873 resultados para non-dialysis management
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The industry has not clearly focused on many important problems, such as rewarding service workers based on productivity. Instead, many industry leaders have focused on "straw men issues," issues that are more rhetoric than substance. The authors examine some of these so-called is- sues in detail: governmental wage policies, immigration laws, the quality of the work force, service worker training, and gratuity management, to provide a fresh look at worker productivity beyond the rhetoric and myths that prevail
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The qualities of vision, communication, trust, and perseverance are strongly identified by leaders in the lodging and food service businesses as characterizing effective leaders. The authors report on their research into essential qualities which mark the innovative industry leader.
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Does your organization integrate the management of risk and opportunity Have you evaluated non-traditional risk exposures? These are critically important questions as today's increasingly complex business environment exposes hospitality companies to numerous risks.
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As most hospitality industry managers in the U.S. are already aware, there is a growing and persistent shortage of labor available for service-sector, non-career jobs, the very jobs so vital to the industry. In most cases, recruitment efforts for these jobs are targeted toward younger workers, those under age 25. The authors explore issues regarding the attractiveness of non-career jobs in the eyes of young persons and suggest that, in addition to factors related to the job itself (pay, hours, type of work), the type of procedures used by employers to make selection decisions are equally influential. Recommendations are made concerning how hospitality employers with non-career positions to fill can maximize the chances of successfully staffing their organizations.
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In - Service Management Concepts: Implications for Hospitality Management – a study by K. Michael Haywood, Associate Professor, School of Hotel and Food Administration, University of Guelph, Ontario, Canada, Associate Professor Haywood initially proffers: “The study and application of hospitality management has progressed on its own for many years; however, managers are not immune to the knowledge gained from study of other service industries. The author synthesizes what is happening in the area of service management, looks at its relevance to hospitality management, and identifies a few important implications of service management for hospitality managers.” The author draws a distinction between non-denominated service management, and service management as it applies to the hospitality industry. This is done to make an apparent comparison, as many people would assume the two are one in the same. They are not, and the contrast works well here. “While much of what we already know about effective management applies to service industries, some of the traditional concepts of management are inadequate in solving the problems faced by service businesses,” Haywood points out. “If a body of knowledge to be known as service management already exists, or is being developed, where does it fit relative to hospitality management,” Haywood asks. According to John Bateson, Testing a Conceptual Framework for Consumer Service Marketing, there are four criteria used to judge service management. Haywood details these for you, the reader, by way of citation. Haywood points to the difficulty in pin-pointing the intangibles that underpin the service industry. Since service is a concept rather than a touchable good, such as inventory, problems arise for both the organization and the client. Haywood points to a classic study of four service industries in France to illustrate the problems, although no realistic suggestions address the issues. “Over the past few years a variety of system models have been developed to explain the service process, that is, how the service is designed, produced, delivered, and consumed,” Haywood offers. These models are depicted in Appendices A-E. In offering perspectives on how the hospitality industry can gain from the experiences of service management, Haywood observes: “Service management places particular emphasis on a strategic outlook. Hospitality firms would be wise to carefully examine how they are perceived in the marketplace vis-a-vis their service concept, position, competitive situation, and management’s leadership abilities.” “Learning from the experiences of other service firms can help keep a company on track, that is, providing needed and valued services,” he closes the thought.
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The high rate of restaurant employee turnover, particularly of the non-supervisory employee, is a continuing problem. The authors assess the possible correlates of this turnover and their relative strengths, ranking and comparing working hours, quality of supervision, chance for promotion, on-the-job training, pay, work of others, employees' attitudes, and management's interest in employees to present possible solutions for the high rate of turnover.
