the United States efficiently allocated to protect resources at risk? A case study from Montana

    Science.gov (United States)

    Derek T. O' Donnell; Tyron J. Venna; David E. Calkin

    2014-01-01

    Federal wildfire management agencies in the United States are under substantial pressure to reduce and economically justify their expenditures. To support economically efficient management of wildfires, managers need better estimates of the resource benefits and avoided damage costs associated with alternative wildfire management strategies. This paper reports findings...

  8. EVOLUTION OF THE FOREST MANAGEMENT PHILOSOPHY IN TURKEY: A CASE STUDY OF ARTVIN PLANNING UNIT

    Directory of Open Access Journals (Sweden)

    Hacı Ahmet Yolasığmaz

    2006-04-01

    Full Text Available Forest management plans were firstly prepared and implemented in Turkey between 1963 and 1973. All forests in Turkey have been managed with timber oriented forest management philosophy; however, there have been some developments about inventory and silviculture techniques for approximately 40 years. Last decade, Turkey participated in Convention of Biological Diversity in Rio (1992 and included in both Pan – European and Near East Region Conventions. Nowadays, Turkish forest management philosophy has changed from timber management to ecosystem-based multiple-use forest planning with the principles of “sustainable forest management” criteria and indicators drafted in a few national and international agreements. Thus, Turkish forestry is underway in a restructuring process. This paper presents evolution of the traditional forest management philosophy in Turkey since 1963. This study was carried out in Artvin Planning Unit. Past two decade planning periods (managed under timber management approach was compared with current case study data used for forest multiple use management approach based on ecosystem in terms of distribution of age class, site class and change of volume and increment. In conclusion, former applications and techniques for adaptation of improvement must be analyzed and interpreted properly. Monetary resources and experts as well as legal, technique and scientific framework must be provided.

  9. Rest lifetime evaluation and ageing management in NPP 'Kozloduy' unit 1-4

    International Nuclear Information System (INIS)

    Erve, M.; Heck, R.; Schmidt, J.; Daum, G.; Bataklieva, L.; Stoev, M.

    1999-01-01

    In 1992 as a result of an IAEA SRM review the 'WANO 6-month program' has been issued to improve operation, maintenance nad safety culture for the four WWER 440/230 units at the NPP 'Kozloduy' Siemens has awarded 3 contracts related to RTL evaluation of the main equipment, integrity of reactor pressure vessel and to the leak-before-break behaviour of the main piping od unit 2. It is pursuit an overall strategy that allows to: implement on the basis of RTL evaluation a long term ageing management program (AMAP) for Kozloduy's units 1-4 to assure their operation until the end of their design life; identify those components and equipment for which from the safety point of view urgent and immediate actions have to be performed; increase step by step the safety and reliability according to the Western standards and to internationally accepted safety culture; keep open the possibility of life extension as far as this would be technically feasible and acceptable and economically reasonable. Under the technical leadership of Siemens studies have been performed related to the subject of integrity and RTL, such as: reirradiation of RPV samples from Unit 1 and 2; evaluation of PV embrittlement of Unit 1; transfer of the results of LBB assessment of Unit 2 to Units 1, 3 and 4; transfer of results of RTL evaluation of Unit 2 to Units 1, 3 and 4; PTS analysis of RPV of Unit 1, 2,3 and 4. The main remarkable results are: no life-limiting mechanisms detected, requiring immediate actions, except for RPVs; residual lifetime determined for RPVs on reliable basis of advanced modern PTS analysis and sample testing; necessary activities in monitoring of ageing and in-service inspection clearly identified successful proof of lBB for main primary piping after slight modification of supports; international experts agreement reached (e.g. Risk Audit, successful IAEA experts meetings and OSART missions)

  10. Managed care market share and cesarean section rates in the United States: is there a link?

    Science.gov (United States)

    Hueston, W J; Sutton, A

    2000-11-01

    After peaking during the early 1980s, cesarean section rates in the United States have been falling for the last decade. At the same time, managed care enrollment has increased dramatically. This study examines whether managed care penetration in local markets is associated with lower cesarean section rates in those geographic area. A cross-sectional comparison of cesarean section rates and health maintenance organization (HMO) market penetration in 61 selected metropolitan areas in the United States was conducted. National birth certificate data for 1996 were used to calculate crude and race-adjusted cesarean section rates for residents in each area. No relationship between overall cesarean section rates in the metropolitan areas and managed care penetration was observed. Subanalyses of racial groups demonstrated the existence of a weak association between managed care penetration and cesarean section rates for white women (21.2% for the highest quartile of HMO penetration, compared with 19.1% for the lowest quartile; P = .03), but not for African-Americans or other minorities. Managed care penetration in a market may have an association with cesarean section rates for white women, but the strength of this relationship is small. Even if managed care delivery systems reduce cesarean section rates in their own populations, this change is likely to have only a small impact on overall cesarean rates. HMO penetration is unlikely to influence national cesarean section rates, nor does it appear to explain state variations in these rates.

  11. Chemical health risk assessment for hazardous and mixed waste management units at Lawrence Livermore National Laboratory

    International Nuclear Information System (INIS)

    1992-09-01

    The waste characterization for each treatment unit or process is based on treatment records from LLNL's computerized Hazardous Waste Management Inventory System (HWMIS). In 1990, these data were compiled into a single database comprising both hazardous waste and mixed waste data. Even though these data originate from the same source used in the previous HRA, the database was modified to set quantities and concentrations to a consistent set of units. This allowed an analysis of waste types by Hazardous Waste Management unit that was more accurate and did not rely upon many of the conservative assumptions used in the Phase II HRA waste characterization. Finally, the current waste characterizations are considered more representative of potential long-term wastes because they were developed by combining all wastes that could be treated in each unit, as opposed to the wastes treated only during 1988 to 1989. This final step more appropriately accounts for the variability in waste types likely to be seen by the Hazardous Waste Management Division. The quantities of each waste listed in the characterization tables represent the sum of all chemical quantities belonging to hazardous and mixed waste types potentially handled by each area

  12. Screening and management of gestational diabetes mellitus in Scottish obstetric units: a national survey.

    Science.gov (United States)

    Stirrat, Laura I; Denison, Fiona C; Love, Corinne D B; Lindsay, Robert S; Reynolds, Rebecca M

    2015-02-01

    The last study of screening practices for gestational diabetes (GDM) in the UK concluded that a lack of consensus about screening was due to a lack of clinical guidelines. We aimed to determine current practices in Scotland since new guidelines recommended that diagnosis should be made at a lower level of hyperglycaemia. An online questionnaire designed to investigate the screening and management of GDM was distributed to all maternity units in Scotland managing women with GDM (n = 15) for completion by relevant clinical team members. The response rate was 100%. Considerable variation in clinical practice existed between units. Thirteen units (86.7%) had adopted the lower glucose tolerance values for diagnosis of GDM (fasting ≥5.1 mmol/L; 2-h ≥8.5 mmol/L) recommended by the Scottish Intercollegiate Guidelines Network in 2010. Available data from units using this guideline (n = 3) revealed a significant increase in the percentage of women diagnosed with GDM between 2010 and 2012 (2010: 1.28%, 2012: 2.54%; p still inconsistencies in screening and management of GDM in Scotland. If a similar increase in the prevalence of GDM is experienced across Scotland, there will be major implications for health care provision and resource allocation. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  13. Control and management unit for a computation platform at the PANDA experiment

    Energy Technology Data Exchange (ETDEWEB)

    Galuska, Martin; Gessler, Thomas; Kuehn, Wolfgang; Lang, Johannes; Lange, Jens Soeren; Liang, Yutie; Liu, Ming; Spruck, Bjoern; Wang, Qiang [II. Physikalisches Institut, Justus-Liebig-Universitaet Giessen (Germany)

    2010-07-01

    The FAIR facility will provide high intensity antiproton and heavy ion beams for the PANDA and HADES experiments, leading to very high reaction rates. PANDA is expected to run at 10-20 MHz with a raw data output rate of up to 200 GB/s. A sophisticated data acquisition system is needed in order to select physically relevant events online. For this purpose a network of interconnected compute nodes can be used. Each compute node can be programmed to run various algorithms, such as online particle track recognition for high level triggering. An ATCA communication shelf provides power, cooling and high-speed interconnections to up to 14 nodes. A single shelf manager supervises and regulates the power distribution and temperature inside the shelf. The shelf manager relies on a local control chip on each node to relay sensor read-outs, provide hardware adresses and power requirements etc. An IPM controller based on an Atmel microcontroller was designed for this purpose, and a prototype was produced. The neccessary software is being developed to allow local communication with the components of the compute node and remote communication with the shelf manager conform to the ATCA specification.

  14. United States Local Government Reform: The Emergence of the City Manager

    Directory of Open Access Journals (Sweden)

    Robert McEVOY

    2002-06-01

    Full Text Available City Managers came into being in the early 1900.s because of the corruption, waste, and lack of responsiveness of local governments in the United States. Business leaders in large cities had begun to recognise that major changes in their local governments were desperately needed for their businesses to grow and prosper. Andrew Carnegie, a founder of United States Steel, had indicated that business needed a stable society to prosper. Local government had to become responsive to the changing needs of the poor, abused and neglected children, the mentally ill and the elderly, to cite a few examples.

  15. Communication Received from the United States of America Concerning its Policies Regarding the Management of Plutonium

    International Nuclear Information System (INIS)

    2012-01-01

    The Secretariat has received a note verbale dated 24 September 2012 from the Permanent Mission of the United States of America to the IAEA in the enclosures of which the Government of the United States of America, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2011 [es

  16. Communication Received from the United States of America Concerning Its Policies Regarding the Management of Plutonium

    International Nuclear Information System (INIS)

    2010-01-01

    The Secretariat has received a letter dated 24 February 2010 from the Permanent Mission of the United States of America to the IAEA in the enclosures of which the Government of the United States of America, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2008 [es

  17. Communication Received from the United States of America Concerning Its Policies Regarding the Management of Plutonium

    International Nuclear Information System (INIS)

    2011-01-01

    The Secretariat has received a note verbale dated 7 September 2011 from the Permanent Mission of the United States of America to the IAEA in the enclosures of which the Government of the United States of America, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2010 [es

  18. Communication Received from the United States of America Concerning Its Policies Regarding the Management of Plutonium

    International Nuclear Information System (INIS)

    2011-01-01

    The Secretariat has received a note verbale dated 7 September 2011 from the Permanent Mission of the United States of America to the IAEA in the enclosures of which the Government of the United States of America, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2010

  19. Communication Received from the United States of America Concerning its Policies Regarding the Management of Plutonium

    International Nuclear Information System (INIS)

    2012-01-01

    The Secretariat has received a note verbale dated 24 September 2012 from the Permanent Mission of the United States of America to the IAEA in the enclosures of which the Government of the United States of America, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2011

  20. Communication Received from the United States of America Concerning Its Policies Regarding the Management of Plutonium

    International Nuclear Information System (INIS)

    2010-01-01

    The Secretariat has received a letter dated 24 February 2010 from the Permanent Mission of the United States of America to the IAEA in the enclosures of which the Government of the United States of America, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2008

  1. Communication Received from the United States of America Concerning Its Policies Regarding the Management of Plutonium

    International Nuclear Information System (INIS)

    2011-01-01

    The Secretariat has received a note verbale dated 7 September 2011 from the Permanent Mission of the United States of America to the IAEA in the enclosures of which the Government of the United States of America, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2010 [fr

  2. Communication Received from the United States of America Concerning its Policies Regarding the Management of Plutonium

    International Nuclear Information System (INIS)

    2012-01-01

    The Secretariat has received a note verbale dated 24 September 2012 from the Permanent Mission of the United States of America to the IAEA in the enclosures of which the Government of the United States of America, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2011 [fr

  3. 40 CFR Table 11 to Subpart G of... - Wastewater-Inspection and Monitoring Requirements for Waste Management Units

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Wastewater-Inspection and Monitoring Requirements for Waste Management Units 11 Table 11 to Subpart G of Part 63 Protection of Environment... and Monitoring Requirements for Waste Management Units To comply with Inspection or monitoring...

  4. 40 CFR Table 7 to Subpart Ggg of... - Wastewater-Inspection and Monitoring Requirements for Waste Management Units

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 11 2010-07-01 2010-07-01 true Wastewater-Inspection and Monitoring Requirements for Waste Management Units 7 Table 7 to Subpart GGG of Part 63 Protection of Environment... for Waste Management Units To comply with Inspection or monitoring requirement Frequency of inspection...

  5. Population structure of the endangered franciscana dolphin (Pontoporia blainvillei: reassessing management units.

    Directory of Open Access Journals (Sweden)

    Haydée A Cunha

    Full Text Available Franciscanas are the most endangered dolphins in the Southwestern Atlantic. Due to their coastal and estuarine habits, franciscanas suffer from extensive fisheries bycatch, as well as from habitat loss and degradation. Four Franciscana Management Areas (FMA, proposed based on biology, demography, morphology and genetic data, were incorporated into management planning and in the delineation of research efforts. We re-evaluated that proposal through the analysis of control region sequences from franciscanas throughout their distribution range (N = 162, including novel sequences from the northern limit of the species and two other previously unsampled localities in Brazil. A deep evolutionary break was observed between franciscanas from the northern and southern portions of the species distribution, indicating that they must be managed as two Evolutionarily Significant Units (ESU. Furthermore, additional FMAs should be recognised to accommodate the genetic differentiation found in each ESU. These results have immediate consequences for the conservation and management of this endangered species.

  6. [Management of quality in an Intensive Care Unit: implementation of ISO 9001:2008 international standard].

    Science.gov (United States)

    Lorenzo Torrent, R; Sánchez Palacios, M; Santana Cabrera, L; Cobian Martinez, J L; García del Rosario, C

    2010-10-01

    The Quality Management Systems make it possible to prioritize actions to maintain the safety and efficacy of health technologies. The Intensive Care Unit of our hospital has implemented a quality management plan, which has obtained accreditation as "Service Certificate that manages its activities according to UNE-EN ISO 9001:2008" standard. With the application of quality management system, it has been possible to detect the needs that the Service can cover in order to obtain the satisfaction of the patient, relative or health personnel of the other services of the hospital, to improve communications inside and outside of service, to secure greater understanding of the processes of the organization and control of risk, to delimit responsibilities clearly to all the personnel, to make better use of the time and resources and, finally, to improve the motivation of the personnel. Copyright © 2009 Elsevier España, S.L. y SEMICYUC. All rights reserved.

  7. Differences in Hospital Managers', Unit Managers', and Health Care Workers' Perceptions of the Safety Climate for Respiratory Protection.

    Science.gov (United States)

    Peterson, Kristina; Rogers, Bonnie M E; Brosseau, Lisa M; Payne, Julianne; Cooney, Jennifer; Joe, Lauren; Novak, Debra

    2016-07-01

    This article compares hospital managers' (HM), unit managers' (UM), and health care workers' (HCW) perceptions of respiratory protection safety climate in acute care hospitals. The article is based on survey responses from 215 HMs, 245 UMs, and 1,105 HCWs employed by 98 acute care hospitals in six states. Ten survey questions assessed five of the key dimensions of safety climate commonly identified in the literature: managerial commitment to safety, management feedback on safety procedures, coworkers' safety norms, worker involvement, and worker safety training. Clinically and statistically significant differences were found across the three respondent types. HCWs had less positive perceptions of management commitment, worker involvement, and safety training aspects of safety climate than HMs and UMs. UMs had more positive perceptions of management's supervision of HCWs' respiratory protection practices. Implications for practice improvements indicate the need for frontline HCWs' inclusion in efforts to reduce safety climate barriers and better support effective respiratory protection programs and daily health protection practices. © 2016 The Author(s).

  8. Auditory Perception in an Open Space: Detection and Recognition

    Science.gov (United States)

    2015-06-01

    recognition ranges of most sounds were approximately 100–200 m. Therefore, it may be hypothesized that this range makes up the soundscape or the range of the... soundscapes . Acta Acustica united with Acustica. 2003;89:287–295. Delaney ME. Range predictions for siren sources. Teddington (UK): National...management of park soundscapes : a review. Applied Acoustics. 2008;69:77–92. Mirabella A, Goldstein D. The effects of ambient noise upon signal detection

  9. Status of activities: Low-level radioactive waste management in the United States

    International Nuclear Information System (INIS)

    Ozaki, C.B.; Shilkett, R.C.; Kirkpatrick, T.D.

    1989-01-01

    A primary objective of low-level radioactive waste management in the United States is to protect the health and safety of the public and the quality of the environment. In support of this objective is the development of waste treatment and disposal technologies designed to provide stabilization and long-term institutional control of low-level radioactive wastes. Presented herein is a technical review of specific low-level radioactive waste management activities in the United States. Waste treatment and disposal technologies are discussed along with the performance objectives of the technologies aimed at protecting the health and safety of the public and the quality of the environment. 13 refs., 4 figs

  10. Surveillance Monitoring Management for General Care Units: Strategy, Design, and Implementation.

    Science.gov (United States)

    McGrath, Susan P; Taenzer, Andreas H; Karon, Nancy; Blike, George

    2016-07-01

    The growing number of monitoring devices, combined with suboptimal patient monitoring and alarm management strategies, has increased "alarm fatigue," which have led to serious consequences. Most reported alarm man- agement approaches have focused on the critical care setting. Since 2007 Dartmouth-Hitchcock (Lebanon, New Hamp- shire) has developed a generalizable and effective design, implementation, and performance evaluation approach to alarm systems for continuous monitoring in general care settings (that is, patient surveillance monitoring). In late 2007, a patient surveillance monitoring system was piloted on the basis of a structured design and implementation approach in a 36-bed orthopedics unit. Beginning in early 2009, it was expanded to cover more than 200 inpatient beds in all medicine and surgical units, except for psychiatry and labor and delivery. Improvements in clinical outcomes (reduction of unplanned transfers by 50% and reduction of rescue events by more than 60% in 2008) and approximately two alarms per patient per 12-hour nursing shift in the original pilot unit have been sustained across most D-H general care units in spite of increasing patient acuity and unit occupancy. Sample analysis of pager notifications indicates that more than 85% of all alarm conditions are resolved within 30 seconds and that more than 99% are resolved before escalation is triggered. The D-H surveillance monitoring system employs several important, generalizable features to manage alarms in a general care setting: alarm delays, static thresholds set appropriately for the prevalence of events in this setting, directed alarm annunciation, and policy-driven customization of thresholds to allow clinicians to respond to needs of individual patients. The systematic approach to design, implementation, and performance management has been key to the success of the system.

  11. Functional planning units for the management of an endangered Brazilian titi monkey.

    Science.gov (United States)

    Gouveia, Sidney F; Souza-Alves, João Pedro; de Souza, Bruno B; Beltrão-Mendes, Raone; Jerusalinsky, Leandro; Ferrari, Stephen F

    2017-05-01

    Conservation practices in the tropics often rely on the data available for a few, better-known species and the adoption of an appropriate spatial scale. By defining a set of landscape units that account for critical aspects of the focal species, the information available on these conservation targets can support regional conservation policies. Here, we define and classify adjacent landscapes, termed planning units, to orientate management decisions within and among these landscapes, which are occupied by an endangered flagship primate species (Coimbra-Filho's titi monkey, Callicebus coimbrai) from eastern Brazil. We use landscape boundaries (highways and river systems), and a high-resolution map of forest remnants to identify continuous and manageable landscapes. We employed functional landscape metrics based on the species' dispersal ability and home range size to characterize and classify these landscapes. We classified planning units by scoring them according to a suite of selected metrics through a Principal Component Analysis. We propose 31 planning units, containing one to six C. coimbrai populations, most with low values of habitat availability, functional connectivity and carrying capacity, and a high degree of degradation. Due to this poor landscape configuration, basic management practices are recommendable. However, additional aspects of the landscapes and the populations they contain (e.g., matrix type and genetic variability) should improve the scheme, which will require a closer integration of research aims with socio-political strategies. Even so, our scheme should prove useful for the combination of information on conservation targets (i.e., focal species) with management strategies on an administrative scale. © 2017 Wiley Periodicals, Inc.

  12. Rest life time management of Kozloduy NPPP Unit 3 and 4

    International Nuclear Information System (INIS)

    Vodenicharov, St.

    2002-01-01

    The radiation life time of reactor pressure vessel (RPV) is the most important limiting factor for the term of exploitation of the whole power unit. The main degradation mechanism of RPV metal is the neutron induced embrittlement. Processes of radiation ageing running in RPV metal lead to fracture toughness decrease and to increased probability of brittle fracture of the vessel under thermal shocks. This explains the importance of RPV integrity assessment and rest life time management

  13. Management, restructuring and industrial relations : organizational change within the United Kingdom broadcasting industry, 1979-2002

    OpenAIRE

    Quinn, Brian J.

    2007-01-01

    In the past decade researchers began to remedy a literature deficit in the study of broadcasting institutions – addressing in particular the issues of labour process, restructuring and industrial relations. This thesis which considers management change, industrial relations and restructuring within the United Kingdom (‘UK’) broadcasting industry employs a case study format with a view to highlighting the variations of industry (macro) and firm (micro) based restructuring. Organizational chang...

  14. Assessment of Weight Management Practices among Adults in the United Arab Emirates

    OpenAIRE

    Attlee, Amita; Atmani, Nour; Stromtsov, Viktor; Ali, Fatima; Tikarly, Rim; Ryad, Sarah; Salah, Ghada; Hasan, Hayder; Obaid, Reyad

    2017-01-01

    With a rise in global incidence of overweight and obesity, the number of patients seeking weight management (WM) advice is likely to increase. Our aim was to explore the prevalence of WM practices and investigate association of WM goals with sociodemographic variables and practices among United Arab Emirates (UAE) adults. An exploratory, cross-sectional research was conducted on 1275 adult males and females, residing in UAE. A structured questionnaire was administered. WM goals to lose/mainta...

  15. Communication Received from the United States of America Concerning Its Policies Regarding the Management of Plutonium

    International Nuclear Information System (INIS)

    2007-01-01

    The Secretariat has received a letter dated 6 April 2007 from the Permanent Mission of the United States of America to the IAEA in the enclosures of which the Government of the United States of America, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2005. The Permanent Mission of the United States has also communicated in its letter that there have been changes in their plutonium and fuel cycle policy since their last statement was submitted, and have additionally included a policy statement in the enclosures of the letter [es

  16. Communication Received from the United States of America Concerning Its Policies Regarding the Management of Plutonium

    International Nuclear Information System (INIS)

    2007-01-01

    The Secretariat has received a letter dated 6 April 2007 from the Permanent Mission of the United States of America to the IAEA in the enclosures of which the Government of the United States of America, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available annual figures for holdings of civil unirradiated plutonium and the estimated amounts of plutonium contained in spent civil reactor fuel as of 31 December 2005. The Permanent Mission of the United States has also communicated in its letter that there have been changes in their plutonium and fuel cycle policy since their last statement was submitted, and have additionally included a policy statement in the enclosures of the letter

  17. Speaker Recognition

    DEFF Research Database (Denmark)

    Mølgaard, Lasse Lohilahti; Jørgensen, Kasper Winther

    2005-01-01

    Speaker recognition is basically divided into speaker identification and speaker verification. Verification is the task of automatically determining if a person really is the person he or she claims to be. This technology can be used as a biometric feature for verifying the identity of a person...

  18. Data structures, computer graphics, and pattern recognition

    CERN Document Server

    Klinger, A; Kunii, T L

    1977-01-01

    Data Structures, Computer Graphics, and Pattern Recognition focuses on the computer graphics and pattern recognition applications of data structures methodology.This book presents design related principles and research aspects of the computer graphics, system design, data management, and pattern recognition tasks. The topics include the data structure design, concise structuring of geometric data for computer aided design, and data structures for pattern recognition algorithms. The survey of data structures for computer graphics systems, application of relational data structures in computer gr

  19. Words from spontaneous conversational speech can be recognized with human-like accuracy by an error-driven learning algorithm that discriminates between meanings straight from smart acoustic features, bypassing the phoneme as recognition unit.

    Science.gov (United States)

    Arnold, Denis; Tomaschek, Fabian; Sering, Konstantin; Lopez, Florence; Baayen, R Harald

    2017-01-01

    Sound units play a pivotal role in cognitive models of auditory comprehension. The general consensus is that during perception listeners break down speech into auditory words and subsequently phones. Indeed, cognitive speech recognition is typically taken to be computationally intractable without phones. Here we present a computational model trained on 20 hours of conversational speech that recognizes word meanings within the range of human performance (model 25%, native speakers 20-44%), without making use of phone or word form representations. Our model also generates successfully predictions about the speed and accuracy of human auditory comprehension. At the heart of the model is a 'wide' yet sparse two-layer artificial neural network with some hundred thousand input units representing summaries of changes in acoustic frequency bands, and proxies for lexical meanings as output units. We believe that our model holds promise for resolving longstanding theoretical problems surrounding the notion of the phone in linguistic theory.

  20. Architecture of security management unit for safe hosting of multiple agents

    Science.gov (United States)

    Gilmont, Tanguy; Legat, Jean-Didier; Quisquater, Jean-Jacques

    1999-04-01

    In such growing areas as remote applications in large public networks, electronic commerce, digital signature, intellectual property and copyright protection, and even operating system extensibility, the hardware security level offered by existing processors is insufficient. They lack protection mechanisms that prevent the user from tampering critical data owned by those applications. Some devices make exception, but have not enough processing power nor enough memory to stand up to such applications (e.g. smart cards). This paper proposes an architecture of secure processor, in which the classical memory management unit is extended into a new security management unit. It allows ciphered code execution and ciphered data processing. An internal permanent memory can store cipher keys and critical data for several client agents simultaneously. The ordinary supervisor privilege scheme is replaced by a privilege inheritance mechanism that is more suited to operating system extensibility. The result is a secure processor that has hardware support for extensible multitask operating systems, and can be used for both general applications and critical applications needing strong protection. The security management unit and the internal permanent memory can be added to an existing CPU core without loss of performance, and do not require it to be modified.

  1. Communication received from the United States of America concerning its policies regarding the management of plutonium

    International Nuclear Information System (INIS)

    2002-01-01

    The Secretariat has received a letter dated 7 August 2002 from the Permanent Mission of the United States of America to the IAEA in which the Government of the United States, in keeping with its commitment under the Guidelines for the Management of Plutonium (contained in INFCIRC/549 of 16 March 1998 and hereinafter referred to as the 'Guidelines'), and in accordance with Annexes B and C of the Guidelines, has made available an annual statement of its national holdings of civil unirradiated plutonium and of plutonium contained in spent civil reactor fuel, as of 31 December 2001. The Permanent Mission of the United States has also communicated in its letter that there have been changes in their plutonium and fuel cycle policy since their last statement was submitted, and have additionally included a policy statement in the enclosures of the letter. In the light of the request expressed by the United States in its note verbale of 1 December 1997, concerning its policies regarding the management of plutonium (INFCIRC/549 of 16 March 1998), the texts of the enclosures of the letter of 7 August 2002 are attached for the information of all Member States

  2. Diabetes mellitus and infection: an evaluation of hospital utilization and management costs in the United States.

    Science.gov (United States)

    Korbel, Lindsey; Spencer, John David

    2015-03-01

    The objective of this study is to evaluate the number of diabetics that seek medical treatment in emergency departments or require hospitalization for infection management in the United States. This study also assesses the socioeconomic impact of inpatient infection management among diabetics. We accessed the Healthcare Cost and Utilization Project's Nationwide Emergency Department Sample database and the Nationwide Inpatient Sample database to perform a retrospective analysis on diabetics presenting to the emergency department or hospitalized for infection management from 2006 to 2011. Emergency Department: Since 2006, nearly 10 million diabetics were annually evaluated in the emergency department. Infection was the primary reason for presentation in 10% of these visits. Among those visits, urinary tract infection was the most common infection, accounting for over 30% of emergency department encounters for infections. Other common infections included sepsis, skin and soft tissue infections, and pneumonia. Diabetics were more than twice as likely to be hospitalized for infection management than patients without diabetes. Hospitalization: Since 2006, nearly 6 million diabetics were annually hospitalized. 8-12% of these patients were hospitalized for infection management. In 2011, the inpatient care provided to patients with DM, and infection was responsible for over $48 billion dollars in aggregate hospital charges. Diabetics commonly present to the emergency department and require hospitalization for infection management. The care provided to diabetics for infection management has a large economic impact on the United States healthcare system. More efforts are needed to develop cost-effective strategies for the prevention of infection in patients with diabetes. Copyright © 2015 Elsevier Inc. All rights reserved.

  3. The content of nurse unit managers' work: a descriptive study using daily activity diaries.

    Science.gov (United States)

    Sveinsdóttir, Herdís; Blöndal, Katrín; Jónsdóttir, Heiður Hrund; Bragadóttir, Helga

    2017-09-07

    NUMs' job description in Icelandic hospitals has been revised and now also includes managerial and financial responsibilities. To describe the actual work activities of nurse unit managers (NUMs) in surgical and internal medicine services as self-documented and reflected in their job description. Prospective exploratory study. The study's setting was the largest hospital in Iceland. Data were collected over 7 days from NUMs working on surgical and medical units with an activity diary listing five domains and 41 activities: 'management and planning' (seven activities), 'staff responsibility (seven activities), 'direct clinical work' (five activities), 'service' (12 activities) and 'other' (nine activities). The managers' spent most of their time within the 'other' domain (32% of their time), then the next significant amount of time on 'management and planning' and 'clinical nursing' (19%), and the least amount of time on 'service' (14%). All reported working on two or more activities simultaneously. NUMs made erroneous estimations approximately half of the time about the domain they spent most of their time in and their satisfaction with their work each day varied greatly. The work of NUMs is highly diverse, including undefined miscellaneous tasks and clinical work beyond their job description. © 2017 Nordic College of Caring Science.

