930 resultados para Event Management
Resumo:
On 15-16 January 2005, three offshore species of cetaceans (33 short-finned pilot whales, Globicephala macrorhynchus, one minke whale, Balaenoptera acutorostrata, and two dwarf sperm whales, Kogia sima) stranded alive on the beaches of North Carolina. The pilot whales stranded near Oregon Inlet, the minke whale in northern North Carolina, and the dwarf sperm whales near Cape Hatteras. Live strandings of three species in one weekend was unique in North Carolina and qualified as an Unusual Mortality Event. Gross necropsies were conducted on 16-17 January 2005 on 27 pilot whales, two dwarf sperm whales, and the minke whale. Samples were collected for clinical pathology, parasitology, gross pathology, histopathology, microbiology and serology. There was variation in the number of animals sampled for each collection type, however, due to carcasses washing off the beach or degradation in carcass condition during the course of the response. Comprehensive histologic examination was conducted on 16 pilot whales, both dwarf sperm whales, and the minke whale. Limited organ or only head tissue suites were obtained from nine pilot whales. Histologic examination of tissues began in February 2005 and concluded in December 2005 when final sampling was concluded. Neither the pilot whales nor dwarf sperm whales were emaciated although none had recently ingested prey in their stomachs. The minke whale was emaciated; it was likely a dependent calf that became separated from the female. Most serum biochemistry abnormalities appear to have resulted from the stranding and indicated deteriorating condition from being on land for an extended period. Three pilot whales had clinical evidence of pre-existing systemic inflammation, which was supported by histopathologic findings. Although gross and histologic lesions involving all organ systems were noted, consistent lesions were not observed across species. Verminous pterygoid sinusitis and healed fishery interactions were seen in pilot whales but neither of these changes were causes of debilitation or death. In three pilot whales and one dwarf sperm whale there was evidence of clinically significant disease in postcranial tissues which led to chronic debilitation. Cardiovascular disease was present in one pilot whale and one dwarf sperm whale; musculoskeletal disease and intra-abdominal granulomas were present in two pilot whales. These lesions were possible, but not definitive, causal factors in the stranding. Remaining lesions were incidental or post-stranding. The minke whale and three of five tested pilot whales had positive morbillivirus titers (≥1:8 with one at >1:256), but there was no histologic evidence of active viral infection. Parasites (nematodes, cestodes, and trematodes) were collected from 26 pilot whales and two dwarf sperm whales. Sites of collection included stomach, nasal/pterygoid, peribullar sinuses, blubber, and abdominal cavity. Parasite species, locations and loads were within normal limits for free-ranging cetaceans and were not considered causative for the stranding event. Gas emboli lesions which were considered consistent with or diagnostic of sonarassociated strandings of beaked whales or small cetaceans were not found in the whales stranded as part of UMESE0501Sp. Twenty-five heads were examined with nine specific anatomic locations of interest: extramandibular fat, intramandibular fat, auditory meatus, peribullar acoustic fat, peribullar soft tissue, peribullar sinus, pterygoid sinus, melon, and brain. The common finding in all examined heads was verminous pterygoid sinusitis. Intramandibular adipose tissue reddening, typically adjacent to the vascular plexus, was observed in some individuals and could represent localized hemorrhage resulting from vascular rete rupture, hypostatic congestion, or erythrocyte rupture during the freeze/thaw cycle. One cetacean had peracute to acute subdural hemorrhage that likely occurred from thrashing on the beach post-stranding, although its occurrence prior to stranding cannot be excluded. Information provided to NMFS by the U.S. Navy indicated routine tactical mid-frequency sonar operations from individual surface vessels over relatively short durations and small spatial scales within the area and time period investigated. No marine mammals were detected by marine mammal observers on operational vessels; standard operating procedure for surface naval vessels operating mid-frequency sonar is the use of trained visual lookouts using high-powered binoculars. Sound propagation modeling using information provided to NMFS indicated that acoustic conditions in the vicinity likely depended heavily on position of the receivers (e.g., range, bearing, depth) relative to that of the sources. Absent explicit information on the location of animals meant that it was not possible to estimate received acoustic exposures from active sonar transmissions. Nonetheless, the event was associated in time and space with naval activity using mid-frequency active sonar. It also had a number of features in common (e.g., the “atypical” distribution of strandings involving multiple offshore species, all stranding alive, and without evidence of common infectious or other disease