Management of intestinal obstruction in advanced malignancy

Peer reviewed

Stress management in mothers of children with Autism Spectrum Disorder : psychological characteristics, coping strategies and biological correlates

Un figlio con un Disturbo dello Spettro Autistico, caratterizzato da gravi difficoltà nelle relazioni, nei comportamenti e nella comunicazione, costringe tutto il sistema familiare a gestire un notevole stress dovuto alla gestione quotidiana di una patologia così complessa. Per questi motivi, i genitori necessitano di un sostegno il più possibile personalizzato rispetto alle caratteristiche del loro contesto familiare. Per fare questo sarebbe importante individuare quali siano i parametri correlati ai livelli di stress nei familiari di pazienti con autismo e che potrebbero avere un’influenza sul benessere familiare. Lo scopo di questo studio è quello di valutare quali caratteristiche di personalità, stili di coping e capacità di gestire le emozioni possano essere in relazione con la reattività individuale alle situazioni di stress, valutata attraverso alcuni correlati biologici, quali il livello di cortisolo (l’ormone dello stress) e la variabilità della frequenza cardiaca. L’ottica di ricerca applicata fa sì che gli obiettivi ultimi di questo lavoro siano anche quelli di diminuire l’accesso ai servizi per questi soggetti, considerando il fatto che progetti individualizzati di sostegno genitoriale costituiscono un fattore protettivo rispetto a conseguenze fisiche e psicologiche di disagio se implementati tenendo conto della variabilità individuale rispetto alle caratteristiche sopra citate.

Environmental Information Access as a Security Risk

The United Sates was founded on the principles of freedom. Events in recent history have threatened the freedoms we as individuals enjoy. Notably, changes to government legislation and policies regarding access to environmentally sensitive information following September 11, 2001, are troubling. The government has struggled with a difficult balancing act. The public has the right of access to information, yet, information some view as sensitive or dangerous must be kept out of the hands of terrorists. This project examines and discusses the information access debate within the United States and how to best provide the public environmentally sensitive information.

How do primary health care teams learn to integrate intimate partner violence (IPV) management? A realist evaluation protocol

Background: Despite the existence of ample literature dealing, on the one hand, with the integration of innovations within health systems and team learning, and, on the other hand, with different aspects of the detection and management of intimate partner violence (IPV) within healthcare facilities, research that explores how health innovations that go beyond biomedical issues—such as IPV management—get integrated into health systems, and that focuses on healthcare teams’ learning processes is, to the best of our knowledge, very scarce if not absent. This realist evaluation protocol aims to ascertain: why, how, and under what circumstances primary healthcare teams engage (if at all) in a learning process to integrate IPV management in their practices; and why, how, and under what circumstances team learning processes lead to the development of organizational culture and values regarding IPV management, and the delivery of IPV management services. Methods: This study will be conducted in Spain using a multiple-case study design. Data will be collected from selected cases (primary healthcare teams) through different methods: individual and group interviews, routinely collected statistical data, documentary review, and observation. Cases will be purposively selected in order to enable testing the initial middle-range theory (MRT). After in-depth exploration of a limited number of cases, additional cases will be chosen for their ability to contribute to refining the emerging MRT to explain how primary healthcare learn to integrate intimate partner violence management. Discussion: Evaluations of health sector responses to IPV are scarce, and even fewer focus on why, how, and when the healthcare services integrate IPV management. There is a consensus that healthcare professionals and healthcare teams play a key role in this integration, and that training is important in order to realize changes. However, little is known about team learning of IPV management, both in terms of how to trigger such learning and how team learning is connected with changes in organizational culture and values, and in service delivery. This realist evaluation protocol aims to contribute to this knowledge by conducting this project in a country, Spain, where great endeavours have been made towards the integration of IPV management within the health system.

Evolution of Posidonia oceanica seagrass meadows and its implications for management

Results of the monitoring network of the Posidonia oceanica meadows in the Valencia region in Spain are analysed. For spatial comparison the whole data set has been analysed, however, for temporal trends we only selected stations that have been monitored at least 6 years in the period of 2002–2011 (26 stations in 13 localities). At the south of the studied area, meadows are larger, and they have higher density and covering than that in the Valencia Gulf, excluding Oropesa meadow. Monitoring of P. oceanica meadows in the Valencia region in Spain indicates that most of them are stationary or they are increasing their density and covering while no decline was observed in the studied meadows. These results indicate that there is not a general decline of P. oceanica meadows and that the decline of P. oceanica, when it has been observed in other studies, is produced by local causes that may be managed at the local level. This study also reflects the importance of long series of direct data to analyse trends in the population dynamics for slow-growing species.