  4. The comparison of license management procedure for nuclear power plant in China and United States

    International Nuclear Information System (INIS)

    Yu Zusheng

    2006-01-01

    'Tow steps' license management procedure for nuclear power plant has been performed bas- ted on the requirement of 10CFR Part50-DOMESTIC LICENSING OF PRODUCTION AND UTILIZATION FACILITIES in United States since last century fifties. In order to ulterior reduce the risk of investment and technical for new construction nuclear power plants, new regulations 'One step' license management procedure-10CFR Part52-EARLY SITE PERMITS; STANDARD DESIGN CERTIFICATIONS; AND COMBINED LICENSES FOR NUCLEAR POWER PLANTS issued in 1989. The new regulations has been adopted by new design of nuclear power plant, for example AP1000. ‘The similar tow steps’ license management procedure for nuclear power plant has been performed basted on the requirement of HAFO01/01 Rules for the Implementation of Regulations on the Safety Regulation for Civilian Nuclear Installations of the People's Re- public of China Part One: Application and Issuance of Safety License for Nuclear Power Plant (December 1993) in China since last century nineties. This article introduces and compares the requirements and characteristics of above license management procedure for nuclear power plant in China and United States. (author)

  5. Habitat Demonstration Unit Project: Leadership and Management Strategies for a Rapid Prototyping Project

    Science.gov (United States)

    Kennedy, Kriss J.; Toup, Larry; Gill, Tracy; Tri, Terry; Howe, Scott; Smitherman, David

    2011-01-01

    This paper gives an overview of the National Aeronautics and Space Administration (NASA) led multi-center Habitat Demonstration Unit (HDU) project leadership and management strategies being used by the NASA HDU team for a rapid prototyping project. The HDU project team constructed and tested an analog prototype lunar surface habitat/laboratory called the Pressurized Excursion Module (PEM) during 2010. The prototype unit subsystems were integrated in a short amount of time, utilizing a tiger team rapid prototyping approach that brought together over 20 habitation-related technologies and innovations from a variety of NASA centers. This paper describes the leadership and management strategies as well as lessons learned pertaining to leading and managing a multi-center diverse team in a rapid prototype environment. The PEM configuration went from a paper design to an operational surface habitat demonstration unit in less than 12 months. The HDU project is part of the strategic plan from the Exploration Systems Mission Directorate (ESMD) Directorate Integration Office (DIO) and the Exploration Mission Systems Office (EMSO) to test destination elements in analog environments. The 2011 HDU-Deep Space Habitat (DSH) configuration will build upon the PEM work, and emphasize validity of crew operations (remote working and living), EVA operations, mission operations, logistics operations, and science operations that might be required in a deep space context for Near Earth Object (NEO) exploration mission architectures. The 2011 HDU-DSH will be field-tested during the 2011 Desert Research and Technologies Studies (DRaTS) field tests. The HDU project is a "technology-pull" project that integrates technologies and innovations from multiple NASA centers. This project will repurpose the HDU 2010 demo unit that was field tested in the 2010 DRaTS, adding habitation functionality to the prototype unit. This paper will describe the strategy of establishing a multi-center project

  6. An Exploration of the Perspectives of Associate Nurse Unit Managers Regarding the Implementation of Smoke-free Policies in Adult Mental Health Inpatient Units.

    Science.gov (United States)

    Dean, Tania D; Cross, Wendy; Munro, Ian

    2018-04-01

    In Adult Mental Health Inpatient Units, it is not unexpected that leadership of Associate Nurse Unit Managers contributes to successful implementation of smoke-free policies. In light of challenges facing mental health nursing, and limited research describing their leadership and the role it plays in addressing smoke-free policy implementation, the aim of this study is to explore Associate Nurse Unit Managers perspectives' regarding the implementation of smoke-free policies, which were introduced on 1 July, 2015. Individual in-depth semi-structured interviews were undertaken six months post the implementation of smoke-free policies. In this qualitative descriptive study, six Associate Nurse Unit Managers working in a Victorian public Adult Mental Health Inpatient Unit, were asked eight questions which targeted leadership and the implementation and enforcement of smoke-free policies. Associate Nurse Unit Managers provide leadership and role modeling for staff and they are responsible for setting the standards that govern the behavior of nurses within their team. All participants interviewed believed that they were leaders in the workplace. Education and consistency were identified as crucial for smoke-free policies to be successful. Participants acknowledged that the availability of therapeutic interventions, staff resources and the accessibility of nicotine replacement therapy were crucial to assist consumers to remain smoke-free while on the unit. The findings from this research may help to improve the understanding of the practical challenges that Associate Nurse Unit Manager's face in the implementation of smoke-free policies with implications for policies, nursing practice, education and research.

  7. Accommodating non-market values in evaluation of wildfire management in the United States: Challenges and opportunities

    Science.gov (United States)

    Tyron J. Venn; David E. Calkin

    2011-01-01

    Forests in the United States generate many non-market benefits for society that can be enhanced and diminished by wildfire and wildfire management. The Federal Wildland Fire Management Policy (1995, updated 2001), and subsequent Guidance to the Implementation of that policy provided in 2009, require fire management priorities be set on the basis of values to be...

  8. CIEQUI: An oracle database for information management in the analytical chemistry unit of CIEMAT

    International Nuclear Information System (INIS)

    Rucandio, M.I.; Roca, M.

    1997-01-01

    An in-house software product named CIEQUI has been developed in CIEMAT, with purpose-written programs as a laboratory information management system (LIMS). It is grounded upon relational data base from ORACLE, with the supported languages SQL, PL/SQL, SQL*Plus, and DEC BASIS, and with the tools SQL*Loader, SQL*Forms and SQL*Menu. Its internal organization and functional structure are schematically represented and the advantages and disadvantages of a tailored management system are described. Although it is difficult to unity the analysis criteria in a R AND D organization such as CIEMAT, because of the wide variety in the sample type and in the involved determinations, our system provides remarkable advantages. CIEQUI reflects the complexity of the laboratories it serves. It is a system easily accessible to all, that help us in many tasks about organization and management of the analytical service provided through the different laboratories of the CIEMAT Analytical Chemistry Unit. (Author)

  9. RECALMIN: The association between management of Spanish National Health Service Internal Medical Units and health outcomes.

    Science.gov (United States)

    Zapatero-Gaviria, Antonio; Javier Elola-Somoza, Francisco; Casariego-Vales, Emilio; Fernandez-Perez, Cristina; Gomez-Huelgas, Ricardo; Bernal, José Luis; Barba-Martín, Raquel

    2017-08-01

    To investigate the association between management of Internal Medical Units (IMUs) with outcomes (mortality and length of stay) within the Spanish National Health Service. Data on management were obtained from a descriptive transversal study performed among IMUs of the acute hospitals. Outcome indicators were taken from an administrative database of all hospital discharges from the IMUs. Spanish National Health Service. One hundred and twenty-four acute general hospitals with available data of management and outcomes (401 424 discharges). IMU risk standardized mortality rates were calculated using a multilevel model adjusted by Charlson Index. Risk standardized myocardial infarction and heart failure mortality rates were calculated using specific multilevel models. Length of stay was adjusted by complexity. Greater hospital complexity was associated with longer average length of stays (r: 0.42; P International Society for Quality in Health Care. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  10. Development of a Carbon Management Geographic Information System (GIS) for the United States

    Energy Technology Data Exchange (ETDEWEB)

    Howard Herzog; Holly Javedan

    2009-12-31

    In this project a Carbon Management Geographical Information System (GIS) for the US was developed. The GIS stored, integrated, and manipulated information relating to the components of carbon management systems. Additionally, the GIS was used to interpret and analyze the effect of developing these systems. This report documents the key deliverables from the project: (1) Carbon Management Geographical Information System (GIS) Documentation; (2) Stationary CO{sub 2} Source Database; (3) Regulatory Data for CCS in United States; (4) CO{sub 2} Capture Cost Estimation; (5) CO{sub 2} Storage Capacity Tools; (6) CO{sub 2} Injection Cost Modeling; (7) CO{sub 2} Pipeline Transport Cost Estimation; (8) CO{sub 2} Source-Sink Matching Algorithm; and (9) CO{sub 2} Pipeline Transport and Cost Model.

  11. Understanding Suicide Across the Lifespan: A United States Perspective of Suicide Risk Factors, Assessment & Management.

    Science.gov (United States)

    Steele, Ian H; Thrower, Natasha; Noroian, Paul; Saleh, Fabian M

    2018-01-01

    Suicide is a troubling, preventable phenomenon. Prior to attempts, individuals often seek help, prompting practitioners to perform risk assessments that ideally use evidence-based risk management strategies. A literature review was performed using Harvard Countway Library of Medicine, Google Scholar, PubMed. Key words used were "Forensic Science," "Suicide Risk Management," "Pediatric Suicide Risk Factors," "Adult Suicide Risk Factors," "Geriatric Suicide Risk Factors," "Suicide Risk Assessment." Parameters limited articles to studies/reviews completed in the past twenty years in the United States. Results indicated predictors of suicide in juveniles were insomnia, burdensomeness, and recent conflicts with family or a romantic partner. Adults had greater risk if male, substance abusing, with marital/job loss. Elderly individuals with multiple medical comorbidities, hopelessness, and isolation were at higher risk. Everyone evaluated should be screened for access to firearms. Management of suicide risk involves providing the least restrictive form of treatment which maintains an individual's safety. © 2017 American Academy of Forensic Sciences.

  12. Development of certified environmental management in hospital and outpatient haemodialysis units.

    Science.gov (United States)

    García Vicente, Sergio; Morales Suárez-Varela, María; Martí Monrós, Anna; Llopis González, Agustín

    2015-01-01

    The environmental impact of haemodialysis is very high. Institutional activity in this sense is important, even in the production of references. Voluntary environmental management systems (EMS), environmental management and auditing systems (EMAS) and the International Organization for Standardization standards (ISO 14001) are important tools for environmental protection, together with legislation, taxation and tax benefits. To determine the degree of implementation of EMS in hospital units and outpatient haemodialysis in the Spanish National Health System to provide a group of reference centres in environmental management in this healthcare activity. Development of a list by autonomous communities showing hospital and outpatient dialysis units using an EMAS and/or ISO 14001 in 2012-2013. The sources of information were the Spanish National Catalogue of Hospitals, Spanish Registry of Healthcare Certification and Accreditation, European and regional EMAS records, world ISO registrations, dialysis centre lists from scientific societies and patients, responses from accredited entities in Spain for environmental certification and the institutional website of each haemodialysis centre identified. Of the 210 hospitals with a dialysis unit, 53 (25%) have the ISO 14001 and 15 of these also have an EMAS). This constitutes 30% of all hospital dialysis chairs in Spain: 1,291 (of 4,298). Only 11 outpatient clinics are recorded, all with the ISO 14001. There is no official documentation of the implementation of EMS in dialysis units. Making this list provides an approach to the situation, with special reference to haemodialysis because of its significant environmental impact. Copyright © 2015 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  13. Modern Management and Diagnosis of Hypertension in the United Kingdom: Home Care and Self-care.

    Science.gov (United States)

    Sheppard, James P; Schwartz, Claire L; Tucker, Katherine L; McManus, Richard J

    2016-01-01

    The effective diagnosis and management of hypertension is one of the most important parts of cardiovascular prevention internationally and this is no different in the United Kingdom. Approximately 14% of the UK population currently receive treatment for hypertension. Recent UK guidelines from the National Institute of Health and Care Excellence have placed greater emphasis on the utilization of out-of-office measurement of blood pressure to more accurately diagnose hypertension. The aim of the present study was to provide a state-of-the-art review of the evidence for screening, diagnosing, and managing hypertension, as implemented in the United Kingdom, with an emphasis on the role of self-monitored and ambulatory blood pressure monitoring in routine clinical care. Consideration was given to the use of ambulatory and home monitoring to confirm a diagnosis of hypertension and the use of self-monitoring and self-management to monitor and guide treatment. The evidence for the use of self-monitoring in patients with hypertension was examined, both in isolation, and in combination with lifestyle and treatment interventions. There is a place for self-monitored blood pressure in specific underresearched populations such as the elderly, specialist conditions, ethnic groups, and during pregnancy and this is discussed here. The evidence supporting the use of out-of-office monitoring in all aspects of routine clinical care has increased substantially in recent years and is reflected in increased utilization by patients and clinicians alike. Several areas require further research but it is clear that out-of-office monitoring is here to stay and is fast becoming an important part of hypertension management in the United Kingdom. Copyright © 2016 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Design and management of database using microsoft access program: application in neurointerventional unit

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, Seon Moon; Jeong, Gyeong Un; Kim, Tae Il; Cha, Ji Hyeon; Pyun, Hae Wook; Woo, Ryu Chang; Kim, Ho Sung; Suh, Dae Chul [University of Ulsan, College of Medicine, Seoul (Korea, Republic of)

    2005-10-15

    Complex clinical information in cerebral angiointervention unit requires effective management of statistical analysis for the classification of diagnosis and intervention including follow-up data from the interventional treatment. We present an application of Microsoft Access program for the management of patient data in cerebral angiointervention unit which suggests practical methods in recording and analyzing the patient data. Since January 2002, patient information from cerebral angiointervention was managed by a database with over 4000 patients. We designed a program which incorporates size items; Table, Query, Form, Report, Page and Macro. Patient data, follow-up data and information regarding diagnosis and intervention were established in the Form section, related by serial number, and connected to each other to an independent Table. Problems in running the program were corrected by establishing Entity Relationship (ER) diagnosis of Tables to define relationships between Tables. Convenient Queries, Forms and Reports were created to display expected information were applied from selected Tables. The relationship program which incorporated six items conveniently provided the number of cases per year, incidence of disease, lesion site, and case analysis based on interventional treatment. We were able to follow the patients after the interventional procedures by creating queries and reports. Lists of disease and patients files were identified easily each time by the Macro function. In addition, product names, size and characteristics of materials used were indexed and easily available. Microsoft Access program is effective in the management of patient data in cerebral angiointervention unit. Accumulation of large amounts of complex data handled by multiple users may require client/sever solutions such as a Microsoft SQL Server.

  15. A framework for sign language recognition using support vector machines and active learning for skin segmentation and boosted temporal sub-units

    OpenAIRE

    Awad, George M.

    2007-01-01

    This dissertation describes new techniques that can be used in a sign language recognition (SLR) system, and more generally in human gesture systems. Any SLR system consists of three main components: Skin detector, Tracker, and Recognizer. The skin detector is responsible for segmenting skin objects like the face and hands from video frames. The tracker keeps track of the hand location (more specifically the bounding box) and detects any occlusions that might happen between any skin objects. ...

  16. Management units radio physics hospital clinic: New management model; Unidades de gestion clinica de radiofisica hospitalaria, ¿nuevo modelo de gestion?

    Energy Technology Data Exchange (ETDEWEB)

    Iborra Oquendo, M.; Angulo Pain, E.; Castro Ramirez, I.; Quinones Rodriguez, L. A.; Urena Llinares, A.; Richarter Reina, J. M.; Lupiani Castellanos, J.; Ramos Caballero, L. I.

    2011-07-01

    Clinical management in the Andalusian Health Service is a process of organizational design that allows professionals to incorporate the management of resources used in their own clinical practice. In the Clinical Management Units activity develops according to different objectives, among them: encourage the involvement of health professionals in managing the centers, enhance continuity of care between the two levels of care, improve work organization and raise patient satisfaction.

  17. Managing the Diabetic Foot Ulcer: How Best Practices Fit the Real 2018 United States.

    Science.gov (United States)

    Ilonzo, Nicole; Patel, Munir; Lantis, John C

    2018-06-01

    Diabetes Mellitus is a serious systemic illness that has an epidemic-like increasing prevalence in the United States, as well as the rest of the world. With the increasing number of people with diabetes comes the higher incidence of diabetes-related complications. One of these known complications, diabetic foot ulcers (DFU), has an estimated lifetime incidence of 15% in diabetics. Having a DFU increases the risk of infection, amputation, and even death, which is why prompt treatment and surveillance of such ulcers is imperative. Multiple organizations and journals have recently published best practices to heal and close DFU. Despite these guidelines, it is estimated that only 50% of all diabetic foot ulcers close within one year in the United States. To further confuse this picture, many trials include postoperative wounds that behave in a very different way than chronic wounds. The management of diabetic ulcers requires an understanding of not only the pathophysiology along with a multi-modal approach involving local wound care, pressure prevention, infection control, and, in some, revascularization, but also how care is delivered in the United States presently. In this review, we hope to elucidate the current knowledge and modalities used in ulcer management and to focus on key areas and best practices to inform the clinician, both in what they should do and what they can do.

  18. The identification and description of the management units of the Goegap Nature Reserve

    Directory of Open Access Journals (Sweden)

    Helga Rosch

    2001-07-01

    Full Text Available Goegap Nature Reserve, near Springbok, is situated in the floral paradise of Namaqualand. This 15 000 ha reserve falls within the Namaqualand Broken Veld and in the transition zone between this Veld type and the False Succulent Karoo. Otherwise, it could be said that the reserve falls within the Upland Succulent Karoo and the transition zone between this vegetation type and the Bushmanland vegetation type. With the use of stratified aerial photographs of the reserve, random sample plots were placed within each homogeneous physiographic-physionomic unit and 284 releves were compiled in September 1998. With the use of the BBPC computer program, the resulting TWINSPAN split the data into two tables, one predominantly for the Plains and one for the Rocky Hills. After refining these tables, 13 plant communities were identified. These communities, together with the stratified aerial photographs, land type and habitat information were used to determine ten management units for the reserve. These units will be used in effective management and monitoring on the reserve. Table 1 and 2 will be uploaded as a supplementary file in due course.

  19. A Systematic Evaluation of State Laws Governing Optometric Glaucoma Management in the United States Upto 2015.

    Science.gov (United States)

    Chodnicki, Kevin; Kalarn, Sachin; Quinn, Laura; Jampel, Henry; Saeedi, Osamah

    2018-03-01

    To describe state laws that govern the optometric practice of glaucoma management in the United States and to correlate those laws with state demographics upto 2015. We performed a cross-sectional ecological study of the 50 United States and the District of Columbia. Regulations governing optometric scope of practice as written by each state Board of Optometry were reviewed. Specific optometric privileges assessed included: ability to manage glaucoma independently, use of diagnostic pharmaceutical agents, use of therapeutic pharmaceutical agents (including topical and oral steroids and other oral pharmaceutical agents), IV injections, intraocular injections, therapeutic lasers, presence of defined referral, and comanagement guidelines, and hours of yearly continuing education needed for glaucoma management. Optometric privilege was compared with demographic and employment information for each state. Optometrists in all states, except for Massachusetts, and the District of Columbia are allowed to manage glaucoma; 16 states have defined comanagement guidelines. Therapeutic lasers are allowed in 3 states: Kentucky, Louisiana, and Oklahoma. States with defined comanagement guidelines had a mean of 6.9±1.9 ophthalmologists per 100,000 people, significantly more than the 5.3±1.1 in states without defined comanagement of glaucoma (Pstate, the less likely there is to be defined comanagement [β (SE)=-0.008 (0.003), P=0.02] and the greater the number of ophthalmologists in a given state, the more likely a state has defined comanagement [β (SE)=-0.13 (0.006)]. There is a diversity of regulations that govern optometric management of glaucoma in each of the 50 states and the District of Columbia. The number of optometrists and ophthalmologists in a state may influence state regulations governing optometric practice and referral guidelines.

  20. The effect of nursing management development program on clinical competency in coronary care unit

    Directory of Open Access Journals (Sweden)

    Ali Akbar Vaezi

    2011-03-01

    Full Text Available Background: Nurses are the main members in nursing cares and nursing managers can improve their clinical competency by applying better leadership skills. This study carried out to determine the effect of nursing management program on clinical competency of nurses in a coronary care unit (CCU.Methods: A quasi-experimental study was carried out in two educational hospitals in Yazd- Iran. These hospitals were allocated randomly in case and control hospitals. 25 matched nurses were selected by convenience sampling from both case and control hospitals. The clinical competency of nurses was measured by related questioners consisted of two dimensions caring and care management behaviors by self-evaluation and head nurse evaluation in case and control groups. Then, the intervention was implemented in four stages including nurse's development, managers' development, adaptation and supervision period during four months in the case group. After intervention, clinical competency of nurses was measured in both groups.Results: The results showed that before intervention more than 80% of nurses in two groups was in the moderate clinical competency level and they were proficient based on Benner's skill acquisition model. After intervention, nurses' clinical competency improved to higher level in case group but it didn't change in control group (P<0.05. Conclusion: Creating necessary modifications in nursing environments through the management development program by head nurses may improve nurses' clinical competency.

  1. Experiences of internationally educated nurses holding management positions in the United States: Descriptive phenomenological study.

    Science.gov (United States)

    Allen, Lilian A

    2018-02-12

    The purpose of this study was to explore the experiences of internationally educated nurses in management positions in United States health care organisations to understand the obstacles and support these individuals' experience when pursuing and working in managerial roles. Although internationally educated nurses are an integral part of the US health care industry, few work in managerial roles. Little is known about the experiences of internationally educated nurses who do obtain management positions. In this qualitative, phenomenological study, seven internationally educated nurses who were managers in Chicago, Illinois, responded to open-ended interview questions. Supervisors contributed to the participants' acceptance of management positions. The participants experienced challenges such as cultural differences, language, and communication. Despite these challenges, the participants had positive working relationships with staff and supervisors. Further, the participants had opportunities for education and professional growth. Internationally educated nurses benefit from participating in organisational committees. They face challenges related to work responsibilities, cultural differences and communication but can succeed in management roles through developing strategies to overcome the challenges and through receiving support from staff, colleagues and supervisors. More internationally educated nurses may obtain managerial positions if supervisors provide encouragement and support. © 2018 John Wiley & Sons Ltd.

  2. Acute stroke unit improves stroke management-four years on from INASC.

    LENUS (Irish Health Repository)

    Shanahan, E

    2015-02-01

    The Irish Heart Foundation carried out the Irish National Audit of Stroke Care (INASC) in 2008. Management practices were significantly poorer than those in the UK Sentinel audits. Since then an acute stroke unit has been established in University Hospital Limerick. A stroke database was established. 12 key indicators of stroke management audited by INASC were identified. Results were compared to those in INASC. 89 stroke patients were admitted. 8 of the 12 key indicators scored significantly better than in INASC. 92.5% had a brain scan within 24hrs (INASC-40%, p = < 0.001). 100% of ischaemic strokes received anti-thrombotics (INASC-85%, p = 0.001). 94% had rehab goals agreed by MDT (22% in INASC p = 0.0000). 55% were treated in stroke unit (2% in INASC, p = 0.0000). MDT input improved with regard to physiotherapy (87% vs 43% in INASC, p = < 0.02) and SALT (74% vs 26%, p = < 0.02). Stroke management has significantly improved from 2008, however some deficiencies remain.

  3. Managing crime through migration law in Australia and the United States: a comparative analysis.

    Science.gov (United States)

    Hoang, Khanh; Reich, Sudrishti

    2017-01-01

    This article examines the intertwining of migration law and criminal law - termed 'crimmigration' by scholars - in Australia and the United States of America, and its implications for non-citizens who engage in criminal conduct. Our comparison of the two systems demonstrates that the laws and policies in both jurisdictions are similar to a significant degree. Both have strong exclusionary policies characterised by sweeping visa cancellation/removal powers, a heavy focus on enforcement, and limited review rights. In Australia, legislative amendments in 2014 have given the executive greater powers to cancel visas and remove non-citizens on character grounds as a means of ensuring national security and public safety. This has coincided with a new law enforcement body created within the Australian Department of Immigration. These changes reflect a repurposing of migration law as a tool for managing criminal threats based on the concept of 'risk management'. Drawing on the experience of the United States - where such a 'risk management' approach is entrenched - we query the utility of this shift and highlight the potential pitfalls of pursuing such a policy for Australia.

  4. Configuration Management Program Application at KNPP Units 5 and 6 Modernization Program

    International Nuclear Information System (INIS)

    Manchev, B.; Yordanova, V.; Nenkova, B.

    2006-01-01

    The need for Configuration Management Program development, became very clear after the initiation of the Modernization Program for Units 5and6, because KNPP personnel needed a good and safe way to control the huge amount of data which were transferred into two directions - input data (design and operational documents from KNPP to Contractors) and the design, vendor, procurement, etc. documents (from Contractors to KNPP). Moreover, most of the measures are in fact design changes and it appeared to be extremely important to track these design changes and their reflection into design and operational documents. It is even more important to obtain a successful transfer of all this information to the operating organization (EP-2) after the completion. The proposal for development of Configuration Management (CM) Program for KNPP Units 5and6 Modernization program was divided into three phases: 1. Information Control (Document Control and Records Management) 2.Technical Decision System (Change Control) 3. Master Equipment List (MEL), (as part of the Design requirements element) Information Control Element was chosen to be developed first. Implementation of Information Control element comprised of: Review and assessment of existing situation (procedures for document control and records Management), Development of new/revision of existing procedure for Document Control and Records Management, Development of SmartDoc software application in support of document control and records management and for measure documentation tracking (with its specifics), Data entry for MP5and6 measures, Implementation at EP-2 (with successful data migration from the existing databases). The SmartDoc development was completed at the end of 2002 and after a testing period it was implemented at Modernization and Investment Department first. Then the data for documents were transferred from the existing databases at EP-2 and the system was implemented at EP-2 and other KNPP facilities. Development

  5. An agent based architecture for high-risk neonate management at neonatal intensive care unit.

    Science.gov (United States)

    Malak, Jaleh Shoshtarian; Safdari, Reza; Zeraati, Hojjat; Nayeri, Fatemeh Sadat; Mohammadzadeh, Niloofar; Farajollah, Seide Sedighe Seied

    2018-01-01

    In recent years, the use of new tools and technologies has decreased the neonatal mortality rate. Despite the positive effect of using these technologies, the decisions are complex and uncertain in critical conditions when the neonate is preterm or has a low birth weight or malformations. There is a need to automate the high-risk neonate management process by creating real-time and more precise decision support tools. To create a collaborative and real-time environment to manage neonates with critical conditions at the NICU (Neonatal Intensive Care Unit) and to overcome high-risk neonate management weaknesses by applying a multi agent based analysis and design methodology as a new solution for NICU management. This study was a basic research for medical informatics method development that was carried out in 2017. The requirement analysis was done by reviewing articles on NICU Decision Support Systems. PubMed, Science Direct, and IEEE databases were searched. Only English articles published after 1990 were included; also, a needs assessment was done by reviewing the extracted features and current processes at the NICU environment where the research was conducted. We analyzed the requirements and identified the main system roles (agents) and interactions by a comparative study of existing NICU decision support systems. The Universal Multi Agent Platform (UMAP) was applied to implement a prototype of our multi agent based high-risk neonate management architecture. Local environment agents interacted inside a container and each container interacted with external resources, including other NICU systems and consultation centers. In the NICU container, the main identified agents were reception, monitoring, NICU registry, and outcome prediction, which interacted with human agents including nurses and physicians. Managing patients at the NICU units requires online data collection, real-time collaboration, and management of many components. Multi agent systems are applied as

  6. Geographic Variations in Arthritis Prevalence, Health-Related Characteristics, and Management - United States, 2015.

    Science.gov (United States)

    Barbour, Kamil E; Moss, Susan; Croft, Janet B; Helmick, Charles G; Theis, Kristina A; Brady, Teresa J; Murphy, Louise B; Hootman, Jennifer M; Greenlund, Kurt J; Lu, Hua; Wang, Yan

    2018-03-16

    Doctor-diagnosed arthritis is a common chronic condition affecting an estimated 23% (54 million) of adults in the United States, greatly influencing quality of life and costing approximately $300 billion annually. The geographic variations in arthritis prevalence, health-related characteristics, and management among states and territories are unknown. Therefore, public health professionals need to understand arthritis in their areas to target dissemination of evidence-based interventions that reduce arthritis morbidity. 2015. The Behavioral Risk Factor Surveillance System is an annual, random-digit-dialed landline and cellular telephone survey of noninstitutionalized adults aged ≥18 years residing in the United States. Self-reported data are collected from the 50 states, the District of Columbia, Guam, and Puerto Rico. Unadjusted and age-standardized prevalences of arthritis, arthritis health-related characteristics, and arthritis management were calculated. County-level estimates were calculated using a validated statistical modeling method. In 2015, in the 50 states and the District of Columbia, median age-standardized prevalence of arthritis was 23.0% (range: 17.2%-33.6%). Modeled prevalence of arthritis varied considerably by county (range: 11.2%-42.7%). In 13 states that administered the arthritis management module, among adults with arthritis, the age-standardized median percentage of participation in a self-management education course was 14.5% (range: 9.1%-19.0%), being told by a health care provider to engage in physical activity or exercise was 58.5% (range: 52.3%-61.9%), and being told to lose weight to manage arthritis symptoms (if overweight or obese) was 44.5% (range: 35.1%-53.2%). Respondents with arthritis who lived in the quartile of states with the highest prevalences of arthritis had the highest percentages of negative health-related characteristics (i.e., arthritis-attributable activity limitations, arthritis-attributable severe joint pain

  7. Perancangan Maintenance Management Informastion System untuk Unit Pemadam Kebakaran (Studi Kasus : PERUSAHAAN X

    Directory of Open Access Journals (Sweden)

    Arief Samuel Gunawan

    2017-08-01

    Full Text Available Unit Pemadam Kebakaran Perusahaan X merupakan unit kerja yang bertugas melakukan pencegahan dan penanggulangan kebakaran di Perusahaan X. Unit ini dilengkapi dengan peralatan dan perlengkapan kerja, salah satunya yaitu mobil pemadam kebakaran. Salah satu permasalahan yang dihadapi oleh unit ini adalah mobil pemadam kebakaran sering mengalami kerusakan pada saat digunakan. Hal ini disebabkan karena umur komponen yang akan habis dan belum dilakukan penggantian. Umumnya bagian pemeliharaan belum memiliki dokumentasi umur komponen dari setiap mobil pemadam kebakaran. Sehingga petugas pemadam kebakaran tidak dapat mengantisipasi kerusakan yang akan terjadi saat mobil pemadam kebakaran digunakan. Untuk menanggulangi permasalahan tersebut, dikembangkan Maintenance Management Information System (MMIS yang dapat memberikan informasi perkiraan umur komponen mobil. Metode Reliability Centered Maintenance (RCM digunakan pada MMIS untuk menentukan Mean Time To Failure (MTTF. Metode Total Productive Maintenance (TPM juga digunakan pada MMIS untuk merencanakan jadwal pemeliharaan sehingga dapat meminimalisir kerusakan saat mobil digunakan. Untuk mendukung MMIS, diterapkan menu untuk konfigurasi yaitu, data pegawai, inventaris mobil pemadam kebakaran serta inventori suku cadang dan pengadaan barang yang akan berhubungan dengan biaya pemeliharaan.

