American company unions; a study of employee representation plans, "works councils" and other substitutes for labor unions,

Cover-title: Company unions.

Report of the committee on the Wills Legacy; with an extract from the will of the late James Wills and the ordinances for the management of the Wills hospital.

Report addressed: To the Select and Common Councils of Philadelphia. - p. 3.

Status and professional association councils. Available in 4 volumes.

This thesis examines the predictive value of a conceptual distinction between status-seeking associations and status-maintaining associations for enhancing understanding of ten selected professional associations and of the attitudes, values, behaviour and policies of their governing organs. Thirty four specific hypotheses have been tested by such research methods as questionnaires administered to individuals and associations, participant observation and an examination of association minutes and publications. Certain hypotheses have been found to be valid for particular matched pairs and/or groups of associations. The findings of the study suggest that the present conceptualisation of profession, the individual professional, professionalism, professionalisation, professional status and that relating to the role of the professions in society needs to be refined and modified in varying degrees in application to accounting associations, business graduate associations and management associations. The concept of the `ideal type' profession is shown to be of limited value in understanding certain aspects of the activities of business graduate and management associations. The findings of the study suggest that in future the professional associations examined may attach less importance to their qualifying role and lay more stress upon their representational role. The professional association faces a managerial challenge to adjust and adapt to a range of `external' pressures and `internal' demands from members and may increasingly need to be regarded as an organisation that possesses certain combinations or sets of characteristics rather than as a type of organisation that possesses a particular or relatively exclusive set. With a blurring of the distinction between the professional and state sector vocational education, and a growing customer/market orientation associated with the changing nature of work, membership of a professional association may, in future, come to be associated rather more with securing access to a relevant range of services and less with qualification for a particular career.

Social media in emergency management:Twitter as a tool for communicating risks to the public

One of the main challenges of emergency management lies in communicating risks to the public. On some occasions, risk communicators might seek to increase awareness over emerging risks, while on others the aim might be to avoid escalation of public reactions. Social media accounts offer an opportunity to rapidly distribute critical information and in doing so to mitigate the impact of emergencies by influencing public reactions. This article draws on theories of risk and emergency communication in order to consider the impact of Twitter as a tool for communicating risks to the public. We analyse 10,020 Twitter messages posted by the official accounts of UK local government authorities (councils) in the context of two major emergencies: the heavy snow of December 2010 and the riots of August 2011. Twitter was used in a variety of ways to communicate and manage associated risks including messages to provide official updates, encourage protective behaviour, increase awareness and guide public attention to mitigating actions. We discuss the importance of social media as means of increasing confidence in emergency management institutions.

Improving publicly funded human services: Incorporating capacity building into the contracting relationship between Children's Services Councils and nonprofit organizations

This qualitative two-site case study examined the capacity building practices that Children’s Services Councils (CSCs), independent units of local government, provide to nonprofit organizations (NPOs) contracted to deliver human services. The contracting literature is replete with recommendations for government to provide capacity building to contracted NPOs, yet there is a dearth of scholarship on this topic. The study’s purpose was to increase the understanding of capacity building provided in a local government contracting setting. Data collection consisted primarily of in-depth interviews and focus groups with 73 staff from two CSCs and 28 contracted NPOs. Interview data were supplemented by participant observation and review of secondary data. The study analyzed capacity building needs, practices, influencing factors, and outcomes. The study identified NPO capacity building needs in: documentation and reporting, financial management, program monitoring and evaluation, participant recruitment and retention, and program quality. Additionally, sixteen different types of CSC capacity building practices were identified. Results indicated that three major factors impacted CSC capacity building: CSC capacity building goals, the relationship between the CSC and NPOs, and the level of NPO participation. Study results also provided insight into the dynamics of the CSC capacity building process, including unique problems, challenges, and opportunities as well as necessary resources. The results indicated that the CSCs’ relational contracting approach facilitated CSC capacity building and that CSC contract managers were central players in the process. The study provided evidence that local government agencies can serve as effective builders of NPO capacity. Additionally, results indicated that much of what is known about capacity building can be applied in this previously unstudied capacity building setting. Finally, the study laid the groundwork for future development of a model for capacity building in a local government contracting setting.

