WorldWideScience

Sample records for vapeps management center

  1. User-Centered Data Management

    CERN Document Server

    Catarci, Tiziana; Kimani, Stephen

    2010-01-01

    This lecture covers several core issues in user-centered data management, including how to design usable interfaces that suitably support database tasks, and relevant approaches to visual querying, information visualization, and visual data mining. Novel interaction paradigms, e.g., mobile and interfaces that go beyond the visual dimension, are also discussed. Table of Contents: Why User-Centered / The Early Days: Visual Query Systems / Beyond Querying / More Advanced Applications / Non-Visual Interfaces / Conclusions

  2. Information sharing guidebook for transportation management centers, emergency operations centers, and fusion centers

    Science.gov (United States)

    2010-06-01

    This guidebook provides an overview of the mission and functions of transportation management centers, emergency operations centers, and fusion centers. The guidebook focuses on the types of information these centers produce and manage and how the sh...

  3. Information sharing guidebook for transportation management centers, emergency operations centers, and fusion centers.

    Science.gov (United States)

    2010-06-01

    This guidebook provides an overview of the mission and functions of transportation management centers, emergency operations centers, and fusion centers. The guidebook focuses on the types of information these centers produce and manage and how the sh...

  4. Patient-centered blood management.

    Science.gov (United States)

    Hohmuth, Benjamin; Ozawa, Sherri; Ashton, Maria; Melseth, Richard L

    2014-01-01

    Transfusions are common in hospitalized patients but carry significant risk, with associated morbidity and mortality that increases with each unit of blood received. Clinical trials consistently support a conservative over a liberal approach to transfusion. Yet there remains wide variation in practice, and more than half of red cell transfusions may be inappropriate. Adopting a more comprehensive approach to the bleeding, coagulopathic, or anemic patient has the potential to improve patient care. We present a patient-centered blood management (PBM) paradigm. The 4 guiding principles of effective PBM that we present include anemia management, coagulation optimization, blood conservation, and patient-centered decision making. PBM has the potential to decrease transfusion rates, decrease practice variation, and improve patient outcomes. PBM's value proposition is highly aligned with that of hospital medicine. Hospitalists' dual role as front-line care providers and quality improvement leaders make them the ideal candidates to develop, implement, and practice PBM. © 2013 Society of Hospital Medicine.

  5. Medical Waste Management in Community Health Centers.

    Science.gov (United States)

    Tabrizi, Jafar Sadegh; Rezapour, Ramin; Saadati, Mohammad; Seifi, Samira; Amini, Behnam; Varmazyar, Farahnaz

    2018-02-01

    Non-standard management of medical waste leads to irreparable side effects. This issue is of double importance in health care centers in a city which are the most extensive system for providing Primary Health Care (PHC) across Iran cities. This study investigated the medical waste management standards observation in Tabriz community health care centers, northwestern Iran. In this triangulated cross-sectional study (qualitative-quantitative), data collecting tool was a valid checklist of waste management process developed based on Iranian medical waste management standards. The data were collected in 2015 through process observation and interviews with the health center's staff. The average rate of waste management standards observance in Tabriz community health centers, Tabriz, Iran was 29.8%. This case was 22.8% in dimension of management and training, 27.3% in separating and collecting, 31.2% in transport and temporary storage, and 42.9% in sterilization and disposal. Lack of principal separation of wastes, inappropriate collecting and disposal cycle of waste and disregarding safety tips (fertilizer device performance monitoring, microbial cultures and so on) were among the observed defects in health care centers supported by quantitative data. Medical waste management was not in a desirable situation in Tabriz community health centers. The expansion of community health centers in different regions and non-observance of standards could predispose to incidence the risks resulted from medical wastes. So it is necessary to adopt appropriate policies to promote waste management situation.

  6. Management of nuclear training center

    International Nuclear Information System (INIS)

    Seo, In Suk; Lee, Han Young; Cho, Boung Jae; Lee, Seung Hee; Lee, Eoi Jin; You, Byung Hoon; Lee, Won Ku; Jeon, Hyung Ryeon; Seo, Kyung Won; Kim, Young Joong; Kim, Ik Hyun; Hyun, Ha Il; Choi, Il Ki; Hong, Choon Sun; Won, Jong Yeul; Joo, Yong Chang; Nam, Jae Yeul; Sin, Eun Jeong

    1996-02-01

    This report describes the annual results of training courses. The scope and contents are as follows : 1. Regional and interregional training courses, 2. Training courses assisted by foreign experts, 3. Training courses for nuclear industry personnel, 4. Training courses for internal staff-members, 5. Training courses under the law. The nuclear training center executed the open-door training courses for 2,699 engineers/scientists from the regulatory body, nuclear industries, research institutes and other related organizations by means of offering 69 training courses during the fiscal year 1995. (Author) .new

  7. Microsoft System Center Configuration Manager

    CERN Document Server

    Sandbu, Marius

    2013-01-01

    This book is a step-by-step tutorial that guides you through the key steps in implementing best solutions for high availability and performance tuning. It is split into two distinct approaches: client and site side HA and optimization.Microsoft SCCM High Availability and Performance Tuning is for IT professionals and consultants working with Configuration Manager who wish to learn the skills to deploy a redundant and scalable solution.

  8. Customer-centered brand management.

    Science.gov (United States)

    Rust, Roland T; Zeithaml, Valarie A; Lemon, Katherine N

    2004-09-01

    Most executives today agree that their efforts should be focused on growing the lifetime value of their customers. Yet few companies have come to terms with the implications of that idea for their marketing management. Oldsmobile, for example, enjoyed outstanding brand equity with many customers through the 1980s. But as the century wore further on, the people who loved the Olds got downright old. So why did General Motors spend so many years and so much money trying to reposition and refurbish the tired,tarnished brand? Why didn't GM managers instead move younger buyers along a path of less resistance, toward another of the brands in GM's stable--or even launch a wholly new brand geared to their tastes? Catering to new customers, even at the expense of the brand, would surely have been the path to profits. The reason, argue the authors, is that in large consumer-goods companies like General Motors, brands are the raison d'etre. They are the focus of decision making and the basis of accountability. But this overwhelming focus on growing brand equity is inconsistent with the goal of growing customer equity. Drawing on a wide range of current examples, the authors offer seven tactics that will put brands in the service of growing customer equity. These include replacing traditional brand managers with a new position--the customer segment manager; targeting brands to as narrow an audience as possible; developing the capability and the mind-set to hand off customers from one brand to another within the company; and changing the way brand equity is measured by basing calculations on individual, rather than average, customer data.

  9. Energy efficient thermal management of data centers

    CERN Document Server

    Kumar, Pramod

    2012-01-01

    Energy Efficient Thermal Management of Data Centers examines energy flow in today's data centers. Particular focus is given to the state-of-the-art thermal management and thermal design approaches now being implemented across the multiple length scales involved. The impact of future trends in information technology hardware, and emerging software paradigms such as cloud computing and virtualization, on thermal management are also addressed. The book explores computational and experimental characterization approaches for determining temperature and air flow patterns within data centers. Thermodynamic analyses using the second law to improve energy efficiency are introduced and used in proposing improvements in cooling methodologies. Reduced-order modeling and robust multi-objective design of next generation data centers are discussed. This book also: Provides in-depth treatment of energy efficiency ideas based on  fundamental heat transfer, fluid mechanics, thermodynamics, controls, and computer science Focus...

  10. Physician-centered management guidelines.

    Science.gov (United States)

    Pulde, M F

    1999-01-01

    The "Fortune 500 Most Admired" companies fully understand the irreverent premise "the customer comes second" and that there is a direct correlation between a satisfied work force and productivity, service quality, and, ultimately, organizational success. If health care organizations hope to recruit and retain the quality workforce upon which their core competency depends, they must develop a vision strategic plan, organizational structure, and managerial style that acknowledges the vital and central role of physicians in the delivery of care. This article outlines a conceptual framework for effective physician management, a "critical pathway," that will enable health care organizations to add their name to the list of "most admired." The nine principles described in this article are based on a more respectful and solicitous treatment of physicians and their more central directing role in organizational change. They would permit the transformation of health care into a system that both preserves the virtues of the physician-patient relationship and meets the demand for quality and cost-effectiveness.

  11. Radioactive waste management centers: an approach

    International Nuclear Information System (INIS)

    Lotts, A.L.

    1980-01-01

    Radioactive waste management centers would satisfy the need for a cost-effective, sound management system for nuclear wastes by the industry and would provide a well integrated solution which could be understood by the public. The future demands for nuclear waste processing and disposal by industry and institutions outside the United States Government are such that a number of such facilities are required between now and the year 2000. Waste management centers can be organized around two general needs in the commercial sector: (1) the need for management of low-level waste generated by nuclear power plants, the once-through nuclear fuel cycle production facilities, from hospitals, and other institutions; and (2) more comprehensive centers handling all categories of nuclear wastes that would be generated by a nuclear fuel recycle industry. The basic technology for radioactive waste management will be available by the time such facilities can be deployed. This paper discusses the technical, economic, and social aspects of organizing radioactive waste managment centers and presents a strategy for stimulating their development

  12. VMware vCenter Operations Manager essentials

    CERN Document Server

    Malhoit, Lauren

    2014-01-01

    This book features step-by-step guides as well as practical, real-world examples, exploiting the premise that there's never just one way to narrow down problems. It tackles scenarios by going through different workflows to find the answers you need.This book is for administrators, engineers, and architects of VMware vSphere as well as those who have or are interested in purchasing the vCenter Operations Manager Suite. It will particularly help administrators who are hoping to use vCenter Operations Manager to optimize their VMware environments as well as quickly troubleshoot both long-term and

  13. ASC Distribution Management Center (DMC) Provides Materiel Management Capability

    National Research Council Canada - National Science Library

    Stewart, Tyler J

    2008-01-01

    ... logistics to sustain a transforming Army at war. The ASM Distribution Management Center (DMC) is the single interface for the synchronization and integration of logistical functions among active Army units in CONUS, Army Commands...

  14. Mastering System Center 2012 Configuration Manager

    CERN Document Server

    Rachui, Steve; Martinez, Santos; Daalmans, Peter

    2012-01-01

    Expert coverage of Microsoft's highly anticipated network software deployment tool The latest version of System Center Configuration Manager (SCCM) is a dramatic update of its predecessor Configuration Manager 2007, and this book offers intermediate-to-advanced coverage of how the new SCCM boasts a simplified hierarchy, role-based security, a new console, flexible application deployment, and mobile management. You'll explore planning and installation, migrating from SCCM 2007, deploying software and operating systems, security, monitoring and troubleshooting, and automating and customizing SCC

  15. Server rack for improved data center management

    Science.gov (United States)

    Bermudez Rodriguez, Sergio A.; Hamann, Hendrik F.; Wehle, Hans-Dieter

    2018-01-09

    Methods and systems for data center management include collecting sensor data from one or more sensors in a rack; determining a location and identifying information for each asset in the rack using a set of asset tags associated with respective assets; communicating the sensor and asset location to a communication module; receiving an instruction from the communication module; and executing the received instruction to change a property of the rack.

  16. Coordinated Management of Academic Health Centers.

    Science.gov (United States)

    Balser, Jeffrey R; Stead, William W

    2017-01-01

    Academic health centers (AHCs) are the nation's primary resource for healthcare discovery, innovation, and training. US healthcare revenue growth has declined sharply since 2009, and is forecast to remain well below historic levels for the foreseeable future. As the cost of education and research at nearly all AHCs is heavily subsidized through large transfers from clinical care margins, our institutions face a mounting crisis. Choices centering on how to increase the cost-effectiveness of the AHC enterprise require unprecedented levels of alignment to preserve an environment that nurtures creativity. Management processes require governance models that clarify decision rights while harnessing the talents and the intellectual capital of a large, diverse enterprise to nimbly address unfamiliar organizational challenges. This paper describes key leadership tactics aimed at propelling AHCs along this journey - one that requires from all leaders a commitment to resilience, optimism, and willingness to embrace change.

  17. 20 CFR 638.808 - Center financial management and reporting.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false Center financial management and reporting... § 638.808 Center financial management and reporting. The Job Corps Director shall establish procedures to ensure that each center operator and each subcontractor maintain a financial management system...

  18. Digitalization influence on shopping centers strategic management

    Directory of Open Access Journals (Sweden)

    Ioniţă Irene Mihaela

    2017-07-01

    Full Text Available Shopping centers are an important aspect of the extremely dynamic life of the 21st century consumer. Nowadays, worldwide, shopping centers represent significant multimillion euro investments, remarking themselves with bold architectures and structures and an individual brand image. Retail markets are currently under transformation by a confluence of new retailing technologies, dramatic shifts in the demographic profile and preferences of more affluent and educated shoppers. Part of the market share in modern retail moved to new forms of selling, which weakened the offer of some traditional retailers, while also creating opportunities for retailers to move and integrate their offerings with new digital tools (via electronic commerce, social commerce and mobile commerce. Meeting customer needs and increasing sales are the primary drivers behind retailers use of information systems and technology (IS/IT. New developments in IS/IT offer new opportunities and challenges for organizations and society. The current paper proposes to analyze the way digital media and information technology (computers and mobile devices influences the virtual and physical shopping experiences, and shopping centers management consequently. The need for communication & sales channels integration, the impact of new information technologies (IT’s, the growing role of social / digital media, the balance between personalization and privacy – all represent challenges retail industry needs to currently adapt to face digitalization. E-commerce is transforming both consumer behavior and retailing business models, by greatly expanding shopping convenience, selection and affordability.

  19. Feed Materials Production Center Waste Management Plan

    International Nuclear Information System (INIS)

    Watts, R.E.; Allen, T.; Castle, S.A.; Hopper, J.P.; Oelrich, R.L.

    1986-01-01

    In the process of producing uranium metal products used in Department of Energy (DOE) defense programs at other DOE facilities, various types of wastes are generated at the Feed Materials Production Center (FMPC). Process wastes, both generated and stored, are discussed in the Waste Management Plan and include low-level radioactive waste (LLW), mixed hazardous/radioactive waste, and sanitary/industrial waste. Scrap metal waste and wastes requiring special remediation are also addressed in the Plan. The Waste Management Plan identifies the comprehensive programs developed to address safe storage and disposition of all wastes from past, present, and future operations at the FMPC. Waste streams discussed in this Plan are representative of the waste generated and waste types that concern worker and public health and safety. Budgets and schedules for implementation of waste disposition are also addressed. The waste streams receiving the largest amount of funding include LLW approved for shipment by DOE/ORO to the Nevada Test Site (NTS) (MgF 2 , slag leach filter cake, and neutralized raffinate); remedial action wastes (waste pits, K-65 silo waste); thorium; scrap metal (contaminated and noncontaminated ferrous and copper scrap); construction rubble and soil generated from decontamination and decommissioning of outdated facilities; and low-level wastes that will be handled through the Low-Level Waste Processing and Shipping System (LLWPSS). Waste Management milestones are also provided. The Waste Management Plan is divided into eight major sections: Introduction; Site Waste and Waste Generating Process; Strategy; Projects and Operations; Waste Stream Budgets; Milestones; Quality Assurance for Waste Management; and Environmental Monitoring Program

  20. Strategic Project Management at the NASA Kennedy Space Center

    Science.gov (United States)

    Lavelle, Jerome P.

    2000-01-01

    This paper describes Project Management at NASA's Kennedy Space Center (KSC) from a strategic perspective. It develops the historical context of the agency and center's strategic planning process and illustrates how now is the time for KSC to become a center which has excellence in project management. The author describes project management activities at the center and details observations on those efforts. Finally the author describes the Strategic Project Management Process Model as a conceptual model which could assist KSC in defining an appropriate project management process system at the center.

  1. Planning and Management of Technology Deployment Center

    International Nuclear Information System (INIS)

    Park, Jae Won; Joo, Po Kook; Kim, Jun Yeon and others

    2005-08-01

    The R and D contents are summarized as follows ; Models were set-up for transferring the developed technologies to the industry and managing technology deployment center to vitalize the commercialization and then the set-up model was tried to apply for transferring technologies for commercialization and to define interfaces between the R and D and industrial applications In this project, new products and processes were developed for promoting the commercialization. Infra-structures were firmly set-up for the venture company promotion and technology deployment developed during executing the proton Engineering frontier Project. Commercialization methodology connection with industrial companies were studied by outside specializing institute. Development of gem-stone coloring and new photo catalyst producing techniques are very high value-adding technologies, therefore, experimental and theoretical R and D were transacted simultaneously to obtain the originality of the technology. The theoretical R and D was committed to a specialist outside

  2. Scientific Data Management Center for Enabling Technologies

    Energy Technology Data Exchange (ETDEWEB)

    Vouk, Mladen A.

    2013-01-15

    Managing scientific data has been identified by the scientific community as one of the most important emerging needs because of the sheer volume and increasing complexity of data being collected. Effectively generating, managing, and analyzing this information requires a comprehensive, end-to-end approach to data management that encompasses all of the stages from the initial data acquisition to the final analysis of the data. Fortunately, the data management problems encountered by most scientific domains are common enough to be addressed through shared technology solutions. Based on community input, we have identified three significant requirements. First, more efficient access to storage systems is needed. In particular, parallel file system and I/O system improvements are needed to write and read large volumes of data without slowing a simulation, analysis, or visualization engine. These processes are complicated by the fact that scientific data are structured differently for specific application domains, and are stored in specialized file formats. Second, scientists require technologies to facilitate better understanding of their data, in particular the ability to effectively perform complex data analysis and searches over extremely large data sets. Specialized feature discovery and statistical analysis techniques are needed before the data can be understood or visualized. Furthermore, interactive analysis requires techniques for efficiently selecting subsets of the data. Finally, generating the data, collecting and storing the results, keeping track of data provenance, data post-processing, and analysis of results is a tedious, fragmented process. Tools for automation of this process in a robust, tractable, and recoverable fashion are required to enhance scientific exploration. The SDM center was established under the SciDAC program to address these issues. The SciDAC-1 Scientific Data Management (SDM) Center succeeded in bringing an initial set of advanced

  3. Annual report of the Management Research Center

    International Nuclear Information System (INIS)

    1987-01-01

    Research on the management of new forms of automation; industrial management; the definition of a new product range; economic management; personnel management; and management of cultural enterprises is presented [fr

  4. The Stanford University US-Japan Technology Management Center

    National Research Council Canada - National Science Library

    Dasher, Richard

    2002-01-01

    This grant established the U.S.-Japan Technology Management Center, Stanford University School of Engineering, as an ongoing center of excellence for the study of emerging trends and interrelationships between technology...

  5. Frequency of adoption of practice management guidelines at trauma centers

    Science.gov (United States)

    Sobrino, Justin; Barnes, Sunni A.; Dahr, Nadine; Kudyakov, Rustam; Berryman, Candice; Nathens, Avery B.; Hemmila, Mark R.; Neal, Melanie

    2013-01-01

    Evidence-based management guidelines have been shown to improve patient outcomes, yet their utilization by trauma centers remains unknown. This study measured adoption of practice management guidelines or protocols by trauma centers. A survey of 228 trauma centers was conducted over 1 year; 55 completed the survey. Centers were classified into three groups: noncompliant, partially compliant, and compliant with adoption of management protocols. Characteristics of compliant centers were compared with those of the other two groups. Most centers were Level I (58%) not-for-profit (67%) teaching hospitals (84%) with a surgical residency (74%). One-third of centers had an accredited fellowship in surgical critical care (37%). Only one center was compliant with all 32 management protocols. Half of the centers were compliant with 14 of 32 protocols studied (range, 4 to 32). Of the 21 trauma center characteristics studied, only two were independently associated with compliant centers: use of physician extenders and daily attending rounds (both P < .0001). Adoption of management guidelines by trauma centers is inconsistent, with wide variations in practices across centers. PMID:23814383

  6. Sensitive Wildlife - Center for Natural Lands Management [ds431

    Data.gov (United States)

    California Natural Resource Agency — This dataset represents sensitive wildlife data collected for the Center for Natural Lands Management (CNLM) at dedicated nature preserves in San Diego County,...

  7. Microsoft System Center 2012 R2 compliance management cookbook

    CERN Document Server

    Baumgarten, Andreas; Roesner, Susan

    2014-01-01

    Whether you are an IT manager, an administrator, or security professional who wants to learn how Microsoft Security Compliance Manager and Microsoft System Center can help fulfil compliance and security requirements, this is the book for you. Prior knowledge of Microsoft System Center is required.

  8. Microsoft System Center Configuration Manager advanced deployment

    CERN Document Server

    Coupland, Martyn

    2014-01-01

    If you are an experienced Configuration Manager administrator looking to advance your career or get more from your current environment, then this book is ideal for you. Prior experience of deploying and managing a Configuration Manager site would be helpful in following the examples throughout this book.

  9. The prevention research centers' managing epilepsy well network.

    Science.gov (United States)

    DiIorio, Colleen K; Bamps, Yvan A; Edwards, Ariele L; Escoffery, Cam; Thompson, Nancy J; Begley, Charles E; Shegog, Ross; Clark, Noreen M; Selwa, Linda; Stoll, Shelley C; Fraser, Robert T; Ciechanowski, Paul; Johnson, Erica K; Kobau, Rosemarie; Price, Patricia H

    2010-11-01

    The Managing Epilepsy Well (MEW) Network was created in 2007 by the Centers for Disease Control and Prevention's (CDC) Prevention Research Centers and Epilepsy Program to promote epilepsy self-management research and to improve the quality of life for people with epilepsy. MEW Network membership comprises four collaborating centers (Emory University, University of Texas Health Science Center at Houston, University of Michigan, and University of Washington), representatives from CDC, affiliate members, and community stakeholders. This article describes the MEW Network's background, mission statement, research agenda, and structure. Exploratory and intervention studies conducted by individual collaborating centers are described, as are Network collaborative projects, including a multisite depression prevention intervention and the development of a standard measure of epilepsy self-management. Communication strategies and examples of research translation programs are discussed. The conclusion outlines the Network's role in the future development and dissemination of evidence-based epilepsy self-management programs. Copyright © 2010 Elsevier Inc. All rights reserved.

  10. Evidences of Faculty Centered Management Style.

    Science.gov (United States)

    Snyder, William F.

    At Wytheville Community College (WCC) in Virginia, the seminal management style is collegial, while the seminal management structure is bureaucratic. Formal bureaucratic structures exist for normal and routine communication and for policy decisions. However, faculty are encouraged to share their concerns with the president and other administrators…

  11. Person-Centered Management in Project Administration.

    Science.gov (United States)

    Caraway, James E.

    The theories of several contemporary management theorists are examined in order to demonstrate that their administrative stance is that of a person-intensive approach to management. After exploring leadership theory and the positions of Douglas McGregor, John J. Morse, Jay W. Lorsch, Rensis Likert, Bernard M. Bass, William Reddin, George H. Rice,…

  12. Managing a Modern University Research Center.

    Science.gov (United States)

    Veres, John G., III

    1988-01-01

    The university research center of the future will function best to serve the rapidly changing public and private demand for services with a highly trained core staff, adequately funded and equipped, whose morale and quality of work performance is a prime consideration. (MSE)

  13. Managing Returns in a Catalog Distribution Center

    Science.gov (United States)

    Gates, Joyce; Stuart, Julie Ann; Bonawi-tan, Winston; Loehr, Sarah

    2004-01-01

    The research team of the Purdue University in the United States developed an algorithm that considers several different factors, in addition to cost, to help catalog distribution centers process their returns more efficiently. A case study to teach the students important concepts involved in developing a solution to the returns disposition problem…

  14. Energy management of internet data centers in smart grid

    CERN Document Server

    Jiang, Tao; Cao, Yang

    2015-01-01

    This book reports the latest findings on intelligent energy management of Internet data centers in smart-grid environments. The book gathers novel research ideas in Internet data center energy management, especially scenarios with cyber-related vulnerabilities, power outages and carbon emission constraints. The book will be of interest to university researchers, R&D engineers and graduate students in communication and networking areas who wish to learn the core principles, methods, algorithms, and applications of energy management of Internet data centers in smart grids.

  15. Knowledge Management for Wireless Grid Operation Centers

    OpenAIRE

    Bordetsky, Alex; Dolk, Daniel

    2002-01-01

    Proceedings of the 35th Hawaii International Conference on System Sciences - 2002 Our objective is to develop generalized principles for grid operations centers that can be applied to specific domains. We focus on the domain of wireless telecommunications NOCs (WNOCs) as a starting point in this process. To address this problem, we focus specifically on the knowledge requirements for service-based decision support within wireless telecommunications. We use a Mission...

  16. Weather information integration in transportation management center (TMC) operations.

    Science.gov (United States)

    2011-01-02

    This report presents the results of the third phase of an on-going FHWA study on weather integration in Transportation Management Center (TMC) operations. The report briefly describes the earlier phases of the integration study, summarizes the findin...

  17. An annotated outline for a traffic management center operations manual

    Science.gov (United States)

    2000-10-01

    This draft Traffic Management Center (TMC) and Operations manual outline is meant to serve as a model "checklist" for the development of similar manuals used in deployed environments. The purpose of this outline is to provide a reference for agencies...

  18. Break-even analysis in a nurse-managed center.

    Science.gov (United States)

    McBryde-Foster, Merry J

    2005-01-01

    The concept of break-even analysis as a financial assessment tool is defined and demonstrated in evaluation of a proposed nurse-managed center. The advantages of using break-even analysis during proposal development are explored.

  19. Microsoft System Center 2012 R2 Operations Manager cookbook

    CERN Document Server

    Beaumont (MVP), Steve; Odika, Chiyo; Ryan, Robert

    2015-01-01

    If you are tasked with monitoring the IT infrastructure within your organization, this book demonstrates how System Center 2012 R2 Operations Manager offers a radical and exciting solution to modern administration.

  20. Data management at Biosphere 2 center

    Science.gov (United States)

    McCreary, Leone F.

    1997-01-01

    Throughout the history of Biosphere 2, the collecting and recording of biological data has been sporadic. Currently no active effort to administer and record regular biological surveys is being made. Also, there is no central location, such as an on-site data library, where all records from various studies have been archived. As a research institute, good, complete data records are at the core of all Biosphere 2's scientific endeavors. It is therefore imperative that an effective data management system be implemented within the management and research departments as soon as possible. Establishing this system would require three general phases: (1) Design/implement a new archiving/management program (including storage, cataloging and retrieval systems); (2) Organize and input baseline and intermediate data from existing archives; and (3) Maintain records by inputting new data.

  1. Logistics Operations Management Center: Maintenance Support Baseline (LOMC-MSB)

    Science.gov (United States)

    Kurrus, R.; Stump, F.

    1995-01-01

    The Logistics Operations Management Center Maintenance Support Baseline is defined. A historical record of systems, applied to and deleted from, designs in support of future management and/or technical analysis is provided. All Flight elements, Ground Support Equipment, Facility Systems and Equipment and Test Support Equipment for which LOMC has responsibilities at Kennedy Space Center and other locations are listed. International Space Station Alpha Program documentation is supplemented. The responsibility of the Space Station Launch Site Support Office is established.

  2. Multi-Institution Research Centers: Planning and Management Challenges

    Science.gov (United States)

    Spooner, Catherine; Lavey, Lisa; Mukuka, Chilandu; Eames-Brown, Rosslyn

    2016-01-01

    Funding multi-institution centers of research excellence (CREs) has become a common means of supporting collaborative partnerships to address specific research topics. However, there is little guidance for those planning or managing a multi-institution CRE, which faces specific challenges not faced by single-institution research centers. We…

  3. Dimensions of Person-Centered Classroom Management

    Science.gov (United States)

    Freiberg, H. Jerome; Lamb, Stacey M.

    2009-01-01

    Public opinion trends over the last five decades show that lack of discipline continues to be one of America's top public educational concerns. This trend suggests that alternatives to the traditional model are urgently needed. In this traditional model of classroom management, based on behaviorism and still common in some areas, discipline is…

  4. Enrollment Management: A Market-Centered Perspective

    Science.gov (United States)

    Kalsbeek, David H.; Hossler, Donald

    2009-01-01

    Enrollment management, the authors suggested in earlier essays, is a deliberate process of achieving an institution's preferred enrollment profile, starting by identifying the strategic purposes and mission of the institution, and then orchestrating the marketing, recruitment, admissions, pricing and aid, retention programs, academic support…

  5. Hazardous Materials Management and Emergency Response training Center needs assessment

    International Nuclear Information System (INIS)

    McGinnis, K.A.; Bolton, P.A.; Robinson, R.K.

    1993-09-01

    For the Hanford Site to provide high-quality training using simulated job-site situations to prepare the 4,000 Site workers and 500 emergency responders for known and unknown hazards a Hazardous Materials Management and Emergency Response Training Center is needed. The center will focus on providing classroom lecture as well as hands-on, realistic training. The establishment of the center will create a partnership among the US Department of Energy; its contractors; labor; local, state, and tribal governments; and Xavier and Tulane Universities of Louisiana. This report presents the background, history, need, benefits, and associated costs of the proposed center

  6. Load Management of Data Centers as Regulation Capacity in Denmark

    DEFF Research Database (Denmark)

    Clausen, Anders; Ghatikar, Girish; Jørgensen, Bo Nørregaard

    2014-01-01

    are of special interest as they account for 500 GWh of consumption in Denmark or nearly 2% of the total electricity consumption. This paper performs an analysis on load management capabilities of data centers in Denmark based on the experiences in the U.S. We characterize the load management capabilities...... for transmission system operators and distribution system operators and balance errors in forecasts made by balance responsible parties. By enabling the demand-side to adapt consumption to match power generation, we can address this in a cost-effective and environmental sound way. In this context, data centers...... of the data centers based on their types, technology, and their application as grid management resources. Further, we identify demand-side entry barriers towards market participation. Our findings suggest that groups of data centers can offer dynamic load flexibility as virtual power plants, and thereby...

  7. Virtualized cloud data center networks issues in resource management

    CERN Document Server

    Tsai, Linjiun

    2016-01-01

    This book discusses the characteristics of virtualized cloud networking, identifies the requirements of cloud network management, and illustrates the challenges in deploying virtual clusters in multi-tenant cloud data centers. The book also introduces network partitioning techniques to provide contention-free allocation, topology-invariant reallocation, and highly efficient resource utilization, based on the Fat-tree network structure. Managing cloud data center resources without considering resource contentions among different cloud services and dynamic resource demands adversely affects the performance of cloud services and reduces the resource utilization of cloud data centers. These challenges are mainly due to strict cluster topology requirements, resource contentions between uncooperative cloud services, and spatial/temporal data center resource fragmentation. Cloud data center network resource allocation/reallocation which cope well with such challenges will allow cloud services to be provisioned with ...

  8. The inner workings of performance management in danish job centers

    DEFF Research Database (Denmark)

    Pihl-Thingvad, Signe

    2016-01-01

    The paper discusses how a central Performance Management system in the Danish job centers affects the employees’ perception of accountability, autonomy, common goals and dialogue. Dysfunctional behavioral effects are explored in qualitative analyses based on 4 case studies. Results indicate...... that the expected positive effects of performance management do not materialize at the Danish job centers because focus in the implementation process gradually shifts from results to process goals. This is related to a series of dysfunctional behavioral effects which instead of creating commitment frustrate...

  9. Human resource management in patient-centered pharmaceutical care.

    Science.gov (United States)

    White, S J

    1994-04-01

    Patient-centered care may have the pharmacists and technicians reporting either directly or in a matrix to other than pharmacy administration. The pharmacy administrative people will need to be both effective leaders and managers utilizing excellent human resource management skills. Significant creativity and innovation will be needed for transition from departmental-based services to patient care team services. Changes in the traditional methods of recruiting, interviewing, hiring, training, developing, inspiring, evaluating, and disciplining are required in this new environment.

  10. An Equity Centered Management Approach to Exploiting Sport Employee Productivity

    OpenAIRE

    Schneider, Robert C.

    2017-01-01

    A primary goal ofsport organizations is to exploit employees’ abilities to their fullestcapacities. Sport managers who successfully maximize employee productivity willgreatly increase the chances of achieving the organization’s goals andobjectives. The full potential of sport employees’ abilities can be realizedthrough the application of the equity component grounded in Adam’s EquityTheory (Adams, 1963). Centered on the premise that the relationship betweensport manager and employer must be o...

  11. Management Matters. Virtual School Library Media Center Management Manual

    Science.gov (United States)

    Pappas, Marjorie L.

    2005-01-01

    In this article, the author describes a management manual she maintained while working as a school library media specialist. She started the manual when she was a student in the organization and administration course in the library science program and kept it current with information gleaned from conferences, workshops, and networking with other…

  12. A College Financial Management Center: What Do Students Think?

    Science.gov (United States)

    Vienne, Kristy; Slate, John R.

    2009-01-01

    With the increasing cost of a college education on the rise, college administrators need to address the long term financial, psychological, and academic risks associated with the increased responsibility of personal debt. In this qualitative study, college students' perspectives regarding the need for a personal financial management center at a…

  13. Responsibility-Centered Management: A 10-Year Nursing Assessment.

    Science.gov (United States)

    McBride, Angela Barron; Neiman, Sandra; Johnson, James

    2000-01-01

    Describes the implementation of responsibility-centered management, a decentralized model giving deans responsibility for expanding and using resources, at Indiana University's nursing school. Discusses how it led to creation of an information-rich environment, strategic decision making, and a performance-based reward structure. (SK)

  14. Air flow management in raised floor data centers

    CERN Document Server

    Arghode, Vaibhav K

    2016-01-01

    The Brief discuss primarily two aspects of air flow management in raised floor data centers. Firstly, cooling air delivery through perforated tiles will be examined and influence of the tile geometry on flow field development and hot air entrainment above perforated tiles will be discussed. Secondly, the use of cold aisle containment to physically separate hot and cold regions, and minimize hot and cold air mixing will be presented. Both experimental investigations and computational efforts are discussed and development of computational fluid dynamics (CFD) based models for simulating air flow in data centers is included. In addition, metrology tools for facility scale air velocity and temperature measurement, and air flow rate measurement through perforated floor tiles and server racks are examined and the authors present thermodynamics-based models to gauge the effectiveness and importance of air flow management schemes in data centers.

  15. Multi-Center Traffic Management Advisor Operational Field Test Results

    Science.gov (United States)

    Farley, Todd; Landry, Steven J.; Hoang, Ty; Nickelson, Monicarol; Levin, Kerry M.; Rowe, Dennis W.

    2005-01-01

    The Multi-Center Traffic Management Advisor (McTMA) is a research prototype system which seeks to bring time-based metering into the mainstream of air traffic control (ATC) operations. Time-based metering is an efficient alternative to traditional air traffic management techniques such as distance-based spacing (miles-in-trail spacing) and managed arrival reservoirs (airborne holding). While time-based metering has demonstrated significant benefit in terms of arrival throughput and arrival delay, its use to date has been limited to arrival operations at just nine airports nationally. Wide-scale adoption of time-based metering has been hampered, in part, by the limited scalability of metering automation. In order to realize the full spectrum of efficiency benefits possible with time-based metering, a much more modular, scalable time-based metering capability is required. With its distributed metering architecture, multi-center TMA offers such a capability.

  16. [Local planning: the speech of basic health care center manager].

    Science.gov (United States)

    Cubas, Márcia Regina

    2005-01-01

    As planning is understood as a management tool, this article offers an argument through the speech framework of Basic Health Care Center Managers in the city of Curitiba-PR, by means of the Collective Subject Speech Methodology on local planning aspects. Its purpose is to bring local managers to a reflection concerning their styles, practices and experiences, as well as to collaborate with central level leading teams towards building their planning processes in an upward, participatory, communicative and strategic way. Considerations of the speeches built from central ideas are presented: planning methodology; inter-sectoriality; territorial basis; team and community participation; training, autonomy and particular profile of local managers; the manager's agenda; and institutional culture.

  17. Technical report from Radioactive Waste Management Funding and Research Center

    International Nuclear Information System (INIS)

    2007-10-01

    As the only one Japanese organization specialized in radioactive waste, RWMC (Radioactive Waste Management Funding and Research Center) has been conducting the two major roles; R and D and the fund administration for radioactive waste management. The focus of its studies includes land disposal of LLW (Low-level radioactive wastes) and it has gradually extended to research on management and disposal techniques for high-level (HLW) and TRU wastes and studies on securing and managing the funds required for disposal of these wastes. The present document is the yearly progress report of 2006 and the main activities and research results are included on spent fuel disposal techniques including radon diffusion and emanation problem, performance studies on underground facilities for radioactive waste disposal and its management, technical assessment for geological environment, remote control techniques, artificial barrier systems proposed and its monitoring systems, and TRU disposals. (S. Ohno)

  18. 41 CFR 102-192.135 - Must we have a mail center manager at our facility?

    Science.gov (United States)

    2010-07-01

    ... center manager at our facility? 102-192.135 Section 102-192.135 Public Contracts and Property Management... PROGRAMS 192-MAIL MANAGEMENT Mail Center Manager Requirements § 102-192.135 Must we have a mail center manager at our facility? Yes, every facility that has more than two full time people dedicated to...

  19. Lower Savannah aging, disability & transportation resource center : regional travel management and coordination center (TMCC) model and demonstration project.

    Science.gov (United States)

    2014-10-01

    This report details the deployed technology and implementation experiences of the Lower Savannah Aging, Disability & Transportation : Resource Center in Aiken, South Carolina, which served as the regional Travel Management and Coordination Center (TM...

  20. Alpha waste management at the Valduc Research Center

    International Nuclear Information System (INIS)

    Jouan, A.; Cartier, R.; Durec, J.P.; Flament, T.

    1995-01-01

    Operation of the reprocessing facilities at the Valduc Research Center of the French Atomic Energy Commission (CEA) generates waste with a variety of characteristics. The waste compatible with surface storage requirements is transferred to the French Radioactive Waste Management Agency (ANDRA); rest is reprocessed under a program which enables storage in compliance with the requirements of permits issued by safety Authorities. The waste reprocessing program provides for the construction of an incinerator capable of handling nearly all of the combustible waste generated by the Center and vitrification facility for treating liquid waste generated by the plutonium handling plant. (authors)

  1. Waste management at the Karlsruhe Nuclear Research Center

    International Nuclear Information System (INIS)

    Hoehlein, G.; Lins, W.

    1982-01-01

    In the Karlsruhe Nuclear Research Center the responsibility for waste management is concentrated in the Decontamination Department which serves to collect and transport all liquid waste and solid material from central areas in the center for further waste treatment, clean radioactive equipment for repair and re-use or for recycling of material, remove from the liquid effluents any radioactive and chemical pollutants as specified in legislation on the protection of waters, convert radioactive wastes into mechanically and chemically stable forms allowing them to be transported into a repository. (orig./RW)

  2. Systems analysis support to the waste management technology center

    International Nuclear Information System (INIS)

    Rivera, A.L.; Osborne-Lee, I.W.; DePaoli, S.M.

    1988-01-01

    This paper describes a systems analysis concept being developed in support of waste management planning and analysis activities for Martin Marietta Energy Systems, Inc. (Energy Systems), sites. This integrated systems model serves as a focus for the accumulation and documentation of technical and economic information from current waste management practices, improved operations projects, remedial actions, and new system development activities. The approach is generic and could be applied to a larger group of sites. This integrated model is a source of technical support to waste management groups in the Energy Systems complex for integrated waste management planning and related technology assessment activities. This problem-solving methodology for low-level waste (LLW) management is being developed through the Waste Management Technology Center (WMTC) for the Low-Level Waste Disposal, Development, and Demonstration (LLWDDD) Program. In support of long-range planning activities, this capability will include the development of management support tools such as specialized systems models, data bases, and information systems. These management support tools will provide continuing support in the identification and definition of technical and economic uncertainties to be addressed by technology demonstration programs. Technical planning activities and current efforts in the development of this system analysis capability for the LLWDDD Program are presented in this paper

  3. Managing the risks of on-site health centers.

    Science.gov (United States)

    Gorman, Kathleen M; Miller, Ross M

    2011-11-01

    This review sought to assess compliance concerns, determine risk management strategies, and identify opportunities for future research to contribute to employers' understanding of the laws and regulations that apply to on-site care. A comprehensive review of databases, professional organizations' websites, and journals resulted in 22 publications reporting on the consequences of noncompliance among on-site health centers accepted for inclusion. None of those studies reported a study design or quantifiable outcome data. Two noncompliance themes were repeated among the publications. First, direct penalties included fines, civil actions, loss of licensure, and, potentially, criminal charges. Second, noncompliance also resulted in indirect costs such as employee mistrust and lowered standards of care, which jeopardize on-site health centers' ability to demonstrate a return on investment. Further research with rigorous methodology is needed to inform employer decisions about on-site health services and associated risk management. Copyright 2011, SLACK Incorporated.

  4. Evaluating and improving incident management using historical incident data : case studies at Texas transportation management centers.

    Science.gov (United States)

    2009-08-01

    The companion guidebook (0-5485-P2) developed as part of this study provides the procedures and : methodologies for effective use of historical incident data at Texas Transportation Management Centers : (TMCs). This research report documents the resu...

  5. System Center 2012 R2 Virtual Machine Manager cookbook

    CERN Document Server

    Cardoso, Edvaldo Alessandro

    2014-01-01

    This book is a step-by-step guide packed with recipes that cover architecture design and planning. The book is also full of deployment tips, techniques, and solutions. If you are a solutions architect, technical consultant, administrator, or any other virtualization enthusiast who needs to use Microsoft System Center Virtual Machine Manager in a real-world environment, then this is the book for you. We assume that you have previous experience with Windows 2012 R2 and Hyper-V.

  6. Dryden Flight Research Center Critical Chain Project Management Implementation

    Science.gov (United States)

    Hines, Dennis O.

    2012-01-01

    In Fiscal Year 2011 Dryden Flight Research Center (DFRC) implemented a new project management system called Critical Chain Project Management (CCPM). Recent NASA audits have found that the Dryden workforce is strained under increasing project demand and that multi-tasking has been carried to a whole new level at Dryden. It is very common to have an individual work on 10 different projects during a single pay period. Employee surveys taken at Dryden have identified work/life balance as the number one issue concerning employees. Further feedback from the employees indicated that project planning is the area needing the most improvement. In addition, employees have been encouraged to become more innovative, improve job skills, and seek ways to improve overall job efficiency. In order to deal with these challenges, DFRC management decided to adopt the CCPM system that is specifically designed to operate in a resource constrained multi-project environment. This paper will discuss in detail the rationale behind the selection of CCPM and the goals that will be achieved through this implementation. The paper will show how DFRC is tailoring the CCPM system to the flight research environment as well as laying out the implementation strategy. Results of the ongoing implementation will be discussed as well as change management challenges and organizational cultural changes. Finally this paper will present some recommendations on how this system could be used by selected NASA projects or centers.

  7. Engineering Center contribution to the Russian NPP aging management

    International Nuclear Information System (INIS)

    Bougaenko, S.

    1993-01-01

    The Engineering Center of strength, reliability and life of the nuclear equipment of the Minatom, Russia, has been set up by the decision of the management of the Russian Federation Ministry on the nuclear power (Russia Minatom) within the framework of the Research and Development Institute of Power Engineering (RDIPE). The Engineering Center is responsible for fulfilling the functions of the leading Institution of the Ministry concerning these issues and it is in charge of the development of the appropriate rules and standards package as well as their compliance with analogous international regulating documents. To put forward the national program on NPP aging management, and to implement it is one of the crucial tasks of the Engineering Center. This activity is conducted by both the cooperation between Russian Institution and experts and within the framework of the international collaboration. In the latter case it is worthy of noting the activity with respect to the American-Russian Working Group 12 ''NPP Aging and Life Extension'' and participation in appropriate programs of the IAEA. The major trends of the above activity are considered in this paper

  8. Roles of managers in academic health centers: strategies for the managed care environment.

    Science.gov (United States)

    Guo, Kristina L

    2002-03-01

    This article addresses survival strategies of academic health centers (AHCs) in responding to market pressures and government reforms. Using six case studies of AHCs, the study links strategic changes in structure and management to managerial role performance. Utilizing Mintzberg's classification of work roles, the roles of liaison, monitor, entrepreneur, and resource allocator were found to be used by top-level managers as they implement strategies to enhance the viability of their AHCs. Based on these new roles, the study recommends improving management practices through education and training as well as changing organizational culture to support management decision making and foster the continued growth of managers and their AHCs.

  9. Center-periphery management in the internationalization of executive masters

    Directory of Open Access Journals (Sweden)

    Ana Christina Celano Teixeira

    2018-03-01

    Full Text Available This article analyzes the process of internationalization of the International Masters Program for Managers (IMPM started in 2012 from a partnership established with a Brazilian institution. Created in 1995 by Henry Mintzberg – also the current director – the IMPM adopted a heterodox model challenging the US traditional MBA model, Mintzberg’s moto “Managers, Not MBA” suggests a new focus on managers instead of overemphasizing analysis and technique. From a critical perspective, this study identifies that, although proposing an appreciation of the culture of the different places where the international modules are hosted, the IMPM still adopts the Anglo-Saxon logic of knowledge imposition. The study reflects the expectation that, when considering the internationalization of management educational programs, from a critical point of view, the voices of peripheral countries are heard, promoting a better balance between the production and consumption of knowledge on management in the contemporary global context. It is necessary, therefore, to work in order to create a more dialogical movement between center and periphery, establishing a dynamic that considers not only cultural aspects, but also that recognizes the production of knowledge in both contexts.

  10. 75 FR 45600 - Information Collection; Customer Data Worksheet Request for Service Center Information Management...

    Science.gov (United States)

    2010-08-03

    ... DEPARTMENT OF AGRICULTURE Farm Service Agency Information Collection; Customer Data Worksheet Request for Service Center Information Management System (SCIMS) Record Changes AGENCY: Farm Service... Customer Data Worksheet Request for Service Center Information Management System (SCIMS) that contains the...

  11. Prevalence and Associated Factors of Eating Disorders in Weight Management Centers in Tanta, Egypt

    Directory of Open Access Journals (Sweden)

    Noha Eladawi

    2018-01-01

    Conclusions: EDs are prevalent among individuals attending the weight management centers in a northern city in Egypt. Specific management strategies are warranted to address this commonly prevalent disease.

  12. Quality management system of Saraykoy Nuclear Research and Training center

    International Nuclear Information System (INIS)

    Gurellier, R.; Akchay, S.; Zararsiz, S.

    2014-01-01

    Full text : Technical competence and national/international acceptance of independency of laboratories is ensured by going through accreditations. It provides decreasing the risk of a slowdown in international trade due to unnecessary repetition of testing and analyses. It also eliminates the cost of additional experiments and analyses. Saraykoy Nuclear Research and Training Center (SANAEM) has performed intensive studies to establish an effective and well-functioning QMS (Quality Management System) by full accordance with the requirements of ISO/IEC 17025, since the begining of 2006. Laboratories, especially serving to public health studies and important trade duties require urgent accreditation. In this regard, SANAEM has established a quality management system and performed accreditation studies

  13. Self-management of change processes in educational centers

    Directory of Open Access Journals (Sweden)

    María Inés Vázquez

    2013-04-01

    Full Text Available This paper addresses the self-management processes of change, referring to a series of processes that take place in education centers undergoing change. The perspective from which the approach is proposed is educational management. The evidences integrated into the document are the result of a study conducted in Uruguay, which involved seven primary, secondary, and technical schools. The approach used has been the study of multiple cases with the intention of analyzing the phenomenon in specific contexts, integrating the possibility of studying it from a global perspective. The overall objective was to achieve greater understanding of the self-evaluation and change processes in schools. Within the specific objectives we highlight: to identify the possible links between self-assessment and decision making

  14. The Value of Metrics for Science Data Center Management

    Science.gov (United States)

    Moses, J.; Behnke, J.; Watts, T. H.; Lu, Y.

    2005-12-01

    The Earth Observing System Data and Information System (EOSDIS) has been collecting and analyzing records of science data archive, processing and product distribution for more than 10 years. The types of information collected and the analysis performed has matured and progressed to become an integral and necessary part of the system management and planning functions. Science data center managers are realizing the importance that metrics can play in influencing and validating their business model. New efforts focus on better understanding of users and their methods. Examples include tracking user web site interactions and conducting user surveys such as the government authorized American Customer Satisfaction Index survey. This paper discusses the metrics methodology, processes and applications that are growing in EOSDIS, the driving requirements and compelling events, and the future envisioned for metrics as an integral part of earth science data systems.

  15. Environmental Management Assessment of the Stanford Linear Accelerator Center

    International Nuclear Information System (INIS)

    1994-01-01

    This report documents the results of the Environmental Management Assessment of the Stanford Linear Accelerator Center (SLAC), Menlo Park, California. During this assessment, the activities conducted by the assessment team included reviews of internal documents and reports from previous assessments; interviews with the US Department of Energy (DOE), US Environmental Protection Agency, State Water Resources Board, California Regional Water Quality Control Board, and SLAC contractor personnel; and inspections and observations of selected facilities and operations. Onsite portion of the assessment was conducted from January 18 through January 31, 1994, by the DOE Office of Environmental Audit (EH-24), located within the Office of Environment, Safety and Health (EH), and the Environment and Safety Support Division (ESS), located within the Oakland Operations Office (OAK). The EH-24 environmental management assessment and the OAK functional appraisal were combined to minimize disruptions to the site. The management disciplines and three technical areas (air quality, groundwater, and inactive waste sites) were evaluated by EH-24, and four other technical areas (surface water, waste management, toxic and chemical materials, and environmental radiation) were assessed by ESS

  16. Alarm management in TRANSPETRO National Oil Control Center

    Energy Technology Data Exchange (ETDEWEB)

    Amado, Helio; Costa, Luciano [TRANSPETRO - PETROBRAS Transporte S.A., Rio de Janeiro, RJ (Brazil)

    2009-07-01

    For sure Alarm Management is not a new issue. EEMUA 191 has been around since 1999 and everyone has received visits from consultants in this area. Besides this regulators have requested that operators have a policy for it. However there are few papers showing actual pipeline operator experience in alarm management. In this paper we present the work developed in TRANSPETRO National Oil Control Center since 2006, where we operate 5509 km of crude oil and refined products pipelines. Since the beginning of the centralized operation in 2002, alarm management has been a concern but a systematic approach has been taken since 2006. Initially we will make a brief revision of the literature and show trends for regulations. Then we will show the tools and the approach we have taken. Finally, the further developments we see. The point that we want to discuss is that, it has been very difficult to implement the system in a linear way and we believe that companies that have huge legacy systems, the same probably will occur. Putting in simple words, our main conclusion is: Implementing an Alarm Management policy produces good results however probably sometimes is better not to follow strictly the traditional steps. (author)

  17. Role of the Technical Information Center in the knowledge management

    International Nuclear Information System (INIS)

    Morales, Alfredo; Marrero, Carmen; Aguero, Manuel

    1999-01-01

    Competitive advantage of companies is directly proportional to their capacity for creating, capturing, handling, inventorying, transferring information, and generating knowledge, as well as for implementing best practices, in order to add value to the production process. Creation of an environment that allows carrying out this process efficiently, constitutes a transcendental step toward the systematic and useful application of knowledge management. This paper presents the role of Technical Information Centers, as entities which provide and integrate information and knowledge, within knowledge communities. The Technical Information Center (CIT for the Spanish: Centro de Information Tecnica) of PDVSA-Intevep and its contribution to strengthen the corporate technological intelligence through the information analysis and technical-scientific knowledge diffusion is also analyzed. The petrochemical and petroleum information network (RIPPET) and its data base RIPPET (from the Spanish Red de Informacion Petrolera y Petroquimica), coordinate by the CIT, and the CIT on line, a virtual organization, are also presented. Both are tools which facilitate the transfer of information and knowledge to communities organized within the company to manage knowledge

  18. Mission: Possible. Center of Excellence for Hazardous Materials Management

    International Nuclear Information System (INIS)

    Bartlett, W.T.; Prather-Stroud, W.

    2006-01-01

    The Center of Excellence for Hazardous Materials Management (CEHMM) was established in May 2004 as a nonprofit research organization. Its purpose is to develop a sustainable technical/scientific community located in Carlsbad, New Mexico, that interacts worldwide to find solutions to hazardous materials management issues. An important part of the mission is to achieve improved protection of worker safety, human health, and the environment. Carlsbad has a large technical community due to the presence of the Waste Isolation Pilot Plant (WIPP) and its many contractors and support organizations. These groups include the Carlsbad Environmental Monitoring and Research Center, Washington Group International, Los Alamos National Laboratory, and Sandia National Laboratories. These organizations form the basis of a unique knowledge community with strengths in many areas, such as geosciences, actinide chemistry, environmental monitoring, and waste transportation. CEHMM works cooperatively with these organizations and others to develop projects that will maintain this knowledge community beyond the projected closure date of WIPP. At present, there is an emphasis in bio-monitoring, air monitoring, hazardous materials educational programs, and endangered species remediation. CEHMM is also currently working with a group from the American Nuclear Society to help facilitate their conference scheduled for April 2006 in Carlsbad. CEHMM is growing rapidly and is looking forward to a diverse array of new projects. (authors)

  19. Responsibility-centered management: a 10-year nursing assessment.

    Science.gov (United States)

    McBride, A B; Neiman, S; Johnson, J

    2000-01-01

    In 1988-89, Indiana University became the first public university to implement responsibility-centered management (RCM) comprehensively. This article describes and assesses the implementation of RCM on the core campus of Indiana University School of Nursing in Indianapolis. It describes how RCM encouraged an information-rich environment, particularly with the advent of economic modeling; decision making linked to strategic goals/objectives; and a performance-based reward structure (e.g., merit pay increases and incentive plans). It ends with a discussion about the worth of RCM and the changes that frame-work produced, particularly in reconceptualizing the roles of the business officer and dean. The most profound consequence of RCM may be the effect it has in encouraging rethinking of what it means to be a school of nursing at this point in time.

  20. Project management plan, Hazardous Materials Management and Emergency Response Training Center

    International Nuclear Information System (INIS)

    Borgeson, M.E.

    1994-01-01

    For the next 30 years, the main activities at the Hanford Site will involve the handling and cleanup of toxic substances. Thousands of workers involved in these new activities will need systematic training appropriate to their tasks and associated risks. This project is an important part of the Hanford Site mission and will enable the US Department of Energy (DOE) to meet high standards for safety. The Hazardous Materials Management and Emergency Response Training Center (HAMMER) project will construct a centralized regional training center dedicated to training hazardous materials workers and emergency responders in classrooms and with hands-on, realistic training aids representing actual field conditions. The HAMMER Training Center will provide a cost-effective, high-quality way to meet the Hanford Site training needs. The training center creates a partnership among DOE; government contractors; labor; local, state, and tribal governments; and selected institutions of higher education

  1. Annual report of the Management Research Center, 1985

    International Nuclear Information System (INIS)

    1986-01-01

    Research on the management of new forms of automation; industrial management; the definition of a new product range; economic management; personnel management; and management of cultural enterprises is presented [fr

  2. 41 CFR 102-192.140 - What are your general responsibilities as a Federal mail center manager?

    Science.gov (United States)

    2010-07-01

    ... responsibilities as a Federal mail center manager? 102-192.140 Section 102-192.140 Public Contracts and Property... ADMINISTRATIVE PROGRAMS 192-MAIL MANAGEMENT Mail Center Manager Requirements § 102-192.140 What are your general responsibilities as a Federal mail center manager? A Federal mail center manager should— (a) Implement policies and...

  3. Unique strategies for technical information management at Johnson Space Center

    Science.gov (United States)

    Krishen, Vijay

    1994-01-01

    In addition to the current NASA manned programs, the maturation of Space Station and the introduction of the Space Exploration programs are anticipated to add substantially to the number and variety of data and documentation at NASA Johnson Space Center (JSC). This growth in the next decade has been estimated at five to ten fold compared to the current numbers. There will be an increased requirement for the tracking and currency of space program data and documents with National pressures to realize economic benefits from the research and technological developments of space programs. From a global perspective the demand for NASA's technical data and documentation is anticipated to increase at local, national, and international levels. The primary users will be government, industry, and academia. In our present national strategy, NASA's research and technology will assume a great role in the revitalization of the economy and gaining international competitiveness. Thus, greater demand will be placed on NASA's data and documentation resources. In this paper the strategies and procedures developed by DDMS, Inc., to accommodate the present and future information utilization needs are presented. The DDMS, Inc., strategies and procedures rely on understanding user requirements, library management issues, and technological applications for acquiring, searching, storing, and retrieving specific information accurately and quickly. The proposed approach responds to changing customer requirements and product deliveries. The unique features of the proposed strategy include: (1) To establish customer driven data and documentation management through an innovative and unique methods to identify needs and requirements. (2) To implement a structured process which responds to user needs, aimed at minimizing costs and maximizing services, resulting in increased productivity. (3) To provide a process of standardization of services and procedures. This standardization is the central

  4. Patient-centered image and data management in radiation oncology

    International Nuclear Information System (INIS)

    Steil, Volker; Schneider, Frank; Kuepper, Beate; Wenz, Frederik; Lohr, Frank; Weisser, Gerald

    2009-01-01

    Background: recent changes in the radiotherapy (RT) workflow through the introduction of complex treatment paradigms such as intensity-modulated radiotherapy (IMRT) and, recently, image-guided radiotherapy (IGRT) with their increase in data traffic for different data classes have mandated efforts to further integrate electronic data management for RT departments in a patient- and treatment-course-centered fashion. Methods: workflow in an RT department is multidimensional and multidirectional and consists of at least five different data classes (RT/machine data, patient-related documents such as reports and letters, progress notes, DICOM (Digital Imaging and Communications in Medicine) image data, and non-DICOM image data). Data has to be handled in the framework of adaptive feedback loops with increasing frequency. This is in contrast to a radiology department where mainly DICOM image data and reports have to be widely accessible but are dealt with in a mainly unidirectional manner. When compared to a diagnostic Radiology Information System (RIS)/Picture Archiving and Communication System (PACS), additional legal requirements have to be conformed to when an integrated electronic RT data management system is installed. Among these are extended storage periods, documentation of treatment plan approval by physicians and physicist, documentation of informed consent, etc. Conclusion: since the transition to a paper- and filmless environment in medicine and especially m radiation ''neology is unavoidable this review discusses these issues and suggests a possible hardware and organizational architecture of an RT department information system under control of a Hospital Information System (HIS), based on combined features of genuine RT Record and Verify (R and V) Systems, PACS, and Electronic Medical Records (EMR). (orig.)

  5. Person-centered pain management - science and art.

    Science.gov (United States)

    Braš, Marijana; Đorđević, Veljko; Janjanin, Mladen

    2013-06-01

    We are witnessing an unprecedented development of the medical science, which promises to revolutionize health care and improve patients' health outcomes. However, the core of the medical profession has always been and will be the relationship between the doctor and the patient, and communication is the most widely used clinical skill in medical practice. When we talk about different forms of communication in medicine, we must never forget the importance of communication through art. Although one of the simplest, art is the most effective way to approach the patient and produce the effect that no other means of communication can achieve. Person-centered pain management takes into account psychological, physical, social, and spiritual aspects of health and disease. Art should be used as a therapeutic technique for people who suffer from pain, as well as a means of raising public awareness of this problem. Art can also be one of the best forms of educating medical professionals and others involved in treatment and decision-making on pain.

  6. User-centered design of a mobile medication management.

    Science.gov (United States)

    Sedlmayr, Brita; Schöffler, Jennifer; Prokosch, Hans-Ulrich; Sedlmayr, Martin

    2018-03-05

    The use of a nationwide medication plan has been promoted as an effective strategy to improve patient safety in Germany. However, the medication plan only exists as a paper-based version, which is related to several problems, that could be circumvented by an electronic alternative. The main objective of this study was to report on the development of a mobile interface concept to support the management of medication information. The human-centered design (UCD) process was chosen. First the context of use was analyzed, and personas and an interaction concept were designed. Next, a paper prototype was developed and evaluated by experts. Based on those results, a medium-fidelity prototype was created and assessed by seven end-users who performed a thinking-aloud test in combination with a questionnaire based on the System Usability Scale (SUS). Initially for one persona/user type, an interface design concept was developed, which received an average SUS-Score of 92.1 in the user test. Usability problems have been solved so that the design concept could be fixed for a future implementation. Contribution: The approach of the UCD process and the methods involved can be applied by other researchers as a framework for the development of similar applications.

  7. Kennedy Space Center's NASA/Contractor Team-Centered Total Quality Management Seminar: Results, methods, and lessons learned

    Science.gov (United States)

    Kinlaw, Dennis C.; Eads, Jeannette

    1992-01-01

    It is apparent to everyone associated with the Nation's aeronautics and space programs that the challenge of continuous improvement can be reasonably addressed only if NASA and its contractors act together in a fully integrated and cooperative manner that transcends the traditional boundaries of proprietary interest. It is, however, one thing to assent to the need for such integration and cooperation; it is quite another thing to undertake the hard tasks of turning such a need into action. Whatever else total quality management is, it is fundamentally a team-centered and team-driven process of continuous improvement. The introduction of total quality management at KSC, therefore, has given the Center a special opportunity to translate the need for closer integration and cooperation among all its organizations into specific initiatives. One such initiative that NASA and its contractors have undertaken at KSC is a NASA/Contractor team-centered Total Quality Management Seminar. It is this seminar which is the subject of this paper. The specific purposes of this paper are to describe the following: Background, development, and evolution of Kennedy Space Center's Total Quality Management Seminar; Special characteristics of the seminar; Content of the seminar; Meaning and utility of a team-centered design for TQM training; Results of the seminar; Use that one KSC contractor, EG&G Florida, Inc. has made of the seminar in its Total Quality Management initiative; and Lessons learned.