  8. Survey of 2014 behavioral management programs for laboratory primates in the United States.

    Science.gov (United States)

    Baker, Kate C

    2016-07-01

    The behavioral management of laboratory nonhuman primates in the United States has not been thoroughly characterized since 2003. This article presents the results of a survey behavioral management programs at 27 facilities and covering a total of 59,636 primates, 27,916 housed in indoor cages and 31,720 in group enclosures. The survey included questions regarding program structure, implementation, and methodology associated with social housing, positive reinforcement training, positive human interaction, exercise enclosures, and several categories of inanimate enrichment. The vast majority of laboratory primates are housed socially (83%). Since 2003, the proportion of indoor-housed primates reported to be housed singly has fallen considerably, from 59% to 35% in the facilities surveyed. The use of social housing remains significantly constrained by: 1) research protocol requirements, highlighting the value of closely involved IACUCs for harmonizing research and behavioral management; and 2) the unavailability of compatible social partners, underscoring the necessity of objective analysis of the methods used to foster and maintain compatibility. Positive reinforcement training appears to have expanded and is now used at all facilities responding to the survey. The use of enrichment devices has also increased in the participating facilities. For most behavioral management techniques, concerns over the possibility of negative consequences to animals are expressed most frequently for social housing and destructible enrichment, while skepticism regarding efficacy is limited almost exclusively to sensory enrichment. Behavioral management program staffing has expanded over time in the facilities surveyed, due not only to increased numbers of dedicated behavioral management technicians but also to greater involvement of animal care technicians, suggesting an increase in the integration of behavioral care into animal husbandry. Broad awareness of common practice may assist

  9. Robust technology and system for management of sucker rod pumping units in oil wells

    Science.gov (United States)

    Aliev, T. A.; Rzayev, A. H.; Guluyev, G. A.; Alizada, T. A.; Rzayeva, N. E.

    2018-01-01

    We propose a technology for calculating the robust, normalized correlation functions of the signal from the force sensor on the rod string attached to the hanger of the sucker rod pumping unit. The robust normalized correlation functions are used to form sets of informative attribute combinations, each of which corresponds to a technical condition of the sucker rod pumping unit. We demonstrate how these sets can be used to solve identification and management problems in the oil production process in real time using inexpensive controllers. The results obtained from using the system on real objects are also presented in this paper. It was determined that the energy saved and prolonged overhaul period substantially increased the cost-effectiveness.

  10. THE INFORMATION CONTENT OF THE FARM AND UNIT LEVEL NUTRIENT BALANCES FOR THE MANAGEMENT

    Directory of Open Access Journals (Sweden)

    T SOMOGYI

    2007-07-01

    Full Text Available The farm gate balance is well known from the environmental literature. This method is not suitable in every case to show the nutrient load for the environment of agricultural companies that is the reason why unit level internal nutrient balances are applied to express the level of nutrient pollution on the environment. These also help to determine the source of the pollution. With the survey of the nutrient flows within the farm we determine the keystones of nutrient management to control the nutrient load of the pollution sources. On the basis of the results and the controlled data of the unit level internal balances we make recommendations for the most appropriate environmental policy instrument to reduce the nutrient pollution.

  11. Integration in a nuclear physics experiment of a visualization unit managed by a microprocessor

    International Nuclear Information System (INIS)

    Lefebvre, M.

    1976-01-01

    A microprocessor (Intel 8080) is introduced in the equipment controlling the (e,e'p) experiment that will take place at the linear accelerator operating in the premises of CEA (Orme des Merisiers, Gif-sur-Yvette, France). The purpose of the microprocessor is to handle the visualization tasks that are necessary to have a continuous control of the experiment. By doing so more time and more memory will be left for data processing by the calculator unit. In a forward version of the system, the controlling of the level of helium in the target might also be in charge of the microprocessor. This work is divided into 7 main parts: 1) a presentation of the linear accelerator and its experimental facilities, 2) the Intel 8080 micro-processor and its programming, 3) the implementation of the micro-processor in the electronic system, 4) the management of the memory, 5) data acquisition, 6) the keyboard, and 7) the visualization unit [fr

  12. Crew resource management training in the intensive care unit. A multisite controlled before-after study.

    Science.gov (United States)

    Kemper, Peter F; de Bruijne, Martine; van Dyck, Cathy; So, Ralph L; Tangkau, Peter; Wagner, Cordula

    2016-08-01

    There is a growing awareness today that adverse events in the intensive care unit (ICU) are more often caused by problems related to non-technical skills than by a lack of technical, or clinical, expertise. Team training, such as crew resource management (CRM), aims to improve these non-technical skills. The present study evaluated the effectiveness of CRM in the ICU. Six ICUs participated in a paired controlled trial, with one pretest and two post-test measurements (after 3 and 12 months). Three ICUs received CRM training and were compared with a matched control unit. The 2-day classroom-based training was delivered to multidisciplinary groups (ie, ICU physicians, nurses, managers). All levels of Kirkpatrick's evaluation framework were assessed using a mixed method design, including questionnaires, observations and routinely administered patient outcome data. Level I-reaction: participants were very positive directly after the training. Level II-learning: attitudes towards behaviour aimed at optimising situational awareness were relatively high at baseline and remained stable. Level III-behaviour: self-reported behaviour aimed at optimising situational awareness improved in the intervention group. No changes were found in observed explicit professional oral communication. Level IV-organisation: patient outcomes were unaffected. Error management culture and job satisfaction improved in the intervention group. Patient safety culture improved in both control and intervention units. We can conclude that CRM, as delivered in the present study, does not change behaviour or patient outcomes by itself, yet changes how participants think about errors and risks. This indicates that CRM requires a combination with other initiatives in order to improve clinical outcomes. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

  13. Best management practices plan for the Lower East Fork Poplar Creek Operable Unit, Oak Ridge, Tennessee

    International Nuclear Information System (INIS)

    1996-04-01

    This plan was prepared in support of the Phase II Remedial Design Report (DOE/OR/01-1449 ampersand D1) and in accordance with requirements under CERCLA to present the plan for best management practices to be followed during the remediation. This document provides the Environmental Restoration Program with information about spill prevention and control, water quality monitoring, good housekeeping practices, sediment and erosion control measures, and inspections and environmental compliance practices to be used during Phase II of the remediation project for the Lower East Fork Poplar Creek Operable Unit

  14. Ageing Management of the reactor internals in Belgian nuclear units in view of Long Term Operation

    International Nuclear Information System (INIS)

    Gerard, R.; Bertolis, D.; Vissers, S.

    2012-01-01

    The reactor internals support the reactor core, distribute the coolant flow through the core, and guide and protect the rod control cluster assemblies and in-core instrumentation. Their integrity must be guaranteed in all operating and accident conditions. They are exposed to specific degradation mechanisms linked to the intense neutron irradiation, like Irradiation Assisted Stress Corrosion Cracking (IASCC) or potentially void swelling, in addition to more classical mechanisms like fatigue, wear and stress corrosion cracking. A rigorous follow-up of in-service degradation and an effective ageing management is therefore of crucial importance and contributes to the safe and economical operation of nuclear PWR units. (author)

  15. Summary of plant life management evaluation for Onagawa Nuclear Power Station Unit-1

    International Nuclear Information System (INIS)

    Nodate, Kazumi

    2014-01-01

    The Onagawa Nuclear Power Station Unit-1 (Onagawa NPS-1) began commercial operation on June 1, 1984, and has reached 30-year from starting of operation on June of 2014. To that end, we implemented the Plant Life Management (PLM) evaluation for Onagawa NPS-1 as our first experience. We decided on a Long-term Maintenance Management Policy from result of the evaluation, and then applied the Safety-Regulations change approval application on November 6, 2013 and its correcting application on April 16, 2014. Our application was approved on May 21, 2014 through investigation by the Nuclear Regulatory Agency. Also at implementation of the PLM evaluation, we considered effects of the Great East Japan Earthquake that occurred on March 11, 2011 against ageing phenomena. In this paper, we introduce summary of PLM evaluation for Onagawa NPS-1 and the evaluation that considered effects of the Great East Japan Earthquake. (author)

  16. Development of severe accident management guidance for Younggwang units 5 and 6

    International Nuclear Information System (INIS)

    Lee, K. W.; Beon, C. S.; Kim, M. K.; Hong, S. Y.; Park, K. S.

    2001-01-01

    Severe Accident Management Guidance (SAMG) has been developed for Younggwang Units 5 and 6. It is consisted of Severe Accident Control Room Guideline, Diagnostic Flow Chart, Severe Accident Guideline, Severe Challenge Guideline, TSC Long Term Monitoring, SAMG Termination. Severe Accident Control Room Guideline, which deals with severe accident after finishing Emergency Operation Procedure, consists of acitions before and after TSC actuation. Seven servere accident management strategies are developed. Diagnostic Flow Chart, Severe Accident Guideline, and Severe Challenge Guideline are developed for each strategy, which enables the users to the implementation of strategy easily and systematically. TSC Long Term Monitoring is also developed to monitor long term activities after a particular strategy. Total of 45 set points are developed for decision making during the implementation of the SAMG

  17. Diagnosis and management of tetanus outside the intensive care unit: a case report

    Science.gov (United States)

    Bravo, T. E.; Siregar, M. L.; Jamil, K. F.

    2018-03-01

    Tetanus is an acute, toxin-mediated disease caused by Clostridium tetani infection. Under favorable anaerobic conditions, such as in the unclean environment, necrotic wounds, this ubiquitous bacillus may produce tetanospasmin, an extremely potent neurotoxin. A 38-year-old man was admitted to an emergency room, at Zainoel Abidin General Hospital, with the main complaint of back-muscle stiffness. Based on physical examination, he was fully alert with a slightly rapid breathing, trismus with the maximum oral cavity opening was only about one finger width, but rhisus sardonicus was not evident. Ten days before admission, while gardening, his left foot accidentally stabbed by wooden tree stake. We immediately started a single dose of tetanus immunoglobulin followed by intravenous metronidazole, penicillin G, and intravenous diazepam. Tetanus diagnosed by physical clinical finding. The management of tetanus patients including the use of immunoglobulin and antibiotic therapy, analgesia, sedation and neuromuscular blockade management and mechanical ventilation, the care was delivered outside the Intensive care unit.

  18. Impact of introduction of an acute surgical unit on management and outcomes of small bowel obstruction.

    Science.gov (United States)

    Musiienko, Anton M; Shakerian, Rose; Gorelik, Alexandra; Thomson, Benjamin N J; Skandarajah, Anita R

    2016-10-01

    The acute surgical unit (ASU) is a recently established model of care in Australasia and worldwide. Limited data are available regarding its effect on the management of small bowel obstruction. We compared the management of small bowel obstruction before and after introduction of ASU at a major tertiary referral centre. We hypothesized that introduction of ASU would correlate with improved patient outcomes. A retrospective review of prospectively maintained databases was performed over two separate 2-year periods, before and after the introduction of ASU. Data collected included demographics, co-morbidity status, use of water-soluble contrast agent and computed tomography. Outcome measures included surgical intervention, time to surgery, hospital length of stay, complications, 30-day readmissions, use of total parenteral nutrition, intensive care unit admissions and overall mortality. Total emergency admissions to the ASU increased from 2640 to 4575 between the two time periods. A total of 481 cases were identified (225 prior and 256 after introduction of ASU). Mortality decreased from 5.8% to 2.0% (P = 0.03), which remained significant after controlling for confounders with multivariate analysis (odds ratio = 0.24, 95% confidence interval 0.08-0.73, P = 0.012). The proportion of surgically managed patients increased (20.9% versus 32.0%, P = 0.003) and more operations were performed within 5 days from presentation (76.6% versus 91.5%, P = 0.02). Fewer patients received water-soluble contrast agent (27.1% versus 18.4%, P = 0.02), but more patients were investigated with a computed tomography (70.7% versus 79.7%, P = 0.02). The ASU model of care resulted in decreased mortality, shorter time to intervention and increased surgical management. Overall complications rate and length of stay did not change. © 2015 Royal Australasian College of Surgeons.

  19. 40 CFR Table 18 to Subpart G of... - Information for Waste Management Units To Be Submitted With Notification of Compliance Status a,b

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 9 2010-07-01 2010-07-01 false Information for Waste Management Units... Subpart G of Part 63—Information for Waste Management Units To Be Submitted With Notification of Compliance Status a,b Waste management unit identification c Description d Wastewater stream(s) received or...

  20. The activities of hospital nursing unit managers and quality of patient care in South African hospitals: a paradox?

    Directory of Open Access Journals (Sweden)

    Susan J. Armstrong

    2015-05-01

    Full Text Available Background: Improving the quality of health care is central to the proposed health care reforms in South Africa. Nursing unit managers play a key role in coordinating patient care activities and in ensuring quality care in hospitals. Objective: This paper examines whether the activities of nursing unit managers facilitate the provision of quality patient care in South African hospitals. Methods: During 2011, a cross-sectional, descriptive study was conducted in nine randomly selected hospitals (six public, three private in two South African provinces. In each hospital, one of each of the medical, surgical, paediatric, and maternity units was selected (n=36. Following informed consent, each unit manager was observed for a period of 2 hours on the survey day and the activities recorded on a minute-by-minute basis. The activities were entered into Microsoft Excel, coded into categories, and analysed according to the time spent on activities in each category. The observation data were complemented by semi-structured interviews with the unit managers who were asked to recall their activities on the day preceding the interview. The interviews were analysed using thematic content analysis. Results: The study found that nursing unit managers spent 25.8% of their time on direct patient care, 16% on hospital administration, 14% on patient administration, 3.6% on education, 13.4% on support and communication, 3.9% on managing stock and equipment, 11.5% on staff management, and 11.8% on miscellaneous activities. There were also numerous interruptions and distractions. The semi-structured interviews revealed concordance between unit managers’ recall of the time spent on patient care, but a marked inflation of their perceived time spent on hospital administration. Conclusion: The creation of an enabling practice environment, supportive executive management, and continuing professional development are needed to enable nursing managers to lead the provision

  1. Impact of a risk management plan on Legionella contamination of dental unit water.

    Science.gov (United States)

    Leoni, Erica; Dallolio, Laura; Stagni, Francesca; Sanna, Tiziana; D'Alessandro, Giovanni; Piana, Gabriela

    2015-02-23

    The study aimed to assess the prevalence of Legionella spp. in dental unit waterlines of a dental clinic and to verify whether the microbiological parameters used as indicators of water quality were correlated with Legionella contamination. A risk management plan was subsequently implemented in the dental health care setting, in order to verify whether the adopted disinfection protocols were effective in preventing Legionella colonization. The water delivered from syringes and turbines of 63 dental units operating in a dental clinic, was monitored for counts of the heterotrophic bacteria P. aeruginosa and Legionella spp. (22 °C and 37 °C). At baseline, output water from dental units continuously treated with disinfection products was more compliant with the recommended standards than untreated and periodically treated water. However, continuous disinfection was still not able to prevent contamination by Legionella and P. aeruginosa. Legionella was isolated from 36.4%, 24.3% and 53.3% of samples from untreated, periodically and continuously treated waterlines, respectively. The standard microbiological parameters used as indicators of water quality proved to be unreliable as predictors of the presence of Legionella, whose source was identified as the tap water used to supply the dental units. The adoption of control measures, including the use of deionized water in supplying the dental unit waterlines and the application of a combined protocol of continuous and periodic disinfection, with different active products for the different devices, resulted in good control of Legionella contamination. The efficacy of the measures adopted was mainly linked to the strict adherence to the planned protocols, which placed particular stress on staff training and ongoing environmental monitoring.

  2. Ungulate management in national parks of the United States and Canada

    Science.gov (United States)

    Demarais, S.; Cornicelli, L.; Kahn, R.; Merrill, E.; Miller, C.; Peek, J.M.; Porter, W.F.; Sargeant, G.A.

    2012-01-01

    Enabling legislation—that which gives appropriate officials the authority to implement or enforce the law—impacts management of ungulates in national parks of Canada and the United States (U.S.). The initial focus of such legislation in both countries centered on preserving natural and culturally significant areas for posterity. Although this objective remains primary, philosophies and practices have changed. A Canadian vision for ungulate management emerged during the latter half of the 20th century to protect and maintain or restore the ecological integrity of representative samples of the country’s 39 distinct landscapes, and to include provisions for traditional hunting and fishing practices representative of past cultural impacts on the environment. The current ungulate management approach in the U.S. relies on natural (ecological) processes, as long as normal conditions are promoted and there is no impairment of natural resources. Emphasizing natural processes as the basis has been a challenge because ecosystem dynamics are complex and management is multi-jurisdictional. Additionally, natural regulation typically will not prevent ungulates from reaching and sustaining densities that are incompatible with preservation or restoration of native flora and fauna, natural processes, or historical landscapes.

  3. When do business units benefit more from collective citizenship behavior of management teams? An upper echelons perspective.

    Science.gov (United States)

    Liu, Wu; Gong, Yaping; Liu, Jun

    2014-05-01

    Drawing upon the notion of managerial discretion from upper echelons theory, we theorize which external contingencies moderate the relationship between collective organizational citizenship behavior (COCB) and unit performance. Focusing on business unit (BU) management teams, we hypothesize that COCB of BU management teams enhances BU performance and that this impact depends on environmental uncertainty and BU management-team decision latitude, 2 determinants of managerial discretion. In particular, the positive effect of COCB is stronger when environmental uncertainty or the BU management-team decision latitude is greater. Time-lagged data from 109 BUs of a telecommunications company support the hypotheses. Additional exploratory analysis shows that the positive moderating effect of environmental uncertainty is further amplified at higher levels of BU management-team decision latitude. Overall, this study extends the internally focused view in the micro OCB literature by introducing external contingencies for the COCB-unit-performance relationship. (c) 2014 APA, all rights reserved.

  4. United States high-level radioactive waste management program: Current status and plans

    International Nuclear Information System (INIS)

    Williams, J.

    1992-01-01

    The inventory of spent fuel in storage at reactor sites in the United States is approximately 20,000 metric tons heavy metal (MTHM). It is increasing at a rate of 1700 to 2100 MTHM per year. According to current projections, by the time the last license for the current generation of nuclear reactors expires, there will be an estimated total of 84,000 MTHm. No commercial reprocessing capacity exists or is planned in the US. Therefore, the continued storage of spent fuel is required. The majority of spent fuel remains in the spent fuel pools of the utilities that generated it. Three utilities are presently supplementing pool capacity with on-site dry storage technologies, and four others are planning dry storage. Commercial utilities are responsible for managing their spent fuel until the Federal waste management system, now under development, accepts spent fuel for storage and disposal. Federal legislation charges the Office of Civilian Radioactive Waste Management (OCRWM) within the US Department of Energy (DOE) with responsibility for developing a system to permanently dispose of spent fuel and high level radioactive waste in a manner that protects the health and safety of the public and the quality of the environment. We are developing a waste management system consisting for three components: a mined geologic repository, with a projected start date of 2010; a monitored retrievable storage facility (MRS), scheduled to begin waste acceptance in 1998; and a transportation system to support MRS and repository operations. This paper discusses the background and framework for the program, as well as the current status and plans for management of spent nuclear fuel at commercial utilities; the OCRWM's development of a permanent geologic repository, an MRS, and a transportation system; the OCRWM's safety approach; the OCRWM's program management initiatives; and the OCRWM's external relations activities

  5. Cost of managing an episode of relapse in multiple sclerosis in the United States

    Directory of Open Access Journals (Sweden)

    Ward Alexandra J

    2003-09-01

    Full Text Available Abstract Background The purpose of this study was to determine the direct medical US cost of managing multiple sclerosis relapses. Methods Direct data analysis and cost modeling were employed to derive typical resource use profiles and costs in 2002 US dollars, from the perspective of a third-party payer responsible for comprehensive health-care. The location and scope of health care services provided over a 90-day period were used to define three levels of relapse management. Hospitalization and resulting subsequent care was defined as high intensity management. A medium level of intervention was defined as either use of the emergency room, an observational unit, or administration of acute treatments, such as intravenous methylprednisolone in an outpatient or home setting. The lowest intensity of care comprised physician office visits and symptom-related medications. Data were obtained from many sources including all payer inpatient, ambulatory and emergency room databases from several states, fee schedules, government reports, and literature. All charges were adjusted using cost-to-charge ratios. Results Average cost per person for high management level was $12,870, based on analysis of 4,634 hospital cases (mean age 48 years, 73% female. Hospital care comprised 71% of that cost. At discharge, 36% required inpatient sub-acute care, rehabilitation or home care. The typical cost per moderate episode was $1,847 and mild episode $243. Conclusions Management strategies leading to a reduction in the frequency and severity of a relapse, less reliance on inpatient care, or increased access to steroid infusions in the home, would have a substantial impact on the economic consequences of managing relapses.

  6. 77 FR 56674 - United States v. Humana Inc. and Arcadian Management Services, Inc.; Public Comment and Response...

    Science.gov (United States)

    2012-09-13

    ... students in the United States. The AMA's comment states that: MA [Medicare Advantage] plans in competitive... Services, Inc.; Public Comment and Response on Proposed Final Judgment Pursuant to the Antitrust Procedures... on the proposed Final Judgment in United States v. Humana Inc. and Arcadian Management Services, Inc...

  7. Diagnosis and Management of Tickborne Rickettsial Diseases: Rocky Mountain Spotted Fever and Other Spotted Fever Group Rickettsioses, Ehrlichioses, and Anaplasmosis - United States.

    Science.gov (United States)

    Biggs, Holly M; Behravesh, Casey Barton; Bradley, Kristy K; Dahlgren, F Scott; Drexler, Naomi A; Dumler, J Stephen; Folk, Scott M; Kato, Cecilia Y; Lash, R Ryan; Levin, Michael L; Massung, Robert F; Nadelman, Robert B; Nicholson, William L; Paddock, Christopher D; Pritt, Bobbi S; Traeger, Marc S

    2016-05-13

    Tickborne rickettsial diseases continue to cause severe illness and death in otherwise healthy adults and children, despite the availability of low-cost, effective antibacterial therapy. Recognition early in the clinical course is critical because this is the period when antibacterial therapy is most effective. Early signs and symptoms of these illnesses are nonspecific or mimic other illnesses, which can make diagnosis challenging. Previously undescribed tickborne rickettsial diseases continue to be recognized, and since 2004, three additional agents have been described as causes of human disease in the United States: Rickettsia parkeri, Ehrlichia muris-like agent, and Rickettsia species 364D. This report updates the 2006 CDC recommendations on the diagnosis and management of tickborne rickettsial diseases in the United States and includes information on the practical aspects of epidemiology, clinical assessment, treatment, laboratory diagnosis, and prevention of tickborne rickettsial diseases. The CDC Rickettsial Zoonoses Branch, in consultation with external clinical and academic specialists and public health professionals, developed this report to assist health care providers and public health professionals to 1) recognize key epidemiologic features and clinical manifestations of tickborne rickettsial diseases, 2) recognize that doxycycline is the treatment of choice for suspected tickborne rickettsial diseases in adults and children, 3) understand that early empiric antibacterial therapy can prevent severe disease and death, 4) request the appropriate confirmatory diagnostic tests and understand their usefulness and limitations, and 5) report probable and confirmed cases of tickborne rickettsial diseases to public health authorities.

  8. A historical context of municipal solid waste management in the United States.

    Science.gov (United States)

    Louis, Garrick E

    2004-08-01

    Municipal solid waste management (MSWM) in the United States is a system comprised of regulatory, administrative, market, technology, and social subcomponents, and can only be understood in the context of its historical evolution. American cities lacked organized public works for street cleaning, refuse collection, water treatment, and human waste removal until the early 1800s. Recurrent epidemics forced efforts to improve public health and the environment. The belief in anticontagionism led to the construction of water treatment and sewerage works during the nineteenth century, by sanitary engineers working for regional public health authorities. This infrastructure was capital intensive and required regional institutions to finance and administer it. By the time attention turned to solid waste management in the 1880s, funding was not available for a regional infrastructure. Thus, solid waste management was established as a local responsibility, centred on nearby municipal dumps. George Waring of New York City organized solid waste management around engineering unit operations; including street sweeping, refuse collection, transportation, resource recovery and disposal. This approach was adopted nationwide, and was managed by City Departments of Sanitation. Innovations such as the introduction of trucks, motorized street sweepers, incineration, and sanitary landfill were developed in the following decades. The Resource Conservation and Recovery Act of 1976 (RCRA), is the defining legislation for MSWM practice in America today. It forced the closure of open dumps nationwide, and required regional planning for MSWM. The closure of municipal dumps caused a 'garbage crisis' in the late 1980s and early 1990s. Private companies assumed an expanded role in MSWM through regional facilities that required the transportation of MSW across state lines. These transboundary movements of MSW created the issue of flow control, in which the US Supreme Court affirmed the protection

  9. Broadening GHG accounting with LCA: application to a waste management business unit.

    Science.gov (United States)

    Fallaha, Sophie; Martineau, Geneviève; Bécaert, Valérie; Margni, Manuele; Deschênes, Louise; Samson, Réjean; Aoustin, Emmanuelle

    2009-11-01

    In an effort to obtain the most accurate climate change impact assessment, greenhouse gas (GHG) accounting is evolving to include life-cycle thinking. This study (1) identifies similarities and key differences between GHG accounting and life-cycle assessment (LCA), (2) compares them on a consistent basis through a case study on a waste management business unit. First, GHG accounting is performed. According to the GHG Protocol, annual emissions are categorized into three scopes: direct GHG emissions (scope 1), indirect emissions related to electricity, heat and steam production (scope 2) and other indirect emissions (scope 3). The LCA is then structured into a comparable framework: each LCA process is disaggregated into these three scopes, the annual operating activities are assessed, and the environmental impacts are determined using the IMPACT2002+ method. By comparing these two approaches it is concluded that both LCA and GHG accounting provide similar climate change impact results as the same major GHG contributors are determined for scope 1 emissions. The emissions from scope 2 appear negligible whereas emissions from scope 3 cannot be neglected since they contribute to around 10% of the climate change impact of the waste management business unit. This statement is strengthened by the fact that scope 3 generates 75% of the resource use damage and 30% of the ecosystem quality damage categories. The study also shows that LCA can help in setting up the framework for a annual GHG accounting by determining the major climate change contributors.

  10. Identifying strengths and weaknesses of Quality Management Unit University of Sumatera Utara software using SCAMPI C

    Science.gov (United States)

    Gunawan, D.; Amalia, A.; Rahmat, R. F.; Muchtar, M. A.; Siregar, I.

    2018-02-01

    Identification of software maturity level is a technique to determine the quality of the software. By identifying the software maturity level, the weaknesses of the software can be observed. As a result, the recommendations might be a reference for future software maintenance and development. This paper discusses the software Capability Level (CL) with case studies on Quality Management Unit (Unit Manajemen Mutu) University of Sumatera Utara (UMM-USU). This research utilized Standard CMMI Appraisal Method for Process Improvement class C (SCAMPI C) model with continuous representation. This model focuses on activities for developing quality products and services. The observation is done in three process areas, such as Project Planning (PP), Project Monitoring and Control (PMC), and Requirements Management (REQM). According to the measurement of software capability level for UMM-USU software, turns out that the capability level for the observed process area is in the range of CL1 and CL2. Planning Project (PP) is the only process area which reaches capability level 2, meanwhile, PMC and REQM are still in CL 1 or in performed level. This research reveals several weaknesses of existing UMM-USU software. Therefore, this study proposes several recommendations for UMM-USU to improve capability level for observed process areas.

  11. Tuberculosis genotyping information management system: enhancing tuberculosis surveillance in the United States.

    Science.gov (United States)

    Ghosh, Smita; Moonan, Patrick K; Cowan, Lauren; Grant, Juliana; Kammerer, Steve; Navin, Thomas R

    2012-06-01

    Molecular characterization of Mycobacterium tuberculosis complex isolates (genotyping) can be used by public health programs to more readily identify tuberculosis (TB) transmission. The Centers for Disease Control and Prevention's National Tuberculosis Genotyping Service has offered M. tuberculosis genotyping for every culture-confirmed case in the United States since 2004. The TB Genotyping Information Management System (TB GIMS), launched in March 2010, is a secure online database containing genotype results linked with case characteristics from the national TB registry for state and local TB programs to access, manage and analyze these data. As of September 2011, TB GIMS contains genotype results for 89% of all culture-positive TB cases for 2010. Over 400 users can generate local and national reports and maps using TB GIMS. Automated alerts on geospatially concentrated cases with matching genotypes that may represent outbreaks are also generated by TB GIMS. TB genotyping results are available to enhance national TB surveillance and apply genotyping results to conduct TB control activities in the United States. Published by Elsevier B.V.

  12. [Activity-based costing methodology to manage resources in intensive care units].