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Objective. The main purpose of this study was to evaluate the associations of lifestyle medical advice and non-HDL cholesterol control of a nationally representative US sample of adults with hypercholesterolemia by race/ethnicity. Methods. Data were collected by appending sociodemographic, anthropometric, and laboratory data from two cycles of the National Health and Nutrition Survey (2007-2008 and 2009-2010). This study acquired data from male and female adults aged ≥ 20 years (N = 11,577), classified as either Mexican American (MA), (), other Hispanic (OH) (), Black non-Hispanic (BNH) (), or White non-Hispanic (WNH) (). Results. Minorities were more likely to report having received dietary, weight management, and exercise recommendations by healthcare professionals than WNH, adjusting for confounders. Approximately 80% of those receiving medical advice followed the recommendation, regardless of race/ethnicity. Of those who received medical advice, reporting “currently controlling or losing weight” was associated with lower non-HDL cholesterol. BNH who reported “currently controlling or losing weight” had higher non-HDL cholesterol than WNH who reported following the advice. Conclusion. The results suggest that current methods of communicating lifestyle advice may not be adequate across race/ethnicity and that a change in perspective and delivery of medical recommendations for persons with hypercholesterolemia is needed.
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One in five adults 65 years and older has diabetes. Coping with diabetes is a lifelong task, and much of the responsibility for managing the disease falls upon the individual. Reports of non-adherence to recommended treatments are high. Understanding the additive impact of diabetes on quality of life issues is important. The purpose of this study was to investigate the quality of life and diabetes self-management behaviors in ethnically diverse older adults with type 2 diabetes. The SF-12v2 was used to measure physical and mental health quality of life. Scores were compared to general, age sub-groups, and diabetes-specific norms. The Transtheoretical Model (TTM) was applied to assess perceived versus actual behavior for three diabetes self-management tasks: dietary management, medication management, and blood glucose self-monitoring. Dietary intake and hemoglobin A1c values were measured as outcome variables. Utilizing a cross-sectional research design, participants were recruited from Elderly Nutrition Program congregate meal sites (n = 148, mean age 75). ^ Results showed that mean scores of the SF-12v2 were significantly lower in the study sample than the general norms for physical health (p < .001), mental health (p < .01), age sub-group norms (p < .05), and diabetes-specific norms for physical health (p < .001). A multiple regression analysis found that adherence to an exercise plan was significantly associated with better physical health (p < .001). Transtheoretical Model multiple regression analyses explained 68% of the variance for % Kcal from fat, 41% for fiber, 70% for % Kcal from carbohydrate, and 7% for hemoglobin A 1c values. Significant associations were found between TTM stage of change and dietary fiber intake (p < .01). Other significant associations related to diet included gender (p < .01), ethnicity (p < .05), employment (p < .05), type of insurance (p < .05), adherence to an exercise plan (p < .05), number of doctor visits/year ( p < .01), and physical health (p < .05). Significant associations were found between hemoglobin A1c values and age ( p < .05), being non-Hispanic Black (p < .01), income (p < .01), and eye problems (p < .05). ^ The study highlights the importance of the beneficial effects of exercise on quality of life issues. Furthermore, application of the Transtheoretical Model in conjunction with an assessment of dietary intake may be valuable in helping individuals make lifestyle changes. ^
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Cognitive behavioral therapy has been shown to be promising for the treatment of individuals experiencing psychotic symptoms, who are often diagnosed with schizophrenia. Using a non-random non-equivalent comparison group design (n = 26), this study explores whether an individually mentored self-help and self-paced intervention based upon cognitive behavioral approaches to auditory hallucinations or "hearing voices" makes a significant positive difference for individuals with major mental disorder diagnoses and psychotic symptoms who are residing in the community and receiving community mental health services. The mentored self-help intervention uses a workbook (Coleman & Smith, 1997) that stemmed from the British psychiatric survivor and "voice hearers"' movements and from cognitive behavioral approaches to treating psychotic symptoms. Thirty individuals entered the study. Pre- and post-intervention assessments of 15 participants in the intervention group and 11 participants in the comparison group were carried out using standardized instruments, including the Rosenberg Self-Esteem Scale, the Brief Psychiatric Rating Scale, and the Hoosier Assurance Plan Inventory - Adult. Four specific research questions address whether levels of self-esteem, overall psychotic symptoms, depression-anxiety, and disruption in life improved in the intervention group, relative to the comparison group. Pre- and post-assessment scores were analyzed using repeated measures analysis of variance. Results showed no significant difference on any measure, with the exception of the Brief Psychiatric Rating subscale for Anxious Depression, which showed a statistically significant pre-post difference with a strong effect size. A conservative interpretation of this single positive result is that it is due to chance. An alternative interpretation is that the mentored self-help intervention made an actual improvement in the level of depression-anxiety experienced by participants. If so, this is particularly important given high levels of depression and suicide among individuals diagnosed with schizophrenia. This alternative interpretation supports further research on the intervention utilized in this study. ^