process) with other sonar-related cetacean mass stranding events. Given that this event was the only stranding of offshore species to occur within a 2-3 day period in the region on record (i.e., a very rare event), and given the occurrence of the event simultaneously in time and space with a naval exercise using active sonar, the association between the naval sonar activity and the location and timing of the event could be a causal rather than a coincidental relationship. However, evidence supporting a definitive association is lacking, and, in particular, there are differences in operational/environmental characteristics between this event and previous events where sonar has apparently played a role in marine mammal strandings. This does not preclude behavorial avoidance of noise exposure. No harmful algal blooms were present along the Atlantic coast south of the Chesapeake Bay during the months prior to the event. Environmental conditions, including strong winds, changes in upwelling- to downwelling-favorable conditions, and gently sloping bathymetry, were consistent with conditions which have been correlated with other mass strandings. In summary, we did not find commonality in gross and histologic lesions that would indicate a single cause for this stranding event. Three pilot whales and one dwarf sperm whale had debilitating conditions identified that could have contributed to stranding, one pilot whale had a debilitating condition (subdural hemorrhage) that could have been present prior to or resulting from stranding. While the pilot and dwarf sperm whale strandings may have had a common cause, the minke whale stranding was probably just coincidental. On the basis of examination of physical evidence in the affected whales, however, we cannot definitively conclude that there was or was not a causal link between anthropogenic sonar activity or environmental conditions (or a combination of these factors) and the strandings. Overall, the cause of UMESE0501Sp in North Carolina is not and likely will not be definitively known. (PDF contains 240 pages)
Resumo:
This is the report of the “DoF/NACA-STREAM/FAO Workshop on Livelihoods Approaches and Analysis” that was conducted in Yangon, Union of Myanmar from 11-15 May 2004. The purpose of the workshop was to develop and document mechanisms for training in livelihoods approaches and analysis, and to build national capacity to conduct livelihoods studies. The workshop in Yangon was the first STREAM event in Myanmar, with colleagues coming to participate from Yangon and many Divisions and States throughout the country. The workshop in Yangon was the fourth in a series, the first of which was held in Iloilo City, Philippines, in November 2003, the second in Ranchi, India, in February 2004, and the third in Vientiane, Lao PDR in March 2004. A subsequent workshop will take place in Yunnan, China. The objectives of the workshop were to: Understand issues of interest to people whose livelihoods include aquatic resources management, especially those with limited resources Build “(national) livelihoods teams” to do livelihoods analyses and training, and share their experiences with communities and other stakeholders Share understandings of livelihoods approaches and analysis using participatory methods Review current NACA-STREAM livelihoods analysis documentation, adapt and supplement, towards the drafting of a Guide for Livelihoods Analysis Experience the use of participatory tools for livelihoods analysis Plan activities for carrying out livelihoods analyses, and Consider how to build capacity in monitoring and evaluation (M&E) and “significant change”. (Pdf contains 56 pages).
Resumo:
This is the report of the “GVT/NACA-STREAM/FAO International Workshop on Livelihoods Approaches and Analysis” that was conducted in Ranchi, India from 2-6 February 2004. The purpose of the workshop was to develop and document mechanisms for training in livelihoods approaches and analysis, and to build national capacity to conduct livelihoods analysis. The workshop in Ranchi was a joint India-Nepal event, with colleagues coming to participate from Kathmandu and other areas of Nepal. The workshop in Ranchi was the second in a series, the first of which was held in Iloilo City, Philippines, in November 2003. Subsequent workshops will take place in other countries in the region, including Lao PDR, Myanmar and Yunnan, China. (Pdf contains 48 pages).
Resumo:
This is the report of the “DLF/NACA-STREAM/FAO National Workshop on Livelihoods Approaches and Analysis” that was conducted in Vientiane, Lao PDR from 8-12 March 2004. The purpose of the workshop was to develop and document mechanisms for training in livelihoods approaches and analysis, and to build national capacity to conduct livelihoods analysis. The workshop in Vientiane was the first STREAM event in Lao PDR, with colleagues coming to participate from Vientiane and many provinces throughout the country. The workshop in Vientiane was the third in a series, the first of which was held in Iloilo City, Philippines, in November 2003 and the second in Ranchi, India, in February, 2004. Subsequent workshops will take place in other countries in the region, including Myanmar and Yunnan, China. (Pdf contains 59 pages).