  8. NOAA Workforce Management Office, e-Learning, Commerce Learning Center

    Science.gov (United States)

    Assignment Program (NRAP) Presidential Management Fellows (PMFs) Program Coordination Office - Leadership (CLC) Home Careers at NOAA Search Criteria Click to Search WORKFORCE MANAGEMENT OFFICE Executive Resources Senior Executive Service ST and SL Responsibilities Performance Management Performance

  9. STUDY REGARDING THE ORGANIZATION OF MANAGEMENT ACCOUNTING IN THE CONTEXT OF RESPONSIBILITY CENTERS

    Directory of Open Access Journals (Sweden)

    RĂCHISAN PAULA RAMONA

    2009-05-01

    Full Text Available The organization on responsibility centers has lately become a generalized practice inside small and medium economic enterprises. Thus it made necessary the adaptation of management accounting to the new requirements. Introducing effective management by o

  10. Metropolitan transportation management center concepts of operation : a cross-cutting study : improving transportation network efficiency

    Science.gov (United States)

    1999-10-01

    The implementor and operator of a regional transportation management center (TMC) face a challenging task. Operators of TMCsthe primary point of coordination for managing transportation resourcestypically control millions of dollars of intellig...

  11. The Stanford University US-Japan Technology Management Center

    National Research Council Canada - National Science Library

    Dasher, Richard

    2002-01-01

    ..., nanotechnologies, MEMS, system-level chip integration, and advanced manufacturing. Our technology management focus embraced industry standards and standardization, intellectual property management, U.S...

  12. Toward sustainable data centers: a comprehensive energy management strategy

    OpenAIRE

    Guitart Fernández, Jordi

    2016-01-01

    Data centers are major contributors to the emission of carbon dioxide to the atmosphere, and this contribution is expected to increase in the following years. This has encouraged the development of techniques to reduce the energy consumption and the environmental footprint of data centers. Whereas some of these techniques have succeeded to reduce the energy consumption of the hardware equipment of data centers (including IT, cooling, and power supply systems), we claim that sustainable data c...

  13. Management Matters. Display and Promotion Ideas for Library Media Centers

    Science.gov (United States)

    Pappas, Marjorie L.

    2005-01-01

    School library media centers should be warm and inviting places where the environment entices children to read and explore. Creative bulletin board and case displays along with other exhibits help to make the library media center an exciting place. Bulletin board displays that promote authors, books, and exciting ideas motivate children to find…

  14. Financing Public Higher Education: The Impact of Responsibility Center Management on a Public Research University

    Science.gov (United States)

    Pappone, David J.

    2016-01-01

    To explore the impacts on public universities of implementing an incentive-based budgeting system, this dissertation focuses on one university's extensive experience with Responsibility Center Management. The financial and non-financial impacts of Responsibility Center Management will be considered by examining the extent to which commonly held…

  15. Learner-Centered (LCI) vs. Teacher-Centered (TCI) Instruction: A Classroom Management Perspective

    Science.gov (United States)

    Minter, Mary Kennedy

    2011-01-01

    Teacher education should incorporate management and leadership training with an emphasis on student audience analysis. Macro perspectives of teaching are needed for a workable approach to the management of education.

  16. Quality Improvement Project to Improve Patient Satisfaction With Pain Management: Using Human-Centered Design.

    Science.gov (United States)

    Trail-Mahan, Tracy; Heisler, Scott; Katica, Mary

    2016-01-01

    In this quality improvement project, our health system developed a comprehensive, patient-centered approach to improving inpatient pain management and assessed its impact on patient satisfaction across 21 medical centers. Using human-centered design principles, a bundle of 6 individual and team nursing practices was developed. Patient satisfaction with pain management, as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems pain composite score, increased from the 25th to just under the 75th national percentile.

  17. Revenue management: a cost saver, not a cost center

    OpenAIRE

    Grier, Rachel

    2017-01-01

    Any hotelier operating today without the support of an automated revenue management system is working at a competitive disadvantage. Advanced revenue management solutions allow hotels to better predict demand, price their product offerings competitively and achieve the optimal business mix for their property as a result. Simply put, revenue management systems allow a hotel to attract the ideal guest, at the ideal price and via the ideal channel. November 2nd, 2017

  18. A Reliable, Non-Invasive Approach to Data Center Monitoring and Management

    Directory of Open Access Journals (Sweden)

    Moises Levy

    2017-08-01

    Full Text Available Recent standards, legislation, and best practices point to data center infrastructure management systems to control and monitor data center performance. This work presents an innovative approach to address some of the challenges that currently hinder data center management. It explains how monitoring and management systems should be envisioned and implemented. Key parameters associated with data center infrastructure and information technology equipment can be monitored in real-time across an entire facility using low-cost, low-power wireless sensors. Given the data centers’ mission critical nature, the system must be reliable and deployable through a non-invasive process. The need for the monitoring system is also presented through a feedback control systems perspective, which allows higher levels of automation. The data center monitoring and management system enables data gathering, analysis, and decision-making to improve performance, and to enhance asset utilization.

  19. Child-Centered Play Therapy in Management of Somatoform Disorders

    Science.gov (United States)

    Dutta, Renuka; Mehta, Manju

    2006-01-01

    Introduction: Child-centered play therapy is a well recognized and research-supported form of child psychotherapy. Methods: Fifteen children in the age range of 5-11 years (eight girls and seven boys) with somatoform disorder were administered 25 sessions of non directive play therapy. Parents received 3 reflective counseling sessions. Children…

  20. NASA Goddard Space Flight Center Supply Chain Management Program

    Science.gov (United States)

    Kelly, Michael P.

    2011-01-01

    This slide presentation reviews the working of the Supplier Assessment Program at NASA Goddard Space Flight Center. The program supports many GSFC projects to ensure suppliers are aware of and are following the contractual requirements, to provide an independent assessment of the suppliers' processes, and provide suppliers' safety and mission assurance organizations information to make the changes within their organization.

  1. HR Shared Service Centers: From Brand Management Towards Success

    NARCIS (Netherlands)

    van Balen, Mitchell; Bondarouk, Tatiana; Ruel, Hubertus Johannes Maria; Guiderdoni-Jourdain, Karine; Oiry, Ewan

    2009-01-01

    In this chapter the authors consider articles in professional literature regarding Human Resource Centers, with the goal to explore issues raised by practice: motivation, risk analysis, structure and implementation. Using Grounded Theory approach, they analysed 34 articles, and through open and

  2. Microsoft System Center Data Protection Manager 2012 R2 cookbook

    CERN Document Server

    Hedblom, Robert

    2015-01-01

    If you are a DPM administrator, this book will help you verify your knowledge and provide you with everything you need to know about the 2012 R2 release. No prior knowledge about System Center DPM is required, however some experience of running backups will come in handy.

  3. Naval Postgraduate School Cost Center Financial Management Guide

    Science.gov (United States)

    1989-12-01

    Expenditures on Official Business 1. Advance registration fees for local workshops , seminars, classes, etc., of less than ten hours duration and...HCOOOHC999 0721-0730 63 Metorology Dept HD HDO0 -HD999 1 073 1-0740 Figure FA6 Sub-Cost Center OPTAR Document SerWa Numb~ers (con’t) Appendix F Page

  4. Study on the operational guides of the off-site emergency management center

    International Nuclear Information System (INIS)

    Park, Won Jong; Han, S. J.; Oh, K. H.

    2005-01-01

    The emergency response organizational groups and roles of Off-site Emergency Management Center was proposed to respond in case of radiological emergency. Development of implementing procedures of Off-site Emergency Management Center in case of radiological emergency to improve effective co-operation and rapid response in radiological emergency. Establishment of 'The Ordinance of Operation of residence radiological emergency office of the Minister of Science and Technology' and announced by the Minister of Science and Technology. The Implementing procedures of Off-site Emergency Management Center and 'The Ordinance of Operation of residence radiological emergency office of the Minister of Science and Technology' can be provide guidelines in case of emergency

  5. VHA Support Service Center Primary Care Management Module (PCMM)

    Data.gov (United States)

    Department of Veterans Affairs — The Primary Care Management Module (PCMM) was developed to assist VA facilities in implementing Primary Care. PCMM supports both Primary Care and non-Primary Care...

  6. Optimal Power Cost Management Using Stored Energy in Data Centers

    OpenAIRE

    Urgaonkar, Rahul; Urgaonkar, Bhuvan; Neely, Michael J.; Sivasubramaniam, Anand

    2011-01-01

    Since the electricity bill of a data center constitutes a significant portion of its overall operational costs, reducing this has become important. We investigate cost reduction opportunities that arise by the use of uninterrupted power supply (UPS) units as energy storage devices. This represents a deviation from the usual use of these devices as mere transitional fail-over mechanisms between utility and captive sources such as diesel generators. We consider the problem of opportunistically ...

  7. The Loyalty of older people in fitness centers: Managing customers for physical activity programs

    Directory of Open Access Journals (Sweden)

    Jerónimo García Fernández

    2010-01-01

    Full Text Available The fitness centers are now places where partners perform «controlled» physical activity, which improves their physical and mental state, and where they socialize with other partners of all ages. These centers have been typically managed by people without training in this subject and with the only interest of obtaining partners without taking into account the long-term impact. This problem, together with management problems of the center and personal problems of the members, have meant that there are high desertion rates in this type of indoor facilities, with the consequent increase in expenditure on marketing and a non-sustainable profitability. We propose a program of physical activity that could improve the rate of loyalty, being the central point of management of sports centers today, the satisfaction and loyalty to the fitness centers.

  8. Donor management parameters and organ yield: single center results.

    Science.gov (United States)

    Marshall, George Ryne; Mangus, Richard S; Powelson, John A; Fridell, Jonathan A; Kubal, Chandrashekhar A; Tector, A Joseph

    2014-09-01

    Management of organ donors in the intensive care unit is an emerging subject in critical care and transplantation. This study evaluates organ yield outcomes for a large number of patients managed by the Indiana Organ Procurement Organization. This is a retrospective review of intensive care unit records from 2008-2012. Donor demographic information and seven donor management parameters (DMP) were recorded at admission, consent, 12 h after consent, and before procurement. Three study groups were created: donors meeting 0-3, 4, or 5-7 DMP. Active donor Organ Procurement Organization management began at consent; so, data analysis focuses on the 12-h postconsent time point. Outcomes included organs transplanted per donor (OTPD) and transplantation of individual solid organs. Complete records for 499 patients were reviewed. Organ yield was 1415 organs of 3992 possible (35%). At 12 h, donors meeting more DMP had more OTPD: 2.2 (0-3) versus 3.0 (4) versus 3.5 (5-7) (P organ except intestine. Oxygen tension, vasopressor use, and central venous pressure were the most frequent independent predictors of organ usage. There were significantly more organs transplanted for donors meeting all three of these parameters (4.5 versus 2.7, P organs, with analysis of individual parameters suggesting that appropriate management of oxygenation, volume status, and vasopressor use could lead to more organs procured per donor. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Transportation management center data capture for performance and mobility measures guidebook.

    Science.gov (United States)

    2013-03-01

    The Guide to Transportation Management Center (TMC) Data Capture for Performance and Mobility Measures is a two-volume document consisting of this summary Guidebook and a Reference Manual. These documents provide technical guidance and recommended pr...

  10. Transportation management center data capture for performance and mobility measures reference manual.

    Science.gov (United States)

    2013-03-01

    The Guide to Transportation Management Center (TMC) Data Capture for Performance and Mobility Measures is a two-volume document consisting of a summary Guidebook and this Reference Manual. These documents provide technical guidance and recommended pr...

  11. Annual report procurement and logistics management center Sandia National Laboratories fiscal year 2002.

    Energy Technology Data Exchange (ETDEWEB)

    Palmer, David L.

    2003-05-01

    This report summarizes the purchasing and transportation activities of the Procurement and Logistics Management Center for Fiscal Year 2002. Activities for both the New Mexico and California locations are included.

  12. Computer-aided dispatch--traffic management center field operational test : state of Utah final report

    Science.gov (United States)

    2006-07-01

    This document provides the final report for the evaluation of the USDOT-sponsored Computer-Aided Dispatch Traffic Management Center Integration Field Operations Test in the State of Utah. The document discusses evaluation findings in the followin...

  13. Computer-aided dispatch--traffic management center field operational test : Washington State final report

    Science.gov (United States)

    2006-05-01

    This document provides the final report for the evaluation of the USDOT-sponsored Computer-Aided Dispatch - Traffic Management Center Integration Field Operations Test in the State of Washington. The document discusses evaluation findings in the foll...

  14. Model Orlando regionally efficient travel management coordination center (MORE TMCC), phase II : final report.

    Science.gov (United States)

    2012-09-01

    The final report for the Model Orlando Regionally Efficient Travel Management Coordination Center (MORE TMCC) presents the details of : the 2-year process of the partial deployment of the original MORE TMCC design created in Phase I of this project...

  15. Louisville region demonstration of travel management coordination center : system pre-deployment preparation.

    Science.gov (United States)

    2013-03-01

    The purpose of the Greater Louisville Region Demonstration of Travel Management Coordination Center (TMCC): System Pre-Deploy-ment Preparation grant was to further phased implementation of the regions TMCC design by focusing on two major component...

  16. 20 CFR 670.535 - Are Job Corps centers required to establish behavior management systems?

    Science.gov (United States)

    2010-04-01

    ... behavior management systems? 670.535 Section 670.535 Employees' Benefits EMPLOYMENT AND TRAINING... systems? (a) Yes, each Job Corps center must establish and maintain its own student incentives system to encourage and reward students' accomplishments. (b) The Job Corps center must establish and maintain a...

  17. U.S. academic medical centers under the managed health care environment.

    Science.gov (United States)

    Guo, K

    1999-06-01

    This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U.S. health care system through their missions of conducting cutting-edge biomedical research, pursuing clinical and technological innovations, providing state-of-the-art medical care and producing highly qualified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical science. To survive the threats of managed care in the health care environment, academic medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 108 CEOs in all the academic medical centers in the U.S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.

  18. Self-management of oral anticoagulant therapy in two centers

    DEFF Research Database (Denmark)

    Nilsson, Hanna; Grove, E; Larsen, Torben Bjerregaard

    of Cardiology, Aarhus University Hospital, Aarhus; 3Department of Cardiology, Aalborg Hospital & Department of Health Science and Technology, Aalborg University, Aalborg, Denmark haana_86@hotmail.com Objectives: Patient-self-management (PSM) of oral anticoagulant therapy with vitamin K antagonists have...

  19. Low-level waste management at the Nuclear Research Center

    International Nuclear Information System (INIS)

    Montanez, O.; Blanco, D.; Vallarino, V.; Calisto, W.

    1986-01-01

    A general overview of low-level radioactive waste management at the Nuclear Investigation Centre (CIN) of Uruguay is presented. The CIN is a pilot centre of research and development of techniques for implementing measurements for radioactive waste storage and control. (M.C.K.) [pt

  20. Managing Information Technology in Academic Medical Centers: A "Multicultural" Experience.

    Science.gov (United States)

    Friedman, Charles P.; Corn, Milton; Krumrey, Arthur; Perry, David R.; Stevens, Ronald H.

    1998-01-01

    Examines how beliefs and concerns of academic medicine's diverse professional cultures affect management of information technology. Two scenarios, one dealing with standardization of desktop personal computers and the other with publication of syllabi on an institutional intranet, form the basis for an exercise in which four prototypical members…

  1. 76 FR 71604 - Kamal Tiwari, M.D.; Pain Management and Surgery Center of Southern Indiana; Decision and Order

    Science.gov (United States)

    2011-11-18

    ..., and his principal place of business, the Pain Management and Surgery Center (Respondent PMSC), holder... Certificate of Registration, BP4917413, issued to Respondent Pain Management and Surgery Center of Southern..., M.D. and Pain Management and Surgery Center of Southern Indiana, to renew or modify such...

  2. [Drug information management through the intranet of a hospital center].

    Science.gov (United States)

    Juárez Giménez, J C; Mendarte Barrenechea, L; Gil Luján, G; Sala Piñol, F; Lalueza Broto, P; Girona Brumós, L; Monterde Junyent, J

    2006-01-01

    This paper describes the methodology used for the implementation and validation of a network resource incorporated to the intranet of the Hospital, in order to retain and disseminate information from the Drug Information Center (DIC) of a pharmacy service in a hospital center. A working group designed the structure, contents, memory needs, priority of access for users and a quality assessment questionnaire. The resource developed by the working group had a capacity of 70 Gb and its structure was based on HTML documents, including files with different format and 12 theme areas. Two levels of priority of access were established depending on the user and two persons were in charge of the resource. The questionnaire was delivered after three months of use. Sixty nine per cent of the users regarded the resource as very useful and 31%, as useful. The final structure, according to the results of the survey, had 11 theme areas. The use of the hospital Intranet in order to include and organize DIC information can be very simple and economic. Furthermore, the involvement of all the users in its design and structure can facilitate the practical use of this tool and improve its quality.

  3. Storage Information Management System (SIMS) Spaceflight Hardware Warehousing at Goddard Space Flight Center

    Science.gov (United States)

    Kubicko, Richard M.; Bingham, Lindy

    1995-01-01

    Goddard Space Flight Center (GSFC) on site and leased warehouses contain thousands of items of ground support equipment (GSE) and flight hardware including spacecraft, scaffolding, computer racks, stands, holding fixtures, test equipment, spares, etc. The control of these warehouses, and the management, accountability, and control of the items within them, is accomplished by the Logistics Management Division. To facilitate this management and tracking effort, the Logistics and Transportation Management Branch, is developing a system to provide warehouse personnel, property owners, and managers with storage and inventory information. This paper will describe that PC-based system and address how it will improve GSFC warehouse and storage management.

  4. Application of VLLW management principles to the CEA research centers

    International Nuclear Information System (INIS)

    Guetat, P.

    1997-01-01

    This document describes the content of a CEA policy relating to very low level waste management elaborated in application of the waste management principles defined in France. The policy deals with very low level waste, subject to recycling, incineration or landfill disposal. It does not deal with reuse. The following principles are applicable to waste streams produced by CEA nuclear installations either during operating or dismantling activities. The policy deals only with very low level wastes (VLLW) (order of magnitude: <100 Bq/g for high energy emitters). It does not deal with low, intermediate or high level waste, which are either recycled or incinerated in nuclear industry or disposed of in the Aube surface disposal (CSA) or kept in intermediate storage, before geological disposal or any alternative final solution

  5. Trends in types of calls managed by U.S. poison centers 2000-2015.

    Science.gov (United States)

    Anderson, Bruce D; Seung, Hyunuk; Klein-Schwartz, Wendy

    2017-12-05

    The number of cases reported to poison centers has decreased since 2008 but there is evidence that the complexity of calls is increasing. The objectives are to evaluate national poison center data for trends in reason and how these changes effect management site, medical outcomes, and poison center workload. Data regarding reason, age, management site, and medical outcome were extracted from annual reports of the National Poison Data System from 2000 to 2015. The proportion of cases by year were determined for unintentional and intentional exposures. Analysis of data from a single poison center from 2005 to 2015 compared the number of interactions between poison center staff and callers for unintentional versus intentional reasons. Trend analyses found that from 2000 to 2015 the percent of unintentional cases decreased (from 85.9 to 78.4%, p Poison centers are managing more intentional exposures and fewer unintentional exposures. Intentional exposures require more poison center staff expertise and time. Looking only at poison center total call volume may not be an adequate method to gauge productivity.

  6. Teacher-Centered Management Style of Public School Principals and Job Satisfaction of Teachers.

    Science.gov (United States)

    Chung, Ki-Suck

    A concept of teacher-centered management was proposed as a style of leadership behavior for school administrators to reduce the incompatibility between social/psychological needs of teachers and monocratic/bureaucratic management patterns in educational organizations. Data obtained from self-report questionnaires distributed to teachers in 21…

  7. The Research Results of Radioactive Waste Management Technology Center Year 1997/1998

    International Nuclear Information System (INIS)

    1998-12-01

    The research results of Radioactive Waste Management Technology Center, National Atomic Energy Agency of Indonesia year 1997/1998 contain paper as form of research results on radioactive waste management related fields. There were included many aspects such as radioactive waste processing, storage, decontamination, decommissioning, safety and environmental aspects. There are 26 papers indexed individually (ID)

  8. The Research Results of Radioactive Waste Management Technology Center Year 1996/1997

    International Nuclear Information System (INIS)

    Budiman, P.; Martono, H.; Las, T.; Lubis, E.; Mulyanto; Wisnubroto, D. S.; Sucipta

    1997-12-01

    The research results of Radioactive Waste Management Technology Center, National Atomic Energy Agency of Indonesia year 1996/1997 contain paper as form of research results on radioactive waste management related fields. There were included many aspects such as radioactive waste processing, storage, decontamination, decommissioning, safety and environmental aspects. There are 24 papers and 12 short communications indexed individually(ID)

  9. Impact of configuration management system of computer center on support of scientific projects throughout their lifecycle

    International Nuclear Information System (INIS)

    Bogdanov, A.V.; Yuzhanin, N.V.; Zolotarev, V.I.; Ezhakova, T.R.

    2017-01-01

    In this article the problem of scientific projects support throughout their lifecycle in the computer center is considered in every aspect of support. Configuration Management system plays a connecting role in processes related to the provision and support of services of a computer center. In view of strong integration of IT infrastructure components with the use of virtualization, control of infrastructure becomes even more critical to the support of research projects, which means higher requirements for the Configuration Management system. For every aspect of research projects support, the influence of the Configuration Management system is reviewed and development of the corresponding elements of the system is described in the present paper.

  10. Impact of configuration management system of computer center on support of scientific projects throughout their lifecycle

    Science.gov (United States)

    Bogdanov, A. V.; Iuzhanin, N. V.; Zolotarev, V. I.; Ezhakova, T. R.

    2017-12-01

    In this article the problem of scientific projects support throughout their lifecycle in the computer center is considered in every aspect of support. Configuration Management system plays a connecting role in processes related to the provision and support of services of a computer center. In view of strong integration of IT infrastructure components with the use of virtualization, control of infrastructure becomes even more critical to the support of research projects, which means higher requirements for the Configuration Management system. For every aspect of research projects support, the influence of the Configuration Management system is being reviewed and development of the corresponding elements of the system is being described in the present paper.

  11. Patient-Centered Medical Home Undergraduate Internship, Benefits to a Practice Manager: Case Study.

    Science.gov (United States)

    Sasnett, Bonita; Harris, Susie T; White, Shelly

    Health services management interns become practice facilitators for primary care clinics interested in pursuing patient-centered recognition for their practice. This experience establishes a collaborative relationship between the university and clinic practices where students apply their academic training to a system of documentation to improve the quality of patient care delivery. The case study presents the process undertaken, benefits, challenges, lessons learned, and recommendations for intern, practice mangers, and educators. The practice manager benefits as interns become Patient-Centered Medical Home facilitators and assist practice managers in the recognition process.

  12. Technology requirements to be addressed by the NASA Lewis Research Center Cryogenic Fluid Management Facility program

    Science.gov (United States)

    Aydelott, J. C.; Rudland, R. S.

    1985-01-01

    The NASA Lewis Research Center is responsible for the planning and execution of a scientific program which will provide advance in space cryogenic fluid management technology. A number of future space missions were identified that require or could benefit from this technology. These fluid management technology needs were prioritized and a shuttle attached reuseable test bed, the cryogenic fluid management facility (CFMF), is being designed to provide the experimental data necessary for the technology development effort.

  13. 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.

  14. Management of radioactive waste of scientific and industrial centers

    International Nuclear Information System (INIS)

    Sobolev, I.A.; Dmitriev, S.A.; Barinov, A.S.; Ojovan, M.I.; Timofeev, E.M.

    1995-01-01

    Available for the time being in the Russian Federation, a system of management of institutional and industrial radioactive waste (e.g. radioactive waste from industry, medicine, scientific organizations and other, which are not related to the nuclear fuel cycle or defense) provides for its collection, transportation, storage, treatment, immobilization and disposal by a network of special enterprises. Russia has 16 such enterprises. Moscow Scientific and Industrial Association Radon deals with the problems of radioactive waste from Central European part of Russia, which includes Moscow, Moscow Region and also Tverskaya, Yaroslavskaya, Vladimirskaya, Kostromskaya, Kaluzhskaya, Bryanskaya, Smolenskaya, Tulskaya, Ryazanskaya regions. The population of the central part of Russia constitutes about 40 million people. At the same time about 80% of the radioactive waste, which is collected for treatment and disposal from the territory of Russia, is included in this region. The average volume of the waste to be treated at SIA Radon is 3,000 m 3 per year for solid waste and 350 m 3 per year for liquid waste. Total radioactivity of processed waste is up to 4 PBq per year

  15. Lead from the center. How to manage divisions dynamically.

    Science.gov (United States)

    Raynor, M E; Bower, J L

    2001-05-01

    Conventional wisdom holds that a company's divisions should be given almost total autonomy--especially under conditions of uncertainty--because they are closer to emerging technologies, customers, and competitors than corporate headquarters could ever be. But research from Michael Raynor and Joseph Bower suggests that the corporate office should be more, not less, directive in turbulent markets. Rapid changes in an industry make it difficult to predict where and when synergies among divisions might emerge. With so many possibilities and such uncertainty, companies can't afford to sacrifice their ability to flexibly execute business strategy. Corporate headquarters must play an active role in defining the scope of division-level strategy, the authors say, so that divisions do not act in ways that undermine opportunities to collaborate in the future. But neither can companies afford to sacrifice the competitiveness of their divisions as stand-alone businesses. In creating corporate-level strategic flexibility, a corporate office must balance the need for divisional autonomy now with the potential need for cooperation in the future. Through an examination of four corporations--Sprint, WPP, Teradyne, and Viacom--the authors challenge traditional approaches to diversification in which a company's divisions are either related (they share resources and collaborate) or unrelated (they compete for resources and operate as stand-alone businesses). They argue that companies should adopt a dynamic approach to cooperation among divisions, enabling varying degrees of relatedness between divisions depending on strategic circumstances. The authors offer four tactics to help executives manage divisions dynamically.

  16. Report on Allegation of Unsatisfactory Conditions Regarding Actions by the Defense Contract Management Agency, Earned Value Management Center

    Science.gov (United States)

    2010-07-28

    object ivity of Defen se Contract Management Agency to carry ou t its ea rn ed va lue managemen t oversight responsibilities; and DCMA Response: Non...Headquarters Services, Directorate for Information Operations and Reports, 1215 Jefferson Davis Highway, Suite 1204, Arlington VA 22202-4302...Earned Value Management Center Director advised us that the 2-week time frame was “standard operating procedure” for performing compliance reviews at

  17. VIRTUAL COGNITIVE CENTERS AS INTELLIGENT SYSTEMS FOR MANAGEMENT INFORMATION SUPPORT OF REGIONAL SECURITY

    Directory of Open Access Journals (Sweden)

    A. V. Masloboev

    2014-03-01

    Full Text Available The paper deals with engineering problems and application perspectives of virtual cognitive centers as intelligent systems for information support of interagency activities in the field of complex security management of regional development. A research prototype of virtual cognitive center for regional security management in crisis situations, implemented as hybrid cloud service based on IaaS architectural framework with the usage of multi-agent and web-service technologies has been developed. Virtual cognitive center is a training simulator software system and is intended for solving on the basis of distributed simulation such problems as: strategic planning and forecasting of risk-sustainable development of regional socioeconomic systems, agents of management interaction specification synthesis for regional components security in different crisis situations within the planning stage of joint anti-crisis actions.

  18. Ant Colony Optimization Algorithm to Dynamic Energy Management in Cloud Data Center

    Directory of Open Access Journals (Sweden)

    Shanchen Pang

    2017-01-01

    Full Text Available With the wide deployment of cloud computing data centers, the problems of power consumption have become increasingly prominent. The dynamic energy management problem in pursuit of energy-efficiency in cloud data centers is investigated. Specifically, a dynamic energy management system model for cloud data centers is built, and this system is composed of DVS Management Module, Load Balancing Module, and Task Scheduling Module. According to Task Scheduling Module, the scheduling process is analyzed by Stochastic Petri Net, and a task-oriented resource allocation method (LET-ACO is proposed, which optimizes the running time of the system and the energy consumption by scheduling tasks. Simulation studies confirm the effectiveness of the proposed system model. And the simulation results also show that, compared to ACO, Min-Min, and RR scheduling strategy, the proposed LET-ACO method can save up to 28%, 31%, and 40% energy consumption while meeting performance constraints.

  19. The NSF Cybersecurity Center of Excellence: Translating Identity Management and Cybersecurity into Scientific Collaboration

    Science.gov (United States)

    Welch, V.

    2016-12-01

    Scientists care deeply about their collaborations: who is a member, who can access, produce, and correct data, and manager instruments critical to their science missions. The communities of cybersecurity and identity management professionals develop tools to support collaborations and the undertaking of trustworthy science, but there are large cultural and linguistic gaps between these communities and the scientists they service. The National Science Foundation has recently funded a NSF Cybersecurity Center of Excellence to help its community of projects by providing leadership and addressing the challenges of trustworthy science. A key goal of this NSF Center has been translating between the goals of the science community into requirements and risks understood by identity management and cybersecurity communities. This talk will give an update on the Center's efforts and other services it provides to the NSF community to bridge these cultures.

  20. The management approach to the NASA space station definition studies at the Manned Spacecraft Center

    Science.gov (United States)

    Heberlig, J. C.

    1972-01-01

    The overall management approach to the NASA Phase B definition studies for space stations, which were initiated in September 1969 and completed in July 1972, is reviewed with particular emphasis placed on the management approach used by the Manned Spacecraft Center. The internal working organizations of the Manned Spacecraft Center and its prime contractor, North American Rockwell, are delineated along with the interfacing techniques used for the joint Government and industry study. Working interfaces with other NASA centers, industry, and Government agencies are briefly highlighted. The controlling documentation for the study (such as guidelines and constraints, bibliography, and key personnel) is reviewed. The historical background and content of the experiment program prepared for use in this Phase B study are outlined and management concepts that may be considered for future programs are proposed.

  1. A Survey of Knowledge Management Research & Development at NASA Ames Research Center

    Science.gov (United States)

    Keller, Richard M.; Clancy, Daniel (Technical Monitor)

    2002-01-01

    This chapter catalogs knowledge management research and development activities at NASA Ames Research Center as of April 2002. A general categorization scheme for knowledge management systems is first introduced. This categorization scheme divides knowledge management capabilities into five broad categories: knowledge capture, knowledge preservation, knowledge augmentation, knowledge dissemination, and knowledge infrastructure. Each of nearly 30 knowledge management systems developed at Ames is then classified according to this system. Finally, a capsule description of each system is presented along with information on deployment status, funding sources, contact information, and both published and internet-based references.

  2. Managing the Shopping Center Ambience Attributes by Using Importance-Performance Analysis: The Case from Serbia

    Directory of Open Access Journals (Sweden)

    Jelica Marković

    2014-06-01

    Full Text Available This paper examined customers’ perceived importance and performance of shopping center ambience on the examples of the Mercator shopping center and Sad Novi Bazaar shopping center in Novi Sad, Serbia. The shopping center ambience was examined through exterior and interior attributes. It was found that a number of them are very important to customers and their shopping behavior. According to the present research, the most important exterior attributes are: address and location, parking availability, congestion and traffic, exterior display windows and entrances. The most important interior attributes are: cleanliness, temperature, merchandise, lighting, music, scents, absence of tobacco smoke, width of aisles and P.A. usage. The paper also provided information for two studied shopping centers with ambience attributes that performed well or not and everything was presented on the importance-performance grids, which can serve managers as guidelines for further development.

  3. Implementing health management information systems: measuring success in Korea's health centers.

    Science.gov (United States)

    Chae, Y M; Kim, S I; Lee, B H; Choi, S H; Kim, I S

    1994-01-01

    This article analyses the effects that the introduction and adoption of a health management information system (HMIS) can have on both the productivity of health center staff as well as on user-satisfaction. The focus is upon the service provided by the Kwonsun Health Center located in Suwon City, Korea. Two surveys were conducted to measure the changes in productivity and adoption (knowledge, persuasion, decision, implementation and confirmation) of health center staff over time. In addition, a third survey was conducted to measure the effects of HMIS on the level of satisfaction perceived by the visitors, by comparing the satisfaction level between the study health center and a similar health center identified as a control. The results suggest that HMIS increased the productivity and satisfaction of the staff but did not increase their persuasion and decision levels; and, that is also succeeded in increasing the levels of visitors' satisfaction with the services provided.

  4. Solid and liquid radioactive waste management of the Nuclear Technology Development Center (CDTN) - NUCLEBRAS

    International Nuclear Information System (INIS)

    Guzella, M.F.R.; Miaw, S.T.W.; Mourao, R.P.; Prado, M.A.S. do; Reis, L.C.A.; Santos, P.O.; Silva, E.M.P.

    1986-01-01

    Low level liquid and solid wastes are produced in several laboratories of the NUCLEAR TECHNOLOGY DEVELOPMENT CENTER (CDTN)-NUCLEBRAS. In the last years, the intensification of technical activities at the Center has increased the radioactive waste volumes. Therefore, the implementation of a Radioactive Waste Management Program has begun. This Program includes the systematic of activities from the waste collection to the transportation for the final disposal. The liquid and solid waste are collected separately in proper containers and stored for later treatment according to the processes available or under development at the Center. (Author) [pt

  5. Solid and liquid radioactive waste management of the Nuclear Technology Development Center (CDTN)- Nuclebras

    International Nuclear Information System (INIS)

    Guzella, M.F.R.; Mourao, R.P.; Reis, L.C.A.; Silva, E.M.P.; Miaw, S.T.W.; Prado, M.A.S.; Santos, P.O.

    1986-01-01

    Low level liquid and solid wastes are produced in several laboratories of the NUCLEAR TECHNOLOGY DEVELOPMENT CENTER (CDTN) - NUCLEBRAS. In the last years, the intensification of technical activities at the Center has increased the radioactive waste volumes. Therefore, the implementation of a Radioactive Waste Management Program has begun. This Program includes the systematic of activities from the waste collection to the transportation for the final disposal. The liquid and solid waste are collected separately in proper containers and stored for later treatment according to the processes available or under development at the Center. (Author) [pt

  6. Japan Link Center (JaLC): link management and DOI assignment for Japanese electronic scholarly contents

    Science.gov (United States)

    Kato, Takafumi; Tsuchiya, Eri; Kubota, Soichi; Miyagawa, Yoshiyuki

    JST, cooperated with several national institutes, is currently developing “Japan Link Center”, which manages Japanese electronic scholarly contents (journal articles, books, dissertations etc.) in an integrated fashion using Digital Object Identifier (DOI). Japan Link Center will manage metadata and whereabouts information of the contents in the digital environment and provide domestic and international linking information, cite/cited information to activate dissemination of S&T information, furthermore, to strengthen transmission of S&T information from Japan. Japan Link Center is expected to be appointed as the 9th DOI registration agency (RA) in the world by the International DOI Foundation (IDF) this spring.

  7. Task analysis and structure scheme for center manager station in large container inspection system

    International Nuclear Information System (INIS)

    Li Zheng; Gao Wenhuan; Wang Jingjin; Kang Kejun; Chen Zhiqiang

    1997-01-01

    LCIS works as follows: the accelerator generates beam pulses which are formed into fan shape; the scanning system drags a lorry with a container passing through the beam in constant speed; the detector array detects the beam penetrating the lorry; the projection data acquisition system reads the projections and completes an inspection image of the lorry. All these works are controlled and synchronized by the center manage station. The author will describe the process of the projection data acquisition in scanning mode and the methods of real-time projection data processing. the task analysis and the structure scheme of center manager station is presented

  8. Disaster recovery using VMware vSphere Replication and vCenter Site Recovery Manager

    CERN Document Server

    GB, Abhilash

    2014-01-01

    This is a step-by-step guide that will help you understand disaster recovery using VMware vSphere Replication 5.5 and VMware vCenter Site Recovery Manager (SRM) 5.5. The topics and configuration procedures are accompanied with relevant screenshots, flowcharts, and logical diagrams that makes grasping the concepts easier. This book is a guide for anyone who is keen on using vSphere Replication or vCenter Site Recovery Manager as a disaster recovery solution. This is an excellent handbook for solution architects, administrators, on-field engineers, and support professionals. Although the book as

  9. Patient-centered disease management (PCDM) for heart failure: study protocol for a randomised controlled trial.

    Science.gov (United States)

    Bekelman, David B; Plomondon, Mary E; Sullivan, Mark D; Nelson, Karin; Hattler, Brack; McBryde, Connor; Lehmann, Kenneth G; Potfay, Jonathan; Heidenreich, Paul; Rumsfeld, John S

    2013-07-09

    Chronic heart failure (HF) disease management programs have reported inconsistent results and have not included comorbid depression management or specifically focused on improving patient-reported outcomes. The Patient Centered Disease Management (PCDM) trial was designed to test the effectiveness of collaborative care disease management in improving health status (symptoms, functioning, and quality of life) in patients with HF who reported poor HF-specific health status. Patients with a HF diagnosis at four VA Medical Centers were identified through population-based sampling. Patients with a Kansas City Cardiomyopathy Questionnaire (KCCQ, a measure of HF-specific health status) score of patients were randomized to receive usual care or the PCDM intervention, which included: (1) collaborative care management by VA clinicians including a nurse, cardiologist, internist, and psychiatrist, who worked with patients and their primary care providers to provide guideline-concordant care management, (2) home telemonitoring and guided patient self-management support, and (3) screening and treatment for comorbid depression. The primary study outcome is change in overall KCCQ score. Secondary outcomes include depression, medication adherence, guideline-based care, hospitalizations, and mortality. The PCDM trial builds on previous studies of HF disease management by prioritizing patient health status, implementing a collaborative care model of health care delivery, and addressing depression, a key barrier to optimal disease management. The study has been designed as an 'effectiveness trial' to support broader implementation in the healthcare system if it is successful. Unique identifier: NCT00461513.

  10. 38 CFR 13.55 - Veterans Service Center Manager to select and appoint or recommend for appointment the person or...

    Science.gov (United States)

    2010-07-01

    ... Manager to select and appoint or recommend for appointment the person or legal entity to receive....55 Veterans Service Center Manager to select and appoint or recommend for appointment the person or.... The Veterans Service Center Manager is authorized to select and appoint (or in the case of a court...

  11. Development of a standardized job description for healthcare managers of metabolic syndrome management programs in Korean community health centers.

    Science.gov (United States)

    Lee, Youngjin; Choo, Jina; Cho, Jeonghyun; Kim, So-Nam; Lee, Hye-Eun; Yoon, Seok-Jun; Seomun, GyeongAe

    2014-03-01

    This study aimed to develop a job description for healthcare managers of metabolic syndrome management programs using task analysis. Exploratory research was performed by using the Developing a Curriculum method, the Intervention Wheel model, and focus group discussions. Subsequently, we conducted a survey of 215 healthcare workers from 25 community health centers to verify that the job description we created was accurate. We defined the role of healthcare managers. Next, we elucidated the tasks of healthcare managers and performed needs analysis to examine the frequency, importance, and difficulty of each of their duties. Finally, we verified that our job description was accurate. Based on the 8 duties, 30 tasks, and 44 task elements assigned to healthcare managers, we found that the healthcare managers functioned both as team coordinators responsible for providing multidisciplinary health services and nurse specialists providing health promotion services. In terms of importance and difficulty of tasks performed by the healthcare managers, which were measured using a determinant coefficient, the highest-ranked task was planning social marketing (15.4), while the lowest-ranked task was managing human resources (9.9). A job description for healthcare managers may provide basic data essential for the development of a job training program for healthcare managers working in community health promotion programs. Copyright © 2014. Published by Elsevier B.V.

  12. Expanding the Use of Time-Based Metering: Multi-Center Traffic Management Advisor

    Science.gov (United States)

    Landry, Steven J.; Farley, Todd; Hoang, Ty

    2005-01-01

    Time-based metering is an efficient air traffic management alternative to the more common practice of distance-based metering (or "miles-in-trail spacing"). Despite having demonstrated significant operational benefit to airspace users and service providers, time-based metering is used in the United States for arrivals to just nine airports and is not used at all for non-arrival traffic flows. The Multi-Center Traffic Management Advisor promises to bring time-based metering into the mainstream of air traffic management techniques. Not constrained to operate solely on arrival traffic, Multi-Center Traffic Management Advisor is flexible enough to work in highly congested or heavily partitioned airspace for any and all traffic flows in a region. This broader and more general application of time-based metering is expected to bring the operational benefits of time-based metering to a much wider pool of beneficiaries than is possible with existing technology. It also promises to facilitate more collaborative traffic management on a regional basis. This paper focuses on the operational concept of the Multi-Center Traffic Management Advisor, touching also on its system architecture, field test results, and prospects for near-term deployment to the United States National Airspace System.

  13. School Age Center Connections: Site-Based Management Strategies for Implementation of Quality Programs.

    Science.gov (United States)

    Willis, Dahna R.

    This paper describes the outcomes of a practicum that initiated site-based-management strategies to support the consistent implementation of a quality school-age child-care program. Implemented at a multisite child-care center, the program sought to enhance staff members' job satisfaction and maximize their opportunities for professional growth…

  14. Measuring Malaysia School Resource Centers' Standards through iQ-PSS: An Online Management Information System

    Science.gov (United States)

    Zainudin, Fadzliaton; Ismail, Kamarulzaman

    2010-01-01

    The Ministry of Education has come up with an innovative way to monitor the progress of 9,843 School Resource Centers (SRCs) using an online management information system called iQ-PSS (Quality Index of SRC). This paper aims to describe the data collection method and analyze the current state of SRCs in Malaysia and explain how the results can be…

  15. A Qualitative Study of Information Technology Managers' Experiences and Perceptions Regarding Outsourced Data Centers

    Science.gov (United States)

    Reid, Eric Justin

    2015-01-01

    This qualitative study explored the perceptions and experiences of IT Managers in publicly traded companies within the San Antonio, Texas area about outsourced data centers. Narrative data was collected using open-ended questions and face-to-face interviews within semi-structured environments. The research questions guided the study: (1)…

  16. Pinon-juniper management research at Corona Range and Livestock Research Center in Central New Mexico

    Science.gov (United States)

    Andres Cibils; Mark Petersen; Shad Cox; Michael Rubio

    2008-01-01

    Description: New Mexico State University's Corona Range and Livestock Research Center (CRLRC) is located in a pinon-juniper (PJ)/grassland ecotone in the southern Basin and Range Province in south central New Mexico. A number of research projects conducted at this facility revolve around soil, plant, livestock, and wildlife responses to PJ woodland management. The...

  17. Design of a consumer health record for supporting the patient-centered management of chronic diseases.

    NARCIS (Netherlands)

    de Clerq, P.A.; Hasman, A.; Wolffenbuttel, B.H.R.

    2001-01-01

    : Medinfo 2001;10(Pt 2):1445-9 Related Articles, Books, LinkOut Design of a consumer health record for supporting the patient-centered management of chronic diseases. de Clercq PA, Hasman A, Wolffenbuttel BH. Department of Medical Informatics, University of Maastricht, Maastricht, The Netherlands.

  18. Tax Exemption Issues Facing Academic Health Centers in the Managed Care Environment.

    Science.gov (United States)

    Jones, Darryll K.

    1997-01-01

    Traditional characteristics of academic health centers are outlined, and conflicts with managed care are identified. Operating strategies designed to resolve the conflicts are discussed in light of tax statutes and regulations, Internal Revenue Service interpretations, and case law. Detailed references are included to provide a complete resource…

  19. Management process invaded Ames as the Center shifted from NACA to NASA oversight. Ames constructed

    Science.gov (United States)

    1968-01-01

    Management process invaded Ames as the Center shifted from NACA to NASA oversight. Ames constructed a review room in its headquarters building where, in the graphical style that prevailed in the 1960's, Ames leadership could review progress against schedule, budget and performance measures. Shown, in October 1965 is Merrill Mead chief of Ames' program and resources office. (for H Julian Allen Retirement album)

  20. A Case Study: An ACT Stress Management Group in a University Counseling Center

    Science.gov (United States)

    Daltry, Rachel M.

    2015-01-01

    The aim of this study was to examine the effectiveness of an acceptance and commitment therapy (ACT) stress management group in a college counseling center setting. This study explored (a) the effectiveness of ACT in increasing participants' ability to tolerate distress, which directly affects their ability to function in a stressful college…

  1. 77 FR 47913 - The National Center for Mobility Management Under FTA's National Research Program

    Science.gov (United States)

    2012-08-10

    ... Management Under FTA's National Research Program AGENCY: Federal Transit Administration (FTA), DOT. ACTION: Notice. SUMMARY: Federal Transit Administration (FTA), as the primary staff agency to the Federal... transportation service delivery. FTA, under its National Research Program, plans to fund a National Center for...

  2. [Management of Grave's disease in the tropics (experience at Bouffard Army Hospital Center in Djibouti].

    Science.gov (United States)

    Coulet, O; Kraemer, P; Leyral, G; Cloatre, G

    2004-01-01

    Based on their experience in managing Grave's disease at the Bouffard Army Hospital Center within the local health care context in Djibouti, the authors advocate surgery as the first line treatment. Medical and economical factors supporting this preference are discussed so that readers can adapt them to his own local context.

  3. Location and distribution management of relief centers: a genetic algorithm approach

    NARCIS (Netherlands)

    Najafi, M.; Farahani, R.Z.; de Brito, M.; Dullaert, W.E.H.

    2015-01-01

    Humanitarian logistics is regarded as a key area for improved disaster management efficiency and effectiveness. In this study, a multi-objective integrated logistic model is proposed to locate disaster relief centers while taking into account network costs and responsiveness. Because this location

  4. Operation and management plan of Rokkasho Low Level Radioactive Waste Disposal Center

    Energy Technology Data Exchange (ETDEWEB)

    Nakanishi, Z.; Tomozawa, T.; Mahara, Y.; Iimura, H. [Japan Nuclear Fuel Ltd., Tokyo (Japan). Radioactive Waste Management Dept.

    1993-12-31

    Japan Nuclear Fuel Limited (JNFL) started the operation of the Rokkasho Low-Level Radioactive Waste Disposal Center in December, 1992. This center is located at Rokkasho Village in Aomori Prefecture. The facility in this center will provide for the disposal of 40,000 m{sup 3} of the low-level radioactive waste (LLW) produced from domestic nuclear power stations. The facility will receive between 5,000 m{sup 3} and 10,000 m{sup 3} of waste every year. Strict and efficient institutional controls, such as the monitoring of the environment and management of the site, is required for about 300 years. This paper provides an outline of the LLW burial operation and management program at the disposal facility. The facility is located 14--19 meters below the ground surface in the hollowed out Takahoko Formation.

  5. Meeting baccalaureate public/community health nursing education competencies in nurse-managed wellness centers.

    Science.gov (United States)

    Thompson, Cheryl W; Bucher, Julia A

    2013-01-01

    The purpose of this article is to describe how community health competencies for baccalaureate nursing education have been met by locating clinical experiences in nurse-managed wellness centers. Such centers are an ideal setting for students to integrate theoretical concepts into clinical practice while building on previous learning. Students are able to develop skills in community health nursing practice at individual, family, and population level. In addition, the practice setting provides other advantages. Clients who represent a vulnerable population group receive valuable health services. Students gain learning opportunities that are broader than community health competencies, and faculty are provided clinical practice, research, and scholarship opportunities. The challenges to year-round sustainability of nurse-managed centers are burdensome; however, the benefits outweigh the difficulty of those challenges. Copyright © 2013 Elsevier Inc. All rights reserved.

  6. Innovation in Innovation Management: The Experience of Petrobras Centers and Networks of Excellence Program

    Directory of Open Access Journals (Sweden)

    Ana Maria de Britto Pires

    2013-04-01

    Full Text Available Since 1996, Petrobras – Petróleo Brasileiro S.A., the biggest company in Latin America, has supported the development of a method to structure networks of partnerships called Centers and Networks of Excellence Practice (PCREX. It aims to support the establishment of centers and networks of excellence in areas in which innovation depends heavily on the articulation of various players from outside the company and different internal areas. This article presents the results of the analysis of the PCREX method, including its characterization and field research carried out in eight Centers and Networks of Excellence developed by Petrobras. The field research and subsequent analysis helped identify (i the alignment between the PCREX method and the best innovation management practices and (ii the difficulties faced by new management models based on resource and knowledge sharing, which highlights that organizational innovations need to be able to count on strong institutional support to succeed.

  7. Operation and management plan of Rokkasho Low Level Radioactive Waste Disposal Center

    International Nuclear Information System (INIS)

    Nakanishi, Z.; Tomozawa, T.; Mahara, Y.; Iimura, H.

    1993-01-01

    Japan Nuclear Fuel Limited (JNFL) started the operation of the Rokkasho Low-Level Radioactive Waste Disposal Center in December, 1992. This center is located at Rokkasho Village in Aomori Prefecture. The facility in this center will provide for the disposal of 40,000 m 3 of the low-level radioactive waste (LLW) produced from domestic nuclear power stations. The facility will receive between 5,000 m 3 and 10,000 m 3 of waste every year. Strict and efficient institutional controls, such as the monitoring of the environment and management of the site, is required for about 300 years. This paper provides an outline of the LLW burial operation and management program at the disposal facility. The facility is located 14--19 meters below the ground surface in the hollowed out Takahoko Formation

  8. Supply Inventory Management: Evaluation of the Defense Supply Center Columbus Qualified Products List and Qualified Manufacturers List Program

    National Research Council Canada - National Science Library

    2002-01-01

    ... was transitioned from the Military Departments. The Defense Supply Center Columbus currently has management responsibility for over 300 Qualified Products Lists and 4 Qualified Manufacturers Lists...

  9. Interconnection Structures, Management and Routing Challenges in Cloud-Service Data Center Networks: A Survey

    Directory of Open Access Journals (Sweden)

    Ahmad Nahar Quttoum

    2018-01-01

    Full Text Available Today’s data center networks employ expensive networking equipments in associated structures that were not designed to meet the increasing requirements of the current large-scale data center services. Limitations that vary between reliability, resource utilization, and high costs are challenging. The era of cloud computing represents a promise to enable large-scale data centers. Computing platforms of such cloud service data centers consist of large number of commodity low-price servers that, with a theme of virtualization on top, can meet the performance of the expensive high-level servers at only a fraction of the price. Recently, the research in data center networks started to evolve rapidly. This opened the path for addressing many of its design and management challenges, these like scalability, reliability, bandwidth capacities, virtual machines’ migration, and cost. Bandwidth resource fragmentation limits the network agility, and leads to low utilization rates, not only for the bandwidth resources, but also for the servers that run the applications. With Traffic Engineering methods, managers of such networks can adapt for rapid changes in the network traffic among their servers, this can help to provide better resource utilization and lower costs. The market is going through exciting changes, and the need to run demanding-scale services drives the work toward cloud networks. These networks that are enabled by the notation of autonomic management, and the availability of commodity low-price network equipments. This work provides the readers with a survey that presents the management challenges, design and operational constraints of the cloud-service data center networks

  10. A management plan for hospitals and medical centers facing radiation incidents

    Directory of Open Access Journals (Sweden)

    Fereshteh Davari

    2015-01-01

    Full Text Available Background: Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. Materials and Methods: In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. Results: We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. Conclusion: With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  11. [The role of county health center in the management of patients with acute coronary syndrome].

    Science.gov (United States)

    Krcmar, Nevenka; Pristas, Ivan; Stevanović, Ranko

    2009-02-01

    Health emergency service teams play an important role in the management of patients with acute coronary syndrome. They have to be educated, equipped, skilful and supported by the entire health care system. The role of county health center in the management of patients with acute coronary syndrome is illustrated in the article, based on the experience acquired at Medimurje County Health Center from Cakovec. The reformed Health Center activities including organization, coordination and linking of teams, population health monitoring at the local level, epidemiologic surveillance, education (active and passive, on both sides of college chair), joint diagnostic and other services, and quality control are discussed in detail. In contrast to a bureaucratic and formal one, a real and innovative reform should take account of necessary changes in the management and organization, not just in standards, rights and obligations. The management protocol for acute coronary syndrome patients is described: setting the main objective (acute coronary disease morbidity and mortality reduction), setting short-term and long-term specific goals, adoption of strategy based on the main objective (education, completion and particular programs pursuit, connecting, collaboration, quality assurance through clinical guidelines and protocols) and other elements, including dignity, leadership, teamwork, adoption and implementation of patient management protocols.

  12. A management plan for hospitals and medical centers facing radiation incidents.

    Science.gov (United States)

    Davari, Fereshteh; Zahed, Arash

    2015-09-01

    Nowadays, application of nuclear technology in different industries has largely expanded worldwide. Proportionately, the risk of nuclear incidents and the resulting injuries have, therefore, increased in recent years. Preparedness is an important part of the crisis management cycle; therefore efficient preplanning seems crucial to any crisis management plan. Equipped with facilities and experienced personnel, hospitals naturally engage with the response to disasters. The main purpose of our study was to present a practical management pattern for hospitals and medical centers in case they encounter a nuclear emergency. In this descriptive qualitative study, data were collected through experimental observations, sources like Safety manuals released by the International Atomic Energy Agency and interviews with experts to gather their ideas along with Delphi method for polling, and brainstorming. In addition, the 45 experts were interviewed on three targeted using brainstorming and Delphi method. We finally proposed a management plan along with a set of practicality standards for hospitals and medical centers to optimally respond to nuclear medical emergencies when a radiation incident happens nearby. With respect to the great importance of preparedness against nuclear incidents adoption and regular practice of nuclear crisis management codes for hospitals and medical centers seems quite necessary.

  13. The impact of managed care and current governmental policies on an urban academic health care center.

    Science.gov (United States)

    Rodriguez, J L; Peterson, D J; Muehlstedt, S G; Zera, R T; West, M A; Bubrick, M P

    2001-10-01

    Managed care and governmental policies have restructured hospital reimbursement. We examined reimbursement trends in trauma care to assess the impact of this market driven change on an urban academic health center. Patients injured between January 1997 and December 1999 were analyzed for Injury Severity Score (ISS), length of hospital stay, hospital cost, payer, and reimbursement. Between 1997 and 1999, the volume of patients with an ISS less than 9 increased and length of stay decreased. In addition, overall cost, payment, and profit margin increased. Commercially insured patients accounted for this margin increase, because the margins of managed care and government insured patients experienced double-digit decreases. Patients with ISS of 9 or greater also experienced a volume increase and a reduction in length of stay; however, costs within this group increased greater than payments, thereby reducing profit margin. Whereas commercially insured patients maintained their margin, managed care and government insured patients did not (double- and triple-digit decreases). Managed care and current governmental policies have a negative impact on urban academic health center reimbursement. Commercial insurers subsidize not only the uninsured but also the government insured and managed care patients as well. National awareness of this issue and policy action are paramount to urban academic health centers and may also benefit commercial insurers.

  14. Pediatric issues in disaster management, part 2: evacuation centers and family separation/reunification.

    Science.gov (United States)

    Mace, Sharon E; Sharieff, Ghazala; Bern, Andrew; Benjamin, Lee; Burbulys, Dave; Johnson, Ramon; Schreiber, Merritt

    2010-01-01

    Although children and infants are likely to be victims in a disaster and are more vulnerable in a disaster than adults, disaster planning and management has often overlooked the specific needs of pediatric patients. We discuss key components of disaster planning and management for pediatric patients including emergency medical services, hospital/facility issues, evacuation centers, family separation/reunification, children with special healthcare needs, mental health issues, and overcrowding/surge capacity. Specific policy recommendations and an appendix with detailed practical information and algorithms are included. The first part of this three part series on pediatric issues in disaster management addresses the emergency medical system from the field to the hospital and surge capacity including the impact of crowding. The second part addresses the appropriate set up and functioning of evacuation centers and family separation and reunification. The third part deals with special patient populations: the special healthcare needs patient and mental health issues.

  15. The Oral Health Care Manager in a Patient-Centered Health Facility.

    Science.gov (United States)

    Theile, Cheryl Westphal; Strauss, Shiela M; Northridge, Mary Evelyn; Birenz, Shirley

    2016-06-01

    The dental hygienist team member has an opportunity to coordinate care within an interprofessional practice as an oral health care manager. Although dental hygienists are currently practicing within interprofessional teams in settings such as pediatric offices, hospitals, nursing homes, schools, and federally qualified health centers, they often still assume traditional responsibilities rather than practicing to the full extent of their training and licenses. This article explains the opportunity for the dental hygiene professional to embrace patient-centered care as an oral health care manager who can facilitate integration of oral and primary care in a variety of health care settings. Based on an innovative model of collaboration between a college of dentistry and a college of nursing, an idea emerged among several faculty members for a new management method for realizing continuity and coordination of comprehensive patient care. Involved faculty members began working on the development of an approach to interprofessional practice with the dental hygienist serving as an oral health care manager who would address both oral health care and a patient's related primary care issues through appropriate referrals and follow-up. This approach is explained in this article, along with the results of several pilot studies that begin to evaluate the feasibility of a dental hygienist as an oral health care manager. A health care provider with management skills and leadership qualities is required to coordinate the interprofessional provision of comprehensive health care. The dental hygienist has the opportunity to lead closer integration of oral and primary care as an oral health care manager, by coordinating the team of providers needed to implement comprehensive, patient-centered care. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. A workshop on asthma management programs and centers in Brazil: reviewing and explaining concepts*

    Science.gov (United States)

    Stelmach, Rafael; Neto, Alcindo Cerci; Fonseca, Ana Cristina de Carvalho Fernandez; Ponte, Eduardo Vieira; Alves, Gerardo; Araujo-Costa, Ildely Niedia; Lasmar, Laura Maria de Lima Belizário Facury; de Castro, Luci Keiko Kuromoto; Lenz, Maria Lucia Medeiros; Silva, Paulo; Cukier, Alberto; Alves, Alexssandra Maia; Lima-Matos, Aline Silva; Cardoso, Amanda da Rocha Oliveira; Fernandes, Ana Luisa Godoy; de São-José, Bruno Piassi; Riedi, Carlos Antônio; Schor, Deborah; Peixoto, Décio Medeiros; Brandenburg, Diego Djones; Camillo, Elineide Gomes dos Santos; Serpa, Faradiba Sarquis; Brandão, Heli Vieira; Lima, João Antonio Bonfadini; Pio, Jorge Eduardo; Fiterman, Jussara; Anderson, Maria de Fátima; Cardoso, Maria do Socorro de Lucena; Rodrigues, Marcelo Tadday; Pereira, Marilyn Nilda Esther Urrutia; Antila, Marti; Martins, Sonia Maria; Guimarães, Vanessa Gonzaga Tavares; Mello, Yara Arruda Marques; de Andrade, Wenderson Clay Correia; Salibe-Filho, William; Caldeira, Zelina Maria da Rocha; da Cruz-Filho, Álvaro Augusto Souza; Camargos, Paulo

    2015-01-01

    Objective: To report the results of a workshop regarding asthma management programs and centers (AMPCs) in Brazil, so that they can be used as a tool for the improvement and advancement of current and future AMPCs. Methods: The workshop consisted of five presentations and the corresponding group discussions. The working groups discussed the following themes: implementation of asthma management strategies; human resources needed for AMPCs; financial resources needed for AMPCs; and operational maintenance of AMPCs. Results: The workshop involved 39 participants, from all regions of the country, representing associations of asthma patients (n = 3), universities (n = 7), and AMPCs (n = 29). We found a direct relationship between a lack of planning and the failure of AMPCs. Based on the experiences reported during the workshop, the common assumptions about AMPCs in Brazil were the importance of raising awareness of managers; greater community participation; interdependence between primary care and specialized care; awareness of regionalization; and use of medications available in the public health system. Conclusions: Brazil already has a core of experience in the area of asthma management programs. The implementation of strategies for the management of chronic respiratory disease and their incorporation into health care system protocols would seem to be a natural progression. However, there is minimal experience in this area. Joint efforts by individuals with expertise in AMPCs could promote the implementation of asthma management strategies, thus speeding the creation of treatment networks, which might have a multiplier effect, precluding the need for isolated centers to start from zero. PMID:25750669

  17. Final priority; Technical Assistance on State Data Collection--IDEA Data Management Center. Final priority.

    Science.gov (United States)

    2014-08-05

    The Assistant Secretary for the Office of Special Education and Rehabilitative Services (OSERS) announces a priority under the Technical Assistance on State Data Collection program. The Assistant Secretary may use this priority for competitions in fiscal year (FY) 2014 and later years. We take this action to fund a cooperative agreement to establish and operate an IDEA Data Management Center (Center) that will provide technical assistance (TA) to improve the capacity of States to meet the data collection requirements of the Individuals with Disabilities Education Act (IDEA).

  18. Comparison of quality control for trauma management between Western and Eastern European trauma center

    Directory of Open Access Journals (Sweden)

    Gambale Giorgio

    2008-11-01

    Full Text Available Abstract Background Quality control of trauma care is essential to define the effectiveness of trauma center and trauma system. To identify the troublesome issues of the system is the first step for validation of the focused customized solutions. This is a comparative study of two level I trauma centers in Italy and Romania and it has been designed to give an overview of the entire trauma care program adopted in these two countries. This study was aimed to use the results as the basis for recommending and planning changes in the two trauma systems for a better trauma care. Methods We retrospectively reviewed a total of 182 major trauma patients treated in the two hospitals included in the study, between January and June 2002. Every case was analyzed according to the recommended minimal audit filters for trauma quality assurance by The American College of Surgeons Committee on Trauma (ACSCOT. Results Satisfactory yields have been reached in both centers for the management of head and abdominal trauma, airway management, Emergency Department length of stay and early diagnosis and treatment. The main significant differences between the two centers were in the patients' transfers, the leadership of trauma team and the patients' outcome. The main concerns have been in the surgical treatment of fractures, the outcome and the lacking of documentation. Conclusion The analyzed hospitals are classified as Level I trauma center and are within the group of the highest quality level centers in their own countries. Nevertheless, both of them experience major lacks and for few audit filters do not reach the mmum standard requirements of ACS Audit Filters. The differences between the western and the eastern European center were slight. The parameters not reaching the minimum requirements are probably occurring even more often in suburban settings.

