834 resultados para Management control
Resumo:
This manual summarizes the roadside tree and brush control methods used by all of Iowa's 99 counties. It is based on interviews conducted in Spring 2002 with county engineers, roadside managers and others. The target audience of this manual is the novice county engineer or roadside manager. Iowa law is nearly silent on roadside tree and brush control, so individual counties have been left to decide on the level of control they want to achieve and maintain. Different solutions have been developed but the goal of every county remains the same: to provide safe roads for the traveling public. Counties in eastern and southern Iowa appear to face the greatest brush control challenge. Most control efforts can be divided into two categories: mechanical and chemical. Mechanical control includes cutting tools and supporting equipment. A chain saw is the most widely used cutting tool. Tractor mounted boom mowers and brush cutters are used to prune miles of brush but have significant safety and aesthetic limitations and boom mowers are easily broken by inexperienced operators. The advent of tree shears and hydraulic thumbs offer unprecedented versatility. Bulldozers are often considered a method of last resort since they reduce large areas to bare ground. Any chipper that violently grabs brush should not be used. Chemical control is the application of herbicide to different parts of a plant: foliar spray is applied to leaves; basal bark spray is applied to the tree trunk; a cut stump treatment is applied to the cambium ring of a cut surface. There is reluctance by many to apply herbicide into the air due to drift concerns. One-third of Iowa counties do not use foliar spray. By contrast, several accepted control methods are directed toward the ground. Freshly cut stumps should be treated to prevent resprouting. Basal bark spray is highly effective in sensitive areas such as near houses. Interest in chemical control is slowly increasing as herbicides and application methods are refined. Fall burning, a third, distinctly separate technique is underused as a brush control method and can be effective if timed correctly. In all, control methods tend to reflect agricultural patterns in a county. The use of chain saws and foliar sprays tends to increase in counties where row crops predominate, and boom mowing tends to increase in counties where grassland predominates. For counties with light to moderate roadside brush, rotational maintenance is the key to effective control. The most comprehensive approach to control is to implement an integrated roadside vegetation management (IRVM) program. An IRVM program is usually directed by a Roadside Manager whose duties may be shared with another position. Funding for control programs comes from the Rural Services Basic portion of a county's budget. The average annual county brush control budget is about $76,000. That figure is thought not to include shared expenses such as fuel and buildings. Start up costs for an IRVM program are less if an existing control program is converted. In addition, IRVM budgets from three different northeastern Iowa counties are offered for comparison in this manual. The manual also includes a chapter on temporary traffic control in rural work zones, a summary of the Iowa Code as it relates to brush control, and rules on avoiding seasonal disturbance of the endangered Indiana bat. Appendices summarize survey and forest cover data, an equipment inventory, sample forms for record keeping, a sample brush control policy, a few legal opinions, a literature search, and a glossary.
Resumo:
The international recommendations issued by GINA (Global Initiative for Asthma) have undergone considerable adaptations over the last years. This article proposes the local adaptation of those guidelines bearing on the practical aspects of the treatment for the general practitioner's use. One of the fundamental changes in these new guidelines on good practice relates to the permanent adaptation of the treatment on the basis of symptom control rather than on the severity of the asthma. Another change from the old recommendations concerns the manner in which the asthma is categorised into different phases.
Resumo:
Severe sepsis and septic shock are systemic manifestations of the host response to infection. Mortality remains high despite advances in pathophysiological knowledge. Hemodynamic and respiratory management is largely supportive, while early antibiotics administration and source of infection's control are crucial for patient outcome. We review the principles guiding the initial management of these patients in emergency situation.
Resumo:
The new Swiss Chronic Obstructive Pulmonary Disease (COPD) Guidelines are based on a previous version, which was published 10 years ago. The Swiss Respiratory Society felt the need to update the previous document due to new knowledge and novel therapeutic developments about this prevalent and important disease. The recommendations and statements are based on the available literature, on other national guidelines and, in particular, on the GOLD (Global Initiative for Chronic Obstructive Lung Disease) report. Our aim is to advise pulmonary physicians, general practitioners and other health care workers on the early detection and diagnosis, prevention, best symptomatic control, and avoidance of COPD as well as its complications and deterioration.
