Evaluation of management scenarios for controlling eutrophication in a shallow tropical urban lake

Urban lakes are typically smaller, shallower, and more exposed to human activities than natural lakes. Although the effects of harmful algal blooms (HABs) associated with eutrophication in urban lakes has become a growing concern for water resources management and environmental protection, studies focussing on this topic in relation to urban lakes are rare and knowledge of the ecological dynamics and effective management strategies for controlling eutrophication in urban lakes is lacking. This study applied an integrated three-dimensional hydrodynamics-ecological model for a small shallow tropical urban lake in Singapore and evaluated various management scenarios to control eutrophication in the lake. It is found that in-lake treatment techniques including artificial destratification, sediment manipulation and algaecide addition are either ineffective or possess environmental concerns; while watershed management strategies including hydraulic flushing and inflow nutrients reduction are more effective and have posed less environmental concerns. In this study, inflow phosphorus reduction was found to be the best strategy after evaluating the advantages and drawbacks of the management strategies studied. Runoff from the watershed exerts significant influence on urban lakes and thus an integrated water resources management at the watershed level is critical for the control of eutrophication

Sustainability analysis and resource management for wireless mesh networks with renewable energy supplies

 There is a growing interest in the use of renewable energy sources to power wireless networks in order to mitigate the detrimental effects of conventional energy production or to enable deployment in off-grid locations. However, renewable energy sources, such as solar and wind, are by nature unstable in their availability and capacity. The dynamics of energy supply hence impose new challenges for network planning and resource management. In this paper, the sustainable performance of a wireless mesh network powered by renewable energy sources is studied. To address the intermittently available capacity of the energy supply, adaptive resource management and admission control schemes are proposed. Specifically, the goal is to maximize the energy sustainability of the network, or equivalently, to minimize the failure probability that the mesh access points (APs) deplete their energy and go out of service due to the unreliable energy supply. To this end, the energy buffer of a mesh AP is modeled as a G/G/1(/N) queue with arbitrary patterns of energy charging and discharging. Diffusion approximation is applied to analyze the transient evolution of the queue length and the energy depletion duration. Based on the analysis, an adaptive resource management scheme is proposed to balance traffic loads across the mesh network according to the energy adequacy at different mesh APs. A distributed admission control strategy to guarantee high resource utilization and to improve energy sustainability is presented. By considering the first and second order statistics of the energy charging and discharging processes at each mesh AP, it is demonstrated that the proposed schemes outperform some existing state-of-the-art solutions.

Self-management programmes in stages 1–4 chronic kidney disease: a literature review

Background
Chronic kidney disease (CKD) is a complex health problem, which requires individuals to invest considerable time and energy in managing their health and adhering to multifaceted treatment regimens.

Objectives
To review studies delivering self-management interventions to people with CKD (Stages 1–4) and assess whether these interventions improve patient outcomes.

Design
Systematic review.

Methods
Nine electronic databases (MedLine, CINAHL, EMBASE, ProQuest Health & Medical Complete, ProQuest Nursing & Allied Health, The Cochrane Library, The Joanna Briggs Institute EBP Database, Web of Science and PsycINFO) were searched using relevant terms for papers published between January 2003 and February 2013.

Results
The search strategy identified 2,051 papers, of which 34 were retrieved in full with only 5 studies involving 274 patients meeting the inclusion criteria. Three studies were randomised controlled trials, a variety of methods were used to measure outcomes, and four studies included a nurse on the self-management intervention team. There was little consistency in the delivery, intensity, duration and format of the self-management programmes. There is some evidence that knowledge- and health-related quality of life improved. Generally, small effects were observed for levels of adherence and progression of CKD according to physiologic measures.

Conclusion
The effectiveness of self-management programmes in CKD (Stages 1–4) cannot be conclusively ascertained, and further research is required. It is desirable that individuals with CKD are supported to effectively self-manage day-to-day aspects of their health.

An empirical analysis of environmental strategy, eco-controls, environmental and economic performance

 This study provides empirical evidence on the role of eco-controls, in terms of both the style of use and bureaucratic stance towards eco-controls, as a critical mediating variable between an organisation’s level of proactive environmental strategy and its environmental and economic performance outcomes.

Enterprise localization practices and their implication for knowledge management in foreign participation in the Chinese construction sector

Foreign firms active in the Chinese construction industry find themselves in a competitive environment unlike the environments in which they operate back home. Adaptations are therefore required in order that firms retain competitive leverage while integrating into the circumstances of the Chinese market. Since these firms primarily compete on superior knowledge capabilities it is instructive to understand how adaptations both serve to transfer propriety capabilities to China while adapting to the knowledge characteristics of the Chinese market into which those capabilities are transplanted. Five localizing parameters across which adaptations take place are identified in this paper and rates of localization are tabulated for 60 foreign firms active in the Chinese construction industry. Revealed localizing behaviors are then analyzed in the light of existing literature for explanatory power. It is concluded that in order to be strategically competitive firms must not only retain knowledge differentials, but that the knowledge must be coded and disseminated in a manner suited to the environment in which it is to be utilized.