Resumo:
This is the report of the “Yunnan DOA/NACA-STREAM/FAO Workshop on Livelihoods Approaches and Analysis” that was conducted in Mengzi, Yunnan from 6-10 September 2004. The purpose of the workshop was to develop and document mechanisms for training in livelihoods approaches and analysis, and to build national capacity to conduct livelihoods analysis. The workshop in Yunnan was the first STREAM event in China, with colleagues coming to participate from throughout the province. It was the fifth workshop in a series, the first of which was held in Iloilo City, Philippines, in November 2003, the second in Ranchi, India, in February 2004, third in Vientiane, Lao PDR, in March 2004 and the fourth in Yangon, Myanmar, in May 2004. (Pdf contains 44 pages).
Resumo:
This statement was prepared by the participants of the FAO/NACA-STREAM Workshop on Aquatic Resources and Livelihoods: Connecting Policy and People, 17-19 March 2005, in Los Baños, Laguna, Philippines. This was the concluding event of the FAO Technical Cooperation Program (TCP) project entitled “Assistance in Poverty Alleviation through Improved Aquatic Resources Management in Asia-Pacific.” The purpose of the workshop was to review and share experiences of the NACA-STREAM Initiative, build consensus on the value of livelihoods approaches in aquatic resources management and poverty alleviation, and identify ways of promoting livelihoods approaches throughout the region. (Pdf contains 2 pages).
Resumo:
This report, "Harmful Algal Bloom Management and Response: Assessment and Plan" reviews and evaluates Harmful Algal Bloom (HAB) management and response efforts, identifies current prevention, control, and mitigation programs for HABs, and presents an innovative research, event response, and infrastructure development plan for advancing the response to HABs. In December 2004, Congress enacted and the President signed into law the Harmful Algal Bloom and Hypoxia Amendments Act of 2004, (HABHRCA 2004). The reauthorization of HABHRCA acknowledged that HABs are one of the most scientifically complex and economically damaging coastal issues challenging our ability to safeguard the health of our Nation’s coastal ecosystems. The Administration further recognized the importance of HABs as a high priority national issue by specifically calling for the implementation of HABHRCA in the President’s U.S. Ocean Action Plan. HABHRCA 2004 requires four reports to assess and recommend research programs on HABs in U.S. waters. This document comprises two linked reports specifically aimed at improving HAB management and response: the Prediction and Response Report and the follow-up plan, the National Scientific Research, Development, Demonstration, and Technology Transfer (RDDTT) Plan on Reducing Impacts from Harmful Algal Blooms. This document was prepared by the Interagency Working Group on Harmful Algal Blooms, Hypoxia, and Human Health, which was chartered through the Joint Subcommittee on Ocean Science and Technology of the National Science and Technology Council and the Interagency Committee on Ocean Science and Resource Management Integration. This report complements and expands upon HAB-related priorities identified in Charting the Course for Ocean Science in the United States for the Next Decade: An Ocean Research Priorities Plan and Implementation Strategy, recently released by the Joint Subcommittee on Ocean Science and Technology. It draws from the contributions of numerous experts and stakeholders from federal, state, and local governments, academia, industry, and non-governmental organizations through direct contributions, previous reports and planning efforts, a public comment period, and a workshop convened to develop strategies for a HAB management and response plan. Given the importance of the Nation’s coastal ocean, estuaries, and inland waters to our quality of life, our culture, and the economy, it is imperative that we move forward to better understand and mitigate the impacts of HABs which threaten all of our coasts and inland waters. This report is an effort to assess the extent of federal, state and local efforts to predict and respond to HAB events and to identify opportunities for charting a way forward.
