Consequences Of Mismanagement Research Articles

Impact of COVID-19 pandemic on plastic surge and environmental effects

ABSTRACT Plastics have set an indispensable place in the daily needs of everyone’s life in the society. It is because of its availability and affordability too. Since it is more economical and reaches everyone easily, all industries have started to produce their products in plastics ranges from small pin to big containers and pipes. This paper depicts the environmental effects of anthropogenic plastic consumption particularly during COVID-19 and other impacts due to plastic pollution. There is no industry that does not use plastic. The use of plastic in the medical industry is highly advantageous. Especially in this pandemic COVID-19 situations where one’s self hygiene is the most important factor; the need of plastic is completely indisputable. The number of medical things used by even general has been increased rapidly because of the COVID-19. However, the improper management of medical tools and devices such as gloves, masks, and personal protection cover worsen the condition of the infection rate and overall plastic stagnation across the world. To minimize the negative consequence of mismanagement of plastic things, serious concern should be given to the management of plastic waste and public awareness has to be increased about the proper use and disposal.

Diabetes and orthopaedic surgery: a review

Diabetes mellitus (DM) is common, estimated to affect 425 million people worldwide in 2017. It is a condition that is continually growing in prevalence and is often associated with multiple co-morbidities. Its multi-system effects on the body mean that its management can pose a challenge, even to more experienced clinicians. In orthopaedic practice, diabetic patients are commonly encountered owing to their increased fracture risk and complications of the disease such as diabetic foot. An appropriate knowledge of diabetes, its pathophysiology, immunology and the pharmacology of medications used in its treatment is essential, as the consequences of mismanagement can be grave. Optimal treatment of diabetics can often require the involvement of a wider multidisciplinary team. Complications that can be encountered in the perioperative and postoperative periods include, diabetic ketoacidosis, hyperosmolar hyperglycaemic state, surgical site infection and venous thromboembolism. This review outlines current concepts in the perioperative management of diabetes and its manifestations within orthopaedic surgery, with a focus on outcomes and complications. A review of the available literature reveals conflicting conclusions between studies, with no clear effect or consensus yet established for many issues. There is a need for a greater number of well-designed, high-quality, appropriately powered trials to establish the true effect of diabetes on outcomes in orthopaedic surgery.

University hospitals in Turkey: Structural crisis in financing or consequence of mismanagement?

University hospitals in Turkey have a prominent role especially in treatment of complex cases and research. However, despite their indispensible place in the health care system, their financial status has long been on the agendas of the Turkish health policy-makers and is seen as a major threat to the financial sustainability of the whole system. It has been reported that the total debt of university hospitals has reached to 4.5 billion TRY (1.1 billion €) in 2016. This debt is to the third parties that provide medical devices, pharmaceuticals or services to these hospitals. There is also an increasing trend in university hospital debts calling for an urgent attention from the government. This article aims at exploring the financial status of university hospitals and showing that with a new management approach focusing on efficiency and effectiveness measures, the problem could be overcome. The example from Hacettepe University Hospital showed that a problem solving management approach and a reformist vision between December 2011-January 2016 has resulted in major improvements in the financial status of the hospital. The debts of the hospital were stabilized in this period by policies focusing on increasing number of patients and procedures, by decreasing the cost of purchasing goods and materials and by following the Social Security Institution’s (SSI) payment procedures. Starting from January 2016 a new management took the office and abandoned the measures taken by the previous administration. This led to an increase in hospital debts again. The article concluded that despite a volatile reimbursement environment, good management practices could help university hospitals to sustain their financial status.

Analysis of landscape changes as an indicator for environmental monitoring.

Mediterranean coastal landscapes are complex systems that are subject to rapid and extensive changes due to unprecedented human interference. Changes in these landscapes are strong indications of anthropogenic disturbances that should be monitored carefully in order to make effective management decisions. Landscape changes can be analyzed using many qualitative and quantitative techniques. In this respect, the importance of land cover information arises from the fact that any change in the composition and/or configuration of land cover can be used as a landscape-level environmental indicator. Therefore, proper understanding of spatial and temporal characteristics of this environmental attribute is of vital importance as it enables decision-makers to reveal causes of environmental issues and to cope with consequences of mismanagement. The aims of this paper are to analyze landscape-level changes using the largest patch index (LPI) as a simple pattern indicator and provide guidelines for studying change phenomena that take place in the Mediterranean coastal areas. In this respect, changes in the LPI values for agricultural and built-up areas in three different sites were analyzed using georeferenced Ikonos and Quickbird images. The concepts of pattern and process were highlighted as important indicators for studying landscapes and understanding their change.