    Science.gov (United States)

    Alvear V, Sandra; Canteros G, Jorge; Jara M, Juan; Rodríguez C, Patricia

    2013-11-01

    An accurate estimation of resources use by individual patients is crucial in hospital management. To measure financial costs of health care actions in intensive care units of two public regional hospitals in Chile. Prospective follow up of 716 patients admitted to two intensive care units during 2011. The financial costs of health care activities was calculated using the Activity-Based Costing methodology. The main activities recorded were procedures and treatments, monitoring, response to patient needs, patient maintenance and coordination. Activity-Based Costs, including human resources and assorted indirect costs correspond to 81 to 88% of costs per disease in one hospital and 69 to 80% in the other. The costs associated to procedures and treatments are the most significant and are approximately $100,000 (Chilean pesos) per day of hospitalization. The second most significant cost corresponds to coordination activities, which fluctuates between $86,000 and 122,000 (Chilean pesos). There are significant differences in resources use between the two hospitals studied. Therefore cost estimation methodologies should be incorporated in the management of these clinical services.

  13. Effect of different water management strategies on water and contaminant fluxes in Doncaster, United Kingdom.

    Science.gov (United States)

    Rueedi, J; Cronin, A A; Moon, B; Wolf, L; Hoetzl, H

    2005-01-01

    In Europe, large volumes of public water supply come from urban aquifers and so efficient urban water management and decision tools are essential to maintain quality of life both in terms of health, personal freedom and environment. In the United Kingdom, this issue gained increased importance with the last year's low volumes of groundwater replenishment that resulted in increased water shortages all over the country. An urban water volume and quality model (UVQ) was applied to a suburb of Doncaster (United Kingdom) to assess the current water supply system and to compare it with new potential scenarios of water management. The initial results show considerable changes in both water and solute fluxes for some scenarios and rather limited changes for others. Changing impermeable roads and paved areas to permeable areas, for example, would lead to higher infiltration rates that may be welcome from a water resources viewpoint but less so from a water quality point of view due to high concentrations of heavy metals. The biggest impact on water quality and quantity leaving the system through sewer, storm water and infiltration system was clearly obtained by re-using grey water from kitchen, bathroom and laundry for irrigation and toilet flush. The testing of this strategy led to lower volumes and higher concentrations of sewerage, a considerable decrease in water consumption and an increase in groundwater recharge. The scenarios were tested neither in terms of costs nor social acceptance for either water supplier or user.

  14. Book review: Biology and management of invasive quagga and zebra mussels in the western United States

    Science.gov (United States)

    Benson, Amy J.

    2017-01-01

    Water is a precious and limited commodity in the western United States and its conveyance is extremely important. Therefore, it is critical to do as much as possible to prevent the spread of two species of dreissenid mussels, both non-native and highly invasive aquatic species already well-established in the eastern half of the United States. This book addresses the occurrences of the two dreissenid mussels in the West, the quagga mussel and the zebra mussel, that are both known to negatively impact water delivery systems and natural ecosystems. It is edited by two researchers whom have extensive experience working with the mussels in the West and is composed of 34 chapters, or articles, written by a variety of experts.Book information: Biology and Management of Invasive Quagga and Zebra Mussels in the Western United States. Edited by Wai Hing Wong and Shawn L. Gerstenberger. Boca Raton (Florida): CRC Press (Taylor & Francis Group). $149.95. xx + 545 p.; ill.; index. ISBN: 978-1-4665-9561-3. [Compact Disc included.] 2015.

  15. Biodiversity and management of the Madrean Archipelago: The Sky Islands of southwestern United States and northwestern Mexico

    Science.gov (United States)

    Leonard H. DeBano; Peter H. Ffolliott; Alfredo Ortega-Rubio; Gerald J. Gottfried; Robert H. Hamre; Carleton B. Edminster

    1995-01-01

    This conference brought together scientists and managers from government, universities, and private organizations to examine the biological diversity and management challenges of the unique "sky island" ecosystems of the mountains of the southwestern United States and northwestern Mexico. Session topics included: floristic resources, plant ecology,...

  16. Use of supply chains and supply chain managment to improve the efficiency and effectiveness of GIS units

    CSIR Research Space (South Africa)

    Schmitz, Peter MU

    2007-06-01

    Full Text Available The objective of this study is to provide a tool, namely the establishment of supply chains and supply chain management to manage this chain, enabling a GIS unit to respond to the needs of their customers with the right product at the right time...

  17. Pre-hospital care after a seizure: Evidence base and United Kingdom management guidelines.

    Science.gov (United States)

    Osborne, Andrew; Taylor, Louise; Reuber, Markus; Grünewald, Richard A; Parkinson, Martin; Dickson, Jon M

    2015-01-01

    Seizures are a common presentation to pre-hospital emergency services and they generate significant healthcare costs. This article summarises the United Kingdom (UK) Ambulance Service guidelines for the management of seizures and explores the extent to which these guidelines are evidence-based. Summary of the Clinical Practice Guidelines of the UK Joint Royal Colleges Ambulance Liaison Committee relating to the management of seizures. Review of the literature relating to pre-hospital management of seizure emergencies. Much standard practice relating to the emergency out of hospital management of patients with seizures is drawn from generic Advanced Life Support (ALS) guidelines although many patients do not need ALS during or after a seizure and the benefit of many ALS interventions in seizure patients remains to be established. The majority of studies identified pertain to medical treatment of status epilepticus. These papers show that benzodiazepines are safe and effective but it is not possible to draw definitive conclusions about the best medication or the optimal route of administration. The evidence base for current pre-hospital guidelines for seizure emergencies is incomplete. A large proportion of patients are transported to hospital after a seizure but many of these may be suitable for home management. However, there is very little research into alternative care pathways or criteria that could be used to help paramedics avoid transport to hospital. More research is needed to improve care for people after a seizure and to improve the cost-effectiveness of the healthcare systems within which they are treated. Copyright © 2014 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  18. Implementing the Corrective Action Management Unit at Sandia National Laboratories, New Mexico

    International Nuclear Information System (INIS)

    Moore, Darlene R.; Schrader, Scott A.; King, Gabriel G.; Cormier, John

    2000-01-01

    In September 1997, following significant public and regulator interaction, Sandia Corporation (Sandia) was granted a Resource Conservation and Recovery Act (RCRA) and Hazardous Solid Waste Amendment (HSWA) permit modification allowing construction and operation of a Correction Action Management Unit (CAMU). The CAMU follows recent regulatory guidance that allows for cost-effective, expedient cleanup of contaminated sites and management of hazardous remediation wastes. The CAMU was designed to store, treat, and provide long-term management for Environmental Restoration (ER) derived wastes. The 154 square meter CAMU site at Sandia National Laboratories, New Mexico (SNL/NM), includes facilities for storing bulk soils and containerized wastes, for treatment of bulk soils, and has a containment cell for long-term disposition of waste. Proposed treatment operations include soil washing and low temperature thermal desorption. The first waste was accepted into the CAMU for temporary storage in January 1999. Construction at the CAMU was completed in March 1999, and baseline monitoring of the containment cell has commenced. At completion of operations the facility will be closed, the waste containment cell will be covered, and long-term post-closure monitoring will begin. Sandia's CAMU is the only such facility within the US Department of Energy (DOE) complex. Implementing this innovative approach to ER waste management has required successful coordination with community representatives, state and federal regulators, the DOE, Sandia corporate management, and contractors. It is expected that cost savings to taxpayers will be significant. The life-cycle CAMU project cost is currently projected to be approximately $12 million

  19. Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN): evolution of a content management system for point-of-care clinical decision support.

    Science.gov (United States)

    Barwise, Amelia; Garcia-Arguello, Lisbeth; Dong, Yue; Hulyalkar, Manasi; Vukoja, Marija; Schultz, Marcus J; Adhikari, Neill K J; Bonneton, Benjamin; Kilickaya, Oguz; Kashyap, Rahul; Gajic, Ognjen; Schmickl, Christopher N

    2016-10-03

    The Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN) is an international collaborative project with the overall objective of standardizing the approach to the evaluation and treatment of critically ill patients world-wide, in accordance with best-practice principles. One of CERTAIN's key features is clinical decision support providing point-of-care information about common acute illness syndromes, procedures, and medications in an index card format. This paper describes 1) the process of developing and validating the content for point-of-care decision support, and 2) the content management system that facilitates frequent peer-review and allows rapid updates of content across different platforms (CERTAIN software, mobile apps, pdf-booklet) and different languages. Content was created based on survey results of acute care providers and validated using an open peer-review process. Over a 3 year period, CERTAIN content expanded to include 67 syndrome cards, 30 procedure cards, and 117 medication cards. 127 (59 %) cards have been peer-reviewed so far. Initially MS Word® and Dropbox® were used to create, store, and share content for peer-review. Recently Google Docs® was used to make the peer-review process more efficient. However, neither of these approaches met our security requirements nor has the capacity to instantly update the different CERTAIN platforms. Although we were able to successfully develop and validate a large inventory of clinical decision support cards in a short period of time, commercially available software solutions for content management are suboptimal. Novel custom solutions are necessary for efficient global point of care content system management.

  20. What to do when she's bleeding through: the recognition, evaluation, and management of abnormal uterine bleeding in adolescents.

    Science.gov (United States)

    Bennett, Alyssa R; Gray, Susan H

    2014-08-01

    This article reviews the current understanding and management of abnormal uterine bleeding (AUB) in adolescents. The readers will learn a practical approach to the evaluation and treatment of mild-to-severe uterine bleeding. In 2011, a new classification system was proposed to standardize the terminology used to describe AUB. This system is based on the pattern and etiology of bleeding and has been adopted by other organizations. The term dysfunctional uterine bleeding has been replaced by AUB. The negative effect of AUB on adolescents' quality of life is now well established. The levonorgestrel-releasing intrauterine system is considered a first-line treatment for heavy menstrual bleeding and should be considered, especially in those adolescents who may also need contraception. AUB is a common adolescent complaint that can vary from mild to life-threatening if not recognized and treated promptly. This article reviews the appropriate assessment and management of AUB and proposes a practical algorithm that can be used in an office or hospital setting.

  1. Integrating genetic data and population viability analyses for the identification of harbour seal (Phoca vitulina) populations and management units

    DEFF Research Database (Denmark)

    Olsen, Morten Tange; Andersen, Liselotte Wesley; Dietz, Rune

    2014-01-01

    present a novel approach, integrating genetic, life-history and demographic data to identify populations and management units in southern Scandinavian harbour seals. First, 15 microsatellite markers and model- and distance-based genetic clustering methods were used to determine the population genetic...... structure in harbour seals. Second, we used harbour seal demographic and life-history data to conduct population viability analyses (PVAs) in the VORTEX simulation model in order to determine whether the inferred genetic units could be classified as management units according to Lowe and Allendorf's (2010......, and that the combined use of genetic data and PVAs constitute a promising approach for delineating populations and management units. This article is protected by copyright. All rights reserved....

  2. CONCEPTUAL BASES OF THE ENERGY EFFICIENT SYSTEM OF MANAGEMENT OF COMBINED UNITS OF WASTEWATER TREATMENT

    Directory of Open Access Journals (Sweden)

    V. N. Shtepa

    2016-01-01

    Full Text Available A critical analysis of the shortcomings of the existing water purification systems is conducted. In order to ensure environmental safety and energy savings it is proposed to use the combined units, including physical, chemical, physical-and-chemical and biological methods. The attention is driven to the fact that the most effective way to maintain current water purification is an adaptive control system. The shortcomings of the management of water treatment units were revealed and it was proposed to produce their synthesis based on the mathematical apparatus of artificial intelligence systems. Taking into account the requirements of the environmental safety and the need in the energy savings, the energy efficiency criteria of combined system functioning has been developed. At an industrial plant (slaughterhouse wastewater treatment the compliance of the production conditions of the criterion has been undertaken that confirmed the criterion relevance and usefulness as applied to the synthesis of energy-efficient control systems. A synthetic control system combined the water treatment plants. Having based on the preliminary research and analysis of the current work in the subject area the architecture of a control system of combined water treatment units that use intelligent technology was developed. The key functional of the unit – information-analytical subsystem of the formation control actions including: multilayer perceptrons self-organization Kohonen network, fuzzy cognitive map. The basic difference between the developed design and its analogues is the ability to adjust the settings of equipment adaptively on the basis of processing sensor data, information on the price of consumables, volley discharges of pollutants, a sudden change in the flow and other force majeure. Adjustment of the parameters of the control system is carried out with the use of experimental and analytical data stored in the knowledge base of technological

  3. Review of selected contributions of the conference 'Integrated quality management systems in completion of units 3 and 4 Mochovce'

    International Nuclear Information System (INIS)

    2009-04-01

    There were 14 contributions presented of the conference focused on the integrated quality management systems in completion EMO34. Contributions were focused both on theoretical problems from the project management area and on the applications in practice in management systems implementation in accordance with the standards: STN EN ISO 9001:2000, STN EN ISO 14 001:2005, and OHSAS 18 001:1999 at the completion of the Nuclear Power Plant Mochovce of units 3 and 4

  4. The influence of impression management scales on the Personality Assessment Inventory in the epilepsy monitoring unit.

    Science.gov (United States)

    Purdom, Catherine L; Kirlin, Kristin A; Hoerth, Matthew T; Noe, Katherine H; Drazkowski, Joseph F; Sirven, Joseph I; Locke, Dona E C

    2012-12-01

    The Somatic Complaints scale (SOM) and Conversion subscale (SOM-C) of the Personality Assessment Inventory perform best in classifying psychogenic non-epileptic seizures (PNES) from epileptic seizures (ES); however, the impact of positive impression management (PIM) and negative impression management (NIM) scales on SOM and SOM-C classification has not been examined. We studied 187 patients from an epilepsy monitoring unit with confirmed PNES or ES. On SOM, the best cut score was 72.5 T when PIM was elevated and 69.5 T when there was no bias. On SOM-C, when PIM was elevated, the best cut score was 67.5 T and 76.5 T when there was no bias. Negative impression management elevations (n=9) were too infrequent to analyze separately. Despite similarities in classification accuracy, there were differences in sensitivity and specificity with and without PIM, impacting positive and negative predictive values. The presence of PIM bias generally increases positive predictive power of SOM and SOM-C but decreases negative predictive power. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Healthcare waste management: a case study from the National Health Service in Cornwall, United Kingdom

    International Nuclear Information System (INIS)

    Tudor, T.L.; Noonan, C.L.; Jenkin, L.E.T.

    2005-01-01

    This paper looks at steps taken towards the development of a 10-year strategy for the management of healthcare waste from the National Health Service (NHS) in Cornwall, United Kingdom. The major issues and challenges that affect the management of waste by the NHS, including its organisational structure and collection infrastructure, are outlined. The waste flows of the main acute medical site are detailed, using waste audits of domestic and clinical bags, redundant equipment, bulky waste, and special waste. Some of the common barriers to change, such as staff habits and public perceptions, are also identified. Recommendations are made with respect to improvements in the overall organisational infrastructure and increased localised control. The recommendations also centre around the formation of strategic partnerships, within the site, between sites and at the broader level between the NHS and its surrounding community. An important challenge to be overcome is the need to progress from the concept of 'waste management', to one of sustainable decision making regarding resource use, including methods of waste minimisation at the source and recycling. Staff training and awareness underpin several of the short and medium/long term solutions suggested to reduce the waste at the source and recover value from that produced. These measures could potentially reduce disposal quantities by as much as 20-30% (wt.) and costs by around 25-35%

  6. Complications of Transvaginal Mesh for Pelvic Organ Prolapse and Stress Urinary Incontinence: Tips for Prevention, Recognition, and Management.

    Science.gov (United States)

    MacDonald, Susan; Terlecki, Ryan; Costantini, Elisabetta; Badlani, Gopal

    2016-08-01

    Mesh-related complications following transvaginal management of pelvic organ prolapse (POP) and/or stress urinary incontinence (SUI) have received significant attention in the last decade. We sought to identify patient, product, and technical factors associated with an increased risk of complications after mesh-based transvaginal repair of anterior POP and SUI. In this review we clarify the different pattern of complications after POP and SUI repairs. Our aim is to provide a practical evidence-based guide for physicians to prevent and, if necessary, manage product-associated complications in a stepwise manner. We conducted a comprehensive PubMed search of all English-language articles published from 2010 to June 2016, using these search terms: mesh, pelvic organ prolapse, and stress urinary incontinence. Expert opinion is also provided. Mesh-related complications are much lower after repair of SUI compared with POP, despite its more frequent use. Vaginal exposure is the most common mesh-specific complication. Patients may present with vaginal discharge, dyspareunia, pain, recurrent urinary tract infection, and/or hematuria. Conversely, patients may be asymptomatic. Small asymptomatic mesh exposures (mesh encountered within the urinary tract must be fully excised. Following excision, pain may persist in up to 50% of patients. Vaginal extrusion, persistent pain, and urethral and/or bladder erosion are the three most common product-specific complications following mesh-based repair for SUI or POP. Conservative therapies may be attempted, but most patients ultimately require partial or complete mesh excision. We reviewed the recent literature on mesh-related complications after repair of pelvic organ prolapse (POP) and stress urinary incontinence (SUI). Vaginal exposure, persistent pain, and erosion into the urinary tract are the most common. These often require surgical management, best suited to a urologist with training and experience in this area. Evidence supports

  7. Model development of production management unit to enhance entrepreneurship attitude of vocational school students from fashion department

    Science.gov (United States)

    Sumaryani, Sri

    2018-03-01

    The purpose of this study is to develop a model of production management unit to enhance entrepreneurship attitude of vocational school students from fashion department. This study concerns in developing students' entrepreneurship attitude in management which includes planning, organizing, applying and evaluation. The study uses Research and Development (R & D) approach with three main steps; preliminary study, development step, and product validation. Research subject was vocational school teachers from fashion department in Semarang, Salatiga and Demak. This study yields a development model of production management unit that could enhance vocational school students' entrepreneurship attitude in fashion department. The result shows that research subjects have understood about of production management unit in Vocational School (SMK).

  8. The Relationship Between the Occurrence of Conflicts in the Work Unit, the Conflict Management Styles in the Work Unit and Workplace Bullying

    Directory of Open Access Journals (Sweden)

    Elfi Baillien

    2010-12-01

    Full Text Available The current study examines the relationship between the occurrence of conflicts in the work unit and conflict management styles in the work unit, and workplace bullying. First, we assume a positive relationship between the occurrence of conflicts and bullying; and that the conflict management styles 'fighting', 'avoiding' and 'yielding' associate positively and 'problem solving' associates negatively with bullying. Second, we expect that the work unit's conflict management styles moderate the relationship between the occurrence of conflicts and bullying. Results ('N' = 942 revealed a positive association between the occurrence of conflicts and bullying, as well as between fighting and bullying. Problem solving related negatively with bullying. Unexpectedly, we found no moderation. Our findings suggest that particularly the occurrence of conflicts relate to bullying, which may be owed to a strong negative connotation associated with (many conflicts at work or to its negative impact on the work unit's social climate. Organisations may also encourage problem solving and discourage fighting to prevent bullying.

  9. Tribal-federal collaboration in resource management

    Science.gov (United States)

    Ellen M. Donoghue; Sara A. Thompson; John C. Bliss

    2010-01-01

    The increase in collaborative projects involving American Indian tribes and natural resource management agencies in the United States reflects two emergent trends: 1) the use of collaborative approaches between agencies and groups in managing natural resources; and 2) the concurrent increased recognition of American Indian rights, institutionalization of consultation...

  10. Management of patients in a dedicated burns intensive care unit (BICU) in a developing country.

    Science.gov (United States)

    Hashmi, Madiha; Kamal, Rehana

    2013-05-01

    In Pakistan the practice of managing extensive burns in dedicated intensive care units is not well established. This audit aims to define the characteristics of the victims of major burns and factors that increase mortality and outcome of the protocol-based management in a dedicated burns intensive care unit (BICU). This prospective audit included all patients admitted to the BICU of Suleiman Dawood Burns Unit in Karachi from 1st September 2002 to 31st August 2011. Demographic information, type and place of burn, total body surface area burn (TBSA), type of organ support provided, length of ICU stay, any associated medical diseases, and out outcome were documented. A total of 1597 patients were admitted to the BICU in 9 years. Median age of the patients was 22 (IQR =32-7). 32% victims were children 50 years old. Male to female ratio was 1.4:1. Fire was the leading cause of burns in adults (64%) and scald burns were most common in (64%) in children. 72.4% of the accidents happened at home, where kitchen was the commonest location (597 cases). Mean TBSA burnt was 32.5% (SD ± 22.95%, 95%CI: 31.36-33.61). 27% patients needed ventilatory support, 4% were dialyzed and split skin graftings were performed in 20% patients. Average length of ICU stay was 10.42 days. Epilepsy, psychiatric illness and drug addiction were not common associations with burns. Overall mortality was 41.30% but it decreased over the years from 75% to 27%. Groups of people most vulnerable to sustain burn are young females getting burnt in the kitchen, young males getting burnt at work, and small children falling in pots of hot water stored for drinking or bathing. TBSA >40%, age >50 years, fire burn and female gender were associated with a higher risk of death. Carefully planned, protocol based management of burn patients by burn teams of dedicated healthcare professionals, even with limited resources reduced mortality. Burn hazard awareness, prevention and educational programmes targeted at the

  11. The management of safety within the completion of units 3. and 4. in NPP Mochovce

    International Nuclear Information System (INIS)

    Ocenas, M.

    2009-01-01

    The contribution defines the way of management of safety and protection of health and protection against the fire during completion of units 3. and 4. in NPP Mochovce. The creation of the management of safety raised from the legal and other requirements applied in the civil activities and mainly from the requirements for coordination of safety on the site. The whole system is methodically managed through the 5 basic documents so-called 'Building rules': 1) Safety-technical conditions of performance in SE, Inc. Bratislava (project MO34); 2) MO34/1/MNA-003.00-02 the elaboration of the integrated safety plan; 3) MO34/1/NA-003.00-03 risks analyse; 4) PNM3460100 Integrated safety plan for completion of Units 3.and 4 in NPP Mochovce; 5) Project of construction organization. The system itself of the management of the safety prevention must by provided by the supplier in compliance with the standard OHSAS 18 001 and ISO 14001, and in compliance with the requirement of the builder applied in the technical specification for the contract. Most of necessary related documentation of Safety plan for the site is usually part of the documentation for quality management of contractor. Therefore it is necessary to put the reference in each chapter of the Safety plan for site and the standpoint how to apply it for the particular specific situation. The coordinator is mandatory to manage the prevention for the part of safety of specified site and to coordinate the activity of suppliers during the works tie in this way, that the each contractor shall meet the safety requirements given by safety plan and also to identify and to eliminate the risks menaced in the particular work places or the suppliers each other. The builder established its own control system and for this purpose he settled the data base so-called 'The system of corrective and precautionary activities'. The system registers in its data base all discrepancies determined during the regular controls of the head workers

  12. Delineating managed land for reporting national greenhouse gas emissions and removals to the United Nations framework convention on climate change.

    Science.gov (United States)

    Ogle, Stephen M; Domke, Grant; Kurz, Werner A; Rocha, Marcelo T; Huffman, Ted; Swan, Amy; Smith, James E; Woodall, Christopher; Krug, Thelma

    2018-05-29

    Land use and management activities have a substantial impact on carbon stocks and associated greenhouse gas emissions and removals. However, it is challenging to discriminate between anthropogenic and non-anthropogenic sources and sinks from land. To address this problem, the Intergovernmental Panel on Climate Change developed a managed land proxy to determine which lands are contributing anthropogenic greenhouse gas emissions and removals. Governments report all emissions and removals from managed land to the United Nations Framework Convention on Climate Change based on this proxy, and policy interventions to reduce emissions from land use are expected to focus on managed lands. Our objective was to review the use of the managed land proxy, and summarize the criteria that governments have applied to classify land as managed and unmanaged. We found that the large majority of governments are not reporting on their application of the managed land proxy. Among the governments that do provide information, most have assigned all area in specific land uses as managed, while designating all remaining lands as unmanaged. This designation as managed land is intuitive for croplands and settlements, which would not exist without management interventions, but a portion of forest land, grassland, and wetlands may not be managed in a country. Consequently, Brazil, Canada and the United States have taken the concept further and delineated managed and unmanaged forest land, grassland and wetlands, using additional criteria such as functional use of the land and accessibility of the land to anthropogenic activity. The managed land proxy is imperfect because reported emissions from any area can include non-anthropogenic sources, such as natural disturbances. However, the managed land proxy does make reporting of GHG emissions and removals from land use more tractable and comparable by excluding fluxes from areas that are not directly influenced by anthropogenic activity. Moreover

  13. [Necrotizing fasciitis: results of a survey on management practices in French-speaking intensive care units].

    Science.gov (United States)

    de Prost, N; Bosc, R; Brun-Buisson, C; Chosidow, O; Decousser, J-W; Dhonneur, G; Lepeule, R; Rahmouni, A; Sbidian, E; Amathieu, R

    2014-12-01

    Necrotizing fasciitis (NF) are rare and severe soft tissue infections associated with a high mortality rate. In order to assess the management of NF in French-speaking intensive care units (ICUs), we conducted a survey endorsed by the French Society of Anesthesia and Intensive Care (SFAR). Online self-administered survey. A link to an online survey was sent by email to 4620 anesthesiologists and/or intensivists and was available online from January to February 2014. One hundred and seventy-five physicians (3.8%) who worked in 135 ICUs filled out the online survey. Among respondents, 42% reported having managed up to two patients with NF during the previous year; 59% and 72% of respondents reported not having a surgical and a medical specialist consultant, respectively. A delayed access to the operating room (OR) of more than 6hours was reported in 31% of cases and access to the OR was reported not to be routinely considered as a priority in 13% of cases. Only 17% of respondents reported that time to transfer to the OR was never a cause for delayed surgery. The main causes for delayed surgery were: delayed diagnosis (45%), delayed validation of surgical intervention (37%), and difficulty of access to the OR (8%). Finally, 83% of respondents estimated that creating dedicated multidisciplinary teams for managing NFs could lead to improving outcomes. This survey illustrates the heterogeneous management of NF in French-speaking ICUs and points out several logistical aspects that should be improved to reduce the time to the first surgical debridement. Copyright © 2014 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

  14. A United States perspective on long term management of areas contaminated with radioactive materials

    International Nuclear Information System (INIS)

    Jones, C.R.

    2003-01-01

    Full text: The United States has far-reaching experience in the long-term management of areas contaminated with radioactive materials. The events resulting from the atmospheric testing of nuclear weapons in the Marshall Islands, follow-up from Hiroshima and Nagasaki, accidents, and the environmental cleanup of our weapons complex have resulted in an extensive body of lessons learned and best practices. The lack of trust created in the affected population, regardless of cause of the spread of radioactive material, creates the working environment for long-term management of the situation. The extent of advanced planning for such an event will define and bound your ultimate success in reaching a conclusion acceptable to the affected parties. The two key issues to be addressed in the long-term management of areas contaminated with radioactive materials are the two 'T's' - technical and trust. The technical issues to be resolved include: access to the affected area; infrastructure to support operations; local and imported staffing; health care for the affected population; and payment to name a few. In addressing the issue of trust it is critical to establish open, honest and inclusive communications and decision making with the affected population and stakeholders, with clear roles and responsibilities defined. Actions must be sensitive to local cultural issues and agreements reached with affected populations prior to actions being taken. Establishment of an alternative views resolution process helps build trust and allow actions to taken. Government to government relations and agreements must be established with an acceptance and understanding of the long term investment in time and resources needed. Planning ahead for such an eventuality and putting in place procedures, agreements and resources needed to address the technical and trust issues associated with the long-term management of areas contaminated with radioactive materials enhances success. (author)

  15. Design of RF energy harvesting platforms for power management unit with start-up circuits

    Science.gov (United States)

    Costanzo, Alessandra; Masotti, Diego

    2013-12-01

    In this contribution we discuss an unconventional rectifier design dedicated to RF energy harvesting from ultra-low sources, such as ambient RF sources which are typically of the order of few to few tens of μW. In such conditions unsuccessful results may occur if the rectenna is directly connected to its actual load since either the minimum power or the minimum activation voltage may not be simultaneously available. For this reason a double-branch rectifier topology is considered for the power management unit (PMU), instead of traditional single-branch one. The new PMU, interposed between the rectenna and application circuits, allows the system to operate with significantly lower input power with respect to the traditional solution, while preserving efficiency during steady-state power conversion.

  16. Design of RF energy harvesting platforms for power management unit with start-up circuits

    International Nuclear Information System (INIS)

    Costanzo, Alessandra; Masotti, Diego

    2013-01-01

    In this contribution we discuss an unconventional rectifier design dedicated to RF energy harvesting from ultra-low sources, such as ambient RF sources which are typically of the order of few to few tens of μW. In such conditions unsuccessful results may occur if the rectenna is directly connected to its actual load since either the minimum power or the minimum activation voltage may not be simultaneously available. For this reason a double-branch rectifier topology is considered for the power management unit (PMU), instead of traditional single-branch one. The new PMU, interposed between the rectenna and application circuits, allows the system to operate with significantly lower input power with respect to the traditional solution, while preserving efficiency during steady-state power conversion

  17. United States Program on Spent Nuclear Fuel and High-Level Radioactive Waste Management

    International Nuclear Information System (INIS)

    Stewart, L.

    2004-01-01

    The President signed the Congressional Joint Resolution on July 23, 2002, that designated the Yucca Mountain site for a proposed geologic repository to dispose of the nation's spent nuclear fuel (SNF) and high-level radioactive waste (HLW). The United States (U.S.) Department of Energy's (DOE) Office of Civilian Radioactive Waste Management (OCRWM) is currently focusing its efforts on submitting a license application to the U.S. Nuclear Regulatory Commission (NRC) in December 2004 for construction of the proposed repository. The legislative framework underpinning the U.S. repository program is the basis for its continuity and success. The repository development program has significantly benefited from international collaborations with other nations in the Americas

  18. Management of encopresis in early adolescence in a medical-psychiatric unit.

    Science.gov (United States)

    Fennig, S; Fennig, S

    1999-01-01

    The aim of this work is to present the role of a medical-psychiatric unit in the treatment of chronic resistant encopresis in adolescence as an effective alternative to the standard approach. Four case reports are presented. The integrative program is based on full patient cooperation and involves separating the patient from the family environment and the use of medical intervention combined with modified behavioral therapy and parental education and guidance. The patient is given full responsibility for the cure. The median full hospital stay for our patients was 2 weeks, and outcome in all cases was complete remission. This experience suggests that chronic resistant encopresis in adolescents requires a different approach from the standard because of the patient's developmental stage and the often hostile family dynamics. A medical-psychiatric setting provides an excellent management milieu and can lead to a dramatic improvement in this chronic disabling condition.