Resumo:
The emergence of powerful new technologies, the existence of large quantities of data, and increasing demands for the extraction of added value from these technologies and data have created a number of significant challenges for those charged with both corporate and information technology management. The possibilities are great, the expectations high, and the risks significant. Organisations seeking to employ cloud technologies and exploit the value of the data to which they have access, be this in the form of "Big Data" available from different external sources or data held within the organisation, in structured or unstructured formats, need to understand the risks involved in such activities. Data owners have responsibilities towards the subjects of the data and must also, frequently, demonstrate that they are in compliance with current standards, laws and regulations. This thesis sets out to explore the nature of the technologies that organisations might utilise, identify the most pertinent constraints and risks, and propose a framework for the management of data from discovery to external hosting that will allow the most significant risks to be managed through the definition, implementation, and performance of appropriate internal control activities.
Resumo:
The cultivation of sugarcane with intensive use of machinery, especially for harvest, induces soil compaction, affecting the crop development. The control of agricultural traffic is an alternative of management in the sector, with a view to preserve the soil physical quality, resulting in increased sugarcane root growth, productivity and technological quality. The objective of this study was to evaluate the physical quality of an Oxisol with and without control traffic and the resulting effects on sugarcane root development, productivity and technological quality. The following managements were tested: no traffic control (NTC), traffic control consisting of an adjustment of the track width of the tractor and sugarcane trailer (TC1) and traffic control consisting of an adjustment of the track width of the tractor and trailer and use of an autopilot (TC2). Soil samples were collected (layers 0.00-0.10; 0.10-0.20 and 0.20-0.30 m) in the plant rows, inter-row center and seedbed region, 0.30 m away from the plant row. The productivity was measured with a specific weighing scale. The technological variables of sugarcane were measured in each plot. Soil cores were collected to analyze the root system. In TC2, the soil bulk density and compaction degree were lowest and total porosity and macroporosity highest in the plant row. Soil penetration resistance in the plant row, was less than 2 MPa in TC1 and TC2. Soil aggregation and total organic carbon did not differ between the management systems. The root surface and volume were increased in TC1 and TC2, with higher productivity and sugar yield than under NTC. The sugarcane variables did not differ between the managements. The soil physical quality in the plant row was preserved under management TC1 and TC2, with an improved root development and increases of 18.72 and 20.29 % in productivity and sugar yield, respectively.
Resumo:
Thirty percent of patients suffering from malignant disease will develop pulmonary metastases. Effective chemotherapy is lacking for many of these tumors. Many studies suggest survival benefit in selected patients when pulmonary metastasectomy allows complete resection. Several operative approach may be offered in order to achieve complete resection and maximal lung sparring. Pre-operative workup must assess the control of the primary tumor and the possibility of performing complete resection. Minimally invasive approaches may offer better quality life and equivalent oncologic outcomes than open approach.
Resumo:
Peripheral assessment of bone density using photon absorptiometry techniques has been available for over 40 yr. The initial use of radio-isotopes as the photon source has been replaced by the use of X-ray technology. A wide variety of models of single- or dual-energy X-ray measurement tools have been made available for purchase, although not all are still commercially available. The Official Positions of the International Society for Clinical Densitometry (ISCD) have been developed following a systematic review of the literature by an ISCD task force and a subsequent Position Development Conference. These cover the technological diversity among peripheral dual-energy X-ray absorptiometry (pDXA) devices; define whether pDXA can be used for fracture risk assessment and/or to diagnose osteoporosis; examine whether pDXA can be used to initiate treatment and/or monitor treatment; provide recommendations for pDXA reporting; and review quality assurance and quality control necessary for effective use of pDXA.