Socio-economic aspects of the fisheries of Nabugabo lakes and implications for management

Fisheries are very important to Uganda's economy. The sector provides a vital source of food, recreation, trade and socioeconomic well being for the people and community globally. The fisheries of small lakes are important for producing fish for local populations who are not near the large lakes. These satellite lakes support important fisheries and other economic activities like fishing, water for domestic purposes and tourism, besides socio-cultural values. A number-of fish;- species, some of which were found only in Lake Victoria have been depleted through over-exploitation, introduction of exotics especiaily Nile perch and environmental degradation. Some of these fishes have been observed to survive in satellite lakes in the Victoria and Kyoga Lake basins. The Nabugabo satellite lakes (Manywa, Kayugi and Kayanja) contain endemic Cichlid fish species acting as reservoirs and therefore very important for conservation of fish biodiversity. Despite the socio-economic importance and uniqueness of these satellite lakes little research on socio-economic studies has been carried out. The sustainability of the lake is being threatened by increasing human activities. The fish stocks and species diversity are declining and this poses a threat to the livelihood of the people who depend on fish for food and income. Arising from this need a study was carried out to establish the socio-economic aspects of Nabugabo fisheries and implications for management, on which basis resource users would be made aware of the impacts of their activities. It was hoped that this would go further to ensure wise use and management of the resources by the users. The specific objectives were identifying activities around the lake, establishing socioeconomic values attached to the lake, identifying problems of the lake and resource users and examining existing local based management institutions. Results show that the activities taking place around the lakes include fishing, farming, watering of animals, deforestation and charcoal burning, brick making, resort beach development and food and refreshment. The major problem facing the lake was found to be encroachment of Hippo grass (Vossia) on the lake, which is decreasing the size of the lake, and limiting open waters for fishing (this only applied to Lake Nabugabo). Other important problems include use of illegal fishing methods, declining fish stocks and loss of cultural identity. The resource users are most pressed by the low incomes resulting from poor fish catches, theft of gears and lack of market. On examining the resource base for the lakes, it was only Lake Nabugabo that had a Landing Management Committee. The other three lakes did not have leadership institutions in place except the local councils for the respective villages. This was probably due to observed limited fisheries activities. Majority of the respondents agreed that Government and other service providers should work jointly to supplement local beach management committees in the management of the lakes resources. This is a good gesture because with increase in fishing effort and rampant use of illegal fishing methods, there is need to strengthen management institutions present on the lake. This would require Government, local community and other service providers to work together in a participatory way to control environment-degrading activities and stop the use of illegal fishing methods. Burning of vegetation on the lake should be stopped since it enhances growth of this grass. Finally, traditional taboos; which are present on some of the Nabugabo lakes, should be enhanced, as away of preserving them.

Fisheries co-management : ecological and social impacts. A case study of Northern Mozambique

Co-management, or participative management of fisheries, consists of returning or opening to the community the management of fisheries. This work, carried out in northern Mozambique, analyzed the ecological and social impacts of the implementation of co-management of fisheries. Firstly 198 species of fish were found and photographed and a guide to identification of species - essential to who works in the marine environment – was produced. Following, the spill-over effect was identified in a marine sanctuary. It occurred after 6 years and only for herbivore fishes and not to the carnivores. In order to evaluate co–management of fisheries effects, the captures of the entire province were analyzed. No differences were found in the diversity of the species caught, but an increase of the fish size was detected: this size was smaller in the fishing centers with no CCP (Community Fishing Councils), slightly bigger in the fishing centers with CCP and even bigger in the fishing centers with a more efficient management. At the same time it was observed that the size of the fish caught is bigger in the fishing centers further away from the markets. In addition to the ecological effects and the effects on fisheries, it was also analyzed the point of view of those who live the co-management. The socioeconomic factors that have a stronger influence in their perceptions are the age and the wealth. Finally and according to the CCP members, their main achievements are in the fisheries inspection and in the creation of conservation areas. Their main difficulties are the lack of means of transportation and the lack of recognition of the CCP's authority; both among the population and in the coordination with local authorities. This thesis pioneered in Mozambique in assessing the effects of Community sanctuaries and the effects of CCP on fisheries as well as by revealing the profile of the supporters of co-management and marine sanctuaries. Finally, an assessment of the matter of fact problems that the communities have to face when implementing co-management was also made.