  19. Human resources management in fitness centers and their relationship with the organizational performance

    Directory of Open Access Journals (Sweden)

    Jerónimo García Fernández

    2014-12-01

    Full Text Available Purpose: Human capital is essential in organizations providing sports services. However, there are few studies that examine what practices are carried out and whether they, affect sports organizations achieve better results are. Therefore the aim of this paper is to analyze the practices of human resource management in private fitness centers and the relationship established with organizational performance.Design/methodology/approach: Questionnaire to 101 managers of private fitness centers in Spain, performing exploratory and confirmatory factor analysis, and linear regressions between the variables.Findings: In organizations of fitness, the findings show that training practices, reward, communication and selection are positively correlated with organizational performance.Research limitations/implications: The fact that you made a convenience sampling in a given country and reduce the extrapolation of the results to the market.Originality/value: First, it represents a contribution to the fact that there are no studies analyzing the management of human resources in sport organizations from the point of view of the top leaders. On the other hand, allows fitness center managers to adopt practices to improve organizational performance.

  20. Evidence-Informed Leadership in the Japanese Context: Middle Managers at a University Self-Access Center

    Science.gov (United States)

    Adamson, John; Brown, Howard

    2012-01-01

    This study reports on the steering of a self-access learning center in a Japanese university by its "middle management" committee over the first years of its operation. Middle management practice was informed by an ethnographic archive of various facets of center use, particularly concerning language policy and curriculum integration, issues about…

  1. Practice of knowledge management in Prototype and Plant Development Center (PDC)

    International Nuclear Information System (INIS)

    Mohamad Safuan Sulaiman; Rapieh Aminuddin; Rosli Darmawan; Mohd Ashhar Khalid

    2007-01-01

    As reflecting the evolvement and movement of world economy direction, Malaysia move one step a head towards knowledge based economy (K-Economy). The movement indirectly changes the Malaysian Nuclear Agency (Nuclear Malaysia) environment to contribute to the K-Economy in the field of science and technology. Therefore, the practice of knowledge management is slowly introduced to the Nuclear Malaysia community to support the K-Economy. This paper describes the detail of the practice of knowledge management at macro and micro level in an organization. The Prototype and Plant Development Center(PDC) under the Technical Support Division, Technical Service Program has been chosen to be the case study in implementing the practice of knowledge management in Nuclear Malaysia. The main objective of this paper is to introduce the right practice of Knowledge management in an organization and PDC as among the first case for this purpose. (Author)

  2. A study on call/contact centers' inbound and outbound management process in Mexico

    Directory of Open Access Journals (Sweden)

    Luis Felipe Llanos Reynoso

    2016-12-01

    Full Text Available One challenge related to contact center management involves determining which process best serves customers, inbound or outbound. Such decisions impact the number of service agents available for operations, affecting costs. The size of the call centers market worldwide is estimated to reach $337 billion dollars by 2018. This industry employs 670,000 people in Mexico. A series of equations for calculating the difference in the number of service agents required by the two processes is determined using the direct demo method. Developed theorems and corollary may help simplify decision-making processes. The findings demonstrate that the number of agents required for both processes depends on the percentage of customers served at each location and on service agent occupation rates. The study recommends some best practices to the Mexican call center industry in order to improve its profits and quality within the inbound outbound services.

  3. A knowledge continuity management program for the energy, infrastructure and knowledge systems center, Sandia National Laboratories.

    Energy Technology Data Exchange (ETDEWEB)

    Menicucci, David F.

    2006-07-01

    A growing recognition exists in companies worldwide that, when employees leave, they take with them valuable knowledge that is difficult and expensive to recreate. The concern is now particularly acute as the large ''baby boomer'' generation is reaching retirement age. A new field of science, Knowledge Continuity Management (KCM), is designed to capture and catalog the acquired knowledge and wisdom from experience of these employees before they leave. The KCM concept is in the final stages of being adopted by the Energy, Infrastructure, and Knowledge Systems Center and a program is being applied that should produce significant annual cost savings. This report discusses how the Center can use KCM to mitigate knowledge loss from employee departures, including a concise description of a proposed plan tailored to the Center's specific needs and resources.

  4. Conceptual design report, Hazardous Materials Management and Emergency Response (HAMMER) Training Center

    Energy Technology Data Exchange (ETDEWEB)

    Kelly, K.E. [Westinghouse Hanford Co., Richland, WA (United States)

    1994-11-09

    For the next 30 years, the main activities at the US Department of Energy (DOE) Hanford Site will involve the management, handling, and cleanup of toxic substances. If the DOE is to meet its high standards of safety, the thousands of workers involved in these activities will need systematic training appropriate to their tasks and the risks associated with these tasks. Furthermore, emergency response for DOE shipments is the primary responsibility of state, tribal, and local governments. A collaborative training initiative with the DOE will strengthen emergency response at the Hanford Site and within the regional communities. Local and international labor has joined the Hazardous Materials Management and Emergency Response (HAMMER) partnership, and will share in the HAMMER Training Center core programs and facilities using their own specialized trainers and training programs. The HAMMER Training Center will provide a centralized regional site dedicated to the training of hazardous material, emergency response, and fire fighting personnel.

  5. Conceptual design report, Hazardous Materials Management and Emergency Response (HAMMER) Training Center

    International Nuclear Information System (INIS)

    Kelly, K.E.

    1994-01-01

    For the next 30 years, the main activities at the US Department of Energy (DOE) Hanford Site will involve the management, handling, and cleanup of toxic substances. If the DOE is to meet its high standards of safety, the thousands of workers involved in these activities will need systematic training appropriate to their tasks and the risks associated with these tasks. Furthermore, emergency response for DOE shipments is the primary responsibility of state, tribal, and local governments. A collaborative training initiative with the DOE will strengthen emergency response at the Hanford Site and within the regional communities. Local and international labor has joined the Hazardous Materials Management and Emergency Response (HAMMER) partnership, and will share in the HAMMER Training Center core programs and facilities using their own specialized trainers and training programs. The HAMMER Training Center will provide a centralized regional site dedicated to the training of hazardous material, emergency response, and fire fighting personnel

  6. Manual to radioactive waste management produced in hospitals, research and education centers

    International Nuclear Information System (INIS)

    Villasenor N, L.F.; Mejia L, M.

    1996-01-01

    This manual collects the experience on the disposal and management of the wastes produced in the preparation and application of radioactive material. Although the content is not so extensive, the authors have tried to provide the necessary guidelines and adequate information for the management of the wastes produced in hospitals and research and education centers. The objective of this work is to describe the basis and principles for the establishment of a minimization program, a segregation program and a provisional waste storage, in order to reduce the generation of wastes, personal exposure and the environmental impact. (authors). 5 refs

  7. Breast Imaging: How We Manage Diagnostic Technology at a Multidisciplinary Breast Center

    Directory of Open Access Journals (Sweden)

    Alejandro Tejerina Bernal

    2012-01-01

    Full Text Available This paper discusses the most important aspects and problems related to the management of breast cancer imaging, at a center specialized in breast pathology. We review the established and emerging diagnostic techniques, their indications, and peculiarities: digital mammography, CAD systems, and the recent digital breast tomosynthesis, ultrasound and complementary elastography, molecular imaging techniques, magnetic resonance imaging, advanced sequences (diffusion, and positron emission mammography (PEM. The adequate integration and rational management of these techniques is essential, but this is not always easy, in order to achieve a successful diagnosis.

  8. Technological drivers in data centers and telecom systems: Multiscale thermal, electrical, and energy management

    International Nuclear Information System (INIS)

    Garimella, Suresh V.; Persoons, Tim; Weibel, Justin; Yeh, Lian-Tuu

    2013-01-01

    Highlights: ► Thermal management approaches reviewed against energy usage of IT industry. ► Challenges of energy efficiency in large-scale electronic systems highlighted. ► Underlying drivers for progress at the business and technology levels identified. ► Thermal, electrical and energy management challenges discussed as drivers. ► Views of IT system operators, manufacturers and integrators represented. - Abstract: We identify technological drivers for tomorrow’s data centers and telecommunications systems, including thermal, electrical and energy management challenges, based on discussions at the 2nd Workshop on Thermal Management in Telecommunication Systems and Data Centers in Santa Clara, California, on April 25–26, 2012. The relevance of thermal management in electronic systems is reviewed against the background of the energy usage of the information technology (IT) industry, encompassing perspectives of different sectors of the industry. The underlying drivers for progress at the business and technology levels are identified. The technological challenges are reviewed in two main categories – immediate needs and future needs. Enabling cooling techniques that are currently under development are also discussed

  9. Status of the technical project design phase of the German Waste Management Center

    International Nuclear Information System (INIS)

    Mischke, J.

    1978-01-01

    Under the waste management concept of the German Federal Government the utilities are to assume responsibility for waste management of the German nuclear power plants within the framework of the polluter pays principle, the ultimate storage of radioactive waste remaining a responsibility of the government. The duties of industry chiefly include planning, construction and operation of the facilities for fuel element storage, reprocessing and waste treatment and for processing the recovered nuclear fuel. The German utilities operating and planning nuclear power plants have set up the Deutsche Gesellschaft fuer Wiederaufarbeitung von Kernbrennstoffen mbH (DWK), which is to build the Waste Management Center and also works on the interim solutions planned for continuous waste management up to the completion of the planned Waste Management Center. For this purpose, DWK plans to construct temporary fuel storage facilities and has entered into agreements to secure reprocessing abroad of fuel elements from German nuclear power plants. In discharging its obligations DWK has acquired the extensive know-how available in the Federal Republic in the field of reprocessing spent fuel elements. (orig.) [de

  10. A center for self-management of chronic illnesses in diverse groups.

    Science.gov (United States)

    Inouye, Jillian; Boland, Mary G; Nigg, Claudio R; Sullivan, Kathleen; Leake, Anne; Mark, Debra; Albright, Cheryl L

    2011-01-01

    Prevention and successful treatment of chronic disease require a scientific understanding of the impacts and interactions of ethnicity, culture, and illness on self-management interventions. This article presents one approach to developing effective methods to address the needs of ethnic minorities living with chronic illnesses. Described is the University of Hawaii Center for Ohana Self-Management of Chronic Illnesses (COSMCI) located in the School of Nursing & Dental Hygiene and funded by the National Institute of Nursing Research (Award Number P20NR010671). The interdisciplinary center focuses on family and community self-management interventions in ethnically diverse populations with chronic illnesses. Areas discussed are: 1) the operational structure for creating an environment conducive to interdisciplinary ohana self-management chronic illness research in ethnically diverse populations; and 2) the development of sustainable interdisciplinary, biobehavioral research capacity. The COSMCI uses a social cognitive theory framework to guide the application of established self-management interventions to Asian and Pacific Island populations (API) through three conceptually linked research projects on HIV infection, type 2 diabetes, and chronic obstructive pulmonary disease. COSMI addresses the feasibility of sharing of lessons learned among the approaches taken. The interdisciplinary nature of COSMCI increases the potential success of the intervention efforts. Hawaii Medical Journal Copyright 2010.

  11. Management of pediatric blunt splenic injury at a rural trauma center.

    Science.gov (United States)

    Bird, Julio J; Patel, Nirav Y; Mathiason, Michelle A; Schroeppel, Thomas J; D'huyvetter, Cecile J; Cogbill, Thomas H

    2012-10-01

    Patterns for nonoperative management of pediatric blunt splenic injuries (BSIs) vary significantly within and between institutions. The indications for repeated imaging, duration of activity restrictions, as well as the impact of volume and type of trauma center (pediatric vs. adult) on outcomes remain unclear. A retrospective review of all patients younger than 16 years with BSI managed at a rural American College of Surgeons-verified adult Level II trauma center from January 1995 to December 2008 was completed. Patients were identified from the trauma registry by DRG International Classification of Diseases-9th Rev. (865.00-865.09) and management codes (41.5, 41.43, and 41.95). Variables reviewed included demographics, mechanism of injury, Injury Severity Score, grade of splenic injury, degree of hemoperitoneum, presence of arterial phase contrast blush on computed tomography at admission, admission and nadir hemoglobin level, blood transfused, length of stay, disposition, outpatient clinical and radiographic follow-up, interval of return to unrestricted activity, and clinical outcomes. During the 13-year study period, 38 children with BSI were identified. Thirty-seven (97%) were successfully managed nonoperatively. Median grade of splenic injury was 3 (range, 1-5); 73% had moderate-to-large hemoperitoneum. Median Injury Severity Score was 10 (range, 4-34). Three patients with isolated contrast blush on initial computed tomography were successfully managed nonoperatively with no angiographic intervention. One patient failed nonoperative management and underwent successful splenorrhaphy. All patients were discharged home. Thirty-day mortality was zero. Median follow-up duration was 5.5 years, with no late complications identified. Of the patients successfully managed nonoperatively, 92% had their follow-up at our institution; 74% underwent subsequent imaging, and none resulted in intervention or alteration of management plan. Pediatric BSI can be managed in adult

  12. Alternative Center of emergency Management; Centro alternativo de gestion de la emergencia

    Energy Technology Data Exchange (ETDEWEB)

    Turrion Lopez, F.

    2013-07-01

    Requirements and general considerations The alternative Center for emergency management (CAGE) is the project engineering and construction that have operating NPPS Spanish in December 2015. It will allow to support the Organization of response to Emergencies, combining the continuity of mitigation actions of the accident with rest and protection of staff, accommodating such executions. Depending on the State of the plant and the evolution of the emergency. The CSN and UNESA have been progressively defined the detailed criteria that has of design CAGE.

  13. Technical Data Management Center: a focal point for meteorological and other environmental transport computing technology

    International Nuclear Information System (INIS)

    McGill, B.; Maskewitz, B.F.; Trubey, D.K.

    1981-01-01

    The Technical Data Management Center, collecting, packaging, analyzing, and distributing information, computer technology and data which includes meteorological and other environmental transport work is located at the Oak Ridge National Laboratory, within the Engineering Physics Division. Major activities include maintaining a collection of computing technology and associated literature citations to provide capabilities for meteorological and environmental work. Details of the activities on behalf of TDMC's sponsoring agency, the US Nuclear Regulatory Commission, are described

  14. Medical waste management in Jordan: A study at the King Hussein Medical Center

    International Nuclear Information System (INIS)

    Oweis, Rami; Al-Widyan, Mohamad; Al-Limoon, Ohood

    2005-01-01

    As in many other developing countries, the generation of regulated medical waste (RMW) in Jordan has increased significantly over the last few decades. Despite the serious impacts of RMW on humans and the environment, only minor attention has been directed to its proper handling and disposal. This study was conducted in the form of a case study at one of Jordan's leading medical centers, namely, the King Hussein Medical Center (KHMC). Its purpose was to report on the current status of medical waste management at KHMC and propose possible measures to improve it. In general, it was found that the center's administration was reasonably aware of the importance of medical waste management and practiced some of the measures to adequately handle waste generated at the center. However, it was also found that significant voids were present that need to be addressed in the future including efficient segregation, the use of coded and colored bags, better handling and transfer means, and better monitoring and tracking techniques, as well as the need for training and awareness programs for the personnel

  15. Integrated Pest Management Intervention in Child Care Centers Improves Knowledge, Pest Control, and Practices.

    Science.gov (United States)

    Alkon, Abbey; Nouredini, Sahar; Swartz, Alicia; Sutherland, Andrew Mason; Stephens, Michelle; Davidson, Nita A; Rose, Roberta

    To reduce young children's exposure to pests and pesticides, an integrated pest management (IPM) intervention was provided for child care center staff. The 7-month IPM education and consultation intervention was conducted by trained nurse child care health consultants in 44 child care centers in California. IPM knowledge surveys were completed by child care staff, objective IPM assessments were completed by research assistants pre- and postintervention, and activity logs were completed by the nurses. There were significant increases in IPM knowledge for the child care staff who attended workshops. There were reductions in the prevalence of pests and increases in IPM practices at the postintervention compared with the preintervention time point. The nurses consulted an average of 5.4 hours per center. A nurse-led IPM intervention in child care centers can reduce exposure to harmful substances for young children attending child care centers. Copyright © 2016 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.

  16. Strategies to improve chronic disease management in seven metro Boston community health centers.

    Science.gov (United States)

    Ndumele, Chima D; Russell, Beverley E; Ayanian, John Z; Landon, Bruce E; Keegan, Thomas; O'Malley, A James; Hicks, Leroi S

    2009-01-01

    The Community, Health Center, and Academic Medicine Partnership Project (CHAMPP) is a partnership between medical researchers, community health centers (CHCs), and a community advisory committee focused on reducing cardiovascular morbidity related to hypertension and diabetes for non-Hispanic Black and Hispanic populations in Boston, Massachusetts. We conducted site visits at seven participating CHCs, located in Boston. The visits were to solicit health center staff opinions about site-specific barriers and enabling factors for optimum preventative cardiovascular care for racial/ethnic minority patients receiving hypertension and diabetes care at their centers. Site visits included a tour of each health center and a series of directed interviews with center personnel. Site visit notes were reviewed to identify themes that emerged during the course of each site visit. A summary matrix was developed for each health center, which included information regarding the most salient and persistent themes of the visit. Site visits uncovered several patient-, provider-, CHC-, and community-based factors that either facilitate or hinder optimal care of chronic disease patients. Commonly referenced barriers included the need for improved patient adherence to provider recommendations; insufficient time for providers to address complex health issues presented by patients and the need for a broader range of healthier food options in surrounding communities. Interactive patient groups and community health workers (CHWs) have been well received when implemented. Recommendations included adopting case management as a part of usual care for chronic disease patients; additionally, widespread implementation of CHWs may to provide a platform for more comprehensive care for patients.

  17. Comparison of poisonings managed at military and Veterans Administration hospitals reported to Texas poison centers.

    Science.gov (United States)

    Forrester, M B

    2017-01-01

    There is little information on poisonings managed at military and Veterans Administration (VA) hospitals. This investigation described and compared poisonings reported to Texas poison centers that were managed at military and VA hospitals. Retrospective analysis of poison centre data. Cases were poisonings among patients aged 18 years or more reported to Texas poison centers during 2000-2015 where management occurred at a military or VA hospital. The distribution of exposures for various demographic and clinical factors was determined for military and veterans hospitals and comparisons were made between the two groups. There were 4353 and 1676 poisonings managed at military and VA hospitals, resepctively. Males accounted for 50.5% of the military hospital patients and 84.9% of the VA hospital patients. The mean age for military hospital patients was 31 years and for VA hospital patients was 50 years. The proportion of poisonings managed at military hospitals and VA hospitals, respectively, were intentional (70.0% vs 64.1%), particularly suspected attempted suicide (57.3% vs 47.7%), and unintentional (25.0% vs 30.5%). More than one substance was reported in 37.7% of military and 33.2% of VA hospital poisonings. The most commonly reported substance categories for poisonings managed at military and VA hospitals, respectively, were analgesics (28.4% vs 19.7%), sedatives/hypnotics/antipsychotics (24.7% vs 23.4%), antidepressants (18.7% vs 19.7%) and alcohol (11.3% vs 10.6%). A number of differences were observed between poisonings managed at military and VA hospitals. These differing patterns of poisonings may need to be taken into account in the education, prevention and treatment of poisonings at these hospitals and among the populations they serve. Copyright © 2016 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  18. Healthcare waste generation and management practice in government health centers of Addis Ababa, Ethiopia.

    Science.gov (United States)

    Tadesse, Menelik Legesse; Kumie, Abera

    2014-11-25

    Healthcare wastes are hazardous organic and inorganic wastes. The waste disposal management in Addis Ababa city is seen unscientific manner. The waste management practice in the health facilities are poor and need improvement. This study will help different organizations, stakeholders and policy makers to correct and improve the existing situation of healthcare waste legislation and enforcement and training of staff in the healthcare facilities in Addis Ababa. The study aimed to assess the existing generation and management practice of healthcare waste in selected government health centers of Addis Ababa. The cross-sectional study was conducted to quantify waste generation rate and evaluate its management system. The study area was Addis Ababa. The sample size was determined by simple random sampling technique, the sampling procedure involved 10 sub-cities of Addis Ababa. Data were collected using both waste collecting and measuring equipment and check list. The Data was entered by EPI INFO version 6.04d and analyzed by and SPSS for WINDOW version15. The mean (±SD) healthcare waste generation rate was 9.61 ± 3.28 kg/day of which (38%) 3.64 ± 1.45 kg/day was general or non-hazardous waste and (62%) 5.97 ± 2.31 kg/day was hazardous. The mean healthcare waste generation rate between health centers was a significant different with Kurskal-Wallis test (χ2 = 21.83, p-value = 0.009). All health centers used safety boxes for collection of sharp wastes and all health centers used plastic buckets without lid for collection and transportation of healthcare waste. Pre treatment of infectious wastes was not practiced by any of the health centers. All health centers used incinerators and had placenta pit for disposal of pathological waste however only seven out of ten pits had proper covering material. Segregation of wastes at point of generation with appropriate collection materials and pre- treatment of infectious waste before disposal should be practiced

  19. Outcome differences in adolescent blunt severe polytrauma patients managed at pediatric versus adult trauma centers.

    Science.gov (United States)

    Rogers, Amelia T; Gross, Brian W; Cook, Alan D; Rinehart, Cole D; Lynch, Caitlin A; Bradburn, Eric H; Heinle, Colin C; Jammula, Shreya; Rogers, Frederick B

    2017-12-01

    Previous research suggests adolescent trauma patients can be managed equally effectively at pediatric and adult trauma centers. We sought to determine whether this association would be upheld for adolescent severe polytrauma patients. We hypothesized that no difference in adjusted outcomes would be observed between pediatric trauma centers (PTCs) and adult trauma centers (ATCs) for this population. All severely injured adolescent (aged 12-17 years) polytrauma patients were extracted from the Pennsylvania Trauma Outcomes Study database from 2003 to 2015. Polytrauma was defined as an Abbreviated Injury Scale (AIS) score ≥3 for two or more AIS-defined body regions. Dead on arrival, transfer, and penetrating trauma patients were excluded from analysis. ATC were defined as adult-only centers, whereas standalone pediatric hospitals and adult centers with pediatric affiliation were considered PTC. Multilevel mixed-effects logistic regression models assessed the adjusted impact of center type on mortality and total complications while controlling for age, shock index, Injury Severity Score, Glasgow Coma Scale motor score, trauma center level, case volume, and injury year. A generalized linear mixed model characterized functional status at discharge (FSD) while controlling for the same variables. A total of 1,606 patients met inclusion criteria (PTC: 868 [54.1%]; ATC: 738 [45.9%]), 139 (8.66%) of which died in-hospital. No significant difference in mortality (adjusted odds ratio [AOR]: 1.10, 95% CI 0.54-2.24; p = 0.794; area under the receiver operating characteristic: 0.89) was observed between designations in adjusted analysis; however, FSD (AOR: 0.38, 95% CI 0.15-0.97; p = 0.043) was found to be lower and total complication trends higher (AOR: 1.78, 95% CI 0.98-3.32; p = 0.058) at PTC for adolescent polytrauma patients. Contrary to existing literature on adolescent trauma patients, our results suggest patients aged 12-17 presenting with polytrauma may experience

  20. Pain management in cancer center inpatients: a cluster randomized trial to evaluate a systematic integrated approach—The Edinburgh Pain Assessment and Management Tool

    OpenAIRE

    Fallon, M; Walker, J; Colvin, L; Rodriguez, A; Murray, G; Sharpe, M

    2018-01-01

    Purpose Pain is suboptimally managed in patients with cancer. We aimed to compare the effect of a policy of adding a clinician-delivered bedside pain assessment and management tool (Edinburgh Pain Assessment and management Tool [EPAT]) to usual care (UC) versus UC alone on pain outcomes. Patients and Methods In a two-arm, parallel group, cluster randomized (1:1) trial, we observed pain outcomes in 19 cancer centers in the United Kingdom and then randomly assigned the centers to eithe...

  1. [Toxicological consultation data management system based on experience of Pomeranian Center of Toxicology].

    Science.gov (United States)

    Kabata, Piotr Maciej; Waldman, Wojciech; Sein Anand, Jacek

    2015-01-01

    In this paper the structure of poisonings is described, based on the material collected from tele-toxicology consults by the Pomeranian Center of Toxicology in Gdańsk and harvested from its Electronic Poison Information Management System. In addition, we analyzed conclusions drawn from a 27-month operation of the system. Data were harvested from the Electronic Poison Information Management System developed in 2012 and used by the Pomeranian Center of Toxicology since then. The research was based on 2550 tele-toxicology consults between January 1 and December 31, 2014. Subsequently the data were electronically cleaned and presented using R programming language. The Pomeranian voivodeship was the prevalent localisation of calls (N = 1879; 73.7%). Most of the calls came from emergency rooms (N = 1495; 58.63%). In the case of 1396 (54.7%) patients the time-lag between intoxication and the consult was less than 6 h. There were no differences in the age distribution between genders. Mean age was 26.3 years. Young people predominated among intoxicated individuals. The majority of intoxications were incidental (N = 888; 34.8%) or suicidal (N = 814; 31.9%) and the most of them took place in the patient's home. Information about Poison Control Center consultations access should be better spread among medical service providers. The extent of poison information collected by Polish Poison Control Centers should be limited and unified. This should contribute to the increased percentage of properly documented consultations. Additional duties stemming from the need of digital archiving of consults provided, require the involvement of additional staff, leading to the increased operation costs incurred by Poison Control Centers. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  2. Aging Management Guideline for commercial nuclear power plants: Motor control centers

    International Nuclear Information System (INIS)

    Toman, G.; Gazdzinski, R.; O'Hearn, E.

    1994-02-01

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

  3. Prevalence and Associated Factors of Eating Disorders in Weight Management Centers in Tanta, Egypt.

    Science.gov (United States)

    Eladawi, Noha; Helal, Randah; Niazy, Nermeen A; Abdelsalam, Sherehan

    2018-01-05

    Eating disorders (EDs) are serious illnesses associated with medical complications and have been increased, especially among societies with an excessive concern about weight, shape, or appearance. This study aimed to investigate the prevalence of EDs among the individuals attending weight management centers and its associated factors. A cross-sectional study was carried out among individuals attending four weight management centers in Tanta, Gharbia Governorate, Egypt during the period from July to December 2016. Precoded interview questionnaires were used to identify the following data: sociodemographic characteristics and medical history of depression or psychological disorders and the Eating Attitude Test (EAT-40) was used to assess the attitudes, behavior, and traits associated with the EDs. A total of 400 participants (112 males and 288 females) were included in the study. According to EAT-40 questionnaires, the prevalence of positive and negative EDs was 65.0% (n = 260) and 35.0% (n = 140), respectively. EDs were more likely reported by females, married singles, rural residents, those with higher education, and nonworking or part-time working patients, those who were overweight or obese, and who were suffering from depression or any psychological problems. Logistic regression analysis revealed that the independent predictors of EDs were age (adjusted odds ratio [OR]: 1.06), nonworking (adjusted OR: 2.32) or part-time working (adjusted OR: 2.18), increased body weight (adjusted OR: 2.66 for overweight and adjusted OR: 1.24 for obese), and having a history of depression or any psychological problem (adjusted OR: 2.76). Factor analysis of EAT-40 revealed four factors (eating behavior, diet-related lifestyle, weight concern, and food preoccupation) that were responsible for 33.2% of the total variance. EDs are prevalent among individuals attending the weight management centers in a northern city in Egypt. Specific management strategies are warranted to address

  4. Rehabilitation centers in change: participatory methods for managing redesign and renovation.

    Science.gov (United States)

    Lahtinen, Marjaana; Nenonen, Suvi; Rasila, Heidi; Lehtelä, Jouni; Ruohomäki, Virpi; Reijula, Kari

    2014-01-01

    The aim of this article is to describe a set of participatory methods that we have either developed or modified for developing future work and service environments to better suit renewable rehabilitation processes. We discuss the methods in a larger framework of change process model and participatory design. Rehabilitation organizations are currently in transition; customer groups, financing, services, and the processes of rehabilitation centers are changing. The pressure for change challenges the centers to develop both their processes and facilities. There is a need for methods that support change management. Four participatory methods were developed: future workshop, change survey, multi-method assessment tool, and participatory design generator cards. They were tested and evaluated in three rehabilitation centers at the different phases of their change process. The developed methods were considered useful in creating a mutual understanding of the change goals between different stakeholders, providing a good picture of the work community's attitudes toward the change, forming an integrated overview of the built and perceived environment, inspiring new solutions, and supporting the management in steering the change process. The change process model described in this article serves as a practical framework that combined the viewpoints of organizational and facility development. However, participatory design continues to face challenges concerning communication between different stakeholders, and further development of the methods and processes is still needed. Intervention studies could provide data on the success factors that enhance the transformations in the rehabilitation sector. Design process, methodology, organizational transformation, planning, renovation.

  5. Data Management Coordinators Monitor STS-78 Mission at the Huntsville Operations Support Center

    Science.gov (United States)

    1996-01-01

    Launched on June 20, 1996, the STS-78 mission's primary payload was the Life and Microgravity Spacelab (LMS), which was managed by the Marshall Space Flight Center (MSFC). During the 17 day space flight, the crew conducted a diverse slate of experiments divided into a mix of life science and microgravity investigations. In a manner very similar to future International Space Station operations, LMS researchers from the United States and their European counterparts shared resources such as crew time and equipment. Five space agencies (NASA/USA, European Space Agency/Europe (ESA), French Space Agency/France, Canadian Space Agency /Canada, and Italian Space Agency/Italy) along with research scientists from 10 countries worked together on the design, development and construction of the LMS. This photo represents Data Management Coordinators monitoring the progress of the mission at the Huntsville Operations Support Center (HOSC) Spacelab Payload Operations Control Center (SL POCC) at MSFC. Pictured are assistant mission scientist Dr. Dalle Kornfeld, Rick McConnel, and Ann Bathew.

  6. LORIS: A web-based data management system for multi-center studies.

    Directory of Open Access Journals (Sweden)

    Samir eDas

    2012-01-01

    Full Text Available LORIS (Longitudinal Online Research and Imaging System is a modular and extensible web-based data management system that integrates all aspects of a multi-center study: from heterogeneous data acquisition (imaging, clinical, behavior, genetics to storage, processing and ultimately dissemination. It provides a secure, user-friendly, and streamlined platform to automate the flow of clinical trials and complex multi-center studies. A subject-centric internal organization allows researchers to capture and subsequently extract all information, longitudinal or cross-sectional, from any subset of the study cohort. Extensive error-checking and quality control procedures, security, data management, data querying and administrative functions provide LORIS with a triple capability (i continuous project coordination and monitoring of data acquisition (ii data storage/cleaning/querying, (iii interface with arbitrary external data processing pipelines. LORIS is a complete solution that has been thoroughly tested through the full life cycle of a multi-center longitudinal project# and is now supporting numerous neurodevelopment and neurodegeneration research projects internationally.

  7. Information System Success Model for Customer Relationship Management System in Health Promotion Centers

    Science.gov (United States)

    Choi, Wona; Rho, Mi Jung; Park, Jiyun; Kim, Kwang-Jum; Kwon, Young Dae

    2013-01-01

    Objectives Intensified competitiveness in the healthcare industry has increased the number of healthcare centers and propelled the introduction of customer relationship management (CRM) systems to meet diverse customer demands. This study aimed to develop the information system success model of the CRM system by investigating previously proposed indicators within the model. Methods The evaluation areas of the CRM system includes three areas: the system characteristics area (system quality, information quality, and service quality), the user area (perceived usefulness and user satisfaction), and the performance area (personal performance and organizational performance). Detailed evaluation criteria of the three areas were developed, and its validity was verified by a survey administered to CRM system users in 13 nationwide health promotion centers. The survey data were analyzed by the structural equation modeling method, and the results confirmed that the model is feasible. Results Information quality and service quality showed a statistically significant relationship with perceived usefulness and user satisfaction. Consequently, the perceived usefulness and user satisfaction had significant influence on individual performance as well as an indirect influence on organizational performance. Conclusions This study extends the research area on information success from general information systems to CRM systems in health promotion centers applying a previous information success model. This lays a foundation for evaluating health promotion center systems and provides a useful guide for successful implementation of hospital CRM systems. PMID:23882416

  8. Information system success model for customer relationship management system in health promotion centers.

    Science.gov (United States)

    Choi, Wona; Rho, Mi Jung; Park, Jiyun; Kim, Kwang-Jum; Kwon, Young Dae; Choi, In Young

    2013-06-01

    Intensified competitiveness in the healthcare industry has increased the number of healthcare centers and propelled the introduction of customer relationship management (CRM) systems to meet diverse customer demands. This study aimed to develop the information system success model of the CRM system by investigating previously proposed indicators within the model. THE EVALUATION AREAS OF THE CRM SYSTEM INCLUDES THREE AREAS: the system characteristics area (system quality, information quality, and service quality), the user area (perceived usefulness and user satisfaction), and the performance area (personal performance and organizational performance). Detailed evaluation criteria of the three areas were developed, and its validity was verified by a survey administered to CRM system users in 13 nationwide health promotion centers. The survey data were analyzed by the structural equation modeling method, and the results confirmed that the model is feasible. Information quality and service quality showed a statistically significant relationship with perceived usefulness and user satisfaction. Consequently, the perceived usefulness and user satisfaction had significant influence on individual performance as well as an indirect influence on organizational performance. This study extends the research area on information success from general information systems to CRM systems in health promotion centers applying a previous information success model. This lays a foundation for evaluating health promotion center systems and provides a useful guide for successful implementation of hospital CRM systems.

  9. Functional design criteria for the Hazardous Materials Management and Emergency Response (HAMMER) Training Center. Revision 1

    International Nuclear Information System (INIS)

    Sato, P.K.

    1995-01-01

    Within the United States, there are few hands-on training centers capable of providing integrated technical training within a practical application environment. Currently, there are no training facilities that offer both radioactive and chemical hazardous response training. There are no hands-on training centers that provide training for both hazardous material operations and emergency response that also operate as a partnership between organized labor, state agencies, tribes, and local emergency responders within the US Department of Energy (DOE) complex. Available facilities appear grossly inadequate for training the thousands of people at Hanford, and throughout the Pacific Northwest, who are required to qualify under nationally-mandated requirements. It is estimated that 4,000 workers at the Hanford Site alone need hands-on training. Throughout the Pacific Northwest, the potential target audience would be over 30,000 public sector emergency response personnel, as well as another 10,000 clean-up workers represented by organized labor. The HAMMER Training Center will be an interagency-sponsored training center. It will be designed, built, and operated to ensure that clean-up workers, fire fighters, and public sector management and emergency response personnel are trained to handle accidental spills of hazardous materials. Training will cover wastes at clean-up sites, and in jurisdictions along the transportation corridors, to effectively protect human life, property, and the environment

  10. ImTK: an open source multi-center information management toolkit

    Science.gov (United States)

    Alaoui, Adil; Ingeholm, Mary Lou; Padh, Shilpa; Dorobantu, Mihai; Desai, Mihir; Cleary, Kevin; Mun, Seong K.

    2008-03-01

    The Information Management Toolkit (ImTK) Consortium is an open source initiative to develop robust, freely available tools related to the information management needs of basic, clinical, and translational research. An open source framework and agile programming methodology can enable distributed software development while an open architecture will encourage interoperability across different environments. The ISIS Center has conceptualized a prototype data sharing network that simulates a multi-center environment based on a federated data access model. This model includes the development of software tools to enable efficient exchange, sharing, management, and analysis of multimedia medical information such as clinical information, images, and bioinformatics data from multiple data sources. The envisioned ImTK data environment will include an open architecture and data model implementation that complies with existing standards such as Digital Imaging and Communications (DICOM), Health Level 7 (HL7), and the technical framework and workflow defined by the Integrating the Healthcare Enterprise (IHE) Information Technology Infrastructure initiative, mainly the Cross Enterprise Document Sharing (XDS) specifications.

  11. The Johnson Space Center management information systems: User's guide to JSCMIS

    Science.gov (United States)

    Bishop, Peter C.; Erickson, Lloyd

    1990-01-01

    The Johnson Space Center Management Information System (JSCMIS) is an interface to computer data bases at the NASA Johnson Space Center which allows an authorized user to browse and retrieve information from a variety of sources with minimum effort. The User's Guide to JSCMIS is the supplement to the JSCMIS Research Report which details the objectives, the architecture, and implementation of the interface. It is a tutorial on how to use the interface and a reference for details about it. The guide is structured like an extended JSCMIS session, describing all of the interface features and how to use them. It also contains an appendix with each of the standard FORMATs currently included in the interface. Users may review them to decide which FORMAT most suits their needs.

  12. Toward patient-centered, personalized and personal decision support and knowledge management: a survey.

    Science.gov (United States)

    Leong, T-Y

    2012-01-01

    This paper summarizes the recent trends and highlights the challenges and opportunities in decision support and knowledge management for patient-centered, personalized, and personal health care. The discussions are based on a broad survey of related references, focusing on the most recent publications. Major advances are examined in the areas of i) shared decision making paradigms, ii) continuity of care infrastructures and architectures, iii) human factors and system design approaches, iv) knowledge management innovations, and v) practical deployment and change considerations. Many important initiatives, projects, and plans with promising results have been identified. The common themes focus on supporting the individual patients who are playing an increasing central role in their own care decision processes. New collaborative decision making paradigms and information infrastructures are required to ensure effective continuity of care. Human factors and usability are crucial for the successful development and deployment of the relevant systems, tools, and aids. Advances in personalized medicine can be achieved through integrating genomic, phenotypic and other biological, individual, and population level information, and gaining useful insights from building and analyzing biological and other models at multiple levels of abstraction. Therefore, new Information and Communication Technologies and evaluation approaches are needed to effectively manage the scale and complexity of biomedical and health information, and adapt to the changing nature of clinical decision support. Recent research in decision support and knowledge management combines heterogeneous information and personal data to provide cost-effective, calibrated, personalized support in shared decision making at the point of care. Current and emerging efforts concentrate on developing or extending conventional paradigms, techniques, systems, and architectures for the new predictive, preemptive, and

  13. The Johnson Space Center Management Information Systems (JSCMIS): An interface for organizational databases

    Science.gov (United States)

    Bishop, Peter C.; Erickson, Lloyd

    1990-01-01

    The Management Information and Decision Support Environment (MIDSE) is a research activity to build and test a prototype of a generic human interface on the Johnson Space Center (JSC) Information Network (CIN). The existing interfaces were developed specifically to support operations rather than the type of data which management could use. The diversity of the many interfaces and their relative difficulty discouraged occasional users from attempting to use them for their purposes. The MIDSE activity approached this problem by designing and building an interface to one JSC data base - the personnel statistics tables of the NASA Personnel and Payroll System (NPPS). The interface was designed against the following requirements: generic (use with any relational NOMAD data base); easy to learn (intuitive operations for new users); easy to use (efficient operations for experienced users); self-documenting (help facility which informs users about the data base structure as well as the operation of the interface); and low maintenance (easy configuration to new applications). A prototype interface entitled the JSC Management Information Systems (JSCMIS) was produced. It resides on CIN/PROFS and is available to JSC management who request it. The interface has passed management review and is ready for early use. Three kinds of data are now available: personnel statistics, personnel register, and plan/actual cost.

  14. Environmental center for integrated waste management: an experience in the Amazon

    Energy Technology Data Exchange (ETDEWEB)

    Jaramillo V, Jairo; Banalcazar, Fernando L.; Noboa Garcia, Gabriel [EnCanEcuador S.A., Houston, TX (United States)

    2004-07-01

    The creation of a large amount of both solid and liquid waste within the petroleum industry should be the reason for providing a facility that makes it possible to apply proper treatment to the waste matter, depending on the degree of complexity, especially if these operations are taking place within or in the area of influence of a national park or a biosphere reserve. EnCanEcuador has invested $1 200,000 in the construction of facilities and equipment for an integrated environmental management center, which will allow us to create in-house resources for the management of waste control. Organic waste is grinded, homogenized with sawdust and placed in a dynamic sanitary fill to form fertilizer. The leachates material will be used as foliage fertilizer. Inorganic waste is classified, grinded, compacted, packed and sent to different recycling companies or in some cases incinerated in a low emission incinerator. Drilling waste: Drilling mud water based potassium nitrate is treated through a de-nitrification process using bioremediation methods. Liquid waste: from well completion, washing vehicles, drains from production stations, is passed through an API separator system into two physical-chemical treatment pits for its later re-injection. Contaminated soil: that may be caused by petroleum activity is treated in a pit where the greatest possible amount of hydrocarbon is recovered by means of hot hydro-washing and is then treated with native bacteria in two land farming centers. Dangerous solid waste is transported to a secure fill for its confinement. Laboratory and Meteorological Station: For the control and monitoring of petroleum activities and to determine climatic variations. Plant nursery: it will have a capacity to produce 300,000 plants a year. Community Cooperatives will manage the center, enforcing our Social responsibility in our daily activities. (author)

  15. Metropolitan transportation management center : a case study : Michigan intelligent transportation system : improving safety and air quality while reducing stress for motorists

    Science.gov (United States)

    1999-10-01

    The following case study provides a snapshot of Michigan's Intelligent Transportation Systems transportation management center (MITSC). It follows the outline provided in the companion document, Metropolitan Transportation Management Center Concepts ...

  16. Reliability Centered Maintenance for Savannah River Site`s interim waste management facilities. Revision 1

    Energy Technology Data Exchange (ETDEWEB)

    Hauer, K.A. [Westinghouse Savannah River Co., Aiken, SC (United States); Wilson, J.F. [PRC, Inc. (US)

    1992-06-01

    The application of Reliability Centered Maintenance (RCM) has been shown to be an effective means to optimize maintenance programs or to establish new programs. The key to success of any RCM program is to customize the methodology to meet the specific needs of the implementing organization. This paper discusses how RCM is being used to establish the preventive maintenance program and how the resulting system data is being used to support the Technical Baseline reconstitution effort for the interim Waste Management Division of Westinghouse Savannah River Company (WSRC).

  17. Reliability Centered Maintenance for Savannah River Site's interim waste management facilities

    Energy Technology Data Exchange (ETDEWEB)

    Hauer, K.A. (Westinghouse Savannah River Co., Aiken, SC (United States)); Wilson, J.F. (PRC, Inc. (US))

    1992-01-01

    The application of Reliability Centered Maintenance (RCM) has been shown to be an effective means to optimize maintenance programs or to establish new programs. The key to success of any RCM program is to customize the methodology to meet the specific needs of the implementing organization. This paper discusses how RCM is being used to establish the preventive maintenance program and how the resulting system data is being used to support the Technical Baseline reconstitution effort for the interim Waste Management Division of Westinghouse Savannah River Company (WSRC).

  18. NASA-Langley Research Center's Aircraft Condition Analysis and Management System Implementation

    Science.gov (United States)

    Frye, Mark W.; Bailey, Roger M.; Jessup, Artie D.

    2004-01-01

    This document describes the hardware implementation design and architecture of Aeronautical Radio Incorporated (ARINC)'s Aircraft Condition Analysis and Management System (ACAMS), which was developed at NASA-Langley Research Center (LaRC) for use in its Airborne Research Integrated Experiments System (ARIES) Laboratory. This activity is part of NASA's Aviation Safety Program (AvSP), the Single Aircraft Accident Prevention (SAAP) project to develop safety-enabling technologies for aircraft and airborne systems. The fundamental intent of these technologies is to allow timely intervention or remediation to improve unsafe conditions before they become life threatening.

  19. Reliability Centered Maintenance for Savannah River Site's interim waste management facilities

    International Nuclear Information System (INIS)

    Hauer, K.A.; Wilson, J.F.

    1992-01-01

    The application of Reliability Centered Maintenance (RCM) has been shown to be an effective means to optimize maintenance programs or to establish new programs. The key to success of any RCM program is to customize the methodology to meet the specific needs of the implementing organization. This paper discusses how RCM is being used to establish the preventive maintenance program and how the resulting system data is being used to support the Technical Baseline reconstitution effort for the interim Waste Management Division of Westinghouse Savannah River Company (WSRC)

  20. USBI Booster Production Company's Hazardous Waste Management Program at the Kennedy Space Center, FL

    Science.gov (United States)

    Venuto, Charles

    1987-01-01

    In response to the hazardous-waste generating processes associated with the launch of the Space Shuttle, a hazardous waste management plan has been developed. It includes waste recycling, product substitution, waste treatment, and waste minimization at the source. Waste material resulting from the preparation of the nonmotor segments of the solid rocket boosters include waste paints (primer, topcoats), waste solvents (methylene chloride, freon, acetone, toluene), waste inorganic compounds (aluminum anodizing compound, fixer), and others. Ways in which these materials are contended with at the Kennedy Space Center are discussed.

  1. Project T100 -- Hazardous Materials Management and Emergency Response Training Center (HAMMER)

    International Nuclear Information System (INIS)

    Norton, C.E.

    1994-01-01

    The scope of this Quality Assurance Program Plan (QAPP) is to provide a system of Quality Assurance reviews and verifications on the design and construction of the Hazardous Materials Management and Emergency Response (HAMMER) Training Center, project 95L-EWT-100 at Hanford. The reviews and verifications will be on activities associated with design, procurement, and construction of the HAMMER project which includes, but is not limited to earthwork, placement of concrete, laying of rail, drilling of wells, water and sewer line fabrication and installation, communications systems, fire protection/detection systems, line tie-ins, building and mock-up (prop) construction, electrical, instrumentation, pump and valves and special coatings

  2. Computer-aided dispatch--traffic management center field operational test final detailed test plan : WSDOT deployment

    Science.gov (United States)

    2003-10-01

    The purpose of this document is to expand upon the evaluation components presented in "Computer-aided dispatch--traffic management center field operational test final evaluation plan : WSDOT deployment". This document defines the objective, approach,...

  3. Computer-aided dispatch--traffic management center field operational test final test plans : state of Utah

    Science.gov (United States)

    2004-01-01

    The purpose of this document is to expand upon the evaluation components presented in "Computer-aided dispatch--traffic management center field operational test final evaluation plan : state of Utah". This document defines the objective, approach, an...

  4. Buying Program of the Standard Automated Materiel Management System. Automated Small Purchase System: Defense Supply Center Philadelphia

    National Research Council Canada - National Science Library

    2001-01-01

    The Standard Automated Materiel Management System Automated Small Purchase System is a fully automated micro-purchases system used by the General and Industrial Directorate at the Defense Supply Center Philadelphia...

  5. Marketing Management and Cultural Learning Center: The Case Study of Arts and Cultural Office, Suansunandha Rajabhat University

    OpenAIRE

    Pirada Techaratpong

    2014-01-01

    This qualitative research has 2 objectives: to study marketing management of the cultural learning center in Suansunandha Rajabhat University and to suggest guidelines to improve its marketing management. This research is based on a case study of the Arts and Culture Office in Suansunandha Rajabhat University, Bangkok. This research found the Art and Culture Office has no formal marketing management. However, the marketing management is partly covered in the overall bu...

  6. Benefits of the implementation and use of a warehouse management system in a distribution center

    Directory of Open Access Journals (Sweden)

    Alexsander Machado

    2011-12-01

    Full Text Available The aim of this article was to describe how the deployment and use of a Warehouse Management System (WMS can help increase productivity, reduce errors and speed up the flow of information in a distribution center. The research method was the case study. We had chosen a distributor of goods, located in Vale do Rio dos Sinos, RS, which sells and distributes for companies throughout Brazil products for business use. The main research technique was participant observation. In order to highlight the observed results, we collected two indicators, productivity and errors for the separation of items into applications. After four months of observation, both showed significant improvement, strengthening the hypothesis that selection and implementation of management system was beneficial for the company.

  7. Management role of surgical center nurses: perceptions by means of images

    Directory of Open Access Journals (Sweden)

    Camila Dalcól

    2016-06-01

    Full Text Available The objective of this study was to analyze the perceptions of surgical center nurses concerning their work environment and management role. Qualitative study conducted with 10 nurse supervisors in public and private hospitals, by means of individual projective interviews, from February to August 2013. The interviews were transcribed and submitted to content analysis. The results allowed analysis of the perceptions of nurses by means of images, such as: strategist, chameleon, conductor, flagship, owl head, and superhero. Regarding the environment, they described images associated with purposes and physical characteristics of the unit, highlighting it as the heart of the hospital. Regarding the management role, the images were associated with leadership, decision-making, adaptation, flexibility, teamwork and supervision. The results showed that nurses had a proactive but sometimes idealized view of their performance. It is of utmost importance that they reflect on their role and try to give their performance higher visibility.

  8. Project plan, Hazardous Materials Management and Emergency Response Training Center: Project 95L-EWT-100

    International Nuclear Information System (INIS)

    Borgeson, M.E.

    1994-01-01

    The Hazardous Materials Management and Emergency Response (HAMMER) Training Center will provide for classroom lectures and hands-on practical training in realistic situations for workers and emergency responders who are tasked with handling and cleanup of toxic substances. The primary objective of the HAMMER project is to provide hands-on training and classroom facilities for hazardous material workers and emergency responders. This project will also contribute towards complying with the planning and training provisions of recent legislation. In March 1989 Title 29 Code of Federal Regulations Occupational Safety and Health Administration 1910 Rules and National Fire Protection Association Standard 472 defined professional requirements for responders to hazardous materials incidents. Two general types of training are addressed for hazardous materials: training for hazardous waste site workers and managers, and training for emergency response organizations

  9. Fundamentals and Catalytic Innovation: The Statistical and Data Management Center of the Antibacterial Resistance Leadership Group.

    Science.gov (United States)

    Huvane, Jacqueline; Komarow, Lauren; Hill, Carol; Tran, Thuy Tien T; Pereira, Carol; Rosenkranz, Susan L; Finnemeyer, Matt; Earley, Michelle; Jiang, Hongyu Jeanne; Wang, Rui; Lok, Judith; Evans, Scott R

    2017-03-15

    The Statistical and Data Management Center (SDMC) provides the Antibacterial Resistance Leadership Group (ARLG) with statistical and data management expertise to advance the ARLG research agenda. The SDMC is active at all stages of a study, including design; data collection and monitoring; data analyses and archival; and publication of study results. The SDMC enhances the scientific integrity of ARLG studies through the development and implementation of innovative and practical statistical methodologies and by educating research colleagues regarding the application of clinical trial fundamentals. This article summarizes the challenges and roles, as well as the innovative contributions in the design, monitoring, and analyses of clinical trials and diagnostic studies, of the ARLG SDMC. © The Author 2017. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. For permissions, e-mail: journals.permissions@oup.com.

  10. Quality Assessment of Acute Inpatient Pain Management in an Academic Health Center.

    Science.gov (United States)

    Lin, Richard J; Reid, M Carrington; Chused, Amy E; Evans, Arthur T

    2016-02-01

    The quality of acute inpatient pain management remains suboptimal and poorly understood. In this retrospective study, we analyze acute pain management practice in a large academic health center using several quality indicators. Not surprisingly, despite high rate of pain assessment, many patients still have frequent, prolonged, and unrelieved severe pain episodes. Upon examination of naloxone administration, we identify potential inappropriate opioid prescription practices such as the use of wrong opioids in hepatic and renal failure and simultaneous use of multiple short-acting opioids. Most importantly, we find that chronic opioid users appear to suffer the most in terms of undertreatment of pain as well as opioid overdose, highlighting the urgent need to target this underserved population of patients. © The Author(s) 2014.

  11. The Center for Excellence in Disaster Management and Humanitarian Assistance (CFE-DMHA): An Assessment of Roles and Missions

    Science.gov (United States)

    2016-01-01

    components include facilities and services (e.g., classroom conditions and food and beverage ), instructor quality (e.g., presenters set a positive...Stephanie Pezard, David E. Thaler, Beth Grill, Ariel Klein, Sean Robson The Center for Excellence in Disaster Management and Humanitarian...has to play in humanitarian assis- tance and disaster relief, congressional legislation established the Center for Excellence in Disaster Management

  12. Visiatome: The French Discovery and Information Center on Radioactive Waste Management

    International Nuclear Information System (INIS)

    Brunel, G.; Rabbe, C.; Moncouyoux, J.P.

    2006-01-01

    The French radioactive waste management act of December 30, 1991, included two key provisions. It initiated a major research program with three areas of investigation concerning high-level long-lived radioactive waste management routes, and called for the Government to submit a legislative proposal to Parliament within 15 years (by 2006) specifying the policy guidelines adopted. Considering the sensitive nature of the subject, the questions surrounding the issue of radioactive waste, and the social, economic and environmental concerns for present and future generations, the Government has inaugurated, in 2005, a nationwide public debate on these issues between the submittal of the research reports and the parliamentary discussion of the proposed law. In this context, the CEA has decided to concentrate at Marcoule the expertise and experience acquired in the area of radioactive waste management and to make it available to stakeholders and to the public. A scientific cultural center, Visiatome, has been built to inform the public and facilitate the acceptance of nuclear energy and radioactive waste management by presenting the subject in a manner adapted to the level of knowledge of the visitors. A modern, fun and interactive exhibition of 600 m 2 allows visitors to find out more about energy, waste products, sources of radioactive waste, their treatment and where they are stored, natural and artificial radioactivity, effects of radiation on mankind. It also offers a media library, an auditorium for group discussions and teaching rooms for school groups with the aim of encouraging students to discover science through enjoyment. Visiatome has received several thousand visitors since it was opened to the public on April 10, 2005, and the initial results of this experience can now be reviewed: the design principles of the center and its permanent exhibits, the characteristics of the visitors and their perception of the subjects presented. (authors)

  13. Management of groundwater in urban centers: A case study; Greater Dammam Metropolitan Area

    International Nuclear Information System (INIS)

    Abderrahman, Walid A.; Elamin, Abdalla S.; Al-Harazin, Ibrahim M.; Eqnaibi, Badie S.

    2007-01-01

    Effective management of groundwater resources in urban centers of arid regions is vital for sustainable development and groundwater protection especially with rapid growth of water demands under water stress conditions. Greater Dammam Metropolitan Area is a good example of rapid growing urban center due to comprehensive development and population growth. The water demand has increased by many times during the last three decades. Groundwater from local aquifers namely Dammam and Umm Er Radhuma, supplies more than 85% of the total water demands. The aquifers have been subjected to extensive and increasing groundwater pumping especially during last three decades. Negative impacts such as significant decline in water levels have been experienced in the area. A new groundwater management scheme in terms of improving the long-term water pumping policies is required for protection of the aquifers groundwater productivity. A special numerical simulation model of the multi-aquifer system including Dammam and Umm Er Radhuma aquifers has been developed to assess the behavior of the aquifer system under long term water stresses in Dammam Metropolitan Area. The developed numerical simulation model has been utilized to predict the responses of the aquifer system in terms of decline in terms of water level under different pumping schemes from the two aquifers during the next 30 years. The model results have postulated the importance of Umm Er Radhuma (UER) aquifer as a major water supply source to Dammam Metropolitan Area, as well as potential recharge source of more than 30% of the total water pumped from Dammam aquifer. These findings have been utilized in improving present and future groundwater management and conservation for the study area. Similar techniques can be used to improve the groundwater management in other parts of the country as well as other arid regions. (author)

  14. An Analysis of Contract Management Processes at the Space and Missile Systems Center and the Air Force Life Cycle Management Center (Wright-Patterson) Using the Contract Management Maturity Model

    Science.gov (United States)

    2012-11-28

    graduation, Capt Chang’s next assignment is at Los Angeles Air Force Base in the Space and Missile Systems Center (SMC). Capt Chang is unmarried with... married to the former Ms. Laura Hazzard, and they have three children, Madden, and twins Aubrey and Tyler. Captain Keith V. Philaphandeth is an Air...2012 SPONSORED RESEARCH TOPICS Acquisition Management  Acquiring Combat Capability via Public-Private Partnerships (PPPs)  BCA: Contractor vs

  15. Feed Materials Production Center Waste Management: Annual report for fiscal year 1986

    International Nuclear Information System (INIS)

    Watts, R.E.; Kottner, S.A.

    1986-01-01

    During FY-1986, the Westinghouse Materials Company of Ohio (WMCO) and the Department of Energy focused on safe storage and disposition of all wastes at the Feed Materials Production Center (FMPC) in compliance with federal and state regulations concerning waste management and worker health and safety. The Waste Management Annual Report identifies the comprehensive programs developed to achieve WMCO goals at the FMPC. The programs address waste issues which concern worker and public health and safety. Among those programs discussed are the decontamination, safe storage, and disposition of low-level and mixed hazardous radioactive waste. Principal attention and resources were allocated to programs which identify the largest waste streams (both currently generated and inventory backlogged). The most voluminous waste streams include low-level waste approved for shipment to the Nevada Test Site (MgF 2 slag, slag leach filter cake, and neutralized raffinate); remedial action wastes (K-65, stormwater runoff/effluent, and waste pits); thorium; and contaminated construction rubble and soil. Goals were established and met for the Waste Management Section in the form of completed milestones. The completed milestones involved such activities as characterization studies for the waste pits, K-65 Silos and adjacent areas; issuance of the Waste Management Plan required by DOE; analysis of decontamination alternatives for copper scrap; and analysis of silo structural integrity and remedial action alternatives

  16. Solid waste management in primary healthcare centers: application of a facilitation tool

    Directory of Open Access Journals (Sweden)

    Ana Maria Maniero Moreira

    Full Text Available Abstract Objectives: to propose a tool to facilitate diagnosis, formulation and evaluation of the Waste Management Plan in Primary Healthcare Centers and to present the results of the application in four selected units. Method: descriptive research, covering the stages of formulation /application of the proposed instrument and the evaluation of waste management performance at the units. Results: the tool consists in five forms; specific indicators of waste generation for outpatients healthcare units were proposed, and performance indicators that give scores for compliance with current legislation. In the studied units it is generated common waste (52-60%, infectious-sharps (31-42% and recyclable (5-17%. The average rates of generation are: 0,09kg of total waste/outpatient assistance and 0,09kg of infectious-sharps waste/outpatient procedure. The compliance with regulations, initially 26-30%, then reached 30-38% a year later. Conclusion: the tool showed to be easy to use, bypassing the existence of a complex range of existing regulatory requirements, allowed to identify non-conformities, pointed out corrective measures and evaluated the performance of waste management. In this sense, it contributes to decision making and management practices relating to waste, tasks usually assigned to nurses. It is recommended that the tool be applied in similar healthcare units for comparative studies, and implementation of necessary adaptations for other medical services.

  17. Solid waste management in primary healthcare centers: application of a facilitation tool 1

    Science.gov (United States)

    Moreira, Ana Maria Maniero; Günther, Wanda Maria Risso

    2016-01-01

    Abstract Objectives: to propose a tool to facilitate diagnosis, formulation and evaluation of the Waste Management Plan in Primary Healthcare Centers and to present the results of the application in four selected units. Method: descriptive research, covering the stages of formulation /application of the proposed instrument and the evaluation of waste management performance at the units. Results: the tool consists in five forms; specific indicators of waste generation for outpatients healthcare units were proposed, and performance indicators that give scores for compliance with current legislation. In the studied units it is generated common waste (52-60%), infectious-sharps (31-42%) and recyclable (5-17%). The average rates of generation are: 0,09kg of total waste/outpatient assistance and 0,09kg of infectious-sharps waste/outpatient procedure. The compliance with regulations, initially 26-30%, then reached 30-38% a year later. Conclusion: the tool showed to be easy to use, bypassing the existence of a complex range of existing regulatory requirements, allowed to identify non-conformities, pointed out corrective measures and evaluated the performance of waste management. In this sense, it contributes to decision making and management practices relating to waste, tasks usually assigned to nurses. It is recommended that the tool be applied in similar healthcare units for comparative studies, and implementation of necessary adaptations for other medical services. PMID:27556874

  18. Integrating knowledge exchange and the assessment of dryland management alternatives - A learning-centered participatory approach.

    Science.gov (United States)

    Bautista, Susana; Llovet, Joan; Ocampo-Melgar, Anahí; Vilagrosa, Alberto; Mayor, Ángeles G; Murias, Cristina; Vallejo, V Ramón; Orr, Barron J

    2017-06-15

    The adoption of sustainable land management strategies and practices that respond to current climate and human pressures requires both assessment tools that can lead to better informed decision-making and effective knowledge-exchange mechanisms that facilitate new learning and behavior change. We propose a learning-centered participatory approach that links land management assessment and knowledge exchange and integrates science-based data and stakeholder perspectives on both biophysical and socio-economic attributes. We outline a structured procedure for a transparent assessment of land management alternatives, tailored to dryland management, that is based on (1) principles of constructivism and social learning, (2) the participation of stakeholders throughout the whole assessment process, from design to implementation, and (3) the combination of site-specific indicators, identified by local stakeholders as relevant to their particular objectives and context conditions, and science-based indicators that represent ecosystem services of drylands worldwide. The proposed procedure follows a pattern of eliciting, challenging, and self-reviewing stakeholder perspectives that aims to facilitate learning. The difference between the initial baseline perspectives and the final self-reviewed stakeholder perspectives is used as a proxy of learning. We illustrate the potential of this methodology by its application to the assessment of land uses in a Mediterranean fire-prone area in East Spain. The approach may be applied to a variety of socio-ecological systems and decision-making and governance scales. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Job satisfaction and perceived autonomy for nurse practitioners working in nurse-managed health centers.