  19. Science Roles and Interactions in Adaptive Management of Large River Restoration Projects, Midwest United States

    Science.gov (United States)

    Jacobson, R. B.; Galat, D. L.; Smith, C. B.

    2010-12-01

    Most large-river restoration projects include formal or informal implementations of adaptive management strategies which acknowledge uncertainty and use scientific inquiry to learn and refine management options. Although the central role of science in reducing uncertainty is acknowledged in such projects, specific roles and interactions can vary widely, including how science relates to decision-making within the governance of these projects. Our objective is to present some structured generalizations about science roles and interactions as developed from the authors’ experiences in adaptive management of large river restoration in the Midwest United States. Scientific information may be introduced into decision making by scientists acting in any of the three roles common to adaptive management -- action agency representative, stakeholder, or science provider. We have observed that confusion and gridlock can arise when it is unclear if a scientist is acting as an advocate for a stakeholder or management position, or instead as an independent, “honest broker” of science. Although both advocacy and independence are proper and expected in public decision making, it is useful when scientists unambiguously identify their role. While complete scientific independence may be illusory, transparency and peer review can promote the ideal. Transparency comes from setting clear directions and objectives at the decision-making level and defining at the outset how learning will help assess progress and inform decisions. Independent peer reviews of proposals, study plans, and publications serve as a powerful tool to advance scientific independence, even if funding sources present a potential conflict of interest. Selection of experts for scientific advice and review often requires consideration of the balance between benefits of the “outside” expert (independent, knowledgeable but with little specific understanding of the river system), compared to those provided by the

  20. Exertional heat stroke management strategies in United States high school football.

    Science.gov (United States)

    Kerr, Zachary Y; Marshall, Stephen W; Comstock, R Dawn; Casa, Douglas J

    2014-01-01

    The 5-year period of 2005-2009 saw more exertional heat stroke-related deaths in organized sports than any other 5-year period in the past 35 years. The risk of exertional heat stroke appears highest in football, particularly during the preseason. To estimate the incidence of exertional heat stroke events and assess the utilization of exertional heat stroke management strategies during the 2011 preseason in United States high school football programs. Cross-sectional study; Level of evidence, 3. A self-administered online questionnaire addressing the incidence of exertional heat stroke events and utilization of exertional heat stroke management strategies (eg, removing athlete's football equipment, calling Emergency Medical Services [EMS]) was completed in May to June 2012 by 1142 (18.0%) athletic trainers providing care to high school football athletes during the 2011 preseason. Among all respondents, 20.3% reported treating at least 1 exertional heat stroke event. An average of 0.50 ± 1.37 preseason exertional heat stroke events were treated per program. Athletic trainers responding to exertional heat stroke reported using an average of 6.6 ± 1.8 management strategies. The most common management strategies were low-level therapeutic interventions such as removing the athlete's football equipment (98.2%) and clothing (77.8%) and moving the athlete to a shaded area (91.6%). Few athletic trainers reported active management strategies such as calling EMS (29.3%) or using a rectal thermometer to check core body temperature (0.9%). Athletic trainers in states with mandated preseason heat acclimatization guidelines reported a higher utilization of management strategies such as cooling the athlete through air conditioning (90.1% vs 65.0%, respectively; P football programs. The standard of care is (and should be) to treat proactively; therefore, treatment is not a perfect proxy for incidence. Nevertheless, there is an urgent need for improved education and awareness of

  1. Employee Recognition and Performance: A Field Experiment

    OpenAIRE

    Bradler, Christiane; Dur, Robert; Neckermann, Susanne; Non, Arjan

    2014-01-01

    This discussion paper led to a publication in 'Management Science' . This paper reports the results from a controlled field experiment designed to investigate the causal effect of unannounced, public recognition on employee performance. We hired more than 300 employees to work on a three-hour data-entry task. In a random sample of work groups, workers unexpectedly received recognition after two hours of work. We find that recognition increases subsequent performance substantially, and particu...

  2. Nurse managers' decision-making in daily unit operation in peri-operative settings: a cross-sectional descriptive study.

    Science.gov (United States)

    Siirala, Eriikka; Peltonen, Laura-Maria; Lundgrén-Laine, Heljä; Salanterä, Sanna; Junttila, Kristiina

    2016-09-01

    To describe the tactical and the operational decisions made by nurse managers when managing the daily unit operation in peri-operative settings. Management is challenging as situations change rapidly and decisions are constantly made. Understanding decision-making in this complex environment helps to develop decision support systems to support nurse managers' operative and tactical decision-making. Descriptive cross-sectional design. Data were collected from 20 nurse managers with the think-aloud method during the busiest working hours and analysed using thematic content analysis. Nurse managers made over 700 decisions; either ad hoc (n = 289), near future (n = 268) or long-term (n = 187) by nature. Decisions were often made simultaneously with many interruptions. Ad hoc decisions covered staff allocation, ensuring adequate staff, rescheduling surgical procedures, confirmation tangible resources and following-up the daily unit operation. Decisions in the near future were: planning of surgical procedures and tangible resources, and planning staff allocation. Long-term decisions were: human recourses, nursing development, supplies and equipment, and finances in the unit. Decision-making was vulnerable to interruptions, which sometimes complicated the managing tasks. The results can be used when planning decision support systems and when defining the nurse managers' tasks in peri-operative settings. © 2016 John Wiley & Sons Ltd.

  3. Chemical health risk assessment for hazardous and mixed waste management units at Lawrence Livermore National Laboratory

    International Nuclear Information System (INIS)

    1992-09-01

    The Lawrence Livermore National Laboratory (LLNL) operates three Hazardous Waste Management Facilities with 24 associated waste management units for the treatment and storage of hazardous and mixed wastes. These wastes are generated by research programs and support operations. The storage and treatment units are presently operated under interim status in accordance with the requirements of the US Envirorunental Protection Agency (US EPA) and the Department of Toxic Substances Control (DTSC), a division of the California Envirorunental Protection Agency (Cal/EPA). As required by the California Hazardous Waste Control Act and the Resource Conservation and Recovery Act (RCRA), LLNL ha s applied for a Part B permit to continue operating the storage and waste treatment facilities. As part of this permitting process, LLNL is required to conduct a health risk assessment (HRA) to examine the potential health impacts to the surrounding community from continued storage and treatment of hazardous and mixed wastes. analysis document presents the results of this risk assessment. An analysis of maximum credible chemical accidents is also included in Section 7.0. This HRA was prepared in accordance with procedures set forth by the California Air Pollution Control Officers Association (CAPCOA) ''Air Toxics Assessment Manual,'' CAPCOA guidelines for preparing risk assessments under the Air Toxic ''Hot Spots'' Act (AB 2588) and requirements of the US EPA. By following these procedures, this risk assessment presents a conservative analysis of a hypothetical Maximally Exposed Individual (MEI) using many worst-case assumptions that will not apply to an actual individual. As such, the risk estimates presented should be regarded as a worst-case estimate of any actual risk that may be present

  4. Recognition of endophytic Trichoderma species by leaf-cutting ants and their potential in a Trojan-horse management strategy

    Science.gov (United States)

    Rocha, Silma L.; Evans, Harry C.; Jorge, Vanessa L.; Cardoso, Lucimar A. O.; Pereira, Fernanda S. T.; Rocha, Fabiano B.; Barreto, Robert W.; Hart, Adam G.

    2017-01-01

    Interactions between leaf-cutting ants, their fungal symbiont (Leucoagaricus) and the endophytic fungi within the vegetation they carry into their colonies are still poorly understood. If endophytes antagonistic to Leucoagaricus were found in plant material being carried by these ants, then this might indicate a potential mechanism for plants to defend themselves from leaf-cutter attack. In addition, it could offer possibilities for the management of these important Neotropical pests. Here, we show that, for Atta sexdens rubropilosa, there was a significantly greater incidence of Trichoderma species in the vegetation removed from the nests—and deposited around the entrances—than in that being transported into the nests. In a no-choice test, Trichoderma-infested rice was taken into the nest, with deleterious effects on both the fungal gardens and ant survival. The endophytic ability of selected strains of Trichoderma was also confirmed, following their inoculation and subsequent reisolation from seedlings of eucalyptus. These results indicate that endophytic fungi which pose a threat to ant fungal gardens through their antagonistic traits, such as Trichoderma, have the potential to act as bodyguards of their plant hosts and thus might be employed in a Trojan-horse strategy to mitigate the negative impact of leaf-cutting ants in both agriculture and silviculture in the Neotropics. We posit that the ants would detect and evict such ‘malign’ endophytes—artificially inoculated into vulnerable crops—during the quality-control process within the nest, and, moreover, that the foraging ants may then be deterred from further harvesting of ‘Trichoderma-enriched’ plants. PMID:28484603

  5. Risk-informed Management of Water Infrastructure in the United States: History, Development, and Best Practices

    Science.gov (United States)

    Wolfhope, J.

    2017-12-01

    This presentation will focus on the history, development, and best practices for evaluating the risks associated with the portfolio of water infrastructure in the United States. These practices have evolved from the early development of the Federal Guidelines for Dam Safety and the establishment of the National Dam Safety Program, to the most recent update of the Best Practices for Dam and Levee Risk Analysis jointly published by the U.S. Department of Interior Bureau of Reclamation and the U.S. Army Corps of Engineers. Since President Obama signed the Water Infrastructure Improvements for the Nation Act (WIIN) Act, on December 16, 2016, adding a new grant program under FEMA's National Dam Safety Program, the focus has been on establishing a risk-based priority system for use in identifying eligible high hazard potential dams for which grants may be made. Finally, the presentation provides thoughts on the future direction and priorities for managing the risk of dams and levees in the United States.

  6. Nicotine addiction management following surgery: a quality improvement approach in the post anesthesia care unit.

    Science.gov (United States)

    Finegan, Barry A; Roblin, Daniel; Hammal, Fadi

    2018-03-14

    For smokers, hospital admission is accompanied by forced involuntary nicotine abstinence due to smoke-free site/grounds policies. An audit of patients admitted to our surgical wards revealed that identification of smoking status was inadequate and that nicotine addiction management (NAM) was infrequently offered. The project aimed to enhance both these metrics by initiating NAM in the post anesthesia care unit (PACU). Out of 744 patients admitted to our PACU in August 2015, 54% had their smoking status documented. The 200 patients (27%) out of the 744 were smokers and only 50% were offered NAM before discharge. PACU unit staff to determine the smoking status of every patient before discharge from the PACU (later changed to OR nursing staff) and, if a patient was identified as a smoker, to offer NRT (patch and mouth spray only) and initiate therapy prior to transfer of the patient to the ward. Data about number of patients admitted, presence of documented smoking status, number of identified smokers, and number offered/accepted nicotine replacement therapy (NRT) were collected at baseline and thereafter quarterly. Engaging video education sessions addressed the education gaps highlighted in a needs assessment. Identification of smoking status was made part of preoperative checklist and NRT was made available in post-operative recovery room. These interventions resulted in an increase in screening for tobacco use from 54% at baseline to 95% and the offer of NRT to smokers from 50 to 89%.

  7. Epidemiology, trends, assessment and management of sport-related concussion in United States high schools.

    Science.gov (United States)

    Guerriero, Réjean M; Proctor, Mark R; Mannix, Rebekah; Meehan, William P

    2012-12-01

    Sport-related concussion affects athletes at every level of participation. The short and long-term effects of concussions that occur during childhood and adolescence are not fully understood. The purpose of this review is to describe the current burden of disease, current practice patterns and current recommendations for the assessment and management of sport-related concussions sustained by United States high school athletes. Millions of high school students participate in organized sports in the United States. Current estimates suggest that, across all sports, approximately 2.5 concussions occur for every 10 000 athletic exposures, in which an athletic exposure is defined as one athlete participating in one game or practice. At schools that employ at least one athletic trainer, most high school athletes who sustain sport-related concussions will be cared for by athletic trainers and primary care physicians. Approximately 40% will undergo computerized neurocognitive assessment. The number of high school athletes being diagnosed with sport-related concussions is rising. American football has the highest number of concussions in high school with girls' soccer having the second highest total number. Fortunately, coaches are becoming increasingly aware of these injuries and return-to-play guidelines are being implemented.

  8. Corrective action management unit application for the Environmental Restoration Disposal Facility

    Energy Technology Data Exchange (ETDEWEB)

    Evans, G.C.

    1994-06-01

    The Environmental Restoration Disposal Facility (ERDF) is to accept both CERCLA (EPA-regulated) and RCRA (Ecology-regulated) remediation waste. The ERDF is considered part of the overall remediation strategy on the Hanford Site, and as such, determination of ERDF viability has followed both RCRA and CERCLA decision making processes. Typically, determination of the viability of a unit, such as the ERDF, would occur as part of record of decision (ROD) or permit modification for each remediation site before construction of the ERDF. However, because construction of the ERDF may take a significant amount of time, it is necessary to begin design and construction of the ERDF before final RODs/permit modifications for the remediation sites. This will allow movement of waste to occur quickly once the final remediation strategy for the RCRA and CERCLA past-practice units is determined. Construction of the ERDF is a unique situation relative to Hanford Facility cleanup, requiring a Hanford Facility specific process be developed for implementing the ERDF that would satisfy both RCRA and CERCLA requirements. While the ERDF will play a significant role in the remediation process, initiation of the ERDF does not preclude the evaluation of remedial alternatives at each remediation site. To facilitate this, the January 1994 amendment to the Tri-Party Agreement recognizes the necessity for the ERDF, and the Tri-Party Agreement states: ``Ecology, EPA, and DOE agree to proceed with the steps necessary to design, approve, construct, and operate such a ... facility.`` The Tri-Party Agreement requires the DOE-RL to prepare a comprehensive ``package`` for the EPA and Ecology to consider in evaluating the ERDF. The package is to address the criteria listed in 40 CFR 264.552(c) for corrective action management unit (CAMU) designation and a CERCLA ROD. This CAMU application is submitted as part of the Tri-Party Agreement-required information package.

  9. Corrective action management unit application for the Environmental Restoration Disposal Facility

    International Nuclear Information System (INIS)

    Evans, G.C.

    1994-06-01

    The Environmental Restoration Disposal Facility (ERDF) is to accept both CERCLA (EPA-regulated) and RCRA (Ecology-regulated) remediation waste. The ERDF is considered part of the overall remediation strategy on the Hanford Site, and as such, determination of ERDF viability has followed both RCRA and CERCLA decision making processes. Typically, determination of the viability of a unit, such as the ERDF, would occur as part of record of decision (ROD) or permit modification for each remediation site before construction of the ERDF. However, because construction of the ERDF may take a significant amount of time, it is necessary to begin design and construction of the ERDF before final RODs/permit modifications for the remediation sites. This will allow movement of waste to occur quickly once the final remediation strategy for the RCRA and CERCLA past-practice units is determined. Construction of the ERDF is a unique situation relative to Hanford Facility cleanup, requiring a Hanford Facility specific process be developed for implementing the ERDF that would satisfy both RCRA and CERCLA requirements. While the ERDF will play a significant role in the remediation process, initiation of the ERDF does not preclude the evaluation of remedial alternatives at each remediation site. To facilitate this, the January 1994 amendment to the Tri-Party Agreement recognizes the necessity for the ERDF, and the Tri-Party Agreement states: ''Ecology, EPA, and DOE agree to proceed with the steps necessary to design, approve, construct, and operate such a ... facility.'' The Tri-Party Agreement requires the DOE-RL to prepare a comprehensive ''package'' for the EPA and Ecology to consider in evaluating the ERDF. The package is to address the criteria listed in 40 CFR 264.552(c) for corrective action management unit (CAMU) designation and a CERCLA ROD. This CAMU application is submitted as part of the Tri-Party Agreement-required information package

  10. Beyond Ebola treatment units: severe infection temporary treatment units as an essential element of Ebola case management during an outbreak.

    Science.gov (United States)

    Janke, Christian; Heim, Katrin Moira; Steiner, Florian; Massaquoi, Moses; Gbanya, Miatta Zenabu; Frey, Claudia; Froeschl, Guenter

    2017-02-06

    In the course of the Ebola outbreak in West Africa that was witnessed since early 2014, the response mechanisms showed deficits in terms of timeliness, volume and adequacy. The authors were deployed in the Ebola campaign in the West African country Liberia, where by September 2014 the changing epidemiological pattern made reconsiderations of guidelines and adopted procedures necessary. A temporary facility set up as a conventional Ebola Treatment Unit in the Liberian capital Monrovia was re-dedicated into a Severe Infections Temporary Treatment Unit. This facility allowed for stratification based on the nosocomial risk of exposure to Ebola virus for a growing subgroup of admitted patients that in the end would turn out as Ebola negative cases. At the same time, adequate diagnostic measures and treatment for the non-Ebola conditions of these patients could be provided without compromising work safety of the employed staff. The key elements of the new unit comprised a Suspect Cases Area similar to that of conventional Ebola treatment units for newly arriving patients, an Unlikely Cases Area for patients with a first negative Ebola PCR result, and a Confirmed Negative Cases Area for patients in whom Ebola could be ruled out. The authors, comprising representatives of the Liberian Ministry of Health and Social Welfare, as well as infectious disease specialists from the German Ebola Task Force are presenting key features of the adapted concept, and are highlighting its relevance in raising acceptance for outbreak counter-measures within the population at stake.

  11. Pattern Recognition

    Directory of Open Access Journals (Sweden)

    Aleš Procházka

    2018-05-01

    Full Text Available Multimodal signal analysis based on sophisticated sensors, efficient communicationsystems and fast parallel processing methods has a rapidly increasing range of multidisciplinaryapplications. The present paper is devoted to pattern recognition, machine learning, and the analysisof sleep stages in the detection of sleep disorders using polysomnography (PSG data, includingelectroencephalography (EEG, breathing (Flow, and electro-oculogram (EOG signals. The proposedmethod is based on the classification of selected features by a neural network system with sigmoidaland softmax transfer functions using Bayesian methods for the evaluation of the probabilities of theseparate classes. The application is devoted to the analysis of the sleep stages of 184 individualswith different diagnoses, using EEG and further PSG signals. Data analysis points to an averageincrease of the length of the Wake stage by 2.7% per 10 years and a decrease of the length of theRapid Eye Movement (REM stages by 0.8% per 10 years. The mean classification accuracy for givensets of records and single EEG and multimodal features is 88.7% ( standard deviation, STD: 2.1 and89.6% (STD:1.9, respectively. The proposed methods enable the use of adaptive learning processesfor the detection and classification of health disorders based on prior specialist experience andman–machine interaction.

  12. Turnover of professional nurses at Mokopane Hospital in the Limpopo Province, South Africa: Experiences of nursing unit managers.

    Science.gov (United States)

    Mmamma, Mogale L; Mothiba, Tebogo M; Nancy, Malema R

    2015-12-17

    Staff turnover of professional nurses remains a concern for public and private hospitals management because it has an impact on the morale of nurses and it may also lead to poor patient care. The objectives of this study were to explore and describe the experiences of nursing unit managers with regard to the turnover of professional nurses who were under their supervision. A qualitative, explorative, descriptive research design was used to determine the experiences of nursing unit managers related to the turnover of professional nurses. Data collection was done by using semi-structured one-to-one interviews with professional nurses .Two groups of participants were interviewed: Those working day duty (n = 9) and those working night duty (n = 3) who were at work on the anticipated days for data collection. The findings revealed that every unit was experiencing a shortage of professional nurses, which caused other nurses to work overtime with an inevitable increase in workload. That led to tiredness, conflict amongst professional nurses, job dissatisfaction, and absenteeism which compromised nursing care. This resulted in patient dissatisfaction and sometimes led to deaths that could have been prevented. It is recommended that staff turnover should be addressed by the hospital top management implementing several strategies. For example, top management could ensure that staff members work in a healthy environment with resources that they need during the provision of care, address the effects of the staff turnover, support the staff members and refrain from putting pressure on nursing unit managers whilst they are attending to problems.

  13. Recognition and management of acute kidney injury in children: The ISN 0by25 Global Snapshot study.

    Directory of Open Access Journals (Sweden)

    Etienne Macedo

    Full Text Available In low and middle-income countries, reliable data on the epidemiology of childhood acute kidney injury (AKI is lacking. The Global Snapshot, conducted by the ISN "0by25" AKI initiative, was a world-wide cross-sectional, observational study to evaluate AKI in hospitalized patients. Here we report the pediatric results of this study.We prospectively collected data on children who met the Kidney Disease Improving Global Outcomes AKI criteria during a 10-week window in late 2014. AKI risk factors, etiological factors, management and outcomes were recorded using standardized forms and protocols. Countries were classified according to their 2014 gross national income (GNI per person into high-income countries (HIC, upper-middle income countries (UMIC and low and low-middle income countries (LLMIC. Need for renal replacement therapy, mortality, and renal recovery were assessed 7 days after AKI diagnosis or at hospital discharge, whichever came first.92 centers from 41 countries collected data on 354 pediatric AKI patients; 53% of the children developed AKI while hospitalized and 47% in the community. The most common etiological factors for AKI differed across GNI categories as well as between patients with community-acquired vs. hospital-acquired AKI. Children from HIC were younger, and larger proportion of AKI in this group were due to post-surgical complications vs. other etiologies when compared to other income categories. In patients with hypotension as the cause of AKI, the adjusted risk of death was almost 10-fold higher compared to patients without hypotension as an etiological factor for AKI development. Mortality was similar within AKI stages in HIC and UMIC. In LLMIC, patients with the highest AKI level of severity had higher mortality than patients in higher income categories. Patients from LLMIC and UMIC had a 57-fold and 11 fold higher adjusted risk of death, respectively, compared to patients from HIC.In resource-limited countries

  14. Operable Unit 3-13, Group 3, Other Surface Soils Remediation Sets 4-6 (Phase II) Waste Management Plan

    International Nuclear Information System (INIS)

    G. L. Schwendiman

    2006-01-01

    This Waste Management Plan describes waste management and waste minimization activities for Group 3, Other Surface Soils Remediation Sets 4-6 (Phase II) at the Idaho Nuclear Technology and Engineering Center located within the Idaho National Laboratory. The waste management activities described in this plan support the selected response action presented in the Final Record of Decision for Idaho Nuclear Technology and Engineering Center, Operable Unit 3-13. This plan identifies the waste streams that will be generated during implementation of the remedial action and presents plans for waste minimization, waste management strategies, and waste disposition

  15. Economic impacts of the total nuclear waste management program envisioned for the United States

    International Nuclear Information System (INIS)

    Busch, L.; Zielen, A.J.; Parry, S.J.S.

    1978-01-01

    This paper presents information on the costs of nuclear waste management and on the impacts of those costs on the price of power and on the capital and labor markets. It is assumed that the LWR would be the sole commercial reactor used through the year 2000. Two fuel cycle options are considered: the throwaway mode (spent fuel is waste), and the full recycle for comparison. Total costs are calculated for all facilities needed to store, package, and reposit all the spent fuel through the lifetime of 380 GW capacity installed by 2000 and operating for 30 y. The economic impact is: the price of power produced by the reactors would be increased by 1.4%; the capital for nuclear plants would apply to waste management; the average annual labor effort needed over the next 50 to 75 years is 3000 to 5000 man years; and the unit cost of spent fuel disposal is $129/kg ($119/kg for full recycle). 7 tables

  16. Firewater Storage, Treatment, Recycling and Management: New Perspectives Based on Experiences from the United Kingdom

    Directory of Open Access Journals (Sweden)

    Miklas Scholz

    2014-02-01

    Full Text Available Smart firewater management and recycling helps reduce water use and protect the environment from pollution. However, contamination of recycled water may pose a health risk to fire fighters. This review assesses international literature to identify best practices, and to recommend new technologies and methods on firewater management and recycling. The literature assessment indicates that this is a new research area where insufficient findings have been published in Web of Science-referenced journals. Therefore, informally published materials (a.k.a. grey literature were also assessed. Findings indicate the need for practical decision support tools to estimate consumption rates, predict “bottlenecks” and bund capacity, assess water quality and determine pump requirements. This article recommends that cost-efficient and rapid on-site treatment methods, such as compact and mobile filtration units for firewater recycling should be researched in the future. The filters should be based on compartments with different media. The empty pore space should decrease from inflow to outflow. A light plastic media should be positioned near the inflow to retain large particles, such as a grid. Activated carbon media could be placed near the outlet to remove fine suspended solids and dissolved contaminants. This should address concerns by fire fighters dealing with contaminated water, spray and foam.

  17. Local government units initiatives on coastal resource management in adjacent municipalities in Camarines Sur, Philippines

    Science.gov (United States)

    Faustino, A. Z.; Madela, H. L.

    2018-03-01

    This research was conducted to determine the local government units (LGUs) initiatives on coastal resource management (CRM) in adjacent municipalities in Camarines Sur, Philippines. The respondents of this study are 100 fisherfolk leaders in the municipalities of Calabanga, Tinambac and Siruma. Descriptive, comparative and evaluative methods of research were employed and a survey questionnaire was used as the primary tool in data gathering. On the test of difference, the computed F-value of 12.038 and p-value of .001 revealed a very high difference in the implementation of CRM initiatives in the adjacent municipalities. The respondents in this study live below the poverty threshold. The intrusion of commercial fishers and the use of active fishing gears inside the 15-km municipal waters significantly affect the marine habitat while fishpond conversion kills the natural cycle in the mangrove forests. However, the FOs membership in the Municipal Fisheries and Aquatic Resources Management Council empower them to engage in governance which can be a venue for them to recommend policies related to CRM. As a result of this study, a CRM monitoring and evaluation model was crafted to guide the LGUs in the review, revision and crafting of CRM programs.

  18. Technology transfer and radioactive waste management at TMI-2 [Three Mile Island Unit 2

    International Nuclear Information System (INIS)

    Saunders, J.R.

    1988-01-01

    The accident that occurred on March 28, 1979, at the Three Mile Island Unit 2 (TMI-2) nuclear generating station caused extensive damage to the reactor core and created high radiation contamination levels throughout the facility. The electric power industry, regulators, and government agencies were faced with one of the most technically challenging recovery situations ever encountered in this country. But it was also realized that this adversity presented opportunities for the advancement of state-of-the-art technologies as well as the potential to produce information that could enhance nuclear power plant safety and reliability. Perhaps one of the more significant aspects of the TMI-2 recovery has been the advancement of radioactive waste management technology. The high levels and unusual nature of the TMI-2 radioactive waste necessitated the development of innovative techniques for processing, packaging, shipping, and disposal. The investment in research was rewarded with large volume reductions and associated cost savings. It is anticipated that the TMI-2 radioactive waste management technology will make major contributions to the design of new systems to meet this growing need. The following areas appear particularly suited for this purpose: volume reduction, high-integrity containers, and selective isotope removal

  19. Clinical Management of Ebola Virus Disease in the United States and Europe.

    Science.gov (United States)

    Uyeki, Timothy M; Mehta, Aneesh K; Davey, Richard T; Liddell, Allison M; Wolf, Timo; Vetter, Pauline; Schmiedel, Stefan; Grünewald, Thomas; Jacobs, Michael; Arribas, Jose R; Evans, Laura; Hewlett, Angela L; Brantsaeter, Arne B; Ippolito, Giuseppe; Rapp, Christophe; Hoepelman, Andy I M; Gutman, Julie

    2016-02-18

    Available data on the characteristics of patients with Ebola virus disease (EVD) and clinical management of EVD in settings outside West Africa, as well as the complications observed in those patients, are limited. We reviewed available clinical, laboratory, and virologic data from all patients with laboratory-confirmed Ebola virus infection who received care in U.S. and European hospitals from August 2014 through December 2015. A total of 27 patients (median age, 36 years [range, 25 to 75]) with EVD received care; 19 patients (70%) were male, 9 of 26 patients (35%) had coexisting conditions, and 22 (81%) were health care personnel. Of the 27 patients, 24 (89%) were medically evacuated from West Africa or were exposed to and infected with Ebola virus in West Africa and had onset of illness and laboratory confirmation of Ebola virus infection in Europe or the United States, and 3 (11%) acquired EVD in the United States or Europe. At the onset of illness, the most common signs and symptoms were fatigue (20 patients [80%]) and fever or feverishness (17 patients [68%]). During the clinical course, the predominant findings included diarrhea, hypoalbuminemia, hyponatremia, hypokalemia, hypocalcemia, and hypomagnesemia; 14 patients (52%) had hypoxemia, and 9 (33%) had oliguria, of whom 5 had anuria. Aminotransferase levels peaked at a median of 9 days after the onset of illness. Nearly all the patients received intravenous fluids and electrolyte supplementation; 9 (33%) received noninvasive or invasive mechanical ventilation; 5 (19%) received continuous renal-replacement therapy; 22 (81%) received empirical antibiotics; and 23 (85%) received investigational therapies (19 [70%] received at least two experimental interventions). Ebola viral RNA levels in blood peaked at a median of 7 days after the onset of illness, and the median time from the onset of symptoms to clearance of viremia was 17.5 days. A total of 5 patients died, including 3 who had respiratory and renal

  20. National Water Model assessment for water management needs over the Western United States.

    Science.gov (United States)

    Viterbo, F.; Thorstensen, A.; Cifelli, R.; Hughes, M.; Johnson, L.; Gochis, D.; Wood, A.; Nowak, K.; Dahm, K.

