Management and outcomes of anorectal infection in the cancer patient

Background. The objective of this retrospective cohort study is to examine the presentation and outcomes for a contemporary series of cancer patients with anorectal infection. In addition, we seek to identify factors which are associated with surgical intervention. ^ Methods. The study cohort was identified from ICD-9 codes for diagnosis of infection of the anal and rectal region and patients who underwent a surgical oncology consultation between 1/2000 and 12/2006. Clinical presentation, treatment rendered, and outcomes were retrospectively recorded. ^ Results. Of the 100 patients evaluated by the surgical oncology service for anorectal infection, 42 were treated non-operatively and 58 underwent surgical intervention. Factors associated with surgical intervention based on logistic multivariable analysis included the diagnosis of an abscess (odds ratio [OR] 10.5; 95% confidence interval [CI] 2.9-38.5) and the documentation of erythema on physical examination (OR 3.1; 95% CI 1.1-8.4). Thrombocytopenia (platelets < 50,000) was associated with non-operative management (OR 0.3; 95% CI 0.1-0.7). Incision and drainage was the most common surgical procedure (79%) while a wide debridement for a necrotizing soft tissue infection was required in 2 patients. Infection-specific 90-day mortality was only 1% (N=1). However, the median overall survival for the entire cohort was only 14.4 months (95% CI 7.9-19.5). ^ Conclusions. Non-operative management is a reasonable treatment option for anorectal infection in patients with cancer. Identification of an abscess, erythema on physical exam, and thrombocytopenia were associated with management strategy. Although rare, necrotizing soft tissue infections are associated with significant mortality. ^

Analysis of a disaster medical track for the Certificate in Emergency Management and Preparedness Program at the University of Texas at Dallas

Since the tragic events of September 11, 2001, the United States has engaged in building the infrastructure and developing the expertise necessary to protect its borders and its citizens from further attacks against its homeland. One approach has been the development of academic courses to educate individuals on the nature and dangers of subversive attacks and to prepare them to respond to attacks and other large-scale emergencies in their roles as working professionals, participating members of their communities, and collaborators with first responders. An initial review of the literature failed to reveal any university-based emergency management courses or programs with a disaster medical component, despite the public health significance and need for such programs. In the Fall of 2003, The School of Management at The University of Texas at Dallas introduced a continuing education Certificate in Emergency Management and Preparedness Program. This thesis will (1) describe the development and implementation of a new Disaster Medical Track as a component of this Certificate in Emergency Management and Preparedness Program, (2) analyze the need for and effectiveness of this Disaster Medical Track, and (3) propose improvements in the track based on this analysis. ^

Organizational perspectives on the management and evaluation of large -scale multicenter controlled clinical trials: An exploratory study of participation in the beta -blocker heart attack trial

A review of literature related to appointment-keeping served as the basis for the development of an organizational paradigm for the study of appointment-keeping in the Beta-blocker Heart Attack Trial (BHAT). Features of the organizational environment, demographic characteristics of BHAT enrollees, organizational structure and processes and previous organizational performance variables were measured so as to provide exploratory information relating to the appointment-keeping behavior of 3,837 participants enrolled at thirty-two Clinical Centers. Results suggest that the social context of individual behavior is an important consideration for the understanding of patient compliance. In particular, the degree to which previous organizational performance--as measured by obtaining recruitment goals--and the ability to utilize resources had particularly strong bivariate associations with appointment-keeping. Implications for future theory development, research and practical implications were provided as was a suggestion for the development of multidisciplinary research efforts conducted within the context of Centers for the study and application of adherence behaviors. ^

Public management and regional development

Este trabajo tiene por objetivo analizar los elementos de la gestión pública del desarrollo regional a partir de las condiciones del desarrollo regional y las nociones de desarrollo local y desarrollo sustentable. Bajo estas premisas se avanzan planteamientos esquemáticos en torno a la gestión pública del desarrollo local

Information Management and Mediation in a Digital Reference Service Focused in Social Sciences