    Science.gov (United States)

    Pron, Ann Linguiti

    2013-04-01

    More primary care providers are needed to deliver health care to Americans living in poverty and those soon to be insured under the Affordable Care Act. Nurse practitioners (NPs) in nurse-managed health centers (NMHCs) are poised to meet this need. This research study examined the characteristics of NPs working in NMHCs and measured job satisfaction and perceived level of autonomy. No studies about job satisfaction or autonomy for NPs working in NMHCs had been previously reported. This descriptive, quantitative study surveyed primary care NPs working in NMHCs that are part of the National Nursing Centers Consortium (NNCC). NP e-mail addresses were obtained from NNCC center directors. Of 198 NPs invited to the electronic survey, 99 completed the Misener Nurse Practitioner Job Satisfaction Scale, demographic questionnaire, questions about perceived autonomy, and whether they would recommend working in an NMHC. Participants came from 16 states and 46 NMHCs. NPs working in NMHCs have job satisfaction, perceive their role as autonomous, and are satisfied with the autonomy they have. NMHCs can provide access to primary health care for many Americans. More NPs may choose employment in NMHCs for job satisfaction and autonomy. ©2012 The Author(s) Journal compilation ©2012 American Association of Nurse Practitioners.

  20. Knowledge management: Role of the the Radiation Safety Information Computational Center (RSICC)

    Science.gov (United States)

    Valentine, Timothy

    2017-09-01

    The Radiation Safety Information Computational Center (RSICC) at Oak Ridge National Laboratory (ORNL) is an information analysis center that collects, archives, evaluates, synthesizes and distributes information, data and codes that are used in various nuclear technology applications. RSICC retains more than 2,000 software packages that have been provided by code developers from various federal and international agencies. RSICC's customers (scientists, engineers, and students from around the world) obtain access to such computing codes (source and/or executable versions) and processed nuclear data files to promote on-going research, to ensure nuclear and radiological safety, and to advance nuclear technology. The role of such information analysis centers is critical for supporting and sustaining nuclear education and training programs both domestically and internationally, as the majority of RSICC's customers are students attending U.S. universities. Additionally, RSICC operates a secure CLOUD computing system to provide access to sensitive export-controlled modeling and simulation (M&S) tools that support both domestic and international activities. This presentation will provide a general review of RSICC's activities, services, and systems that support knowledge management and education and training in the nuclear field.

  1. The Role of the Radiation Safety Information Computational Center (RSICC) in Knowledge Management

    International Nuclear Information System (INIS)

    Valentine, T.

    2016-01-01

    Full text: The Radiation Safety Information Computational Center (RSICC) is an information analysis center that collects, archives, evaluates, synthesizes and distributes information, data and codes that are used in various nuclear technology applications. RSICC retains more than 2,000 packages that have been provided by contributors from various agencies. RSICC’s customers obtain access to such computing codes (source and/or executable versions) and processed nuclear data files to promote on-going research, to help ensure nuclear and radiological safety, and to advance nuclear technology. The role of such information analysis centers is critical for supporting and sustaining nuclear education and training programmes both domestically and internationally, as the majority of RSICC’s customers are students attending U.S. universities. RSICC also supports and promotes workshops and seminars in nuclear science and technology to further the use and/or development of computational tools and data. Additionally, RSICC operates a secure CLOUD computing system to provide access to sensitive export-controlled modeling and simulation (M&S) tools that support both domestic and international activities. This presentation will provide a general review of RSICC’s activities, services, and systems that support knowledge management and education and training in the nuclear field. (author

  2. Comparison of optimal cardiovascular risk factor management in patients with Type 2 diabetes who attended urban medical health center with those attended a tertiary care center: Experiences from Tehran, Iran

    Directory of Open Access Journals (Sweden)

    Sedighe Moradi

    2016-01-01

    Conclusions: Both centers have failure in target achievement in some risk factors; however, the inability of the primary care center in controlling hyperlipidemia in comparison with the tertiary center is a serious warning to provide training about managing dyslipidemia in these centers.

  3. Easy access to geophysical data sets at the IRIS Data Management Center

    Science.gov (United States)

    Trabant, C.; Ahern, T.; Suleiman, Y.; Karstens, R.; Weertman, B.

    2012-04-01

    At the IRIS Data Management Center (DMC) we primarily manage seismological data but also have other geophysical data sets for related fields including atmospheric pressure and gravity measurements and higher level data products derived from raw data. With a few exceptions all data managed by the IRIS DMC are openly available and we serve an international research audience. These data are available via a number of different mechanisms from batch requests submitted through email, web interfaces, near real time streams and more recently web services. Our initial suite of web services offer access to almost all of the raw data and associated metadata managed at the DMC. In addition, we offer services that apply processing to the data before it is sent to the user. Web service technologies are ubiquitous with support available in nearly every programming language and operating system. By their nature web services are programmatic interfaces, but by choosing a simple subset of web service methods we make our data available to a very broad user base. These interfaces will be usable by professional developers as well as non-programmers. Whenever possible we chose open and recognized standards. The data returned to the user is in a variety of formats depending on type, including FDSN SEED, QuakeML, StationXML, ASCII, PNG images and in some cases where no appropriate standard could be found a customized XML format. To promote easy access to seismological data for all researchers we are coordinating with international partners to define web service interfaces standards. Additionally we are working with key partners in Europe to complete the initial implementation of these services. Once a standard has been adopted and implemented at multiple data centers researchers will be able to use the same request tools to access data across multiple data centers. The web services that apply on-demand processing to requested data include the capability to apply instrument corrections and

  4. Implementation of Patient-Centered Education for Chronic-Disease Management in Uganda: An Effectiveness Study.

    Science.gov (United States)

    Siddharthan, Trishul; Rabin, Tracy; Canavan, Maureen E; Nassali, Faith; Kirchhoff, Phillip; Kalyesubula, Robert; Coca, Steven; Rastegar, Asghar; Knauf, Felix

    2016-01-01

    The majority of non-communicable disease related deaths occur in low- and middle-income countries. Patient-centered care is an essential component of chronic disease management in high income settings. To examine feasibility of implementation of a validated patient-centered education tool among patients with heart failure in Uganda. Mixed-methods, prospective cohort. A private and public cardiology clinic in Mulago National Referral and Teaching Hospital, Kampala, Uganda. Adults with a primary diagnosis of heart failure. PocketDoktor Educational Booklets with patient-centered health education. The primary outcomes were the change in Patient Activation Measure (PAM-13), as well as the acceptability of the PocketDoktor intervention, and feasibility of implementing patient-centered education in outpatient clinical settings. Secondary outcomes included the change in satisfaction with overall clinical care and doctor-patient communication. A total of 105 participants were enrolled at two different clinics: the Mulago Outpatient Department (public) and the Uganda Heart Institute (private). 93 participants completed follow up at 3 months and were included in analysis. The primary analysis showed improved patient activation measure scores regarding disease-specific knowledge, treatment options and prevention of exacerbations among both groups (mean change 0.94 [SD = 1.01], 1.02 [SD = 1.15], and 0.92 [SD = 0.89] among private paying patients and 1.98 [SD = 0.98], 1.93 [SD = 1.02], and 1.45 [SD = 1.02] among public paying patients, pmanagement as well as satisfaction with doctor-patient communication and overall care in Uganda. Our results show that printed booklets are locally appropriate, highly acceptable and feasible to implement in an LMIC outpatient setting across socioeconomic groups.

  5. The International Center for Integrated Water Resources Management (ICIWaRM): The United States' Contribution to UNESCO IHP's Global Network of Water Centers

    Science.gov (United States)

    Logan, W. S.

    2015-12-01

    The concept of a "category 2 center"—i.e., one that is closely affiliated with UNESCO, but not legally part of UNESCO—dates back many decades. However, only in the last decade has the concept been fully developed. Within UNESCO, the International Hydrological Programme (IHP) has led the way in creating a network of regional and global water-related centers.ICIWaRM—the International Center for Integrated Water Resources Management—is one member of this network. Approved by UNESCO's General Conference, the center has been operating since 2009. It was designed to fill a niche in the system for a center that was backed by an institution with on-the-ground water management experience, but that also had strong connections to academia, NGOs and other governmental agencies. Thus, ICIWaRM is hosted by the US Army Corps of Engineers' Institute for Water Resources (IWR), but established with an internal network of partner institutions. Three main factors have contributed to any success that ICIWaRM has achieved in its global work: A focus on practical science and technology which can be readily transferred. This includes the Corps' own methodologies and models for planning and water management, and those of our university and government partners. Collaboration with other UNESCO Centers on joint applied research, capacity-building and training. A network of centers needs to function as a network, and ICIWaRM has worked together with UNESCO-affiliated centers in Chile, Brazil, Paraguay, the Dominican Republic, Japan, China, and elsewhere. Partnering with and supporting existing UNESCO-IHP programs. ICIWaRM serves as the Global Technical Secretariat for IHP's Global Network on Water and Development Information in Arid Lands (G-WADI). In addition to directly supporting IHP, work through G-WADI helps the center to frame, prioritize and integrate its activities. With the recent release of the United Nation's 2030 Agenda for Sustainable Development, it is clear that

  6. A Comprehensive Approach to Management of Workplace and Environmental Noise at NASA Lewis Research Center

    Science.gov (United States)

    Cooper, Beth A.

    1995-01-01

    NASA Lewis Research Center is home to more than 100 experimental research testing facilities and laboratories, including large wind tunnels and engine test cells, which in combination create a varied and complex noise environment. Much of the equipment was manufactured prior to the enactment of legislation limiting product noise emissions or occupational noise exposure. Routine facility maintenance and associated construction also contributes to a noise exposure management responsibility which is equal in magnitude and scope to that of several small industrial companies. The Noise Program, centrally managed within the Office of Environmental Programs at LRC, maintains overall responsibility for hearing conservation, community noise control, and acoustical and noise control engineering. Centralized management of the LRC Noise Program facilitates the timely development and implementation of engineered noise control solutions for problems identified via either the Hearing Conservation of Community Noise Program. The key element of the Lewis Research Center Noise Program, Acoustical and Noise Control Engineering Services, is focused on developing solutions that permanently reduce employee and community noise exposure and maximize research productivity by reducing or eliminating administrative and operational controls and by improving the safety and comfort of the work environment. The Hearing Conservation Program provides noise exposure assessment, medical monitoring, and training for civil servant and contractor employees. The Community Noise Program aims to maintain the support of LRC's neighboring communities while enabling necessary research operations to accomplish their programmatic goals. Noise control engineering capability resides within the Noise Program. The noise control engineering, based on specific exposure limits, is a fundamental consideration throughout the design phase of new test facilities, labs, and office buildings. In summary, the Noise Program

  7. Improved Discovery and Re-Use of Oceanographic Data through a Data Management Center

    Science.gov (United States)

    Rauch, S.; Allison, M. D.; Groman, R. C.; Chandler, C. L.; Galvarino, C.; Gegg, S. R.; Kinkade, D.; Shepherd, A.; Wiebe, P. H.; Glover, D. M.

    2013-12-01

    Effective use and reuse of ecological data are not only contingent upon those data being well-organized and documented, but also upon data being easily discoverable and accessible by others. As funding agency and publisher policies begin placing more emphasis on, or even requiring, sharing of data, some researchers may feel overwhelmed in determining how best to manage and share their data. Other researchers may be frustrated by the inability to easily find data of interest, or they may be hesitant to use datasets that are poorly organized and lack complete documentation. In all of these scenarios, the data management and sharing process can be facilitated by data management centers, as demonstrated by the Biological and Chemical Oceanography Data Management Office (BCO-DMO). BCO-DMO was created in 2006 to work with investigators to manage data from research funded by the Division of Ocean Sciences (OCE) Biological and Chemical Oceanography Sections and the Division of Polar Programs (PLR) Antarctic Organisms and Ecosystems Program of the US National Science Foundation (NSF). BCO-DMO plays a role throughout the data lifecycle, from the early stages of offering support to researchers in developing data management plans to the final stages of depositing data in a permanent archive. An overarching BCO-DMO goal is to provide open access to data through a system that enhances data discovery and reuse. Features have been developed that allow users to find data of interest, assess fitness for purpose, and download the data for reuse. Features that enable discovery include both text-based and geospatial-based search interfaces, as well as a semantically-enabled faceted search [1]. BCO-DMO data managers work closely with the contributing investigators to develop robust metadata, an essential component to enable data reuse. The metadata, which describe data acquisition and processing methods, instrumentation, and parameters, are enhanced by the mapping of local vocabulary

  8. Current construction status of Korea Wolsong Nuclear Environment Management Center (low and intermediate level radioactive waste disposal facility)

    International Nuclear Information System (INIS)

    Suzuki, Yasuo

    2010-01-01

    Through the RANDEC delegation tour to Korea in Nov. 2009, we have earned new information on recent development of the radioactive waste management in Korea. In this report, we will introduce such development in Korea, focusing on the current construction status of Korean LILW (low and intermediate level radioactive waste) disposal site, now called, Wolsong Nuclear Environment Management Center. (author)

  9. 20 CFR 670.515 - What responsibilities do the center operators have in managing work-based learning?

    Science.gov (United States)

    2010-04-01

    ... have in managing work-based learning? 670.515 Section 670.515 Employees' Benefits EMPLOYMENT AND TRAINING ADMINISTRATION, DEPARTMENT OF LABOR THE JOB CORPS UNDER TITLE I OF THE WORKFORCE INVESTMENT ACT... managing work-based learning? (a) The center operator must emphasize and implement work-based learning...

  10. Feed Materials Production Center waste management plan (Revision to NLCO-1100, R.6)

    International Nuclear Information System (INIS)

    Watts, R.E.; Allen, T.; Castle, S.A.; Hopper, J.P.; Oelrich, R.L.

    1986-01-01

    In the process of producing uranium metal products used in Department of Energy (DOE) defense programs at other DOE facilities, various types of wastes are generated at the Feed Materials Production Center (FMPC). Process wastes, both generated and stored, are discussed in the Waste Management Plan and include low-level radioactive waste (LLW), mixed hazardous/radioactive waste, and sanitary/industrial waste. Scrap metal waste and wastes requiring special remediation are also addressed in the Plan. The Waste Management Plan identifies the comprehensive programs developed to address safe storage and disposition of all wastes from past, present, and future operations at the FMPC. Waste streams discussed in this Plan are representative of the wastes generated and waste types that concern worker and public health and safety. Budgets and schedules for implementation of waste disposition are also addressed. The waste streams receiving the largest amount of funding include LLW approved for shipment by DOE/ORO to the Nevada Test Site (NTS) (MgF 2 , slag leach filter cake, and neutralized raffinate); remedial action wastes (waste pits, K-65 silo waste); thorium; scrap metal (contaminated and noncontaminated ferrous and copper scrap); construction rubble and soil generated from decontamination and decommissioning of outdated facilities; and low-level wastes that will be handled through the Low-Level Waste Processing and Shipping System (LLWPSS). Waste Management milestones are also provided. The Waste Management Plan is divided into eight major sections: Introduction; Site Waste and Waste Generating Process; Strategy; Projects and Operations; Waste Stream Budgets; Milestones; Quality Assurance for Waste Management; and Environmental Monitoring Program

  11. Designing a crisis management model in Iran’s archival centers: Pre-crisis stage

    Directory of Open Access Journals (Sweden)

    Maryam Nakhoda

    2018-03-01

    Full Text Available The purpose of this research is to design a crisis management model in the archival centers of Iran during the pre-crisis phase. The present study was conducted with a qualitative approach using the Grounded theory method. The necessary data was collected using semi-structured interviews. Data saturation was a major factor in determining the sample size. The research population included 20 crisis management specialists and managers of archives in Iran and the data analysis was performed in three stages: open, axial, and selective coding. The paradigmatic model derived from the findings of the research includes the sections of the causal conditions, strategies, intervening conditions and the underlying conditions and their outcomes. The causal conditions are located in two categories of internal crises such as biological crises and lack of proper management, and external crises such as natural disasters, fires and human-made crises. Intervener conditions and backgrounds include cat-egories such as lack of specialist staff training, lack of appropriate environmental conditions and management mechanisms, archival building and human resources issues. To prevent and mitigate the effects of the crisis in archives, some strategies are required such as modern education for resil-ience, teaching how to use documents, standardizing buildings and equipment (non-use of steel skeletons in building archives, use of concrete skeletons Armed or metal, as well as the use of walls and doors and floors of anti-fire covers in the building of archives and the establishment of multi-layer protective systems for the protection of documents.

  12. Perioperative management of patients with antiphospholipid syndrome: a single-center experience.

    Science.gov (United States)

    Atisha-Fregoso, Yemil; Espejo-Poox, Eric; Carrillo-Maravilla, Eduardo; Pulido-Ramírez, Alma Lilia; Lugo Baruqui, Diego; Hernández-Molina, Gabriela; Cabral, Antonio R

    2017-07-01

    The objective was to describe the management and risk factors for complications of antiphospholipid syndrome (APS) patients who underwent a surgical procedure in a single center. We reviewed medical records of all patients with primary or secondary APS who underwent an elective surgery during a 6-year period. Demographical data, management of anticoagulation and complications were recorded. We identified 43 patients, mean age 37.9 ± 8.9 years, who underwent a total of 48 elective surgeries. All patients had history of at least one thrombotic event and were under vitamin K antagonists. Before surgery, all patients received bridging therapy with intravenous infusion of heparin or low molecular weight heparin (LMWH). Among the LMWH group, 36 had a full anticoagulation regimen and nine prophylactic doses. In 62% of the surgeries, we identified an optimal management of periprocedural anticoagulation according to guidelines. Overall six patients had severe bleeding and three thrombotic complications (full anticoagulation regimen n = 2 and prophylactic dose group n = 1). Patients with optimal management of anticoagulation experienced less thrombotic and hemorrhagic complications (7 vs. 33%; OR 0.14, 95% CI 0.02-0.81; p = 0.040) and patients with INR ≤1.5 at surgery had fewer episodes of major bleeding (6 vs. 29%; OR 0.19, 95% CI 0.02-0.98; p = 0.050). All three thrombotic events occurred in patients with INR ≤1.5. Proper management of anticoagulation based on guidelines is associated with less complications in patients with APS. Notwithstanding the proper use of bridging therapy, some patients may develop thrombotic complications.

  13. Assessment of medical waste management at a primary health-care center in Sao Paulo, Brazil

    Energy Technology Data Exchange (ETDEWEB)

    Moreira, A.M.M., E-mail: anamariainforme@hotmail.com [Department of Environmental Health, School of Public Health, University of Sao Paulo, Avenida Doutor Arnaldo 715, Sao Paulo 01246-904 (Brazil); Guenther, W.M.R. [Department of Environmental Health, School of Public Health, University of Sao Paulo, Avenida Doutor Arnaldo 715, Sao Paulo 01246-904 (Brazil)

    2013-01-15

    Highlights: Black-Right-Pointing-Pointer Assessment of medical waste management at health-care center before/after intervention. Black-Right-Pointing-Pointer Qualitative and quantitative results of medical waste management plan are presented. Black-Right-Pointing-Pointer Adjustments to comply with regulation were adopted and reduction of waste was observed. Black-Right-Pointing-Pointer The method applied could be useful for similar establishments. - Abstract: According to the Brazilian law, implementation of a Medical Waste Management Plan (MWMP) in health-care units is mandatory, but as far as we know evaluation of such implementation has not taken place yet. The purpose of the present study is to evaluate the improvements deriving from the implementation of a MWMP in a Primary Health-care Center (PHC) located in the city of Sao Paulo, Brazil. The method proposed for evaluation compares the first situation prevailing at this PHC with the situation 1 year after implementation of the MWMP, thus allowing verification of the evolution of the PHC performance. For prior and post-diagnosis, the method was based on: (1) application of a tool (check list) which considered all legal requirements in force; (2) quantification of solid waste subdivided into three categories: infectious waste and sharp devices, recyclable materials and non-recyclable waste; and (3) identification of non-conformity practices. Lack of knowledge on the pertinent legislation by health workers has contributed to non-conformity instances. The legal requirements in force in Brazil today gave origin to a tool (check list) which was utilized in the management of medical waste at the health-care unit studied. This tool resulted into an adequate and simple instrument, required a low investment, allowed collecting data to feed indicators and also conquered the participation of the unit whole staff. Several non-conformities identified in the first diagnosis could be corrected by the instrument utilized

  14. Technical, organizational and human-centered requirements for the purpose of accident management

    International Nuclear Information System (INIS)

    Berning, A.; Fassmann, W.; Preischl, W.

    1998-01-01

    A catalog of ergonomic recommendations for organizational measures and design of paper documented work aids for accident management situations in nuclear power plants was developed. Attention was given to provide recommendations meeting practical needs and being sufficiently flexible to allow plant specific [aptation. A weight was assigned to each recommendation indicating its importance. The development of the recommendations was based on the state of the art concerning research and practical experience. Results from walk-/talk-through experiments, training and exercises, discussions with on-site experts, and investigations of emergency manuals from German and foreign nuclear power plants were taken into account. The catalog is founded on a bro[ knowledge base covering important aspects. The catalog is intended for qualitative evaluation and design of organizational measures and procedures. The catalog shall assure high quality. The project further provides an important contribution to the standardization of organizational and human centered demands concerning accident management procedures. Thus it can contribute to develop general regulations regarding ergonomic design of accident management measures. (orig.) [de

  15. Care Management Medical Home Center Model: Preliminary Results of a Patient-Centered Approach to Improving Care Quality for Diabetic Patients.

    Science.gov (United States)

    Page, Timothy F; Amofah, St Anthony; McCann, Shelia; Rivo, Julie; Varghese, Asha; James, Terisa; Rivo, Marc; Williams, Mark L

    2015-07-01

    This article presents preliminary findings of the impact of an innovative care management model for diabetic patients. The model was implemented by seven Federally Qualified Health Centers serving 10,000 diabetic patients in Miami-Dade County. A primary intervention of this model is a centralized care management team that makes previsit phone calls to diabetic patients who have scheduled appointments. These previsit phone calls optimize patient knowledge and self-management goals, and provide patient care coordinators with relevant clinical information to optimize the office visit and help to ensure completion of recommended diabetic preventive and chronic care services. Data suggest that following the implementation of this care management model, more diabetic patients are receiving regular care, and compliance with recommended tests and screenings has improved. © 2015 Society for Public Health Education.

  16. Real Time Data for Seismology at the IRIS Data Management Center, AN Nsf-Sponsored Facility

    Science.gov (United States)

    Benson, R. B.; Ahern, T. K.; Trabant, C.; Weertman, B. R.; Casey, R.; Stromme, S.; Karstens, R.

    2012-12-01

    When IRIS was incorporated in 1984, it committed to provide long-term support for the science of seismology. It first upgraded analog networks by installing observatory grade digital seismic recording equipment (by constructing the Global Seismic Network to upgrade the World Wide Standardized Seismographic Network) that became the backbone of the International Federation of Digital Seismic Networks (FDSN), and in 1990 constructed a state-of-the-art data center that would allow free and open access to data to everyone. For the first decade, IRIS leveraged a complicated system of telemetry which laid the foundation for delivering (relatively) high rate and continuous seismic time series data to the IRIS Data Management Center, which was designed to accept data that arrived with highly variable latencies and on many media formats. This meant that science had to often wait until data became complete, which at the time was primarily related to studying earthquakes or similar events. During the 1990's, numerous incremental but small improvements were made to get data into the hands of users with less latency, leveraging dialup, satellite telemetry, and a variety of Internet protocols. But beginning in 2000, the IRIS Data Management Center began the process of accumulating data comprehensively in real time. It was first justified because it eliminated the time-consuming transcription and manual data handling on various media formats, like magnetic tapes, CD's and DVD's. However, the switch to real-time telemetry proved to be a major improvement technologically because it not only simplified data transfer, it opened access to a large volume of previously inaccessible data (local resource limitations), and many networks began willingly providing their geophysical data to the broad research community. It also enabled researchers the ability to process data in different and streamlined ways, by incorporating data directly into workflows and processing packages. Any network on

  17. The Link between Internal Marketing and Customer Relationship Management : A Case Study of one Nordea Call Center in Sweden

    OpenAIRE

    Stenbeck, Joakim; Cabander, Robin

    2008-01-01

    Purpose: The purpose of this thesis is to increase the understanding of the link between internal marketing and customer relationship management by conducting a case study of one Nordea call center. Background: Keeping existing customers is less expensive than acquiring new ones. Nowadays, up to sixty percent of marketing budgets are being dedicated towards retaining customers. So forth customer relationship manage-ment is slowly beginning to penetrate the banking industry as sustaina-ble rel...

  18. An ethical framework for identifying, preventing, and managing conflicts confronting leaders of academic health centers.

    Science.gov (United States)

    Chervenak, Frank A; McCullough, Laurence B

    2004-11-01

    Leaders of academic health centers (AHCs) hold positions that by their very nature have a high potential for ethical conflict. The authors offer an ethical framework for identifying, preventing, and managing conflicts in the leadership of AHCs. This framework is based on and implements both the ethical concept of AHCs as fiduciary organizations and also the legitimate interests of various stakeholders. The authors describe practical steps that can be tools for the preventive-ethics leadership of AHCs that enable leaders to avoid strategic ambiguity and strategic procrastination and replace these with transparency. The ethical framework is illustrated by applying it to an organizational case study. The major contribution of the ethical framework is that it transforms decision making from simply negotiating power struggles to explicitly identifying and making ethical decisions based on the legitimate interests and fiduciary responsibilities of all stakeholders.

  19. Solid health care waste management status at health care centers in the West Bank - Palestinian Territory

    International Nuclear Information System (INIS)

    Al-Khatib, Issam A.; Sato, Chikashi

    2009-01-01

    Health care waste is considered a major public health hazard. The objective of this study was to assess health care waste management (HCWM) practices currently employed at health care centers (HCCs) in the West Bank - Palestinian Territory. Survey data on solid health care waste (SHCW) were analyzed for generated quantities, collection, separation, treatment, transportation, and final disposal. Estimated 4720.7 m 3 (288.1 tons) of SHCW are generated monthly by the HCCs in the West Bank. This study concluded that: (i) current HCWM practices do not meet HCWM standards recommended by the World Health Organization (WHO) or adapted by developed countries, and (ii) immediate attention should be directed towards improvement of HCWM facilities and development of effective legislation. To improve the HCWM in the West Bank, a national policy should be implemented, comprising a comprehensive plan of action and providing environmentally sound and reliable technological measures.

  20. Patient-centered activity monitoring in the self-management of chronic health conditions.

    Science.gov (United States)

    Chiauzzi, Emil; Rodarte, Carlos; DasMahapatra, Pronabesh

    2015-04-09

    As activity tracking devices become smaller, cheaper, and more consumer-accessible, they will be used more extensively across a wide variety of contexts. The expansion of activity tracking and personal data collection offers the potential for patient engagement in the management of chronic diseases. Consumer wearable devices for activity tracking have shown promise in post-surgery recovery in cardiac patients, pulmonary rehabilitation, and activity counseling in diabetic patients, among others. Unfortunately, the data generated by wearable devices is seldom integrated into programmatic self-management chronic disease regimens. In addition, there is lack of evidence supporting sustained use or effects on health outcomes, as studies have primarily focused on establishing the feasibility of monitoring activity and the association of measured activity with short-term benefits. Monitoring devices can make a direct and real-time impact on self-management, but the validity and reliability of measurements need to be established. In order for patients to become engaged in wearable data gathering, key patient-centered issues relating to usefulness in care, motivation, the safety and privacy of information, and clinical integration need to be addressed. Because the successful usage of wearables requires an ability to comprehend and utilize personal health data, the user experience should account for individual differences in numeracy skills and apply evidence-based behavioral science principles to promote continued engagement. Activity monitoring has the potential to engage patients as advocates in their personalized care, as well as offer health care providers real world assessments of their patients' daily activity patterns. This potential will be realized as the voice of the chronic disease patients is accounted for in the design of devices, measurements are validated against existing clinical assessments, devices become part of the treatment 'prescription', behavior

  1. Medication therapy management clinic: perception of healthcare professionals in a University medical center setting

    Directory of Open Access Journals (Sweden)

    Shah M

    2013-09-01

    Full Text Available Objective: To determine the overall perception and utilization of the pharmacist managed medication therapy management (MTM clinic services, by healthcare professionals in a large, urban, university medical care setting.Methods: This was a cross-sectional, anonymous survey sent to 195 healthcare professionals, including physicians, nurses, and pharmacists at The University of Illinois Outpatient Care Center to determine their perception and utilization of the MTM clinic. The survey consisted of 12 questions and was delivered through a secure online application. Results: Sixty-two healthcare professionals (32% completed the survey. 82% were familiar with the MTM clinic, and 63% had referred patients to the clinic. Medication adherence and disease state management was the most common reason for referral. Lack of knowledge on the appropriate referral procedure was the prominent reason for not referring patients to the MTM clinic. Of the providers that were aware of MTM services, 44% rated care as ‘excellent’, 44% as ‘good’, 5% as ‘fair’, and 0% stated ‘poor’. Strengths of MTM clinic identified by healthcare providers included in-depth education to patients, close follow-up, and detailed medication reconciliation provided by MTM clinic pharmacists. Of those familiar with MTM clinic, recommendations included; increase marketing efforts to raise awareness of the MTM clinic service, create collaborative practice agreements between MTM pharmacists and physicians, and ensure that progress notes are more concise.Conclusion: In a large, urban, academic institution MTM clinic is perceived as a valuable resource to optimize patient care by providing patients with in-depth education as it relates to their prescribed medications and disease states. These identified benefits of MTM clinic lead to frequent patient referrals specifically for aid with medication adherence and disease state management.

  2. PASTE: patient-centered SMS text tagging in a medication management system.

    Science.gov (United States)

    Stenner, Shane P; Johnson, Kevin B; Denny, Joshua C

    2012-01-01

    To evaluate the performance of a system that extracts medication information and administration-related actions from patient short message service (SMS) messages. Mobile technologies provide a platform for electronic patient-centered medication management. MyMediHealth (MMH) is a medication management system that includes a medication scheduler, a medication administration record, and a reminder engine that sends text messages to cell phones. The object of this work was to extend MMH to allow two-way interaction using mobile phone-based SMS technology. Unprompted text-message communication with patients using natural language could engage patients in their healthcare, but presents unique natural language processing challenges. The authors developed a new functional component of MMH, the Patient-centered Automated SMS Tagging Engine (PASTE). The PASTE web service uses natural language processing methods, custom lexicons, and existing knowledge sources to extract and tag medication information from patient text messages. A pilot evaluation of PASTE was completed using 130 medication messages anonymously submitted by 16 volunteers via a website. System output was compared with manually tagged messages. Verified medication names, medication terms, and action terms reached high F-measures of 91.3%, 94.7%, and 90.4%, respectively. The overall medication name F-measure was 79.8%, and the medication action term F-measure was 90%. Other studies have demonstrated systems that successfully extract medication information from clinical documents using semantic tagging, regular expression-based approaches, or a combination of both approaches. This evaluation demonstrates the feasibility of extracting medication information from patient-generated medication messages.

  3. Graded Exercise Testing in a Pediatric Weight Management Center: The DeVos Protocol.

    Science.gov (United States)

    Eisenmann, Joey C; Guseman, Emily Hill; Morrison, Kyle; Tucker, Jared; Smith, Lucie; Stratbucker, William

    2015-12-01

    In this article, we describe a protocol used to test the functional capacity of the obese pediatric patient and describe the peak oxygen consumption (VO2peak) of patients seeking treatment at a pediatric weight management center. One hundred eleven (mean age, 12.5 ± 3.0 years) patients performed a multistage exercise test on a treadmill, of which 90 (81%) met end-test criteria and provided valid VO2peak data. Peak VO2 was expressed: (1) in absolute terms (L·min(-1)); (2) as the ratio of the volume of oxygen consumed per minute relative to total body mass (mL·kg(-1)·min(-1)); and (3) as the ratio of the volume of oxygen consumed per minute relative to fat-free mass (mL·FFM·kg(-1)·min(-1)). Mean BMI z-score was 2.4 ± 0.3 and the mean percent body fat was 36.5 ± 9.7%. Absolute VO2peak (L·min(-1)) was significantly different between sexes; however, relative values were similar between sexes. Mean VO2peak was 25.7 ± 4.8 mL·kg(-1)·min(-1) with a range of 13.5-36.7 mL·kg(-1)·min(-1). Obese youth seeking treatment at a stage 3 pediatric weight management center exhibit low VO2peak. The protocol outlined here should serve as a model for similar programs interested in the submaximal and peak responses to exercise in obese pediatric patients.

  4. Epidemiology and management of chronic thromboembolic pulmonary hypertension: experience from two expert centers

    Directory of Open Access Journals (Sweden)

    Maria Anna Bazmpani

    2018-01-01

    Full Text Available Objectives: Chronic thromboembolic pulmonary hypertension (CTEPH is a rare, distinct pulmonary vascular disease, and therefore, there is a lack of data regarding its clinical presentation, diagnosis, and management at a national basis. We aimed to describe the demographics and management of patients with CTEPH in Northern Greece. Methods: We conducted a retrospective, observational study by a joint collaboration between two pulmonary hypertension expert centers in Greece, and the study included patients diagnosed with CTEPH. The patient population was divided into two groups depending on their operability. Results: Overall, 27 consecutive patients were included (59% female, mean age 59.3±15.1 years. Dyspnea and fatigue were the most common presenting symptoms. History of pulmonary embolism was present in 82%. Of patients, 18 (67% were assessed as operable, of whom 10 (55% finally underwent pulmonary endarterectomy (PEA. There were no differences in symptoms, WHO functional class, 6-min walking test distance, and hemodynamics between the operable and nonoperable groups. At the end of follow-up, all non-operable and operable patients who did not receive surgical treatment were treated with at least one pulmonary hypertension-specific drug. Conclusion: This is the first report that presents data of patients diagnosed with CTEPH in Greece. The percentage of patients who underwent surgical treatment is lower but approaches the reported rates in large registries. Considering that PEA is a relatively safe and potentially curative surgical procedure, we emphasize the need for establishing a designated PEA center in Greece. Keywords: Chronic thromboembolic pulmonary hypertension, pulmonary endarterectomy, registry, riociguat

  5. Management of anemia and iron deficiency in a cancer center in France.

    Science.gov (United States)

    Laï-Tiong, Florence; Brami, Cloé; Dubroeucq, Olivier; Scotté, Florian; Curé, Hervé; Jovenin, Nicolas

    2016-03-01

    Anemia affects most patients treated for cancer by chemotherapy. It is a known major contributor to fatigue and loss of quality of life and is likely to have a negative effect on prognosis and mortality from cancer. The main purpose of this study was to characterize the management of anemia and iron deficiency in a French oncology day-care center. A retrospective study was conducted between May and November 2012 in the oncology day unit of the Jean Godinot Cancer Center (France). The 133 patients included were all over the age of 18 and being treated by chemotherapy and had mild, moderate, or severe anemia. Over half (58%) the patients were shown to be receiving no specific treatment for anemia. Iron balance was assessed in 71 patients and iron deficiency diagnosed in 37. Stepwise logistic regression showed that patients with severe to moderate anemia were nearly four times more likely to have an iron balance assessment than those with mild anemia (OR, 3.78; 95% CI, 1.84-7.76; P = 0.0003). Classical logistic regression shows that older patients (≥70) are three times less likely to have an iron balance assessment than patients anemia and iron deficiency, and the associated quality-of-life concerns, has yet to be defined for patients with cancer. Screening and treatment of mild to moderate anemia are inadequate, despite the advent of erythropoiesis-stimulating agents. Large scale, multicenter studies are required to define a clear medical framework for the management of anemia and iron deficiency.

  6. The impact of patient centered communication in managing Gardner′s syndrome

    Directory of Open Access Journals (Sweden)

    Gayathri Subramanian

    2015-01-01

    Full Text Available Effective patient communication and comprehension are fundamental toward empowering the patient to make optimal health decisions. Barriers in patient health literacy extend beyond cultural and language differences and can significantly impede this process. This case report illustrates a major communication gap that resulted in contradictory perceptions between a treating oncologist and a patient. The patient′s dentist was able to resolve this miscommunication and facilitate the patient′s acceptance of the recommended intravenous chemotherapy for management of malignant desmoid tumors occurring secondary to Gardner′s syndrome (GS. This report also documents classic craniofacial manifestations of GS including multiple unerupted supernumerary teeth, compound odontomas associated with a dentigerous cyst, as well as multiple osteomas in both arches and in the ethmoid and irregularly shaped radioopacities in both arches. In summary, effective patient-centered communication is a prerequisite for the optimal delivery of healthcare. Both interdisciplinary care and one-on-one patient-provider relationship center on coherent bidirectional communication.

  7. Information management for global environmental change, including the Carbon Dioxide Information Analysis Center

    Energy Technology Data Exchange (ETDEWEB)

    Stoss, F.W. [Oak Ridge National Lab., TN (United States). Carbon Dioxide Information Analysis Center

    1994-06-01

    The issue of global change is international in scope. A body of international organizations oversees the worldwide coordination of research and policy initiatives. In the US the National Science and Technology Council (NSTC) was established in November of 1993 to provide coordination of science, space, and technology policies throughout the federal government. NSTC is organized into nine proposed committees. The Committee on Environmental and Natural Resources (CERN) oversees the US Department of Energy`s Global Change Research Program (USGCRP). As part of the USGCRP, the US Department of Energy`s Global Change Research Program aims to improve the understanding of Earth systems and to strengthen the scientific basis for the evaluation of policy and government action in response to potential global environmental changes. This paper examines the information and data management roles of several international and national programs, including Oak Ridge National Laboratory`s (ORNL`s) global change information programs. An emphasis will be placed on the Carbon Dioxide Information Analysis Center (CDIAC), which also serves as the World Data Center-A for Atmospheric Trace Gases.

  8. Improving emergency management through shared information processing - considerations in Emergency Operations Center design

    International Nuclear Information System (INIS)

    DeBusk, R.E.; Walker, J.A.

    1987-01-01

    An Emergency Operations Center (EOC) is a shared information processing facility. Although seemingly obvious, many EOCs are designed and operated based on other criteria. The results, measured in terms of response effectiveness, are difficult to determine. A review of some recent disasters reveals a pattern of poor performance for the EOCs involved. These conclusions are tentative because so little research has been done on the design, operation, or evaluation of emergency operations centers. The EOC is not an onsite response command post but a facility removed from the response where tactical and strategic decisions are made based on information from the response site and elsewhere. The EOC is therefore the central focus of emergency information processing and higher-level decision making. Examining existing EOCs, several common functions emerge. These functions can be described in terms of shared information processing. However, many factors impact the design and operation of EOCs. Politics, budgets, and personal ambition are only a few such factors. Examining EOC design and operation in terms of shared information processing operationalized in the seven principal functions within the EOC provides a framework for establishing principles of EOC design and operation. In the response to emergencies such as Bhopal or Chernobyl the stakes are high. Applying new techniques and technologies of management systems can improve the probability of success. This research is a beginning step - to understand how EOCs function, to define the system. Predictive or prescriptive analysis must wait until sufficient empirical data is available to complete a descriptive model for EOC operations

  9. Managing environmental enhancement plans for individual research projects at a national primate research center.

    Science.gov (United States)

    Thom, Jinhee P; Crockett, Carolyn M

    2008-05-01

    We describe a method for managing environmental enhancement plans for individual research projects at a national primate research center where most monkeys are assigned to active research projects. The Psychological Well-being Program (PWB) at the University of Washington National Primate Research Center developed an Environmental Enhancement Plan form (EEPL) that allows PWB to quantify and track changes in enrichment allowances over time while ensuring that each animal is provided with as much enrichment as possible without compromising research. Very few projects involve restrictions on toys or perches. Some projects have restrictions on food treats and foraging, primarily involving the provision of these enrichments by research staff instead of husbandry staff. Restrictions are not considered exemptions unless they entirely prohibit an element of the University of Washington Environmental Enhancement Plan (UW EE Plan). All exemptions must be formally reviewed and approved by the institutional animal care and use committee. Most exemptions from elements of the UW EE Plan involve social housing. Between 2004 and 2006, the percentage of projects with no social contact restrictions increased by 1%, but those prohibiting any tactile social contact declined by 7%, and projects permitting tactile social contact during part of the study increased by 9%. The EEPL form has facilitated informing investigators about the enrichment their monkeys will receive if no restrictions or exemptions are requested and approved. The EEPL form also greatly enhances PWB's ability to coordinate the specific enrichment requirements of a project.

  10. A Single Center Experience on the Management of Placental Invasion Abnormalities

    Directory of Open Access Journals (Sweden)

    Alper Biler

    2016-03-01

    Full Text Available Objective: The aim of this study is to investigate our management of placental invasion abnormalities. Methods: A retrospective study was conducted on pa­tients admitted to a tertiary referral center with a diagno­sis of placental invasion abnormalities between 2011 and 2015. Risk factors and perinatal outcomes associated with placental invasion abnormalities were identified. Results: The overall incidence of placental invasion ab­normalities during the 5-year period was 8.3/10000 de­liveries, which showed an increasing trend. Ultrasonog­raphy and magnetic resonance imaging correctly identi­fied placental invasion abnormality in 36.7% and 68.7% cases, respectively. Majority of patients (55.1% with ad­herent placenta were diagnosed at the time of delivery. Of these patients, 22.4% underwent hysterectomy, 83.8% required at least one of the additional surgical procedures and 55% were transfused at least four units of packed red blood cell. Conclusion: Since placental invasion abnormalities are associated with significant morbidity, delivery should be scheduled in a tertiary center with appropriate expertise and facilities. J Clin Exp Invest 2016; 7 (1: 14-18

  11. Determination of management by labor competencies in the production process of the Isotope Center

    International Nuclear Information System (INIS)

    Pérez Centurión, Yoneiki; Fernández Rodríguez, Rosio

    2016-01-01

    The present research is carried out in the Center of Isotopes (CENTIS) belonging to the Agency of Nuclear Energy and Advanced Technologies of the Ministry of Science, Technology and Environment of Cuba (CITMA). Its mission is to develop, produce, and supply radiopharmaceuticals, clinical diagnostics and scientific and technical health services in the national and international markets. Based on a diagnosis of the organization through the GRH-DPC model, it was determined that the main problem is the Deficient Management of Human Resources, highlighting as main cause that the labor competencies are not identified at any of its three levels . As a result of this analysis the need to establish a procedure to carry out the process of identification and validation of the competency system, as well as the design of the profile of positions by competencies of the entity. For the development of this work, different tools and techniques were used in the field of research such as: bibliographical analysis, brainstorming, expert method, statistical tools, cause and effect diagram, SWOT matrix, flow diagram, among others. The main result of the research is the identification of the organization's distinctive competencies, those of the key production processes of 99 Mo-99mTc Generators and the profiles of the positions of the Production Management linked to the selected subprocesses.

  12. Fecal sludge management in developing urban centers: a review on the collection, treatment, and composting.

    Science.gov (United States)

    Odey, Emmanuel Alepu; Li, Zifu; Zhou, Xiaoqin; Kalakodio, Loissi

    2017-10-01

    The problems posed by fecal sludge (FS) are multidimensional because most cities rapidly urbanize, which results in the increase in population, urban settlement, and waste generation. Issues concerning health and waste treatment have continued to create alarming situations. These issues had indeed interfered with the proper steps in managing FS, which contaminates the environment. FS can be used in agriculture as fertilizer because it is an excellent source of nutrients. The recent decline in crop production due to loss of soil organic component, erosion, and nutrient runoff has generated interest in the recycling of FS into soil nutrients through stabilization and composting. However, human feces are considerably liable to spread microorganisms to other persons. Thus, sanitation, stabilization, and composting should be the main objectives of FS treatment to minimize the risk to public and environmental health. This review presents an improved FS management (FSM) and technology option for soil amendment that is grouped into three headings, namely, (1) collection, (2) treatment, and (3) composting. On the basis of the literature review, the main problems associated with the collection and treatment of FS, such as inadequate tools and improper treatment processes, are summarized, and the trends and challenges that concern the applicability of each of the technologies in developing urban centers are critically reviewed. Stabilization during pretreatment before composting is suggested as the best method to reduce pathogens in FS. Results are precisely intended to be used as a support for decisions on policies and strategies for FSM and investments for improved treatment facilities.

  13. [ISO 9001certification of a quality management system in a clinical investigation center].

    Science.gov (United States)

    Chesnais, Jimmy; Fougerou-Leurent, Claire; Laforest, Claire; Renault, Alain; Bellissant, Eric; Laviolle, Bruno

    2018-05-03

    Beyond the application of legal requirements, clinical trials must have a permanent approach of quality control. The clinical investigation centers (CICs) are academic structures of clinical research certified by the French National institute of health and medical research (Inserm) and whose functioning relies on recommendations of good practice. It is important to accompany this standardization of practices by the implementation of a quality management system. This article presents the process that enabled the CIC of Rennes to become certified ISO 9001 by French standards association (Afnor) certification in May, 2016. The application of the fundamental principles of the standard ISO 9001 in the domain of clinical research is approached. The problem of the perimeter for the certification and the related process mapping are exposed. The activities of methodology, management and analysis of clinical studies were chosen for the initial certification of the CIC of Rennes. The perspectives for the extension of the perimeter of certification are also approached at the end of article. Copyright © 2018 Société française de pharmacologie et de thérapeutique. Published by Elsevier Masson SAS. All rights reserved.

  14. Hypertension and hyperlipidemia management in patients treated at community health centers.

    Science.gov (United States)

    Kirchhoff, Anne C; Drum, Melinda L; Zhang, James X; Schlichting, Jennifer; Levie, Jessica; Harrison, James F; Lippold, Susan A; Schaefer, Cynthia T; Chin, Marshall H

    2008-01-01

    OBJECTIVE: Community health centers (HCs) provide care for millions of medically underserved Americans with disproportionate burdens of hypertension and hyperlipidemia. For both conditions, treatment guidelines recently became more stringent and quality improvement (QI) efforts have intensified. We assessed hypertension and hyperlipidemia management in HCs during this time of guideline revision and increased QI efforts. DESIGN: Cross-sectional chart review. SETTING AND PARTICIPANTS: Eleven Midwestern HCs for 2000 and 9 for 2002 provided audit data from 2,976 randomly chosen patients with hypertension and/or hyperlipidemia. MEASUREMENT: Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (JNC VI/VII) and National Cholesterol Education Program Adult Treatment Panel (NCEP-ATP III) guidelines were used to assess management of these conditions. RESULTS: Hypertension (2000, N=808; 2002, N=692) and hyperlipidemia (2000, N=774; 2002, N=702) outcomes improved for specific clinical subgroups. Hypertensive patients with 1 or more cardiovascular risk factors demonstrated significant improvement (34% vs. 45% controlled at risk factors (39% vs. 58% controlled at risk groups; however, ongoing QI is necessary.

  15. NASA's Corrosion Technology Laboratory at the Kennedy Space Center: Anticipating, Managing, and Preventing Corrosion

    Science.gov (United States)

    Calle, Luz Marina

    2015-01-01

    The marine environment at NASAs Kennedy Space Center (KSC) has been documented by ASM International (formerly American Society for Metals) as the most corrosive in North America. With the introduction of the Space Shuttle in 1981, the already highly corrosive conditions at the launch pads were rendered even more severe by the highly corrosive hydrochloric acid (HCl) generated by the solid rocket boosters (SRBs). Numerous failures at the launch pads are caused by corrosion. The structural integrity of ground infrastructure and flight hardware is critical to the success, safety, cost, and sustainability of space missions. NASA has over fifty years of experience dealing with unexpected failures caused by corrosion and has developed expertise in corrosion control in the launch and other environments. The Corrosion Technology Laboratory at KSC evolved, from what started as an atmospheric exposure test site near NASAs launch pads, into a capability that provides technical innovations and engineering services in all areas of corrosion for NASA, external partners, and customers.This paper provides a chronological overview of NASAs role in anticipating, managing, and preventing corrosion in highly corrosive environments. One important challenge in managing and preventing corrosion involves the detrimental impact on humans and the environment of what have been very effective corrosion control strategies. This challenge has motivated the development of new corrosion control technologies that are more effective and environmentally friendly. Strategies for improved corrosion protection and durability can have a huge impact on the economic sustainability of human spaceflight operations.

  16. Operation of emergency operating centers during mass casualty incidents in taiwan: a disaster management perspective.

    Science.gov (United States)

    Wen, Jet-Chau; Tsai, Chia-Chou; Chen, Mei-Hsuan; Chang, Wei-Ta

    2014-10-01

    On April 27, 2011, a train derailed and crashed in Taiwan, causing a mass casualty incident (MCI) that was similar to a previous event and with similar consequences. In both disasters, the emergency operating centers (EOCs) could not effectively integrate associated agencies to deal with the incident. The coordination and utilization of resources were inefficient, which caused difficulty in command structure operation and casualty evacuation. This study was designed to create a survey questionnaire with problem items using disaster management phases mandated by Taiwan's Emergency Medical Care Law (EMCL), use statistical methods (t test) to analyze the results and issues the EOCs encountered during the operation, and propose solutions for those problems. Findings showed that EOCs lacked authority to intervene or coordinate with associated agencies. Also, placing emphasis on the recovery phase should improve future prevention and response mechanisms. To improve the response to MCIs, the EMCL needs to be amended to give EOCs the lead during disasters; use feedback from the recovery phase to improve future disaster management and operation coordination; and establish an information-sharing platform across agencies to address all aspects of relief work.(Disaster Med Public Health Preparedness. 2014;0:1-6).

  17. Impelementation of Information Technology Service Management at Data And Information System Center of XYZ University

    Directory of Open Access Journals (Sweden)

    Kornelius Irfandhi

    2016-03-01

    Full Text Available Information Technology (IT is increasingly progressing. Nowadays, the success of a business of the organization/company is highly dependent on the IT infrastructure used. Therefore, organizations/companies have to manage their IT service to be optimal to their customers. Looking at this matter and the increasing dynamics of XYZ University, then Data and Information System Center (Pusdatin - an IT provider of XYZ University began implementing IT Service Management (ITSM from 2013 using the latest version of Information Technology Infrastructure Library (ITIL, namely ITIL v3 as a framework for implementing ITSM in its business processes. However, along the way, there are still some problems happen in Pusdatin in order that ITSM can actually support and align with the objectives of XYZ University. Through this paper, the authors want to explain how the implementation of ITSM at Pusdatin, identify the problems related to the implementation of ITSM, and provide the solutions for each problem. The methods used are direct observation to Pusdatin, conductan interview with the Head of Pusdatin and Staff of Pusdatin, and also perform a literature review of books and papers that discuss about ITIL. The result of this research is that ITSM process of Pusdatin generally works quite well but there are still some shortcomings because ITSM is not 100% implemented in all areas.

  18. Patient-centered approach to ensuring appropriateness of care through blood management.

    Science.gov (United States)

    King, Rita; Michelman, Mark; Curran, Vivian; Bean, Jo; Rowden, Paul; Lindsey, Jeffrey

    2013-06-01

    Concerns have been raised about the safety and efficacy of blood transfusions. Blood products are in demand and a decreasing supply is projected, with resource conservation a global concern. A consultant group determined that the transfusion rate at Mease Countryside Hospital was higher than an average baseline. A process-improvement project was initiated using a multidisciplinary team approach to improve blood utilization and ensure appropriateness in transfusion practice. The foundation of this project was to create new guidelines for transfusion; provide detailed education, communication, reporting, and feedback; and develop criteria to ensure compliance. The mean monthly usage of red blood cell units per 1000 inpatient discharges between April 2010 and October 2011 was 321.4 compared with 212.0 for the 5 months after implementation. The mean monthly number of patients transfused per 1000 inpatient discharges from April 2010 to October 2011 was 135.2 compared with 90.2 after implementation. In both cases, this reduction was found to be statistically significant at a 95% confidence level (P = 0.000 in both respects). The success of this project was the result of careful planning and execution, administrative support, physician leadership, and teamwork. Blood management includes strategies to avoid inappropriate transfusions and proactively treat anemia. Anemia management should be based on the patient's symptoms, laboratory values, and clinical assessment. Treatment of anemia should encompass a patient-centered approach, with the aim of promoting patient safety and minimizing the risk from exposure to blood products.

  19. CONCEPT OF STRUCTURAL ORGANIZATION INFORMATION SITUATIONAL CENTERS FOR OPERATIONAL MANAGEMENT MACHINEBUILDING DIVISION WITH A GEOGRAPHICALLY DISTRIBUTED PRODUCTION

    Directory of Open Access Journals (Sweden)

    Alexander V. Rechkalov

    2014-01-01

    Full Text Available The article considers the problem of organizing the planning system based on virtual manufacturing in constructingsituational center for engineering division. The analysis of foreign and domestic experience in the field of situational management, organization planning and managementsystems as virtual production in relation to the real (underlying production is provided. The scheme of organization situational center for engine-building enterprises of theEngineering Division is given.

  20. Data base management system and display software for the National Geophysical Data Center geomagnetic CD-ROM's

    Science.gov (United States)

    Papitashvili, N. E.; Papitashvili, V. O.; Allen, J. H.; Morris, L. D.

    1995-01-01

    The National Geophysical Data Center has the largest collection of geomagnetic data from the worldwide network of magnetic observatories. The data base management system and retrieval/display software have been developed for the archived geomagnetic data (annual means, monthly, daily, hourly, and 1-minute values) and placed on the center's CD-ROM's to provide users with 'user-oriented' and 'user-friendly' support. This system is described in this paper with a brief outline of provided options.

  1. Evaluation of management of radioactive waste in nuclear medicine department of radiation and isotopes center, Khartoum

    International Nuclear Information System (INIS)

    Ahmed, Amel Bushra Abaker

    2001-01-01

    Evaluation of management of radioactive waste in nuclear medicine department of radiation and isotopes center in Khartoum, Sudan, was conducted using radiation survey meter. The purpose of this study is to provide protection of workers, patients, co patients, an the environment by introducing good practice in management of radioactive waste generated in this lab. In this work measurement of radiation effective dose at different locations in the department were carried out. These locations were selected around the radioactive liquid and solid waste disposal position. It was found that the effective doses per year from radioactive wastes obtained through this work using the survey meter RDS-120 at these locations, are 1.47 mSv/y at the neighbouring patients room, 5.47 mSv/y at the hot lab., 0.09 mSv/y at the neighbouring toilet, 0.321 mSv/y at the water closet, and 1.4 mSv/y at the place down water closet. The results obtained shows that the dose levels waste at the location not exceed the recommended dose limits for workers 20 mSv/y, that set by basic safety standards (Bss 115) which published by the international atomic energy agency. Also it s comply with the national regulation, regulation on basic radiation protection requirement and dose limits 1996, issued by sudan atomic energy commission act 1996. The annual dose calculated for the patients and co-patients at rooms around the nuclear medicine department, the results shows that dose are fairly high. Measure should taken to improve the waste management in the department for better protection of workers, patients and co patients. (Author)

  2. Systemic challenges in bipolar disorder management: A patient-centered approach.

    Science.gov (United States)

    Nestsiarovich, Anastasiya; Hurwitz, Nathaniel G; Nelson, Stuart J; Crisanti, Annette S; Kerner, Berit; Kuntz, Matt J; Smith, Alicia N; Volesky, Emma; Schroeter, Quentin L; DeShaw, Jason L; Young, S Stanley; Obenchain, Robert L; Krall, Ronald L; Jordan, Kimmie; Fawcett, Jan; Tohen, Mauricio; Perkins, Douglas J; Lambert, Christophe G

    2017-12-01

    As part of a series of Patient-Centered Outcomes Research Institute-funded large-scale retrospective observational studies on bipolar disorder (BD) treatments and outcomes, we sought the input of patients with BD and their family members to develop research questions. We aimed to identify systemic root causes of patient-reported challenges with BD management in order to guide subsequent studies and initiatives. Three focus groups were conducted where patients and their family members (total n = 34) formulated questions around the central theme, "What do you wish you had known in advance or over the course of treatment for BD?" In an affinity mapping exercise, participants clustered their questions and ranked the resulting categories by importance. The research team and members of our patient partner advisory council further rated the questions by expected impact on patients. Using a Theory of Constraints systems thinking approach, several causal models of BD management challenges and their potential solution were developed with patients using the focus group data. A total of 369 research questions were mapped to 33 categories revealing 10 broad themes. The top priorities for patient stakeholders involved pharmacotherapy and treatment alternatives. Analysis of causal relationships underlying 47 patient concerns revealed two core conflicts: for patients, whether or not to take pharmacotherapy, and for mental health services, the dilemma of care quality vs quantity. To alleviate the core conflicts identified, BD management requires a coordinated multidisciplinary approach including: improved access to mental health services, objective diagnostics, sufficient provider visit time, evidence-based individualized treatment, and psychosocial support. © 2017 The Authors. Bipolar Disorders Published by John Wiley & Sons Ltd.

  3. A proposal for improving data center management through strategic implementation of Server virtualization technology to support Malaysian Nuclear Agency's activities

    International Nuclear Information System (INIS)

    Mohamad Safuan Sulaiman; Abdul Muin Abdul Rahman; Raja Murzaferi Raja Moktar; Saaidi Ismail

    2010-01-01

    Management of servers in Nuclear Malaysia's data center poses a big challenge to IT Center as well as to the general management. Traditional server management techniques have been used to provide reliable and continuous support for the ever increasing services and applications demanded by researchers and the other staffs of Nuclear Malaysia. Data centers are cost centers which need logistical support such as electricity, air conditioning, room space, manpower and other resources. To save cost and comply with Green Technology while maintaining or improving the level of services, a new concept called server virtualization is proposed and a feasibility study of this technology has been initiated to explore its potential to accommodate IT centers ever demanding services while reducing the need for such logistical supports, hence adhering to the Green IT concept. Server virtualization is a new technology where a single high performance physical server can host multiple high processing services, and different types operating systems with different hardware and software requirements which are traditionally performed by multiple server machines. This paper briefly explains server virtualization concepts, tools and techniques and proposes an implementation strategy of the technology for Nuclear Malaysia's data center. (author)

  4. Patient-centered care in chronic disease management: a thematic analysis of the literature in family medicine.

    Science.gov (United States)

    Hudon, Catherine; Fortin, Martin; Haggerty, Jeannie; Loignon, Christine; Lambert, Mireille; Poitras, Marie-Eve

    2012-08-01

    The objective was to provide a synthesis of the results of the research and discourse lines on main dimensions of patient-centered care in the context of chronic disease management in family medicine, building on Stewart et al.'s model. We developed search strategies for the Medline, Embase, and Cochrane databases, from 1980 to April 2009. All articles addressing patient-centered care in the context of chronic disease management in family medicine were included. A thematic analysis was performed using mixed codification, based on Stewart's model of patient-centered care. Thirty-two articles were included. Six major themes emerged: (1) starting from the patient's situation; (2) legitimizing the illness experience; (3) acknowledging the patient's expertise; (4) offering realistic hope; (5) developing an ongoing partnership; (6) providing advocacy for the patient in the health care system. The context of chronic disease management brings forward new dimensions of patient-centered care such as legitimizing the illness experience, acknowledging patient expertise, offering hope and providing advocacy. Chronic disease management calls for the adaptation of the family physician's role to patients' fluctuating needs. Literature also suggests the involvement of the family physician in care transitions as a component of patient-centered care. Crown Copyright © 2012. Published by Elsevier Ireland Ltd. All rights reserved.

  5. Assessment of Information Security Management System based on ISO/IEC 27001:2013 On Subdirectorate of Data Center and Data Recovery Center in Ministry of Internal Affairs

    Directory of Open Access Journals (Sweden)

    Kurnianto Ari

    2018-01-01

    Full Text Available Information security is a problem effected business process of an organization, so it needs special concern. Information security assessment which is good and has international standard is done using Information Security Management System (ISMS ISO/IEC 27001:2013. In this research, the high level assessment has been done using ISO/IEC 27001:2013 to observe the strength of information secuity in Ministry of Internal Affairs. The research explains about the assessment of information security management which is built using PHP. The input data use primary and secondary data which passed observation. The process gets maturity using the assessment of ISO/IEC 27001:2013. GAP Analysis observes the condition now a days and then to get recommendation and road map. The result of this research gets all of the information security process which has not been already good enough in Ministry of Internal Affairs, gives recommendation and road map to improve part of all information system being running. It indicates that ISO/IEC 27001:2013 is good used to rate maturity of information security management. As the next analyzation, this research use Clause and Annex in ISO/IEC 27001:2013 which is suitable with condition of Data Center and Data Recovery Center, so it gets optimum result and solving problem of the weakness information security.

  6. Assessment of Information Security Management System based on ISO/IEC 27001:2013 On Subdirectorate of Data Center and Data Recovery Center in Ministry of Internal Affairs

    Science.gov (United States)

    Kurnianto, Ari; Isnanto, Rizal; Widodo, Aris Puji

    2018-02-01

    Information security is a problem effected business process of an organization, so it needs special concern. Information security assessment which is good and has international standard is done using Information Security Management System (ISMS) ISO/IEC 27001:2013. In this research, the high level assessment has been done using ISO/IEC 27001:2013 to observe the strength of information secuity in Ministry of Internal Affairs. The research explains about the assessment of information security management which is built using PHP. The input data use primary and secondary data which passed observation. The process gets maturity using the assessment of ISO/IEC 27001:2013. GAP Analysis observes the condition now a days and then to get recommendation and road map. The result of this research gets all of the information security process which has not been already good enough in Ministry of Internal Affairs, gives recommendation and road map to improve part of all information system being running. It indicates that ISO/IEC 27001:2013 is good used to rate maturity of information security management. As the next analyzation, this research use Clause and Annex in ISO/IEC 27001:2013 which is suitable with condition of Data Center and Data Recovery Center, so it gets optimum result and solving problem of the weakness information security.

  7. Cytomegalovirus infection management in solid organ transplant recipients across European centers in the time of molecular diagnostics: An ESGICH survey.