A Construction Management Framework for Mass Customisation in Traditional Construction

A Mass Customisation model is discussed as a competitive positioning strategy in the marketplace adding value to the customer’s end-use. It includes the user as part of the construction process responding to the customer’s demands and wishes. To the present day, almost all proposals for Mass Customisation have been focused on the design phase and single family houses. The reality is that the processes carried out in the work execution are so inefficient that the costs of the Mass Customisation models are assumed by the customer and they do not offer solutions that support the change management. Furthermore, this inefficiency often makes Mass Customisation unfeasible in terms of deadlines and site management. Therefore, the present proposal focuses on achieving the paradigm of Mass Customisation in the traditional residential construction complementary to the existing proposals in the design phase. All this through the proposal of a framework for the integral management in the work execution, which will address change management introduced by the users offering an efficient and productive model that reduces costs in the process. This model will focus on the synergy between different strategies, techniques and technologies currently used in the construction management (such as Lean Construction or Six Sigma), together with, other strategies and technologies that have proven to be valid solutions in other fields (such as Business Process Management, Service Oriented Architecture, etc.).

Use of an Inverse Method for Time Series to Estimate the Dynamics of and Management Strategies for the Box Jellyfish Carybdea marsupialis

Frequently, population ecology of marine organisms uses a descriptive approach in which their sizes and densities are plotted over time. This approach has limited usefulness for design strategies in management or modelling different scenarios. Population projection matrix models are among the most widely used tools in ecology. Unfortunately, for the majority of pelagic marine organisms, it is difficult to mark individuals and follow them over time to determine their vital rates and built a population projection matrix model. Nevertheless, it is possible to get time-series data to calculate size structure and densities of each size, in order to determine the matrix parameters. This approach is known as a “demographic inverse problem” and it is based on quadratic programming methods, but it has rarely been used on aquatic organisms. We used unpublished field data of a population of cubomedusae Carybdea marsupialis to construct a population projection matrix model and compare two different management strategies to lower population to values before year 2008 when there was no significant interaction with bathers. Those strategies were by direct removal of medusae and by reducing prey. Our results showed that removal of jellyfish from all size classes was more effective than removing only juveniles or adults. When reducing prey, the highest efficiency to lower the C. marsupialis population occurred when prey depletion affected prey of all medusae sizes. Our model fit well with the field data and may serve to design an efficient management strategy or build hypothetical scenarios such as removal of individuals or reducing prey. TThis This sdfsdshis method is applicable to other marine or terrestrial species, for which density and population structure over time are available.

Smart Monitoring Embedded Service for Energy-Efficient and Sustainable Management in Data Centers

Information technologies (IT) currently represent 2% of CO2 emissions. In recent years, a wide variety of IT solutions have been proposed, focused on increasing the energy efficiency of network data centers. Monitoring is one of the fundamental pillars of these systems, providing the information necessary for adequate decision making. However, today’s monitoring systems (MSs) are partial, specific and highly coupled solutions. This study proposes a model for monitoring data centers that serves as a basis for energy saving systems, offered as a value-added service embedded in a device with low cost and power consumption. The proposal is general in nature, comprehensive, scalable and focused on heterogeneous environments, and it allows quick adaptation to the needs of changing and dynamic environments. Further, a prototype of the system has been implemented in several devices, which has allowed validation of the proposal in addition to identification of the minimum hardware profile required to support the model.

'Institutional Shopping' for Natural Resource Management in a Protected Area and Indigenous Territory in the Bolivian Amazon.

Focusing on an overlapping protected area and indigenous territory in the Bolivian Amazon, this article discusses how indigenous people continue to negotiate access to natural resources. Using the theoretical framework of New Institutionalism, ethnographic data from participatory observations, and interviews with Takana indigenous resource users and park management staff, we identified four phases of institutional change. We argue that under the current institutionally pluralistic setting in the overlapping area, indigenous users apply “institutional shopping” to choose, according to their power and knowledge, the most advantageous institutional framework in a situation. Indigenous users strategically employed arguments of conservation, indigeneity, or long-term occupation to legitimize their claims based on the chosen institution. Our results highlight the importance of ideologies and bargaining power in shaping the interaction of individuals and institutions. As a potential application of our research to practice, we suggest that rather than seeing institutional pluralism solely as a threat to successful resource management, the strengths of different frameworks may be combined to build robust institutions from the bottom up that are adapted to the local context. This requires taking into account local informal institutions, such as cultural values and beliefs, and integrating them with conservation priorities through cross-cultural participatory planning.

Diet in dyspepsia and other diseases of the stomach and bowels : an elementary treatise on their dietetic and hygienic management.

Mode of access: Internet.

Herbert Hoover national historic site, interpretive prospectus (1971) B1; Natural resources management plan (1980) B2; Cultural resources management plan (1981) B3; Annual statement for interpretation and visitor services B4; Snowmobile use, environmental assessment (EA) : environmental impact statement.

Mode of access: Internet.

Pipe Spring National Monument (N.M.), interim interpretive plan, second draft (1977) B1; Master plan (1978) B2; Development concept plan, environmental assessment (EA) B3; Statement for management (1981) B4; Record of decision, draft development concept plan and Finding of no significant impact (FONSI) (1982) : environmental impact statement.

Mode of access: Internet.

Tongass National Forest (N.F.), land management plan : environmental impact statement.

D,F also available in microfiche.

Kitsatchie National Forest (N.F.), Land and resource(s) management plan (LRMP) : environmental impact statement.

Mode of access: Internet.