A Decade Of Malaria During Pregnancy In Brazil: What Has Been Done Concerning Prevention And Management.

In Brazil, malaria remains a disease of major epidemiological importance because of the high number of cases in the Amazonian Region. Plasmodium spp infections during pregnancy are a significant public health problem with substantial risks for the pregnant woman, the foetus and the newborn child. In Brazil, the control of malaria during pregnancy is primarily achieved by prompt and effective treatment of the acute episodes. Thus, to assure rapid diagnosis and treatment for pregnant women with malaria, one of the recommended strategy for low transmission areas by World Health Organization and as part of a strategy by the Ministry of Health, the National Malaria Control Program has focused on integrative measures with woman and reproductive health. Here, we discuss the approach for the prevention and management of malaria during pregnancy in Brazil over the last 10 years (2003-2012) using morbidity data from Malaria Health Information System. Improving the efficiency and quality of healthcare and education and the consolidation of prevention programmes will be challenges in the control of malaria during pregnancy in the next decade.

Management Of Severe Thoracic Impalement Trauma Against Two-wheeled Horse Carriage: A Case Report And Literature Review.

Thoracic injuries in general are of great importance due to their high incidence and high mortality. Thoracic impalement injuries are rare but severe due to the combination of cause, effect and result. This study's primary objective is to report the case of a young man who was impaled by a two-wheeled horse carriage shaft while crashing his motorcycle in a rural zone. An EMT-B ferry was called at the crash scene and a conscious patient was found, sustaining a severe impalement injury to the left hemithorax, suspended over the floor by the axial skeleton with the carriage shaft coming across his left chest. As a secondary objective, a literature review of thoracic impalement injuries is performed. Cases of thoracic impalement injury require unique and individualized care based on injury severity and affected organs. Reported protocols for managing impalement injuries are entirely anecdotal, with no uniformity on impaled patient's approach and management. In penetrating trauma, it is essential not to remove the impaled object, so that possible vascular lesions remain buffered by the object, avoiding major bleeding and exsanguination haemorrhage. Severed impaled thoracic patients should be transferred to a specialist centre for trauma care, as these lesions typically require complex multidisciplinary treatment. High-energy thoracic impalement injuries are rare and hold a high mortality rate, due to the complexity of trauma and associated injuries such as thoracic wall and lung lesions. Modern medicine still seems limited in cases of such seriousness, not always with satisfactory results.

Key Issues In Inhibitor Management In Patients With Haemophilia.

12 Suppl 1

[consensus Of The Brazilian Society Of Rheumatology For The Diagnosis, Management And Treatment Of Lupus Nephritis].

To develop recommendations for the diagnosis, management and treatment of lupus nephritis in Brazil. Extensive literature review with a selection of papers based on the strength of scientific evidence and opinion of the Commission on Systemic Lupus Erythematosus members, Brazilian Society of Rheumatology. 1) Renal biopsy should be performed whenever possible and if this procedure is indicated; and, when the procedure is not possible, the treatment should be guided with the inference of histologic class. 2) Ideally, measures and precautions should be implemented before starting treatment, with emphasis on attention to the risk of infection. 3) Risks and benefits of treatment should be shared with the patient and his/her family. 4) The use of hydroxychloroquine (preferably) or chloroquine diphosphate is recommended for all patients (unless contraindicated) during induction and maintenance phases. 5) The evaluation of the effectiveness of treatment should be made with objective criteria of response (complete remission/partial remission/refractoriness). 6) ACE inhibitors and/or ARBs are recommended as antiproteinuric agents for all patients (unless contraindicated). 7) The identification of clinical and/or laboratory signs suggestive of proliferative or membranous glomerulonephritis should indicate an immediate implementation of specific therapy, including steroids and an immunosuppressive agent, even though histological confirmation is not possible. 8) Immunosuppressives must be used during at least 36 months, but these medications can be kept for longer periods. Its discontinuation should only be done when the patient achieve and maintain a sustained and complete remission. 9) Lupus nephritis should be considered as refractory when a full or partial remission is not achieved after 12 months of an appropriate treatment, when a new renal biopsy should be considered to assist in identifying the cause of refractoriness and in the therapeutic decision.