    Science.gov (United States)

    Navarro, David; San-Juan, Rafael; Manuel, Oriol; Giménez, Estela; Fernández-Ruiz, Mario; Hirsch, Hans H; Grossi, Paolo Antonio; Aguado, José María

    2017-12-01

    Scant information is available about how transplant centers are managing their use of quantitative molecular testing (QNAT) assays for active cytomegalovirus (CMV) infection monitoring in solid organ transplant (SOT) recipients. The current study was aimed at gathering information on current practices in the management of CMV infection across European centers in the era of molecular testing assays. A questionnaire-based cross-sectional survey study was conducted by the European Study Group of Infections in Immunocompromised Hosts (ESGICH) of the Society of Clinical Microbiology and Infectious Diseases (ESCMID). The invitation and a weekly reminder with a personal link to an Internet service provider (https://es.surveymonkey.com/) was sent to transplant physicians, transplant infectious diseases specialists, and clinical virologists working at 340 European transplant centers. Of the 1181 specialists surveyed, a total of 173 responded (14.8%): 73 transplant physicians, 57 transplant infectious diseases specialists, and 43 virologists from 173 institutions located at 23 different countries. The majority of centers used QNAT assays for active CMV infection monitoring. Most centers preferred commercially available real-time polymerase chain reaction (RT-PCR) assays over laboratory-developed procedures for quantifying CMV DNA load in whole blood or plasma. Use of a wide variety of DNA extraction platforms and RT-PCR assays was reported. All programs used antiviral prophylaxis, preemptive therapy, or both, according to current guidelines. However, the centers used different criteria for starting preemptive antiviral treatment, for monitoring systemic CMV DNA load, and for requesting genotypic assays to detect emerging CMV-resistant variants. Significant variation in CMV infection management in SOT recipients still remains across European centers in the era of molecular testing. International multicenter studies are required to achieve commutability of CMV testing and

  8. A critical review of the life sciences project management at Ames Research Center for the Spacelab Mission development test 3

    Science.gov (United States)

    Helmreich, R. L.; Wilhelm, J. M.; Tanner, T. A.; Sieber, J. E.; Burgenbauch, S. F.

    1979-01-01

    A management study was initiated by ARC (Ames Research Center) to specify Spacelab Mission Development Test 3 activities and problems. This report documents the problems encountered and provides conclusions and recommendations to project management for current and future ARC life sciences projects. An executive summary of the conclusions and recommendations is provided. The report also addresses broader issues relevant to the conduct of future scientific missions under the constraints imposed by the space environment.

  9. National atmospheric release advisory center (NARAC) tools and services for emergency management

    International Nuclear Information System (INIS)

    Nasstrom, J.

    2003-01-01

    Full text: This paper describes recent scientific and technological advances in the National Atmospheric Release Advisory Center (NARAC) that aid emergency management. The U.S. Department of Energy's NARAC system provides tools and services that help map the probable spread of hazardous material accidentally or intentionally released into the atmosphere. Located at Lawrence Livermore National Laboratory, NARAC is a national support and resource center for planning, real-time assessment and detailed studies of incidents involving a wide variety of hazards, including nuclear, radiological, chemical, or biological emissions. In recent years, the DOE National Nuclear Security Agency (NNSA) Office of Emergency Response and Chemical and Biological National Security Program (CBNP) have supported major upgrades and modernization of NARAC that have advanced the accuracy and utility of NARAC products for emergency planning and management. A new NARAC central modeling system, which became operational in the year 2000, has provided a higher-resolution suite of diagnostic and prognostic meteorological models, and a Lagrangian particle dispersion model, for producing predictions of air concentration, ground deposition, and dose. The 3-D meteorological data assimilation model, ADAPT, and Lagrangian particle dispersion model, LODI, allow the simulation of mean wind advection, turbulent diffusion, radioactive decay and production, bio-agent degradation, first-order chemical reactions, wet deposition, gravitational settling, dry deposition, and buoyant/momentum plume rise. The functions performed by this system have been fully automated to minimized response time for emergencies. An in-house version of the Naval Research Laboratory's COAMPS numerical weather prediction model is used to provide mesoscale forecasts. The final plume predictions are plotted with key geographical information (including estimates of the counts of affected population), and with applicable U

  10. Enforcement management system for decommissioning project in Ningyo-toge Environmental Engineering Center. Results of activities in fiscal year 2014

    International Nuclear Information System (INIS)

    Ema, Akira; Miyagawa, Hiroshi; Ishimori, Yuu

    2016-03-01

    The Ningyo-toge Environmental Engineering Center of the Japan Atomic Energy Agency had managed the decommissioning project based on the Quality Management System and the Environmental Management System, but found that these systems were unsuitable for project management from several viewpoints. In order to solve these problems, the Task Team for Enforcement Backend Project temporarily managed the decommissioning project in 2013. To enforce the project management systematically, the Research and Development Promotion Section was organized newly in the Environmental Research and Development Department in April 2014, and started the project management. On the other hand, to establish the primary and secondary documents related to the new system, until April 2015 the section has been developing the Enforcement Management System (EMS) to separate from the Quality Management System or the Environmental Management System. This report summarizes the state of these activities in the FY 2014. Section 1 presents the introduction. Section 2 explains the procedure of the project management and its achievements. Section 3 discusses how to develop the primary and secondary documents. Section 4 concludes the new management system and further views. (author)

  11. NASA's Corrosion Technology Laboratory at the Kennedy Space Center: Anticipating, Managing, and Preventing Corrosion

    Science.gov (United States)

    Calle, Luz Marina

    2014-01-01

    Corrosion is the degradation of a material that results from its interaction with the environment. The marine environment at NASAs Kennedy Space Center (KSC) has been documented by ASM International (formerly American Society for Metals) as the most corrosive in the United States. With the introduction of the Space Shuttle in 1981, the already highly corrosive conditions at the launch pads were rendered even more severe by the 70 tons of highly corrosive hydrochloric acid that were generated by the solid rocket boosters. Numerous failures at the launch pads are caused by corrosion.The structural integrity of ground infrastructure and flight hardware is critical to the success, safety, cost, and sustainability of space missions. As a result of fifty years of experience with launch and ground operations in a natural marine environment that is highly corrosive, NASAs Corrosion Technology Laboratory at KSC is a major source of corrosion control expertise in the launch and other environments. Throughout its history, the Laboratory has evolved from what started as an atmospheric exposure facility near NASAs launch pads into a world-wide recognized capability that provides technical innovations and engineering services in all areas of corrosion for NASA and external customers.This presentation will provide a historical overview of the role of NASAs Corrosion Technology in anticipating, managing, and preventing corrosion. One important challenge in managing and preventing corrosion involves the detrimental impact on humans and the environment of what have been very effective corrosion control strategies. This challenge has motivated the development of new corrosion control technologies that are more effective and environmentally friendly. Strategies for improved corrosion protection and durability can have a huge impact on the economic sustainability of human spaceflight operations.

  12. A Management State of POPs (Persistent Organic Pollutants) and the Measuring Direction - Centered By-Products

    Energy Technology Data Exchange (ETDEWEB)

    Park, Jeong Gyu; Lee, Hee Seon [Korea Environment Institute, Seoul (Korea)

    2000-12-01

    The chemical materials, DDT and Dioxin, threaten the human health and take the high toxicity on ecosystem and a living thing. Because the chemical materials remain in environment for a long time due to a slow natural decomposition, they are biologically concentrated through the food cycle in ecosystem and have a characteristic to move a long distance. Owing to such toxicity and the characteristics of chemical materials, the world organization named them as Persistent Organic Pollutants (POPs) and has been actively progressing the international movement to strictly restrict them since the middle of 1990s. POPs regulation agreement, which is on progress centered in UNEP, is facing to the conclusion of the agreement of 2001 year. An agricultural chemical of organic chlorine among 12 POPs indicated by UNEP has been already prohibited in the domestic use and manufacturing or not registered, so the basic research, including search and monitoring if POPs remain or not, is required afterward. Because Dioxin, Puran, Hexachlorobenzene (HCB) among POPs, which are produced as by-products from all kinds of industrial processes, are not raw materials dislike other POPs, their use and manufacturing cannot be only prohibited by the related law but also they have few substitutes. Therefore, they should be applied by the different regulation from the existing toxic chemicals in order to manage the toxicity of the materials. However, the regulation on by-products among POPs is just in the beginning stage, and even the producing source has not been yet confirmed. This study suggests the necessity of the management on Dioxin, Puran, HCB, by-products among POPs, and presents the measuring direction with grasping the domestic and foreign trend of the regulation on the materials. 70 refs., 2 figs., 56 tabs.

  13. Management approaches for suspected and established Lyme disease used at the Lyme disease diagnostic center.

    Science.gov (United States)

    Wormser, Gary P; McKenna, Donna; Nowakowski, John

    2016-01-14

    2015 marks the 27th year that the Lyme Disease Diagnostic Center, located in New York State in the United States, has provided care for patients with suspected or established deer tick-transmitted infections. There are five deer tick-transmitted infectious in this geographic area of which Lyme disease is the most common.For patients with erythema migrans, we do not obtain any laboratory testing. However, if the patient is febrile at the time of the visit or reports rigors and high-grade fevers, we consider the possibility of a co-infection and order pertinent laboratory tests.Our preferred management for Lyme disease-related facial palsy and/or radiculopathy is a 2-week course of doxycycline. Patients who are hospitalized for Lyme meningitis are usually treated at least initially with ceftriaxone. We have not seen convincing cases of encephalitis or myelitis solely due to Borrelia burgdorferi infection in the absence of laboratory evidence of concomitant deer tick virus infection (Powassan virus). We have also never seen Lyme encephalopathy or a diffuse axonal peripheral neuropathy and suggest that these entities are either very rare or nonexistent.We have found that Lyme disease rarely presents with fever without other objective clinical manifestations. Prior cases attributed to Lyme disease may have overlooked an asymptomatic erythema migrans skin lesion or the diagnosis may have been based on nonspecific IgM seroreactivity. More research is needed on the appropriate management and significance of IgG seropositivity in asymptomatic patients who have no history of Lyme disease.

  14. Education of nurse practitioners in academic nurse-managed centers: student perspectives.

    Science.gov (United States)

    Tanner, Clare L; Pohl, Joanne; Ward, Sheila; Dontje, Kathy

    2003-01-01

    Clinical experiences for advanced practice nurses are increasingly a challenge. Finding settings that demonstrate primary care nursing practice in its finest form can be difficult. This article reports on nurse practitioner (NP) student feedback on clinical placements in the academic nurse-managed centers (ANMCs) associated with four Michigan schools or colleges of nursing. Student feedback was solicited over three years through site and preceptor evaluation tools and focus groups. Students were overwhelmingly satisfied with their experience in ANMCs. Being mentored by an NP preceptor in an ANMC was a valuable experience for students. They valued the role modeling of the NP and the quality of their preceptors' instruction. Students stated that the nursing model of care to which they were exposed was congruent with classroom learning. They reported learning to apply an understanding of their patients' economic, social, and cultural situations to treatment decisions and patient-education efforts and learning to understand the role of community-based care. One limitation of ANMCs from the students' perspective was a relatively low volume of patients, particularly in the initial years. However, the benefit of having time to spend with clients and to reflect on clinical practice was also articulated.

  15. Pharmaceutical speakers' bureaus, academic freedom, and the management of promotional speaking at academic medical centers.

    Science.gov (United States)

    Boumil, Marcia M; Cutrell, Emily S; Lowney, Kathleen E; Berman, Harris A

    2012-01-01

    Pharmaceutical companies routinely engage physicians, particularly those with prestigious academic credentials, to deliver "educational" talks to groups of physicians in the community to help market the company's brand-name drugs. Although presented as educational, and even though they provide educational content, these events are intended to influence decisions about drug selection in ways that are not based on the suitability and effectiveness of the product, but on the prestige and persuasiveness of the speaker. A number of state legislatures and most academic medical centers have attempted to restrict physician participation in pharmaceutical marketing activities, though most restrictions are not absolute and have proven difficult to enforce. This article reviews the literature on why Speakers' Bureaus have become a lightning rod for academic/industry conflicts of interest and examines the arguments of those who defend physician participation. It considers whether the restrictions on Speakers' Bureaus are consistent with principles of academic freedom and concludes with the legal and institutional efforts to manage industry speaking. © 2012 American Society of Law, Medicine & Ethics, Inc.

  16. Implementation of an Anesthesia Information Management System in an Ambulatory Surgery Center.

    Science.gov (United States)

    Mudumbai, Seshadri C

    2016-01-01

    Anesthesia information management systems (AIMS) are increasingly being implemented throughout the United States. However, little information exists on the implementation process for AIMS within ambulatory surgery centers (ASC). The objectives of this descriptive study are to document: 1) the phases of implementation of an AIMS at an ASC; and 2) lessons learnt from a socio-technical perspective. The ASC, within the Veterans Health Administration (VHA), has hosted an AIMS since 2008. As a quality improvement effort, we implemented a new version of the AIMS. This new version involved fundamental software changes to enhance clinical care such as real-time importing of laboratory data and total hardware exchange. The pre-implementation phase involved coordinated preparation over six months between multiple informatics teams along with local leadership. During this time, we conducted component, integration, and validation testing to ensure correct data flow from medical devices to AIMS and centralized databases. The implementation phase occurred in September 2014 over three days and was successful. Over the next several months, during post-implementation phase, we addressed residual items like latency of the application. Important lessons learnt from the implementation included the utility of partnering early with executive leadership; ensuring end user acceptance of new clinical workflow; continuous testing of data flow; use of a staged rollout; and providing additional personnel throughout implementation. Implementation of an AIMS at an ASC can utilize methods developed for large hospitals. However, issues unique to an ASC such as limited number of support personnel and distinctive workflows must be considered.

  17. Management of vestibular schwannomas with linear accelerator-based stereotactic radiosurgery: a single center experience.

    Science.gov (United States)

    Sager, Omer; Beyzadeoglu, Murat; Dincoglan, Ferrat; Demiral, Selcuk; Uysal, Bora; Gamsiz, Hakan; Oysul, Kaan; Dirican, Bahar; Sirin, Sait

    2013-01-01

    The primary goal of treatment for vestibular schwannoma is to achieve local control without comprimising regional cranial nerve function. Stereotactic radiosurgery has emerged as a viable therapeutic option for vestibular schwannoma. The aim of the study is to report our 15-year single center experience using linear accelerator-based stereotactic radiosurgery in the management of patients with vestibular schwannoma. Between July 1998 and January 2013, 68 patients with unilateral vestibular schwannoma were treated using stereotactic radiosurgery at the Department of Radiation Oncology, Gulhane Military Medical Academy. All patients underwent high-precision stereotactic radiosurgery using a linear accelerator with 6-MV photons. Median follow-up time was 51 months (range, 9-107). Median age was 45 years (range, 20-77). Median dose was 12 Gy (range, 10-13) prescribed to the 85%-95% isodose line encompassing the target volume. Local tumor control in patients with periodic follow-up imaging was 96.1%. Overall hearing preservation rate was 76.5%. Linear accelerator-based stereotactic radiosurgery offers a safe and effective treatment for patients with vestibular schwannoma by providing high local control rates along with improved quality of life through well-preserved hearing function.

  18. Evolution of the Building Management System in the INFN CNAF Tier-1 data center facility.

    Science.gov (United States)

    Ricci, Pier Paolo; Donatelli, Massimo; Falabella, Antonio; Mazza, Andrea; Onofri, Michele

    2017-10-01

    The INFN CNAF Tier-1 data center is composed by two different main rooms containing IT resources and four additional locations that hosts the necessary technology infrastructures providing the electrical power and cooling to the facility. The power supply and continuity are ensured by a dedicated room with three 15,000 to 400 V transformers in a separate part of the principal building and two redundant 1.4MW diesel rotary uninterruptible power supplies. The cooling is provided by six free cooling chillers of 320 kW each with a N+2 redundancy configuration. Clearly, considering the complex physical distribution of the technical plants, a detailed Building Management System (BMS) was designed and implemented as part of the original project in order to monitor and collect all the necessary information and for providing alarms in case of malfunctions or major failures. After almost 10 years of service, a revision of the BMS system was somewhat necessary. In addition, the increasing cost of electrical power is nowadays a strong motivation for improving the energy efficiency of the infrastructure. Therefore the exact calculation of the power usage effectiveness (PUE) metric has become one of the most important factors when aiming for the optimization of a modern data center. For these reasons, an evolution of the BMS system was designed using the Schneider StruxureWare infrastructure hardware and software products. This solution proves to be a natural and flexible development of the previous TAC Vista software with advantages in the ease of use and the possibility to customize the data collection and the graphical interfaces display. Moreover, the addition of protocols like open standard Web services gives the possibility to communicate with the BMS from custom user application and permits the exchange of data and information through the Web between different third-party systems. Specific Web services SOAP requests has been implemented in our Tier-1 monitoring system in

  19. The Counseling Center: An Undervalued Resource in Recruitment, Retention, and Risk Management

    Science.gov (United States)

    Bishop, John B.

    2010-01-01

    A primary responsibility for directors of college and university counseling centers is to explain to various audiences the multiple ways such units are of value to their institutions. This article reviews the history of how counseling center directors have been encouraged to develop and describe the work of their centers. Often overlooked are the…

  20. The financial management of research centers and institutes at U.S. medical schools: findings from six institutions.

    Science.gov (United States)

    Mallon, William T

    2006-06-01

    To explore three questions surrounding the financial management of research centers and institutes at U.S. medical schools: How do medical schools allocate institutional funds to centers and institutes? How and by whom are those decisions made? What are the implications of these decision-making models on the future of the academic biomedical research enterprise? Using a qualitative research design, the author and associates interviewed over 150 faculty members and administrators at six medical schools and their parent universities in 2004. Interview data were transcribed, coded, and analyzed using a grounded theory approach. This methodology generated rich descriptions and explanations of the six medical schools, which can produce extrapolations to, but not necessarily generalizable findings to, other institutions and settings. An examination of four dimensions of financial decision-making-funding timing, process, structure, and culture-produces two essential models of how medical schools approach the financial management of research centers. In the first, a "charity" model, center directors make hat-in-hand appeals directly to the dean, the result of which may depend on individual negotiation skills and personal relationships. In the second, a "planned-giving" model, the process for obtaining and renewing funds is institutionalized, agreed upon, and monitored. The ways in which deans, administrators, department chairs, and center directors attend to, decide upon, and carry out financial decisions can influence how people throughout the medical school think about interdisciplinary and collaborative activities marshalled though centers and institutes.

  1. Building partnerships to produce actionable science to support climate-informed management decisions: North Central Climate Science Center example

    Science.gov (United States)

    Lackett, J.; Ojima, D. S.; McNeeley, S.

    2017-12-01

    As climate change impacts become more apparent in our environment, action is needed to enhance the social-ecological system resilience. Incorporating principles which lead to actionable research and project co-development, when appropriate, will facilitate building linkages between the research and the natural resource management communities. In order to develop strategies to manage for climatic and ecosystem changes, collaborative actions are needed between researchers and resource managers to apply appropriate knowledge of the ecosystem and management environments to enable feasible solutions and management actions to respond to climate change. Our team has been involved in developing and establishing a research and engagement center, the North Central Climate Science Center (NC CSC), for the US Department of Interior, to support the development and translation of pertinent climate science information to natural resource managers in the north central portion of the United States. The NC CSC has implemented a platform to support the Resource for Vulnerability Assessment, Adaptation, and Mitigation Projects (ReVAMP) with research, engagement, and training activities to support resource managers and researchers. These activities are aimed at the co-production of appropriate response strategies to climate change in the region, in particular to drought-related responses. Through this platform we, with other partners in the region, including the Department of Interior and the Department of Agriculture, are bringing various training tools, climate information, and management planning tools to resource managers. The implementation of ReVAMP has led to development of planning efforts which include a more explicit representation of climate change as a driver of drought events in our region. Scenario planning provides a process which integrates management goals with possible outcomes derived from observations and simulations of ecological impacts of climate change. Co

  2. Center for information management and intelligence of the School of Public Legal Defense of the State of Bahia

    Directory of Open Access Journals (Sweden)

    Barbara Coelho Neves

    2012-04-01

    Full Text Available This paper presents the experience report about the implementation of the Center for Information Management and Intelligence administered by the Library of the Public Defender of the State of Bahia. The Center aims to corroborate the information stock, based on capturing the tacit knowledge of public Defenders of DPE. Aspires to social inclusion and the preservation of memory used in human rights activities defensoriais developed. The biggest benefit of creating the Center for Information Management and Intelligence is to provide the availability of information gained by the defenders in a structured way, to all persons interested in the topics defensoriais seized through legal experiences, conferences, training courses, seminars, workshops , Among others. The Center for Information Management and Intelligence of the DPE Library is an important way to efficiently connect "those who know" with those who "need to know" and converting personal knowledge into the organization's memory. For this, the proposal develops the collection, storage, management and dissemination of knowledge with a methodology based on models of the authors Nonaka and Takeuchi, with the help of teenagers "apprentices" in fulfillment of socio-educational measure the Mother City Foundation.

  3. Experiences in the management of plutonium-containing solid-wastes at the Nuclear Research Center Karlsruhe

    International Nuclear Information System (INIS)

    Baehr, W.; Hild, W.; Scheffler, K.

    1974-10-01

    Solid-plutonium-containing wastes from a fuel production plant, a reprocessing plant and several research laboratories are treated at the decontamination department of the Karlsruhe Nuclear Research Center for disposal in the Asse salt mine. Conditioning as well as future aspects in α-waste management are the subject of this Paper. (orig.) [de

  4. How Wageningen University and Research Center managed to influence researchers publishing behaviour towards more quality, impact and visibility

    NARCIS (Netherlands)

    Fondermann, Philipp; Togt, van der P.L.

    2016-01-01

    Wageningen University and Research Center (WUR) is one of the most prestigious research institutions in the world in life sciences and improved significantly in several rankings over the last years. One of the `drivers` of this success story is a comprehensive quality management exercise based on

  5. Marshall Space Flight Center Propulsion Systems Department (PSD) Knowledge Management (KM) Initiative

    Science.gov (United States)

    Caraccioli, Paul; Varnedoe, Tom; Smith, Randy; McCarter, Mike; Wilson, Barry; Porter, Richard

    2006-01-01

    NASA Marshall Space Flight Center's Propulsion Systems Department (PSD) is four months into a fifteen month Knowledge Management (KM) initiative to support enhanced engineering decision making and analyses, faster resolution of anomalies (near-term) and effective, efficient knowledge infused engineering processes, reduced knowledge attrition, and reduced anomaly occurrences (long-term). The near-term objective of this initiative is developing a KM Pilot project, within the context of a 3-5 year KM strategy, to introduce and evaluate the use of KM within PSD. An internal NASA/MSFC PSD KM team was established early in project formulation to maintain a practitioner, user-centric focus throughout the conceptual development, planning and deployment of KM technologies and capabilities within the PSD. The PSD internal team is supported by the University of Alabama's Aging Infrastructure Systems Center of Excellence (AISCE), lntergraph Corporation, and The Knowledge Institute. The principle product of the initial four month effort has been strategic planning of PSD KNI implementation by first determining the "as is" state of KM capabilities and developing, planning and documenting the roadmap to achieve the desired "to be" state. Activities undertaken to suppoth e planning phase have included data gathering; cultural surveys, group work-sessions, interviews, documentation review, and independent research. Assessments and analyses have beon pedormed including industry benchmarking, related local and Agency initiatives, specific tools and techniques used and strategies for leveraging existing resources, people and technology to achieve common KM goals. Key findings captured in the PSD KM Strategic Plan include the system vision, purpose, stakeholders, prioritized strategic objectives mapped to the top ten practitioner needs and analysis of current resource usage. Opportunities identified from research, analyses, cultural1KM surveys and practitioner interviews include

  6. The IRIS Data Management Center: Enabling Access to Observational Time Series Spanning Decades

    Science.gov (United States)

    Ahern, T.; Benson, R.; Trabant, C.

    2009-04-01

    The Incorporated Research Institutions for Seismology (IRIS) is funded by the National Science Foundation (NSF) to operate the facilities to generate, archive, and distribute seismological data to research communities in the United States and internationally. The IRIS Data Management System (DMS) is responsible for the ingestion, archiving, curation and distribution of these data. The IRIS Data Management Center (DMC) manages data from more than 100 permanent seismic networks, hundreds of temporary seismic deployments as well as data from other geophysical observing networks such as magnetotelluric sensors, ocean bottom sensors, superconducting gravimeters, strainmeters, surface meteorological measurements, and in-situ atmospheric pressure measurements. The IRIS DMC has data from more than 20 different types of sensors. The IRIS DMC manages approximately 100 terabytes of primary observational data. These data are archived in multiple distributed storage systems that insure data availability independent of any single catastrophic failure. Storage systems include both RAID systems of greater than 100 terabytes as well as robotic tape robots of petabyte capacity. IRIS performs routine transcription of the data to new media and storage systems to insure the long-term viability of the scientific data. IRIS adheres to the OAIS Data Preservation Model in most cases. The IRIS data model requires the availability of metadata describing the characteristics and geographic location of sensors before data can be fully archived. IRIS works with the International Federation of Digital Seismographic Networks (FDSN) in the definition and evolution of the metadata. The metadata insures that the data remain useful to both current and future generations of earth scientists. Curation of the metadata and time series is one of the most important activities at the IRIS DMC. Data analysts and an automated quality assurance system monitor the quality of the incoming data. This insures data

  7. The impact of ED nurse manager leadership style on staff nurse turnover and patient satisfaction in academic health center hospitals.

    Science.gov (United States)

    Raup, Glenn H

    2008-10-01

    Nurse managers with effective leadership skills are an essential component to the solution for ending the nursing shortage. Empirical studies of existing ED nurse manager leadership styles and their impact on key nurse management outcomes such as staff nurse turnover and patient satisfaction have not been performed. The specific aims of this study were to determine what types of leadership styles were used by ED nurse managers in academic health center hospitals and examine their influence on staff nurse turnover and patient satisfaction. ED nurse managers were asked to complete the Multifactor Leadership Questionnaire and a 10-item researcher defined nurse manager role and practice demographics survey. Completed surveys (15 managers and 30 staff nurses) representing 15 out of 98 possible U.S. academic health centers were obtained. Fisher's exact test with 95% confidence intervals were used to analyze the data. The sample percentage of managers who exhibited Transformational leadership styles and demographic findings of nurse manager age, total years experience and length of time in current position matched current reports in the literature. A trend of lower staff nurse turnover with Transformational leadership style compared to non-Trasformational leadership styles was identified. However, the type of leadership style did not appear to have an effect on patient satisfaction. The ED is an ever-changing, highly regulated, critical-care environment. Effective ED nurse manager leadership strategies are vital to maintaining the standards of professional emergency nursing practice to create an environment that can produce management outcomes of decreased staff nurse turnover, thereby enhancing staff nurse retention and potentially impacting patient satisfaction.

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

    Directory of Open Access Journals (Sweden)

    S Suresh

    2013-12-01

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

  9. On Security Management: Improving Energy Efficiency, Decreasing Negative Environmental Impact, and Reducing Financial Costs for Data Centers

    Directory of Open Access Journals (Sweden)

    Katarzyna Mazur

    2015-01-01

    Full Text Available Security management is one of the most significant issues in nowadays data centers. Selection of appropriate security mechanisms and effective energy consumption management together with caring for the environment enforces a profound analysis of the considered system. In this paper, we propose a specialized decision support system with a multilevel, comprehensive analysis scheme. As a result of the extensive use of mathematical methods and statistics, guidelines and indicators returned by the proposed approach facilitate the decision-making process and conserve decision-maker’s time and attention. In the paper we utilized proposed multilevel analysis scheme to manage security-based data flow in the example data center. Determining the most secure, energy-efficient, environmental friendly security mechanisms, we implemented the role-based access control method in Quality of Protection Modeling Language (QoP-ML and evaluated its performance in terms of mentioned factors.

  10. The Development of the Multi-Center Traffic Management Advisor (MCTMA): Traffic Flow Management Research in a Multi-Facility Environment

    Science.gov (United States)

    Lee, Katharine K.; Davis, Thomas J.; Levin, Kerry M.; Rowe, Dennis W.

    2001-01-01

    The Traffic Management Advisor (TMA) is a decision-support tool for traffic managers and air traffic controllers that provides traffic flow visualization and other flow management tools. TMA creates an efficiently sequenced and safely spaced schedule for arrival traffic that meets but does not exceed specified airspace system constraints. TMA is being deployed at selected facilities throughout the National Airspace System in the US as part of the FAA's Free Flight Phase 1 program. TMA development and testing, and its current deployment, focuses on managing the arrival capacity for single major airports within single terminal areas and single en route centers. The next phase of development for this technology is the expansion of the TMA capability to complex facilities in which a terminal area or airport is fed by multiple en route centers, thus creating a multicenter TMA functionality. The focus of the multi-center TMA (McTMA) development is on the busy facilities in the Northeast comdor of the US. This paper describes the planning and development of McTMA and the challenges associated with adapting a successful traffic flow management tool for a very complex airspace.

  11. Financial management of large, multi-center trials in a challenging funding milieu.

    Science.gov (United States)

    Lovegreen, Olivia; Riggs, Danielle; Staten, Myrlene A; Sheehan, Patricia; Pittas, Anastassios G

    2018-05-03

    Randomized clinical trials that have public health implications but no or low potential for commercial gain are predominantly funded by governmental (e.g., National Institutes of Health (NIH)) and not-for-profit organizations. Our objective was to develop an alternative clinical trial site funding model for judicious allocation of declining public research funds. In the Vitamin D and Type 2 Diabetes (D2d) study, an NIH-supported, large clinical trial testing the effect of vitamin D supplementation on incident diabetes in 2423 participants at high risk for diabetes, a hybrid financial management model for supporting collaborating clinical sites was developed and applied. The funding model employed two reimbursement components: Core (for study start-up and partial efforts throughout the study, ~40% of the total site budget), invoiced by sites, and Performance-Based Payments (for successful enrollment of participants and completion of follow-up visits, ~60% of the total site budget), automatically issued to the sites by the Coordinating Center based on actual recruitment and visits conducted. Underperforming sites transitioned to Performance-Based Payments only. Recruitment occurred from October 2013 through December 2016, requiring one additional year than the 2-year projection. Median enrollment at each site was 88 participants (range 29-318; 20 to 205% of the site target). At the end of year 1, study-wide recruitment was at 12% of the target (vs. 50% projected) and 12% of the total grant award was invested. The model constantly evaluated sites' needs and re-allocated resources to meet the study enrollment goal. If D2d had issued cost reimbursement subaward agreements and sites invoiced for their entire budget, 83% of the award would have been spent for all study activities over the first 4 years of the trial compared to 65% of the award spent (US$26M) under the hybrid model used by D2d. It is feasible to foster a hybrid financial management approach to steward

  12. Management of Placenta Invasion Anomaly and Cesarean Hysterectomy: Eight-year Experience of A Tertiary Center

    Directory of Open Access Journals (Sweden)

    İbrahim Kalelioğllu

    2013-09-01

    Full Text Available Objective: We aimed to present our experience with the management of placenta invasion anomaly by reviewing clinical and operative features of the cases of cesarean hysterectomy performed due to placenta invasion anomaly. Methods: In this retropective study, the charts of all patients who underwent cesarean hysterectomy with an indication of placenta invasion anomaly in Istanbul Faculty of Medicine Department of Obstetrics and Gynecology between 2005 and 2012 were reviewed. Results: In this period a total of 85 patients underwent cesarean hysterectomy. 81 (95.3% cases had experienced at least one cesarean delivery before. Majority of the operations (82.4% were performed in elective conditions. In 16 (18.8% cases bilateral hypogastric artery ligation was carried out because of profuse bleeding. There were no mortalities in the intra- or postoperative period. In 18 (21.2% cases, intraoperative urology consultation was needed. Full- thickness bladder laceration occured in 17 patients, and partial cyctectomy was performed in one patient due to the placenta percreata invading posterior wall of the bladder. Transfusion was needed in 72 (84.7% cases during and 50 (58.8% patients after operation. Dilutional trombocytopenia developed in 17 (20% patients due to massive transfusion. Histopathologically the diganosis was placenta accreata in 55 (64.7%, placenta increata in 1 (1.2% and placenta percreata in 25 (29.4% patients. The incidence of placenta invasion anomaly rose from 0.2% (7/3435 in 2005-2006 up to 0.8% (37/4344 in 2011-2012. Conclusion: The incidence of placenta invasion anomaly is increasing progressively. Cesarean hysterectomy being its classical treatment is an operation with a high risk of morbidity and it should be performed by experienced teams after appropriate preparations in tertiary centers where multidiciplinary approach is possible.

  13. 25 years of monitoring the Waste Management Center of the Almirante Alvaro Alberto Nuclear Power Station

    Energy Technology Data Exchange (ETDEWEB)

    Ferreira, O.C; Barboza, E.; Cardoso, S.N.M., E-mail: landocf@eletronuclear.gov.br, E-mail: barboza@eletronuclear.gov.br, E-mail: sergion@eletronuclear.gov.br [Eletrobras Eletronuclear S.A (ELETONUCLEAR), Paraty, RJ (Brazil). Lab. de Monitoracao Ambiental

    2013-07-01

    The goal of this paper is to present an assessment of 25 years of monitoring of the environment around the Waste Management Center (WMC) of the Almirante Alvaro Alberto Nuclear Power Station (AAANPS) since 1986 until 2011. The Environmental Monitoring Laboratory (EML) has, for purposes, to monitor the environment around the station to verify if there's a potential impact caused by the operation of the two units and to verify the dose rate levels around the waste deposits. The WMC is located in an area belonging to the AAANPS and receive solid waste of low and medium activities from Angra 1 NPP. The waste generated from Angra 2 NPP is stored inside the unit. The EML monitors the environment around the WMC to determine the environmental dose rate. The monitoring is made by direct measurement of the radiation using thermoluminescent dosimeters (TLD). Nowadays, the TLD are installed, at this time, in 6 points at the boundaries of WMC and are changed monthly. The locations of these points were already changed several times to allow the construction of new buildings. The constitution of the TLD are 4 crystals, being 3 crystals of Calcium Sulphate doped with Thulium (CaSO{sub 4}:Tm) with 3 shields and 1 crystal of Lithium Borate doped with Copper (Li{sub 2}B{sub 4}O{sub 7}:Cu) without shield. The results of the TLD measurements are normalized to a period of 30 days to compensate accidental statistical variations of the dose rates. The results, in these 25 years, show that the external area of the WMC is a supervised area, following the Norm CNEN-NN-3.01 - 'Diretrizes Basicas de Protecao Radiologica' - with access permitted only for authorized people. (author)

  14. 25 years of monitoring the Waste Management Center of the Almirante Alvaro Alberto Nuclear Power Station

    International Nuclear Information System (INIS)

    Ferreira, O.C; Barboza, E.; Cardoso, S.N.M.

    2013-01-01

    The goal of this paper is to present an assessment of 25 years of monitoring of the environment around the Waste Management Center (WMC) of the Almirante Alvaro Alberto Nuclear Power Station (AAANPS) since 1986 until 2011. The Environmental Monitoring Laboratory (EML) has, for purposes, to monitor the environment around the station to verify if there's a potential impact caused by the operation of the two units and to verify the dose rate levels around the waste deposits. The WMC is located in an area belonging to the AAANPS and receive solid waste of low and medium activities from Angra 1 NPP. The waste generated from Angra 2 NPP is stored inside the unit. The EML monitors the environment around the WMC to determine the environmental dose rate. The monitoring is made by direct measurement of the radiation using thermoluminescent dosimeters (TLD). Nowadays, the TLD are installed, at this time, in 6 points at the boundaries of WMC and are changed monthly. The locations of these points were already changed several times to allow the construction of new buildings. The constitution of the TLD are 4 crystals, being 3 crystals of Calcium Sulphate doped with Thulium (CaSO 4 :Tm) with 3 shields and 1 crystal of Lithium Borate doped with Copper (Li 2 B 4 O 7 :Cu) without shield. The results of the TLD measurements are normalized to a period of 30 days to compensate accidental statistical variations of the dose rates. The results, in these 25 years, show that the external area of the WMC is a supervised area, following the Norm CNEN-NN-3.01 - 'Diretrizes Basicas de Protecao Radiologica' - with access permitted only for authorized people. (author)

  15. Development of a Standardized Job Description for Healthcare Managers of Metabolic Syndrome Management Programs in Korean Community Health Centers

    Directory of Open Access Journals (Sweden)

    Youngjin Lee, RN, PhD

    2014-03-01

    Conclusion: A job description for healthcare managers may provide basic data essential for the development of a job training program for healthcare managers working in community health promotion programs.

  16. Clinical practice guidelines (CPGs) reduce costs in the management of isolated splenic injuries at pediatric trauma centers.

    Science.gov (United States)

    Gutierrez, Ivan M; Zurakowski, David; Chen, Qiaoli; Mooney, David P

    2013-02-01

    The American Pediatric Surgical Association Trauma Committee proposed the use of a clinical practice guideline (CPG) for the non-operative management of isolated splenic injuries in 1998. An analysis was conducted to determine the financial impact of CPGs on the management of these injuries. The Pediatric Health Information System database, which contains data from 44 children's hospitals, was used to identify children who sustained a graded isolated splenic injury between June 2005 and June 2010. Demographics, length of stay (LOS), readmission rates, and laboratory, imaging, procedural, and total cost data were determined for all hospitals verified as a pediatric trauma center by the American College of Surgeons and/or designated by their local authority. Comparisons were made between facilities self-identifying as having a splenic injury management CPG and those without a CPG. Children (1,154) with isolated splenic injuries (grades 1-4) were cared for in 26 pediatric trauma centers: 20 with a CPG and 6 without (non-CPG). Median costs were significantly lower at CPG than non-CPG centers for imaging (US $163 vs. US $641, P splenic injuries at a pediatric trauma center results in significantly reduced imaging, laboratory, and total hospital costs independent of patient age, gender, grade, and LOS.

  17. Development of Management, Child Development Centers Organization rule Local Government in Udon thani

    OpenAIRE

    Suriya Sukram; Chaiyot Ruangsuwan

    2017-01-01

    This research aims to study the composition and indications 1. The Child Development Centre under the local governments in UdonThani province 2. Study the current state and the desired operating child care centers under the jurisdiction of local governments in UdonThani province. 3. Develop the child development centers under the local governments in UdonThani province. The operation is divided. Phase one of the elements and indicators, the Child Development Center. By synthesi...

  18. The design of maternal centered life-style modification program for weight gain management during pregnancy - a study protocol.

    Science.gov (United States)

    Farajzadegan, Ziba; Pozveh, Zahra Amini

    2013-08-01

    Abnormal weight gain during pregnancy increases the adverse health outcomes during the pregnancy, delivery, and the postpartum period. Most of the pregnant women develop weight gain more than the recommended limits; therefore, interventions to manage such disproportionate weight gain are needed. In this paper, the design of the maternal centered life-style intervention study is described, which focuses on controlling weight gaining during pregnancy for all body mass index (BMI) groups. In our randomized field trial, 160 pregnant women with 6-10 weeks of gestational age who visit one of the participating Isfahan four urban public-health centers and 4 private obstetric offices are included. The maternal centered life-style intervention carried out by trained midwives is standardized in a protocol. All the participants are visited at 6-10, 11-15, 16-20, 21-25, 26-30, 31-34, 35-37, 38, 39, and 40 weeks of pregnancy. The women who are randomized in the intervention group receive maternal centered educational package of prenatal care for the pregnant woman and a log book in the first visit. Counselors accompany the pregnant women to maintain or develop a healthy life-style. Data collection will perform monthly measuring body weight, BMI. Because, we don't have structured protocol for weight management during pregnancy especially, in private sectors if the maternal centered life-style intervention proves to be effective, it will be suggested to merge this package to routine care. Therewith by empowering women to manage their weight the public-health burden can be reduced. Beside that private obstetricians also have structured protocol for their client management.

  19. Relation of people-centered public health and person-centered healthcare management: a case study to reduce burn-out.

    Science.gov (United States)

    Stoyanov, Drozdstoj S; Cloninger, C Robert

    2012-01-01

    Healthcare management is one practical tool for mediation and implementation of public health into clinical healthcare outcomes and is taken in our case study as an exemplar arena to demonstrate the vital importance of the person-centered approach. Healthcare personnel are frequently at risk for the 'burn-out' syndrome. However, modern measures of burn-out recognize burn-out only at a late stage when it is fully developed. There are no available methods to assess the risk for vulnerability to burnout in healthcare systems. Our aim was therefore to design a complex person-centered model for detection of high risk for burn-out at an early stage, that has been termed 'flame-out'. We accept the observation that decreased personal performance is one crucial expression of burn-out. Low personal performance and negative emotions are strongly related to low self-directedness as measured by the Temperament and Character Inventory (TCI). At the same time, burn-out is characterized by decreased interest and positive emotions from work. Decreased positive emotion is directly related to low self-transcendence as measured by the TCI. Burn-out is also frequently associated with feelings of social alienation or inadequacy of support, which is in turn related to low TCI Cooperativeness. However, high Persistence and Harm Avoidance are predisposing traits for burn-out in healthcare professionals who are often overly perfectionistic and compulsive, predisposing them to anxiety, depression, suicide and burn-out. Hence, people at risk for future burn-out are often highly conscientious over-achievers with intense mixtures of positive and negative emotions. The high demand for perfection comes from both intrinsic characteristics and from features of the social milieu in their psychological climate. Letting go of the unfulfillable desire to be perfect by increasing self-transcendence allows acceptance of the imperfection of the human condition, thereby preventing burn-out and other

  20. Trauma centers with higher rates of angiography have a lesser incidence of splenectomy in the management of blunt splenic injury.

    Science.gov (United States)

    Capecci, Louis M; Jeremitsky, Elan; Smith, R Stephen; Philp, Frances

    2015-10-01

    Nonoperative management (NOM) for blunt splenic injury (BSI) is well-established. Angiography (ANGIO) has been shown to improve success rates with NOM. Protocols for NOM are not standardized and vary widely between centers. We hypothesized that trauma centers that performed ANGIO at a greater rate would demonstrate decreased rates of splenectomy compared with trauma centers that used ANGIO less frequently. A large, multicenter, statewide database (Pennsylvania Trauma Systems Foundation) from 2007 to 2011 was used to generate the study cohort of patients with BSI (age ≥ 13). The cohort was divided into 2 populations based on admission to centers with high (≥13%) or low (Splenectomy rates were then compared between the 2 groups, and multivariable logistic regression for predictors of splenectomy (failed NOM) were also performed. The overall rate of splenectomy in the entire cohort was 21.0% (1,120 of 5,333 BSI patients). The high ANGIO group had a lesser rate of splenectoy compared with the low ANGIO group (19% vs 24%; P splenectomy compared with low ANGIO centers (odds ratio, 0.68; 95% CI 0.58-0.80; P splenectomy rates compared with centers with lesser rate of ANGIO. Inclusion of angiographic protocols for NOM of BSI should be considered strongly. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. Waste management tasks of the Radwaste Collecting Centers of the Laender

    International Nuclear Information System (INIS)

    Dreisvogt, H.

    1994-01-01

    The paper outlines the manifold activities of the Radwaste Collecting Centers of the Laender. According to section 9 a, sub-sec. 3 of the Atomic Energy Act, the various Laender in Germany are obliged to establish such centers whose purpose among other things is to serve as interim storage site for radwaste accrued at medical, industrial, or research facilities. (HP) [de

  2. Management and performance features of cancer centers in Europe: A fuzzy-set analysis

    NARCIS (Netherlands)

    Wind, Anke; Lobo, Mariana Fernandes; van Dijk, Joris; Lepage-Nefkens, Isabelle; Laranja-Pontes, Jose; da Conceicao Goncalves, Vitor; van Harten, Willem H.; Rocha-Goncalves, Francisco Nuno

    2016-01-01

    The specific aim of this study is to identify the performance features of cancer centers in the European Union by using a fuzzy-set qualitative comparative analysis (fsQCA). The fsQCA method represents cases (cancer centers) as a combination of explanatory and outcome conditions. This study uses

  3. A Measurement Management Technology for Improving Energy Efficiency in Data Centers and Telecommunication Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Hendrik Hamann, Levente Klein

    2012-06-28

    Data center (DC) electricity use is increasing at an annual rate of over 20% and presents a concern for the Information Technology (IT) industry, governments, and the society. A large fraction of the energy use is consumed by the compressor cooling to maintain the recommended operating conditions for IT equipment. The most common way to improve the DC efficiency is achieved by optimally provisioning the cooling power to match the global heat dissipation in the DC. However, at a more granular level, the large range of heat densities of today's IT equipment makes the task of provisioning cooling power optimized to the level of individual computer room air conditioning (CRAC) units much more challenging. Distributed sensing within a DC enables the development of new strategies to improve energy efficiency, such as hot spot elimination through targeted cooling, matching power consumption at rack level with workload schedule, and minimizing power losses. The scope of Measurement and Management Technologies (MMT) is to develop a software tool and the underlying sensing technology to provide critical decision support and control for DC and telecommunication facilities (TF) operations. A key aspect of MMT technology is integration of modeling tools to understand how changes in one operational parameter affect the overall DC response. It is demonstrated that reduced ordered models for DC can generate, in less than 2 seconds computational time, a three dimensional thermal model in a 50 kft{sup 2} DC. This rapid modeling enables real time visualization of the DC conditions and enables 'what if' scenarios simulations to characterize response to 'disturbances'. One such example is thermal zone modeling that matches the cooling power to the heat generated at a local level by identifying DC zones cooled by a specific CRAC. Turning off a CRAC unit can be simulated to understand how the other CRAC utilization changes and how server temperature responds

  4. Project Portfolio Management: An Investigation of One Air Force Product Center

    National Research Council Canada - National Science Library

    Edmunds, Bryan D

    2005-01-01

    .... This research focuses on the portfolio management (project selection and resource allocation) part of the CTRRP. The purpose of this research effort was to investigate the use of portfolio management within the Air Force...

  5. Decision support tools to support the operations of traffic management centers (TMC)

    Science.gov (United States)

    2011-01-31

    The goal of this project is to develop decision support tools to support traffic management operations based on collected intelligent transportation system (ITS) data. The project developments are in accordance with the needs of traffic management ce...

  6. Management of Low-Level Radioactive Waste from Research, Hospitals and Nuclear Medical Centers in Egypt - 13469

    Energy Technology Data Exchange (ETDEWEB)

    Hasan, M.A.; Selim, Y.T.; Lasheen, Y.F. [Hot Labs and Waste Management Center, Atomic Energy Authority, 3 Ahmed El-Zomor St., El-Zohour District, Naser City, 11787, Cairo (Egypt)

    2013-07-01

    The application of radioisotopes and radiation sources in medical diagnosis and therapy is an important issue. Physicians can use radioisotopes to diagnose and treat diseases. Methods of treatment, conditioning and management of low level radioactive wastes from the use of radiation sources and radioisotopes in hospitals and nuclear medicine application, are described. Solid Radioactive waste with low-level activity after accumulation, minimization, segregation and measurement, are burned or compressed in a compactor according to the international standards. Conditioned drums are transported to the interim storage site at the Egyptian Atomic Energy Authority (EAEA) represented in Hot Labs and Waste Management Center (HLWMC) for storage and monitoring. (authors)

  7. The Effect of Family-centered Care on Management of Blood Glucose Levels in Adolescents with Diabetes.

    Science.gov (United States)

    Cheraghi, Fatemeh; Shamsaei, Farshid; Mortazavi, Sayyedeh Zohreh; Moghimbeigi, Abbas

    2015-07-01

    Responsibility for diabetes management tasks must shift from caregivers to adolescents as adolescents grow older. Also, family-centered care is a way to provide efficient care for them at home. This study aimed to identify the effect of family-centered care on management of blood glucose levels in adolescents with type 1 diabetes mellitus (T1DM). This is a Pre-experimental study with a pre- and post-test design. The participants consisted of forty adolescents with T1DM, aged between 10-14 years, with their caregivers who were selected through simple random sampling from Hamadan Diabetes Research Center in Iran in 2013. The sample was divided into four similar groups. Educational sessions were conducted for each group for 30 to 40 minutes. Data collection tools were "Supervisory Behaviors of Caregiver" (SBC), "Management Behaviors of adolescents" (MBA) questionnaires, and the "Blood Glucose Levels Record Sheet". Data were analyzed using SPSS 19 and based on descriptive statistics, Kolmogorov-Smirnov, paired t-test and Pearson coefficient. There was a significant difference between the subjects' MBA and SBC mean scores before (110.17±26.6) and after (134.6±1.28) intervention in four domains: "blood glucose testing", "insulin therapy", "meal plan" and "physical activity" (PPearson coefficient showed a positive relationship between the supervisory behaviors of caregivers with management behaviors of adolescents before and after the intervention (Pmanagement of blood glucose levels and reduce their HbA1Clevels. Therefore, Family-centered care could provide for better regime adherence at home.

  8. JobCenter: an open source, cross-platform, and distributed job queue management system optimized for scalability and versatility

    Directory of Open Access Journals (Sweden)

    Jaschob Daniel

    2012-07-01

    Full Text Available Abstract Background Laboratories engaged in computational biology or bioinformatics frequently need to run lengthy, multistep, and user-driven computational jobs. Each job can tie up a computer for a few minutes to several days, and many laboratories lack the expertise or resources to build and maintain a dedicated computer cluster. Results JobCenter is a client–server application and framework for job management and distributed job execution. The client and server components are both written in Java and are cross-platform and relatively easy to install. All communication with the server is client-driven, which allows worker nodes to run anywhere (even behind external firewalls or “in the cloud” and provides inherent load balancing. Adding a worker node to the worker pool is as simple as dropping the JobCenter client files onto any computer and performing basic configuration, which provides tremendous ease-of-use, flexibility, and limitless horizontal scalability. Each worker installation may be independently configured, including the types of jobs it is able to run. Executed jobs may be written in any language and may include multistep workflows. Conclusions JobCenter is a versatile and scalable distributed job management system that allows laboratories to very efficiently distribute all computational work among available resources. JobCenter is freely available at http://code.google.com/p/jobcenter/.

  9. JobCenter: an open source, cross-platform, and distributed job queue management system optimized for scalability and versatility.

    Science.gov (United States)

    Jaschob, Daniel; Riffle, Michael

    2012-07-30

    Laboratories engaged in computational biology or bioinformatics frequently need to run lengthy, multistep, and user-driven computational jobs. Each job can tie up a computer for a few minutes to several days, and many laboratories lack the expertise or resources to build and maintain a dedicated computer cluster. JobCenter is a client-server application and framework for job management and distributed job execution. The client and server components are both written in Java and are cross-platform and relatively easy to install. All communication with the server is client-driven, which allows worker nodes to run anywhere (even behind external firewalls or "in the cloud") and provides inherent load balancing. Adding a worker node to the worker pool is as simple as dropping the JobCenter client files onto any computer and performing basic configuration, which provides tremendous ease-of-use, flexibility, and limitless horizontal scalability. Each worker installation may be independently configured, including the types of jobs it is able to run. Executed jobs may be written in any language and may include multistep workflows. JobCenter is a versatile and scalable distributed job management system that allows laboratories to very efficiently distribute all computational work among available resources. JobCenter is freely available at http://code.google.com/p/jobcenter/.

  10. A research on the enhancement of research management efficiency for the division of research, Korea cancer center hospital

    International Nuclear Information System (INIS)

    Lee, S. W.; Ma, K. H.; Kim, J. R.; Lee, D. C.; Lee, J. H.

    1999-06-01

    The research activities of Korea Cancer Center Hospital have increased for the past a few years just in proportion to the increase of research budget, but the assisting manpower of the office of research management has never been increased and the indications are that the internal and external circumstances will not allow the recruitment for a fairly long time. It has, therefore, become inevitable to enhance the work efficiency of the office by analyzing the administrative research assistance system, finding out problems and inefficiency factors, and suggesting possible answers to them. The office of research management and international cooperation has conducted this research to suggest possible ways to facilitate the administrative support for the research activities of Korea Cancer Center Hospital By analyzing the change of research budget, organization of the division of research and administrative support, manpower, and the administrative research supporting system of other institutes, we suggested possible ways to enhance the work efficiency for administrative research support and developed a relative database program. The research report will serve as a data for the organization of research support division when the Radiation Medicine Research Center is established. The database program has already been used for research budget management

  11. Role of the health center in health crisis management, especially in a radiation disaster

    International Nuclear Information System (INIS)

    Kurahashi, Toshiyuki

    2013-01-01

    In a disaster, in particular a radiation disaster, health centers should play an active role in taking advantage of its own expertise. There are various causes of a health crisis; the response to a health crisis is defined according to each cause. However, it should be adequately addressed by assuming the worst case for a health crisis of unknown cause. The role of health centers, in addition to the implementation of appropriate and timely treatment of any health crisis, is prevention of a future health crisis, advanced preparation, and damage recovery; activities during normal times are also important to maintain. Regarding the specific activities of the health center, judgment in the preference of measures to be performed is important. That the information is collected properly based on the idea of risk communication, coordination, and public relations transmission is required also for health centers. (author)

  12. Solid waste management in primary healthcare centers: application of a facilitation tool.

    Science.gov (United States)

    Moreira, Ana Maria Maniero; Günther, Wanda Maria Risso

    2016-08-18

    to propose a tool to facilitate diagnosis, formulation and evaluation of the Waste Management Plan in Primary Healthcare Centers and to present the results of the application in four selected units. descriptive research, covering the stages of formulation /application of the proposed instrument and the evaluation of waste management performance at the units. the tool consists in five forms; specific indicators of waste generation for outpatients healthcare units were proposed, and performance indicators that give scores for compliance with current legislation. In the studied units it is generated common waste (52-60%), infectious-sharps (31-42%) and recyclable (5-17%). The average rates of generation are: 0,09kg of total waste/outpatient assistance and 0,09kg of infectious-sharps waste/outpatient procedure. The compliance with regulations, initially 26-30%, then reached 30-38% a year later. the tool showed to be easy to use, bypassing the existence of a complex range of existing regulatory requirements, allowed to identify non-conformities, pointed out corrective measures and evaluated the performance of waste management. In this sense, it contributes to decision making and management practices relating to waste, tasks usually assigned to nurses. It is recommended that the tool be applied in similar healthcare units for comparative studies, and implementation of necessary adaptations for other medical services. propor instrumento para facilitar diagnóstico, elaboração e avaliação de Plano de Gerenciamento de Resíduos em Unidades Básicas de Saúde e apresentar os resultados da aplicação em quatro unidades selecionadas. pesquisa descritiva que contemplou as etapas de construção/aplicação do instrumento proposto e a avaliação de desempenho do gerenciamento de resíduos nas unidades estudadas. geração de instrumento composto por cinco formulários; proposta de indicadores específicos de geração de resíduos para unidades assistenciais de saúde sem

  13. Challenges in the management of nutritional disorders and communicable diseases in child day care centers: a quantitative and qualitative approach.

    Science.gov (United States)

    Konstantyner, Tulio; Konstantyner, Thais Cláudia Roma de Oliveira; Toloni, Maysa Helena Aguiar; Longo-Silva, Giovana; Taddei, José Augusto de Aguiar Carrazedo

    2017-03-01

    In Brazil, although many children from low income families attend day care centers with appropriate hygiene practices and food programs, they have nutritional disorders and communicable diseases. This quantitative and qualitative cross-sectional study identified staff challenges in child day care centers and suggested alternative activity management to prevent nutritional disorders and communicable diseases. The study included 71 nursery teachers and 270 children from public and philanthropic day care centers (teacher to child ratios of 1:2.57 and 1:6.40, respectively). Interviews and focus groups were conducted with teachers and parents, and anthropometry and blood samples were drawn from the children by digital puncture. Children in philanthropic child day care centers were more likely to be hospitalized due to communicable diseases. Teachers from philanthropic child day care centers had lower age, income and education and higher work responsibilities based on the number of children and working time. The focus groups characterized institutions with organized routines, standard food practices, difficulties with caretaking, and lack of training to provide healthcare to children. Strategies to improve children's health in day care settings should focus on training of teachers about healthcare and nutrition.

  14. Management of pelvic inflammatory disease by primary care physicians. A comparison with Centers for Disease Control and Prevention guidelines.

    Science.gov (United States)

    Hessol, N A; Priddy, F H; Bolan, G; Baumrind, N; Vittinghoff, E; Reingold, A L; Padian, N S

    1996-01-01

    The Centers for Disease Control and Prevention published recommendations for clinicians on the management of pelvic inflammatory disease, but it is unknown if providers are aware of the guidelines or follow them. To compare pelvic inflammatory disease screening, diagnosis, treatment, and reporting practices among primary care physicians with the Centers for Disease Control and Prevention guidelines for pelvic inflammatory disease. A weighted random sample of California primary care physicians surveyed in November 1992 and January 1993. Of the 1,165 physicians surveyed, 553 (48%) returned completed questionnaires. Among respondents, 302 (55%) reported having treated a case of pelvic inflammatory disease during the last 12 months, and of these, 52% answered that they were unsure of or do not follow the Centers for Disease Control and Prevention guidelines for pelvic inflammatory disease. Pediatricians and those with more years since residency were less likely to deviate from the Centers for Disease Control and Prevention guidelines for pelvic inflammatory disease, and family practitioners were more likely to deviate from the guidelines. Pelvic inflammatory disease is commonly encountered by primary care physicians in California. Training and experience were important predictors of compliance with the Centers for Disease Control and Prevention recommendations; however, substantial divergence from the guidelines occurs.

  15. Joint Assessment of Renewable Energy and Water Desalination Research Center (REWDC) Program Capabilities and Facilities In Radioactive Waste Management

    International Nuclear Information System (INIS)

    Bissani, M; Fischer, R; Kidd, S; Merrigan, J

    2006-01-01

    The primary goal of this visit was to perform a joint assessment of the Renewable Energy and Water Desalination Center's (REWDC) program in radioactive waste management. The visit represented the fourth technical and scientific interaction with Libya under the DOE/NNSA Sister Laboratory Arrangement. Specific topics addressed during the visit focused on Action Sheet P-05-5, ''Radioactive Waste Management''. The Team, comprised of Mo Bissani (Team Lead), Robert Fischer, Scott Kidd, and Jim Merrigan, consulted with REWDC management and staff. The team collected information, discussed particulars of the technical collaboration and toured the Tajura facility. The tour included the waste treatment facility, waste storage/disposal facility, research reactor facility, hot cells and analytical labs. The assessment team conducted the first phase of Task A for Action Sheet 5, which involved a joint assessment of the Radioactive Waste Management Program. The assessment included review of the facilities dedicated to the management of radioactive waste at the Tourja site, the waste management practices, proposed projects for the facility and potential impacts on waste generation and management

  16. Managing the output of intermittent sources of electricity: Managers of distribution networks at the center of smart grids

    International Nuclear Information System (INIS)

    Gallean, Gilles

    2013-01-01

    A literal revolution is under way in electricity grids owing to: the rapid decentralized production of electricity, the emergence of an active management of demand, the announcement of new means of storage, and the development of new uses, such as electric vehicles. These changes will gradually happen, differently depending on the country and region; but they will combine to form a system that, to be managed, will call for more intelligence, robots and electronics. At the junction between the production and consumption of electricity, distribution network managers must oversee the new system's technical complexity, limit rising costs and guarantee the quality of the services expected by clients

  17. Relationship Between Self-Management Strategy and Self-Efficacy Among Staff of Ardabil Disaster and Emergency Medical Management Centers

    Directory of Open Access Journals (Sweden)

    Mohammad Taghi Amini

    2018-01-01

    Conclusion: In general, considering that job stress, safety behavior and self-management predictive self-efficacy of emergency staff. Individuals with high self-efficacy wait for the desired outcomes of their performance. So by giving stress management training and applying their safety principles and strategies, targeting can create a sense of self-efficacy such that a person can withstand persistent efforts to overcome obstacles. Improving working conditions also plays an effective role in increasing productivity.

  18. Clinic Workload, the Quality of Staff Relationships and Diabetes Management in Community Health Centers Catering to Latino and Chinese Patients.

    Science.gov (United States)

    Vargas Bustamante, Arturo; Martinez, Ana; Chen, Xiao; Rodriguez, Hector P

    2017-06-01

    We examine whether workplace climate-quality of staff relationships (QSR) and manageable clinic workload (MCW) are related to better patient care experiences and diabetes care in community health centers (CHCs) catering to Latino and Chinese patients. Patient experience surveys of adult patients with type 2 diabetes and workplace climate surveys of clinicians and staff from CHCs were included in an analytic sample. Comparisons of means analyses examine patient and provider characteristics. The associations of QSR, MCW and the diabetes care management were examined using regression analyses. Diabetes care process were more consistently provided in CHCs with high quality staff relations and more manageable clinic workload, but HbA1c, LDL cholesterol, and blood pressure outcomes were no different between clinics with high vs. low QSR and MCW. Focusing efforts on improvements in practice climate may lead to more consistent provision of important processes of diabetes care for these patients.

