Current Trends In Management Research Articles

Sepsis Immunometabolism: From Defining Sepsis to Understanding How Energy Production Affects Immune Response.

Objectives:This review will examine current definitions and trends in sepsis management as well pathophysiologic mechanisms in animal and ex vivo studies that correlate decreased energy production with deranged inflammatory response during the septic process.Data Sources:The latest articles in the literature that focus on the role of immunometabolism and associated mechanisms in sepsis were selected.Study Selection:The most relevant, original articles were included in the review.Data Extraction:All pertinent data for sepsis definitions as well as changes in immunometabolic pathways during the septic process was reviewed and assessed for inclusion in this article.Data Synthesis:Sepsis is a major cause of multiple organ dysfunction. It is the principal cause of death resulting from infection and one of the most expensive conditions treated in the United States. Despite current efforts to accurately define sepsis, novel treatments and highly trained providers, mortality rates for sepsis remain high, prompting a need for further investigation of underlying immunometabolic mechanisms to identify potential treatment targets. The definition of sepsis has shifted and changed in the past few decades due to poorly defined criteria, as well as unclear guidelines for providers with regards to management of severe sepsis and septic shock. The early identification of patients with a systemic inflammatory response that will progress to septic shock is critical since recent traditional therapeutic approaches, such as early goal-directed therapy, IV immunoglobulin, and anti–tumor necrosis factor-α antibodies have failed.Conclusions:There are no effective anti-sepsis drug therapies due to complex inflammatory and metabolic interactions. Further studies regarding the interface between innate immunity and metabolism should be investigated to effectively address septic patient mortality rates.

UTILIZATION OF BY-PRODUCTS GENERATED BY A WOOD GASIFICATION PLANT THROUGH ITS USE FOR THE RECLAMATION OF DISTURBED TERRAINS

One of the biggest disturbances and pollutants of the environment occur due to the mining industry. For this reason, when talking about the restoration and recultivation of damaged lands and soils a recovery of the disturbed areas affected by mining activities should be first understood. Current waste management trends make us look for opportunities to recultivate disturbed mining areas by using waste or products that have the necessary properties and are a by-product (or waste) of industry. In this study, we have investigated, through laboratory methods, the possibility of using a by-product from a biomass gasification plant (FP) that potentially possesses the properties to improve soils quality during the reclamation process.
 The paper analyzes the possibilities of using the FP by defining its effect on the soil forming process on disturbed sites, including: acidity, content of nutrients and mobility of heavy metals.
 In order to determine the possibility of using the FP to enhance soils quality, in the experiment, we used soils that are going to be used for the reclamation of the Eastern embankment of the Ellatzite copper mine and by-product (FP), generated from a Biomass gasification plant located near the mine.
 The territory that is possible to be reclaimed with FP is an embankment covered with rocks from the Ellatzite mine which has acidic reaction, high content of heavy metals and very low organic content. In general, conditions for land reclamation are severe and specific measures need to be implemented to achieve sustainable results.

Current practice trends of oedema management in the hands of people with tetraplegia in Australia.

Study designSurvey research design.ObjectivesTo describe current practice methods for oedema management in people with tetraplegia.SettingAustralia.MethodsOnline survey with open and closed questions regarding clinical practice trends in the assessment and treatment of oedema in the hands in people with tetraplegia.ResultsSeventeen occupational therapists working in spinal cord injury (SCI) in Australia completed the survey. Oedema was identified by visual inspection (n = 17, 100%) and recorded using circumferential tape measurement (n = 13, 76%). Elevation was used by all participants in conjunction with compression gloves (n = 13, 76%), retrograde massage (n = 13, 76%), compression bandaging (n = 12, 71%) and the boxing glove splint (n = 9, 53%). Participants stated that oedema presented challenges to patients with difficulty exercising (n = 11, 65%), changes to body image (n = 5, 29%) and pain (n = 4, 24%).ConclusionAssessment and treatment practices were not consistent. Oedema in the hands in people with tetraplegia was perceived to have various impacts on a person’s rehabilitation and hand function. The findings highlight the need for research evidence to guide practice.

