Complementary and Alternative Medicine and Pain Management

Over the past several years, there has been a growing interest in CAM therapies at UCHC. There are doctors, nurses, researchers and students all actively learning about, researching and using CAM modalities. Among them is Dr. Mitch Kennedy, the first Naturopathic Physician to treat patients at the University of Connecticut Health Center.

Are Shirking and Leisure Substitutable? An Empirical Test of Efficiency Wages Based on Urban Economic Theory

Recent theoretical work has examined the spatial distribution of unemployment using the efficiency wage model as the mechanism by which unemployment arises in the urban economy. This paper extends the standard efficiency wage model in order to allow for behavioral substitution between leisure time at home and effort at work. In equilibrium, residing at a location with a long commute affects the time available for leisure at home and therefore affects the trade-off between effort at work and risk of unemployment. This model implies an empirical relationship between expected commutes and labor market outcomes, which is tested using the Public Use Microdata sample of the 2000 U.S. Decennial Census. The empirical results suggest that efficiency wages operate primarily for blue collar workers, i.e. workers who tend to be in occupations that face higher levels of supervision. For this subset of workers, longer commutes imply higher levels of unemployment and higher wages, which are both consistent with shirking and leisure being substitutable.

Understanding treatment-related symptoms, symptom management techniques, and symptom management self-efficacy in a sample of non-muscle invasive bladder cancer patients

The current literature available on bladder cancer symptom management from the perspective of the patients themselves is limited. There is also limited psychosocial research specific to bladder cancer patients and no previous studies have developed and validated measures for bladder cancer patients’ symptom management self-efficacy. The purpose of this study was to investigate non-muscle invasive bladder cancer patients’ health related quality of life through two main study objectives: (1) to describe the treatment related symptoms, reported effectiveness of symptom-management techniques, and the advice a sample of non-muscle invasive bladder cancer patients would convey to physicians and future patients; and (2) to evaluate Lepore’s symptom management self-efficacy measure on a sample of non-muscle invasive bladder cancer patients. Methods. A total of twelve (n=12) non-muscle invasive bladder cancer patients participated in an in-depth interview and a sample of 46 (n=4) non-muscle invasive bladder cancer patients participated in the symptom-management self-efficacy survey. Results. A total of five symptom categories emerged for the participants’ 59 reported symptoms. Four symptom management categories emerged out of the 71 reported techniques. A total of 62% of the participants’ treatment related symptom-management techniques were reported as effective in managing their treatment-related symptoms. Five advice categories emerged out of the in-depth interviews: service delivery; medical advice; physician-patient communication; encouragement; and no advice. An exploratory factor analysis indicated a single-factor structure for the total population and a multiple factor structure for three subgroups: all males, married males, and all married participants. Conclusion. These findings can inform physicians and patients of effective symptom-management techniques thus improving patients’ health-related quality of life. The advice these patients’ impart can improve service-delivery and patient education.^

A comparison of labor and delivery management activities in two settings

Similarities and differences in management activities and patient health outcomes between a traditional physician staffed labor and delivery setting and a certified nurse-midwife staffed Birth Center within the same hospital were described. The 950 study subjects, low income, minority women, were classified as low obstetrical risk by a POPRAS score of 25 points or less at time of admission for labor and delivery. The study subjects were similar in demographic, antepartum and intrapartum characteristics; the labor course was problem free for the majority in both settings. There were no remarkable differences in health outcomes between the groups. Management activities varied between settings; these variations were policy related rather than health related. The POPRAS rating system was an accurate predictor for 93% of BC subjects and 85% of LDU subjects. Charge for service was approximately $600 less for BC women; length of stay did not contribute to the difference in charge. Overall, BC respondents to the attitude survey were more satisfied with their labor and delivery experience than L\&DU women. ^

The impact of traditional psychiatric services and case management services on the functioning of people with schizophrenia: A cross-national study in Nova Scotia and Texas