  19. A Study on Optimized Management Options for the Wolsong Low- and Intermediate - Level Waste Disposal Center in Korea - 13479

    Energy Technology Data Exchange (ETDEWEB)

    Park, JooWan; Kim, DongSun; Choi, DongEun [Korea Radioactive Waste Management Corporation, Korea 89, Bukseongno, Gyeongju, 780-050 (Korea, Republic of)

    2013-07-01

    The safe and effective management of radioactive waste is a national task required for sustainable generation of nuclear power and for energy self-reliance in Korea. Currently, for permanent disposal of low- and intermediate-level waste (LILW), the Wolsong LILW Disposal Center (WLDC) is under construction. It will accommodate a total of 800,000 drums at the final stage after stepwise expansion. As an implementing strategy for cost-effective development of the WLDC, various disposal options suitable for waste classification schemes would be considered. It is also needed an optimized management of the WLDC by taking a countermeasure of volume reduction treatment. In this study, various management options to be applied to each waste class are analyzed in terms of its inventory and disposal cost. For the volume reduction and stabilization of waste, the vitrification and plasma melting methods are considered for combustible and incombustible waste, respectively. (authors)

  20. From honeybees to Internet servers: biomimicry for distributed management of Internet hosting centers.

    Science.gov (United States)

    Nakrani, Sunil; Tovey, Craig

    2007-12-01

    An Internet hosting center hosts services on its server ensemble. The center must allocate servers dynamically amongst services to maximize revenue earned from hosting fees. The finite server ensemble, unpredictable request arrival behavior and server reallocation cost make server allocation optimization difficult. Server allocation closely resembles honeybee forager allocation amongst flower patches to optimize nectar influx. The resemblance inspires a honeybee biomimetic algorithm. This paper describes details of the honeybee self-organizing model in terms of information flow and feedback, analyzes the homology between the two problems and derives the resulting biomimetic algorithm for hosting centers. The algorithm is assessed for effectiveness and adaptiveness by comparative testing against benchmark and conventional algorithms. Computational results indicate that the new algorithm is highly adaptive to widely varying external environments and quite competitive against benchmark assessment algorithms. Other swarm intelligence applications are briefly surveyed, and some general speculations are offered regarding their various degrees of success.

  1. Managing service potentiality of small urban centers case study: City of Sardasht, south east of Iran

    Directory of Open Access Journals (Sweden)

    Farjam Rasoul

    2017-06-01

    Finding showed that those services which are more important in role fulfillment of Sardasht market-town include: sanitation house, health, remedial centers, drugstore, dentistry, high school, pre-university, library, transportation, trading agricultural instrument, referring to the banks, foodstuff and nonfood stuffs stores, post office and telecommunication, referring to official & disciplinary centers, medical services, veterinary. And to some extent farming instruments markets doesn’t affect role fulfillment so it should be focused by those locals in charge. Also the results showed that three settlements, Khomeinishahr, Jakdan and Goharan are going to continue the role fulfillment of Sardasht market- town.

  2. Efficient workload management in geographically distributed data centers leveraging autoregressive models

    Science.gov (United States)

    Altomare, Albino; Cesario, Eugenio; Mastroianni, Carlo

    2016-10-01

    The opportunity of using Cloud resources on a pay-as-you-go basis and the availability of powerful data centers and high bandwidth connections are speeding up the success and popularity of Cloud systems, which is making on-demand computing a common practice for enterprises and scientific communities. The reasons for this success include natural business distribution, the need for high availability and disaster tolerance, the sheer size of their computational infrastructure, and/or the desire to provide uniform access times to the infrastructure from widely distributed client sites. Nevertheless, the expansion of large data centers is resulting in a huge rise of electrical power consumed by hardware facilities and cooling systems. The geographical distribution of data centers is becoming an opportunity: the variability of electricity prices, environmental conditions and client requests, both from site to site and with time, makes it possible to intelligently and dynamically (re)distribute the computational workload and achieve as diverse business goals as: the reduction of costs, energy consumption and carbon emissions, the satisfaction of performance constraints, the adherence to Service Level Agreement established with users, etc. This paper proposes an approach that helps to achieve the business goals established by the data center administrators. The workload distribution is driven by a fitness function, evaluated for each data center, which weighs some key parameters related to business objectives, among which, the price of electricity, the carbon emission rate, the balance of load among the data centers etc. For example, the energy costs can be reduced by using a "follow the moon" approach, e.g. by migrating the workload to data centers where the price of electricity is lower at that time. Our approach uses data about historical usage of the data centers and data about environmental conditions to predict, with the help of regressive models, the values of the

  3. Work-Nonwork Boundary Management Profiles: A Person-Centered Approach

    Science.gov (United States)

    Kossek, Ellen Ernst; Ruderman, Marian N.; Braddy, Phillip W.; Hannum, Kelly M.

    2012-01-01

    The goal of this paper is to advance the measurement and theory of work-nonwork boundary management styles. Boundary management styles are defined as the approaches individuals use to demarcate boundaries and attend to work and family and other nonwork roles, given identity centralities and perceived boundary control. We argue that research should…

  4. Heart transplant centers with multidisciplinary team show a higher level of chronic illness management - Findings from the International BRIGHT Study.

    Science.gov (United States)

    Cajita, Maan Isabella; Baumgartner, Eva; Berben, Lut; Denhaerynck, Kris; Helmy, Remon; Schönfeld, Sandra; Berger, Gabriele; Vetter, Christine; Dobbels, Fabienne; Russell, Cynthia L; De Geest, Sabina

    The objectives of this study were to: (1) explore the proportion of HTx centers that have a multidisciplinary team and (2) assess the relationship between multidisciplinarity and the level of chronic illness management (CIM). The International Society for Heart and Lung Transplantation (ISHLT) recommends a multidisciplinary approach in heart transplant (HTx) follow-up care but little is known regarding the proportion of HTx centers that meet this recommendation and the impact on patient care. HTx centers with a multidisciplinary team may offer higher levels of CIM, a care model that has the potential to improve outcomes after HTx. We conducted a secondary analysis of the BRIGHT study, a cross-sectional study in 11 countries. Multidisciplinarity in the 36 HTx centers was assessed through HTx director reports and was defined as having a team that was composed of physician(s), nurse(s), and another healthcare professional (either a social worker, psychiatrist, psychologist, pharmacist, dietician, physical therapist, or occupational therapist). CIM was assessed with the Patient Assessment of Chronic Illness Care (PACIC). Multiple linear regression assessed the relationship between multidisciplinarity and the level of CIM. Twenty-nine (80.6%) of the HTx centers had a multidisciplinary team. Furthermore, multidisciplinarity was significantly associated with higher levels of CIM (β = 5.2, P = 0.042). Majority of the HTx centers follows the ISHLT recommendation for a multidisciplinary approach. Multidisciplinarity was associated with CIM and point toward a structural factor that needs to be in place for moving toward CIM. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Quality Management Procedures Influence the Food Safety Practices at Childcare Centers

    Science.gov (United States)

    Enke, Allison A.; Briley, Margaret E.; Curtis, Suzanne R.; Greninger, Sue A.; Staskel, Deanna M.

    2007-01-01

    Childcare in the United States (US) has become a necessary part of life for most working parents with the increased use of center-based childcare over the past three decades. Approximately 13 million preschoolers attend some form of childcare. Literature indicates the main predictors of quality childcare programs are adequate experience and…

  6. Management of a Cryptosporidium hominis Outbreak in a Day- care Center

    NARCIS (Netherlands)

    Vandenberg, Olivier; Robberecht, Françoise; Dauby, Nicolas; Moens, Catherine; Talabani, Hana; Dupont, Eddy; Menotti, Jean; van Gool, Tom; Levy, Jack

    2012-01-01

    Background: Cryptosporidium outbreaks in day-care centers (DCCs) occur commonly. However, controlling spread of infection in these settings is difficult, and data about effectiveness of different control strategies are sparse. In this study, a Cryptosporidium outbreak in a large DCC located in

  7. Efficient management of data center resources for massively multiplayer online games

    NARCIS (Netherlands)

    Nae, V.; Iosup, A.; Podlipnig, S.; Prodan, R.; Epema, D.H.J.; Fahringer, T.

    2008-01-01

    Today's massively multiplayer online games (MMOGs) can include millions of concurrent players spread across the world. To keep these highly-interactive virtual environments online, a MMOG operator may need to provision tens of thousands of computing resources from various data centers. Faced with

  8. Natural and Accelerated Bioremediation Research (NABIR) Field Research Center (FRC) Management Plan

    Energy Technology Data Exchange (ETDEWEB)

    Watson, D.B.

    2002-02-28

    The Environmental Sciences Division at Oak Ridge National Laboratory has established a Field Research Center (FRC) to support the Natural and Accelerated Bioremediation Research (NABIR) Program on the U.S. Department of Energy (DOE) Oak Ridge Reservation in Oak Ridge, Tennessee for the DOE Headquarters Office of Biological and Environmental Research within the Office of Science.

  9. Design and implementation of a national center for storage and management of radioactive waste

    International Nuclear Information System (INIS)

    RAKOTOMALALA, H.C.

    2009-01-01

    Despite the benefits of the radioactive sources use, waste generated by radioactive sources, may have harmful effects on human health and the environment. According to principle number 9 of the radioactive waste management, 'the safety of facilities for radioactive waste management should be provided as appropriate throughout their lifetime' radioactive waste must be managed safely, because they are potentially dangerous. By remedy this problem, it well necessary for each waste radioactive producer to establish, an infrastructure for waste radioactive management and storage. For this, the knowledge of climatic, meteorological, geological, seismic and hydrological conditions is a prerequisite for achieving the realization of the storage site. The room storage greatness, offices and other rooms depends on the nature of radiation and characteristics of materials used for construction of walls, as part the construction safety.The strictly tell management must be strictly observed during all operations. The acquisition of equipments for measurement, detection, decontamination and accessories for operations management should not be neglected. After performing the inventory and characterizing all the spent sealed radioactive sources existing in Madagascar (about 130 sealed sources), for to achieve such construction, we would need a capital budget that varies between 250 000 and 300 000 USD (including apparatus detection and accessories for the management of the construction). [fr

  10. Interdisciplinary trauma room management: staff-related apparative and logistic concepts in three level trauma centers in Europe

    International Nuclear Information System (INIS)

    Kroetz, M.; Linsenmaier, U.; Pfeifer, K.J.; Reiser, M.; Bode, P.J.; Haeuser, H.

    2002-01-01

    Objective. To analyse common and divergent features of staff-related, equipmental and spatial/logistical concepts of three large trauma centers of highest health care level.Methods. The health care mandate as well as the staff management, the organisational and the constructional-spacial structure of trauma room diagnostics and therapy of the trauma centers of the Universities of Leiden and Munich (Innenstadt) and the Zentralklinikum Augsburg are described. In particular the technical equipment and the process of the radiological diagnostic procedures in the trauma room are outlined.Results. Staff availability and basic technical equipment of the trauma rooms are comparable between the three hospitals. Divergent concepts exist concerning the complexity of the initial radiologic examination protocols. Spacial connection and importance of computed tomography are also discussed controversially. Urgent interventional procedures are increasingly performed within the trauma room. Magnetic-resonance-tomography does not play a role in early care from multiple injured patients.Conclusion. Trauma centers have to meet certain personnel and technical prerequisites to guarantee a temporally optimised care for multiple injured patients. Differences between the three centers concerning the logistic sequence and the radiologic examination techniques used are mainly due to variable emphasis put on CT in the initial phase of patient care. (orig.) [de

  11. Evolution of Information Management at the GSFC Earth Sciences (GES) Data and Information Services Center (DISC): 2006-2007

    Science.gov (United States)

    Kempler, Steven; Lynnes, Christopher; Vollmer, Bruce; Alcott, Gary; Berrick, Stephen

    2009-01-01

    Increasingly sophisticated National Aeronautics and Space Administration (NASA) Earth science missions have driven their associated data and data management systems from providing simple point-to-point archiving and retrieval to performing user-responsive distributed multisensor information extraction. To fully maximize the use of remote-sensor-generated Earth science data, NASA recognized the need for data systems that provide data access and manipulation capabilities responsive to research brought forth by advancing scientific analysis and the need to maximize the use and usability of the data. The decision by NASA to purposely evolve the Earth Observing System Data and Information System (EOSDIS) at the Goddard Space Flight Center (GSFC) Earth Sciences (GES) Data and Information Services Center (DISC) and other information management facilities was timely and appropriate. The GES DISC evolution was focused on replacing the EOSDIS Core System (ECS) by reusing the In-house developed disk-based Simple, Scalable, Script-based Science Product Archive (S4PA) data management system and migrating data to the disk archives. Transition was completed in December 2007

  12. Changes in chronic disease management among community health centers (CHCs) in China: Has health reform improved CHC ability?

    Science.gov (United States)

    Wang, Zhaoxin; Shi, Jianwei; Wu, Zhigui; Xie, Huiling; Yu, Yifan; Li, Ping; Liu, Rui; Jing, Limei

    2017-07-01

    Since the 1980s, China has been criticized for its mode of chronic disease management (CDM) that passively provides treatment in secondary and tertiary hospitals but lacks active prevention in community health centers (CHCs). Since there are few systematic evaluations of the CHCs' methods for CDM, this study aimed to analyze their abilities. On the macroperspective, we searched the literature in China's largest and most authoritative databases and the official websites of health departments. Literature was used to analyze the government's efforts in improving CHCs' abilities to perform CDM. At the microlevel, we examined the CHCs' longitudinal data after the New Health Reform in 2009, including financial investment, facilities, professional capacities, and the conducted CDM activities. A policy analysis showed that there was an increasing tendency towards government efforts in developing CDM, and the peak appeared in 2009. By evaluating the reform at CHCs, we found that there was an obvious increase in fiscal and public health subsidies, large-scale equipment, general practitioners, and public health physicians. The benefited vulnerable population in this area also rose significantly. However, rural centers were inferior in their CDM abilities compared with urban ones, and the referral system is still not effective in China. This study showed that CHCs are increasingly valued in managing chronic diseases, especially after the New Health Reform in 2009. However, we still need to improve collaborative management for chronic diseases in the community and strengthen the abilities of CHCs, especially in rural areas. Copyright © 2017 John Wiley & Sons, Ltd.

  13. Reference Management Methodologies for Large Structural Models at Kennedy Space Center

    Science.gov (United States)

    Jones, Corey; Bingham, Ryan; Schmidt, Rick

    2011-01-01

    There have been many challenges associated with modeling some of NASA KSC's largest structures. Given the size of the welded structures here at KSC, it was critically important to properly organize model struc.ture and carefully manage references. Additionally, because of the amount of hardware to be installed on these structures, it was very important to have a means to coordinate between different design teams and organizations, check for interferences, produce consistent drawings, and allow for simple release processes. Facing these challenges, the modeling team developed a unique reference management methodology and model fidelity methodology. This presentation will describe the techniques and methodologies that were developed for these projects. The attendees will learn about KSC's reference management and model fidelity methodologies for large structures. The attendees will understand the goals of these methodologies. The attendees will appreciate the advantages of developing a reference management methodology.

  14. Integration of weather information in transportation management center operations : self-evaluation and planning guide

    Science.gov (United States)

    2008-06-30

    The Federal Highway Administrations Road Weather Management Program is helping to reduce the adverse impacts of weather on the transportation system by assisting agencies in integrating weather information and technologies into their daily Transpo...

  15. Financial Management: Ordnance Accountability at Fleet Combat Training Center Atlantic (D-2003-084)

    National Research Council Canada - National Science Library

    Granetto, Paul

    2003-01-01

    .... The audit was performed in support of Public Law 101-576, the "Chief Financial Officers Act of 1990," November 15, 1990, as amended by Public Law 103-356, the "Federal Financial Management Act...

  16. Supply Inventory Management: Industrial Prime Vendor Program at the Air Force Air Logistics Centers

    National Research Council Canada - National Science Library

    2002-01-01

    ... in maintenance, repair, and overhaul facilities. The IPV Program is a customer-oriented, supply-chain management initiative that transfers complete responsibility for bench-stock material to a third-party vendor...

  17. The CMS Electromagnetic Calorimeter: Results on Crystal Measurements, Quality Control and Data Management in the Rome Regional Center

    CERN Document Server

    Costantini, S

    2004-01-01

    The barrel of the CMS electromagnetic calorimeter is currently under construction and will contain 61200 PbWO4 crystals. Half of them are being fully characterized for dimensions, optical properties and light yield in the INFN-ENEA Regional Center near Rome. We describe the setup of an automatic quality control system for the crystal measurements and the present results on their qualification, as well as the REDACLE project, which has been developed to control and ease the production process. As it will not be possible to precalibrate the whole calorimeter,the crystal measurements and quality checks performed at the Regional Center will be crucial to provide a basis for fast in-situ calibration with particles. REDACLE is at the same time a fast database and a data management system, where the database and the workflow structures are decoupled, in order to obtain the best flexibility.

  18. Capabilities for Clinical Management of Radiation Injuries of the Nikiforov Russian Center of Emergency and Radiation Medicine (EMERCOM of Russia)

    International Nuclear Information System (INIS)

    Aleksanin, S.

    2016-01-01

    This article presents an overview of the capabilities for clinical management of radiation injuries available at the Nikiforov Russian Center of Emergency and Radiation Medicine (NRCERM) of the Ministry of the Russian Federation for Civil Defense, Emergencies and Elimination of Consequences of Natural Disasters (EMERCOM). NRCERM is a federal state budgetary institution and the Russian Federation's head organization for providing medical assistance for persons overexposed to ionizing radiation, responders to radiation emergencies and people evacuated from radiation contaminated areas. As the WHO Collaborating Center for Treatment and Rehabilitation of Accident Recovery Workers of Nuclear and Other Disasters and a member of the WHO Radiation Emergency Medical Preparedness and Assistance Network (REMPAN), NRCERM is prepared to provide assistance and technical support in case of a radiation accident. For this purpose, NRCERM hospitals are equipped with technologically advanced facilities and possess well-trained specialist staff. (authors)

  19. Diagnosis and Management Pattern of Lateral Epicondylitis in a Tertiary Care Center

    Directory of Open Access Journals (Sweden)

    Sita Dhakal

    2016-10-01

    application of heat, 63% use of tennis elbow band, 29% exercise and 28% physiotherapy. Surgical intervention (3% was also done when the conservative management failed.  Conclusion: There is professional risk of tennis elbow for housewives, farmers and shopkeepers in context of Nepal. Only one treatment approach is not effective in management of tennis elbow for long term effect. Keywords: lateral epicondylitis; NSAIDs; physiotherapy; steroid; tennis elbow.

  20. New developments in the conduct and management of multi-center trials

    DEFF Research Database (Denmark)

    Gluud, C; Sørensen, T I

    1995-01-01

    There is an urgent need for the performance of more, better designed, and better managed randomized clinical trials. After visits to 43 leading organizations and units involved in clinical trials in Europe and North America during 1993, the way of conducting randomized clinical trials was analyzed...... and data management systems). By employing such developments, randomized clinical trials can run much more efficiently. This facilitates faster and better answers to the questions addressed by randomized clinical trials, thereby also making them more ethical....

  1. Economic perspective on strategic human capital management and planning for the Centers for Disease Control and Prevention.

    Science.gov (United States)

    Roy, Kakoli; Chen, Zhuo Adam; Crawford, Carol A Gotway

    2009-11-01

    An organization's workforce--or human capital--is its most valuable asset. The 2002 President's Management Agenda emphasizes the importance of strategic human capital management by requiring all federal agencies to improve performance by enhancing personnel and compensation systems. In response to these directives, the Centers for Disease Control and Prevention (CDC) drafted its strategic human capital management plan to ensure that it is aligned strategically to support the agency's mission and its health protection goals. In this article, we explore the personnel economics literature to draw lessons from research studies that can help CDC enhance its human capital management and planning. To do so, we focus on topics that are of practical importance and empirical relevance to CDC's internal workforce and personnel needs with an emphasis on identifying promising research issues or methodological approaches. The personnel economics literature is rich with theoretically sound and empirically rigorous approaches for shaping an evidence-based approach to human capital management that can enhance incentives to attract, retain, and motivate a talented federal public health workforce, thereby promoting the culture of high-performance government.

  2. Human-Centered Development of an Online Social Network for Metabolic Syndrome Management.

    Science.gov (United States)

    Núñez-Nava, Jefersson; Orozco-Sánchez, Paola A; López, Diego M; Ceron, Jesus D; Alvarez-Rosero, Rosa E

    2016-01-01

    According to the International Diabetes Federation (IDF), a quarter of the world's population has Metabolic Syndrome (MS). To develop (and assess the users' degree of satisfaction of) an online social network for patients who suffer from Metabolic Syndrome, based on the recommendations and requirements of the Human-Centered Design. Following the recommendations of the ISO 9241-210 for Human-Centered Design (HCD), an online social network was designed to promote physical activity and healthy nutrition. In order to guarantee the active participation of the users during the development of the social network, a survey, an in-depth interview, a focal group, and usability tests were carried out with people suffering from MS. The study demonstrated how the different activities, recommendations, and requirements of the ISO 9241-210 are integrated into a traditional software development process. Early usability tests demonstrated that the user's acceptance and the effectiveness and efficiency of the social network are satisfactory.

  3. Cost-effectiveness analysis of a patient-centered care model for management of psoriasis.

    Science.gov (United States)

    Parsi, Kory; Chambers, Cindy J; Armstrong, April W

    2012-04-01

    Cost-effectiveness analyses help policymakers make informed decisions regarding funding allocation of health care resources. Cost-effectiveness analysis of technology-enabled models of health care delivery is necessary to assess sustainability of novel online, patient-centered health care models. We sought to compare cost-effectiveness of conventional in-office care with a patient-centered, online model for follow-up treatment of patients with psoriasis. Cost-effectiveness analysis was performed from a societal perspective on a randomized controlled trial comparing a patient-centered online model with in-office visits for treatment of patients with psoriasis during a 24-week period. Quality-adjusted life expectancy was calculated using the life table method. Costs were generated from the original study parameters and national averages for salaries and services. No significant difference existed in the mean change in Dermatology Life Quality Index scores between the two groups (online: 3.51 ± 4.48 and in-office: 3.88 ± 6.65, P value = .79). Mean improvement in quality-adjusted life expectancy was not significantly different between the groups (P value = .93), with a gain of 0.447 ± 0.48 quality-adjusted life years for the online group and a gain of 0.463 ± 0.815 quality-adjusted life years for the in-office group. The cost of follow-up psoriasis care with online visits was 1.7 times less than the cost of in-person visits ($315 vs $576). Variations in travel time existed among patients depending on their distance from the dermatologist's office. From a societal perspective, the patient-centered online care model appears to be cost saving, while maintaining similar effectiveness to standard in-office care. Copyright © 2011 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  4. Quality-assurance and data-management plan for water-quality activities in the Kansas Water Science Center, 2014

    Science.gov (United States)

    Rasmussen, Teresa J.; Bennett, Trudy J.; Foster, Guy M.; Graham, Jennifer L.; Putnam, James E.

    2014-01-01

    As the Nation’s largest water, earth, and biological science and civilian mapping information agency, the U.S. Geological Survey is relied on to collect high-quality data, and produce factual and impartial interpretive reports. This quality-assurance and data-management plan provides guidance for water-quality activities conducted by the Kansas Water Science Center. Policies and procedures are documented for activities related to planning, collecting, storing, documenting, tracking, verifying, approving, archiving, and disseminating water-quality data. The policies and procedures described in this plan complement quality-assurance plans for continuous water-quality monitoring, surface-water, and groundwater activities in Kansas.

  5. FAMILY BEHAVIOR IN MAINTENANCE STATUS HB CHRONIC RENAL FAILURE PATIENTS THROUGH FAMILY CENTERED CARE APPROACH OF DIET FE MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Anggia Fajar Hardianti

    2017-04-01

    Full Text Available Introduction: Erythropoietic agent as standard practice for anemia treatment, which has a function to increase the value of hemoglobin (Hb to 12 g/dl in patients with chronic renal failure (CRF, who receiving dialysis treatment. The use of erythropoietin has to keep of the iron/Fe amount in the body. Family who have a duty of care should have knowledge, attitude, and behavior to maintain patient’s Hb by giving support to the patient to obey the Fe diet. The aimed of this study was to investigate the effect of family centered care approach in management Fe diet toward family’s behaviour in maintenance Hb level of CRF patients in hemodialysis ward, Gambiran Hospital, Kediri. Method: This study was used a pre experimental design. Total sample were 10 respondents, who met to inclusion criteria. The independent variables were knowledge, attitude, and psychomotor of family in maintenance of Hb level in CRF’s patients. The dependent variable was Fe diet management with family centered care approach. Data was collected by using a structured questionnaire and home visit observation. Result: Data was analyzed by using Wilcoxon Sign Rank Test with significance level α≤0.05. Results showed that Fe diet management with family centered care approach took effect to family’s knowledge (p=0.011, family’s attitude (p=0.005 and family’s psychomotor (p=0.005 in maintenance Hb level of CRF patients. Discussion: Family’s knowledge, attitude, and psychomotor were effected by experiences during the care of a patient, not affordable to access information and patient’s own decision. The strengths and weaknesses in the family to got a better plan of care can be made by discuss and sharing among researcher, patient and his family. It can be concluded that Fe diet management with family centered care approach took effect to family’s behaviour. Further studies should involve larger respondents and better measurement tools to obtain more accurate results.

  6. Development of a site-wide accident management center for the Savannah River Site

    International Nuclear Information System (INIS)

    Heal, D.W.; Britt, T.E.

    1992-01-01

    In 1990, the Safety Analysis Group at the Savannah River Site (SRS) began development of an Accident Management program. The program was designed to provide a total system which would meet the Department of Energy (DOE) Safety Performance Criteria, in regard to severe accident management, in the most effective manner. This paper will present two significant changes in the current SRS Accident Management program which will be used to meet these expanded needs. The first and most significant change will be to expand the diversity of the groups involved in the Accident Management process. In the future, organizations such as Environmental Safety, Health ampersand Quality Assurance, Emergency Planning, Site Management, Human Factors, Risk Assessment, and many others will work as an integrated team to solve facility problems. Organizations such as Materials Technology, Equipment Engineering and many of the laboratories on site will be utilized as support groups to increase the technical capability for specific accident analyses. This phase of the program is currently being structured, and should be operational by January of 1993

  7. Evaluation of an electronic health record-supported obesity management protocol implemented in a community health center: a cautionary note.

    Science.gov (United States)

    Steglitz, Jeremy; Sommers, Mary; Talen, Mary R; Thornton, Louise K; Spring, Bonnie

    2015-07-01

    Primary care clinicians are well-positioned to intervene in the obesity epidemic. We studied whether implementation of an obesity intake protocol and electronic health record (EHR) form to guide behavior modification would facilitate identification and management of adult obesity in a Federally Qualified Health Center serving low-income, Hispanic patients. In three studies, we examined clinician and patient outcomes before and after the addition of the weight management protocol and form. In the Clinician Study, 12 clinicians self-reported obesity management practices. In the Population Study, BMI and order data from 5000 patients and all 40 clinicians in the practice were extracted from the EHR preintervention and postintervention. In the Exposure Study, EHR-documented outcomes for a sub-sample of 46 patients actually exposed to the obesity management form were compared to matched controls. Clinicians reported that the intake protocol and form increased their performance of obesity-related assessments and their confidence in managing obesity. However, no improvement in obesity management practices or patient weight-loss was evident in EHR records for the overall clinic population. Further analysis revealed that only 55 patients were exposed to the form. Exposed patients were twice as likely to receive weight-loss counseling following the intervention, as compared to before, and more likely than matched controls. However, their obesity outcomes did not differ. Results suggest that an obesity intake protocol and EHR-based weight management form may facilitate clinician weight-loss counseling among those exposed to the form. Significant implementation barriers can limit exposure, however, and need to be addressed. © The Author 2015. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  8. Interdepartmental interaction model on the extracurricular activities of students in the city of Surgut in the quality management system of the municipal state institution "Information and Methodological Center"

    OpenAIRE

    Loseva E. A.

    2018-01-01

    in this article the author considers interdepartmental interaction model in the field of extracurricular activities of students in the quality management system. The topic is examined on the example of the municipal state institution "Information and Methodological Center".

  9. The Relationship between Knowledge and Attitude of Managers with Preparedness of Healthcare Centers in Rey Health Network against Earthquake Risk - 2013

    Directory of Open Access Journals (Sweden)

    Mohammad Asadzadeh

    2014-06-01

    Conclusions: Considering that managers’ knowledge was rather low, preparedness among centers was low as well. According to low knowledge and unsuitable preparedness, more theoretical and practical trainings and maneuvers were necessary to be held for managers about earthquake preparedness.

  10. Nurse manager perceptions of role satisfaction and retention at an academic medical center.

    Science.gov (United States)

    Zwink, Jennifer E; Dzialo, Maureen; Fink, Regina M; Oman, Kathleen S; Shiskowsky, Kaycee; Waite, Kathi; DeVine, Deborah; Sanders, Carolyn L; Le-Lazar, Jamie T T

    2013-03-01

    The aim of this study was to explore the perceptions of inpatient acute care nurse managers (NM) employed at an academic Magnet® hospital about factors that influence NM retention, including current work environment, satisfaction, work-life balance, sucssful NM traits, and personal development and educational needs. Nurse managers are challenged with increased workloads impacting their ability to implement all role components. A qualitative descriptive study design used focus group methodology to explore perceptions of the NM role. Nurse managers identified staff recognition, support, peer relationships, collaboration, and ability to make positive change as factors influencing their decision to remain in the role. Burnout factors included workload issues, work-life imbalance, and difficulty sustaining positive relationships. Traits supporting success were communication, resiliency, integrity, and a visionary outlook. Suggestions for NM development and education were identified. Findings can be used to improve NM satisfaction, work-life balance, recruitment, retention, and succession planning.

  11. Implementation of Information Management System for Radiation Safety of Personnel at the Russian Northwest Center for Radioactive Waste Management 'SevRAO' - 13131

    Energy Technology Data Exchange (ETDEWEB)

    Chizhov, K.; Simakov, A.; Seregin, V.; Kudrin, I.; Shandala, N.; Tsovyanov, A.; Kryuchkov, V. [Burnasyan Federal Medical Biophysical Center of Federal Medical Biological Agency, RF Ministry of Health and Social Development. 46, Zhivopisnaya St., Moscow, 123182 (Russian Federation); Krasnoschekov, A.; Kosnikov, A. [Northwest Center for Radioactive Waste Management ' SevRAO' - a branch of the Federal State Unitary Enterprise ' Enterprise for Radioactive Waste Management' ' RosRAO' 183017, Murmansk, Lobova st., 100 (Russian Federation); Kemsky, I. [Regional management - 120 of the Federal Medical-Biological Agency, 184682, Snezhnogorsk, Valentina Biryukova St., 5/1 (Russian Federation); Sneve, M. [Norwegian Radiation Protection Authority, Postboks 55, 1332 Oesteraas (Norway)

    2013-07-01

    The report is an overview of the information-analytical system designed to assure radiation safety of workers. The system was implemented in the Northwest Radioactive Waste Management Center 'SevRAO' (which is a branch of the Federal State Unitary Enterprise 'Radioactive Waste Management Enterprise RosRAO'). The center is located in the Northwest Russia. In respect to 'SevRAO', the Federal Medical-Biological Agency is the regulatory body, which deals with issues of radiation control. The main document to regulate radiation control is 'Reference levels of radiation factors in radioactive wastes management center'. This document contains about 250 parameters. We have developed a software tool to simplify control of these parameters. The software includes: input interface, the database, dose calculating module and analytical block. Input interface is used to enter radiation environment data. Dose calculating module calculates the dose on the route. Analytical block optimizes and analyzes radiation situation maps. Much attention is paid to the GUI and graphical representation of results. The operator can enter the route at the industrial site or watch the fluctuations of the dose rate field on the map. Most of the results are presented in a visual form. Here we present some analytical tasks, such as comparison of the dose rate in some point with control levels at this point, to be solved for the purpose of radiation safety control. The program helps to identify points making the largest contribution to the collective dose of the personnel. The tool can automatically calculate the route with the lowest dose, compare and choose the best route. The program uses several options to visualize the radiation environment at the industrial site. This system will be useful for radiation monitoring services during the operation, planning of works and development of scenarios. The paper presents some applications of this system on real data

  12. Configuration Management (CM) Support for KM Processes at NASA/Johnson Space Center (JSC)

    Science.gov (United States)

    Cioletti, Louis

    2010-01-01

    Collection and processing of information are critical aspects of every business activity from raw data to information to an executable decision. Configuration Management (CM) supports KM practices through its automated business practices and its integrated operations within the organization. This presentation delivers an overview of JSC/Space Life Sciences Directorate (SLSD) and its methods to encourage innovation through collaboration and participation. Specifically, this presentation will illustrate how SLSD CM creates an embedded KM activity with an established IT platform to control and update baselines, requirements, documents, schedules, budgets, while tracking changes essentially managing critical knowledge elements.

  13. Task shifting of HIV/AIDS case management to Community Health Service Centers in urban China: a qualitative policy analysis.

    Science.gov (United States)

    Ma, Fuchang; Lv, Fan; Xu, Peng; Zhang, Dapeng; Meng, Sining; Ju, Lahong; Jiang, Huihui; Ma, Liping; Sun, Jiangping; Wu, Zunyou

    2015-07-02

    The growing number of people living with HIV/AIDS (PLWHA) in China points to an increased need for case management services of HIV/AIDS. This study sought to explore the challenges and enablers in shifting the HIV/AIDS case management services from Centers for Disease Control and Prevention (CDCs) to Community Health Service Centers (CHSCs) in urban China. A qualitative method based on the Health Policy Triangle (HPT) framework was employed to gain in-depth insights into four elements of the task shifting strategy. This included a review on published literature and health policy documents, 15 focus group discussions (FGDs) and 30 in-depth interviews (IDIs) with four types of key actors from three cities in China. A total of 78 studies and 17 policy files at the national, municipal and local levels were obtained and reviewed comprehensively. Three semi-structured interview guides were used to explore key actors' views on shifting the HIV/AIDS case management services to CHSCs. It is necessary and feasible for CHSCs to engage in case management services for PLWHA in local communities. The increasing number of PLWHA and shortage of qualified health professionals in CDCs made shifting case management services downwards to CHSCs an urgent agenda. CHSCs' wide distribution, technical capacity, accessibility and current practice enabled them to carry out case management services for PLWHA. However our findings indicated several challenges in this task shifting process. Those challenges included lack of specific policy and stable financial support for CHSCs, inadequate manpower, relatively low capacity for health service delivery, lack of coordination among sectors, PLWHA's fear for discrimination and privacy disclosure in local communities, which may compromise the effectiveness and sustainability of those services. Shifting the HIV/AIDS case management services from CDCs to CHSCs is a new approach to cope with the rising number of PLWHA in China, but it should be

  14. Management of Type II Odontoid Fractures: Experience from Latin American Spine Centers.

    Science.gov (United States)

    Falavigna, Asdrubal; Righesso, Orlando; da Silva, Pedro Guarise; Siri, Carlos Rocca; Daniel, Jefferson W; Esteves Veiga, José Carlos; de Azevedo, Gustavo Borges Laurindo; Carelli, Luis Eduardo; Yurac, Ratko; Sanchez Chavez, Felix Adolfo; Sfreddo, Ericson; Cecchini, Andre; do Reis, Marcelo Martins; Jiménez Avila, Jose Maria; Riew, K Daniel

    2017-02-01

    To analyze characteristics of type II odontoid fracture (TII-OF), including clinical and radiographic factors, that influence surgical planning in 8 Latin American centers. Retrospective chart review was performed of 88 patients with TII-OF between 2004 and 2015 from 8 Latin American centers. Parameters studied included 1) demographic data and causes of TII-OF, 2) clinical and neurologic presentation, 3) characteristics of fracture (degree of odontoid displacement, displacement of odontoid relative to C2 body, anatomy of fracture line, distance between fragments, presence of comminution, contact area between odontoid and C2 body), 4) type of treatment, and 5) clinical and radiographic outcome. Bone fusion was assessed using computed tomography. Mean patient age was 45.33 years ± 23.54; 78.4% of patients were male. Surgery was the primary treatment in 65 patients (73.8%), with an anterior approach in 64.6%. Surgery was usually preferred in patients with posterior or horizontal oblique fracture lines, local pain, and a smaller bone contact surface between the odontoid and the body of C2. A posterior approach was chosen when distance between the fractured bone fragments was >2 mm or after failed conservative or anterior odontoid screw treatment in a symptomatic patient. The treatment of choice for TII-OF in 8 Latin American trauma centers was surgery through an anterior approach using screw fixation. Posterior segmental C1-C2 fixation was indicated when distance between bone fragments was >2 mm and in symptomatic patients with nonunion. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Inventory management and control at the central distribution center for Univar Products International B.V.

    NARCIS (Netherlands)

    Pholnukulkit, Pimara

    2008-01-01

    This report presents the outcome of the Logistics Design Project carried out for Univar Products International B.V. The goal of this project is to design an inventory control system and implement an inventory control tool that supports decisions in managing inventory of all products in the central

  16. A consumer health record for supporting the patient-centered management of chronic diseases

    NARCIS (Netherlands)

    de Clercq, Paul A.; Hasman, Arie; Wolffenbuttel, Bruce H. R.

    2003-01-01

    OBJECTIVES: To design and implement a shareable consumer health record system to investigate whether the system can assist in the management of chronic diseases. METHODS: A toolkit was designed for constructing the consumer health record system in an evolutionary way. An ethnographic-like approach

  17. A consumer health record for supporting the patient-centered management of chronic diseases

    NARCIS (Netherlands)

    Clercq, de P.A.; Hasman, A.; Wolffenbuttel, B.H.R.

    2003-01-01

    Objectives : To design and implement a shareable consumer health record system to investigate whether the system can assist in the management of chronic diseases. Methods : A toolkit was designed for constructing the consumer health record system in an evolutionary way. An ethnographic-like approach

  18. A Risk-based, Practice-centered Approach to Project Management for HPCMP CREATE

    Science.gov (United States)

    2015-10-05

    form of videoconferencing. These impediments have been mitigated to some extent by using browser-based Software as a Service ( SaaS ) access to CREATE...one-time password (OTP), and OpenID. Security is managed within the DREN, as opposed to every desktop. As a “Software as a Service” ( SaaS

  19. Determining Successful Approaches for a Total Quality Management Training Program for Tripler Army Medical Center, Hawaii

    Science.gov (United States)

    1993-08-01

    job in the private sector ."’ 23) WHAT HAVE YOU LEARNED FROM THE TQM IMPLEMENTATION PROCESS? (LESSONS LEARNED?) 1) Top management support. 2) JIT...wanted ’blanket training’ for TQM familiarization. 10) HOW WAS YOUR TQM TRAINING PROGRAM FORMULATED (INTERNAL ASSESSMENT)? "We used a quality of worklife

  20. A consumer health record for supporting the patient-centered management of chronic diseases

    NARCIS (Netherlands)

    De Clercq, Paul A; Hasman, Arie; Wolffenbuttel, Bruce H R

    Objectives : To design and implement a shareable consumer health record system to investigate whether the system can assist in the management of chronic diseases. Methods : A toolkit was designed for constructing the consumer health record system in an evolutionary way. An ethnographic-like approach

  1. Surgical management in enterovesical fistula in Crohn disease at a single medical center.

    Science.gov (United States)

    Su, Yann-Rong; Shih, I-Lun; Tai, Huai-Ching; Wei, Shu-Chen; Lin, Been-Ren; Yu, Hong-Jeng; Huang, Chao-Yuan

    2014-01-01

    Crohn disease is a chronic, transmural, inflammatory disease of the gastrointestinal tract with unknown etiology. It can affect any part of the gastrointestinal tract and may cause fistula, stricture, or abscess formation with disease progression. The preoperative diagnosis and definite management of this rare complication are challenges for physicians, urologists, and surgeons.

  2. Urgent surgical management for embolized occluder devices in childhood: single center experience

    Directory of Open Access Journals (Sweden)

    Gokaslan Gokhan

    2012-12-01

    Full Text Available Abstract Background In this study, we sought to analyze our experience in urgent surgical management for embolized cardiac septal and ductal occluder devices resulting from trans-catheter closure of atrial septal defect, ventricular septal defect and patent ductus arteriosus in childhood patient group. Methods We retrospectively reviewed 9 patients (aged 2–15 years who underwent urgent surgery due to cardiac septal and ductal occluder embolization between January 2007 and December 2010. Congenital defects were atrial septal defect (n = 6, ventricular septal defect (n = 1, and patent ductus arteriosus (n = 2. Risk factors for device embolization and urgent surgical management techniques for embolized device removal were discussed. Results Removal of embolized devices in all cases and repair of damaged tricuspid valve in 2 patients were performed. Inevitably, all congenital defects were closed or ligated up to the primary defect. Total circulator arrest necessitated in 1 patient with ascending aortic device embolization. All operations were completed successfully and no hospital mortality or morbidity was encountered. Conclusions Although closure of left to right shunting defects by percutaneous occluder devices has a lot of advantages, device embolization is still a major complication. If embolized device retrieval fails with percutaneous intervention attempts, surgical management is the only method to remove embolized devices. In this circumstance, to provide an uneventful perioperative course, urgent management strategies should be well planned.

  3. Diagnosis and improvement proposals for the Ezeiza Atomic Center quality management system by carrying out the third laboratories workshop

    International Nuclear Information System (INIS)

    Eliosoff, Nilda M.

    2003-01-01

    By the end of 2001 the management of the Ezeiza Atomic Center (EAC) under the National Atomic Energy Commission of Argentina, stated the necessity of carrying out a survey of its laboratories. The purpose of this survey was to get information that would allow to assess the quality of the laboratories and the services they perform, including the degree of implementation of the management systems. In order to comply with this purpose fourteen EAC's laboratories were studied. The information obtained was related to the staff, their training, the kind of tasks they perform as services or as research and development, the customers, the amount of invoicing, the premises, the equipment and the adapting and implementation of the quality management system. With the results obtained from the survey a report was issued. Economic, Financial, Commercial and Human Resources workshops as well as Technical Aspects and Quality Management workshops were organized. These workshops were to go deep into the analysis of the information obtained and to generate improvement proposals of the different subjects. (author)

  4. Engaging Teens with Asthma in Designing a Patient-Centered Mobile App to Aid Disease Self-Management.

    Science.gov (United States)

    Schneider, Tali; Panzera, Anthony D; Couluris, Marisa; Lindenberger, James; McDermott, Robert; Bryant, Carol A

    2015-08-10

    Despite the growing market of e-health disease self-management tools, few studies have reported the presence of teen patients in all phases of product design. While rates of American teens using mobile Internet grow, an opportunity to deliver disease self-management targeted for teen patients exists. Building on findings from previous investigations with teens with asthma, we explored teens' insights on the development of a patient-centered asthma management application (app). Two existing asthma apps were used by 16 teen asthmatics for 7-10 days. At the end of the trial period, in-depth interviews were conducted with each participant to gather insights about the user experience. Participants requested more asthma-related content that educates them about their condition. Suggested improvements to currently available apps included a longer list of selectable symptoms to track, medication tracking, and more compelling interface features. Participants showed interest in using apps for managing their asthma, yet recommended improvements on current design. Whereas national figures point to a more ubiquitous mobile device environment, implementation efforts must respond to participants' recommendations while minding lingering digital divides. Currently available apps lack appealing components that teens seek or desire. Subsequent development should include teens' participation in component design insights.

  5. Epidemiology, surgical management and early postoperative outcome in a cohort of gastric cancer patients of a tertiary referral center in relation to multi-center quality assurance studies.

    Science.gov (United States)

    Garlipp, Benjamin; Schwalenberg, Jens; Adolf, Daniela; Lippert, Hans; Meyer, Frank

    2011-03-01

    The aim of the study was to analyze epidemiologic parameters, treatment-related data and prognostic factors in the management of gastric cancer patients of a university surgical center under conditions of routine clinical care before the onset of the era of multimodal therapies. By analyzing our data in relation with multi-center quality assurance trials [German Gastric Cancer Study - GGCS (1992) and East German Gastric Cancer Study - EGGCS (2004)] we aimed at providing an instrument of internal quality control at our institution as well as a base for comparison with future analyses taking into account the implementation of evolving (multimodal) therapies and their influence on treatment results. Retrospective analysis of prospectively gathered data of gastric cancer patients treated at a single institution during a defined 10-year time period with multivariate analysis of risk factors for early postoperative outcome. From 04/01/1993 through 03/31/2003, a total of 328 gastric cancer patients were treated. In comparison with the EGGCS cohort there was a larger proportion of patients with locally advanced and proximally located tumors. 272 patients (82.9%) underwent surgery with curative intent; in 88.4% of these an R0 resection was achieved (EGGCS/GGCS: 82.5%/71.5%). 68.2% of patients underwent preoperative endoluminal ultrasound (EUS) (EGGCS: 27.4%); the proportion of patients undergoing EUS increased over the study period. Diagnostic accuracy of EUS for T stage was 50.6% (EGGCS: 42.6%). 77.2% of operated patients with curative intent underwent gastrectomy (EGGCS/GGCS: 79.8%/71.1%). Anastomotic leaks at the esophagojejunostomy occurred slightly more frequently (8.8%) than in the EGGCS (5.9%) and GGCS (7.2%); however, postoperative morbidity (36.1%) and early postoperative mortality (5.3%) were not increased compared to the multi-center quality assurance study results (EGGCS morbidity, 45%); EGGCS/GGCS mortality, 8%/8.9%). D2 lymphadenectomy was performed in 72

  6. MABEL at IPAC: managing address books and email lists at the Infrared Processing and Analysis Center

    Science.gov (United States)

    Crane, Megan; Brinkworth, Carolyn; Gelino, Dawn; O'Leary, Ellen

    2012-09-01

    The Infrared Processing and Analysis Center (IPAC), located on the campus of the California Institute of Technology, is NASA's multi-mission data center for infrared astrophysics. Some of IPAC's services include administering data analysis funding awards to the astronomical community, organizing conferences and workshops, and soliciting and selecting fellowship and observing proposals. As most of these services are repeated annually or biannually, it becomes necessary to maintain multiple lists of email contacts associated with each service. MABEL is a PHP/MySQL web database application designed to facilitate this process. It serves as an address book containing up-to-date contact information for thousands of recipients. Recipients may be assigned to any number of email lists categorized by IPAC project and team. Lists may be public (viewable by all project members) or private (viewable only by team members). MABEL can also be used to send HTML or plain-text emails to multiple lists at once and prevents duplicate emails to a single recipient. This work was performed at the California Institute of Technology under contract to the National Aeronautics and Space Administration.

  7. Drip, ship, and grip, then slice and dice: Comprehensive stroke center management of cervical and intracranial emboli.

    Directory of Open Access Journals (Sweden)

    Jason D Hinman

    2013-07-01

    Full Text Available BACKGROUND AND PURPOSE: Tandem acute thrombotic emboli in the cervical and intracranial arteries are an unusual case of stroke presenting unique management challenges. In regional systems of acute stroke care anchored by Comprehensive Stroke Centers, combined fibrinolytic, endovascular, and open surgical intervention is a new therapeutic option. SUMMARY OF CASE: A 28 year old male underwent retinal surgery, including post-operative neck compression and the next day presented to a primary stroke center with aphasia and right hemiplegia. Intravenous tissue plasminogen activator therapy was initiated and the patient was transferred to a comprehensive stroke center (CSC for higher level of care (drip and ship. Imaging at the CSC demonstrated tandem thrombi: a near occlusive lesion at the origin of the left cervical internal carotid artery and a total occlusion of the M1 segment of the left middle cerebral artery. Endovascular thrombectomy with the Solitaire stent retriever resulted in intracranial recanalization (grip. Immediately after the endovascular procedure, open carotid thrombectomy was performed to achieve cervical carotid revascularization without systemic heparinization (slice. Both cervical carotid and intracranial thrombi were processed for proteomic analysis via mass spectrometry (dice. CONCLUSION: Combined fibrinolytic, endovascular, and open surgical intervention can yield revascularization and good clinical outcome in cases of tandem lesions.

  8. Impact of a Newly Implemented Burn Protocol on Surgically Managed Partial Thickness Burns at a Specialized Burns Center in Singapore.

    Science.gov (United States)

    Tay, Khwee-Soon Vincent; Chong, Si-Jack; Tan, Bien-Keem

    2016-03-01

    This study evaluated the impact of a newly implemented protocol for superficial to mid-dermal partial thickness burns which involves early surgery and rapid coverage with biosynthetic dressing in a specialized national burns center in Singapore. Consecutive patients with 5% or greater total body surface area (TBSA) superficial to mid-dermal partial thickness burns injury admitted to the Burns Centre at the Singapore General Hospital between August and December 2014 for surgery within 48 hours of injury were prospectively recruited into the study to form the protocol group. Comparable historical cases from the year 2013 retrieved from the burns center audit database were used to form the historical control group. Demographics (age, sex), type and depth of burns, %TBSA burnt, number of operative sessions, and length of stay were recorded for each patient of both cohorts. Thirty-nine burns patients managed under the new protocol were compared with historical control (n = 39) comparable in age and extensiveness of burns. A significantly shorter length of stay (P burns was observed in the new protocol group (0.74 day/%TBSA) versus historical control (1.55 day/%TBSA). Fewer operative sessions were needed under the new protocol for burns 10% or greater TBSA burns (P protocol for surgically managed burns patients which involves early surgery and appropriate use of biosynthetic dressing on superficial to mid-dermal partial thickness burns. Clinically, shorter lengths of stay, fewer operative sessions, and decreased need for skin grafting of burns patient were observed.

  9. Environmental systems and management activities on the Kennedy Space Center, Merritt Island, Florida: results of a modeling workshop

    Science.gov (United States)

    Hamilton, David B.; Andrews, Austin K.; Auble, Gregor T.; Ellison, Richard A.; Farmer, Adrian H.; Roelle, James E.

    1985-01-01

    In the early 1960's, the National Aeronautics and Space Administration (NASA) began purchasing 140,000 acres on Merritt Island, Florida, in order to develop a center for space exploration. Most of this land was acquired to provide a safety and security buffer around NASA facilities. NASA, as the managing agency for the Kennedy Space Center (KSC), is responsible for preventing or controlling environmental pollution from the Federal facilities and activities at the Space Center and is committed to use all practicable means to protect and enhance the quality of the surrounding environment. The Merritt Island National Wildlife Refuge was established in 1963 when management authority for undeveloped lands at KSC was transferred to the U.S. Fish and Wildlife Service. In addition to manage for 11 Federally-listed threatened and endangered species and other resident and migratory fish and wildlife populations, the Refuge has comanagement responsibility for 19,000 acres of mosquito control impoundments and 2,500 acres of citrus groves. The Canaveral National Seashore was developed in 1975 when management of a portion of the coastal lands was transferred from NASA to the National Park Service. This multiagency jurisdiction on Merritt Island has resulted in a complex management environment. The modeling workshop described in this report was conducted May 21-25, 1984, at the Kennedy Space Center to: (1) enhance communication among the agencies with management responsibilities on Merritt Island; (2) integrate available information concerning the development, management, and ecology of Merritt Island; and (3) identify key research and monitoring needs associated with the management and use of the island's resources. The workshop was structured around the formulation of a model that would simulate primary management and use activities on Merritt Island and their effects on upland, impoundment, and estuarine vegetation and associated wildlife. The simulation model is composed of

  10. Design of SCADA water resource management control center by a bi-objective redundancy allocation problem and particle swarm optimization

    International Nuclear Information System (INIS)

    Dolatshahi-Zand, Ali; Khalili-Damghani, Kaveh

    2015-01-01

    SCADA is an essential system to control critical facilities in big cities. SCADA is utilized in several sectors such as water resource management, power plants, electricity distribution centers, traffic control centers, and gas deputy. The failure of SCADA results in crisis. Hence, the design of SCADA system in order to serve a high reliability considering limited budget and other constraints is essential. In this paper, a bi-objective redundancy allocation problem (RAP) is proposed to design Tehran's SCADA water resource management control center. Reliability maximization and cost minimization are concurrently considered. Since the proposed RAP is a non-linear multi-objective mathematical programming so the exact methods cannot efficiently handle it. A multi-objective particle swarm optimization (MOPSO) algorithm is designed to solve it. Several features such as dynamic parameter tuning, efficient constraint handling and Pareto gridding are inserted in proposed MOPSO. The results of proposed MOPSO are compared with an efficient ε-constraint method. Several non-dominated designs of SCADA system are generated using both methods. Comparison metrics based on accuracy and diversity of Pareto front are calculated for both methods. The proposed MOPSO algorithm reports better performance. Finally, in order to choose the practical design, the TOPSIS algorithm is used to prune the Pareto front. - Highlights: • Multi-objective redundancy allocation problem (MORAP) is proposed to design SCADA system. • Multi-objective particle swarm optimization (MOPSO) is proposed to solve MORAP. • Efficient epsilon-constraint method is adapted to solve MORAP. • Non-dominated solutions are generated on Pareto front of MORAP by both methods. • Several multi-objective metrics are calculated to compare the performance of methods

  11. National Aeronautics and Space Administration Marshall Space Flight Center Space Transportation Directorate Risk Management Implementation Program

    Science.gov (United States)

    Duarte, Luis Alberto; Kross, Denny (Technical Monitor)

    2001-01-01

    The US civil aerospace program has been a great contributor to the creation and implementation of techniques and methods to identify, analyze, and confront risk. NASA has accomplished mission success in many instances, but also has had many failures. Anomalies have kept the Agency from achieving success on other occasions, as well. While NASA has mastered ways to prevent risks, and to quickly and effectively react and recover from anomalies or failures, it was not until few years ago that a comprehensive Risk Management process started being implemented in some of its programs and projects. A Continuous Risk Management (CRM) cycle process was developed and has been promoted and used successfully in programs and projects across the Agency.

  12. Decision-support information system to manage mass casualty incidents at a level 1 trauma center.

    Science.gov (United States)

    Bar-El, Yaron; Tzafrir, Sara; Tzipori, Idan; Utitz, Liora; Halberthal, Michael; Beyar, Rafael; Reisner, Shimon

    2013-12-01

    Mass casualty incidents are probably the greatest challenge to a hospital. When such an event occurs, hospitals are required to instantly switch from their routine activity to conditions of great uncertainty and confront needs that exceed resources. We describe an information system that was uniquely designed for managing mass casualty events. The web-based system is activated when a mass casualty event is declared; it displays relevant operating procedures, checklists, and a log book. The system automatically or semiautomatically initiates phone calls and public address announcements. It collects real-time data from computerized clinical and administrative systems in the hospital, and presents them to the managing team in a clear graphic display. It also generates periodic reports and summaries of available or scarce resources that are sent to predefined recipients. When the system was tested in a nationwide exercise, it proved to be an invaluable tool for informed decision making in demanding and overwhelming situations such as mass casualty events.

  13. Closing the loop in person-centered care: patient experiences of a chronic kidney disease self-management intervention

    Directory of Open Access Journals (Sweden)

    Havas K

    2017-11-01

    Full Text Available Kathryn Havas,1,2 Clint Douglas,1 Ann Bonner1–3 1School of Nursing, Queensland University of Technology, 2NHMRC Chronic Kidney Disease Centre for Research Excellence, University of Queensland, 3Kidney Health Service, Metro North Hospital and Health Service, Brisbane, QLD, Australia Purpose: The provision of self-management support (SMS for people with earlier stages (1–4 of chronic kidney disease (CKD can improve patient outcomes and extend time to dialysis. However, attempts to deliver such support have often not taken patient preferences into account. After the development, implementation, and quantitative evaluation of the person-centered CKD-SMS intervention, the aim of this study was to investigate participant experiences and perceptions of the program, as well as to seek suggestions to improve future SMS attempts.Patients and methods: Semi-structured, face-to-face interviews were conducted with almost all (63/66 participants in the CKD-SMS. Deductive categories were derived from previous research into self-management from the CKD patient’s perspective, and this was supplemented by categories that emerged inductively during multiple readings of interview transcripts. Content analysis was used to analyze interview data.Results: Participants recognized self-management of CKD as complex and multifaceted. They felt that the CKD-SMS helped them develop skills to engage in necessary self-management tasks, as well as their knowledge about their condition and confidence to take an active role in their healthcare. These participants experience a healthcare environment that is characterized by complexity and inconsistency, and participation in the intervention helped them to navigate it. The benefit of participating in this research to contribute to the scientific literature was also recognized by participants. Overall, participants found the CKD-SMS useful in its current format, and made some suggestions for future interventions

  14. Effectivity System of Management Information in Information Tehcnology Center University of Sam Ratulangi Manado.

    OpenAIRE

    Kalalo, Intani Kirana; Mandey, Jantje; Pombengi, Jericho

    2015-01-01

    In accordance with Regulation of the Minister of Education and Culture of the Republic of Indonesia on the Organization and Work of Sam Ratulangi University of article 105, paragraph 1, which states that the Information and Communication Technology Unit is a unit of the technical implementation in the field of development and management of systems and information and communication technology. And Article 106, namely, Information and Communication Technology Unit has the t...

  15. Surgical Management of Benign Biliary Stricture in Chronic Pancreatitis: A Single-Center Experience.

    Science.gov (United States)

    Ray, Sukanta; Ghatak, Supriyo; Das, Khaunish; Dasgupta, Jayanta; Ray, Sujay; Khamrui, Sujan; Sonar, Pankaj Kumar; Das, Somak

    2015-12-01

    Biliary stricture in chronic pancreatitis (CP) is not uncommon. Previously, all cases were managed by surgery. Nowadays, three important modes of treatment in these patients are observation, endoscopic therapy, and surgery. In the modern era, surgery is recommended only in a subset of patients who develop biliary symptoms or those who have asymptomatic biliary stricture and require surgery for intractable abdominal pain. We want to report on our experience regarding surgical management of CP-induced benign biliary stricture. Over a period of 5 years, we have managed 340 cases of CP at our institution. Bile duct stricture was found in 62 patients. But, surgical intervention was required in 44 patients, and the remaining 18 patients were managed conservatively. Demographic data, operative procedures, postoperative complications, and follow-up parameters of these patients were collected from our prospective database. A total 44 patients were operated for biliary obstruction in the background of CP. Three patients were excluded, so the final analysis was based on 41 patients. The indication for surgery was symptomatic biliary stricture in 27 patients and asymptomatic biliary stricture with intractable abdominal pain in 14 patients. The most commonly performed operation was Frey's procedure. There was no inhospital mortality. Thirty-five patients were well at a mean follow-up of 24.4 months (range 3 to 54 months). Surgery is still the best option for CP-induced benign biliary stricture, and Frey's procedure is a versatile operation unless you suspect malignancy as the cause of biliary obstruction.

  16. An Ontology-centered Approach for Designing an Interactive Competence Management System for IT Companies

    Directory of Open Access Journals (Sweden)

    Stefan TRAUSAN-MATU

    2009-01-01

    Full Text Available The paper presents a generic framework for an intelligent information system of competence management based on ontologies for information technology companies. In a first step it will be applied in an information technology (IT small enterprise and then its applicability will be verified for other organizations of the same type. The work presented in the paper is performed under the project "CONTO – Ontology-based Competencies Management in Information Technology" funded by the Romanian Ministry of Education and Research, involving two universities, a research institute and an IT private company. A competence management system (CMS, in our vision has to achieve three functions: (a to support the complete and systematic acquisition of knowledge about the competence of the members of an enterprise; (b to provide the knowledge about competences and their owners; (c to apply the available knowledge to serve a purpose. The core of the competence management information system is an ontology that plays the role of the declarative knowledge repository containing the basic concepts (such as: company-job, competence, domain, group, person etc. and their relationships with other concepts, instances and properties. The Protégé environment was used for the development of this ontology. The structure of the ontology is conceived so that description logics can be used to represent the concept definitions of the application domain in a structured and formally well-understood way. Knowledge acquisition is performed in our approach by enriching the ontology, according to the requirements of the IT company. An advantage of using an ontology-based system is the possibility of the identification of new relations among concepts based on inferences starting from the existing knowledge. The user can choose to query instances of one type of concept. The paper also presents some use-cases.

  17. Ambulatory intercostal drainage for the management of malignant pleural effusion: a single center experience.

    Science.gov (United States)

    Bazerbashi, Samer; Villaquiran, Jaime; Awan, Mohammad Yousaf; Unsworth-White, Michael Jonathan; Rahamim, Joe; Marchbank, Adrian

    2009-12-01

    Malignant pleural effusions are common and can be difficult to manage. We have reviewed our use of ambulatory drains (Pleurex drains) in this regard with particular reference to hospital stay, duration of drainage, and incidence of complications. Of 125 patients with malignant pleural effusion with trapped lung or failed previous pleurodesis who underwent insertion of ambulatory pleural drain, 41 patients were under local anesthesia and 84 patients were under general anesthesia. Mean age was 66.5 years with male:female = 80:45. Data were collected retrospectively from the clinical notes, and the family doctors' clinics were contacted to enquire about the patients' survival. When data collection concluded, 48 patients (38.4%) had died, giving mean survival following drain insertion of 84.1 days. There were no in-hospital deaths related to the procedure. One procedure was converted to a mini-thoracotomy to control bleeding from a lung tear. Mean duration of catheter placement was 87.01 days (5-434). Video-assisted thoracoscopic surgery was used in 77 patients (61.6%), and Seldinger's technique was used in 48 patients (38.4%). Mesothelioma was the most common malignant cause. Minor complications were encountered in 15 patients (12%), and they were managed as outpatients. The use of ambulatory pleural catheters for managing malignant pleural effusion is a safe and effective strategy. It has only minor complications that are related to prolonged drainage. We feel that this strategy should be considered the first choice option for these patients.