Ready-to-Eat Salad Crops: A Plant Pathogen's Heaven.

The ready-to-eat salad sector, also called fresh-cut or bagged salads, is a fast-growing segment of the fresh-food industry. The dynamism and specialization of this sector, together with the lack of adequate crop rotation, the globalization of the seed market, and climate change, are the main causes of the development of many new diseases that cause severe production losses. Newly detected diseases of the most important crops grown (lettuce, wild and cultivated rocket, lamb's lettuce, chicory, endive, basil, spinach, and Swiss chard) are critically discussed. The management of these diseases represents a formidable challenge, since few fungicides are registered on these minor-use crops. An interesting feature of the ready-to-eat salad sector is that most crops are grown under protection, often in soilless systems, which provide an environment helpful to the implementation of innovative control methods. Current trends in disease management are discussed, with special focus on the most sustainable practices.

Current Trends in Management of Nonsyndromic Unilateral Coronal Craniosynostosis: A Cross-sectional Survey.

Background:Although the natural history of nonsyndromic unilateral coronal craniosynostosis has been extensively described, optimal management remains controversial due to lack of Level 1 evidence. This study aims to assess the current state of practice among craniofacial surgeons.Methods:Ninety-four craniofacial surgeons were approached to complete a survey consisting of 15 questions. Data were collected assessing surgeons’ primary surgical indication, timing of intervention, preoperative imaging, and choice of technique for patients presenting with nonsyndromic unilateral coronal craniosynostosis. Choice of technique and timing of intervention in case of recurrence were also investigated.Results:After 5 mailings, the response rate was 61%. The combination of both appearance and raised intracranial pressure was the primary indication for treatment for 73.2% of surgeons. Preoperative CT scan of the skull was “always” performed by 70.1% of respondents. Open surgical management was most commonly performed at 8–10 months of age (38.6%). Bilateral frontal craniectomy with remodeling of the supraorbital bandeau and frontal bone was the most common choice of procedure (84.2%). In case of mild to moderate and moderate to severe recurrences at 1 year of age, 89.5% and 47.4% of surgeons opted for conservative management, respectively. Optimal timing for repeat cranioplasty was after 4 years of age (65.5%). Overall, 43.4% quoted lack of evidence as the greatest obstacle to clinical decision-making when dealing with unilateral synostosis.Conclusion:This survey exposes the lack of consensus and the disparity of opinion among craniofacial surgeons regarding the management of nonsyndromic coronal synostosis, particularly in the setting of recurrence.

Integrating promotive, preventive, and curative health care services at hospitals and health centers in Addis Ababa, Ethiopia.

BackgroundThe current trend in patients’ disease management is mostly aimed at addressing their present health complaints; the focus is thus purely curative. As the limits of curative medicine become apparent and the cost of medical care escalates, disease prevention is gaining prominence. Factors that contribute to unreliable delivery of an integrated health care service are worth investigation. This study explores the extent to which health promotion and disease prevention services are integrated to curative health care and identifies the factors associated with not reliably providing the services.MethodsA cross-sectional quantitative study using an exploratory and descriptive design was used to explore and describe the extent of health promotion, preventive, and curative health care services provision, and investigated factors related to low performance. Phase I of the study examined the degree of promotive and preventive health care provision at hospitals and health centers while investigating the staffing and equipment and supply status of the facilities. Phase II, using the Delphi consensus-seeking process, focused on the validation of the findings from Phase I.ResultsOf all patients who attended health facilities, only 2.4% (n=20) received optimal health promotion services. Disease prevention services were optimally provided to only 3.6% (n=30) patients. Integrated health promotion and disease prevention services were provided to only 0.8% (n=7) patients. The main reasons for not providing an integrated health care service were shortage of skilled health staff, equipment, medication, protocols, and guidelines, and high service cost, poor patient awareness, and health professionals’ focus on curative health care.ConclusionHealth service providers were not routinely conducting patient-specific health promotion, disease prevention, and integrated health care services, losing the opportunities of patient’s presence for health promotion and diseases prevention purposes. Addressing barriers can help with integrating health promotion and disease prevention services to the curative health care services.