The purpose of this study was to determine the impact of traditional psychiatric services with case management services on the functioning of people with schizophrenia. Traditional services were defined as routine clinic services consisting of medication follow-along, psychotherapy, and support services. Case management consisted of activities involved in linking, planning, and monitoring services for the outpatient client who has schizophrenia. The target population was adult schizophrenics who had been receiving outpatient clinic services for a minimum of six months. Structured interviews were conducted using standardized scales (e.g., Quality of Life, Self-Efficacy, and Brief Symptom Inventory) with 78 outpatient client volunteers from two sites: Nova Scotia (Canada) and Texas (USA). The researcher tested for differences in psychiatric symptomatology, recidivism, and quality of life for persons with schizophrenia receiving traditional psychiatric services in Nova Scotia and traditional plus case management services in Texas. Data were collected from the structured interviews and medical records review forms. Types of services were blocked into low and high levels of Intensity (frequency x minutes) and compared to determine the relative contribution of each. Finally, the role of clients' self-efficacy was tested as an intervening variable. Although the findings did not support the hypotheses in the direction anticipated, there were some interesting and useful results. From the Nova Scotia site, clients who received low levels of services were hospitalized less compared to the Texas site. The more psychotic a patient was the higher their involvement in medication follow-along and the more monitoring they received. The more psychotherapy received, the lower the reported satisfaction with social relationships. Of particular interest is the role that self-efficacy played in improved client outcomes. Although self-efficacy scores were related to improved functioning, the mechanism for this still needs to be clarified through subsequent research. ^

A Methodological model to assist the optimization and risk management of mining investment decisions

Identifying, quantifying, and minimizing technical risks associated with investment decisions is a key challenge for mineral industry decision makers and investors. However, risk analysis in most bankable mine feasibility studies are based on the stochastic modelling of project “Net Present Value” (NPV)which, in most cases, fails to provide decision makers with a truly comprehensive analysis of risks associated with technical and management uncertainty and, as a result, are of little use for risk management and project optimization. This paper presents a value-chain risk management approach where project risk is evaluated for each step of the project lifecycle, from exploration to mine closure, and risk management is performed as a part of a stepwise value-added optimization process.

Relating goal scheduling, precedence, and memory management in and-parallel execution of logic programs

The interactions among three important issues involved in the implementation of logic programs in parallel (goal scheduling, precedence, and memory management) are discussed. A simplified, parallel memory management model and an efficient, load-balancing goal scheduling strategy are presented. It is shown how, for systems which support "don't know" non-determinism, special care has to be taken during goal scheduling if the space recovery characteristics of sequential systems are to be preserved. A solution based on selecting only "newer" goals for execution is described, and an algorithm is proposed for efficiently maintaining and determining precedence relationships and variable ages across parallel goals. It is argued that the proposed schemes and algorithms make it possible to extend the storage performance of sequential systems to parallel execution without the considerable overhead previously associated with it. The results are applicable to a wide class of parallel and coroutining systems, and they represent an efficient alternative to "all heap" or "spaghetti stack" allocation models.

A proposal for a flexible scheduling and memory management scheme for non-deterministic, andparallel execution of logic programs

In this paper, we examine the issue of memory management in the parallel execution of logic programs. We concentrate on non-deterministic and-parallel schemes which we believe present a relatively general set of problems to be solved, including most of those encountered in the memory management of or-parallel systems. We present a distributed stack memory management model which allows flexible scheduling of goals. Previously proposed models (based on the "Marker model") are lacking in that they impose restrictions on the selection of goals to be executed or they may require consume a large amount of virtual memory. This paper first presents results which imply that the above mentioned shortcomings can have significant performance impacts. An extension of the Marker Model is then proposed which allows flexible scheduling of goals while keeping (virtual) memory consumption down. Measurements are presented which show the advantage of this solution. Methods for handling forward and backward execution, cut and roll back are discussed in the context of the proposed scheme. In addition, the paper shows how the same mechanism for flexible scheduling can be applied to allow the efficient handling of the very general form of suspension that can occur in systems which combine several types of and-parallelism and more sophisticated methods of executing logic programs. We believe that the results are applicable to many and- and or-parallel systems.