  18. Visceral artery aneurysms: Incidence, management, and outcome analysis in a tertiary care center over one decade

    Energy Technology Data Exchange (ETDEWEB)

    Pitton, Michael B.; Dappa, Evelyn; Jungmann, Florian; Kloeckner, Roman; Schotten, Sebastian; Wirth, Gesine M.; Mildenberger, Peter; Kreitner, Karl-Friedrich; Oberholzer, Katja; Dueber, Christoph [University Hospital of Mainz, Department of Diagnostic and Interventional Radiology, Mainz (Germany); Mittler, Jens; Lang, Hauke [University Hospital of Mainz, Department of Abdominal, Visceral and Transplantation Surgery, Mainz (Germany)

    2015-07-15

    To evaluate the incidence, management, and outcome of visceral artery aneurysms (VAA) over one decade. 233 patients with 253 VAA were analyzed according to location, diameter, aneurysm type, aetiology, rupture, management, and outcome. VAA were localized at the splenic artery, coeliac trunk, renal artery, hepatic artery, superior mesenteric artery, and other locations. The aetiology was degenerative, iatrogenic after medical procedures, connective tissue disease, and others. The rate of rupture was much higher in pseudoaneurysms than true aneurysms (76.3 % vs.3.1 %). Fifty-nine VAA were treated by intervention (n = 45) or surgery (n = 14). Interventions included embolization with coils or glue, covered stents, or combinations of these. Thirty-five cases with ruptured VAA were treated on an emergency basis. There was no difference in size between ruptured and non-ruptured VAA. After interventional treatment, the 30-day mortality was 6.7 % in ruptured VAA compared to no mortality in non-ruptured cases. Follow-up included CT and/or MRI after a mean period of 18.0 ± 26.8 months. The current status of the patient was obtained by a structured telephone survey. Pseudoaneurysms of visceral arteries have a high risk for rupture. Aneurysm size seems to be no reliable predictor for rupture. Interventional treatment is safe and effective for management of VAA. (orig.)

  19. New solutions for waste management centers of new Russian-type nuclear power plant designs

    International Nuclear Information System (INIS)

    Buettner, Klaus

    2010-01-01

    There has been a change of mind with respect to waste management among power plant operators in Russia and planners of the new VVER reactor line. Solid waste no longer is to be stored on the site of the power plant; instead, a functioning direct method of treatment of the different categories of waste arising in operation is favored. Waste conditioning and reduced storage volumes are indispensable arguments in selling reactor technology to markets outside Russia. Reference often is made to the internationally discussed volume of 50 m 3 of waste per reactor unit and year, which is then defined as a target. NUKEM Technologies verified existing technical concepts and worked out proposals of improved waste management. One project proposal accepted by ASE (Atomstroyexport) was elaborated to the Technical Project (corresponding to Basic Design) status. Specific management of materials flows, the use of processes tailored to the waste stream, and adaptation of the throughputs of these plants to the waste arisings actually expected are able to reduce clearly both the volume of conditioned waste to be stored and the capital costs. (orig.)

  20. Moderator's view: Patient-centered approaches for optimizing AKI management: the role of kidney biomarkers.

    Science.gov (United States)

    Mehta, Ravindra L

    2017-03-01

    Patients with acute kidney injury (AKI) continue to pose challenges for clinicians worldwide. Our understanding of the pathophysiology, epidemiology and course of the disease has improved significantly; however, this has not translated into any significant improvement in outcomes. Multiple new biomarkers have been developed to characterize the course of the disease and have been evaluated in multiple trials. Unfortunately, the adoption of biomarkers into routine clinical care has not been as expected. Several factors contribute to the slow uptake and can be addressed. This article provides a framework for a patient-centered approach to utilize biomarkers to improve patient care and outcomes in AKI. © The Author 2017. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.

  1. Management of complications arising from transvaginal mesh kit procedures: a tertiary referral center's experience.

    Science.gov (United States)

    Hurtado, Eric A; Appell, Rodney A

    2009-01-01

    This case series' purpose is to review a referral center's experience with complications from mesh kits. A chart review of 12 patients who presented with complications associated with transvaginal mesh kit procedures was performed. All patients underwent complete surgical removal of the mesh to treat mesh exposure, pain, or vaginal bleeding/discharge followed by an anterior or posterior repair. The mean follow-up time after surgery was 3.4 months. Eight of 12 patients had mesh that had formed a fibrotic band. Six of 12 patients had complete resolution of pain. Of the nine patients with mesh exposure, all required significant resection of the vaginal wall. No further mesh exposure occurred. The use of transvaginal mesh kits may cause previously undescribed complications such as pelvic/vaginal pain or large extrusions requiring complete removal. Removal of all mesh except the arms may cure or significantly improve these problems.

  2. Atrial Fibrillation Following Surgical Management of Ischemic Heart Disease; One Year, Single Center, Single Surgeon Results

    Directory of Open Access Journals (Sweden)

    Ahmet Barış Durukan

    2012-08-01

    Full Text Available Introduction: Postoperative atrial fibrillation is the most common arrhythmia following bypasssurgery with significant morbidity, mortality and increased healthcare costs. The aim of this studyis to determine the incidence and timing of atrial fibrillation, identify the risk factors coveringpreoperative and intraoperative periods, evaluate rate of return to sinus rhythm by disharge, andexplore the impact on postoperative outcomes in a large group of patients operated in a singlecenter by a single surgeon.Patients and Methods: Between January 2011 and January 2012, 418 patients on preoperativesinus rhythm were operated for ischemic heart disease and associated complications (left ventricleaneurysm repair and ischemic mitral insufficiency in a single center, by a single surgeon.The preoperative, intraoperative and postoperative variables were studied.Results: The mean age of the patients were 61.92 ± 10.05, and 77.5% were male. Atrial fibrillationdeveloped in 68 (16.3% patients. The incidence peaked at second day. Patients with atrialfibrillation were older (p< 0.001. Gender, preoperative comorbidities, ejection fraction, left atrialdiameter, preoperative beta-blocker use, leukocyte count, type of operation and intraoperativevariables did not affect its occurence. Intensive care unit and hospital length of stay were longer(p< 0.05. 95.5% (n= 65 of patients were in normal sinus rhythm at discharge.Conclusion: Postoperative atrial fibrillation is a popular subject with unknowns and controversialresults which may lead to wrong interpretations. We believe that every center has its own risk factors related with the population of that region. Discussion will last, but simple precautions and close monitoring will help to minimizeadverse outcomes.

  3. Correlates of quality of life among individuals with epilepsy enrolled in self-management research: From the US Centers for Disease Control and Prevention Managing Epilepsy Well Network.

    Science.gov (United States)

    Sajatovic, Martha; Tatsuoka, Curtis; Welter, Elisabeth; Friedman, Daniel; Spruill, Tanya M; Stoll, Shelley; Sahoo, Satya S; Bukach, Ashley; Bamps, Yvan A; Valdez, Joshua; Jobst, Barbara C

    2017-04-01

    Epilepsy is a chronic neurological condition that causes substantial burden on patients and families. Quality of life may be reduced due to the stress of coping with epilepsy. For nearly a decade, the Centers for Disease Control (CDC) Prevention Research Center's Managing Epilepsy Well (MEW) Network has been conducting research on epilepsy self-management to address research and practice gaps. Studies have been conducted by independent centers across the U.S. Recently, the MEW Network sites, collaboratively, began compiling an integrated database to facilitate aggregate secondary analysis of completed and ongoing studies. In this preliminary analysis, correlates of quality of life in people with epilepsy (PWE) were analyzed from pooled baseline data from the MEW Network. For this analysis, data originated from 6 epilepsy studies conducted across 4 research sites and comprised 459 PWE. Descriptive comparisons assessed common data elements that included gender, age, ethnicity, race, education, employment, income, seizure frequency, quality of life, and depression. Standardized rating scales were used for quality of life (QOLIE-10) and for depression (Patient Health Questionnaire, PHQ-9). While not all datasets included all common data elements, baseline descriptive analysis found a mean age of 42 (SD 13.22), 289 women (63.0%), 59 African Americans (13.7%), and 58 Hispanics (18.5%). Most, 422 (92.8%), completed at least high school, while 169 (61.7%) were unmarried, divorced/separated, or widowed. Median 30-day seizure frequency was 0.71 (range 0-308). Depression at baseline was common, with a mean PHQ-9 score of 8.32 (SD 6.04); 69 (29.0%) had depression in the mild range (PHQ-9 score 5-9) and 92 (38.7%) had depression in the moderate to severe range (PHQ-9 score >9). Lower baseline quality of life was associated with greater depressive severity (pepilepsy research studies. While findings must be tempered by potential sample bias, i.e. a relative under

  4. Factors affecting patients’ self-management in chronic venous disorders: a single-center study

    Directory of Open Access Journals (Sweden)

    Barański K

    2016-08-01

    Full Text Available Kamil Barański,1,2 Jerzy Chudek2,3 1Department of Epidemiology, Medical School in Katowice, 2Department of Pathophysiology, Medical University of Silesia, Katowice, 3Angiology Outpatient Clinic “Combi-Med,” Częstochowa, Poland Background: The conservative treatment of chronic venous disorders (CVDs includes pharmacotherapy, compression therapy, physiotherapy, and changes in lifestyle. These methods are available without prescription and not reimbursed by Polish National Health Service. Adherence to therapy is affected by poorly characterized patient-related factors. Objective: The aim of the study was to perform an assessment of factors that affect the usage and resignation from conservative methods in CVD self-management. Methods: A structured interview concerning self-management was carried out with 407 consecutive CVD patients of mean age 64.4 years (range: 23–87 years. All the patients had recently undergone Doppler examination and were classified in accordance with Clinical, Etiology, Anatomy, and Pathophysiology (CEAP classification. Results: Pharmacotherapy was the most frequently (85.0% of respondents used method in CVD self-management. Obese (odds ratio [OR] =1.75 [95% confidence interval {CI} 0.99–3.05] and subjects with longer duration of the disease (OR =1.74 [95% CI 1.16–2.62] were more likely to use venoactive drugs, while females used ointments commonly containing heparin (OR =1.82 [95% CI 1.08–3.03]. Compression therapy was perceived by respondents as the most difficult method in self-management (OR =2.50 [95% CI 1.61–3.88] and was also recognized as the most effective method of treatment (OR =13.9 [95% CI 7.35–26.4]. Longer duration of CVD (≥15 years increased (OR =1.78 [95% CI 1.16–2.71] while obesity decreased (OR =0.38 [95% CI 0.20–0.72] the utilization of compression therapy. Females were more likely to adhere to lifestyle changes than males (OR =1.68 [95% CI 0.97–2.90]. Physiotherapy was rarely

  5. [Automated management of the Center of Transfusion Blood Bank equipped with Autogrouper 16 C].

    Science.gov (United States)

    Girard, M; Connes, Y; Picot, P

    1981-11-01

    We describe in this paper a first processing of direct connection and data management from the Autogrouper 16 C. It bas been used since November 1980 in the Centre Départemental de Tranfusion Sanguine des Hauts-de-Seine. The automation of validation procedures, updating blood donors' file and labelling blood units allows the suppression of clerical errors that are the major cause of Trannsfusion accidents. The progressive development of programming lets a good adaptation of working methods and makes the setting of the system much easier in the Blood Bank.

  6. Pictorial essay: Interventional radiology in the management of hemodialysis vascular access - A single-center experience

    International Nuclear Information System (INIS)

    Mammen, Suraj; Keshava, Shyamkumar N; Moses, Vinu; Babu, Surendra; Varughese, Santhosh

    2012-01-01

    Chronic kidney disease (CKD) is a worldwide public health problem and is associated with high morbidity and mortality. The majority of patients with CKD stage 5 (CKD-5), who cannot undergo renal transplant, depend on maintenance hemodialysis by surgically created access sites. Native fistulae are preferred over grafts due to their longevity. More than half of these vital portals for dialysis access will fail over time. Screening procedures to select high-risk patients before thrombosis or stenosis appears have resulted in aggressive management. These patients are referred for angiographic evaluation and/or therapy. We present the patterns of dialysis-related interventions done in our institution

  7. A Conceptual Framework for Occupant-Centered Building Management Decision Support System

    DEFF Research Database (Denmark)

    Lazarova-Molnar, Sanja; Shaker, Hamid Reza

    2016-01-01

    -obvious/-direct incentive to reduce energy use and no access to their levels of consumption. In this paper we present a framework for a building energy management decision support system that is motivated by these findings, and therefore, centres the occupants and motivates them to both achieve business-wise and improve......Buildings’ energy consumption makes the largest portion of the overall energy consumption. Commercial buildings are specific and their energy efficiency should not be viewed as a standalone issue. On the contrary, it needs to be viewed in function of the goals of the hosted businesses...

  8. Assessment of medical waste management at a primary health-care center in São Paulo, Brazil

    International Nuclear Information System (INIS)

    Moreira, A.M.M.; Günther, W.M.R.

    2013-01-01

    Highlights: ► Assessment of medical waste management at health-care center before/after intervention. ► Qualitative and quantitative results of medical waste management plan are presented. ► Adjustments to comply with regulation were adopted and reduction of waste was observed. ► The method applied could be useful for similar establishments. - Abstract: According to the Brazilian law, implementation of a Medical Waste Management Plan (MWMP) in health-care units is mandatory, but as far as we know evaluation of such implementation has not taken place yet. The purpose of the present study is to evaluate the improvements deriving from the implementation of a MWMP in a Primary Health-care Center (PHC) located in the city of São Paulo, Brazil. The method proposed for evaluation compares the first situation prevailing at this PHC with the situation 1 year after implementation of the MWMP, thus allowing verification of the evolution of the PHC performance. For prior and post-diagnosis, the method was based on: (1) application of a tool (check list) which considered all legal requirements in force; (2) quantification of solid waste subdivided into three categories: infectious waste and sharp devices, recyclable materials and non-recyclable waste; and (3) identification of non-conformity practices. Lack of knowledge on the pertinent legislation by health workers has contributed to non-conformity instances. The legal requirements in force in Brazil today gave origin to a tool (check list) which was utilized in the management of medical waste at the health-care unit studied. This tool resulted into an adequate and simple instrument, required a low investment, allowed collecting data to feed indicators and also conquered the participation of the unit whole staff. Several non-conformities identified in the first diagnosis could be corrected by the instrument utilized. Total waste generation increased 9.8%, but it was possible to reduce the volume of non

  9. Management of single-ventricle patients with Berlin Heart EXCOR Ventricular Assist Device: single-center experience.

    Science.gov (United States)

    Mackling, Tracey; Shah, Tejas; Dimas, Vivian; Guleserian, Kristine; Sharma, Mahesh; Forbess, Joseph; Ardura, Monica; Gross-Toalson, Jami; Lee, Ying; Journeycake, Janna; Barnes, Aliessa

    2012-06-01

    There are minimal data regarding chronic management of single-ventricle ventricular assist device (VAD) patients. This study aims to describe our center's multidisciplinary team management of single-ventricle patients supported long term with the Berlin Heart EXCOR Pediatric VAD. Patient #1 was a 4-year-old with double-outlet right ventricle with aortic atresia, L-looped ventricles, and heart block who developed heart failure 1 year after Fontan. She initially required extracorporeal membrane oxygenation support and was transitioned to Berlin Heart systemic VAD. She was supported for 363 days (cardiac intensive care unit [CICU] 335 days, floor 28 days). The postoperative course was complicated by intermittent infection including methicillin-resistant Staphylococcus aureus, intermittent hepatic and renal insufficiencies, and transient antithrombin, protein C, and protein S deficiencies resulting in multiple thrombi. She had a total of five pump changes over 10 months. Long-term medical management included anticoagulation with enoxaparin, platelet inhibition with aspirin and dipyridamole, and antibiotic prophylaxis using trimethoprim/sulfamethoxazole. She developed sepsis of unknown etiology and subsequently died from multiorgan failure. Patient #2 was a 4-year-old with hypoplastic left heart syndrome who developed heart failure 2 years after bidirectional Glenn shunt. At systemic VAD implantation, he was intubated with renal insufficiency. Post-VAD implantation, his renal insufficiency resolved, and he was successfully extubated to daytime nasal cannula and biphasic positive airway pressure at night. He was supported for 270 days (CICU 143 days, floor 127 days). The pump was upsized to a 50-mL pump in May 2011 for increased central venous pressures (29 mm Hg). Long-term medical management included anticoagulation with warfarin and single-agent platelet inhibition using dipyridamole due to aspirin resistance. He developed increased work of breathing requiring

  10. Outcomes of endovascular management of acute thoracic aortic emergencies in an academic level 1 trauma center.

    Science.gov (United States)

    Echeverria, Angela B; Branco, Bernardino C; Goshima, Kay R; Hughes, John D; Mills, Joseph L

    2014-12-01

    Thoracic aortic emergencies account for 10% of thoracic-related admissions in the United States and remain associated with high morbidity and mortality rates. Open repair has declined owing to the emergence of thoracic endovascular aortic repair (TEVAR), but data on emergency TEVAR use for acute aortic pathology remain limited. We therefore reviewed our experience. We retrospectively evaluated emergency descending thoracic aortic endovascular interventions performed at a single academic level 1 trauma center between January 2005 and August 2013 including all cases of traumatic aortic injury, ruptured descending thoracic aneurysm, penetrating atherosclerotic ulcer, aortoenteric fistula, and acute complicated type B dissection. Demographics, clinical data, and outcomes were extracted. Stepwise logistic regression was used to identify independent risk factors for death. During the study period, 51 patients underwent TEVAR; 22 cases (43.1%) were performed emergently (11 patients [50.0%] traumatic aortic injury; 4 [18.2%] ruptured descending thoracic aneurysm; 4 [18.2%] complicated type B dissection; 2 [9.1%] penetrating aortic ulcer; and 1 [4.5%] aortoenteric fistula). Overall, 72.7% (n = 16) were male with a mean age of 54.8 ± 15.9 years. Nineteen patients (86.4%) required only a single TEVAR procedure, whereas 2 (9.1%) required additional endovascular therapy, and 1 (4.5%) open thoracotomy. Four traumatic aortic injury patients required exploratory laparotomy for concomitant intra-abdominal injuries. During a mean hospital length of stay of 18.9 days (range, 1 to 76 days), 3 patients (13.6%) developed major complications. In-hospital mortality was 27.2%, consisting of 6 deaths from traumatic brain injury (1); exsanguination in the operating room before repair could be achieved (2); bowel ischemia (1) and multisystem organ failure (1); and family withdrawal of care (1). A stepwise logistic regression model identified 24-hour packed red blood cell requirements ≥4

  11. IMPROVEMENT OF BODY SHOP MANAGING AS A PART OF VEHICLE IMPORTERS CENTER

    Directory of Open Access Journals (Sweden)

    Vasil Stamboliski

    2014-12-01

    Full Text Available The dynamic rhythm of living in today’s contemporary surroundings can not be considered without the use of personal and commercial vehicles, for transport of passengers and cargo. This means that every manufacturer in this segment, in their departments for development, find a way to increase their participation in the market. Since the race with time, for promoting new models on the market, not always is in positive relation with the profit which the manufacturer plans to achieve, issues the manufacturer’s focus in the after-sale activities. The body shop with its service, as part of the after-sale activities, brings the client satisfaction to a higher level and of course contributes to realization of higher profit of the company. The setting of the equipment and the staff management, the analysis of the number of entries and realized working hours in the body shop of an importer centre are the central topic/main subject for the author in this paper work. Finding the key factors, as well as the possibility for implementation of the key factors, would reflect increased number of entries, increased number of realized working hours and possibility for improving of the existing system of managing.

  12. Development of Improved Graphical Displays for an Advanced Outage Control Center, Employing Human Factors Principles for Outage Schedule Management

    Energy Technology Data Exchange (ETDEWEB)

    St Germain, Shawn Walter [Idaho National Lab. (INL), Idaho Falls, ID (United States); Farris, Ronald Keith [Idaho National Lab. (INL), Idaho Falls, ID (United States); Thomas, Kenneth David [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2015-09-01

    The long-term viability of existing nuclear power plants in the United States (U.S.) is dependent upon a number of factors, including maintaining high capacity factors, maintaining nuclear safety, and reducing operating costs, particularly those associated with refueling outages. Refueling outages typically take 20-30 days, and for existing light water NPPs in the U.S., the reactor cannot be in operation during the outage. Furthermore, given that many NPPs generate between $1-1.5 million/day in revenue when in operation, there is considerable interest in shortening the length of refueling outages. Yet refueling outages are highly complex operations, involving multiple concurrent and dependent activities that are somewhat challenging to coordinate; therefore, finding ways to improve refueling outage performance, while maintaining nuclear safety has proven to be difficult. The Advanced Outage Control Center (AOCC) project is a research and development (R&D) demonstration activity under the LWRS Program. LWRS is an R&D program that works closely with industry R&D programs to establish technical foundations for the licensing and managing of long-term, safe, and economical operation of current fleet of NPPs. As such, the LWRS Advanced Outage Control Center project has the goal of improving the management of commercial NPP refueling outages. To accomplish this goal, INL is developing an advanced outage control center (OCC) that is specifically designed to maximize the usefulness of communication and collaboration technologies for outage coordination and problem resolution activities. The overall focus is on developing an AOCC with the following capabilities that enables plant and OCC staff to; Collaborate in real-time to address emergent issues; Effectively communicate outage status to all workers involved in the outage; Effectively communicate discovered conditions in the field to the OCC; Provide real-time work status; Provide automatic pending support notifications

  13. Development of Improved Graphical Displays for an Advanced Outage Control Center, Employing Human Factors Principles for Outage Schedule Management

    International Nuclear Information System (INIS)

    St Germain, Shawn Walter; Farris, Ronald Keith; Thomas, Kenneth David

    2015-01-01

    The long-term viability of existing nuclear power plants in the United States (U.S.) is dependent upon a number of factors, including maintaining high capacity factors, maintaining nuclear safety, and reducing operating costs, particularly those associated with refueling outages. Refueling outages typically take 20-30 days, and for existing light water NPPs in the U.S., the reactor cannot be in operation during the outage. Furthermore, given that many NPPs generate between $1-1.5 million/day in revenue when in operation, there is considerable interest in shortening the length of refueling outages. Yet refueling outages are highly complex operations, involving multiple concurrent and dependent activities that are somewhat challenging to coordinate; therefore, finding ways to improve refueling outage performance, while maintaining nuclear safety has proven to be difficult. The Advanced Outage Control Center (AOCC) project is a research and development (R&D) demonstration activity under the LWRS Program. LWRS is an R&D program that works closely with industry R&D programs to establish technical foundations for the licensing and managing of long-term, safe, and economical operation of current fleet of NPPs. As such, the LWRS Advanced Outage Control Center project has the goal of improving the management of commercial NPP refueling outages. To accomplish this goal, INL is developing an advanced outage control center (OCC) that is specifically designed to maximize the usefulness of communication and collaboration technologies for outage coordination and problem resolution activities. The overall focus is on developing an AOCC with the following capabilities that enables plant and OCC staff to; Collaborate in real-time to address emergent issues; Effectively communicate outage status to all workers involved in the outage; Effectively communicate discovered conditions in the field to the OCC; Provide real-time work status; Provide automatic pending support notifications

  14. Emergency CT for assessment and management of blunt traumatic splenic injuries at a Level 1 Trauma Center: 13-year study.

    Science.gov (United States)

    Margari, Sergio; Garozzo Velloni, Fernanda; Tonolini, Massimo; Colombo, Ettore; Artioli, Diana; Allievi, Niccolò Ettore; Sammartano, Fabrizio; Chiara, Osvaldo; Vanzulli, Angelo

    2018-05-12

    To determine the relationship between multidetector computed tomography (MDCT) findings, management strategies, and ultimate clinical outcomes in patients with splenic injuries secondary to blunt trauma. This Institutional Review Board-approved study collected 351 consecutive patients admitted at the Emergency Department (ED) of a Level I Trauma Center with blunt splenic trauma between October 2002 and November 2015. Their MDCT studies were retrospectively and independently reviewed by two radiologists to grade splenic injuries according to the American Association for the Surgery of Trauma (AAST) organ injury scale (OIS) and to detect intraparenchymal (type A) or extraparenchymal (type B) active bleeding and/or contained vascular injuries (CVI). Clinical data, information on management, and outcome were retrieved from the hospital database. Statistical analysis relied on Student's t, chi-squared, and Cohen's kappa tests. Emergency multiphase MDCT was obtained in 263 hemodynamically stable patients. Interobserver agreement for both AAST grading of injuries and vascular lesions was excellent (k = 0.77). Operative management (OM) was performed in 160 patients (45.58% of the whole cohort), and high-grade (IV and V) OIS injuries and type B bleeding were statistically significant (p trauma event, without significant increase of mortality. Both intraparenchymal and extraparenchymal active bleeding were predictive of NOM failure (p splenic traumas and contributes to the shift toward NOM in hemodynamically stable patients.

  15. Guidelines for Implementation of an Advanced Outage Control Center to Improve Outage Coordination, Problem Resolution, and Outage Risk Management

    Energy Technology Data Exchange (ETDEWEB)

    St. Germain, Shawn W. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Farris, Ronald K. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Whaley, April M. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Medema, Heather D. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Gertman, David I. [Idaho National Lab. (INL), Idaho Falls, ID (United States)

    2014-09-01

    This research effort is a part of the Light-Water Reactor Sustainability (LWRS) Program, which is a research and development (R&D) program sponsored by Department of Energy (DOE) and performed in close collaboration with industry R&D programs that provide the technical foundations for licensing and managing the long-term, safe, and economical operation of current nuclear power plants. The LWRS program serves to help the U.S. nuclear industry adopt new technologies and engineering solutions that facilitate the continued safe operation of the plants and extension of the current operating licenses. The purpose of this research is to improve management of nuclear power plant (NPP) outages through the development of an advanced outage control center (AOCC) that is specifically designed to maximize the usefulness of communication and collaboration technologies for outage coordination and problem resolution activities. This technical report for industry implementation outlines methods and considerations for the establishment of an AOCC. This report provides a process for implementation of a change management plan, evaluation of current outage processes, the selection of technology, and guidance for the implementation of the selected technology. Methods are presented for both adoption of technologies within an existing OCC and for a complete OCC replacement, including human factors considerations for OCC design and setup.

  16. Automated system for the management of the radiological safety in a radiopharmaceutical and labelled compounds production center

    International Nuclear Information System (INIS)

    Amador B, Z.H.; Alvarez Builla de Sologuren, E.

    2006-01-01

    The establishment in the Center of Isotopes of Cuba of a managerial quality system in matter of radiological safety Y the accumulated operational experience, its constitute the foundations for the development of a system of management of the radiological safety organically structured, with the application of evaluative techniques of it management Y it integration in an automated system. The Visual Basic 5 platform for the programming of the 'SASR' system is used. The functions of each one of the 11 modules that integrate it are described. With this it can be carried out the registration of the data of the training Y the personnel's authorization, the checkup of the radioactive inventory of the installation, the annual upgrade of the registrations of the individual doses of those workers, the analysis of the state of the available equipment for magnitude to control, the radiological situation of the work positions, the public exposure by the gassy discharges, the experiences of the radiological events, the annual consolidation of the costs of the safety Y the evaluation of indicators Y of tendencies. A computer tool that facilitates the effective management of the radiological safety in a radioactive installation is obtained. (Author)

  17. Total Quality Management and Productivity in Information Centers Bilgi Kurumlarında Toplam Kalite Yönetimi ve Verimlilik

    Directory of Open Access Journals (Sweden)

    Ayşe Üstün

    1998-03-01

    Full Text Available Nowadays, a new management style known as "Total Quality Management" is adapted by all institutions. Naturally, high quality of products or services is important in all estabilishments, but factors effecting quality has recently been reassesed and a new outlook has been developed. Libraries, documentation-information centers are service institutions. Performance and success depend mainly on the skill and talent of employers. Total quality management, information services and productivity relationship is discussed in this paper. Günümüzde turn işletmelerde "toplam kalite yönetimi" adı verilen yeni bir yönetim anlayışı benimsenmektedir. Tüm kurumlarda kaliteli mal ya da hizmet önemlidir. Ancak kaliteyi etkileyen ögeler değişime uğramış, yeni bir anlam kazanmıştır. Kütüphane, arşiv, belge-bılgi merkezleri birer hizmet işletmesi türüdürler. Başarı ve performans büyük ölçüde çalışanların beceri ve yeteneklerine bağlıdır. Bu makalede toplam kalite yönetimi, bilgi hizmetleri ve verimlilik ilişkileri tartışılmaktadır.

  18. Environmental management systems tools applied to the nuclear fuel center of IPEN

    International Nuclear Information System (INIS)

    Mattos, Luis A. Terribile de; Meldonian, Nelson Leon; Madi Filho, Tufic

    2013-01-01

    This work aims to identify and classify the major environmental aspects and impacts related to the operation of the Nuclear Fuel Center of IPEN (CCN), through a systematic survey data, using interviews questions and consulting of licensing documents and operational records. First, the facility processes and activities, and the interactions between these processes were identified. Then, an analysis of potential failures and their probable causes was conducted to establish the significance of environmental aspects, as well as the operational controls, which are necessary to ensure the prevention of impacts on the environment. The results obtained so far demonstrate the validity of this study as a tool for identification of environmental aspects and impacts of nuclear facilities in general, as a way to achieving compliance with the ISO 14001:2004 standard. Moreover, it can serve as an auxiliary method for resolving issues related to the attendance of applicable regulatory and legal requirements of National Nuclear Energy Commission (CNEN) and Brazilian Institute of Environment (IBAMA). (author)

  19. Environmental management systems tools applied to the nuclear fuel center of IPEN

    Energy Technology Data Exchange (ETDEWEB)

    Mattos, Luis A. Terribile de; Meldonian, Nelson Leon; Madi Filho, Tufic, E-mail: mattos@ipen.br, E-mail: meldonia@ipen.br, E-mail: tmfilho@ipen.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil)

    2013-07-01

    This work aims to identify and classify the major environmental aspects and impacts related to the operation of the Nuclear Fuel Center of IPEN (CCN), through a systematic survey data, using interviews questions and consulting of licensing documents and operational records. First, the facility processes and activities, and the interactions between these processes were identified. Then, an analysis of potential failures and their probable causes was conducted to establish the significance of environmental aspects, as well as the operational controls, which are necessary to ensure the prevention of impacts on the environment. The results obtained so far demonstrate the validity of this study as a tool for identification of environmental aspects and impacts of nuclear facilities in general, as a way to achieving compliance with the ISO 14001:2004 standard. Moreover, it can serve as an auxiliary method for resolving issues related to the attendance of applicable regulatory and legal requirements of National Nuclear Energy Commission (CNEN) and Brazilian Institute of Environment (IBAMA). (author)

  20. The IEO Data Center Management System: Tools for quality control, analysis and access marine data

    Science.gov (United States)

    Casas, Antonia; Garcia, Maria Jesus; Nikouline, Andrei

    2010-05-01

    Since 1994 the Data Centre of the Spanish Oceanographic Institute develops system for archiving and quality control of oceanographic data. The work started in the frame of the European Marine Science & Technology Programme (MAST) when a consortium of several Mediterranean Data Centres began to work on the MEDATLAS project. Along the years, old software modules for MS DOS were rewritten, improved and migrated to Windows environment. Oceanographic data quality control includes now not only vertical profiles (mainly CTD and bottles observations) but also time series of currents and sea level observations. New powerful routines for analysis and for graphic visualization were added. Data presented originally in ASCII format were organized recently in an open source MySQL database. Nowadays, the IEO, as part of SeaDataNet Infrastructure, has designed and developed a new information system, consistent with the ISO 19115 and SeaDataNet standards, in order to manage the large and diverse marine data and information originated in Spain by different sources, and to interoperate with SeaDataNet. The system works with data stored in ASCII files (MEDATLAS, ODV) as well as data stored within the relational database. The components of the system are: 1.MEDATLAS Format and Quality Control - QCDAMAR: Quality Control of Marine Data. Main set of tools for working with data presented as text files. Includes extended quality control (searching for duplicated cruises and profiles, checking date, position, ship velocity, constant profiles, spikes, density inversion, sounding, acceptable data, impossible regional values,...) and input/output filters. - QCMareas: A set of procedures for the quality control of tide gauge data according to standard international Sea Level Observing System. These procedures include checking for unexpected anomalies in the time series, interpolation, filtering, computation of basic statistics and residuals. 2. DAMAR: A relational data base (MySql) designed to

  1. NASA Stennis Space Center Integrated System Health Management Test Bed and Development Capabilities

    Science.gov (United States)

    Figueroa, Fernando; Holland, Randy; Coote, David

    2006-01-01

    Integrated System Health Management (ISHM) is a capability that focuses on determining the condition (health) of every element in a complex System (detect anomalies, diagnose causes, prognosis of future anomalies), and provide data, information, and knowledge (DIaK)-not just data-to control systems for safe and effective operation. This capability is currently done by large teams of people, primarily from ground, but needs to be embedded on-board systems to a higher degree to enable NASA's new Exploration Mission (long term travel and stay in space), while increasing safety and decreasing life cycle costs of spacecraft (vehicles; platforms; bases or outposts; and ground test, launch, and processing operations). The topics related to this capability include: 1) ISHM Related News Articles; 2) ISHM Vision For Exploration; 3) Layers Representing How ISHM is Currently Performed; 4) ISHM Testbeds & Prototypes at NASA SSC; 5) ISHM Functional Capability Level (FCL); 6) ISHM Functional Capability Level (FCL) and Technology Readiness Level (TRL); 7) Core Elements: Capabilities Needed; 8) Core Elements; 9) Open Systems Architecture for Condition-Based Maintenance (OSA-CBM); 10) Core Elements: Architecture, taxonomy, and ontology (ATO) for DIaK management; 11) Core Elements: ATO for DIaK Management; 12) ISHM Architecture Physical Implementation; 13) Core Elements: Standards; 14) Systematic Implementation; 15) Sketch of Work Phasing; 16) Interrelationship Between Traditional Avionics Systems, Time Critical ISHM and Advanced ISHM; 17) Testbeds and On-Board ISHM; 18) Testbed Requirements: RETS AND ISS; 19) Sustainable Development and Validation Process; 20) Development of on-board ISHM; 21) Taxonomy/Ontology of Object Oriented Implementation; 22) ISHM Capability on the E1 Test Stand Hydraulic System; 23) Define Relationships to Embed Intelligence; 24) Intelligent Elements Physical and Virtual; 25) ISHM Testbeds and Prototypes at SSC Current Implementations; 26) Trailer

  2. A 'people-centered' concept of society-wide risk management

    International Nuclear Information System (INIS)

    Siddal, E.; Bennett, C.R.

    1985-05-01

    A methodology for society-wide risk management is proposed which would start by estimating the totality of real risk to the members of the society and break this down into all those components or categories which make an appreciable contribution to the total - say a minimum of 1%. Obviously, any component contributing less than this minimum should receive little attention, since even its complete elimination would have a neglible effect. Among the important components and categories, the magnitude and the 'tractability' would be decisive in the amount of effort which would be devoted to their reduction. These factors would combine in the estimated cost of saving an extra statistical life in that activity. Most effort should be devoted to those activities with the lowest such index; the general law of diminishing returns would make the allocation dynamic rather than fixed

  3. Environmental Management in the Process of Purification of Cuban Furfural in the Chemical Bioactive Center Plant

    Directory of Open Access Journals (Sweden)

    Ing. Liset Rodríguez-Machín

    2016-02-01

    Full Text Available It is necessary to establish in the installed equipment, operating conditions and quality specifications in the purification of furfural produced in Cuba. To do this some literature review and experiments are carried out. The approved batches by the quality control are quantified as well as the heat and evaporation losses and the impact on workers health. Energy management is performed by identifying electricity as the energy source of higher consumption. Some measures are applied like coating the evaporator portions that are required together with condenser modification and improvement of the room ventilation. As a result it was shown that it is possible to purify the Cuban furfural in the installed equipment, the process efficiency increases in 5,5 %, the evaporation losses decrease and non-acceptance by quality control drops. If the imported furfural is replaced by the Cuban are saved about 39 000 • per year production.

  4. Evaluation of decision making in technical support center for effective severe accident management

    International Nuclear Information System (INIS)

    Huh, C.; Suh, N.

    2010-01-01

    We have evaluated the technical and organizational aspect of the current SAMG focusing on the decision making process in TSC. Technically, we found that the current SAMG is a good software kind of tool which can help operators to manage the severe accident. But the clear cutting of EOP and SAMG, shift of plant control from MCR to TSC seems to have no firm ground to be accepted as it is. Study on the organizational behavior shows that the group decision under risky situation will be inevitably polarized either toward risky or cautious way. Since the current SAMG makes TSC to evaluate the pros and cons of strategies to be implemented and choose one based on group decision, we are not free of this group polarization phenomenon. We propose that the proven organization of EOP needs to be maintained and also that the SAMG needs to be more proceduralized. (authors)

  5. Wound management and outcome of 595 electrical burns in a major burn center.

    Science.gov (United States)

    Li, Haisheng; Tan, Jianglin; Zhou, Junyi; Yuan, Zhiqiang; Zhang, Jiaping; Peng, Yizhi; Wu, Jun; Luo, Gaoxing

    2017-06-15

    Electrical burns are important causes of trauma worldwide. This study aims to analyze the clinical characteristics, wound management, and outcome of electric burns. This retrospective study was performed at the Institute of Burn Research of the Third Military Medical University during 2013-2015. Data including the demographics, injury patterns, wound treatment, and outcomes were collected and analyzed. A total of 595 electrical burn patients (93.8% males) were included. The average age was 37.3 ± 14.6 y, and most patients (73.5%) were aged 19∼50 years. Most patients (67.2%) were injured in work-related circumstances. The mean total body surface area was 8.8 ± 11.8% and most wounds (63.5%) were full-thickness burns. Operation times of high-voltage burns and current burns were higher than those of low-voltage burns and arc burns, respectively. Of the 375 operated patients, 83.2% (n = 312) underwent skin autografting and 49.3% (n = 185) required skin flap coverage. Common types of skin flaps were adjacent (50.3%), random (42.2%), and pedicle (35.7%). Amputation was performed in 107 cases (18.0%) and concentrated on the hands (43.9%) and upper limbs (39.3%). The mean length of stay was 42.9 ± 46.3 d and only one death occurred (0.2%). Current burns and higher numbers of operations were major risk factors for amputation and length of stay, respectively. Electrical burns mainly affected adult males with occupational exposures in China. Skin autografts and various skin flaps were commonly used for electric burn wound management. More standardized and effective strategies of treatment and prevention are still needed to decrease amputation rates. Copyright © 2017 Elsevier Inc. All rights reserved.

  6. Successful Implementation of a Clinical Care Pathway for Management of Epistaxis at a Tertiary Care Center.

    Science.gov (United States)

    Vosler, Peter S; Kass, Jason I; Wang, Eric W; Snyderman, Carl H

    2016-11-01

    We compare the management of patients with severe epistaxis before and after the implementation a clinical care pathway (CCP) to standardize care, minimize hospital stay, and decrease cost. Single prospective analysis with historical control. Tertiary academic hospital. Patients treated for epistaxis between October 2012 to December 2013 were compared with a prospective analysis of patients treated for severe epistaxis after implementation of a CCP from June 2014 to February 2015. Severe epistaxis was defined as nasal bleeding not able to be controlled with local pressure, topical vasoconstrictors, or simple anterior packing. Severe epistaxis was similar in the pre- and post-CCP cohorts: 24.7% (n = 42) vs 18.9% (n = 22), respectively. Implementation of early sphenopalatine artery ligation resulted in decreased number of days packed (3.2 ± 1.6 to 1.4 ± 1.6; P = .001), decreased hospital stay (5.2 ± 3.9 to 2.1 ± 1.3 days; P vs 54.5%; P = .035), admission to an appropriate hospital location with access to key resources (41.7% vs 83.3%; P = .007), and decreased overall cost of hospitalization by 66% ($9435 saved). No patients received embolization after the CCP was implemented. Implementation of a CCP decreased hospital stay and days of packing, facilitated definitive care in patients with severe epistaxis, improved patient safety, and decreased cost. The results of this study can serve as a model for the management of severe epistaxis and for future quality improvement measures. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2016.

  7. Management of autoimmune hemolytic anemia in children and adolescents: A single center experience

    Directory of Open Access Journals (Sweden)

    Nazan Sarper

    2011-09-01

    Full Text Available Objective: To present and discuss the treatment of autoimmune hemolytic anemia (AIHA. Materials and Methods: The medical records of all patients (n=19 diagnosed in a tertiary hematology center between 1999 and 2010 were retrospectively reviewed.Results: Median age at diagnosis of AIHA was 5 years (range: 4 months-17 years. In all, 13 patients had primary (idiopathic AIHA, whereas 2 had primary Evans Syndrome (ES, 2 had autoimmune lymphoproliferative syndrome (ALPS+ES, and 1 had Wiskott-Aldrich syndrome (WAS+AIHA. Among the 13 primary idiopathic AIHA patients, 9 recovered following a 4-8-week course of prednisolone treatment without relapses, whereas 3 patients required a longer course of prednisolone. One AIHA patient that was very resistant to prednisolone recovered after cyclosporine A was added to the treatment. All patients with primary idiopathic AIHA were in remission for a median of 3 years (range: 4 months-10 years at the time this manuscript was written. Among the patients with primary ES, 2 had relapses similar to the ALPS patients. Splenectomy was performed in 1 primary ES patient, who at the time this report was written was also in remission. One ALPS patient required the addition of mycophenolate mofetil due to prednisolone resistance. The WAS patient was treatment resistant and died due to septicemia.Conclusions: Primary AIHA in pediatric patients generally has an acute onset and good response to corticosteroids. Primary or secondary ES has a chronic or relapsing course, and treatment may require other immunosuppressive agents in addition to corticosteroids. Complications of splenectomy must not be underestimated in patients with underlying immunodeficiency. AIHA often causes considerable morbidity and mortality in WAS.

  8. Planning Report for Establishment and Management of IAEA Designated International Cooperation Center

    International Nuclear Information System (INIS)

    Byun, Myung Woo; Jo, Cheol Hun; Noh, Yong Chang

    2006-05-01

    Establishment of research infrastructure and assistant of industry renovation is needed to achieve technology level-up in the all industry areas including plant engineering, material engineering, polymers, nondestructive tests, radioisotope tracer application, environment engineering, medical science, agriculture, sterilization, sprouting, biotechnology and aerospace, which would be the core motivation of our future industry. Early settlement of research environment is needed for the new RT-specialized national institute, Advanced Radiation Technology Institute (ARTi) in Jeongup, Chonbuk, Korea. From the early settlement, development of user program, technical assistance, and trendy information can be rapidly initiated by an industry-university-institute network. As a result, a RT hub in the northeast Asia will be founded with upgrade of international level of Korea. For this purpose, an intensive system construction is demanded. Establishment of a basic and advanced analysis system should be set up to analyze and evaluate the research products scientifically and industrially produced by using the RT-based research facilities. Establishment of a collaboration network in R and D among industry, university and institutes related to RT or RFT as well as development of an advanced RT industry system is demanded for the assistance of technology transfer. From the clarification of project details, comparisons of domestic/international technology levels and the demand of project in technical and economical aspects, and the prospect of development tendency of related technology, it is expected the effect and possible utilization after completion of the project. Especially, we proposed the direction for development of IAEA appointed international cooperation center with a long term development plan for the national radiation technology. This project report was consistently prepared with a long term development plan and consisted of establishments of training system for

  9. 2014 Korean Liver Cancer Study Group-National Cancer Center Korea Practice Guideline for the Management of Hepatocellular Carcinoma

    Science.gov (United States)

    2015-01-01

    The guideline for the management of hepatocellular carcinoma (HCC) was first developed in 2003 and revised in 2009 by the Korean Liver Cancer Study Group and the National Cancer Center, Korea. Since then, many studies on HCC have been carried out in Korea and other countries. In particular, a substantial body of knowledge has been accumulated on diagnosis, staging, and treatment specific to Asian characteristics, especially Koreans, prompting the proposal of new strategies. Accordingly, the new guideline presented herein was developed on the basis of recent evidence and expert opinions. The primary targets of this guideline are patients with suspicious or newly diagnosed HCC. This guideline provides recommendations for the initial treatment of patients with newly diagnosed HCC. PMID:25995680

  10. Minimally invasive management of achalasia cardia: results from a single center study.

    Science.gov (United States)

    Palanivelu, C; Maheshkumar, G S; Jani, Kalpesh; Parthasarthi, R; Sendhilkumar, K; Rangarajan, M

    2007-01-01

    Since the performance of the first laparoscopic cardiomyotomy for achalasia cardia in 1991, the popularity of the minimally invasive approach for this troublesome disease has been growing. We present our experience of 226 patients who underwent laparoscopic cardiomyotomy and discuss the relevant issues. A retrospective analysis was carried out of 226 patients who have undergone laparoscopic cardiomyotomy since 1993. The preoperative workup, surgical technique, and postoperative management are described. Patients included 146 males and 80 females; average age was 36.4 years (range, 6 to 85). Mean duration of symptoms was 1.4 years. Nearly half of the patients (112) had undergone prior pneumatic dilatation. In 20 patients, myotomy alone was done, 44 patients had a Dor's fundoplication, and 162 had Toupet's fundoplication. The average operating time was 96 minutes. Mean postoperative hospital stay was 2.2 days. Dysphagia was eliminated in 88.9% of the patients with an overall morbidity of 4.4% and nil mortality over a mean follow-up of 4.3 years. Laparoscopic cardiomyotomy with Toupet's fundoplication is a safe and effective treatment of achalasia cardia. Dor's fundoplication is done selectively, especially when suspicion is present of mucosal injury.

  11. Identification, Prevention, and Management of Childhood Overweight and Obesity in a Pediatric Primary Care Center.

    Science.gov (United States)

    Reed, Monique; Cygan, Heide; Lui, Karen; Mullen, Mary

    2016-08-01

    Background In the United States, overweight/obesity among youth has reached epidemic proportions. The purpose of this project was to (1) examine primary care provider adherence to American Academy of Pediatrics guidelines; (2) compare adherence based on patients' weight classification, age, race, and gender; and (3) identify areas for improvement in health care delivery. Methods A retrospective chart audit and feedback quality improvement project was conducted with a stratified random sample of 175 charts of 6- to 19-year-olds seen for well-child visits. Frequencies of provider adherence were reported. χ(2) Analyses of weight classification, age, race, or gender influence on adherence was calculated. Results After discussion with the primary care providers, 5 areas were identified as priorities for change (diagnosis based on BMI, parental history of obesity, sleep assessment, endocrine assessment, and attendance of patients at the follow-up visit). Conclusion Cost-efficient, feasible strategies to improve provider adherence to recommendations for identification, prevention and management of childhood overweight and obesity were identified. © The Author(s) 2015.

  12. Management of ureteral endometriosis with hydronephrosis: Experience from a tertiary medical center.

    Science.gov (United States)

    Huang, Jing-Zhi; Guo, Hong-Ling; Li, Jin-Bo; Chen, Shu-Qin

    2017-10-01

    We report the clinical characteristics and experience of the surgical management of ureteral endometriosis in our institution. We retrospectively reviewed the data of patients with hydronephrosis resulting from ureteral endometriosis. Forty-six patients with different degrees of hydronephrosis were included in the study; 35% had urinary tract symptoms. Concomitant involvement of the ipsilateral ovary occurred in more than two-thirds of the patients. Four patients had nephrectomy, one of which involved ureterolysis because of hydronephrosis recurrence six months later. Hydronephrosis may be caused by uncommon reasons, such as ureteral endometriosis, which can even cause silent loss of renal function. Routine ultrasound scanning of the upper urinary tract for severe stages of endometriosis is very important in order to detect any potential ureteral lesions. Ureterolysis should be considered as the first surgical step, not only to avoid iatrogenic ureteral injuries but also to better evaluate ureter involvement for further procedures. To warrant tension-free and lesion-free anastomosis, it is wise to perform ureteroneocystostomy for long-term sound results. © 2017 Japan Society of Obstetrics and Gynecology.

  13. Targeting Parents for Childhood Weight Management: Development of a Theory-Driven and User-Centered Healthy Eating App

    Science.gov (United States)

    Lahiri, Sudakshina; Brown, Katherine Elizabeth

    2015-01-01

    Background The proliferation of health promotion apps along with mobile phones' array of features supporting health behavior change offers a new and innovative approach to childhood weight management. However, despite the critical role parents play in children’s weight related behaviors, few industry-led apps aimed at childhood weight management target parents. Furthermore, industry-led apps have been shown to lack a basis in behavior change theory and evidence. Equally important remains the issue of how to maximize users’ engagement with mobile health (mHealth) interventions where there is growing consensus that inputs from the commercial app industry and the target population should be an integral part of the development process. Objective The aim of this study is to systematically design and develop a theory and evidence-driven, user-centered healthy eating app targeting parents for childhood weight management, and clearly document this for the research and app development community. Methods The Behavior Change Wheel (BCW) framework, a theoretically-based approach for intervention development, along with a user-centered design (UCD) philosophy and collaboration with the commercial app industry, guided the development process. Current evidence, along with a series of 9 focus groups (total of 46 participants) comprised of family weight management case workers, parents with overweight and healthy weight children aged 5-11 years, and consultation with experts, provided data to inform the app development. Thematic analysis of focus groups helped to extract information related to relevant theoretical, user-centered, and technological components to underpin the design and development of the app. Results Inputs from parents and experts working in the area of childhood weight management helped to identify the main target behavior: to help parents provide appropriate food portion sizes for their children. To achieve this target behavior, the behavioral diagnosis

  14. Targeting Parents for Childhood Weight Management: Development of a Theory-Driven and User-Centered Healthy Eating App.

    Science.gov (United States)

    Curtis, Kristina Elizabeth; Lahiri, Sudakshina; Brown, Katherine Elizabeth

    2015-06-18

    The proliferation of health promotion apps along with mobile phones' array of features supporting health behavior change offers a new and innovative approach to childhood weight management. However, despite the critical role parents play in children's weight related behaviors, few industry-led apps aimed at childhood weight management target parents. Furthermore, industry-led apps have been shown to lack a basis in behavior change theory and evidence. Equally important remains the issue of how to maximize users' engagement with mobile health (mHealth) interventions where there is growing consensus that inputs from the commercial app industry and the target population should be an integral part of the development process. The aim of this study is to systematically design and develop a theory and evidence-driven, user-centered healthy eating app targeting parents for childhood weight management, and clearly document this for the research and app development community. The Behavior Change Wheel (BCW) framework, a theoretically-based approach for intervention development, along with a user-centered design (UCD) philosophy and collaboration with the commercial app industry, guided the development process. Current evidence, along with a series of 9 focus groups (total of 46 participants) comprised of family weight management case workers, parents with overweight and healthy weight children aged 5-11 years, and consultation with experts, provided data to inform the app development. Thematic analysis of focus groups helped to extract information related to relevant theoretical, user-centered, and technological components to underpin the design and development of the app. Inputs from parents and experts working in the area of childhood weight management helped to identify the main target behavior: to help parents provide appropriate food portion sizes for their children. To achieve this target behavior, the behavioral diagnosis revealed the need for eliciting change in

  15. Federal Research: Opportunities Exist to Improve the Management and Oversight of Federally Funded Research and Development Centers

    National Research Council Canada - National Science Library

    Woods, William; Mittal, Anu; Neumann, John; Williams, Cheryl; Candon, Sharron; Sterling, Suzanne; Wade, Jacqueline; Zwanzig, Peter

    2008-01-01

    .... FFRDCs -- including laboratories, studies and analyses centers, and systems engineering centers -- conduct research in military space programs, nanotechnology, microelectronics, nuclear warfare...

  16. Sandia National Laboratories Facilities Management and Operations Center Design Standards Manual

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, Timothy L. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2014-09-01

    At Sandia National Laboratories in New Mexico (SNL/NM), the design, construction, operation, and maintenance of facilities is guided by industry standards, a graded approach, and the systematic analysis of life cycle benefits received for costs incurred. The design of the physical plant must ensure that the facilities are "fit for use," and provide conditions that effectively, efficiently, and safely support current and future mission needs. In addition, SNL/NM applies sustainable design principles, using an integrated whole-building design approach, from site planning to facility design, construction, and operation to ensure building resource efficiency and the health and productivity of occupants. The safety and health of the workforce and the public, any possible effects on the environment, and compliance with building codes take precedence over project issues, such as performance, cost, and schedule. These design standards generally apply to all disciplines on all SNL/NM projects. Architectural and engineering design must be both functional and cost-effective. Facility design must be tailored to fit its intended function, while emphasizing low-maintenance, energy-efficient, and energy-conscious design. Design facilities that can be maintained easily, with readily accessible equipment areas, low maintenance, and quality systems. To promote an orderly and efficient appearance, architectural features of new facilities must complement and enhance the existing architecture at the site. As an Architectural and Engineering (A/E) professional, you must advise the Project Manager when this approach is prohibitively expensive. You are encouraged to use professional judgment and ingenuity to produce a coordinated interdisciplinary design that is cost-effective, easily contractible or buildable, high-performing, aesthetically pleasing, and compliant with applicable building codes. Close coordination and development of civil, landscape, structural, architectural, fire

  17. Use of Condom Tamponade to Manage Massive Obstetric Hemorrhage at a Tertiary Center in Rajasthan.

    Science.gov (United States)

    Hasabe, Rakesh; Gupta, Kumud; Rathode, Pallavi

    2016-10-01

    Conventionally postpartum hemorrhage (PPH) has been defined as blood loss of more than 500 ml following vaginal delivery and 1000 ml following a cesarean section [Pritchard et al. in Am J Obstet Gynecol 84(10):1271-1282, (1962)]. Another definition labels PPH as any blood loss which causes a 10 % drop in hematocrit [Combs et al. in Obstet Gynecol 77:69-76, (1991)] or which threatens the hemodynamic stability of the patient and necessitates blood transfusion [Prendiville et al. in Cochrane Database Syst Rev 2:CD000007, (2000)]. The purpose of this study was to evaluate the effectiveness of condom tamponade in the management of massive obstetric hemorrhage. To evaluate the efficacy of a condom as a tamponade for intrauterine pressure to stop massive PPH. This prospective study was done in the Obstetrics and Gynecology Department of NIMS Medical College and Hospital, Jaipur, between December 2013 and February 2015. With aseptic precautions, a sterile rubber catheter fitted with a condom was introduced into the uterus. The condom was inflated with 250-500 ml normal saline according to need. Vaginal bleeding was observed, and further inflation was stopped when bleeding ceased. In all but 2 (94.44 %) the cases, postpartum bleeding was stopped within 10 min of creation of tamponade. On an average, 350 ml of normal saline was required to create adequate tamponade to stop the bleeding. Use of condom tamponade can effectively help in reducing both maternal morbidity and mortality associated with PPH. Our study encourages use of condom tamponade which is efficient, cost-effective, easily available and requires lesser skills as compared to the traditional surgical procedures.

  18. Use of medicinal herbs by patients with severe asthma managed at a Referral Center

    Directory of Open Access Journals (Sweden)

    Tacila Pires Mega

    2011-09-01

    Full Text Available Asthma is a chronic inflammatory disease of the airways that may lead to limitations in regular activities, to hospitalizations and a decrease in quality of life. Adherence to drug treatment is crucial for control of the disease. The use of medicinal herbs can reduce adherence to prescriptions, as the medication may be replaced by infusions or herbal products. The objective of this study was to evaluate the frequency of use of traditional herbal medicine among severe asthmatics in Salvador. Information on use of homemade remedies was obtained through application of a questionnaire during patient visits to a referral center. We also collected data on economic and social aspects as well as disease control. One hundred and forty-four (91,1% out of one hundred and fifty-eight patients evaluated used herbal medicines, but only 26.5% attributed improvement of asthma symptoms to this alternative treatment and only 8 had substituted a prescribed medication by herbal medicines. There was a trend towards lower adherence to prescription drug treatment in this group of patients. Despite the high frequency of use of medicinal herbs in our sample, there was no improvement in the asthma treatment in this population compared to non-users. Adherence to conventional drug treatment was satisfactory and there was neither reduction in asthma control nor increase in hospitalizations among the users of medicinal plants.A asma é uma enfermidade inflamatória crônica das vias aéreas que pode resultar em limitações nas atividades diárias, internações e prejuízo da qualidade de vida. A adesão ao tratamento medicamentoso é fundamental para o controle da doença. O uso de plantas medicinais pode reduzir a adesão ao tratamento prescrito, à medida que os medicamentos são substituídos por chás ou ervas. O objetivo deste estudo foi avaliar a frequência de uso de plantas medicinais entre asmáticos graves em Salvador. As informações sobre uso de rem

  19. Are the resources adoptive for conducting team-based diabetes management clinics? An explorative study at primary health care centers in Muscat, Oman.

    Science.gov (United States)

    Al-Alawi, Kamila; Johansson, Helene; Al Mandhari, Ahmed; Norberg, Margareta

    2018-05-08

    AimThe aim of this study is to explore the perceptions among primary health center staff concerning competencies, values, skills and resources related to team-based diabetes management and to describe the availability of needed resources for team-based approaches. The diabetes epidemic challenges services available at primary health care centers in the Middle East. Therefore, there is a demand for evaluation of the available resources and team-based diabetes management in relation to the National Diabetes Management Guidelines. A cross-sectional study was conducted with 26 public primary health care centers in Muscat, the capital of Oman. Data were collected from manual and electronic resources as well as a questionnaire that was distributed to the physician-in-charge and diabetes management team members.FindingsThe study revealed significant differences between professional groups regarding how they perceived their own competencies, values and skills as well as available resources related to team-based diabetes management. The perceived competencies were high among all professions. The perceived team-related values and skills were also generally high but with overall lower recordings among the nurses. This pattern, along with the fact that very few nurses have specialized qualifications, is a barrier to providing team-based diabetes management. Participants indicated that there were sufficient laboratory resources; however, reported that pharmacological, technical and human resources were lacking. Further work should be done at public primary diabetes management clinics in order to fully implement team-based diabetes management.

  20. An Adaptive CBPR Approach to Create Weight Management Materials for a School-Based Health Center Intervention

    Directory of Open Access Journals (Sweden)

    Andrew L. Sussman

    2013-01-01

    Full Text Available Purpose. From our previous clinical work with overweight/obese youth, we identified the need for research to create an effective weight management intervention to address the growing prevalence of adolescent metabolic syndrome. Formative assessment through an adaptive community-based participatory research (CBPR approach was conducted toward the development of a nutritional and physical activity (DVD and clinician toolkit for a school-based health center (SBHC weight management intervention. Methods. We first conducted parent and adolescent interviews on views and experiences about obesity while convening a community advisory council (CAC recruited from two participating urban New Mexico high schools. Thematic findings from the interviews were analyzed with the CAC to develop culturally and developmentally appropriate intervention materials. Results. Themes from the parent and adolescent interviews included general barriers/challenges, factors influencing motivation, and change facilitators. The CAC and university-based research team reached consensus on the final content of nutrition and physical activity topics to produce a DVD and clinician toolkit through six monthly sessions. These materials used in the SBHC intervention resulted in a greater reduction of body mass index when compared to adolescents receiving standard care. Conclusions. Formative assessment using an adaptive CBPR approach resulted in the creation of culturally and age appropriate weight reduction materials that were acceptable to study participants. This trial is registered with ClinicalTrials.gov NCT00841334.

  1. Design and Operational Evaluation of the Traffic Management Advisor at the Ft. Worth Air Route Traffic Control Center

    Science.gov (United States)

    Swenson, Harry N.; Vincent, Danny; Tobias, Leonard (Technical Monitor)

    1997-01-01

    NASA and the FAA have designed and developed and an automation tool known as the Traffic Management Advisor (TMA). The system was operationally evaluated at the Ft. Worth Air Route Traffic Control Center (ARTCC). The TMA is a time-based strategic planning tool that provides Traffic Management Coordinators and En Route Air Traffic Controllers the ability to efficiently optimize the capacity of a demand impacted airport. The TMA consists of trajectory prediction, constraint-based runway scheduling, traffic flow visualization and controllers advisories. The TMA was used and operationally evaluated for forty-one rush traffic periods during a one month period in the Summer of 1996. The evaluations included all shifts of air traffic operations as well as periods of inclement weather. Performance data was collected for engineering and human factor analysis and compared with similar operations without the TMA. The engineering data indicates that the operations with the TMA show a one to two minute per aircraft delay reduction during rush periods. The human factor data indicate a perceived reduction in en route controller workload as well as an increase in job satisfaction. Upon completion of the evaluation, the TMA has become part of the normal operations at the Ft. Worth ARTCC.

  2. A Patient-Centered Emergency Department Management Strategy for Sickle-Cell Disease Super-Utilizers.

    Science.gov (United States)

    Simpson, Grant G; Hahn, Hallie R; Powel, Alex A; Leverence, Robert R; Morris, Linda A; Thompson, Lara G; Zumberg, Marc S; Borde, Deepa J; Tyndall, Joseph A; Shuster, Jonathan J; Yealy, Donald M; Allen, Brandon R

    2017-04-01

    A subpopulation of sickle-cell disease patients, termed super-utilizers, presents frequently to emergency departments (EDs) for vaso-occlusive events and may consume disproportionate resources without broader health benefit. To address the healthcare needs of this vulnerable patient population, we piloted a multidisciplinary intervention seeking to create and use individualized patient care plans that alter utilization through coordinated care. Our goals were to assess feasibility primarily, and to assess resource use secondarily. We evaluated the effects of a single-site interventional study targeted at a population of adult sickle-cell disease super-utilizers using a pre- and post-implementation design. The pre-intervention period was 06/01/13 to 12/31/13 (seven months) and the post-intervention period was 01/01/14 to 02/28/15 (14 months). Our approach included patient-specific best practice advisories (BPA); an ED management protocol; and formation of a "medical home" for these patients. For 10 subjects targeted initially we developed and implemented coordinated care plans; after deployment, we observed a tendency toward reduction in ED and inpatient utilization across all measured indices. Between the annualized pre- and post-implementation periods we found the following: ED visits decreased by 16.5 visits/pt-yr (95% confidence interval [CI] [-1.32-34.2]); ED length of state (LOS) decreased by 115.3 hours/pt-yr (95% CI [-82.9-313.5]); in-patient admissions decreased by 4.20 admissions/pt-yr (95% CI [-1.73-10.1]); in-patient LOS decreased by 35.8 hours/pt-yr (95% CI [-74.9-146.7]); and visits where the patient left before treatment were reduced by an annualized total of 13.7 visits. We observed no patient mortality in our 10 subjects, and no patient required admission to the intensive care unit 72 hours following discharge. This effort suggests that a targeted approach is both feasible and potentially effective, laying a foundation for broader study.

