Chronic disease self-management education programs: challenges ahead

♦ Chronic disease self-management education programs aim to empower patients through providing information and teaching skills and techniques to improve self-care and doctor–patient interaction, with the ultimate goal of improving quality of life.

♦ The recent 2006–07 federal budget allocated an unprecedented $515 million over 5 years for activation of patient self-management activities, commencing this financial year.

♦ Previous attempts in other countries to incorporate self-management education activities into the health care sector have faced setbacks because of inadequate integration into primary care.

♦ Engagement of health care professionals and their endorsement of self-management activities is critical to success.

Nutrients in Pirron Yallock Creek, southwestern Victoria : paleolimnological and management considerations

The concentrations of various forms of nitrogen and phosphorus in the main stream and selected tributaries of Pirron Yallock Creek, southwestern Victoria were examined over a two-year period. Exceedingly high levels of both nutrients were found within a particular tributary, while generally high nutrient levels were observed throughout the catchment. The speciation results indicated that dairy effluent was the primary source of nutrients to Pirron Yallock Creek. A palaeolimnological study was undertaken to determine the impact of European settlement upon waterway nutrient concentrations within the region. The palaeolimnological study focused primarily on the diatom flora preserved within the sediments of nearby Lakes Corangamite and Bullen Merri. Lack of preservation of diatoms within the sediments of Lake Corangamite resulted in no water quality inferences for this lake. The preserved diatoms within Lake Bullen Merri suggested an increase in trophic status of this lake during the last 500 years. While a change in the diatom flora of Lake Bullen Merri was evident, it was not possible to differentiate the impact of European settlement upon nutrient status of this waterway from long-term trophic status change. In light of the particularly high nutrient concentrations observed in Pirron Yallock Creek, improved nutrient management strategies are proposed for the catchment. These strategies, which consider current nutrient management activities, are predominantly focussed on the dairy industry, which occupies the majority of the catchment.

Underpricing, risk management, hot issue and crowding out effects : evidence from the Australian resources sector initial public offerings

The main purpose of this paper is to explore the role of risk management, speculative industry competition effect and hot issue markets. We used a sample of 260 initial public offerings (IPOs) in the Australian resource sector for the 1994–2004 period to test the underpricing effect. We do not find any evidence that risk management can reduce the uncertainty relating to the new issue and hence alleviate the extent of underpricing. A plausible explanation for this lack of evidence is the poor information content of publicly available disclosures regarding risk management activities of IPO firms. We further provide evidence that the underpricing returns for resources IPOs are not impacted upon by the strength of alternative speculative IPO markets. We also show that the degree of underpricing adjusts to both market return in the preceding three months and the average underpricing of resources IPOs in the 12 month period leading to the float which offers an explanation to the hot issue effect observed in the IPO market.

An ontology-based learning resources management framework for exploratory e-learning

This paper presents an ontology-based conceptual framework for effectively managing exploratory e-learning resources. The proposed framework has five significant novel features including authentication of retrieved resources, automatic ontology-based query refinement, reuse-oriented management of retrieved resources, adaptive retrieval of learning resources based on the style and preference of individual learners, and synthesisation of retrieval and management activities for creating reusable learning repositories. The applicability of the framework is demonstrated using a sample fragment of an ontology developed in the database domain.

Feral swine damage and damage management in forested ecosystems

Invasive feral swine (Sus scrofa) cause deleterious impacts to ecosystem processes and functioning throughout their worldwide distribution, including forested ecosystems in the United States. Unfortunately, many feral swine damage management programs are conducted in a piecemeal fashion, are not adequately funded, and lack clearly stated or realistic objectives. This review paper identifies damage caused by feral swine to forest resources and presents techniques used to prevent and control feral swine damage. Concluding points related to planning a feral swine damage management program are: (1) the value of using a variety of techniques in an integrated fashion cannot be overstated; (2) there is value in using indices for both feral swine populations and their damage pre and post management activities; (3) innovative technologies will increasing be of value in the pursuit of feral swine damage reduction; and (4) though not appropriate in every situation, there is value in involving the public in feral swine damage management decisions and activities.