Riding out of the storm: How to deal with the complexity of grid and cloud management

Over the last decade, Grid computing paved the way for a new level of large scale distributed systems. This infrastructure made it possible to securely and reliably take advantage of widely separated computational resources that are part of several different organizations. Resources can be incorporated to the Grid, building a theoretical virtual supercomputer. In time, cloud computing emerged as a new type of large scale distributed system, inheriting and expanding the expertise and knowledge that have been obtained so far. Some of the main characteristics of Grids naturally evolved into clouds, others were modified and adapted and others were simply discarded or postponed. Regardless of these technical specifics, both Grids and clouds together can be considered as one of the most important advances in large scale distributed computing of the past ten years; however, this step in distributed computing has came along with a completely new level of complexity. Grid and cloud management mechanisms play a key role, and correct analysis and understanding of the system behavior are needed. Large scale distributed systems must be able to self-manage, incorporating autonomic features capable of controlling and optimizing all resources and services. Traditional distributed computing management mechanisms analyze each resource separately and adjust specific parameters of each one of them. When trying to adapt the same procedures to Grid and cloud computing, the vast complexity of these systems can make this task extremely complicated. But large scale distributed systems complexity could only be a matter of perspective. It could be possible to understand the Grid or cloud behavior as a single entity, instead of a set of resources. This abstraction could provide a different understanding of the system, describing large scale behavior and global events that probably would not be detected analyzing each resource separately. In this work we define a theoretical framework that combines both ideas, multiple resources and single entity, to develop large scale distributed systems management techniques aimed at system performance optimization, increased dependability and Quality of Service (QoS). The resulting synergy could be the key 350 J. Montes et al. to address the most important difficulties of Grid and cloud management.

Leadership and project management competences in executive women: different styles from the agents' perceptions

The exercise of management and leadership are key aspects to achieve objectives, goals and relationships in the current knowledge society marked by increasingly competitive environments in which cognitive factors, creativity, knowledge and information determine the success of organizations. Both concepts have been historically associated with the male domain because of the underrepresentation of women in managerial positions. However, the increasing participation of women in the workplace has led to the development of an extensive literature on the possible existence of differences between the styles of male and female leadership, although it has not been addressed from the analysis of competences associated with each sex. Through a participatory process the abilities and skills related to women managers are analyzed and the differences in leadership styles. The results indicate that women particularly value the skills associated with human relationships, and that female leadership style tends to be transformational.

Experiences of spanish public administration in requirements management and acquisition management processes

This paper shows the main contributions of the 1st Symposium on Improvement Process Models and Software Quality of Public Administrations. The obtained results expose the need to promote the implementation of Software Maturity Models and show possible advantages of its application in software processes of Public Administrations. Specifically, it was analyzed the current status in two process areas: Requirements Management and Subcontracting Management.

Landslide risk in Haiti and land management in Port au Prince

This thesis aims to identify landslide risk zones in Haiti as a whole (regional scale) and Port au Prince specifically (local scale) and to evaluate how this landslide risk can affect them, especially to Port au Prince, in order to elaborate recommendations in priority zones of the city. Landslide risk priority zones are marked in order to apply land management recommendations supported in the Haitian land tenure to reduce, mitigate or delete at maximum the possible damages that these zones can suffer in the future due to landslides. These recommendations are collected in order to stakeholders decide which of them are the best options for each priority zone. Different types of maps are generated in order to locate all landslide risk zones and priority zones.