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Computer networks produce tremendous amounts of event-based data that can be collected and managed to support an increasing number of new classes of pervasive applications. Examples of such applications are network monitoring and crisis management. Although the problem of distributed event-based management has been addressed in the non-pervasive settings such as the Internet, the domain of pervasive networks has its own characteristics that make these results non-applicable. Many of these applications are based on time-series data that possess the form of time-ordered series of events. Such applications also embody the need to handle large volumes of unexpected events, often modified on-the-fly, containing conflicting information, and dealing with rapidly changing contexts while producing results with low-latency. Correlating events across contextual dimensions holds the key to expanding the capabilities and improving the performance of these applications. This dissertation addresses this critical challenge. It establishes an effective scheme for complex-event semantic correlation. The scheme examines epistemic uncertainty in computer networks by fusing event synchronization concepts with belief theory. Because of the distributed nature of the event detection, time-delays are considered. Events are no longer instantaneous, but duration is associated with them. Existing algorithms for synchronizing time are split into two classes, one of which is asserted to provide a faster means for converging time and hence better suited for pervasive network management. Besides the temporal dimension, the scheme considers imprecision and uncertainty when an event is detected. A belief value is therefore associated with the semantics and the detection of composite events. This belief value is generated by a consensus among participating entities in a computer network. The scheme taps into in-network processing capabilities of pervasive computer networks and can withstand missing or conflicting information gathered from multiple participating entities. Thus, this dissertation advances knowledge in the field of network management by facilitating the full utilization of characteristics offered by pervasive, distributed and wireless technologies in contemporary and future computer networks.
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Non-native fishes present a management challenge to maintaining Everglades National Park (ENP) in a natural state. We summarized data from long-term fish monitoring studies in ENP and reviewed the timing of introductions relative to water-management changes. Beginning in the early 1950s, management actions have added canals, altered wetland habitats by flooding and drainage, and changed inflows into ENP, particularly in the Taylor Slough/C-111 basin and Rocky Glades. The first non-native fishes likely entered ENP by the late 1960s, but species numbers increased sharply in the early 1980s when new water-management actions were implemented. After 1999, eight non-native species and three native species, all previously recorded outside of Park boundaries, were found for the first time in ENP. Several of these incursions occurred following structural and operational changes that redirected water deliveries to wetlands open to the eastern boundary canals. Once established, control non-native fishes in Everglades wetlands is difficult; therefore, preventing introductions is key to their management. Integrating actions that minimize the spread of non-native species into protected natural areas into the adaptive management process for planning, development, and operation of water-management features may help to achieve the full suite of objectives for Everglades restoration.
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Ecosystem management practices that modify the major drivers and stressors of an ecosystem often lead to changes in plant community composition. This paper examines how closely the trajectory of vegetation change in seasonally-flooded wetlands tracks management-induced alterations in hydrology and soil characteristics. We used trajectory analysis, a multivariate method designed to test hypotheses about rates and directions of community change, to examine vegetation shifts in response to changes in water management practices within the Taylor Slough basin of Everglades National Park. We summarized vegetation data by non-metric multidimensional scaling ordination, and examined the time trajectory of each site along environmental vectors representing hydrology and soil phosphorus gradients. In the Taylor Slough basin, vegetation change trajectories closely followed the hydrologic changes caused by the operation of water pumps and detention ponds adjacent to the canals. We also observed a shift in vegetation composition along a vector of increasing soil phosphorus, which suggests the need for implementing measures to avoid P-enrichment in southern Everglades marl prairies. This study indicates that shifts in vegetation composition in response to changes in hydrologic conditions and associated parameters may be detected through trajectory analysis, thereby providing feedback for adaptive management of wetland ecosystems.