    2017-12-01

    The NOAA National Water Model (NWM) became operational in August 2016, providing the first ever, real-time distributed high-resolution forecasts for the continental United States. Since the model predictions occur at the CONUS scale, there is a need to evaluate the NWM in different regions to assess the wide variety and heterogeneity of hydrological processes that are included (e.g., snow melting, ice freezing, flash flooding events). In particular, to address water management needs in the western U.S., a collaborative project between the Bureau of Reclamation, NOAA, and NCAR is ongoing to assess the NWM performance for reservoir inflow forecasting needs and water management operations. In this work, the NWM is evaluated using different forecast ranges (short to medium) and retrospective historical runs forced by North American Land Data Assimilation System (NLDAS) analysis to assess the NWM skills over key headwaters watersheds in the western U.S. that are of interest to the Bureau of Reclamation. The streamflow results are analyzed and compared with the available observations at the gauge sites, evaluating different NWM operational versions together with the already existing local River Forecast Center forecasts. The NWM uncertainty is also considered, evaluating the propagation of the precipitation forcing uncertainties in the resulting hydrograph. In addition, the possible advantages of high-resolution distributed output variables (such as soil moisture, evapotranspiration fluxes) are investigated, to determine the utility of such information for water managers in terms of watershed characteristics in areas that traditionally have not had any forecast information. The results highlight the NWM's ability to provide high-resolution forecast information in space and time. As anticipated, the performance is best in regions that are dominated by natural flows and where the model has benefited from efforts toward parameter calibration. In highly regulated basins, the

  1. Management of wastestreams in United States; Jaetevirtojen hallinta USA:ssa

    Energy Technology Data Exchange (ETDEWEB)

    Itaevaara, M. [VTT Biotekniikka, Espoo (Finland)

    2001-07-01

    International markets are advancing waste management practices more than the legislation. The instructions and guidelines issued by the US EPA are not being implemented in practice. Restrictions designed to minimise the impacts of industrial activities are also scarce. Recycling and reuse of materials vary locally, and have recently increased considerably in some states. The goal of the US EPA is to keep the amount of waste generated per capita at the same level, in spite of increasing amounts of waste. Recycling goals have been set at levels that prevent the amounts of waste from increasing. Former US President Clinton signed the Kioto Agreement concerning global restrictions on impacts to the environment. However, the agreement has never been ratified by the Congress, and has therefore not even been started. European legislation and restrictions that effect international trade and exports are carefully followed, and changes in waste management practices in the US will probably be driven more by the international markets than by local legislation. Many companies in the US still consider environmental aspects to be a luxury which they cannot afford. In Europe, and especially in Scandinavia, environmentally friendly industrial products are considered to be marketing tools because of the high environmental awareness in these countries; in contrast, no such benefits are seen in the United States. In addition to national and international legislation, the cultural habits of the population strongly affect reuse, recycling and treatment efficiency. These cultural and national aspects should be taken into account when developing collection technologies and other waste management technologies for the US markets. (orig.)

  2. Presentation and management of organophosphate poisoning in an intensive care unit

    International Nuclear Information System (INIS)

    Asghar, S.P.; Ather, N.; Farooq, M.; Sarah, S.; Ijaz, A.

    2014-01-01

    To determine the various demographic factors, clinical features, management and outcome of organophosphate poisoning in an intensive care unit (ICU) setting. Study Design: Descriptive quantitative study. Place and Duration of study: ICU of PNS Shifa hospital, Karachi. From February 2008-February 2010. Patients and Methods: Total of 40 patients were admitted in the ICU of PNS Shifa hospital, Karachi from Feb 2008- Feb 2010 with the history of organophosphate (OP) ingestion. A complete history was taken from the patients and relatives. Baseline laboratory investigations were done. All the data was tabulated on a structured performed after tasking consent from the relatives. Variables of the study were demographic factors as gender, age, cause and mode of poisoning, clinical course, ICU management and its outcome. Results: Out of 40 patients 32 (80%) were females and 8 (20%) were males. The age varied from 12-56 years. Twenty eight (70%) were in the 14-28 years age group. Twenty nine (72%) had poison for suicidal purpose and rest had the insecticide accidently. Twenty six (62%) of them were unmarried. In 38 (95%) patients the clinical features of parasympathetic overactivity was observed. All these patients were given atropine and pralidoxime. Fifteen (37%) patients required mechanical ventilation. Five (12%) out of these patients developed ventilator associated pneumonia. The time duration of mechanical ventilation was 1-3 weeks. All the patients were successfully recovered. Total duration of hospital stay on our patients was 2-4 weeks. Conclusion: Early and aggressive management of organophosphate poisoning in an ICU setting reduces not only the mortality but also decreases the duration of hospital stay. (author)

  3. Cultural Landscapes as a Methodology for Understanding Natural Resource Management Impacts in the Western United States

    Directory of Open Access Journals (Sweden)

    Rebecca S. Toupal

    2003-07-01

    Full Text Available Multicultural demands on public lands in the United States continue to challenge federal land managers to address social and cultural concerns in their planning efforts. Specifically, they lack adequate knowledge of cultural concerns, as well as a consistent strategy for acquiring that knowledge for use in decision-making. Current federal approaches to understanding such issues as access, use, and control of resources include public participation, conservation partnerships, government-to-government consultations with American Indian tribes, cultural resource inventories, and landscape analysis. Given that cultural knowledge arises from human-nature relationships and shared perceptions of natural environments, and that landscapes are the ultimate expression of such knowledge, an exploratory methodology was developed to provide a different approach to understanding cultural concerns through landscape perceptions. Using cultural landscape theories and applications from the natural and social sciences, this study examines the landscape perceptions of four groups concerned with management planning of the Baboquivari Wilderness Area in southern Arizona: the Bureau of Land Management, the landowners of the Altar Valley, recreationists, and members of the Tohono O'odham Nation. The methodology is based on a human-nature relationship rather than cultural aspects or features. It takes a holistic approach that differs from other perception studies in that it includes: emic aspects of data collection and analysis; a spatial component (triangulation of data collection through narrative and graphic descriptions; ethnographic, on-site interviews; and cultural consensus analysis and small-sample theory. The results include: verification of four cultural groups; two levels of consensus (in the population of concern, and in each group that overlap in some aspects of landscape perception; descriptions of four cultural landscapes that illustrate similarities and

  4. Historical Agricultural Nitrogen Fertilizer Management in the Contiguous United States during 1850-2015.

    Science.gov (United States)

    Lu, C.; Cao, P.; Yu, Z.

    2017-12-01

    The United States has a century-long history of managing anthropogenic nitrogen (N) fertilizer to booster the crop production. Accurate characterization of N fertilizer use history could provide essential implications for N use efficiency (NUE) enhancement and N loss reduction. However, a spatially explicit time-series data remains lacking to describe how N fertilizer use varied among crop types, regions, and time periods. In this study, we therefore developed long-term gridded N management maps depicting N fertilizer application rate, timing, and ratio of fertilizer forms in nine major crops (i.e. corn, soybean, winter wheat, spring wheat, cotton, sorghum, rice, barley, and durum wheat) in the contiguous U.S. at a resolution of 1 km × 1 km during 1850-2015. We found that N application rates of the U.S. increased by approximately 34 times since 1940. Nonetheless, spatial analysis revealed that N-use hotspots have shifted from the West and Southeast to the Midwest and the Great Plains since 1900. Specifically, corn of the Corn Belt region received the most intensive N input in spring, followed by large N application amount in fall, implying a high N loss risk in this region. Moreover, spatiotemporal patterns of NH4+/NO3- ratio varied largely among regions. Generally, farmers have increasingly favored NH4+-form fertilizers over NO3- fertilizers since the 1940s. The N fertilizer use data developed in this study could serve as an essential input for modeling communities to fully assess the N addition impacts, and improve N management to alleviate environmental problems.

  5. Understanding Carbon Sequestration Options in the United States: Capabilities of a Carbon Management Geographic Information System

    Energy Technology Data Exchange (ETDEWEB)

    Dahowski, Robert T.; Dooley, James J.; Brown, Daryl R.; Mizoguchi, Akiyoshi; Shiozaki, Mai

    2001-04-03

    While one can discuss various sequestration options at a national or global level, the actual carbon management approach is highly site specific. In response to the need for a better understanding of carbon management options, Battelle in collaboration with Mitsubishi Corporation, has developed a state-of-the-art Geographic Information System (GIS) focused on carbon capture and sequestration opportunities in the United States. The GIS system contains information (e.g., fuel type, location, vintage, ownership, rated capacity) on all fossil-fired generation capacity in the Untied States with a rated capacity of at least 100 MW. There are also data on other CO2 sources (i.e., natural domes, gas processing plants, etc.) and associated pipelines currently serving enhanced oil recovery (EOR) projects. Data on current and prospective CO2 EOR projects include location, operator, reservoir and oil characteristics, production, and CO2 source. The system also contains information on priority deep saline aquifers and coal bed methane basins with potential for sequestering CO2. The GIS application not only enables data storage, flexible map making, and visualization capabilities, but also facilitates the spatial analyses required to solve complex linking of CO2 sources with appropriate and cost-effective sinks. A variety of screening criteria (spatial, geophysical, and economic) can be employed to identify sources and sinks most likely amenable to deployment of carbon capture and sequestration systems. The system is easily updateable, allowing it to stay on the leading edge of capture and sequestration technology as well as the ever-changing business landscape. Our paper and presentation will describe the development of this GIS and demonstrate its uses for carbon management analysis.

  6. Critical evaluation of contemporary management in a new Pelvic Exenteration Unit: The first 25 consecutive cases.

    Science.gov (United States)

    Chew, Min Hoe; Yeh, Yu-Ting; Toh, Ee-Lin; Sumarli, Stephen Aditya; Chew, Ghee Kheng; Lee, Lui Shiong; Tan, Mann Hong; Hennedige, Tiffany Priyanthi; Ng, Shin Yi; Lee, Say Kiat; Chong, Tze Tec; Abdullah, Hairil Rizal; Goh, Terence Lin Hon; Rasheed, Mohamed Zulfikar; Tan, Kok Chai; Tang, Choong Leong

    2017-05-15

    . One patient experienced grade 4a Clavien-Dindo complication, requiring temporary renal dialysis without long-term disability. The R0 resection rate was 64%. There were 7 post-exenteration recurrences during the follow-up period. No statistically significant relationship was found among histological origin of tumour, microscopic resection margin status and postoperative recurrence ( P = 0.67). Four patients died from sequelae of recurrent disease during follow-up. By utilizing modern assessment and surgical techniques, our PE Unit can manage complex pelvic cancers with acceptable morbidities, zero-rate mortality and equivalent oncologic outcomes.

  7. Making a Good Impression at Work: National Differences in Employee Impression Management Behaviors in Japan, Korea, and the United States.

    Science.gov (United States)

    Krieg, Alexander; Ma, Li; Robinson, Patricia

    2018-02-17

    Impression management has important implications for success at work. This study explores differences in impression management in the East and West by examining the use of self-promotion, ingratiation, and exemplification directed towards three targets: supervisors, peers, and subordinates among 945 company employees from Japan, Korea, and the United States. Our results show that Korean employees used all three strategies most frequently, followed by United States, and then Japanese employees. Japanese and Korean employees used impression management strategies differentially across the three targets, and U.S. employees used impression management equally across targets. This elucidates how cultural trends in hierarchical relationships impact social behavior within the workplace. A follow-up mediation analysis found that relational or labor mobility fully mediated country differences in impression management, suggesting that culture is also reflected in larger social ecological trends in employee's ability and likelihood to change jobs, which also account for impression management strategy usage. Theoretical and practical implications for international business are discussed. This research may be useful in aligning strategies foreign employees might employ for using impression management when in Japan, Korea, and the United States.

  8. Financial management skills are associated with food insecurity in a sample of households with children in the United States.

    Science.gov (United States)

    Gundersen, Craig G; Garasky, Steven B

    2012-10-01

    Food insecurity is one of the leading public health challenges facing children in the United States today. Reducing food insecurity and its attendant consequences requires an understanding of the determinants of food insecurity. Although previous work has greatly advanced our understanding of these determinants, the role of one of the oft-speculated important determinants of food insecurity, household financial management skills, has not been considered. To address this research lacuna, we use a recently conducted survey, the Survey of Household Finances and Childhood Obesity, that has information on specific financial management practices, impressions of financial management skills, and households' food insecurity. The sample included 904 households with children. Within this sample, 19.3% were food insecure and, for our central financial management skill variable, the mean value was 3.55 on a 5-point scale. Probit regression models estimated the probability of a household being food insecure as conditional on financial management skills and other covariates. We found a large and significant inverse relationship between a respondent's use of specific financial management practices and food insecurity and between a respondent's confidence in his or her financial management skills and food insecurity. That is, households with greater financial management abilities are less likely to be food insecure. This finding also holds when the sample is restricted to households with incomes <200% of the poverty line. These results suggest that improving households' financial management skills has the potential to reduce food insecurity in the United States.

  9. Recognition and management of platelet-refractory bleeding in patients with Glanzmann’s thrombasthenia and other severe platelet function disorders

    Directory of Open Access Journals (Sweden)

    Chitlur M

    2017-04-01

    patients with suspected platelet refractoriness should be referred to such a hematologist as early as possible. A critical unmet need is the development of a definition of an adequate response to platelet transfusion, which would facilitate early recognition of platelet refractoriness in patients with PFDs who exhibit a normal platelet count. Keywords: platelet function disorder, Glanzmann’s thrombasthenia, alloantibodies, antiplatelet antibodies, platelet refractoriness, bleeding management

  10. Development and implementation of documents control and records management system for KNPP units 5 and 6 modernization program

    International Nuclear Information System (INIS)

    Manchev, B.L.; Ilieva, M.; Nenkova, B. G. . E-mail of corresponding author: ilieva@riskeng.bg; Ilieva, M.)

    2005-01-01

    It was proposed to KNPP to develop and implement a Dcuments Control and Records Management System for an efficient and effective Configuration Management (CM) Program. It will provide reasonable assurance that consistency among design requirements, physical configuration and facility documentation is established and maintained during the Modernization Program and throughout the life of KNPP Units 5 and 6. The fully implemented CM Program will consider and track the modifications resulting from the Units 5 and 6 Modernization Program and will be consistent with internationally recognized principles and customized to fit within the KNPP organizational structure and philosophy (ANSI/NIRMA CM 1.0 - 2000, Configuration Management Of Nuclear Facilities). Development and implementation phase of Documents Control and Records Management System and SmartDoc information system, as well as ideas for further development are presented in this report. (author)

  11. Women's experiences of nurse case management on a gynaecological oncology unit in a Swiss tertiary hospital. A thematic analysis.

    Science.gov (United States)

    Grob, Silvia; Bläuer, Cornelia; Frei, Irena Anna

    2017-12-01

    Women with gynaecological cancer face various physical, social and emotional challenges concerning their health. Existing research shows that case management can improve patient satisfaction and reduce readmission rates. Although nurse case management was introduced on a gynaecological oncology unit in a Swiss university hospital in 2013, little is known about the experiences of female patients on a unit that uses this model of care. The aims were to explore women's experiences and to gain deeper understanding about hospital-based nurse case management on a gynaecological oncology unit and to qualitatively evaluate the concept of nurse case management. Sound research knowledge suggests that experiences are best explored with a qualitative research design. Ten participant interviews were conducted and inductively analysed between September 2014 and May 2015 as described by the thematic analysis method. Ethical approval was obtained, and the women signed a consent form. The first theme was named continuous relationship, with the nurse case manager as contact person and trusted partner. Study participants explained that friendliness and being present were essential qualities of nurse case management. Secondly, an essential support for women dealing with the situation of gynaecological cancer was described in the theme sharing information. The organisation of rehabilitation and other services by the nurse case management defined the third theme coordinating care. Trust was seen as the basis of the continuous relationship, marked by friendliness and presence of the nurse case manager. The helpful approach of persons practicing nurse case management made dealing with the situation of illness easier for women with gynaecological cancer. Coordination of information between the nurse case management and other healthcare services could be improved. Further evaluation is suggested to explore effects of the concept on family members. © 2017 Nordic College of Caring Science.

  12. A survey of castration methods and associated livestock management practices performed by bovine veterinarians in the United States

    OpenAIRE

    Bradburn Ryan M; Barbur Laura A; Nutsch Abbey L; Coetzee Johann F

    2010-01-01

    Abstract Background Castration of male calves destined for beef production is a common management practice performed in the United States amounting to approximately 15 million procedures per year. Societal concern about the moral and ethical treatment of animals is increasing. Therefore, production agriculture is faced with the challenge of formulating animal welfare policies relating to routine management practices such as castration. To enable the livestock industry to effectively respond t...

  13. Impact of role-, job- and organizational characteristics on Nursing Unit Managers' work related stress and well-being.

    Science.gov (United States)

    Van Bogaert, Peter; Adriaenssens, Jef; Dilles, Tinne; Martens, Daisy; Van Rompaey, Bart; Timmermans, Olaf

    2014-11-01

    To study the impact of role, job- and organizational characteristics on nurse managers' work related stress and well-being such as feelings of emotional exhaustion, work engagement, job satisfaction and turnover intention. Various studies investigated role-, job- and organizational characteristics influencing nurse-related work environments. Research on nurse managers' related work environments define influencing factors, but, a clear understanding of the impact of nurse-managers' work-environment characteristics on their work related stress and well-being is limited. A cross-sectional design with a survey. A cross-sectional survey (N = 365) was carried out between December 2011-March 2012. The questionnaire was based on various validated measurement instruments identified by expert meetings (e.g. staff nurses, nurse managers and executives and physicians). Hierarchical regression analyses were performed using emotional exhaustion, work engagement, job satisfaction and turnover intentions as outcome variables. Study results showed one out of six nursing unit managers have high to very high feelings of emotional exhaustion and two out of three respondents have high to very high work engagement. Hierarchical regression models showed that role conflict and role meaningfulness were strong predictors of nursing unit managers' work related stress and well-being, alongside with job- and organizational characteristics. Several risk factors and stimulating factors influencing nurse unit managers' work related stress and well-being were identified. Further challenges will be to develop proper interventions and strategies to support nursing unit managers and their team in daily practice to deliver the best and safest patient care. © 2014 John Wiley & Sons Ltd.

  14. Design, Planning and Management of the Hospital Custody Unit at Hospital Universitario Fundación Alcorcón

    Directory of Open Access Journals (Sweden)

    C. de la Fuente-Martín

    Full Text Available Objective: The design and management of a Hospital Custody Unit at Hospital Universitario Fundación Alcorcón, to focus the aim of this study on specialized medical care for extra-penitentiary patients who have suffered from a disease. We are building a new space to facilitate their daily lives at hospital and we want to offer a double function to the patients that consists of a custody space and a health rehabilitation space. Material and methods: We carried out a scientific literature search on the international and national databases, about Hospital Custody Units or Restricted Access Units. The language of the reviews that we checked was English and Spanish. Results: We wrote the Action Guide of the Hospital Custody Unit for the design, planning and management of the Hospital Custody Unit at Hospital Universitario Fundación Alcorcón. (We included complementary bibliographic material and the Quick Guide in the Unit. Discussion: The Hospital Custody Unit will be compatible with medical activity, occupational safety and the custody of patients that are in prison. We thus require consensus with police departments about custody protocols along with assistance from the clinicians' teams at penitentiary centers and referral hospitals. Furthermore, it is important to step up special care for mental health and to promote telemedicine and new technologies to streamline medical care along with coordination with healthcare professionals.

  15. Review of survey articles regarding medication therapy management (MTM) services/programs in the United States.

    Science.gov (United States)

    Oladapo, Abiola O; Rascati, Karen L

    2012-08-01

    To provide a summary of published survey articles regarding the provision of medication therapy management (MTM) services in the United States. A literature search was conducted to identify original articles on MTM-related surveys conducted in the United States, involving community and outpatient pharmacists, physicians, patients, or pharmacy students and published by the primary researchers who conducted the study. Search engines used included PubMed, Medline, and International Pharmaceutical Abstracts (IPA). If MTM was in the keyword list, mesh heading, title, or abstract, the article was reviewed. References from these articles were searched to determine whether other relevant articles were available. A total of 405 articles were initially reviewed; however, only 32 articles met the study requirements. Of the 32 articles, 17 surveyed community/outpatient pharmacists, 3 surveyed pharmacy students, 4 surveyed physicians, and 8 surveyed patients. The survey periods varied across the different studies, with the earliest survey conducted in 2004 and the most recent survey conducted in 2009. The surveys were conducted via the telephone, US mail, interoffice mail, e-mails, Internet/Web sites, hand-delivered questionnaires, and focus groups. Despite the identified barriers to the provision of MTM services, pharmacists reportedly found it professionally rewarding to provide these services. Pharmacists claimed to have adequate clinical knowledge, experience, and access to information required to provide MTM services. Pharmacy students were of the opinion that the provision of MTM services was important to the advancement of the pharmacy profession and in providing patients with a higher level of care. Physicians supported having pharmacists adjust patients’ drug therapy and educate patients on general drug information but not in selecting patients’ drug therapy. Finally, patients suggested that alternative ways need to be explored in describing and marketing MTM

  16. UHF-RFID solutions for logistics units management in the food supply chain

    Directory of Open Access Journals (Sweden)

    Paolo Barge

    2013-09-01

    Full Text Available The availability of systems for automatic and simultaneous identification of several items belonging to a logistics unit during production, warehousing and delivering can improve supply chain management and speed traceability controls. Radio frequency identification (RFID is a powerful technique that potentially permits to reach this goal, but some aspects as, for instance, food product composition (e.g. moisture content, salt or sugar content and some peculiarities of the production environment (high moisture, high/low temperatures, metallic structures have prevented, so far, its application in food sector. In the food industry, composition and shape of items are much less regular than in other commodities sectors. In addition, a wide variety of packaging, composed by different materials, is employed. As material, size and shape of items to which the tag should be attached strongly influence the minimum power requested for tag functioning, performance improvements can be achieved only selecting suitable RF identifier for the specific combination of food product and packaging. When dealing with logistics units, the dynamic reading of a vast number of tags originates simultaneous broadcasting of signals (tag-to-tag collisions that could affect reading rates and the overall reliability of the identification procedure. This paper reports the results of an extensive analysis of the reading performance of UHF RFID systems for multiple dynamic electronic identification of food packed products in controlled conditions. Products were considered singularly or arranged on a logistics pallet. The effects on reading rate and reading zone of different factors, among which the type of product, the number and position of antennas, the field polarization, the reader RF power output, the interrogation protocol configuration as well as the transit speed, the number of tags and their interactions were analysed and compared.

  17. Staff satisfaction and retention and the role of the nursing unit manager.

    Science.gov (United States)

    Duffield, Christine; Roche, Michael; O'Brien-Pallas, Linda; Catling-Paull, Christine; King, Madeleine

    2009-01-01

    Despite recent increases in nursing recruitment in Australia, participation in the workforce is still below the numbers predicted to meet future needs. This paper discusses factors impacting on nurses' job satisfaction, satisfaction with nursing and intention to leave in public sector hospitals in New South Wales (NSW), Australia. Staffing and patient data were collected on 80 medical and surgical units during 2004/5. This included a wide range of individual nurse data from a Nurse Survey; detailed and comprehensive staffing data including skill mix variables; patient characteristics; workload data; a profile of the ward's characteristics; and adverse event patient data. Nurses who were intending to remain in their job were more likely to be satisfied, be older, and have dependents. They were also likely to be experiencing good leadership and to have allied health support on the ward. Most nurses reported being satisfied with their profession, while a lower proportion reported satisfaction with their current position. Work environment factors such as nurses' autonomy, control over their practice and nursing leadership on the ward were statistically significant predictors of job satisfaction. This study will inform decision-making and policy for managers in both the public and private hospital sectors. This is the first large study which explored the work environment at the ward/unit level in public hospitals in NSW (Australia). It illustrates that there are no typical wards; each ward functions differently. The importance of nursing leadership at the ward level to job satisfaction, satisfaction with nursing and intention to leave, cannot be overstated.

  18. Management of hypoxaemic respiratory failure in a Respiratory High-dependency Unit.

    Science.gov (United States)

    Hukins, Craig; Wong, Mimi; Murphy, Michelle; Upham, John

    2017-07-01

    There are limited data on outcomes of hypoxaemic respiratory failure (HRF), especially in non-intensive care unit (ICU) settings. To assess outcomes in HRF (without multi-system disease and not requiring early intubation) of patients directly admitted to a Respiratory High-dependency Unit (R-HDU). This is a retrospective cohort study of HRF compared to hypercapnic respiratory failure (HCRF) in a R-HDU (2007-2011). Patient characteristics (age, gender, pre-morbid status, diagnoses) and outcomes (non-invasive ventilation (NIV) use, survival, ICU admission) were assessed. There were 1207 R-HDU admissions in 2007-2011, 205 (17%) with HRF and 495 (41%) with HCRF. The proportion with HRF increased from 12.2% in 2007 to 20.1% in 2011 (P < 0.05). HRF patients were younger, more often male and had better pre-morbid performance. Compared to HCRF, HRF was more frequently associated with lung consolidation (61% vs 15%, P < 0.001), interstitial lung disease (12% vs 1%, P < 0.001) and pulmonary hypertension (7% vs 0%, P < 0.001) and less frequently with chronic obstructive pulmonary disease (24% vs 65%, P < 0.001) and obstructive sleep apnoea (8% vs 26%, P < 0.001). Fewer patients with HRF were treated with NIV (28% vs 87%, P < 0.001), but NIV was discontinued early more often (28% vs 7%, P < 0.001). A total of 18% with HRF was transferred to ICU compared to 6% with HCRF (P = 0.06). More patients with HRF died (19.5% vs 12.3%, P = 0.02). Interstitial lung disease, consolidation, shock, malignancy and poorer pre-morbid function were associated with increased mortality. Initial R-HDU management is an effective option in selected HRF to reduce ICU demand, although mortality and clinical deterioration despite NIV are more common than in HCRF. © 2017 Royal Australasian College of Physicians.

  19. Autonomous micro-platform for multisensors with an advanced power management unit (PMU

    Directory of Open Access Journals (Sweden)

    P. Bellier

    2018-04-01

    Full Text Available In this work, we developed and characterised an autonomous micro-platform including several types of sensors, an advanced power management unit (PMU and radio frequency (RF transmission capabilities. Autonomy requires integration of an energy harvester, an energy storage device, a PMU, ultra-low-power components (including sensors and optimized software. Our choice was to use commercial off-the-shelf components with low-power consumption, low cost and compactness as selection criteria. For the multi-purpose micro-platform, we choose to include the most common sensors (such as temperature, humidity, luminosity, acceleration, etc. and to integrate them in one miniaturised autonomous device.A processing unit is embedded in the system. It allows for data acquisition from each sensor individually, simple data processing, and storing and/or wireless data transmission. Such a system can be used as stand-alone, with an internal storage in a non-volatile memory, or as a node in a wireless network, with bi-directional communication with a hub device where data can be analysed further. According to specific application requirements, system settings can be adjusted, such as the sampling rate, the resolution and the processing of the sensor data.Parallel to full autonomous functionality, the low-power design enables us to power the system by a small battery leading to a high degree of autonomy at a high sampling rate. Therefore, we also developed an alternative battery-powered version of the micro-platform that increases the range of applications. As such, the system is highly versatile and due to its reduced dimensions, it can be used nearly everywhere. Typical applications include the Internet of Things, Industry 4.0, home automation and building structural health monitoring.

  20. Effects of the Educational Leadership of Nursing Unit Managers on Team Effectiveness: Mediating Effects of Organizational Communication.

    Science.gov (United States)

    Choi, Eun Ha; Kim, Eun-Kyung; Kim, Pil Bong

    2018-03-31

    EDUCATIONAL LEADERSHIP OF NURSING UNIT MANAGERS ON TEAM EFFECTIVENESS: Mediating Effects of Organizational Communication Satisfaction. This study identifies the effects of the educational leadership of nursing unit managers on team effectiveness and the mediating effects of organizational communication satisfaction; it highlights the importance of educational leadership and organizational communication and provides the data needed to enhance the education capacity of managers. The participants were 216 nursing unit managers of staff nurses at a tertiary hospital located in C Region, South Korea, and nurses who had worked for more than six months at the same hospital. This study was conducted using questionnaires on educational leadership, team effectiveness, and organizational communication satisfaction. Data analysis was performed with a t-test, ANOVA, Scheffé, Pearson's correlation coefficient, and simple and multiple regression analyses using SPSS version 23.0. Mediation analysis was tested using Baron and Kenny's regression analysis and a Sobel test. The mean score for the educational leadership of nursing unit managers was 3.74(±0.68); for organizational communication satisfaction, 3.14(±0.51); and for team effectiveness, 3.52(±0.49). Educational leadership was significantly positively correlated with team effectiveness and organizational communication satisfaction. Organizational communication satisfaction demonstrated a complete mediating effect on the relationship between educational leadership and team effectiveness (β=.61, pcommunication satisfaction among nurses; this supports the idea that educational leadership can contribute to team effectiveness. This suggests that the educational leadership and communication capacity of nursing unit managers must be improved to enhance the performance of nursing organizations. Copyright © 2018. Published by Elsevier B.V.

  1. [Invasive candidiasis in non-neutropenic adults : Guideline-based management in the intensive care unit].

    Science.gov (United States)

    Glöckner, A; Cornely, O A

    2013-12-01

    Invasive Candida infections represent a diagnostic and therapeutic challenge for clinicians particularly in the intensive care unit (ICU). Despite substantial advances in antifungal agents and treatment strategies, invasive candidiasis remains associated with a high mortality. Recent guideline recommendations on the management of invasive candidiasis by the European Society of Clinical Microbiology and Infectious Diseases (ESCMID) from 2012, the German Speaking Mycological Society and the Paul Ehrlich Society for Chemotherapy (DMykG/PEG) from 2011 and the Infectious Diseases Society of America (IDSA) from 2009 provide valuable guidance for diagnostic procedures and treatment of these infections but need to be interpreted in the light of the individual situation of the patient and the local epidemiology of fungal pathogens. The following recommendations for management of candidemia are common to all three guidelines. Any positive blood culture for Candida indicates disseminated infection or deep organ infection and requires antifungal therapy. Treatment should be initiated as soon as possible. Removal or changing of central venous catheters or other foreign material in the bloodstream is recommended whenever possible. Ophthalmological examination for exclusion of endophthalmitis and follow-up blood cultures during therapy are also recommended. Duration of therapy should be 14 days after clearance of blood cultures and resolution of symptoms. Consideration of surgical options and a prolonged antifungal treatment (weeks to months) are required when there is organ involvement. During the last decade several new antifungal agents were introduced into clinical practice. These innovative drugs showed convincing efficacy and favorable safety in randomized clinical trials. Consequently, they were integrated in recent therapeutic guidelines, often replacing former standard drugs as first-line options. Echinocandins have emerged as the generally preferred primary treatment in

  2. Diagnostic reference levels for X-ray investigations in pain management units in Belgium

    International Nuclear Information System (INIS)

    Lichtherte, S.; Le Polain de Waroux, B.