  3. Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the Design and Operation of Multi-center Clinical Trials: a Qualitative Research Study

    OpenAIRE

    Eisenstein, Eric L.; Diener, Lawrence W.; Nahm, Meredith; Weinfurt, Kevin P.

    2010-01-01

    New technologies may be required to integrate the National Institutes of Health’s Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators ...

  4. Presentation, Management, and Outcome of Thyroglossal Duct Cysts in Adult and Pediatric Populations: A 14-Year Single Center Experience

    Directory of Open Access Journals (Sweden)

    Hassan Al-Thani

    2016-07-01

    Full Text Available Objectives: A thyroglossal duct cyst (TDC is a frequent congenital midline anomaly of the neck that usually manifests during the first decade of life. We aimed to describe the presentation, management, and outcome of TDC in pediatric and adult cases. Methods: A retrospective observational analysis was conducted for all patients diagnosed and treated for TDC between 2000 and 2014 in a single center in Qatar. Data included patients’ demographics, presentations, preoperative investigations, anesthesia type, histopathological findings, surgical management, recurrences, and complications. Results: We identified 102 patients, of which 57% were males. The mean age of patients was 20.2±15.6 years. A bimodal distribution of TDC has been observed, which peaked between the ages of 6–13 years and at ≥19 years. The preoperative evaluation mainly includes ultrasonography (66%, thyroid function test (44%, and fine-needle aspiration cytology (10%. The median size of the cyst was 25 (2–60 mm. Patients mainly presented with an asymptomatic midline neck mass at or below the hyoid bone (82%, followed by fistula (9%, infection (2%, and dysphagia (2%. Eighty-nine cases were identified preoperatively as TDC. The histopathological findings confirmed TDC with hyoid bone in 61 cases, and TDC alone in 38 cases. Eighty patients underwent the Sistrunk procedure while excision of TDC alone was observed in 18 cases. Five cases of recurrent disease were also treated. Adults had a greater median cyst size (30 (9–60 vs. 22 (2–55 mm; p = 0.005 and required prolonged operation time (69 (1–169 vs. 32.5 (1–140 mins; p = 0.004 compared to the pediatric group. Conclusion: The occurrence of TDC shows a bimodal age distribution. Preoperative evaluation and time for surgery vary whereas clinical presentations, surgical management, and postoperative outcomes are comparable among adult and pediatric groups. Ultrasonography is the preferred diagnostic modality, and the

  5. A survey of factors associated with the utilization of community health centers for managing hypertensive patients in Chengdu, China.

    Directory of Open Access Journals (Sweden)

    Yun Chai

    Full Text Available BACKGROUND: For decades the development of community health services has been emphasized in China to cope with the growing burden of chronic diseases by providing basic medical services. This survey aims at investigating factors associated with the use of Community Health Centers (CHCs for the management of hypertensive patients in Chengdu, China. METHODS: We used a systematic sampling method to select 2,030 patients with hypertension or diabetes registered in 29 CHCs in Chengdu in 2007. Researchers interviewed patients who consented to participate at their home. This paper reports findings from the survey of 1,716 hypertensive patients with completed questionnaires. Univariate analyses and multiple logistic regression analyses were conducted to explore factors influencing the use of CHCs for the management of hypertensive patients. RESULTS: 81.4% of hypertensive patients regularly used CHCs for hypertension monitoring and treatment in Chengdu. Univariate analyses indicated that use of CHCs was associated with the education level, occupation, types of medical insurance, Body Mass Index(BMI, patients' knowledge on hypertension, awareness of CHCs functions, satisfaction of the service of CHCs. Multiple regression analyses found that use of CHCs was positively associated with the following factors: the Urban Resident Basic Medical Insurance(URBMI, knowledge on blood pressure, awareness of the sites in CHCs to measure blood pressure, awareness of having to take life-long antihypertensive medicine once the treatment started, awareness of the health records registration in CHCs, regular follow up, improved convenience of seeing doctor. Patients with professional job were less likely to use the services of CHCs. CONCLUSIONS: The use of CHCs for hypertension management could be increased by improving residents' knowledge on the monitoring and treatment of hypertension, and the awareness of CHCs functions. The CHCs could play an important role in

  6. Personalizing Type 2 Diabetes Management: Use of a Patient-Centered Approach to Individualizing A1C Goals and Pharmacological Regimens.

    Science.gov (United States)

    Lahiri, Sharon W

    2017-12-01

    IN BRIEF Caring for people with type 2 diabetes requires a patient-centered approach to treatment targets and medication regimens. Focusing on patients' individual characteristics, needs, and treatment responses can improve compliance and clinical outcomes. Medication selection can be guided by the mechanisms of action, advantages, disadvantages, and costs of available options; patients' behavioral and psychological variables, personal preferences, and socioeconomic status also should be taken into account. This article provides an overview of patient-centered and individualized diabetes management, offers pharmacological recommendations for specific clinical scenarios, and describes a complicated case illustrating the patient-centered approach in clinical practice.

  7. Characterization and Management of Patients with Heroin versus Nonheroin Opioid Overdoses: Experience at an Academic Medical Center.

    Science.gov (United States)

    Morizio, Kate M; Baum, Regan A; Dugan, Adam; Martin, Julia E; Bailey, Abby M

    2017-07-01

    To characterize the differences between patients who had heroin and nonheroin opioid overdoses and to determine whether there were any significant differences in their management with regard to the naloxone use. Retrospective cohort study. Large academic medical center. A total of 923 patients admitted to the medical center who were identified for overdose by heroin or other opiate-related narcotics between January 2010 and September 2015; 480 patients experienced a nonheroin opioid overdose event, and 443 patients experienced a heroin overdose event. Patients presenting with heroin overdose tended to be younger and male, with higher rates of hepatitis C virus (HCV) infection compared with those presenting with nonheroin opioid overdose (pevent, history of injection drug use, and history of prescription opioid abuse compared with the nonheroin group (pevent with the same drug. The proportion of patients presenting with a heroin overdose steadily increased from 2010-2015; the number of patients presenting to the emergency department with nonheroin opioid overdoses steadily decreased. As rates of heroin overdose increased each year, the incidence of HCV infection increased dramatically. This study indicates that the incidence of heroin overdoses has significantly increased over the last several years, and the rates of HCV infection 4-fold since the start of the study period. Patients admitted for nonheroin opioid overdose were more likely to be admitted to the hospital and intensive care unit compared with those admitted for heroin overdose. The rise in overdose events only further illustrates a gap in our understanding of the cycle of addiction, drug abuse, and overdose events. © 2017 Pharmacotherapy Publications, Inc.

  8. Police Officer, Deal-Maker, or Healthcare Provider? Moving to a Patient-Centered Framework for Chronic Opioid Management

    Science.gov (United States)

    Nicolaidis, Christina

    2016-01-01

    How we frame our thoughts about chronic opioid therapy greatly influences our ability to practice patient-centered care. Even providers who strive to be non-judgmental may approach clinical decision-making about opioids by considering if the pain is real or they can trust the patient. Not only does this framework potentially lead to poor or unshared decision-making, it likely adds to provider and patient discomfort by placing the provider in the position of a police officer or judge. Similarly, providers often find themselves making deals with patients using a positional bargaining approach. Even if a compromise is reached, this framework can potentially inadvertently weaken the therapeutic relationship by encouraging the idea that the patient and provider have opposing goals. Reframing the issue can allow the provider to be in a more therapeutic role. As recommended in the APS/AAPM guidelines, providers should decide whether the benefits of opioid therapy are likely to outweigh the harms for a specific patient (or sometimes, for society) at a specific time. This paper discusses how providers can use a benefit-to-harm framework to make and communicate decisions about the initiation, continuation, and discontinuation of opioids for managing chronic non-malignant pain. Such an approach focuses decisions and discussions on judging the treatment, not the patient. It allows the provider and the patient to ally together and make shared decisions regarding a common goal. Moving to a risk-benefit framework may allow providers to provide more patient-centered care, while also increasing provider and patient comfort with adequately monitoring for harm. PMID:21539703

  9. Subanesthetic ketamine for pain management in hospitalized children, adolescents, and young adults: a single-center cohort study

    Directory of Open Access Journals (Sweden)

    Sheehy KA

    2017-04-01

    Full Text Available Kathy A Sheehy,1,* Caroline Lippold,1,* Amy L Rice,1 Raissa Nobrega,1 Julia C Finkel,1 Zenaide MN Quezado1,2 1Division of Anesthesiology, Pain, and Perioperative Medicine, The Sheikh Zayed Institute for Pediatric Surgical Innovation, Children’s Research Institute, Children’s National Health System, George Washington University School of Medicine and Health Sciences, 2Center for Neuroscience Research, Children’s Research Institute, Children’s National Health System, Washington, DC, USA *These authors contributed equally to this work Background: Subanesthetic doses of ketamine, an N-methyl-D-aspartate receptor antagonist used as an adjuvant to opioid for the treatment of pain in adults with acute and chronic pain, have been shown, in some instances, to improve pain intensity and to decrease opioid intake. However, less is known about the role of ketamine in pain management in children, adolescents, and young adults. Purpose: We examined the effects of subanesthetic ketamine on pain intensity and opioid intake in children, adolescents, and young adults with acute and chronic pain syndromes treated in an inpatient setting. Methods: This is a longitudinal cohort study of patients treated with subanesthetic ketamine infusions in regular patient care units in a tertiary pediatric hospital. Primary outcomes included changes in pain scores and morphine-equivalent intake. Results: The study cohort included 230 different patients who during 360 separate hospital admissions received subanesthetic ketamine infusions for pain management. Overall, ketamine infusions were associated with significant reductions in mean pain scores from baseline (mean pain scores 6.64 [95% CI: 6.38–6.90] to those recorded on the day after discontinuation of ketamine (mean pain scores 4.38 [95% CI: 4.06–4.69], p<0.001. Importantly, the effect of ketamine on pain scores varied according to clinical diagnosis (p=0.011, infusion duration (p=0.004, and pain location (p=0

  10. Management of a comprehensive radiation safety program in a major American University and affiliated academic medical center

    International Nuclear Information System (INIS)

    Yoshizumi, T.T.; Reiman, R.E.; Vylet, V.; Clapp, J.R.; Thomann, W.R.; Lyles, K.W.

    2000-01-01

    Duke University, which operates under eight radiation licenses issued by the State of North Carolina, consists of a leading medical center including extensive inpatient and outpatient facilities, a medical school, biomedical research labs, and an academic campus including two major accelerator facilities. The Nuclear Medicine and Radiation Oncology departments handle over 40,000 diagnostic and therapeutic procedures annually, including approximately 160 radioiodine therapeutic cases. In biomedical research labs, about 300 professors are authorized to use radioactive materials. Over 2,000 radiation workers are identified on campus. Over the past two years, we have transformed the existing radiation safety program into a more responsive and more accountable one. Simultaneously, the institutional 'culture' changed, and the Radiation Safety Division came to be viewed as a helpful ally by investigators. The purpose of this paper is to present our experiences that have made this transformation possible. Our initiatives included; (a) defining short-term and long-term goals; (b) establishing a definitive chain of authority; (c) obtaining an external review by a consultant Health Physicist; (d) improving existing radiation safety programs; (e) reorganizing the Radiation Safety Division, with creation of multidisciplinary professional staff positions; (f) implementing campus-wide radiation safety training, (g) increasing technician positions; (h) establishing monthly medical center radiation safety executive meeting. As a result progress made at the Divisional level includes; (a) culture change by recruiting professionals with academic credentials and recent college graduates; (b) implementing weekly staff meetings and monthly quality assurance meetings; (c) achieving academic prominence by publishing and presenting papers in national meetings; (d) senior staff achieving faculty appointments with academic departments; (e) senior staff participating in graduate student

  11. Iowa Water Center | Iowa Water Center

    Science.gov (United States)

    Home Iowa State University Extension Iowa Water Center Submitted by mollyd on April 24, 2012 - 09 :42 Advancing the state of water knowledge and management The Iowa Water Center is a part of a nationwide network of university-based water centers created to encourage interdisciplinary water research

  12. Data center thermal management

    Science.gov (United States)

    Hamann, Hendrik F.; Li, Hongfei

    2016-02-09

    Historical high-spatial-resolution temperature data and dynamic temperature sensor measurement data may be used to predict temperature. A first formulation may be derived based on the historical high-spatial-resolution temperature data for determining a temperature at any point in 3-dimensional space. The dynamic temperature sensor measurement data may be calibrated based on the historical high-spatial-resolution temperature data at a corresponding historical time. Sensor temperature data at a plurality of sensor locations may be predicted for a future time based on the calibrated dynamic temperature sensor measurement data. A three-dimensional temperature spatial distribution associated with the future time may be generated based on the forecasted sensor temperature data and the first formulation. The three-dimensional temperature spatial distribution associated with the future time may be projected to a two-dimensional temperature distribution, and temperature in the future time for a selected space location may be forecasted dynamically based on said two-dimensional temperature distribution.

  13. Information systems center management

    OpenAIRE

    Μελάς, Μιχαήλ

    2013-01-01

    Η Οικονομική κρίση στην Ευρωζώνη, και ειδικότερα στην Ελλάδα, είναι ένα φαινόμενο με πολύπλευρες οικονομικές, πολιτισμικές, κοινωνικές επιπτώσεις. Η κρίση αυτή επηρεάζει κάθε επιχείρηση, κάθε οργανισμό, τους ανθρώπους της, αλλά και τις δραστηριότητές της. Έχει διαπιστωθεί ότι όσο καλύτερη είναι η μηχανογράφηση μιας επιχείρησης, τόσο καλύτερη είναι η διοίκηση και η οργάνωση της, με αποτέλεσμα την βιωσιμότητα, και την ανάπτυξή της. Η παρούσα διατριβή, στοχεύει να αναδείξει την οικονομική σημασί...

  14. Injuries of the Medial Clavicle: A Cohort Analysis in a Level-I-Trauma-Center. Concomitant Injuries. Management. Classification.

    Science.gov (United States)

    Bakir, Mustafa Sinan; Merschin, David; Unterkofler, Jan; Guembel, Denis; Langenbach, Andreas; Ekkernkamp, Axel; Schulz-Drost, Stefan

    2017-01-01

    Introduction: Although shoulder girdle injuries are frequent, those of the medial clavicle are widely unexplored. An applied classification is less used just as a standard management. Methods: A retrospective analysis of medial clavicle injuries (MCI) during a 5-year-term in a Level-1-Trauma-Center. We analyzed amongst others concomitant injuries, therapy strategies and the classification following the AO standards. Results: 19 (2.5%) out of 759 clavicula injuries were medial ones (11 A, 6 B and 2 C-Type fractures) thereunder 27,8% were displaced and thus operatively treated Locked plate osteosynthesis was employed in unstable fractures and a reconstruction of the ligaments at the sternoclavicular joint (SCJ) in case of their disruption. 84,2% of the patients sustained relevant concomitant injuries. Numerous midshaft fractures were miscoded as medial fracture, which limited the study population. Conclusions: MCI resulted from high impact mechanisms of injury, often with relevant dislocation and concomitant injuries. Concerning medial injury's complexity, treatment should occur in specialized hospitals. Unstable fractures and injuries of the SCJ ligaments should be considered for operative treatment. Midshaft fractures should be clearly distinguished from the medial ones in ICD-10-coding. Further studies are required also regarding a subtyping of the AO classification for medial clavicle fractures including ligamental injuries. Celsius.

  15. Quality management and accreditation of research tissue banks: experience of the National Center for Tumor Diseases (NCT) Heidelberg.

    Science.gov (United States)

    Herpel, Esther; Röcken, Christoph; Manke, Heike; Schirmacher, Peter; Flechtenmacher, Christa

    2010-12-01

    Tissue banks are key resource and technology platforms in biomedical research that address the molecular pathogenesis of diseases as well as disease prevention, diagnosis, and treatment. Due to the central role of tissue banks in standardized collection, storage, and distribution of human tissues and their derivatives, quality management and its external assessment is becoming increasingly relevant for the maintenance, acceptance, and funding of tissue banks. Little experience exists regarding formalized external evaluation of tissue banks, especially regarding certification and accreditation. Based on the accreditation of the National Center of Tumor Diseases (NCT) tissue bank in Heidelberg (Germany), criteria, requirements, processes, and implications were compiled and evaluated. Accreditation formally approved professional competence and performance of the tissue bank in all steps involved in tissue collection, storage, handling as well as macroscopic and histologic examination and final (exit) examination of the tissue and transfer supervised by board-certified competent histopathologists. Thereby, accreditation provides a comprehensive measure to evaluate and document the quality standard of tissue research banks and may play a significant role in the future assessment of tissue banks. Furthermore, accreditation may support harmonization and standardization of tissue banking for biomedical research purposes.

  16. Depression management within GP-centered health care - A case-control study based on claims data.

    Science.gov (United States)

    Freytag, Antje; Krause, Markus; Lehmann, Thomas; Schulz, Sven; Wolf, Florian; Biermann, Janine; Wasem, Jürgen; Gensichen, Jochen

    For most patients with depression, GPs are the first and long-term medical providers. GP-centered health care (GPc-HC) programs target patients with chronic diseases. What are the effects of GPc-HC on primary care depression management? An observational retrospective case-control study was conducted using health insurance claims data of patients with depressive disorder from July 2011 to December 2012. From 40,298 patients insured with the largest health plan in Central Germany participating in the GPc-HC program (intervention group, IG), we observed 4645 patients with depression over 18months: 72.2% women; 66.6years (mean); multiple conditions (morbidity-weight 2.50 (mean), 86%>1.0). We compared them with 4013 patients who did not participate (control group). In participants we found lower number of incomplete/non-specified depression diagnoses (4.46vs.4.82;MD-0.36; pcare" (38.2%vs.30.2%;PP+8.0;pDepressive patients participating in a GPc-HC program may be more often diagnosed by a GP, receive symptom-monitoring and appropriate depression treatment. Copyright © 2016 Elsevier Inc. All rights reserved.

  17. Role of vacuum assisted suction drainage in management of deep sternal wound infection: Experience in one center

    Directory of Open Access Journals (Sweden)

    Abd-Allah Ibrahim Badr

    2017-03-01

    Conclusions: The incidence of DSWI was similar in our center to that in other cardiothoracic centers. Various risk factors were found to be associated with DSWI. The DSWI pathogens in our center are similar to those in other reports most of our patients were treated successfully with this technique with excellent wound healing. So, vacuum therapy is safe and effective method for treating DSWI.

  18. Advanced Air Traffic Management Research (Human Factors and Automation): NASA Research Initiatives in Human-Centered Automation Design in Airspace Management

    Science.gov (United States)

    Corker, Kevin M.; Condon, Gregory W. (Technical Monitor)

    1996-01-01

    NASA has initiated a significant thrust of research and development focused on providing the flight crew and air traffic managers automation aids to increase capacity in en route and terminal area operations through the use of flexible, more fuel-efficient routing, while improving the level of safety in commercial carrier operations. In that system development, definition of cognitive requirements for integrated multi-operator dynamic aiding systems is fundamental. The core processes of control and the distribution of decision making in that control are undergoing extensive analysis. From our perspective, the human operators and the procedures by which they interact are the fundamental determinants of the safe, efficient, and flexible operation of the system. In that perspective, we have begun to explore what our experience has taught will be the most challenging aspects of designing and integrating human-centered automation in the advanced system. We have performed a full mission simulation looking at the role shift to self-separation on board the aircraft with the rules of the air guiding behavior and the provision of a cockpit display of traffic information and an on-board traffic alert system that seamlessly integrates into the TCAS operations. We have performed and initial investigation of the operational impact of "Dynamic Density" metrics on controller relinquishing and reestablishing full separation authority. (We follow the assumption that responsibility at all times resides with the controller.) This presentation will describe those efforts as well as describe the process by which we will guide the development of error tolerant systems that are sensitive to shifts in operator work load levels and dynamic shifts in the operating point of air traffic management.

  19. Training Childcare Center Administrators about Integrated Pest Management through Greener Environmental Communication Venues and Collecting Pesticide Use Data in the Process

    Science.gov (United States)

    Anderson, Marcia

    2014-01-01

    Many people assume that schools and childcare centers are environmentally safe places for children to learn. However, adverse health effects from pest allergy related illnesses or pesticide exposure incidents can demonstrate the need for safer and more effective pest management strategies. The goal of this research is to measure the efficacy of…

  20. Application of database management system for data-ware of work on power engineering problems in the National Nuclear Center of the Republic of Kazakhstan

    International Nuclear Information System (INIS)

    Afanas'eva, T.Yu.

    2001-01-01

    In this article there are some development tendencies of state-of-art data management system. Also it describes databases on the status of the world power engineering and power engineering in Kazakhstan created in the National Nuclear Center of the Republic of Kazakhstan. (author)

  1. School Health Connection Goes Electronic: Developing a Health Information Management System for New Orleans' School-Based Health Centers. Program Results Report

    Science.gov (United States)

    Rastorfer, Darl

    2011-01-01

    From February 2008 through April 2011, School Health Connection, a program of the Louisiana Public Health Institute, developed an electronic health information management system for newly established school-based health centers in Greater New Orleans. School Health Connection was established as part of a broader effort to restore community health…

  2. The challenges of managing acute extradural hematoma in a Nigerian neurosurgical center--still a long way to go.

    Science.gov (United States)

    Emejulu, Jude Kennedy C; Uche, Enoch Ogbonnaya; Nwankwo, Ezekiel Uche

    2014-12-01

    Acute extradural hematoma (EDH) is the collection of blood in the potential space between the dura mater and endocranium within 3 days of an incident. It is usually, but not always, a neurosurgical emergency, and early treatment reduces morbidity and mortality, although the outcome is still affected by some other determinants. In Nigeria, the National Health Insurance Scheme does not cover neurosurgical cases, and patients have to pay for all of their treatment regardless of the emergency status. We evaluate epidemiologic patterns, management protocols, and outcome, especially in relation to timely operative intervention, in patients with acute extradural hematoma who presented to our recently established neurosurgical service. This prospective study comprised cases managed in our center from May 2006 to July 2013. Data of all patients with acute EDH were collected on Microsoft Excel software and complemented with hospital charts and operative records. Demographic data, etiologic factors, time interval from injury to presentation in our service, time interval from presentation to definitive treatment, and outcome were collected and analyzed. Within the 86-month study period, 1648 patients presented to our service with head injuries. Acute EDH constituted 3.03%, with a mean of 7.14 cases per year. Among the cases of acute EDH, 92% involved male patients (male-to-female ratio, 11.5:1). Peak age incidence (42%) was 21-30 years (mean, 23 years), and motorcycle road traffic accident was the most common etiologic factor (72%). Operative treatment was performed in 84% of the cases (in 57.1%, operative treatment occurred within 1 week of presentation). Conservative management was employed in 10% of cases. Mortality was 14.9%; most (10%) had severe head injury, although 2.1% had mild injury known to be associated with 0% mortality. Acute EDH is a potentially fatal condition that is easily treatable if presentation, diagnosis, and treatment occur promptly. Our outcomes could

  3. Tehran Nuclear Research Center

    International Nuclear Information System (INIS)

    Taherzadeh, M.

    1977-01-01

    The Tehran Nuclear Research Center was formerly managed by the University of Tehran. This Center, after its transformation to the AEOI, has now become a focal point for basic research in the area of Nuclear Energy in Iran

  4. Strategies in Interventional Radiology: Formation of an Interdisciplinary Center of Vascular Anomalies - Chances and Challenges for Effective and Efficient Patient Management.

    Science.gov (United States)

    Sadick, Maliha; Dally, Franz Josef; Schönberg, Stefan O; Stroszczynski, Christian; Wohlgemuth, Walter A

    2017-10-01

    Background  Radiology is an interdisciplinary field dedicated to the diagnosis and treatment of numerous diseases and is involved in the development of multimodal treatment concepts. Method  Interdisciplinary case management, a broad spectrum of diagnostic imaging facilities and dedicated endovascular radiological treatment options are valuable tools that allow radiology to set up an interdisciplinary center for vascular anomalies. Results  Image-based diagnosis combined with endovascular treatment options is an essential tool for the treatment of patients with highly complex vascular diseases. These vascular anomalies can affect numerous parts of the body so that a multidisciplinary treatment approach is required for optimal patient care. Conclusion  This paper discusses the possibilities and challenges regarding effective and efficient patient management in connection with the formation of an interdisciplinary center for vascular anomalies with strengthening of the clinical role of radiologists. Key points   · Vascular anomalies, which include vascular tumors and malformations, are complex to diagnose and treat.. · There are far more patients with vascular anomalies requiring therapy than interdisciplinary centers for vascular anomalies - there is currently a shortage of dedicated interdisciplinary centers for vascular anomalies in Germany that can provide dedicated care for affected patients.. · Radiology includes a broad spectrum of diagnostic and minimally invasive therapeutic tools which allow the formation of an interdisciplinary center for vascular anomalies for effective, efficient and comprehensive patient management.. Citation Format · Sadick M, Dally FJ, Schönberg SO et al. Strategies in Interventional Radiology: Formation of an Interdisciplinary Center of Vascular Anomalies - Chances and Challenges for Effective and Efficient Patient Management. Fortschr Röntgenstr 2017; 189: 957 - 966. © Georg Thieme Verlag KG Stuttgart · New

  5. Impact of the Patient-Reported Outcomes Management Information System (PROMIS) upon the design and operation of multi-center clinical trials: a qualitative research study.

    Science.gov (United States)

    Eisenstein, Eric L; Diener, Lawrence W; Nahm, Meredith; Weinfurt, Kevin P

    2011-12-01

    New technologies may be required to integrate the National Institutes of Health's Patient Reported Outcome Management Information System (PROMIS) into multi-center clinical trials. To better understand this need, we identified likely PROMIS reporting formats, developed a multi-center clinical trial process model, and identified gaps between current capabilities and those necessary for PROMIS. These results were evaluated by key trial constituencies. Issues reported by principal investigators fell into two categories: acceptance by key regulators and the scientific community, and usability for researchers and clinicians. Issues reported by the coordinating center, participating sites, and study subjects were those faced when integrating new technologies into existing clinical trial systems. We then defined elements of a PROMIS Tool Kit required for integrating PROMIS into a multi-center clinical trial environment. The requirements identified in this study serve as a framework for future investigators in the design, development, implementation, and operation of PROMIS Tool Kit technologies.

  6. Evidence Underpinning the Centers for Medicare & Medicaid Services' Severe Sepsis and Septic Shock Management Bundle (SEP-1): A Systematic Review.

    Science.gov (United States)

    Pepper, Dominique J; Jaswal, Dharmvir; Sun, Junfeng; Welsh, Judith; Natanson, Charles; Eichacker, Peter Q

    2018-04-17

    This article has been corrected. To see what has changed, please read the Letter to the Editor and the authors' response. The original version (PDF) is appended to this article as a Supplement. The Severe Sepsis and Septic Shock Early Management Bundle (SEP-1), the sepsis performance measure introduced in 2015 by the Centers for Medicare & Medicaid Services (CMS), requires the reporting of up to 5 hemodynamic interventions, as many as 141 tasks, and 3 hours to document for a single patient. To evaluate whether moderate- or high-level evidence shows that use of the 2015 SEP-1 or its hemodynamic interventions improves survival in adults with sepsis. PubMed, Embase, Scopus, Web of Science, and ClinicalTrials.gov from inception to 28 November 2017 with no language restrictions. Randomized and observational studies of death among adults with sepsis who received versus those who did not receive either the entire SEP-1 bundle or 1 or more SEP-1 hemodynamic interventions, including serial lactate measurements; a fluid infusion of 30 mL/kg of body weight; and assessment of volume status and tissue perfusion with a focused examination, bedside cardiovascular ultrasonography, or fluid responsiveness testing. Two investigators independently extracted study data and assessed each study's risk of bias; 4 authors rated level of evidence by consensus using CMS criteria published in 2013. High- or moderate-level evidence required studies to have no confounders and low risk of bias. Of 56 563 references, 20 studies (18 reports) met inclusion criteria. One single-center observational study reported lower in-hospital mortality after implementation of the SEP-1 bundle. Sixteen studies (2 randomized and 14 observational) reported increased survival with serial lactate measurements or 30-mL/kg fluid infusions. None of the 17 studies were free of confounders or at low risk of bias. In 3 randomized trials, fluid responsiveness testing did not alter survival. Few trials, poor-quality and

  7. Resources, environment and solid waste management; Shigen {center{underscore}dot} kankyo mondai to haikibutsu shori no tenkai

    Energy Technology Data Exchange (ETDEWEB)

    Takeda, Nobuo [Kyoto University, Kyoto (Japan). Department of Environmental Engineering

    1999-09-20

    Solid waste management should be considered in close relation to conservation of energy and resources. The history and situation of solid waste management in Japan is outlined and the new concept of waste management is discussed for sustainable development. (author)

  8. Procedure for implementing the system of quality management in the testing laboratory of the Center for Genetic Engineering and Biotechnology in Sancti Spiritus.

    Directory of Open Access Journals (Sweden)

    Lídice Peraza Cruz

    2014-03-01

    Full Text Available Implementation of Quality Management System in testing laboratories offers the possibility of its accreditation and a frame for cooperation with other organizations, supporting information and experience exchange, as well as standards and procedures harmonization. To improve the performance of the Center for Genetic Engineering and Biotechnology of Sancti Spíritus testing laboratory, assuring technically valid data and results which promote technical competence and credibility of in vitro diagnostics and biological reagents products, a procedure was designed to implement a Quality Management System. This procedure applies Deming´s Quality Cycle and considers all relevant requirements in NC ISO/IEC 17025:2006 “General requirements for the competence of testing and calibration laboratories” and Regulation No. 20 2004 “Good Manufacturing Practices for in vitro Diagnostics” of Center for State Control of Drugs, Equipment and Medical Devices. We recommend an auto evaluation method, designed by authors, to verify quality management system accomplishment.

  9. The Comparing Options for Management: Patient-centered Results for Uterine Fibroids (COMPARE-UF) Registry: Rationale and Design.

    Science.gov (United States)

    Stewart, Elizabeth A; Lytle, Barbara L; Thomas, Laine; Wegienka, Ganesa R; Jacoby, Vanessa; Diamond, Michael P; Nicholson, Wanda K; Anchan, Raymond M; Venable, Sateria; Wallace, Kedra; Marsh, Erica E; Maxwell, George L; Borah, Bijan J; Catherino, William H; Myers, Evan R

    2018-05-08

    To design and establish a uterine fibroid (UF) registry based in the United States (US) to provide comparative effectiveness data regarding UF treatment. We report here the design and initial recruitment for the Comparing Options for Management: Patient-centered Results for Uterine Fibroids (COMPARE-UF) registry (Clinicaltrials.gov, NCT02260752), funded by the Agency for Healthcare Research and Quality (AHRQ) in collaboration with the-Patient-Centered Outcomes Research Institute (PCORI). COMPARE-UF is designed to help answer critical questions about treatment options for women with symptomatic UF. Women undergoing a procedure for UF (hysterectomy, myomectomy [abdominal, hysteroscopic, vaginal and laparoscopic/robotic], endometrial ablation, radiofrequency fibroid ablation, uterine artery embolization, magnetic resonance guided focused ultrasound or progestin-releasing intrauterine device insertion) at one of the COMPARE-UF sites are invited to participate in a prospective registry with three years follow-up for post-procedural outcomes. Enrolled participants provide annual follow-up through an online portal or through traditional phone contact. A central data abstraction center provides information obtained from imaging, operative or procedural notes and pathology reports. Women with uterine fibroids and other stakeholders are a key part of the COMPARE-UF registry and participate at all points from study design to dissemination of results. We built a network of nine clinical sites across the US with expertise in the care of women with UF to capture geographic, racial, ethnic and procedural diversity. Of the initial 2031 women enrolled in COMPARE-UF, 42% are self-identified as Black or African-American and 40% are age 40 years or younger with 16% of participants under age 35. Women undergoing myomectomy comprise the largest treatment group at 46% of all procedures with laparoscopic or robotic myomectomy comprising the largest subset of myomectomies at 19% of all

  10. Center for Women Veterans

    Science.gov (United States)

    ... Business with VA Acquisition, Logistics, & Construction Small & Veteran Business Programs VetBiz.gov Financial & Asset Enterprise Management Security Investigation Center/Background Clearances Freedom of Information ...

  11. Great Lakes Science Center

    Data.gov (United States)

    Federal Laboratory Consortium — Since 1927, Great Lakes Science Center (GLSC) research has provided critical information for the sound management of Great Lakes fish populations and other important...

  12. Moving towards patient-centered medicine for COPD management: multidimensional approaches versus phenotype-based medicine--a critical view.

    Science.gov (United States)

    Lopez-Campos, Jose Luis; Bustamante, Víctor; Muñoz, Xavier; Barreiro, Esther

    2014-09-01

    For decades, chronic obstructive pulmonary disease (COPD) has been considered a relentlessly progressive disease in which the deterioration of lung function is associated with an increase in symptoms, interrupted only by periods of exacerbation. However, this paradigm of COPD severity based on FEV1 has been challenged by currently available evidence. So far, three main approaches, though with contradictory aspects, have been proposed in order to address the complexity of COPD as well as to develop appropriate diagnostic, prognostic and therapeutic strategies for the disease: 1) the use of independent, clinically relevant variables, 2) the use of multidimensional indices, and 3) disease approaches based on clinical phenotypes. Multivariable systems seem superior to FEV1 in predicting prognosis and defining disease severity. However, selection of variables available from current literature must be confronted with issues of medical practice. Future evidence will be needed to reveal their effective relationship with disease long-term prognosis and to demonstrate the most adequate cutoff values to be used in clinical settings. Multidimensional scores provide a good prognostic instrument for the identification of patients with a particular degree of disease severity. Clinical phenotyping can help clinicians identify the patients who respond to specific pharmacological interventions; however, there is some controversy about the phenotypes to select and their long-term implications. Although these approaches are not perfect, they represent the first step towards patient-centered medicine for COPD. In the near-future, these different approaches should converge towards one new field to focus on the better management of COPD patients.

  13. Clinical management of chronic hepatitis B infection: results from a registry at a German tertiary referral center.

    Science.gov (United States)

    Demir, M; Nigemeier, J; Kütting, F; Bowe, A; Schramm, C; Hoffmann, V; Waldschmidt, D; Goeser, T; Steffen, H-M

    2015-04-01

    We studied a cohort of adult patients with chronic hepatitis B (CHB) infection, followed at a tertiary referral liver center in Germany over 12.5 years to analyze the clinical features and impact of management on disease progression and survival of CHB patients in general and of those with CHB and HCC in particular. We retrospectively evaluated the medical records of 242 adult (age ≥ 18 years) patients. CHB was defined as positive hepatitis B surface antigen (HBsAg) and/or HBV-DNA levels >10 IU/mL for at least 6 months. Patient demographics, HBV markers, antiviral treatment, laboratory parameters, liver imaging and histology were recorded for each visit. HCC patients were divided into two groups and separately analyzed (group 1: n = 24, HCC at first visit and group 2: n = 11, HCC during surveillance). The mean age was 44 years in CHB patients without HCC (63% male) and about 59 years in patients with HCC (77% male). Antiviral therapy was given to 59% of patients without HCC compared to only 25% in group 1 and 18% in group 2 with comparable median HBV DNA levels of approximately 36,000 IU/mL. There was no statistically significant difference concerning the HCC stages (Milan, UCSF, BCLC) at first diagnosis. Five-year survival was 19% in group 1 vs. 64% in group 2 (p = 0.019), with LTx performed in 12 vs. 45%, respectively. Surveillance of CHB patients did not result in early stage detection of HCC but in a higher likelihood to receive potentially curative treatments.

  14. Advancing Patient-Centered Care in Tuberculosis Management: A Mixed-Methods Appraisal of Video Directly Observed Therapy.

    Science.gov (United States)

    Holzman, Samuel B; Zenilman, Avi; Shah, Maunank

    2018-04-01

    Directly observed therapy (DOT) remains an integral component of treatment support and adherence monitoring in tuberculosis care. In-person DOT is resource intensive and often burdensome for patients. Video DOT (vDOT) has been proposed as an alternative to increase treatment flexibility and better meet patient-specific needs. We conducted a pragmatic, prospective pilot implementation of vDOT at 3 TB clinics in Maryland. A mixed-methods approach was implemented to assess (1) effectiveness, (2) acceptability, and (3) cost. Medication adherence on vDOT was compared with that of in-person DOT. Interviews and surveys were conducted with patients and providers before and after implementation, with framework analysis utilized to extract salient themes. Last, a cost analysis assessed the economic impacts of vDOT implementation across heterogeneous clinic structures. Medication adherence on vDOT was comparable to that of in-person DOT (94% vs 98%, P = .17), with a higher percentage of total treatment doses (inclusive of weekend/holiday self-administration) ultimately observed during the vDOT period (72% vs 66%, P = .03). Video DOT was well received by staff and patients alike, who cited increased treatment flexibility, convenience, and patient privacy. Our cost analysis estimated a savings with vDOT of $1391 per patient for a standard 6-month treatment course. Video DOT is an acceptable and important option for measurement of TB treatment adherence and may allow a higher proportion of prescribed treatment doses to be observed, compared with in-person DOT. Video DOT may be cost-saving and should be considered as a component of individualized, patient-centered case management plans.

  15. Single-center open-label randomized study of anemia management improvement in ESRD patients with secondary hyperparathyroidism

    Directory of Open Access Journals (Sweden)

    Bellasi Antonio

    2016-04-01

    Full Text Available Whether anemia and mineral bone abnormalities (chronic kidney disease–mineral bone disorder [CKD-MBD] are associated still remains to be elucidated. Both anemia and CKD-MBD have been associated with adverse cardiovascular outcome and poor quality of life. However, recent evidence suggests that use of large doses of erythropoietin-stimulating agents (ESAs to correct hemoglobin (Hb may be detrimental in CKD. The Optimal Anemia Treatment in End Stage Renal Disease (ESRD (Optimal ESRD Treatment study will assess whether lowering of parathyroid hormone (PTH is associated with a reduction in ESA consumption. The Optimal ESRD Treatment study is a pilot single-center open-label study with blinded end point (a prospective randomized open blinded end-point [PROBE] design enrolling 50 patients on maintenance dialysis. Eligible patients with intact PTH (iPTH 300-540 pg/mL and Hb 10-11.5 g/dL will be randomized 1:1 to strict PTH control (150-300 pg/mL versus standard care (PTH range 300-540 pg/mL. Available drugs for CKD-MBD and anemia treatment will be managed by the attending physician to maintain the desired levels of PTH (according to study arm allocation and Hb (10-11.5 g/dL. Echocardiographic data for cardiac structure and function as well as arterial stiffness will be assessed at study inception and completion. The Optimal ESRD Treatment study should shed light on the complicated interplay of anemia and CKD-MBD and on the feasibility of clinical trials in this domain. The study results are expected in the spring of 2017.

  16. Challenges in Strategy and Management of Multinational R&D Centers in Emerging Markets: Perspective from a German Headquarters in the Chemical Sector

    Directory of Open Access Journals (Sweden)

    Osmar Mitsuo Saito

    2013-03-01

    Full Text Available The expansion of multinational company (MNCs operations abroad represents an observed trend for decades. The news is that in recent years the research and development (R&D activities also have become internationalized, including more intensified focus on emerging countries. Among the implications is the challenge for the MNCs to implement effective organizational structures with the intention to facilitate the articulated coordination of strategies and R&D management between the headquarters and their global R&D centers. The purpose of this study is to evaluate the strategy from the perspective of the corporate headquarters of a multinational company and the challenges in the formulation of the global R&D strategy and management of each center located inemerging and developed markets. For this reason, we developed an empirical research based on qualitative multiple case exploratory study in a German chemical MNC company in its five global R&D centers located in Germany (headquarters, USA, Brazil, China and India. The results suggested the needs to creation of organizational management capabilities for constant re-evaluation of its R&D strategy in order to capture the demands and the temporary windows of opportunities from these markets. These capabilities lead to reducing the strong observed centralization level and assigning more responsibilities to the subsidiaries with global R&D center status.

  17. 20 CFR 670.950 - What are the financial management responsibilities of Job Corps center operators and other...

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 3 2010-04-01 2010-04-01 false What are the financial management... WORKFORCE INVESTMENT ACT Administrative and Management Provisions § 670.950 What are the financial... and other service providers must manage Job Corps funds using financial management information systems...

  18. Online Canton Fairs Ready for Convenient Trade--An Interview with Ding Qiang, General Manager of MOFCOM China International Electronic Commerce Center

    Institute of Scientific and Technical Information of China (English)

    Li Yinghong; Sun Yongjian

    2006-01-01

    @@ In 2006, the Canton Fairs will greet the 99th and 100th respectively in spring and fall. To meet the need of the development of the convenient trade, the Canton Fairs website, the platform of the online Canton Fairs run by MOFCOM China International Electronic Commerce Center is ready to take several effective measures to offer more convenient services. On March 24, China's Foreign Trade took the occasion to interview with Mr. Ding Qiang, General Manager of MOFCOM China International Electronic Commerce Center.

  19. Patient experience in a coordinated care model featuring diabetes self-management education integrated into the patient-centered medical home.

    Science.gov (United States)

    Janiszewski, Debra; O'Brian, Catherine A; Lipman, Ruth D

    2015-08-01

    The purpose of this study is to gain insight about patient experience of diabetes self-management education in a patient-centered medical home. Six focus groups consisting of 37 people with diabetes, diverse in race and ethnicity, were conducted at 3 sites. Participants described their experience in the program and their challenges in diabetes self-management; they also suggested services to meet their diabetes care needs. The most common theme was ongoing concerns about care and support. There was much discussion about the value of the support provided by health navigators integrated in the diabetes health care team. Frequent concerns expressed by participants centered on personal challenges in engaging in healthy lifestyle behaviors. Ongoing programmatic support of self-management goals was widely valued. Individuals who received health care in a patient-centered medical home and could participate in diabetes self-management education with integrated support valued both activities. The qualitative results from this study suggest need for more formalized exploration of effective means to meet the ongoing support needs of people with diabetes. © 2015 The Author(s).

  20. Integrated surgical emergency training plan in the internship: A step toward improving the quality of training and emergency center management.

    Science.gov (United States)

    Akhlaghi, Mohammad Reza; Vafamehr, Vajiheh; Dadgostarnia, Mohammad; Dehghani, Alireza

    2013-01-01

    In this study, by using a problem-oriented approach in the needs assessment, identifying the defects and deficiencies in emergency health training centers has been determined as the basis for the requirements. The main objective of the study was the implementation of surgical emergencies integration of the five surgical groups (general surgery, urology, orthopedics, neurosurgery, and ENT) to meet the needs and determining its efficacy. THIS INTERVENTIONAL STUDY WAS CONDUCTED IN THREE PHASES: (1) Phase I (design and planning): Needs assessment, recognition of implementation barriers and providing the objectives and training program for integrated emergencies. (2) Phase II (implementation): Justification of the main stakeholders of the project, preparation of students' duties in the emergency department, preparation of on-duty plans, supervising the implementation of the program, and reviewing the plan in parallel with the implementation based on the problems. (3) Phase III (evaluation): Reviewing the evidences based on the amount of efficiency of the plan and justification for its continuation. In the first and the second phase, the data were collected through holding focus group meetings and interviews. In the third phase, the opened-reply and closed-reply researcher-made questionnaires were used. The questionnaire face and content validity were confirmed by experts and the reliability was assessed by calculating the Cronbach's alpha. ACCORDING TO THE VIEWS OF THE INTERNS, ASSISTANTS, TEACHERS, AND EMERGENCY PERSONNEL, THE POSITIVE FEATURES OF THE PLAN INCLUDED THE FOLLOWING: Increasing the patients' satisfaction, reducing the patients' stay in the Emergency Department, increasing the speed of handling the patients, balancing the workloads of the interns, direct training of interns by young teachers of emergency medicine, giving the direct responsibility of the patient to the intern, practical and operational training of emergency issues, increasing the teamwork

  1. PTSD: National Center for PTSD

    Medline Plus

    Full Text Available ... TEE) Tournament Wheelchair Games Winter Sports Clinic Locations Hospitals & Clinics Vet Centers Regional Benefits Offices Regional Loan Centers ... Prevention / Wellness Public Health Weight Management (MOVE!) Locations Hospitals & Clinics Vet Centers Veterans Canteen Service (VCS) Research Research ...

  2. Design and Operational Evaluation of the Traffic Management Advisor at the Fort Worth Air Route Traffic Control Center

    Science.gov (United States)

    1997-06-19

    NASA and the Federal Aviation Administration (FAA) have designed and developed an automation tool known as the Traffic Management Advisor (TMA). The TMA is a time-based strategic planning tool that provides Traffic Management Coordinators (TMCs) and ...

  3. Proposal of an Observatory of Trends for Nanotechnology in the Context of Technology Management in an Oil and Gas R&D Center – Case: Nanotechnology

    Directory of Open Access Journals (Sweden)

    Viviane Masseran Antunes Parreiras

    2013-12-01

    Full Text Available The paper presents basic concepts on nanotechnology and the use of this in an oil and gas research and development (R&D center, the Research and Development Center Leopoldo Américo Miguez de Mello of Petrobras (CENPES. The aim of this paper is to present a proposal of an observatory of trends in the area of nanotechnology at CENPES, to generate information, such as the state of the art technologies, technological trajectories, movements of competitors and partners, and aspects relating to regulations and incentives for decision making in the technology management process. The model consists of five steps that should occur in a continuous cycle: literature review, expert consultation, analysis of opportunities and threats, timelines or roadmaps, and monitoring. In conclusion, the proposed observatory includes a set of topics (variables, sources, techniques of competitive technical intelligence and technological foresight, systematized in order to support decision making in technology management.

  4. A comparative study on managers', staffs' and clients' viewpoints about organizational and structural obstacles in family planning counseling in health-care centers in Isfahan in 2012.

    Science.gov (United States)

    Taheri, Safoura; Ehsanpour, Soheila; Kohan, Shahnaz

    2014-03-01

    Organizational and structural obstacles are a group of major obstacles in achievement of appropriate family planning counseling. Detection of these obstacles from the viewpoint of managers, staffs and clients who are key members in health services providing system is a major step toward appropriate planning to modify or delete this group of obstacles. The present study was conducted with the goal of comparing managers', staffs' and clients' viewpoints about organizational and structural obstacles in family planning counseling in health-care centers in Isfahan in 2012. This is a cross-sectional one-step three-group comparative descriptive study conducted on 295 subjects including 59 managers, 110 staffs and 126 clients in medical health-care centers in Isfahan in 2012. Managers and the staffs were selected by census sampling and the clients were recruited through convenient random sampling. The date collection tool was a researcher made questionnaire, which was designed in two sections of fertility and personal characteristics and viewpoint measurement. Descriptive and inferential statistical test were used to analyze the data. The obtained results showed no significant difference between mean scores of viewpoints in three groups of managers, staffs and clients concerning organizational and structural obstacles in family planning counseling (P = 0.677). In addition, most of the managers, staffs and clients reported organizational and structural obstacles as the obstacles in the process of family planning in moderate level. The results showed the necessity of health services managers' planning to modify or delete organizational and structural obstacles especially the agreed obstacles from the viewpoint of managers, staffs and clients.

  5. An evaluation of the total quality management implementation strategy for the advanced solid rocket motor project at NASA's Marshall Space Flight Center. M.S. Thesis - Tennessee Univ.

    Science.gov (United States)

    Schramm, Harry F.; Sullivan, Kenneth W.

    1991-01-01

    An evaluation of the NASA's Marshall Space Flight Center (MSFC) strategy to implement Total Quality Management (TQM) in the Advanced Solid Rocket Motor (ASRM) Project is presented. The evaluation of the implementation strategy reflected the Civil Service personnel perspective at the project level. The external and internal environments at MSFC were analyzed for their effects on the ASRM TQM strategy. Organizational forms, cultures, management systems, problem solving techniques, and training were assessed for their influence on the implementation strategy. The influence of ASRM's effort was assessed relative to its impact on mature projects as well as future projects at MSFC.

  6. Identifying patient- and family-centered outcomes relevant to inpatient versus at-home management of neutropenia in children with acute myeloid leukemia.

    Science.gov (United States)

    Szymczak, Julia E; Getz, Kelly D; Madding, Rachel; Fisher, Brian; Raetz, Elizabeth; Hijiya, Nobuko; Gramatges, Maria M; Henry, Meret; Mian, Amir; Arnold, Staci D; Aftandilian, Catherine; Collier, Anderson B; Aplenc, Richard

    2018-04-01

    Efficacy of therapeutic strategies relative to patient- and family-centered outcomes in pediatric oncology must be assessed. We sought to identify outcomes important to children with acute myeloid leukemia and their families related to inpatient versus at-home management of neutropenia. We conducted qualitative interviews with 32 children ≥8 years old and 54 parents. Analysis revealed the impact of neutropenia management strategy on siblings, parent anxiety, and child sleep quality as being outcomes of concern across respondents. These themes were used to inform the design of a questionnaire that is currently being used in a prospective, multiinstitutional comparative effectiveness trial. © 2017 Wiley Periodicals, Inc.

  7. The role of endorectal ultrasound and magnetic resonance imaging in the management of early rectal lesions in a tertiary center.

    Science.gov (United States)

    Patel, Rikesh Kumar; Sayers, Adele Elizabeth; Kumar, Prashanth; Khulusi, Sam; Razack, Abdul; Hunter, Iain Andrew

    2014-12-01

    In early rectal cancer, ERUS has a vital role in determining radical or local excision based on identification of T-stage. Transanal endoscopic microsurgery (TEMs) has a reduced morbidity and mortality compared with radical surgery. Correct identification of lesions that can be managed with TEMs is therefore imperative. Our aim was to assess the accuracy of ERUS in identifying mucosal/submucosal lesions and thus their suitability for TEMs. A retrospective analysis of a prospectively maintained database of patients who underwent ERUS was carried out over an initial 25-month period at a tertiary colorectal center. Our main outcome measures were T-stage measured using ERUS or magnetic resonance imaging (MRI) (indicating suitability for local excision, ie, ≤ T1) with correlation with that of the subsequent surgical specimen and improvement in accuracy over time. After data analysis and review, the study was repeated over the subsequent 12 months to establish whether there was a learning curve with the use of ERUS. Over the initial period, 52 patients who met the inclusion criteria underwent ERUS. T-staging was accurate in 73.1% (38/52) with identification of ≤ T1 lesions having a sensitivity of 70.8% and a specificity 100%. The accuracy, sensitivity, and specificity of MRI was similar to that of ERUS (72.7%, 70.0%, and 100% respectively). Over the subsequent period, 23 patients underwent ERUS with T-staging accuracy improving to 78.3% (18/23) (P = .777). In our experience, ERUS is a useful adjunct to clinical assessment and pelvic MRI in determining suitability for local excision. Its 100% specificity in determining that a lesion is limited to the mucosa or submucosa aids in the assessment of lesions that are being considered for submucosal resection. Over the time periods assessed, improvement in T-staging accuracy was demonstrated, which might be due to the presence of a learning curve. Copyright © 2014 Elsevier Inc. All rights reserved.

  8. Collections management plan for the U.S. Geological Survey Woods Hole Coastal and Marine Science Center Data Library

    Science.gov (United States)

    List, Kelleen M.; Buczkowski, Brian J.; McCarthy, Linda P.; Orton, Alice M.

    2015-08-17

    The U.S. Geological Survey Woods Hole Coastal and Marine Science Center has created a Data Library to organize, preserve, and make available the field, laboratory, and modeling data collected and processed by Woods Hole Coastal and Marine Science Center staff. This Data Library supports current research efforts by providing unique, historic datasets with accompanying metadata. The Woods Hole Coastal and Marine Science Center’s Data Library has custody of historic data and records that are still useful for research, and assists with preservation and distribution of marine science records and data in the course of scientific investigation and experimentation by researchers and staff at the science center.

  9. Comparison of tissue plasminogen activator administration management between Telestroke Network hospitals and academic stroke centers: the Telemedical Pilot Project for Integrative Stroke Care in Bavaria/Germany.

    Science.gov (United States)

    Audebert, Heinrich J; Kukla, Christian; Vatankhah, Bijan; Gotzler, Berthold; Schenkel, Johannes; Hofer, Stephan; Fürst, Andrea; Haberl, Roman L

    2006-07-01

    Systemic thrombolysis is the only therapy proven to be effective for ischemic stroke. Telemedicine may help to extend its use. However, concerns remain whether management and safety of tissue plasminogen activator (tPA) administration after telemedical consultation are equivalent in less experienced hospitals compared with tPA administration in academic stroke centers. During the second year of the ongoing Telemedical Pilot Project for Integrative Stroke Care, all systemic thrombolyses in stroke patients of the 12 regional clinics and the 2 stroke centers were recorded prospectively. Patients' demographics, stroke severity (National Institutes of Health Stroke Scale), frequency of administration, time management, protocol violations, and safety were included in the analysis. In 2004, 115 of 4727 stroke or transient ischemic attack patients (2.4%) in the community hospitals and 110 of 1889 patients in the stroke centers (5.8%) received systemic thrombolysis. Prehospital latencies were shorter in the regional hospitals despite longer distances. Door to needle times were shorter in the stroke centers. Although blood pressure was controlled more strictly in community hospitals, symptomatic intracerebral hemorrhage rate (7.8%) was higher (P=0.14) than in stroke centers (2.7%) but still within the range of the National Institute of Neurological Disorders and Stroke trial. In-hospital mortality rate was low in community hospitals (3.5%) and in stroke centers (4.5%). Although with a lower rate of systemic thrombolysis, there was no evidence of lower treatment quality in the remote hospitals. With increasing numbers of tPA administration and growing training effects, the telestroke concept promises better coverage of systemic thrombolysis in nonurban areas.

  10. Continued implementation and testing of a Neighborhood Office Center (NOC) and integration of the NOC with an administrative correspondence management information system

    Science.gov (United States)

    1978-01-01

    The concept of decentralized (remote) neighborhood offices, linked together through a self-sustaining communications network for exchanging voice messages, video images, and digital data was quantitatively evaluated. Hardware and procedures for the integrated multifunctional system were developed. The configuration of the neighborhood office center (NOC) is explained, its production statistics given, and an experiment for NOC network integration via satellite is described. The hardware selected for the integration NOC/management information system is discussed, and the NASA teleconferencing network is evaluated.

  11. [The quality management in clinical diagnostic laboratory in conditions of the Federal Center of traumatology, orthopedics and endoprosthesis replacement of Minzdrav of Russia (Cheboksary)].

    Science.gov (United States)

    Nikolaev, N S; Nazarova, V V; Dobrovol'skaia, N Iu; Orlova, A V; Pchelova, N N

    2014-10-01

    The article presents experience of clinical diagnostic laboratory of the Federal Center of traumatology, orthopedics and endoprosthesis replacement of Minzdrav of Russia (Cheboksary) in the area of quality management of medical laboratory services on the basis of evaluation of efficacy and effectiveness of processes. The factors effecting quality of functioning of clinical diagnostic laboratory are indicated. The criteria and indicators of efficacy of work of employees of clinical diagnostic laboratory are presented.

  12. The emergency Management Alternative Center (EMAC). Requirements and general considerations; Centro Alternativo de Gestion de la Emergencia (CAGE). Requisitos y consideraciones generales

    Energy Technology Data Exchange (ETDEWEB)

    Turrion, F.; Barrio, M. A. del; Cobos, A.

    2014-10-01

    The Emergency Management Alternative Center (EMAC) will give support to the emergency Organization Response on site, combining the continuity of the accident mitigation actions with the rest and the protection of personnel, adjusting these works to the conditions of the Power Plant and the evolution of the emergency. It must be operational in the Spanish NNPP by December 2015 and the design must be in accordance with the criteria by the Nuclear Safety Council. (Author)

  13. ?I have to live like I?m old.? Young adults? perspectives on managing hypertension: a multi-center qualitative study

    OpenAIRE

    Johnson, Heather M.; Warner, Ryan C.; LaMantia, Jamie N.; Bowers, Barbara J.

    2016-01-01

    Background In the U.S., young adults (18?39 year-olds) have the lowest hypertension control rates among hypertensive adults. Understanding young adults? unique perceptions about hypertension and perceived barriers to hypertension control is critical to develop effective interventions for this population. This multi-center study explored young adults?: 1) emotions and reactions after a hypertension diagnosis, 2) attitudes about managing hypertension (lifestyle changes, follow-up visits, antihy...

  14. Data Center Tasking.

    Science.gov (United States)

    Temares, M. Lewis; Lutheran, Joseph A.

    Operations tasking for data center management is discussed. The original and revised organizational structures of the data center at the University of Miami are also described. The organizational strategy addresses the functions that should be performed by the data center, anticipates the specialized skills required, and addresses personnel…

  15. The effect of organizational factors on the structure of the buying center :the case study of corporate travel management

    OpenAIRE

    Damonte, Lowell Taylor

    1994-01-01

    In this study the researcher attempts to advance the understanding of the structure of firm buying centers for air travel services. First, an attempt is made to find empirical support for the proposition that firm air travel service buying centers can be grouped on the basis of their size, degree of complexity, centralization, and formalization. The study investigates the relationship of size, structure, and technology of the organization as a whole to the structure of the b...

  16. Workforce Retention Study in support of the U.S. Army Aberdeen Test Center human capital management strategy

    OpenAIRE

    Fore, Richard; Hacker, Kelly; Reedy, Michael; Sanchez-Vahamonde, Kristi; Whelan, Sean

    2016-01-01

    Approved for public release; distribution is unlimited In Fiscal Year 15, the U.S. Army Aberdeen Test Center (ATC) experienced an attrition rate of 10.4% of its civilian workforce. Without mitigation, the current employee turnover could result in a loss of organizational knowledge, reduction in the number of highly skilled test center employees, and a failure for ATC to meet mission objectives, namely the execution of rigorous testing to support Department of Defense acquisition programs. ...

  17. Fire Management in the Inter Galatic Interface or 30 Years of Fire Management at Merritt Island National Wildlife Refuge/Kennedy Space Center, Florida

    Science.gov (United States)

    Frederic W. Adrian

    2006-01-01

    Prescribed burning is essential on Merritt Island National Wildlife Refuge. Not only is it needed to manage the volatile fuels, but also to manage the complex system of fire maintained habitats found here. Fire management on the Refuge presents unique challenges. In addition to the restraints to prescribed burning that are common to many prescribed burning programs,...

  18. In view of standardization Part 2: Management of challenges in the initial treatment of burn patients in Burn Centers in Germany, Austria and Switzerland.

    Science.gov (United States)

    Ziegler, Benjamin; Hirche, Christoph; Horter, Johannes; Kiefer, Jurij; Grützner, Paul Alfred; Kremer, Thomas; Kneser, Ulrich; Münzberg, Matthias

    2017-03-01

    Initial therapy of severe burns in specialized burn trauma centers is a challenging task faced by the treating multi-professional and interdisciplinary team. A lack of consistent operating procedures and varying structural conditions was recently demonstrated in preliminary data of our group. These results raised the question on how specific treatment measures in acute burn care are met in the absence of standardized guidelines. A specific questionnaire containing 57 multiple-choice questions was sent to all 22 major burn centers in Germany, Austria and Switzerland. The survey included standards of airway management and ventilation, fluid management and circulation, body temperature monitoring and management, topical burn wound treatment and a microbiological surveillance. Additionally, the distribution of standardized course systems was covered. 17 out of 22 questionnaires (77%) were returned completed. Regarding volume resuscitation, results showed a similar approach in estimating initial fluid while discrepancies persisted in the use of colloidal fluid and human albumin. Elective tracheostomy and the need for bronchoscopy with suspected inhalation injury were the most controversial issues revealed by the survey. Topical treatment of burned body surface also followed different principles regarding the use of synthetic epidermal skin substitutes or enzymatic wound debridement. Less discrepancy was found in basic diagnostic measures, body temperature management, estimation of the extent of burns and microbiological surveillance. While many burn-related issues are clearly not questionable and managed in a similar way in most participating facilities, we were able to show that the most contentious issues in burn trauma management involve initial volume resuscitation, management of inhalation trauma and topical burn wound treatment. Further research is required to address these topics and evaluate a potential superiority of a regime in order to increase the level of

  19. Relationship between personality trait and self- management in diabetic patients referred to Bushehr medical centers in 2012-13

    Directory of Open Access Journals (Sweden)

    Azita Noroozi

    2014-01-01

    Full Text Available Abstract Background: Diabetes is a serious problem and self- management is effective factor for diabetes control. Personality trait is one of the important factors in diabetes self- management. In this study, purpose was determination of effective personality traits in self- management. Material and Methods: In this cross sectional study, data were collected from a convenience sample of 396 diabetic patients, using self- management and Big five personality Scales. For data analysis, multiple linear regression models were used. Results: Among five personality traits, the most effective traits in self- management were conscientiousness, openness, and extraversion (R2= 32%. Conscientiousness and openness were significant predictors for all of self- management aspects. Extraversion was effective factors in self- regulation, self- integration, and following treatment. Conclusion: The education for diabetic patients with neuroticism and agreeableness traits is necessary and Patients with conscientiousness, openness, and extraversion traits can be used as model in educational process.

  20. Management of acute combined fractures of the atlas and axis: A retrospective study of two trauma centers

    Directory of Open Access Journals (Sweden)

    Joseph DiDomenico

    2017-01-01

    Conclusions: This study demonstrates the variety of treatment strategies used for the management of combined C1-C2 fractures. Patients managed operatively tend to have both anterior and posterior C1 arch fractures, while patients managed nonoperatively tend to have either anterior or posterior arch fractures. In general, treatments should be tailored to patients' needs depending on the stability of the fractures, neurological state, and medical comorbidities.