Resumo:
This paper discusses the application of Discrete Event Simulation (DES) in modelling the complex relationship between patient types, case-mix and operating theatre allocation in a large National Health Service (NHS) Trust in London. The simulation model that was constructed described the main features of nine theatres, focusing on operational processes and patient throughput times. The model was used to test three scenarios of case-mix and to demonstrate the potential of using simulation modelling as a cost effective method for understanding the issues of healthcare operations management and the role of simulation techniques in problem solving. The results indicated that removing all day cases will reduce patient throughput by 23.3% and the utilization of the orthopaedic theatre in particular by 6.5%. This represents a case example of how DES can be used by healthcare managers to inform decision making. © 2008 IEEE.
Resumo:
Water supply and wastewater control are critical elements of society's infrastructure. The objective of this study will be to provide a generic risk assessment tool to provide municipalities and the nation as a whole with a quantifiable assessment of their vulnerability to water infrastructure threats. The approach will prioritize countermeasures and identify where research and development is required to further minimize risk. This paper outlines the current context, primary concerns and state-of-the art in critical infrastructure risk management for the water sector and proposes a novel approach to resolve existing questions in the field. The proposed approach is based on a modular framework that derives a quantitative risk index for varied domains of interest. The approach methodology is scaleable and based on formal definitions of event probability and severity. The framework is equally applicable to natural and human-induced hazard types and can be used for analysis of compound risk events.
Resumo:
Understanding the population genetic structure is a prerequisite for conservation of a species. The degree of genetic variability characteristic of the mitochondrial DNA control region has been widely exploited in studies of population genetic structure and can be useful in identifying meaningful population subdivisions. To estimate the genetic profile of the Yangtze finless porpoise (Neophocaena phocaenoides asiaeorientalis), an endangered freshwater population endemic to China, the complete mtDNA control region was examined in 39 individuals belonging to seven different stocks inhabiting the middle and lower reaches of the Yangtze River. Very low genetic diversity was found (nucleotide diversity 0.0011 +/- 0.0002 and haplotypic diversity 0.65 +/- 0.05). The mtDNA genetic pattern of the Yangtze population appears to indicate a founder event in its evolutionary history and to support the marine origin for this population. Analyses by F-st and Phi(st) yielded statistically significant population genetic structure (F-st = 0.44, P < 0.05; phi(st) = 0.36, P < 0.05). These results may have significant implications for the management and conservation of the Yangtze finless porpoise in the future.
Resumo:
Objective: To develop sedation, pain, and agitation quality measures using process control methodology and evaluate their properties in clinical practice. Design: A Sedation Quality Assessment Tool was developed and validated to capture data for 12-hour periods of nursing care. Domains included pain/discomfort and sedation-agitation behaviors; sedative, analgesic, and neuromuscular blocking drug administration; ventilation status; and conditions potentially justifying deep sedation. Predefined sedation-related adverse events were recorded daily. Using an iterative process, algorithms were developed to describe the proportion of care periods with poor limb relaxation, poor ventilator synchronization, unnecessary deep sedation, agitation, and an overall optimum sedation metric. Proportion charts described processes over time (2 monthly intervals) for each ICU. The numbers of patients treated between sedation-related adverse events were described with G charts. Automated algorithms generated charts for 12 months of sequential data. Mean values for each process were calculated, and variation within and between ICUs explored qualitatively. Setting: Eight Scottish ICUs over a 12-month period. Patients: Mechanically ventilated patients. Interventions: None. Measurements and Main Results: The Sedation Quality Assessment Tool agitation-sedation domains correlated with the Richmond Sedation Agitation Scale score (Spearman [rho] = 0.75) and were reliable in clinician-clinician (weighted kappa; [kappa] = 0.66) and clinician-researcher ([kappa] = 0.82) comparisons. The limb movement domain had fair correlation with Behavioral Pain Scale ([rho] = 0.24) and was reliable in clinician-clinician ([kappa] = 0.58) and clinician-researcher ([kappa] = 0.45) comparisons. Ventilator synchronization correlated with Behavioral Pain Scale ([rho] = 0.54), and reliability in clinician-clinician ([kappa] = 0.29) and clinician-researcher ([kappa] = 0.42) comparisons was fair-moderate. Eight hundred twenty-five patients were enrolled (range, 59-235 across ICUs), providing 12,385 care periods for evaluation (range 655-3,481 across ICUs). The mean proportion of care periods with each quality metric varied between ICUs: excessive sedation 12-38%; agitation 4-17%; poor relaxation 13-21%; poor ventilator synchronization 8-17%; and overall optimum sedation 45-70%. Mean adverse event intervals ranged from 1.5 to 10.3 patients treated. The quality measures appeared relatively stable during the observation period. Conclusions: Process control methodology can be used to simultaneously monitor multiple aspects of pain-sedation-agitation management within ICUs. Variation within and between ICUs could be used as triggers to explore practice variation, improve quality, and monitor this over time