Resumo:
The Office of the Drug Policy Coordinator is established in Chapter 80E of the Code of Iowa. The Coordinator directs the Governor’s Office of Drug Control Policy; coordinates and monitors all statewide counter-drug efforts, substance abuse treatment grants and programs, and substance abuse prevention and education programs; and engages in other related activities involving the Departments of public safety, corrections, education, public health, and human services. The coordinator assists in the development of local and community strategies to fight substance abuse, including local law enforcement, education, and treatment activities. The Drug Policy Coordinator serves as chairperson to the Drug Policy Advisory Council. The council includes the directors of the departments of corrections, education, public health, public safety, human services, division of criminal and juvenile justice planning, and human rights. The Council also consists of a prosecuting attorney, substance abuse treatment specialist, substance abuse prevention specialist, substance abuse treatment program director, judge, and one representative each from the Iowa Association of Chiefs of Police and Peace Officers, the Iowa State Police Association, and the Iowa State Sheriff’s and Deputies’ Association. Council members are appointed by the Governor and confirmed by the Senate. The council makes policy recommendations related to substance abuse education, prevention, and treatment, and drug enforcement. The Council and the Coordinator oversee the development and implementation of a comprehensive State of Iowa Drug Control Strategy. The Office of Drug Control Policy administers federal grant programs to improve the criminal justice system by supporting drug enforcement, substance abuse prevention and offender treatment programs across the state. The ODCP prepares and submits the Iowa Drug and Violent Crime Control Strategy to the U.S. Department of Justice, with recommendations from the Drug Policy Advisory Council. The ODCP also provides program and fiscal technical assistance to state and local agencies, as well as program evaluation and grants management.
Resumo:
Quantitative information from magnetic resonance imaging (MRI) may substantiate clinical findings and provide additional insight into the mechanism of clinical interventions in therapeutic stroke trials. The PERFORM study is exploring the efficacy of terutroban versus aspirin for secondary prevention in patients with a history of ischemic stroke. We report on the design of an exploratory longitudinal MRI follow-up study that was performed in a subgroup of the PERFORM trial. An international multi-centre longitudinal follow-up MRI study was designed for different MR systems employing safety and efficacy readouts: new T2 lesions, new DWI lesions, whole brain volume change, hippocampal volume change, changes in tissue microstructure as depicted by mean diffusivity and fractional anisotropy, vessel patency on MR angiography, and the presence of and development of new microbleeds. A total of 1,056 patients (men and women ≥ 55 years) were included. The data analysis included 3D reformation, image registration of different contrasts, tissue segmentation, and automated lesion detection. This large international multi-centre study demonstrates how new MRI readouts can be used to provide key information on the evolution of cerebral tissue lesions and within the macrovasculature after atherothrombotic stroke in a large sample of patients.
Resumo:
ABSTRACT Nitrogen losses by ammonia (NH3) volatilization can be reduced by appropriate irrigation management or by alternative N sources, replacing urea. The objective of this study was to evaluate the efficiency of irrigation management and N source combinations in decreasing NH3 volatilization from an Argissolo Vermelho Distrófico típico cultivated for 28 years with black oat (Avena strigosa) and maize (Zea mays), under no-tillage in the region of Depressão Central, Rio Grande do Sul, Brazil. The experiment was arranged in a randomized block design with split plots with three replications, where the main plots consisted of irrigation systems: no irrigation; irrigation immediately before and irrigation immediately after fertilization. The subplots were treated with different N sources: urea, urea with urease inhibitor and slow-release fertilizer, at an N rate of 180 kg ha-1, broadcast over maize, plus a control treatment without N fertilization. Ammonia volatilization was assessed using semi-open static collectors for 1, 2, 4, 6, and 10 days after N fertilization. In general, more than 90 % of total NH3-N losses occurred until three days after N fertilization, with peaks up to 15.4 kg ha-1 d-1. The irrigation was efficient to reduce NH3 losses only when applied after N fertilization. However, reductions varied according to the N fertilizer, and were higher for urea (67 %) and slightly lower for urea with urease inhibitor (50 %) and slow-release fertilizer (40 %), compared with the mean of the treatments without irrigation and irrigation before fertilization. The use of urea with urease inhibitor instead of urea was only promising under volatilization-favorable conditions (no irrigation or irrigation before N fertilization). Compared to urea, slow-release fertilizer did not reduce ammonia volatilization in any of the rainfed or irrigated treatments.