This paper investigates the current relationship between information management and information mediation along with the digital reference service through a case study which took place in an academic library. The concept of information mediation is herein analyzed, since a conceptual examination provides elements that will help people to comprehend and evaluate the concerned service. The information professional plays a very important role in the mediation aforementioned, which may be directly or indirectly; consciously or unconsciously; by himself/herself or plurally; individually or inserted into a group ? in all such manners that mediator facilitates the acquisition of information, fully or partially satisfying a user?s need of all sorts of knowledge. Meanwhile, we here approach information management from a scope that points out a description over performed activities concerned to policies and procedures put into effect until the service evaluation by proposing a criterion for such point. Finally, we outline a few actions to be implemented in long-term perspective, which goal is to continually ameliorate such assistance, taking in account the human factor

Information Management and Mediation in a Digital Reference Service Focused in Social Sciences

This paper investigates the current relationship between information management and information mediation along with the digital reference service through a case study which took place in an academic library. The concept of information mediation is herein analyzed, since a conceptual examination provides elements that will help people to comprehend and evaluate the concerned service. The information professional plays a very important role in the mediation aforementioned, which may be directly or indirectly; consciously or unconsciously; by himself/herself or plurally; individually or inserted into a group ? in all such manners that mediator facilitates the acquisition of information, fully or partially satisfying a user?s need of all sorts of knowledge. Meanwhile, we here approach information management from a scope that points out a description over performed activities concerned to policies and procedures put into effect until the service evaluation by proposing a criterion for such point. Finally, we outline a few actions to be implemented in long-term perspective, which goal is to continually ameliorate such assistance, taking in account the human factor

Public management and regional development

Este trabajo tiene por objetivo analizar los elementos de la gestión pública del desarrollo regional a partir de las condiciones del desarrollo regional y las nociones de desarrollo local y desarrollo sustentable. Bajo estas premisas se avanzan planteamientos esquemáticos en torno a la gestión pública del desarrollo local

Public management and regional development

Este trabajo tiene por objetivo analizar los elementos de la gestión pública del desarrollo regional a partir de las condiciones del desarrollo regional y las nociones de desarrollo local y desarrollo sustentable. Bajo estas premisas se avanzan planteamientos esquemáticos en torno a la gestión pública del desarrollo local

Information Management and Mediation in a Digital Reference Service Focused in Social Sciences

This paper investigates the current relationship between information management and information mediation along with the digital reference service through a case study which took place in an academic library. The concept of information mediation is herein analyzed, since a conceptual examination provides elements that will help people to comprehend and evaluate the concerned service. The information professional plays a very important role in the mediation aforementioned, which may be directly or indirectly; consciously or unconsciously; by himself/herself or plurally; individually or inserted into a group ? in all such manners that mediator facilitates the acquisition of information, fully or partially satisfying a user?s need of all sorts of knowledge. Meanwhile, we here approach information management from a scope that points out a description over performed activities concerned to policies and procedures put into effect until the service evaluation by proposing a criterion for such point. Finally, we outline a few actions to be implemented in long-term perspective, which goal is to continually ameliorate such assistance, taking in account the human factor

Naval Station Rota reptile and amphibian survey

This report summarizes the results of a herpetofauna (reptile and amphibian) survey at Naval Station Rota (NAVSTA Rota), Spain conducted during June and October 2008, March 2009 and July 2010. The main objective of this investigation was to develop an inventory of herpetofauna, including their base-wide distribution and habitat use. Data from these surveys was used to supplement information in the 2010 Cultural/Natural Resources Management User's Guide and can also be used for environmental planning, natural resource management and conservation. Prior to this survey, only cursory field work had been conducted on the station for herpetofauna with the exception of the common chameleon (Chamaleo chamaeleon). A comprehensive population count and habitat assessment for the common chameleon was conducted in September 2001.

Ecosystem regimes and responses in a coupled ancient lake system from MIS 5b to present: the diatom record of lakes Ohrid and Prespa