Resumo:
This thesis examines the relationship between initial loss events and the corporate governance and earnings management behaviour of these firms. This is done using four years of corporate governance information spanning the report of an initial loss for companies listed on the UK Stock Exchange. An industry- and sizematched control sample is used in a difference-in-difference analysis to isolate the impact of the initial loss event during the period. It is reported that, in general, an initial loss motivates an improvement in corporate governance in those loss firms where a relative weakness existed prior to the loss and that these changes mainly occur before the initial loss is announced. Firms with stronger (i.e. better quality) corporate governance have less need to alter it in response to the loss. It is also reported that initial loss firms use positive abnormal accruals in the year before the loss in an attempt to defer/avoid the loss — the weaker corporate governance the more likely is it that loss firms manage earnings in this manner. Abnormal accruals are also found to be predictive of an initial loss and when used as a conditioning variable, the quality of corporate governance is an important mitigating factor in this regard. Once the loss is reported, loss firms unwind these abnormal accruals although no evidence of big-bath behaviour is found. The extent to which these abnormal accruals are subsequently unwound are also found to be a function of both the quality of corporate governance as well as the severity of the initial loss.
Resumo:
Purpose The aim of this paper is to explore the issues involved in developing and applying performance management approaches within a large UK public sector department using a multiple stakeholder perspective and an accompanying theoretical framework. Design/methodology/approach An initial short questionnaire was used to determine perceptions about the implementation and effectiveness of the new performance management system across the organisation. In total, 700 questionnaires were distributed. Running concurrently with an ethnographic approach, and informed by the questionnaire responses, was a series of semi-structured interviews and focus groups. Findings Staff at all levels had an understanding of the new system and perceived it as being beneficial. However, there were concerns that the approach was not continuously managed throughout the year and was in danger of becoming an annual event, rather than an ongoing process. Furthermore, the change process seemed to have advanced without corresponding changes to appraisal and reward and recognition systems. Thus, the business objectives were not aligned with motivating factors within the organisation. Research limitations/implications Additional research to test the validity and usefulness of the theoretical model, as discussed in this paper, would be beneficial. Practical implications The strategic integration of the stakeholder performance measures and scorecards was found to be essential to producing an overall stakeholder-driven strategy within the case study organisation. Originality/value This paper discusses in detail the approach adopted and the progress made by one large UK public sector organisation, as it attempts to develop better relationships with all of its stakeholders and hence improve its performance. This paper provides a concerted attempt to link theory with practice.
Resumo:
BACKGROUND:
End-stage renal disease (ESRD) is increasingly prevalent but the inpatient costs associated with this condition are poorly defined due to limitations with data extraction and failure to differentiate between hospitalisation for renal and non-renal disease reasons. The impact of admissions primarily for the management of ESRD on hospital bed utilisation was assessed over a 5-year period in a large teaching hospital.
METHODS:
All admission episodes were reviewed and the ESRD group was identified by a primary International Classification of Diseases code for ESRD or a non-specific primary renal failure code with a secondary code for ESRD. The frequency and duration of hospitalisation and contribution to bed day occupancy of this group with ESRD was determined.
RESULTS:
There were 70,808 patients responsible for a total of 116,915 admissions and 919,212 bed days over the study period. Of these, 988 (1.4%) patients were admitted for the management of ESRD, accounting for 2,387 (2.0%) of admissions and utilisation of 23,011 (2.5%) bed days. After adjustment for age and gender, those admitted for ESRD management were significantly more likely to have a prolonged admission exceeding 30 days (odds ratio 1.46, 95% confidence interval 1.23-1.72, p < 0.001). When the admission was an emergency rather than an elective event, the patient was 4.6 times more likely to be hospitalised for over 30 days.
CONCLUSIONS:
Persons admitted for ESRD management are hospitalised more frequently and for longer than the overall inpatient population, occupying a substantial number of bed days.