Resumo:
Background: there is little information regarding the health status of migrants compared to subjects who remained in their country of origin. The aim was to compare Portuguese living in Porto (Portugal) with Portuguese migrants living in Lausanne (Switzerland). Design: cross-sectional studies conducted in Porto (EpiPorto, n=1150) and Lausanne (CoLaus, n=388) among Portuguese subjects aged between 35 and 65 years. Methods: body mass index, blood pressure, cholesterol and glucose levels were assessed using standardized procedures. Educational level, antihypertensive, hypocholesterolemic and antidiabetic treatments were collected using questionnaires. Results: Portuguese living in Lausanne were younger, more frequently male and had a lower education than Portuguese living in Porto. After multivariate adjustment, Portuguese living in Porto had a higher likelihood of being obese [Odds ratio and 95% confidence interval: 1.40 (1.01-1.94)] or abdominal obese [OR: 1.40 (1.02-1.93)] than Portuguese living in Lausanne. Portuguese living in Porto had a higher likelihood of being hypertensive than Portuguese living in Lausanne [OR: 1.38 (1.01-1.90)], while no differences were found regarding hypertension management and control. Portuguese living in Porto had a higher likelihood of being hypercholesterolemic [OR: 1.40 (1.06-1.85)] and were less likely to be treated [OR: 0.47 (0.27-0.83)] and controlled [OR: 0.47 (0.27-0.83)] than Portuguese living in Lausanne. Finally, no differences were found regarding smoking, prevalence and management of diabetes. Conclusion: Portuguese living in Lausanne, Switzerland, present a better cardiovascular risk profile and tend to be better managed regarding their cardiovascular risk factors than Portuguese living in Porto, Portugal.
Resumo:
Transportation agencies in Iowa are responsible for a significant public investment with the installation and maintenance of traffic control devices and pavement markings. Included in this investment are thousands of signs and other inventory items, equipment, facilities, and staff. The proper application of traffic control devices and pavement markings is critical to public safety on streets and highways, and local governments have a prescribed responsibility under the Code of Iowa to properly manage these assets. This research report addresses current traffic control and pavement marking application, maintenance, and management in Iowa.
Resumo:
The project described herein has led to a convenient, computer-based expert system for identifying and evaluating potentially effective erosion- and sedimentation-control measures for use in roadway construction throughout Iowa and elsewhere in the Midwest. The expert system is intended to be an accessible and efficient practical resource to aid state, county, and municipal engineers in the selection of the best management practices for preventing unwanted erosion and sedimentation at roadway construction sites, during and after construction.
Resumo:
La prévalence du diabète peut être estimée entre 20 et 30% parmi les patients en hôpital aigu. Il a été démontré que l'hyperglycémie, même modérée, est associée à une augmentation de la morbi-mortalité hospitalière, tandis que le contrôle glycémique efficace a un impact favorable sur celle-ci. La prise en charge de l'hyperglycémie demeure pourtant largement inefficace hors des soins intensifs, en raison de la persistance d'une pratique inadaptée. Nous développons actuellement un projet de soins destiné à faire changer les pratiques. Pour un contrôle glycémique efficace, une formation des soignants à une gestion basée sur le concept de couverture des besoins en insuline du patient est nécessaire. La démarche doit être intégrée à une approche de type systémique, prenant en compte le contexte dans lequel les soignants évoluent. The hospital inpatient prevalence of diabetes mellitus can be estimated between 20 and 30%. Even moderate hyperglycemia is associated with increased morbidity and mortality in the acute care setting, whereas efficient glycemic control has been shown to improve both of them significantly. Glycemic control however remains largely inefficient outside of the intensive care unit due to the persistance of an inadequate glycemic management practice. We are currently developing a clinical care project aimed at changing this practice. For an efficient glycemic control, a training programme for health care professionals based on the concept of covering the insulin needs of the patient is mandatory. This programme needs to be integrated in a systemic approach, which takes the professionals' context in account.