Effects of management on native and exotic plant communities in Pictured Rocks National Lakeshore in the Upper Peninsula of Michigan

Ecological disturbances may be caused by a range of biotic and abiotic factors. Among these are disturbances that result from human activities such as the introduction of exotic plants and land management activities. This dissertation addresses both of these types of disturbance in ecosystems in the Upper Peninsula of Michigan. Invasive plants are a significant cause of disturbance at Pictured Rocks Natural Lakeshore. Management of invasive plants is dependent on understanding what areas are at risk of being invaded, what the consequences of an invasion are on native plant communities and how effective different tools are for managing the invasive species. A series of risk models are described that predict three stages of invasion (introduction, establishment and spread) for eight invasive plant species at Pictured Rocks National Lakeshore. These models are specific to this location and include species for which models have not previously been produced. The models were tested by collecting point data throughout the park to demonstrate their effectiveness for future detection of invasive plants in the park. Work to describe the impacts and management of invasive plants focused on spotted knapweed in the sensitive Grand Sable Dunes area of Pictured Rocks National Lakeshore. Impacts of spotted knapweed were assessed by comparing vegetation communities in areas with varying amounts of spotted knapweed. This work showed significant increases in species diversity in areas invaded by knapweed, apparently as a result of the presence of a number of non-dune species that have become established in spotted knapweed invaded areas. An experiment was carried out to compare annual spot application of two herbicides, Milestone® and Transline® to target spotted knapweed. This included an assessment of impacts of this type of treatment on non-target species. There was no difference in the effectiveness of the two herbicides, and both significantly reduced the density of spotted knapweed during the course of the study. Areas treated with herbicide developed a higher percent cover of grasses during the study, and suffered limited negative impacts on some sensitive dune species such as beach pea and dune stitchwort, and on some other non-dune species such as hawkweed. The use of these herbicides to reduce the density of spotted knapweed appears to be feasible over large scales.

Spatial variability and potential impacts of climate change on flood and debris flow hazard zone mapping and implications for risk management

The main goals of this study were to identifythe alpine torrent catchments that are sensitive to climatic changes and to assess the robustness of the methods for the elaboration of flood and debris flow hazard zone maps to specific effects of climate changes. In this study, a procedure for the identification and localization of torrent catchments in which the climate scenarios will modify the hazard situation was developed. In two case studies, the impacts of a potential increase of precipitation intensities to the delimited hazard zones were studied. The identification and localization of the torrent and river catchments, where unfavourable changes in the hazard situation occur, could eliminate speculative and unnecessary measures against the impacts of climate changes like a general enlargement of hazard zones or a general over dimensioning of protection structures for the whole territory. The results showed a high spatial variability of the sensitivity of catchments to climate changes. In sensitive catchments, the sediment management in alpine torrents will meet future challenges due to a higher rate for sediment removal from retention basins. The case studies showed a remarkable increase of the areas affected by floods and debris flow when considering possible future precipitation intensities in hazard mapping. But, the calculated increase in extent of future hazard zones lay within the uncertainty of the methods used today for the delimitation of the hazard zones. Thus, the consideration of the uncertainties laying in the methods for the elaboration of hazard zone maps in the torrent and river catchments sensitive to climate changes would provide a useful instrument for the consideration of potential future climate conditions. The study demonstrated that weak points in protection structures in future will become more important in risk management activities.

Analysing factors determining the adoption of environmental management measures on the highlands of Ethiopia

A study was conducted on the highlands of Ethiopia to identify and analyse the factors determining the adoption of environmental management measures. In 1985, Ethiopia was classified into low –and high-potential areas based on the suitability of the natural environment for rain-fed agriculture. To address these objectives, case study areas were selected from low-potential and high-potential areas randomly. Data were collected through face-to-face interview and key informants, focus group discussion and field observation. In the low-potential areas, the physical environment ‒ particularly soil and forest environments have shown substantial recovery. Similarly, the water environment has improved. However, in the high-potential areas sampled, these resources are still being degraded. Clear understanding of the benefits of soil conservation structures by farmers, active involvement and technical support from the government and full and genuine participation of farmers in communal environmental resources management activities were found to be main factors in the adoption of environmental management measures.