    2008-01-01

    X-rays are commonly used in pain treatment centres where infiltrative techniques are performed. Although X-rays are useful in increasing the precision of infiltrative techniques, their use puts patients and staff at risk of radiation exposure. As a result, medical staff now have to obtain a certificate of training on the use of X-rays before being allowed to use X-rays in practice. This analysis was based on 373 detailed registrations of procedure-related parameters in the six centres that participated in this study between January 2009 and July 2009. Examinations chosen for inclusion in this study were the most commonly performed fluoroscopic imaging-guided procedures in a pain management unit: epidural (cervical/lumbar), facet joint nerve blocks (cervical/lumbar) and trans-foraminal (cervical/lumbar). The sample size, the dose-area product (DAP) range for whole population, the mean and the third quartile DAP corrected for patient size (DAP corr ), the screening time range, the mean and the third quartile screening time are presented. The proposed DRLs for epidural, facet joint nerve blocks and trans-foraminal are 0.5, 2.5 and 3 Gy cm 2 for DAP values and 12, 60 and 50 s for screening times, respectively. In the absence of national diagnostic reference levels (DRLs) for pain management fluoroscopic procedures, these DAP and screening time values provide a possible way of establishing provisional DRLs for local use. The values for each examination type could be used as a baseline against which to monitor the effectiveness of dose reduction strategies as part of the optimisation process that is the goal of any quality control and patient dose monitoring system. (authors)

  3. Primary hyperparathyroidism: Recognition and management

    International Nuclear Information System (INIS)

    Avioli, L.V.

    1987-01-01

    Many cases may be missed, particularly those that are normocalcemic. The disease should be considered in all older patients with chronic mental or behavioral disturbances, nonspecific neuromuscular or GI complaints, and arthralgias--not only because hyperparathyroidism is eminently curable but also because it is virtually impossible to predict when the disease will become life threatening. 13 refs

  4. Outbreak of carbapenem-resistant Acinetobacter baumannii in the intensive care unit: a multi-level strategic management approach.

    Science.gov (United States)

    Molter, G; Seifert, H; Mandraka, F; Kasper, G; Weidmann, B; Hornei, B; Öhler, M; Schwimmbeck, P; Kröschel, P; Higgins, P G; Reuter, S

    2016-02-01

    An outbreak of carbapenem-resistant Acinetobacter baumannii (CRAb) occurred in an interdisciplinary intensive care unit, affecting 10 patients. Within hours of recognition of the spread of CRAb an intervention team was instituted for collection of available data, decision-making, communication and monitoring of all interventions performed, including cohorting, temporary stop of admissions, staff education, and enforcement of infection control measures. An area was defined for cohortation of patients colonized with CRAb, with a separate nursing team and a second set of mobile equipment. New transmissions were no longer observed after only four days into the institution of enhanced infection control measures. Copyright © 2015 The Healthcare Infection Society. Published by Elsevier Ltd. All rights reserved.

  5. Review of nuclear regulatory activities associated with safety culture and the management of safety in the United Kingdom

    International Nuclear Information System (INIS)

    Woodhouse, P.A.

    1995-01-01

    This paper describes some of the key regulatory activities which have taken place in the United Kingdom in recent years in the areas of safety culture and management of safety. It explains how the UK's nuclear licensing regime, regulated and enforced by the Nuclear Installations Inspectorate, (NII), provides the framework for a viable safety management system and identifies a management of safety model which a NII Task Force has developed. It finally identifies further work which is being undertaken by the NII. (author). 4 refs, 2 figs

  6. Major alternatives for government policies, organizational structures, and actions in civilian nuclear reactor emergency management in the United States

    International Nuclear Information System (INIS)

    1980-01-01

    The purpose of this report is to identify and assess major alternatives for governmental policies, organizational structures, and actions in civilian nuclear reactor emergency management in the United States. The National Academy of Public Administration agreed to identify and evaluate alternatives for governmental policies, organizational structures, and actions in civilian nuclear reactor emergency management. It agreed to review present policies and practices in civilian nuclear reactor emergency management, to review selected experiences and practices of governmental agencies other than the Nuclear Regulatory Commission, and industries other than the nuclear power industry, and to identify alternatives to the present nuclear emergency system

  7. Economic Screening of Geologic Sequestration Options in the United States with a Carbon Management Geographic Information System

    Energy Technology Data Exchange (ETDEWEB)

    Dahowski, Robert T.(BATTELLE (PACIFIC NW LAB)); Dooley, James J.(BATTELLE (PACIFIC NW LAB)); Brown, Daryl R.(BATTELLE (PACIFIC NW LAB)); Stephan, Alex J.(BATTELLE (PACIFIC NW LAB)); Badie I. Morsi

    2001-10-19

    Developing a carbon management strategy is a formidable task for nations as well as individual companies. It is often difficult to understand what options are available, let alone determine which may be optimal. In response to the need for a better understanding of complex carbon management options, Battelle has developed a state-of-the-art Geographic Information System (GIS) model with economic screening capability focused on carbon capture and geologic sequestration opportunities in the United States. This paper describes the development of this GIS-based economic screening model and demonstrates its use for carbon management analysis.

  8. 40 CFR 63.7886 - What are the general standards I must meet for my affected remediation material management units?

    Science.gov (United States)

    2010-07-01

    ... refinery) is no longer subject to this subpart. (3) If the remediation material management unit is also... emissions limitations and work practice standards under the other subpart (e.g., you install and operate the required air pollution controls or have implemented the required work practice to reduce HAP emissions to...

  9. 75 FR 2463 - Continuing Contract for Civil Works Project Managed by the United States Army Corps of Engineers...

    Science.gov (United States)

    2010-01-15

    ... be considered a breach of contract and shall not entitle the Contractor to a price adjustment under... constitute a breach of this contract and shall not entitle the Contractor to any price adjustment under the... Continuing Contract for Civil Works Project Managed by the United States Army Corps of Engineers Clauses...

  10. Public policies for managing urban growth and protecting open space: policy instruments and lessons learned in the United States

    Science.gov (United States)

    David N. Bengston; Jennifer O. Fletcher

    2003-01-01

    The public sector in the United States has responded to growing concern about the social and environmental costs of sprawling development patterns by creating a wide range of policy instruments designed to manage urban growth and protect open space. These techniques have been implemented at the local, regional, state and, to a limited extent, national levels. This...

  11. Attitudes toward Business Ethics and Degree of Opinion Leadership of Future Managers In the United States, Finland, and China

    Science.gov (United States)

    Comegys, Charles; Vaisanen, Jaani; Lupton, Robert A.; Rawlinson, David R.

    2013-01-01

    The purpose of this study was to compare the attitudes towards business ethics of future managers in three countries: the United State, Finland, and China, and determine whether business ethics attitudes differed by the student's major, class year, GPA, gender, age, and the number of ethics and religious studies courses completed. Additionally the…

  12. 40 CFR 267.101 - What must I do to address corrective action for solid waste management units?

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 26 2010-07-01 2010-07-01 false What must I do to address corrective action for solid waste management units? 267.101 Section 267.101 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) SOLID WASTES (CONTINUED) STANDARDS FOR OWNERS AND OPERATORS OF HAZARDOUS WASTE FACILITIES OPERATING UNDER A...

  13. Efficiencies of forestry best management practices for reducing sediment and nutrient losses in the eastern United States

    Science.gov (United States)

    Pamela Edwards; Karl W.J. Williard

    2010-01-01

    Quantifying the effects of forestry best management practices (BMPs) on sediment and nutrient loads is a critical need. Through an exhaustive literature search, three paired forested watershed studies in the eastern United States were found that permitted the calculation of BMP efficiencies--the percent reduction in sediment or nutrients achieved by BMPs. For sediment...

  14. Effectiveness of classroom based crew resource management training in the intensive care unit: Study design of a controlled trial

    NARCIS (Netherlands)

    Kemper, P.F.; de Bruijne, M.C.; van Dyck, C.; Wagner, C.

    2011-01-01

    Background: Crew resource management (CRM) has the potential to enhance patient safety in intensive care units (ICU) by improving the use of non-technical skills. However, CRM evaluation studies in health care are inconclusive with regard to the effect of this training on behaviour and

  15. Effectiveness of classroom based crew resource management training in the intensive care unit: study design of a controlled trial.

    NARCIS (Netherlands)

    Kemper, P.F.; Bruijne, M. de; Dyck, C. van; Wagner, C.

    2011-01-01

    Background: Crew resource management (CRM) has the potential to enhance patient safety in intensive care units (ICU) by improving the use of non-technical skills. However, CRM evaluation studies in health care are inconclusive with regard to the effect of this training on behaviour and

  16. The Meaning of Work and Performance-Focused Work Attitudes among Midlevel Managers in the United States and Brazil

    Science.gov (United States)

    Kuchinke, K. Peter; Cornachione, Edgard B., Jr.

    2010-01-01

    This survey-based study investigated work meaning and performance-focused work attitudes of some 315 midlevel managers in diverse industries in the United States and Brazil to determine similarities, differences, and relationships among absolute and relative meaning of work, work role identification, desired work outcomes, and job satisfaction,…

  17. Management of invasive candidiasis and candidemia in adult non-neutropenic intensive care unit patients: Part II. Treatment.

    NARCIS (Netherlands)

    Guery, B.P.; Arendrup, M.C.; Auzinger, G.; Azoulay, E.; Borges Sa, M.; Johnson, E.M.; Muller, E.; Putensen, C.; Rotstein, C.; Sganga, G.; Venditti, M.; Zaragoza Crespo, R.; Kullberg, B.J.

    2009-01-01

    BACKGROUND: Invasive candidiasis and candidemia are frequently encountered in the nosocomial setting particularly in the intensive care unit (ICU). OBJECTIVE AND METHODS: To review the current management of invasive candidiasis and candidemia in non-neutropenic adult ICU patients based on a review

  18. Acute intensive care unit management of mustard gas victims: the Turkish experience.

    Science.gov (United States)

    Kilic, Ertugrul; Ortatatli, Mesut; Sezigen, Sermet; Eyison, Rusen Koray; Kenar, Levent

    2018-05-07

    Sulphur mustard (SM) is an highly toxic and vesicant chemical weapon that was used in various military conflicts several times in the history. The severity of ocular, dermal, and pulmonary symptoms that may appear following a characteristic asymptomatic period are depending on the SM concentration and exposure duration. The aim of this study is to present the clinical features and share the intensive care unit (ICU) experiences for the medical management of mustard gas victims. Thirteen Free Syrian Army soldiers near Al-Bab region of North Syria were reportedly exposed to oily blackish smoke with garlic smell due to the explosion of a trapped bomb without causing any blast or thermal effect on 26th November 2016. None of them wore any chemical protective suits or gas masks during explosion. Since they observed skin lesions including bullous formation next day, they were admitted to the Turkish Field Hospital at the Turkish - Syrian border and then evacuated to the State Hospital of Gaziantep Province, Turkey for further management. Eight victims who were very close to point of explosion suffered burning eyes, sore throat, dry cough and dyspnoea after the chemical attack. On admission to hospital, all cases had conjunctivitis, hoarseness and bullae on various body areas. Blepharospasm and opacity were found in 8 patients and 5 of them had corneal erosions and periorbital oedema. Temporary loss of vision in 4 cases lasted for 24 h. Multiple fluid-filled blisters were observed especially on the scalp, neck, arms and hands, where direct skin exposure to the agent occurred. A definitive clinical care and infection prophylaxis measures along with the burn treatment and bronchodilators for respiratory effects were applied in ICU. Two patients received granulocyte-colony-stimulating factor due to the SM-mediated bone marrow suppression on the 16th day of exposure and one of them died because of necrotic bronchial pseudomembrane obstruction resulting in cardiopulmonary

  19. Prospective Observational Evaluation of Sedation and Pain Management Guideline Adherence Across New Jersey Intensive Care Units.

    Science.gov (United States)

    Brophy, Alison; Cardinale, Maria; Andrews, Liza B; Kaplan, Justin B; Adams, Christopher; Opsha, Yekaterina; Brandt, Kimberly A; Dixit, Deepali; Nerenberg, Steven F; Saleh, Julie A

    2018-01-01

    The practice guidelines for the management of pain, agitation, and delirium (PAD) from the Society of Critical Care Medicine shifted from primarily focusing on the treatment of anxiety in 2002 to the treatment of pain in 2013. This prospective, observational, multicenter study aimed to assess the degree of practice adherence to the PAD guidelines for ventilated patients in New Jersey intensive care units (ICUs). Pharmacist investigators at 8 centers designated 4 days at least 10 days apart to evaluate all patients on mechanical ventilation. The primary outcomes included adherence to 4 guideline recommendations: treatment of pain before sedation, use of nonnarcotic analgesic medications, use of nonbenzodiazepine sedative medications, and use of goal-directed sedation. Of 138 patients evaluated, 50% had a primary medical diagnosis (as opposed to surgical, cardiac, or neurological diagnosis), and the median Sequential Organ Failure Assessment (SOFA) score was 7. Pain was treated prior to administration of sedatives in 55.4% of subjects, with fentanyl being the primary analgesic used. In addition, 19% received no analgesia, and 11.5% received nonopioid analgesia. Sedative agents were administered to 87 subjects (48 nonbenzodiazepine and 39 benzodiazepine). Of those receiving benzodiazepines, 22 received intermittent bolus regimens and 16 received continuous infusions, of which 5 were for another indication besides sedation. Validated scales measuring the degree of sedation were completed at least once in 56 (81.6%) patients receiving sedatives. Current sedation practices suggest that integration of evidence-based PAD guidelines across New Jersey adult ICUs is inconsistent despite pharmacist involvement.

  20. Sorption-reagent treatment of brines produced by reverse osmosis unit for liquid radioactive waste management

    International Nuclear Information System (INIS)

    Avramenko, V. A.; Zheleznov, V. V.; Sergienko, V. I.; Chizhevsky, I. Yu

    2003-01-01

    The results of the pilot plant tests (2002-2003) of the sorption-reagent decontamination of high salinity radioactive waste (brines) remaining after the low-salinity liquid radioactive waste (LRW) treatment in the reverse-osmosis unit from long-lived radionuclides are presented. The sorption-reagent materials used in this work were developed in the Institute of Chemistry FEDRAS. They enable one to decontaminate brines with total salt content up to 50 g/l from long-lived radionuclides of Cs, Sr and Co. At joint application of the reverse-osmosis and sorption-reagent technologies total volume of solid radioactive waste (SRW) decreases up to 100-fold as compared to the technology of cementation of reverse osmosis brines. In this case total cost of LRW treatment and SRW disposal decreases more than 10-fold. Brines decontaminated from radionuclides are then diluted down to the ecologically safe total salts content in water to be disposed of. Tests were performed to compare the efficiency of technologies including evaporation of brines remaining after reverse osmosis process and their decontamination by means of the sorption-reagent method. It was shown that, as compared to evaporation, the sorption-reagent technology provides substantial advantages as in regard to radioactive waste total volume reduction as in view of total cost of the waste management

  1. WIPP Sampling and Analysis Plan for Solid Waste Management Units and Areas of Concern

    International Nuclear Information System (INIS)

    2000-01-01

    This Sampling and Analysis Plan (SAP) has been prepared to fulfill requirements of Module VII, Section VII.M.2 and Table VII.1, requirement 4 of the Waste Isolation Pilot Plant (WIPP) Hazardous Waste Permit, NM4890139088-TSDF (the Permit); (NMED [New Mexico Environment Department], 1999a). This SAP describes the approach for investigation of the Solid Waste Management Units (SWMU) and Areas of Concern (AOC) specified in the Permit. This SAP addresses the current Permit requirements for a RCRA Facility Investigation(RFI) investigation of SWMUs and AOCs. It uses the results of previous investigations performed at WIPP and expands the investigations as required by the Permit. As an alternative to the RFI specified in Module VII of the Permit, current NMED guidance identifies an Accelerated Corrective Action Approach (ACAA) that may be used for any SWMU or AOC (NMED, 1998). This accelerated approach is used to replace the standard RFI work plan and report sequence with a more flexible decision-making approach. The ACAA process allows a facility to exit the schedule of compliance contained in the facility's Hazardous and Solid Waste Amendments (HSWA) permit module and proceed on an accelerated time frame. Thus, the ACAA process can beentered either before or after a RFI work plan. According to NMED's guidance, a facility can prepare a RFI work plan or SAP for any SWMU or AOC (NMED, 1998).

  2. Organizational structuring and strategic business units in function of an effective management

    Directory of Open Access Journals (Sweden)

    Kovač Aleksandar

    2012-01-01

    Full Text Available In modern business conditions, in the conditions of extremely fast market changes which affect the way and the organization of a company's business, it is necessary to set up such an organizational structure which will provide the necessary flexibility and the base for further growth and development of the company. Each wrong business decision results in a waste of time, money and energy. In order to minimize mistakes as much as possible it is necessary to have a quality system of accounting information which is essential for making business decisions. In that sense, in order to provide quality accounting information and to enable the monitoring of the performances of particular parts of the company by the central management, forming and organizational structuring of the strategic business units is an effective way to answer the challenges of the business environment. Recently, a certain tendency of changes in the field of organizational structuring is noticeable, or, more precisely, of organizational restructuring of the business systems in closer and wider environment with a goal of delegating authorities and responsibilities to the organizational divisions. Profit centre, as an organizational part of a company which does not have a legal status, is of an exceptional importance.

  3. Environmental management at the Grand Rapids Generating Station following the Unit No.1 headcover failure

    International Nuclear Information System (INIS)

    Windsor, D.C.

    1993-01-01

    Failure of the headcover of Unit 1 in the Grand Rapids generating station in March, 1992 caused the station to flood, releasing several thousand gallons of oil and removing the station from service for several weeks. Environmental considerations were a considerable part of the station restoration activities, reservoir and flow management programs and responses to public concerns arising from the accident. A major oil spill containment and cleanup program was undertaken, with station cleanup and debris disposal carried out in a manner acceptable to environmental authorities. Reservoir spillage was necessitated by the station shutdown. The spill recreated fish habitat in the spillway and walleye spawning were documented. A compensation program was developed to respond to problems caused by debris flushed from the spillway channel. On spill termination, a fish salvage program removed fish from a scour hole in the spillway channel. A proactive program of public information provided local residents with the facts about the incident and response program, and allayed concerns about public safety. 4 refs., 2 figs

  4. Late presentation and management of South Asian breast cancer patients in West Yorkshire, United Kingdom.

    Science.gov (United States)

    Rajan, Sreekumar Sundara; Lim, Jennifer N W; Haq, Anwar

    2011-01-01

    The objective of this study was to bridge the knowledge gap and improve our understanding of the late presentation and management of breast cancer among South Asian women of non-oriental origin (SA) living in the United Kingdom. Retrospective review of the breast cancer waiting list data-base held at Calderdale and Huddersfield NHS trust was undertaken to identify SA women diagnosed with breast cancer from January 2000 to August 2007. We identified 41 (2.5%) SA women among 1,630 patients diagnosed with breast cancer during this period and 36 were included (median age=53.5 years, range=32-84). Only 19% (n=7) were screen detected and 81% (n=29) presented thorough symptomatic breast clinic. In the latter, 66% (n=19) were in the screening age group and 45% (n=13) presented beyond 8 weeks (late presentation). In our cohort, 91% (n=29) patients had advanced disease (TNM stage 2 and 3) resulting in a high mastectomy rate of 61% (n=22). 19% (n=7) died as a direct result of cancer and the remaining 78% (n=28) remains disease free following treatment thus far. The delay in presentation and poor national breast screening programme uptake among the SA women resulted in advanced disease at diagnosis. There is need for increasing the breast cancer awareness as well as encouraging breast screening among SA women in the UK.

  5. Implementation of Inventory Management System (IMS) case study on XYZ online store business unit

    Science.gov (United States)

    Bagus Yosan, R.; Kholil, Muhammad; Hanum, Bhetriza

    2018-03-01

    XYZ baby and child shop is a new player in the business of selling toys and baby gears. Consumers target for XYZ toy shop is segmentation of middle and upper financial ability buyers. XYZ toy store sells imported toys and baby products with high quality products, using international grade production materials and ISO production certificates: 9002. With this conceptual, establishment XYZ business line is as a provider (seller) toys and baby equipment premium brand; then the scope of the product sold must meet all expectations of market demands. Meet the expectations of market demand is not easy; because by fulfilling all expectations, then the impact is the high stock of goods that must be available. The high stock of goods will directly impact on the needs of a large storage area of goods and reduce money. Based on the previous description, the formulation of the problem in this research is: "What inventory management strategy can be applied to improve the productivity of Lean Manufacturing business unit of XYZ online store?"

  6. A Comparison of Two Control Display Unit Concepts on Flight Management System Training

    Science.gov (United States)

    Abbott, Terence S.

    1997-01-01

    One of the biggest challenges for a pilot in the transition to a 'glass' cockpit is understanding the flight management system (FMS). Because of both the complex nature of the FMS and the pilot-FMS interface, a large portion of transition training is devoted to the FMS. The current study examined the impact of the primary pilot-FMS interface, the control display unit (CDU), on FMS training. Based on the hypothesis that the interface design could have a significant impact on training, an FMS simulation with two separate interfaces was developed. One interface was similar to a current-generation design, and the other was a multiwindows CDU based on graphical user interface techniques. For both application and evaluation reasons, constraints were applied to the graphical CDU design to maintain as much similarity as possible with the conventional CDU. This preliminary experiment was conducted to evaluate the interface effects on training. Sixteen pilots with no FMS experience were used in a between-subjects test. A time-compressed, airline-type FMS training environment was simulated. The subjects were trained to a fixed-time criterion, and performance was measured in a final, full-mission simulation context. This paper describes the technical approach, simulation implementation, and experimental results of this effort.

  7. Mapping landscape units in Galicia (Spain: A first step for assessment and management?

    Directory of Open Access Journals (Sweden)

    Corbelle-Rico Eduardo

    2017-12-01

    Full Text Available In the beginning of 2015, the Regional Administration of Galicia (NW Spain set the requirements for a map of landscape units: it had to be produced in less than 3 months, it should cover the whole territory of the region (29,574 km², and it should be useful for management at a scale of 1:25,000. With these objectives in mind, we pro- posed a semiautomatic mapping methodology entirely based on the use of free software (GRASS GIS and already available cartographic information. Semi-automatic classification of different land-use patterns was at the heart of the proposed process. Consultation with experts of different academic background took place along the project. This consultation process allowed to identify both problems and opportunities. As it could be expected, the diverse epistemic community represented by the expert panel implied that one of the main challenges was to reach consensus on the understanding of the concept of landscape and the decisions leading to the mapping methodology proposed in this paper. This initiated a very interesting debate that, in our view, was centred around three main issues: the approach to the landscape, the purpose of the mapping exercise, and the ability to include subjectivity into the analysis.

  8. WIPP Sampling and Analysis Plan for Solid Waste Management Units and Areas of Concern

    Energy Technology Data Exchange (ETDEWEB)

    None, None

    2000-05-23

    This Sampling and Analysis Plan (SAP) has been prepared to fulfill requirements of Module VII, Section VII.M.2 and Table VII.1, requirement 4 of the Waste Isolation Pilot Plant (WIPP) Hazardous Waste Permit, NM4890139088-TSDF (the Permit); (NMED [New Mexico Environment Department], 1999a). This SAP describes the approach for investigation of the Solid Waste Management Units (SWMU) and Areas of Concern (AOC) specified in the Permit. This SAP addresses the current Permit requirements for a RCRA Facility Investigation(RFI) investigation of SWMUs and AOCs. It uses the results of previous investigations performed at WIPP and expands the investigations as required by the Permit. As an alternative to the RFI specified in Module VII of the Permit, current NMED guidance identifies an Accelerated Corrective Action Approach (ACAA) that may be used for any SWMU or AOC (NMED, 1998). This accelerated approach is used to replace the standard RFI work plan and report sequence with a more flexible decision-making approach. The ACAA process allows a facility to exit the schedule of compliance contained in the facility's Hazardous and Solid Waste Amendments (HSWA) permit module and proceed on an accelerated time frame. Thus, the ACAA process can beentered either before or after a RFI work plan. According to NMED's guidance, a facility can prepare a RFI work plan or SAP for any SWMU or AOC (NMED, 1998).

  9. Risk management and the vulnerability assessment process of the United States Department of Energy

    International Nuclear Information System (INIS)

    Rivers, J.D.; Johnson, O.B.; Callahan, S.N.

    2001-01-01

    Full text: Risk management is an essential element in influencing how the United States Department of Energy's safeguards and security mission is executed. Risk management exists as a function of a target's attractiveness, along with the potential consequences associated with the unauthorized use of that target. The goal of risk management encompasses the fielding and operating of appropriate, cost-effective protection systems generating sufficient deterrence to protect sensitive programs and facilities. Risk mitigation and risk prevention are accomplished through the vulnerability assessment process. The implementation and continued validation of measures to prevent or mitigate risk to acceptable levels constitute the fundamental approach of the Department's risk management program. Due to the incomplete knowledge inherent in any threat definition, it is impossible to precisely tailor a protective system to defend against all threats. The challenge presented to safeguards and security program managers lies in developing systems sufficiently effective to defend against an array of threats slightly greater than can be hypothetically postulated (the design basis threat amended for local conditions). These systems are then balanced against technological, resource, and fiscal constraints. A key element in the risk assessment process is analyzing the security systems against the Design Basis Threat (DBT). The DBT is used to define the level and capability of the threat against the DOE facilities and their assets. In particular it defines motivation, numbers of adversaries, capabilities, and their objectives. Site Safeguards and Security Plans (SSSPs) provide the basis and justification for safeguards and security program development, budget, and staffing requirements. The SSSP process examines, describes, and documents safeguards and security programs, site-wide and by facility; establishes safeguards and security program improvement priorities; describes site and

  10. Do United States’ Teachers Know and Adhere to the National Guidelines on Asthma Management in the Classroom? A Systematic Review

    Directory of Open Access Journals (Sweden)

    Yudilyn Jaramillo

    2015-01-01

    Full Text Available Proper asthma management in schools is important in achieving optimum asthma control in children with asthma. The National Heart, Lung, and Blood Institute (NHLBI has developed guidelines on classroom asthma management. We conducted a systematic review to examine teacher knowledge of the NHLBI guidelines on asthma management in the classroom. We searched PubMed and EMBASE using search terms “asthma management,” “teacher(s,” “school teacher,” and “public school.” The inclusion criteria were articles published in English from 1994 to May 2014 that focus on schools in the United States (US. From 535 titles and abstracts, 9 studies met inclusion criteria. All studies reported that school teachers did not know the policies and procedures of asthma management. Teachers relied on school nurses to handle medical emergencies. Some studies identified that lack of full-time school nurses was a barrier to asthma management. Only one study showed directly that classroom teachers were not following the NHLBI guidelines on asthma management. Our literature review revealed that US teachers do not know the NHLBI guidelines on asthma management in the classroom. Future research should focus on interventions targeted toward training classroom teachers on asthma management as per NHLBI guidelines to ultimately improve asthma management in schools.

  11. The influence of capacity management on the unit cost of production: a case study in a flexible plastic packaging company

    Directory of Open Access Journals (Sweden)

    Tálita Floriano Goulart Silva

    2013-08-01

    Full Text Available This article presents the relationship between capacity management and cost management in determining the unit cost. The objective was to show how the use of effective capacity decreases the unit cost of manufacturing. For this, follow these steps: 1 Knowledge and analysis of production process and PPPC; 2 Data Collection; 3 Application of the Method Cost Center; 4Verification of the relationship between the Capacity Management and Cost Management. Through the company’s accounting reports, observations and interviews, the following results was possible: knowledge of the production process and functioning of PPCP, measuring the cost of each step of the production process and the unit cost of each product. Subsequently, we compared the unit cost using the effective capacity and normal capacity. The results showed that the unit costs decrease with the use of effective capacity, while increasing the margin for each product, even with the lower sale price, thus establishing a virtuous circle: effective capacity utilization, reduced unit cost, most competitive prices and increase in the number of requests.

  12. Expanded public notice: Washington State notice of intent for corrective action management unit, Hanford Environmental Restoration Disposal

    International Nuclear Information System (INIS)

    1994-01-01

    This document is to serve notice of the intent to operate an Environmental Restoration Disposal Facility (ERDF), adjacent to the 200 West Area of the Hanford Facility, Richland, Washington, as a Corrective Action Management Unit (CAMU), in accordance with 40 Code of Federal Regulation (CFR) 264.552. The ERDF CAMU will serve as a management unit for the majority of waste (primarily soil) excavated during remediation of waste management sites on the Hanford Facility. Only waste that originates from the Hanford Facility can be accepted in this ERDF CAMU. The waste is expected to consist of dangerous waste, radioactive waste, and mixed waste. Mixed waste contains radioactive and dangerous components. The primary features of the ERDF could include the following: one or more trenches, rail and tractor/trailer container handling capability, railroads, an inventory control system, a decontamination building, and operational offices

  13. Turnover of professional nurses at Mokopane Hospital in the Limpopo Province, South Africa: Experiences of nursing unit managers

    Directory of Open Access Journals (Sweden)

    Mogale L. Mmamma

    2015-12-01

    Full Text Available Background: Staff turnover of professional nurses remains a concern for public and private hospitals management because it has an impact on the morale of nurses and it may also lead to poor patient care. Objectives: The objectives of this study were to explore and describe the experiences of nursing unit managers with regard to the turnover of professional nurses who were under their supervision. Method: A qualitative, explorative, descriptive research design was used to determine the experiences of nursing unit managers related to the turnover of professional nurses. Data collection was done by using semi-structured one-to-one interviews with professional nurses .Two groups of participants were interviewed: Those working day duty (n = 9 and those working night duty (n = 3 who were at work on the anticipated days for data collection. Results: The findings revealed that every unit was experiencing a shortage of professional nurses, which caused other nurses to work overtime with an inevitable increase in workload. That led to tiredness, conflict amongst professional nurses, job dissatisfaction, and absenteeism which compromised nursing care. This resulted in patient dissatisfaction and sometimes led to deaths that could have been prevented. Conclusion: It is recommended that staff turnover should be addressed by the hospital top management implementing several strategies. For example, top management could ensure that staff members work in a healthy environment with resources that they need during the provision of care, address the effects of the staff turnover, support the staff members and refrain from putting pressure on nursing unit managers whilst they are attending to problems.

