A prospective randomised trial of a "test and treat" policy versus endoscopy based management in young Helicobacter pylori positive patients with ulcer-like dyspepsia, referred to a hospital clinic

Management of dyspepsia remains a controversial area. Although the European Helicobacter pylori study group has advised empirical eradication therapy without oesophagogastroduodenoscopy (OGD) in young H pylori positive dyspeptic patients who do not exhibit alarm symptoms, this strategy has not been subjected to clinical trial.

Perceptions of resident behavior problems and their clinical management in Long Term Care facilities

The objective of this study was to describe the perceptions of Long Term Care (LTC) service providers in urban Canadian care facilities regarding the prevalence and nature of resident behavior problems and how staff manage these problems. Key informants from 15 LTC facilities housing 1,928 residents, participated in a cross sectional survey which employed semi-structured telephone interviews. Respondents estimated that on average 61% (n = 1,176) of residents had some type of mental health/behavioral problem, with facility estimates ranging from 20% to 90%. The most frequently reported problem behaviors included: general agitation and restlessness (36%); pacing and aimless wandering (28%); hoarding things (24%); hitting either self or others (23%); and verbal aggression (22%). Behaviors reported by respondents as "disruptive" or "very disruptive" were screaming (13%), sexual disinhibition (10%), and hitting either self or others (10%). The most common interventions used by staff were behavioral interventions followed by the use of medications. Low levels of staffing and educational training of staff were among the most common factors recognized as contributing to the difficulty in caring for residents with mental health needs.

Testate amoebae (thecamoebians) as water quality indicators in lakes: development of a modern distributional dataset from the Greater Toronto Area

Thecamoebians were examined from 123 surface sediment samples collected from 45 lakes in the Greater Toronto Area (GTA) and the surrounding region to i) elucidate the controls on faunal distribution in modern lake environments; and ii) to consider the utility of thecamoebians in quantitative studies of water quality change. This area was chosen because it includes a high density of lakes that are threatened by urban development and where water quality has deteriorated locally as a result of contaminant inputs, particularly nutrients. Canonical Correspondence analysis (CCA) and a series of partial CCAs were used to examine species-environment relationships. Twenty-four environmental variables were considered, including water properties (e.g. pH, DO, conductivity), substrate characteristics, nutrient loading, and environmentally available metals. The thecamoebian assemblages showed a strong association with Olsen's Phosphorus, reflecting the eutrophic status of many of the lakes, and locally to elevated conductivity measurements, which appear to reflect road salt inputs associated with winter de-icing operations. A transfer function was developed for Olsen P using this training set based on weighted averaging with inverse deshrinking (WA Inv). The model was applied to infer past changes in Phosphorus enrichment in core samples from several lakes, including eutrophic Haynes Lake within the GTA. Thecamoebian-inferred changes in sedimentary Phosphorus from a 210Pb dated core from Haynes Lake are related to i) widespread introduction of chemical fertilizers to agricultural land in the post WWII era; ii) a steep decline in Phosphorous with a change in agricultural practices in the late 1970s; and iii) the construction of a golf course in close proximity to the lake in the early 1990s. This preliminary study confirms that thecamoebians have considerable potential as indicators of eutrophication in lakes and can provide an estimate of baseline conditions.

Diabetes management in patients receiving palliative care

A literature review revealed no evidence-based guidelines specific to managing diabetes in the context of palliative care. The purpose of the current project was to describe the management practices of doctors and nurses caring for people with diabetes and advanced disease. Palliative care doctors, palliative care nurses, endocrinologists, and diabetes nurse educators participated in this study. A two-phase project was undertaken: 1) two focus groups, and 2) a cross-sectional survey using a self-completed questionnaire. The focus group and questionnaire data identified that doctors and nurses used a range of practices and blood glucose testing frequencies to control blood glucose based on experience and not according to a robust evidence base. Implications for practice include the importance of collaboration between diabetes and palliative care specialists, and the need to develop clinical management guidelines.

Developing tomorrow's leaders-Evidence of global talent management in multinational enterprises

Organizations are becoming relentless in managing and developing their key talent. This is a view, however, largely based on anecdote rather than reliable empirical evidence. Utilizing data from 260 multinational enterprises (MNEs), this paper helps redress this deficit. Specifically, this paper explores the extent to which MNEs engage in global talent management (GTM) and deciphers some of the factors which may explain the use and non-use of GTM practices. In so doing, we find that although a significant number of MNEs have systems and mechanisms in place to strategically identify and develop their talent many more seemingly adopt an ad hoc or haphazard approach. For instance, less than half of all MNEs have both global succession planning and formal management development programs for their high-potentials. Consequently it seems that there is a considerable distance yet to be travelled to arrive at a universal appreciation of the need to strategically manage one's key employees. We find the size of the MNE has a significant effect on GTM system usage-larger MNEs are more likely to undertake GTM. Other significant, positive influences include whether products or services are standardized regionally or globally, and if the MNE has a global human resources policy formation body. Of considerable interest is the finding that MNEs operating in the low-tech/low-cost sectors are significantly more likely to have formal global systems to identify and develop high-potentials. © 2009 Elsevier Inc. All rights reserved.