Biomedical informatics applications for epilepsy management: A systematic review

Epilepsy is a very complex disease which can have a variety of etiologies, co-morbidities, and a long list of psychosocial factors4. Clinical management of epilepsy patients typically includes serological tests, EEG's, and imaging studies to determine the single best antiepileptic drug (AED). Self-management is a vital component of achieving optimal health when living with a chronic disease. For patients with epilepsy self-management includes any necessary actions to control seizures and cope with any subsequent effects of the condition9; including aspects of treatment, seizure, and lifestyle. The use of computer-based applications can allow for more effective use of clinic visits and ultimately enhance the patient-provider relationship through focused discussion of determinants affecting self-management. ^ The purpose of this study is to conduct a systematic literature review on informatics application in epilepsy self-management in an effort to describe current evidence for informatics applications and decision support as an adjunct to successful clinical management of epilepsy. Each publication was analyzed for the type of study design utilized. ^ A total of 68 publications were included and categorized by the study design used, development stage, and clinical domain. Descriptive study designs comprised of three-fourths of the publications and indicate an underwhelming use of prospective studies. The vast majority of prospective studies also focused on clinician use to increase knowledge in treating patients with epilepsy. ^ Due to the chronic nature of epilepsy and the difficulty that both clinicians and patients can experience in managing epilepsy, more prospective studies are needed to evaluate applications that can effectively increase management activities. Within the last two decades of epilepsy research, management studies have employed the use of biomedical informatics applications. While the use of computer applications to manage epilepsy has increased, more progress is needed.^

Facility closure management:the case of Vauxhall Motors Luton

Purpose – The purpose of the paper is to present the findings of a study of factory closure management. It details the sequence and the results of the key strategic manufacturing management decisions made from the time of the announcement of the plant closure to the cessation of operations. The paper also includes an analysis of the human resource management (HRM) actions taken during this same time period and their consequences upon all those involved in the closure management process. Design/methodology/approach – The case study methodology consisted of two initial site visits to monitor closure management effectiveness (adherence to plan and the types and frequency of closure management communications). During these visits, documentary evidence of the impact of the closure decision upon production performance was also collected (manufacturing output and quality performance data). Following plant closure, interviews were held with senior business, production and HRM managers and production personnel. A total of 12 interviews were carried out. Findings – The case study findings have informed the development of a conceptual model of facility closure management. Information obtained from the interviews suggests that the facility closure management process consists of five key management activities. The unexpected announcement of a factory closure can cause behavioural changes similar to those of bereavement, particularly by those employees who are its survivors. In addition, similar reactions to the closure announcement may be displayed by those who choose to remain employed by the factory owner throughout the phased closure of the plant. Originality/value – Facility closure management is an insufficiently researched strategic operations management activity. This paper details a recommended procedure for its management. A conceptual model has also been developed to illustrate the links between the key facility closure management tasks and the range of employee changes of behaviour that can be induced by their execution.

Knowledge management systems:finding a way with technology

Purpose - To consider the role of technology in knowledge management in organizations, both actual and desired. Design/methodology/approach - Facilitated, computer-supported group workshops were conducted with 78 people from ten different organizations. The objective of each workshop was to review the current state of knowledge management in that organization and develop an action plan for the future. Findings - Only three organizations had adopted a strongly technology-based "solution" to knowledge management problems, and these followed three substantially different routes. There was a clear emphasis on the use of general information technology tools to support knowledge management activities, rather than the use of tools specific to knowledge management. Research limitations/implications - Further research is needed to help organizations make best use of generally available software such as intranets and e-mail for knowledge management. Many issues, especially human, relate to the implementation of any technology. Participation was restricted to organizations that wished to produce an action plan for knowledge management. The findings may therefore represent only "average" organizations, not the very best practice. Practical implications - Each organization must resolve four tensions: Between the quantity and quality of information/knowledge, between centralized and decentralized organization, between head office and organizational knowledge, and between "push" and "pull" processes. Originality/value - Although it is the group rather than an individual that determines what counts as knowledge, hardly any previous studies of knowledge management have collected data in a group context.

Employability management needs analysis and the ICT sector in Europe:the case of small and medium-sized enterprises

The purpose of this paper is to deal with the outcomes of a so-called “employability management needs analysis” that is meant to provide more insight into current employability management activities and its possible benefits for Information and Communication Technology (ICT) professionals working in Small- and Medium-sized enterprises (SMEs) throughout Europe. A considerable series of interviews (N=107) were conducted with managers in SMEs in seven European countries, including Germany, Greece, Italy, the Netherlands, Norway, Poland, and the UK. A semi-structured interview protocol was used during the interviews to cover three issues: employability (13 items), ageing (8 items), and future developments and requirements (13 items). Analysis of all final interview transcriptions was at a national level using an elaborate common coding scheme. Although an interest in employability emerged, actual policy and action lagged behind. The recession in the ICT sector at the time of the investigation and the developmental stage of the sector in each participating country appeared connected. Ageing was not seen as a major issue in the ICT sector because managers considered ICT to be a relatively young sector. There appeared to be a serious lack of investment in the development of expertise of ICT professionals. Generalization of the results to large organizations in the ICT sector should be made with caution. The interview protocol developed is of value for further research and complements survey research undertaken within the employability field of study. It can be concluded that proactive HRM (Human Resource Management) policies and strategies are essential, even in times of economic downturn. Employability management activities are especially important in the light of current career issues. The study advances knowledge regarding HRM practices adopted by SMEs in the ICT sector, especially as there is a gap in knowledge about career development issues in that particular sector.