The impact of sustainable construction and knowledge management on sustainability goals. A review of the venezuelan renewable energy sector

The recognition of the relevance of energy, especially of the renewable energies generated by the sun, water, wind, tides, modern biomass or thermal is growing significantly in the global society based on the possibility it has to improve societies′ quality of life, to support poverty reduction and sustainable development. Renewable energy, and mainly the energy generated by large hydropower generation projects that supply most of the renewable energy consumed by developing countries, requires many technical, legal, financial and social complex processes sustained by innovations and valuable knowledge. Besides these efforts, renewable energy requires a solid infrastructure to generate and distribute the energy resources needed to solve the basic needs of society. This demands a proper construction performance to deliver the energy projects planned according to specifications and respecting environmental and social concerns, which implies the observance of sustainable construction guidelines. But construction projects are complex and demanding and frequently face time and cost overruns that may cause negative impacts on the initial planning and thus on society. The renewable energy issue and the large renewable energy power generation and distribution projects are particularly significant for developing countries and for Latin America in particular, as this region concentrates an important hydropower potential and installed capacity. Using as references the performance of Venezuelan large hydropower generation projects and the Guri dam construction, this research evaluates the tight relationship existing between sustainable construction and knowledge management and their impact to achieve sustainability goals. The knowledge management processes are proposed as a basic strategy to allow learning from successes and failures obtained in previous projects and transform the enhancement opportunites into actions to improve the performance of the renewable energy power generation and distribution projects.

People and Facility Management. The team: the main asset of any management

From the moment we enter a large office building until we leave it, we receive a lot of attentions served by the management of services to the user. However, it is usually quite inappreciable the work that is being developed to keep things running smoothly.The services provided in a building are carried out by people. However, we often tend to forget these people when we talk about the tasks that make that a building operates properly 24 hours a day, 365 days a year.But, for example, what would happen if one day the service provided by the reception in a large building did not function as it should? What would it be like if one day the person performing the service of maintenance of the building's cleaning were not at his post? How would the working day develop if there were not a correct air handling system?People are the foundation of the proper functioning of a building. The work of the Facilities Manager and the Facility Management is the management of their functions: the responsible management of the team.

The potential of organic fertilizers and water management to reduce N2O emissions in Mediterranean climate cropping systems. A review.

Environmental problems related to the use of synthetic fertilizers and to organic waste management have led to increased interest in the use of organic materials as an alternative source of nutrients for crops, but this is also associated with N2O emissions. There has been an increasing amount of research into the effects of using different types of fertilization on N2O emissions under Mediterranean climatic conditions, but the findings have sometimes been rather contradictory. Available information also suggests that water management could exert a high influence on N2O emissions. In this context, we have reviewed the current scientific knowledge, including an analysis of the effect of fertilizer type and water management on direct N2O emissions. A meta-analysis of compliant reviewed experiments revealed significantly lower N2O emissions for organic as opposed to synthetic fertilizers (23% reduction). When organic materials were segregated in solid and liquid, only solid organic fertilizer emissions were significantly lower than those of synthetic fertilizers (28% reduction in cumulative emissions). The EF is similar to the IPCC factor in conventionally irrigated systems (0.98% N2O-N N applied−1), but one order of magnitude lower in rainfed systems (0.08%). Drip irrigation produces intermediate emission levels (0.66%). Differences are driven by Mediterranean agro-climatic characteristics, which include low soil organic matter (SOM) content and a distinctive rainfall and temperature pattern. Interactions between environmental and management factors and the microbial processes involved in N2O emissions are discussed in detail. Indirect emissions have not been fully accounted for, but when organic fertilizers are applied at similar N rates to synthetic fertilizers, they generally make smaller contributions to the leached NO3− pool. The most promising practices for reducing N2O through organic fertilization include: (i) minimizing water applications; (ii) minimizing bare soil; (iii) improving waste management; and (iv) tightening N cycling through N immobilization. The mitigation potential may be limited by: (i) residual effect; (ii) the long-term effects of fertilizers on SOM; (iii) lower yield-scaled performance; and (iv) total N availability from organic sources. Knowledge gaps identified in the review included: (i) insufficient sampling periods; (ii) high background emissions; (iii) the need to provide N2O EF and yield-scaled EF; (iv) the need for more research on specific cropping systems; and (v) the need for full GHG balances. In conclusion, the available information suggests a potential of organic fertilizers and water-saving practices to mitigate N2O emissions under Mediterranean climatic conditions, although further research is needed before it can be regarded as fully proven, understood and developed.