Nurses' perceptions of using an evidence-based care bundle for initial emergency nursing management of patients with severe traumatic brain injury: A qualitative study.

Evidence to guide initial emergency nursing care of patients with severe traumatic brain injury (TBI) in Thailand is currently not available in a useable form. A care bundle was used to summarise an evidence-based approach to the initial emergency nursing management of patients with severe TBI and was implemented in one Thai emergency department. The aim of this study was to describe Thai emergency nurses' perceptions of care bundle use. A descriptive qualitative study was used to describe emergency nurses' perceptions of care bundle use during the implementation phase (Phase-One) and then post-implementation (Phase-Two). Ten emergency nurses participated in Phase-One, while 12 nurses participated in Phase-Two. In Phase-One, there were five important factors identified in relation to use of the care bundle including quality of care, competing priorities, inadequate equipment, agitated patients, and teamwork. In Phase Two, participants perceived that using the care bundle helped them to improve quality of care, increased nurses' knowledge, skills, and confidence. Care bundles are one strategy to increase integration of research evidence into clinical practice and facilitate healthcare providers to deliver optimal patient care in busy environments with limited resources.

Using an evidence-based care bundle to improve initial emergency nursing management of patients with severe traumatic brain injury

AIMS AND OBJECTIVES: To test the feasibility of an evidence-based care bundle in a Thai emergency department. The specific objective of this study was to examine the impact of the implementation of the care bundle on the initial emergency nursing management of patients with severe traumatic brain injury. BACKGROUND: A care bundle approach is one strategy used to improve the consistency, quality and safety of emergency care for different patients groups, however, has not been tested in patients with severe traumatic brain injury. DESIGN: A pretest/post-test design was used. The study intervention was an evidence-based care bundle for initial emergency nursing management of patients with severe traumatic brain injury. METHODS: Nonparticipant observations were conducted between October 2012-June 2013 at an emergency department of a 640 bed regional hospital in Southern Thailand. The initial emergency nursing care was observed in 45 patients with severe traumatic brain injury: 20 patients in the pretest period and 25 patients in the post-test period. RESULTS: There were significant improvements in clinical care of patients with severe traumatic brain injury after implementation of the care bundle: (1) use of end-tidal carbon dioxide monitoring, (2) frequency of respiratory rate assessment, (3) frequency of pulse rate and blood pressure assessment, and (4) patient positioning. CONCLUSION: This study demonstrated that implementation of an evidence-based care bundle improved specific elements of emergency nurses' clinical management of patients with severe traumatic brain injury. RELEVANCE TO CLINICAL PRACTICE: The study suggests that a care bundle approach can be used as a strategy to improve emergency nursing care of patients with severe traumatic brain injury.

Improving the implementation of responsible alcohol management practices by community sporting clubs: A randomised controlled trial

INTRODUCTION AND AIMS: Despite an increased prevalence of risky alcohol consumption and alcohol-related harm among members of sporting groups and at sporting venues, sporting clubs frequently fail to implement alcohol management practices consistent with liquor legislation and best practice guidelines. The aim of this study was to assess the impact of a multi-strategy intervention in improving the implementation of responsible alcohol management practices by sports clubs. DESIGN AND METHODS: A randomised controlled trial was conducted with 87 football clubs, with half randomised to receive a multi-strategy intervention to support clubs to implement responsible alcohol management practices. The 2-year intervention, which was based on implementation and capacity building theory and frameworks, included project officer support, funding, accreditation rewards, printed resources, observational audit feedback, newsletters, training and support from state sporting organisations. Interviews were undertaken with club presidents at baseline and post-intervention to assess alcohol management practice implementation. RESULTS: Post-intervention, 88% of intervention clubs reported implementing '13 or more' of 16 responsible alcohol management practices, which was significantly greater than the proportion of control groups reporting this level of implementation (65%) [odds ratio: 3.7 (95% confidence interval: 1.1-13.2); P = 0.04]. All intervention components were considered highly useful and three-quarters or more of clubs rated the amount of implementation support to be sufficient. DISCUSSION AND CONCLUSIONS: The multi-strategy intervention was successful in improving alcohol management practices in community sports clubs. Further research is required to better understand implementation barriers and to assess the long-term sustainability of the change in club alcohol management practices.

Knowledge management view of environmental sustainability in manufacturing SMEs in the Philippines

This study highlights the role of knowledge management (KM) in enabling small and medium enterprises (SMEs) in a manufacturing industry in a developing country to engage in environmentally sustainable business. Drawing on the knowledge-based view of the firm, it argues that resource-constrained SMEs rely on their relational capital to augment their capability to innovate in order to find better and environmentally sound ways of doing business. However, SMEs need to harness their KM orientation in order to leverage the knowledge-based resources emanating from their relational capital towards building their innovation capability. This capability is essential in integrating effective environmental management practices in business. The findings from our analysis of data from a survey of 241 manufacturing SMEs in the Philippines support these hypotheses and underscore the importance of developing an organisational capability to engage in KM in order to adopt sustainable business practices. The implications of the findings are also discussed.