  14. Decentralized Method for Load Sharing and Power Management in a Hybrid Single/Three-Phase-Islanded Microgrid Consisting of Hybrid Source PV/Battery Units

    DEFF Research Database (Denmark)

    Karimi, Yaser; Oraee, Hashem; Guerrero, Josep M.

    2017-01-01

    This paper proposes a new decentralized power management and load sharing method for a photovoltaic based, hybrid single/three-phase islanded microgrid consisting of various PV units, battery units and hybrid PV/battery units. The proposed method is not limited to the systems with separate PV...... in different load, PV generation and battery conditions is validated experimentally in a microgrid lab prototype consisted of one three-phase unit and two single-phase units....

  15. Changes in the fraction of total hypoxia and hypoxia subtypes in human squamous cell carcinomas upon fractionated irradiation: Evaluation using pattern recognition in microcirculatory supply units

    International Nuclear Information System (INIS)

    Maftei, Constantin-Alin; Bayer, Christine; Shi, Kuangyu; Astner, Sabrina T.; Vaupel, Peter

    2011-01-01

    Background and purpose: Evaluate changes in total hypoxia and hypoxia subtypes in vital tumor tissue of human head and neck squamous cell carcinomas (hHNSCC) upon fractionated irradiation. Materials and methods: Xenograft tumors were generated from 5 hHNSCC cell lines (UT-SCC-15, FaDu, SAS, UT-SCC-5 and UT-SCC-14). Hypoxia subtypes were quantified in cryosections based on (immuno-)fluorescent marker distribution patterns of Hoechst 33342 (perfusion), pimonidazole (hypoxia) and CD31 (endothelium) in microcirculatory supply units (MCSUs). Tumors were irradiated with 5 or 10 fractions of 2 Gy, 5×/week. Results: Upon irradiation with 10 fractions, the overall fraction of hypoxic MCSUs decreased in UT-SCC-15, FaDu and SAS, remained the same in UT-SCC-5 and increased in UT-SCC-14. Decreases were observed in the proportion of chronically hypoxic MCSUs in UT-SCC-15, in the fraction of acutely hypoxic MCSUs in UT-SCC-15 and SAS, and in the percentage of hypoxemically hypoxic MCSUs in SAS tumors. After irradiation with 5 fractions, there were no significant changes in hypoxia subtypes. Changes in the overall fraction of hypoxic MCSUs were comparable to corresponding alterations in the proportions of acutely hypoxic MCSUs. There was no correlation between radiation resistance (TCD 50 ) and any of the investigated hypoxic fractions upon fractionated irradiation. Conclusions: This study shows that there are large alterations in the fractions of hypoxia subtypes upon irradiation that can differ from changes in the overall fraction of hypoxic MCSUs.

  16. Comparison of semiautomated bird song recognition with manual detection of recorded bird song samples

    OpenAIRE

    Lisa A. Venier; Marc J. Mazerolle; Anna Rodgers; Ken A. McIlwrick; Stephen Holmes; Dean Thompson

    2017-01-01

    Automated recording units are increasingly being used to sample wildlife populations. These devices can produce large amounts of data that are difficult to process manually. However, the information in the recordings can be summarized with semiautomated sound recognition software. Our objective was to assess the utility of the semiautomated bird song recognizers to produce data useful for conservation and sustainable forest management applications. We compared detection data generated from ex...

  17. Phragmites australis management in the United States: 40 years of methods and outcomes

    OpenAIRE

    Hazelton, Eric L. G.; Mozdzer, Thomas J.; Burdick, David M.; Kettenring, Karin M.; Whigham, Dennis F.

    2014-01-01

    Studies on invasive plant management are often short in duration and limited in the methods tested, and lack an adequate description of plant communities that replace the invader following removal. Here we present a comprehensive review of management studies on a single species, in an effort to elucidate future directions for research in invasive plant management. We reviewed the literature on Phragmites management in North America in an effort to synthesize our understanding of management ef...

  18. Stroke unit Nurse Managers' views of individual and organizational factors liable to influence evidence-based practice: A survey.

    Science.gov (United States)

    Drury, Peta; McInnes, Elizabeth; Hardy, Jennifer; Dale, Simeon; Middleton, Sandy

    2016-04-01

    The uptake of evidence into practice may be impeded or facilitated by individual and organizational factors within the local context. This study investigated Nurse Managers of New South Wales, Australia, stroke units (n = 19) in their views on: leadership ability (measured by the Leadership Practices Inventory), organizational learning (measured by the Organizational Learning Survey), attitudes and beliefs towards evidence-based practice (EBP) and readiness for change. Overall Nurse Managers reported high-level leadership skills and a culture of learning. Nurse Managers' attitude towards EBP was positive, although nursing colleague's attitudes were perceived as less positive. Nurse Managers agreed that implementing evidence in practice places additional demands on staff; and almost half (n = 9, 47%) reported that resources were not available for evidence implementation. The findings indicate that key persons responsible for evidence implementation are not allocated sufficient time to coordinate and implement guidelines into practice. The findings suggest that barriers to evidence uptake, including insufficient resources and time constraints, identified by Nurse Managers in this study are not likely to be unique to stroke units. Furthermore, Nurse Managers may be unable to address these organizational barriers (i.e. lack of resources) and thus provide all the components necessary to implement EBP. © 2015 John Wiley & Sons Australia, Ltd.

  19. The Role of Antibody in Korean Word Recognition

    Science.gov (United States)

    Lee, Chang Hwan; Lee, Yoonhyoung; Kim, Kyungil

    2010-01-01

    A subsyllabic phonological unit, the antibody, has received little attention as a potential fundamental processing unit in word recognition. The psychological reality of the antibody in Korean recognition was investigated by looking at the performance of subjects presented with nonwords and words in the lexical decision task. In Experiment 1, the…

  20. Nursing Leaders' Satisfaction with Information Systems in the Day-to-Day Operations Management in Hospital Units.

    Science.gov (United States)

    Peltonen, Laura-Maria; Junttila, Kristiina; Salanterä, Sanna

    2018-01-01

    Information usage in the day-to-day operations management of hospital units is complex due to numerous information systems in use. The aim of this study was to describe and compare nurse leaders' satisfaction with information systems used in the day-to-day operations management in hospital units. The design was a cross-sectional survey with five questions rated from one (disagree) to five (fully agree). The response rate was 65 % (n = 453). Respondents reported fair satisfaction with how information systems support decision-making (median 4, IQR 3-4) and improve ease of access to information (median 4, IQR 3-4). However, respondents were less satisfied with how systems improve speed of access to information (median 3, IQR 3-4). Nor did respondents think that systems were developed for them (median 3, IQR 2-4). Respondents further reported needing numerous systems daily to support decision-making (median 4, IQR 3-5). A clear need for one system, which would gather important information for display was stated (median 5, IQR 4-5). Work experience, gender and time when overseeing the unit were associated with some aspects related to satisfaction. In conclusion, information system improvements are needed to better support the day-to-day operations management in hospital units.

  1. WIPP Facility Work Plan for Solid Waste Management Units and Areas of Concern

    International Nuclear Information System (INIS)

    2001-01-01

    This 2001 Facility Work Plan (FWP) has been prepared as required by Module VII, Section VII.M.1 of the Waste Isolation Pilot Plant (WIPP) Hazardous Waste Facility Permit, NM4890139088-TSDF (the Permit); (NMED, 1999a), and incorporates comments from the New Mexico Environment Department (NMED) received on December 6, 2000 (NMED, 2000a). This February 2001 FWP describes the programmatic facility-wide approach to future investigations at Solid Waste Management Units (SWMUs) and Areas of Concern (AOCs) specified in the Permit. The permittees are evaluating data from previous investigations of the SWMUs and AOCs against the newest guidance proposed by the NMED. Based on these data, the permittees expect that no further sampling will be required and that a request for No Further Action (NFA) at the SWMUs and AOCs will be submitted to the NMED. This FWP addresses the current Permit requirements. It uses the results of previous investigations performed at WIPP and expands the investigations as required by the Permit. As an alternative to the Resource Conservation and Recovery Act (RCRA) Facility Investigation (RFI) specified in Module VII of the Permit, current NMED guidance identifies an Accelerated Corrective Action Approach (ACAA) that may be used for any SWMU or AOC (NMED, 1998). This accelerated approach is used to replace the standard RFI Work Plan and Report sequence with a more flexible decision-making approach. The ACAA process allows a Facility to exit the schedule of compliance contained in the Facility's Hazardous and Solid Waste Amendments (HSWA) permit module and proceed on an accelerated time frame. Thus, the ACAA process can be entered either before or after an RFI Work Plan. According to the NMED's guidance, a facility can prepare an RFI Work Plan or Sampling and Analysis Plan (SAP) for any SWMU or AOC (NMED, 1998). Based on this guidance, a SAP constitutes an acceptable alternative to the RFI Work Plan specified in the Permit.

  2. Current Trends in the Management of Lateral Ankle Sprain in the United States.

    Science.gov (United States)

    Feger, Mark A; Glaviano, Neal R; Donovan, Luke; Hart, Joseph M; Saliba, Susan A; Park, Joseph S; Hertel, Jay

    2017-03-01

    To characterize trends in the acute management (within 30 days) after lateral ankle sprain (LAS) in the United States. Descriptive epidemiology study. Of note, 825 718 ankle sprain patients were identified; 96.2% were patients with LAS. Seven percent had an associated fracture and were excluded from the remaining analysis. Primary and tertiary care settings. We queried a database of national health insurance records for 2007 to 2011 by ICD-9 codes for patients with LAS while excluding medial and syndesmotic sprains and any LAS with an associated foot or ankle fracture. The percentage of patients to receive specific diagnostic imaging, orthopedic devices, or physical therapy treatments within 30 days of the LAS diagnosis and the associated costs. Over two-thirds of patients with LAS without an associated fracture received radiographs, 9% received an ankle brace, 8.1% received a walking boot, 6.5% were splinted, and 4.8% were prescribed crutches. Only 6.8% received physical therapy within 30 days of their LAS diagnosis, 94.1% of which performed therapeutic exercise, 52.3% received manual therapy, and 50.2% received modalities. The annual cost associated with physician visits, diagnostic imaging, orthopedic devices, and physical therapy was 152 million USD, 81.5% was from physician evaluations, 7.9% from physical therapy, 7.2% from diagnostic imaging, and 3.4% from orthopedic devices. Most patients with LAS do not receive supervised rehabilitation. The small proportion of patients with LAS to receive physical therapy get rehabilitation prescribed in accordance with clinical practice guidelines. The majority (>80%) of the LAS financial burden is associated with physician evaluations.

  3. Assessment of Weight Management Practices among Adults in the United Arab Emirates.

    Science.gov (United States)

    Attlee, Amita; Atmani, Nour; Stromtsov, Viktor; Ali, Fatima; Tikarly, Rim; Ryad, Sarah; Salah, Ghada; Hasan, Hayder; Obaid, Reyad

    2017-01-01

    With a rise in global incidence of overweight and obesity, the number of patients seeking weight management (WM) advice is likely to increase. Our aim was to explore the prevalence of WM practices and investigate association of WM goals with sociodemographic variables and practices among United Arab Emirates (UAE) adults. An exploratory, cross-sectional research was conducted on 1275 adult males and females, residing in UAE. A structured questionnaire was administered. WM goals to lose/maintain/gain weight were reported in 88.3% participants. WM goals were significantly associated with age, sex, marital status, education, current body weight perception, and medical condition. Out of 21 selected WM practices, popular strategies included increasing physical activity (52.9%), eating less fat (51.1%), consuming fewer calories (43.3%), joining gym (27.5%), skipping meals (26.1%), and consuming natural herbs and teas (20.7%). Visiting dietitian (12.3%) ranked ninth in the order of preference. Males focused on physical activity, gyms, and wellness centers and females on calories counting, dietitian visits, meals replacement, skipping meals, and natural herbs/teas. Married adults reported eating less fat (54.3% versus 47.3%, p = 0.020); singles opted calories counting, gyms, and meals replacement. Frequent referral sources were friends (37.8%) and Internet (32.1%). Most UAE adults had WM goals that were associated with sociodemographic variables and WM practices. Awareness about the ill-effects of unhealthy WM practices and importance of dietitian's consultation are imperative.

  4. Phylogeography, Genetic Diversity, and Management Units of Hawksbill Turtles in the Indo-Pacific.

    Science.gov (United States)

    Vargas, Sarah M; Jensen, Michael P; Ho, Simon Y W; Mobaraki, Asghar; Broderick, Damien; Mortimer, Jeanne A; Whiting, Scott D; Miller, Jeff; Prince, Robert I T; Bell, Ian P; Hoenner, Xavier; Limpus, Colin J; Santos, Fabrício R; FitzSimmons, Nancy N

    2016-05-01

    Hawksbill turtle (Eretmochelys imbricata) populations have experienced global decline because of a history of intense commercial exploitation for shell and stuffed taxidermied whole animals, and harvest for eggs and meat. Improved understanding of genetic diversity and phylogeography is needed to aid conservation. In this study, we analyzed the most geographically comprehensive sample of hawksbill turtles from the Indo-Pacific Ocean, sequencing 766 bp of the mitochondrial control region from 13 locations (plus Aldabra, n = 4) spanning over 13500 km. Our analysis of 492 samples revealed 52 haplotypes distributed in 5 divergent clades. Diversification times differed between the Indo-Pacific and Atlantic lineages and appear to be related to the sea-level changes that occurred during the Last Glacial Maximum. We found signals of demographic expansion only for turtles from the Persian Gulf region, which can be tied to a more recent colonization event. Our analyses revealed evidence of transoceanic migration, including connections between feeding grounds from the Atlantic Ocean and Indo-Pacific rookeries. Hawksbill turtles appear to have a complex pattern of phylogeography, showing a weak isolation by distance and evidence of multiple colonization events. Our novel dataset will allow mixed-stock analyses of hawksbill turtle feeding grounds in the Indo-Pacific by providing baseline data needed for conservation efforts in the region. Eight management units are proposed in our study for the Indo-Pacific region that can be incorporated in conservation plans of this critically endangered species. © The American Genetic Association. 2015. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  5. Assessment of Weight Management Practices among Adults in the United Arab Emirates

    Directory of Open Access Journals (Sweden)

    Amita Attlee

    2017-01-01

    Full Text Available With a rise in global incidence of overweight and obesity, the number of patients seeking weight management (WM advice is likely to increase. Our aim was to explore the prevalence of WM practices and investigate association of WM goals with sociodemographic variables and practices among United Arab Emirates (UAE adults. An exploratory, cross-sectional research was conducted on 1275 adult males and females, residing in UAE. A structured questionnaire was administered. WM goals to lose/maintain/gain weight were reported in 88.3% participants. WM goals were significantly associated with age, sex, marital status, education, current body weight perception, and medical condition. Out of 21 selected WM practices, popular strategies included increasing physical activity (52.9%, eating less fat (51.1%, consuming fewer calories (43.3%, joining gym (27.5%, skipping meals (26.1%, and consuming natural herbs and teas (20.7%. Visiting dietitian (12.3% ranked ninth in the order of preference. Males focused on physical activity, gyms, and wellness centers and females on calories counting, dietitian visits, meals replacement, skipping meals, and natural herbs/teas. Married adults reported eating less fat (54.3% versus 47.3%, p=0.020; singles opted calories counting, gyms, and meals replacement. Frequent referral sources were friends (37.8% and Internet (32.1%. Most UAE adults had WM goals that were associated with sociodemographic variables and WM practices. Awareness about the ill-effects of unhealthy WM practices and importance of dietitian’s consultation are imperative.

  6. Nutritional screening and dietitian consultation rates in a geriatric evaluation and management unit.

    Science.gov (United States)

    Dent, Elsa; Wright, Olivia; Hoogendijk, Emiel O; Hubbard, Ruth E

    2018-02-01

    Nutritional screening may not always lead to intervention. The present study aimed to determine: (i) the rate of nutritional screening in hospitalised older adults; (ii) whether nutritional screening led to dietitian consultation and (iii) factors associated with malnutrition. In this prospective study of patients aged ≥70 years admitted to a Geriatric Evaluation and Management Unit (GEMU), malnutrition was screened for using the Mini Nutritional Assessment Short Form (MNA-SF) and identified using the Mini Nutritional Assessment (MNA). Of the 172 patients participating in the study, 53 (30.8%) patients were malnourished, and 84 (48.8%) were at risk of malnutrition. Mean (SD) age was 85.2 (6.4 years), with 131 patients (76.2%) female. Nutritional screening was performed for all patients; however, it was incomplete in 59 (34.3%) because of omission of the anthropometric measurement. Overall, 62 (36.0%) of the total number of patients were seen by the dietitian, which included 26 (49%) of malnourished patients, 27 (32%) of at-risk patients and 9 (26%) of the well-nourished patients. No patients lost >1% of body weight during GEMU stay. Malnourished patients were more likely to be frail, have poor appetite, depression, and have lower levels of: albumin, cognition, physical function, grip strength and quality of life. The full benefits of nutritional screening by MNA-SF may not be realised if it does not result in malnourished patients receiving a dietitian consultation. However, it is possible that enrichment of the foodservice with high protein/high-energy options minimised patient weight loss in the GEMU. © 2017 Dietitians Association of Australia.

  7. Corrective Action Management Unit Report of Post-Closure Care Activities Calendar Year 2017.

    Energy Technology Data Exchange (ETDEWEB)

    Ziock, Robert [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Little, Bonnie Colleen [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2018-02-01

    The Corrective Action Management Unit (CAMU) at Sandia National Laboratories, New Mexico (SNL/NM) consists of a containment cell and ancillary systems that underwent regulatory closure in 2003 in accordance with the Closure Plan in Appendix D of the Class 3 Permit Modification (SNL/NM September 1997). The containment cell was closed with wastes in place. On January 27, 2015, the New Mexico Environment Department (NMED) issued the Hazardous Waste Facility Operating Permit (Permit) for Sandia National Laboratories (NMED January 2015). The Permit became effective February 26, 2015. The CAMU is undergoing post-closure care in accordance with the Permit, as revised and updated. This CAMU Report of Post-Closure Care Activities documents all activities and results for Calendar Year (CY) 2017 as required by the Permit. The CAMU containment cell consists of engineered barriers including a cover system, a bottom liner with a leachate collection and removal system (LCRS), and a vadose zone monitoring system (VZMS). The VZMS provides information on soil conditions under the cell for early leak detection. The VZMS consists of three monitoring subsystems, which include the primary subliner (PSL), a vertical sensor array (VSA), and the Chemical Waste Landfill (CWL) sanitary sewer (CSS) line. The PSL, VSA, and CSS monitoring subsystems are monitored quarterly for soil moisture concentration, the VSA is monitored quarterly for soil temperature, and the VSA and CSS monitoring subsystems are monitored annually for volatile organic compound (VOC) concentrations in the soil vapor at various depths. Baseline data for the soil moisture, soil temperature, and soil vapor were established between October 2003 and September 2004.

  8. Comparison of risk management regulation from a corporate governance perspective within the German and united states legal areas

    Directory of Open Access Journals (Sweden)

    Remmer Sassen

    2014-11-01

    Full Text Available Risk management is one of the main corporate governance components or management tasks. This paper details a comparison of risk management regulation from a corporate governance perspective of listed stock corporations in Germany and the United States (U.S.. Obviously, there are differences and commonalities between the national legal norms and the regulatory levels of risk management in both countries. The comparison helps to understand different traditions and practices in terms of how significant corporate governance rules are for risk management. Therefore, this article intends to inspire future research on the regulation of risk management across different regions and explore the relevance of national interests in the regulation of risk management. A principal finding of the comparison is that the U.S. corporate governance system seems to be more strongly regulated than the German system. This results from the powerful and coordinating role of the U.S. Securities and Exchange Commission (SEC. Thus, the seemingly more liberal system of non-binding standards in the U.S. has a higher impact on the regulation of risk management than in Germany.

  9. Face Detection and Recognition

    National Research Council Canada - National Science Library

    Jain, Anil K

    2004-01-01

    This report describes research efforts towards developing algorithms for a robust face recognition system to overcome many of the limitations found in existing two-dimensional facial recognition systems...

  10. Regulatory approaches in the United States of America for safe management and disposal of long-lived radionuclides

    International Nuclear Information System (INIS)

    Greeves, J.T.; Bell, M.J.; Nelson, R.A.

    1998-01-01

    Regulation of the safe management and disposal of commercial, man-made, long-lived radioactive wastes in the United States is the responsibility of the US Nuclear Regulatory Commission (NRC). In some instances, state regulatory authorities have entered into agreements with the NRC to exercise regulatory authority over management and disposal of low-level radioactive wastes and uranium mill tailings within their borders. The legal and regulatory framework employed to achieve safe management and disposal of long-lived radioactive wastes in the US regulatory system is quite detailed, and in many cases the requirements are considerably prescriptive. The NRC has undertaken an initiative to move in the direction of adopting risk-informed, performance-based and risk-informed, less-prescriptive regulations. The current status and future direction of the legal and regulatory framework for management and disposal of commercial long-lived radioactive waste in the US is described. (author)

  11. Managing guidelines to support parents with the hospitalisation of their child in a private paediatric unit

    OpenAIRE

    2008-01-01

    The purpose of this research study was to describe managerial guidelines to support parents with the hospitalisation of their child in a private paediatric unit. The study explored and described: · the nursing care experiences of parents regarding the hospitalisation of their child in a paediatric unit; · managerial guidelines to support parents with their lived experiences of their child’s hospitalisation in a private paediatric unit. To achieve the purpose and the objectives of the research...

  12. A Comparative Assessment of Knowledge Management Programs Across the United States Armed Services

    National Research Council Canada - National Science Library

    Booker, Patrick L

    2006-01-01

    .... This can be achieved through effective knowledge management. Knowledge management involves processes to create, to store, and transfer knowledge to accomplish business objectives and to achieve a competitive advantage...

  13. Graphical symbol recognition

    OpenAIRE

    K.C. , Santosh; Wendling , Laurent

    2015-01-01

    International audience; The chapter focuses on one of the key issues in document image processing i.e., graphical symbol recognition. Graphical symbol recognition is a sub-field of a larger research domain: pattern recognition. The chapter covers several approaches (i.e., statistical, structural and syntactic) and specially designed symbol recognition techniques inspired by real-world industrial problems. It, in general, contains research problems, state-of-the-art methods that convey basic s...

  14. Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN): evolution of a content management system for point-of-care clinical decision support

    NARCIS (Netherlands)

    Barwise, Amelia; Garcia-Arguello, Lisbeth; Dong, Yue; Hulyalkar, Manasi; Vukoja, Marija; Schultz, Marcus J.; Adhikari, Neill K. J.; Bonneton, Benjamin; Kilickaya, Oguz; Kashyap, Rahul; Gajic, Ognjen; Schmickl, Christopher N.

    2016-01-01

    The Checklist for Early Recognition and Treatment of Acute Illness (CERTAIN) is an international collaborative project with the overall objective of standardizing the approach to the evaluation and treatment of critically ill patients world-wide, in accordance with best-practice principles. One of

  15. An Evaluation of Leadership and Management Training in the United States Coast Guard

    Science.gov (United States)

    1982-07-06

    organizational behavior, operations. research, system theory, applied management P-nalysik, and other courses in economics, planning, and financial management ...continued existence in a period of severe financial stress. 3. If there is no positive impact, document this so that top- management in t•he Coast...Relations InstituIte 5. Drug Education Specialist course 6. U. S. Navy Managkment course 7. A Management course og another service 8. Other formal

  16. Automatic speech recognition for radiological reporting

    International Nuclear Information System (INIS)

    Vidal, B.

    1991-01-01

    Large vocabulary speech recognition, its techniques and its software and hardware technology, are being developed, aimed at providing the office user with a tool that could significantly improve both quantity and quality of his work: the dictation machine, which allows memos and documents to be input using voice and a microphone instead of fingers and a keyboard. The IBM Rome Science Center, together with the IBM Research Division, has built a prototype recognizer that accepts sentences in natural language from 20.000-word Italian vocabulary. The unit runs on a personal computer equipped with a special hardware capable of giving all the necessary computing power. The first laboratory experiments yielded very interesting results and pointed out such system characteristics to make its use possible in operational environments. To this purpose, the dictation of medical reports was considered as a suitable application. In cooperation with the 2nd Radiology Department of S. Maria della Misericordia Hospital (Udine, Italy), a system was experimented by radiology department doctors during their everyday work. The doctors were able to directly dictate their reports to the unit. The text appeared immediately on the screen, and eventual errors could be corrected either by voice or by using the keyboard. At the end of report dictation, the doctors could both print and archive the text. The report could also be forwarded to hospital information system, when the latter was available. Our results have been very encouraging: the system proved to be robust, simple to use, and accurate (over 95% average recognition rate). The experiment was precious for suggestion and comments, and its results are useful for system evolution towards improved system management and efficency

  17. The management of human resources in the Basic Units of Cooperative Production in Cuba: An essential challenge

    Directory of Open Access Journals (Sweden)

    Deysi Alfonso Porraspita

    2018-02-01

    Full Text Available The socioeconomic structure of Cuba has undergone a stage of profound transformation, with various factors that have intervened in this process, where different forms of business structures have converged, one of which has been represented by the cooperative sector, fundamentally developed in agriculture from the country. In this scenario the issue of the effectiveness of these entities has been subject to dissimilar analyzes and debates from different sides, where what is related to the human factor has played an essential role, this implies a detailed observation of the adequate management of human resources in the integral management of these organizations. In this line, the fundamental challenge will be to manage human resources in a way that contributes to the continuous improvement of the Cooperative Production Units as one of the representative structures of the agrarian cooperative sector in Cuba. Carrying out an analysis highlighting the importance of the management of human resources as a contribution to affectivity of the Basic Units of Cooperative production constituted the objective of the work. Through analysis, synthesis and use of the logical historical in the system analysis, the work addressed the theoretical pillars and methodological aspects that support the management of human resources in the cooperative entities analyzed as a tribute to the effectiveness of their results.

  18. Turning Diversity into Competitive Advantage: A Case Study of Managing Diversity in the United States of America

    Directory of Open Access Journals (Sweden)

    Eddy M. Sutanto

    2009-01-01

    Full Text Available Esty, Griffin, and Hirsch (1995 state that today’s workforce is truly a mosaic of different races, ages, genders, ethnic groups, religions, and lifestyles. As a manager or a supervisor, it is your job to make sure that the desperate pieces of a mosaic fit together in a harmonious, coordinated way, maximally utilizing the talents and abilities of each employee. If skillfully managed, this diversity can bring a competitive advantage to an organization. If not, however, the bottom line can be negatively affected, and the work environment can become unwelcoming. Dealing with a diverse work group is new terrain for most managers and supervisors. The United States rose to the top using a-one-size-fits-all approach to managing employees. This work in past because, historically, most of the work force was white, and male. This has all changed. The following parts will clearly provide a description about diversity, changes in the United States work force, challenges and opportunities of the changes for organizations, and how managers and supervisors as front liners deal with diversity and to turn diversity into a competitive advantage.

  19. Regulatory Lessons for Internet Traffic Management from Japan, the European Union, and the United States: Toward Equity, Neutrality and Transparency

    Directory of Open Access Journals (Sweden)

    John Harris Stevenson

    2010-01-01

    Full Text Available As network neutrality has been one of the most contentious Internet public policy issues of the past decade, this article provides a comparative overview of events, policies, and legislation surrounding Internet traffic management practises (ITMPs (e.g., network neutrality in Japan, the European Union, the United States, and Canada. Using the frame provided by Richard Rose of “hybrid lessons”to create a policy synthesis, the paper details the telecom policy environment, Internet Service provider competition, legislative jurisdiction, remedies for ITMPs, consumer transparency, and adherence to privacy protection in each country. The analysis focuses on Canada’s first significant regulatory effort to address network neutrality, which came during the Canadian Radio-television and Telecommunications Commission 2009 process on Internet traffic management. This paper presents a brief overview of the Canadian regulatory environment and the specific questions which were the subject of the CRTC review. Employing Richard Rose’s methods for comparative public policy analysis, we offer a number of regulatory “lessons” from Japan, the European Union, and the United States based on their experiences with traffic management issues. Applying these lessons to the Canadian context, we make several specific policy recommendations, among them that competition be encouraged within the Internet service provider space, that network management practises be reasonable and limited, and that ISPs provide full disclosure of network management policies and practises.

  20. Diabetes management patterns in a palliative care unit in Saudi Arabia

    Directory of Open Access Journals (Sweden)

    Sami Ayed Alshammary

    2016-01-01

    Conclusion: Diabetes management varied among PCU patients. There is a real need for evidence-based guidelines for diabetes management among patients at the end of life. These guidelines should be tailored to patients' individual preferences in goals of care. Advance care planning should include discussion about patient preferences for management of diabetes at the end of life.