Measurement-based Policy-driven QoS Management in Converged Next Generation Networks

Policy-based management is considered an effective approach to address the challenges of resource management in large complex networks. Within the IU-ATC QoS Frameworks project, a policy-based network management framework, CNQF (Converged Networks QoS Framework) is being developed aimed at providing context-aware, end-to-end QoS control and resource management in converged next generation networks. CNQF is designed to provide homogeneous, transparent QoS control over heterogeneous access technologies by means of distributed functional entities that co-ordinate the resources of the transport network through policy-driven decisions. In this paper, we present a measurement-based evaluation of policy-driven QoS management based on CNQF architecture, with real traffic flows on an experimental testbed. A Java based implementation of the CNQF Resource Management Subsystem is deployed on the testbed and results of the experiments validate the framework operation for policy-based QoS management of real traffic flows.

Supply Chain Management in Confined Site Construction: Strategies to Reduce Delay in the Delivery of Materials to Site

With the increase in construction in dense urban environments, the delays associated with managing the material supply chain to site is called into question. Purpose: The aim of this investigation is to gain the perspective of construction contractors operating in a dense urban environment and the resulting strategies adopted to reduce delays in the delivery of materials to site. Methodology: This is achieved through incorporating a comprehensive literature review on the subject in conjunction with industry interviews with construction professionals in the identification of various management issues and corresponding strategies in the reduction of delays in the delivery of materials to site. Findings: The key issue which emerges is the lack of space for unloading bays while the corresponding key strategy is to schedule deliveries outside peak congestion times. Practical Implication: With confined site construction evident throughout the industry and the noted importance of an effective supply chain, the findings here in further assist on-site management in the daily task of ensuring the effective delivery and off-loading of materials in a complex and hazardous environment. Originality/Value: This research aids on-site management of confined site environments in the coordination of the material supply chain to site.

Material Management in Confined Site Construction

The objective of this paper is to identify various managerial issues encountered and resulting strategies adopted, with regards management of materials on confined construction site. This is achieved through classifying the various managerial burdens encountered with the numerous strategies adopted, for the successful management of such confined environments within the realm of materials management.


Through conducting an extensive literature review and detailed interviews, a comprehensive insight into the materials management concerns within a confined construction site environment is envisaged and portrayed. The following are the leading issues highlighted; (1)Lack of adequate storage space, (2)Work place becoming over-crowded, (3)Lack of adequate room for the effective handling of materials and (4)Difficult to transport materials around site. The leading managerial strategies to the management of materials on confined construction sites may be listed in order of importance, as follows; (1)Pre-fabrication and pre-assembly, (2)Providing adequate storage, (3)Space scheduling, (4)Just-In-Time delivery techniques, and (5)Effective design site layout.

Based on the research conducted, it can be concluded, that through effective management of the issues identified along with implementing the various strategies highlighted; successful materials management within a confined construction site environment is attainable.


Innovative Aspect of Paper: An empirical study of three different construction sites in three different countries (Ireland, England and USA) investigating the managerial issues and strategies relating to implementation of materials management in confined construction sites.

Compromising Spatial Quality: Modernity in the Era of National State Building in Cairo

The paper examines the imposition of western ideals of urbanism within colonial Cairo between1882-1952. It looks at the ideologies of capitalism, state control, and utopian idealism, which were vital tools to create modern built environments in the city. The argument is that principles of Western urbanism were at work and deeply influenced the institutional and professional practices of the Egyptian planners, who were mostly educated in Europe; however the outcomes revealed a major shift towards more inflexible solutions described as more open to compromise with the existing conditions. The paper analyses the case of a re-planning scheme drafted in the 1920s by the first Egyptian director of the Ministry of Town Planning under the British occupation. The scheme represented the superimposition of a western-style neighbourhood model on a historically rooted traditional quarter in Cairo. The paper largely relies on original archival materials, maps, documents and accounts to support the historical narrative of urban planning in Cairo. It reports that westernization approaches for planning Cairo were introduced to offer a new imagery representation, which remained central to the development of planning practices in postcolonial Egypt through different practical applications.