Primary health care management in Nigeria

This research sets out to assess if the PHC system in rural Nigeria is effective by testing the research hypothesis: `PHC can be effective if and only if the Health Care Delivery System matches the attitudes and expectations of the Community'. The field surveys to accomplish this task were carried out in IBO, YORUBA, and HAUSA rural communities. A variety of techniques have been used as Research Methodology and these include questionnaires, interviews and personal observations of events in the rural community. This thesis embraces three main parts. Part I traces the socio-cultural aspects of PHC in rural Nigeria, describes PHC management activities in Nigeria and the practical problems inherent in the system. Part II describes various theoretical and practical research techniques used for the study and concentrates on the field work programme, data analysis and the research hypothesis-testing. Part III focusses on general strategies to improve PHC system in Nigeria to make it more effective. The research contributions to knowledge and the summary of main conclusions of the study are highlighted in this part also. Based on testing and exploring the research hypothesis as stated above, some conclusions have been arrived at, which suggested that PHC in rural Nigeria is ineffective as revealed in people's low opinions of the system and dissatisfaction with PHC services. Many people had expressed the view that they could not obtain health care services in time, at a cost they could afford and in a manner acceptable to them. Following the conclusions, some alternative ways to implement PHC programmes in rural Nigeria have been put forward to improve and make the Nigerian PHC system more effective.

Tudásmenedzsmentet támogató szervezeti megoldások (Knowledge management supported by organizational solutions)

A tudás a vállalatok egyre fontosabb erőforrásává vált, ezért tudatos megoldásokkal kell törekedni a szervezeti tudásban rejlő lehetőségek hatékony kihasználására. A tudás kezelésére irányuló tevékenységeket mind technológiai-informatikai, mind HR-, mind pedig szervezeti megoldásokkal lehet támogatni. Jelen cikkben a vállalatok szervezeti megoldásait elemzi a szerző: rámutat a szervezeti struktúrák, a szervezeti kultúra, a vezetői megközelítések (leadership) szerepére, valamint a kommunikáció különböző formáinak lehetőségeire. ______ Knowledge management activities became important part of knowledge oriented organisations, like software development companies. These activities can be supported by technological and organisational solutions. This paper concentrates on the organisational support factors of knowledge management activities in the software development industries, and examines the role of organisational design, structures, processes, communication and management support, while highlights the challenges.

Relating precipitation and water management to nutrient concentrations in the oligotrophic ‘‘upside-down’’ estuaries of the Florida Everglades

We present 8 yr of long-term water quality, climatological, and water management data for 17 locations in Everglades National Park, Florida. Total phosphorus (P) concentration data from freshwater sites (typically ,0.25 mmol L21, or 8 mg L21) indicate the oligotrophic, P-limited nature of this large freshwater–estuarine landscape. Total P concentrations at estuarine sites near the Gulf of Mexico (average ø0.5 m mol L21) demonstrate the marine source for this limiting nutrient. This ‘‘upside down’’ phenomenon, with the limiting nutrient supplied by the ocean and not the land, is a defining characteristic of the Everglade landscape. We present a conceptual model of how the seasonality of precipitation and the management of canal water inputs control the marine P supply, and we hypothesize that seasonal variability in water residence time controls water quality through internal biogeochemical processing. Low freshwater inflows during the dry season increase estuarine residence times, enabling local processes to control nutrient availability and water quality. El Nin˜o–Southern Oscillation (ENSO) events tend to mute the seasonality of rainfall without altering total annual precipitation inputs. The Nin˜o3 ENSO index (which indicates an ENSO event when positive and a La Nin˜a event when negative) was positively correlated with both annual rainfall and the ratio of dry season to wet season precipitation. This ENSO-driven disruption in seasonal rainfall patterns affected salinity patterns and tended to reduce marine inputs of P to Everglades estuaries. ENSO events also decreased dry season residence times, reducing the importance of estuarine nutrient processing. The combination of variable water management activities and interannual differences in precipitation patterns has a strong influence on nutrient and salinity patterns in Everglades estuaries.