Conservative Management For Lingual Thyroid Ectopic.

Lingual thyroid gland is a rare clinical entity. The presence of an ectopic thyroid gland located at the base of the tongue may be presented with symptoms like dysphagia, dysphonia, and upper airway obstruction. We are introducing a case of an 8-year-old girl who had lingual thyroid that presented dysphagia and foreign body sensation in the throat. The diagnostic was reached with clinical examination, thyroid scintigraphy with Tc(99m) and ultrasound. A laryngoscopy was performed which confirmed a spherical mass at base of tongue. Investigation should include thyroid function tests. In this case we observed subclinical hypothyroidism. There are different types of surgical approaches for the treatment of this condition; however, the treatment with Levothyroxine Sodium allowed the stabilization of TSH levels and clinical improvement of symptoms in a follow-up of 2 years.

Dysphagia Progression And Swallowing Management In Parkinson's Disease: An Observational Study.

Dysphagia is relatively common in individuals with neurological disorders. To describe the swallowing management and investigate associated factors with swallowing in a case series of patients with Parkinson's disease. It is a long-term study with 24 patients. The patients were observed in a five-year period (2006-2011). They underwent Fiberoptic Endoscopic Evaluation of Swallowing, Functional Oral Intake Scale and therapeutic intervention every three months. In the therapeutic intervention they received orientation about exercises to improve swallowing. The Chi-square, Kruskal-Wallis and Fisher's tests were used. The period of time for improvement or worsening of swallowing was described by Kaplan-Meier analysis. During the follow-up, ten patients improved, five stayed the same and nine worsened their swallowing functionality. The median time for improvement was ten months. Prior to the worsening there was a median time of 33 months of follow-up. There was no associated factor with improvement or worsening of swallowing. The maneuvers frequently indicated in therapeutic intervention were: chin-tuck, bolus consistency, bolus effect, strengthening-tongue, multiple swallows and vocal exercises. The swallowing management was characterized by swallowing assessment every three months with indication of compensatory and rehabilitation maneuvers, aiming to maintain the oral feeding without risks. There was no associated factor with swallowing functionality in this case series.

Comparative analysis of adverse events between infliximab and adalimumab in Crohn's disease management: a Brazilian single-centre experience

INTRODUCTION: Data is scarce regarding adverse events (AE) of biological therapy used in the management of Crohn's Disease (CD) among Brazilian patients. OBJECTIVES: To analyse AE prevalence and profile in patients with CD treated with Infliximab (IFX) or Adalimumab (ADA) and to verify whether there are differences between the two drugs. METHOD: Retrospective observational single-centre study of CD patients on biological therapy. Variables analysed: Demographic data, Montreal classification, biological agent administered, treatment duration, presence and type of AE and the need for treatment interruption. RESULTS: Forty-nine patients were analysed, 25 treated with ADA and 24 with IFX. The groups were homogeneous in relation to the variables studied. The average follow-up period for the group treated with ADA was 19.3 months and 21.8 months for the IFX group (p = 0.585). Overall, 40% (n = 10) of patients taking ADA had AE compared with 50% (n = 12) of IFX users (p = 0.571). There was a tendency towards higher incidence of cutaneous and infusion reactions in the IFX group and higher incidence of infections in the ADA treated group, although without significant difference. CONCLUSIONS: No difference was found in the AE prevalence and profile between ADA and IFX CD patients in the population studied.