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This dissertation consists of three essays on different aspects of water management. The first essay focuses on the sustainability of freshwater use by introducing the notion that altruistic parents do bequeath economic assets for their offspring. Constructing a two-period, over-lapping generational model, an optimal ratio of consumption and pollution for old and young generations in each period is determined. Optimal levels of water consumption and pollution change according to different parameters, such as, altruistic degree, natural recharge rate, and population growth. The second essay concerns water sharing between countries in the case of trans-boundary river basins. The paper recognizes that side payments fail to forge water-sharing agreement among the international community and that downstream countries have weak bargaining power. An interconnected game approach is developed by linking the water allocation issue with other non-water issues such as trade or border security problems, creating symmetry between countries in bargaining power. An interconnected game forces two countries to at least partially cooperate under some circumstances. The third essay introduces the concept of virtual water (VW) into a traditional international trade model in order to estimate water savings for a water scarce country. A two country, two products and two factors trade model is developed, which includes not only consumers and producer's surplus, but also environmental externality of water use. The model shows that VW trade saves water and increases global and local welfare. This study should help policy makers to design appropriate subsidy or tax policy to promote water savings especially in water scarce countries.^
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Objective: The main purpose of this study was to evaluate the associations of lifestyle medical advice and non-HDL cholesterol control of a nationally representative US sample of adults with hypercholesterolemia by race/ethnicity. Methods: Data were collected by appending sociodemographic, anthropometric, and laboratory data from two cycles of the National Health and Nutrition Survey (2007-2008 and 2009-2010). This study acquired data from male and female adults aged ≥ 20 years (N = 11,577), classified as either Mexican American (MA), (), other Hispanic (OH) (), Black non-Hispanic (BNH) (), or White non-Hispanic (WNH) (). Results: Minorities were more likely to report having received dietary, weight management, and exercise recommendations by healthcare professionals than WNH, adjusting for confounders. Approximately 80% of those receiving medical advice followed the recommendation, regardless of race/ethnicity. Of those who received medical advice, reporting “currently controlling or losing weight” was associated with lower non-HDL cholesterol. BNH who reported “currently controlling or losing weight” had higher non-HDL cholesterol than WNH who reported following the advice. Conclusion: The results suggest that current methods of communicating lifestyle advice may not be adequate across race/ethnicity and that a change in perspective and delivery of medical recommendations for persons with hypercholesterolemia is needed.
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Men, particularly minorities, have higher rates of diabetes as compared with their counterparts. Ongoing diabetes self-management education and support by specialists are essential components to prevent the risk of complications such as kidney disease, cardiovascular diseases, and neurological impairments. Diabetes self-management behaviors, in particular, as diet and physical activity, have been associated with glycemic control in the literature. Recommended medical care for diabetes may differ by race/ethnicity. This study examined data from the National Health and Nutrition Examination Surveys, 2007 to 2010 for men with diabetes (N = 646) from four racial/ethnic groups: Mexican Americans, other Hispanics, non-Hispanic Blacks, and non-Hispanic Whites. Men with adequate dietary fiber intake had higher odds of glycemic control (odds ratio = 4.31, confidence interval [1.82, 10.20]), independent of race/ethnicity. There were racial/ethnic differences in reporting seeing a diabetes specialist. Non-Hispanic Blacks had the highest odds of reporting ever seeing a diabetes specialist (84.9%) followed by White non-Hispanics (74.7%), whereas Hispanics reported the lowest proportions (55.2% Mexican Americans and 62.1% other Hispanics). Men seeing a diabetes specialist had the lowest odds of glycemic control (odds ratio = 0.54, confidence interval [0.30, 0.96]). The results of this study suggest that diabetes education counseling may be selectively given to patients who are not in glycemic control. These findings indicate the need for examining referral systems and quality of diabetes care. Future studies should assess the effectiveness of patient-centered medical care provided by a diabetes specialist with consideration of sociodemographics, in particular, race/ethnicity and gender.