Hiding in the Shadow of Wagner-Steagall

Problem, research strategy, and findings: Researchers have explored public housing in large U.S. cities in great detail, including its history, design, effect on neighborhoods, role in urban renewal, the livelihoods of residents, and the consequences of mismanagement, demolition, and rebuilding. Based on these studies, scholars have largely concluded that public housing failed to achieve its goals. Yet, a parallel history of public housing construction and preservation in small towns and rural areas, a history that might challenge the dominant narrative of failure, remains unexplored. This article reviews the existing rural public housing literature, identifies important gaps, and explores its legacy. We find that while federal public housing policy in small towns and rural areas played an important role in the supply of affordable housing in these communities, little research has documented its impact. Rural public housing offers an alternative narrative less marked by problems and failures and more by solutions and successes, an idea that deserves much more attention from housing researchers in the future. Takeaway for practice: In the coming years, planners working in rural places will face numerous questions about not only how to house low-income households, but also how to preserve existing housing units in safe and sanitary conditions so that they remain viable. We identify a set of questions and issues pertaining to housing conditions in rural areas that, if answered, could offer planners valuable new insight into future federal housing policy more sensitive to community needs.

Degradation of landscape in Serbian ski resorts-aspects of scale and transfer of impacts

The environmental impacts in Serbian ski resorts (Kopaonik, Zlatibor, Stara planina, Divcibare) are very strong, leading to degradation of unique mountain landscape, and functionality losses. Processes of urbanization, construction or improvement works, cause hard degradation of topsoil and native vegetation. The logging, large excavation activities, erosion, noise and water pollution constantly impact the habitats of all animal and plant species residing in small areas. The process leads to severe fragmentation of the remaining old-growth forests, endangering future subsistence. Consequences of mismanagement in ski areas are noticeable in downstream sections of river beds, causing floods and bed-load deposition, with high concentration of pollutants, in reservoirs for water supply. Legal nature-protection standards are weakly implemented in regional ski areas. Effective protection of landscape in Serbian ski-areas is based on careful considerations of impact assessment at all levels of planning (spatial and urban planning) and designing activities, which enables application of restoration concept, in accordance with general goals of environmental protection (preserving biodiversity, CO2 sequestration, attenuation of effects of global climate changes).

Restoration of eroded surfaces in Serbian ski-areas

The environmental impacts in Serbian ski areas are very strong, leading to landscape degradation and functionality losses. Construction or improvement works cause serious destruction of topsoil and native vegetation. Some activities enhance erosion production and sediment yield: clear cuttings; trunk transport down the slope; road construction and large excavations. Also, lack of erosion control works in ski areas, especially between April and October, result in various forms of land degradation such as furrows, gullies, landslides, or debris from rock weathering. The consequences of mismanagement in ski areas are noticeable in downstream sections of river beds, causing floods and bed-load deposition. Planning and designing activities, with the application of technical and biotechnical erosion control structures, through the concept of restoration, are necessary measures in the protection of ski areas.

Comparison of current local practice and the Ottawa Ankle Rules to determine the need for radiography in acute ankle injury

Ankle injuries are a frequent cause of attendance to accident and emergency (A&E) departments. Although often classed as 'minor injuries', the consequences of mismanagement can be debilitating for patients. In addition, it is not always easy to differentiate those injuries with bony fractures from solely ligamentous injuries, and most patients are radiographed unnecessarily. Clinical prediction rules such as the Ottawa Ankle Rules have been devised to reduce the degree of radiographic requests, thus limiting harmful radiation exposure, and reducing departmental costs. The A&E environment of our centre often includes a variety of clinicians with little pure orthopaedic training or knowledge of these clinical prediction rules, hence, providing a prime atmosphere for their assessing their effectiveness. A prospective study was performed in our centre to investigate the validity of the clinician's decision in diagnosis of a bony injury in the absence of training with the Ottawa Ankle Rules. The effectiveness of applying the rules was then determined on the same set of patients.

Difficult and impossible intubation

This chapter reviews the problem of the management of the difficult airway. Although the incidence of difficulty is relatively small, the consequences of mismanagement can be quite disastrous. Prediction of the difficult intubation can be made by a variety of simple clinical observations and measurements in a majority of cases. A combination of these methods is likely to lead to a lower index of false positives. Radiological assessment may be valuable if planned beforehand. Nevertheless, a number of cases of unsuspected difficulty occur. The options available in cases of difficulty are reviewed, including direct laryngoscopy using the oral and nasal routes, fibreoptic guided intubation and the use of special guiding laryngoscope blades and ancillary devices such as the laryngeal mask, the pharyngotracheal lumen airway, the Combi tube and the light wand. The technique of retrograde guided intubation is described. The surgical airway is required in certain cases of impossible intubation. Cricothyrotomy is the technique of choice in the emergency situation because it is simpler and safer to perform. Tracheostomy may be preferred in the planned case with an anticipated long-term problem. Confirmation of correct tracheal tube placement is essential. Unrecognized misplacement leads to death or severe brain damage. Simple clinical methods are generally satisfactory but are not infallible. Other methods of confirmation such as fibreoptic visualization, light wand transillumination, carbon dioxide detectors and air aspiration are discussed. A regimen for difficult airway management is produced as an algorithm.