We reconstruct the aquatic ecosystem interactions since the last interglacial period in the oldest, most diverse, hydrologically connected European lake system, by using palaeolimnological diatom and selected geochemistry data from Lake Ohrid “DEEP site” core and equivalent data from Lake Prespa core, Co1215. Driven by climate forcing, the lakes experienced two adaptive cycles during the last 92 ka: "interglacial and interstadial" and "glacial" cycle. The short-term ecosystems reorganizations, e.g. regime shifts within these cycles substantially differ between the lakes, as evident from the inferred amplitudes of variation. The deeper Lake Ohrid shifted between ultra oligo- and oligotrophic regimes in contrast to the much shallower Lake Prespa, which shifted from a deeper, (oligo-) mesotrophic to a shallower, eutrophic lake and vice versa. Due to the high level of ecosystem stability (e.g. trophic state, lake level), Lake Ohrid appears relatively resistant to external forcing, such as climate and environmental change. Recovering in a relatively short time from major climate change, Lake Prespa is a resilient ecosystem. At the DEEP site, the decoupling between the lakes' response to climate change is marked in the prolonged and gradual changes during the MIS 5/4 and 2/1 transitions. These response differences and the lakes' different physical and chemical properties may limit the influence of Lake Prespa on Lake Ohrid. Regime shifts of Lake Ohrid due to potential hydrological change in Lake Prespa are not evident in the data presented here. Moreover, a complete collapse of the ecosystems functionality and loss of their diatom communities did not happen in either lake for the period presented in the study.

Knowledge Management and Information Systems based on Workflow Technology

Knowledge management is critical for the success of virtual communities, especially in the case of distributed working groups. A representative example of this scenario is the distributed software development, where it is necessary an optimal coordination to avoid common problems such as duplicated work. In this paper the feasibility of using the workflow technology as a knowledge management system is discussed, and a practical use case is presented. This use case is an information system that has been deployed within a banking environment. It combines common workflow technology with a new conception of the interaction among participants through the extension of existing definition languages.

Normalización del análisis de la piedra y conservación del patrimonio cultural. The Standardization of Stone Analysis and Conservation of Cultural Heritage

La normalización de los métodos de análisis y de los principales aspectos relacionados con la conservación de los bienes culturales ha empezado en 2004 con la creación del comité europeo de normalización, CEN/TC 346 Conservation of Cultural Property, que tiene la responsabilidad no solamente de redactar protocolos de ensayos en laboratorio, sino también proponer las recomendaciones más adecuadas para designarlos de forma consensual y conservarlos de la forma más apropiada. Se comentan los aspectos relacionados con el origen de estas normas, el trabajo desarrollado y que muchas de ellas, aunque no estén dirigidas específicamente a la piedra, tienen en cuenta la presencia de este material en objetos arqueológicos, obras de arte, estructuras de fábricas y elementos ornamentales.

Knowledge Management and Leadership in the Higher Education: A First Approach

Today, it is more and more important to develop competences in the learning process of the university students (that is to say, to acquire knowledge but also skills, abilities, attitudes and values). This is because professional practice requires that the future graduates design and market products, defend the interests of their clients, be introduced in the Administration or, even, in the Politics. Universities must form professionals that become social and opinion leaders, consultants, advisory, entrepreneurs and, in short, people with capacity to solve problems. This paper offers a tool to evaluate the application for the professor of different styles of management in the process of the student’s learning. Its main contribution consists on advancing toward the setting in practice of a model that overcomes the limitations of the traditional practices based on the masterful class, and that it has been applied in Portugal and Spain.

Evaluation of reproductive sucess and conservation strategies for Senecio coincyi (Asteraceae), a narrow and threatened species

Senecio coincyi is a threatened endemic plant of central western Spain, with a very narrow extent of occurrence. The reproductive success and germination behaviour of this species were studied. The area of occupancy, habitat types and size of 13 known subpopulations of S. coincyi were evaluated. The number of individuals that form all these subpopulations was counted. In addition, the number of flowers and cypselas per fruit head and the number of fruit heads per individual plant were recorded in a subset of subpopulations. Germination tests were carried out to evaluate the effect of temperature and light regimes on, and possible intraspecific variation in, cypsela germination. Cypselas reached very high germination percentages (90?100%) from 15?C to 30?C. However, the germination decreased (19%) at 10?C. The light conditions assayed (16-h light photoperiod and complete darkness) did not significantly affect cypsela germination. In general, there was no intraspecific variability in germination patterns of S. coincyi cypselas. Livestock is the most important factor that can be a threat for this species. S. coincyi showed high reproductive success and, therefore, its conservation problems are not due to agents related to its reproduction, but rather to other factors such as alteration of its habitat caused by the presence of livestock.