Current Trends in Research Data Management

This article presents an analysis of policies, guidelines and requirements set by governments of a number of countries in the field of data openness, grantors, and publishers, as well as a review of publications, which allows tracing the main trends in research data management, and the Guide to Research Data Management, which reflects the basic concepts and features of preparing a data management plan, metadata standards, data identifiers, etc. It is concluded that it is necessary to develop service management and create institutional and national research data management services.

FEATURES ENSURING FINANCIAL CONTROL IN A COMMERCIAL BANK: RUSSIAN AND FOREIGN EXPERIENCE

Current global trends in financial management and in banking in particular are demonstrating a gradual shift in focus from remote external financial control over bank’s operations to more internal risk-oriented financial control. Against this background, there is a fundamental change in organization of financial control in commercial banks, associated with the implementation of international norms and standards as well as Russian Federation legislation compliance with these norms and standards.
 In the context of rapid development and changes of nearly all technologies, the impacts from real and potential threats to internal and external environments, internal financial banking control is becoming increasingly important in ensuring growth of banks’ financial performance.
 Thus, given the importance of the very institution of financial control in the banking sector for financial and economic stability of any state, the presence of problematic issues in this area necessitates further studies of the characteristics of financial control in a commercial bank stemming from the already accumulated Russian and foreign experience.

Current trends in tendinopathy management.

Tendinopathy (pain and dysfunction in a tendon) is a prevalent clinical musculoskeletal presentation across the age spectrum, mostly in active and sporting people. Excess load above the tendon's usual capacity is the primary cause of clinical presentation. The propensity towards chronicity and the extended times for recovery and optimal function and the challenge of managing tendinopathy in a sporting competition season make this a difficult condition to treat. Tendinopathy is a heterogeneous condition in terms of its pathology and clinical presentation. Despite ongoing research, there is no consensus on tendon pathoetiology and the complex relationship between tendon pathology, pain and function is incompletely understood. The diagnosis of tendinopathy is primarily clinical, with imaging only useful in special circumstances. There has been a surge of tendinopathy treatments, most of which are poorly supported and warrant further exploration. The evidence supports a slowly progressive loading program, rather than complete rest, with other treatment modalities used as adjuncts mainly targeted at achieving pain relief.

Current trends in management of acute pancreatitis: A review

Current trends in management of acute pancreatitis: A review

Predictors of early synchronized non-invasive ventilation failure for infants < 32 weeks of gestational age with respiratory distress syndrome.

IntroductionThe current trend in management of preterm neonates with respiratory distress syndrome is to attempt noninvasive ventilation (NIV) to avoid endotracheal intubation. However, failure of noninvasive ventilation may lead to increased morbidity and mortality. There is a scarcity of studies establishing predictors for the usefulness of NIV in this age group. Our aim here was to determine the predictors of NIV in preterm infants with respiratory distress syndrome (RDS) treated with synchronized nasal intermittent positive pressure ventilation (SNIPPV) for initial respiratory support.Material and methodsWe conducted a follow-up study on 85 infants < 32 weeks of gestational age, and < 1500 g with RDS who received early SNIPPV. Perinatal history, physical characteristics, ventilatory settings, and arterial blood gas analysis results were collected. We recorded the failure rate and potential predictive factors of this failure.ResultsThere were 12 (14.1%) patients who had SNIPPV failure. The SNIPPV failure group had multiple significantly different characteristics compared to the successful SNIPPV group including gestation age, birth weight, grading of disease, severity of respiratory distress, antenatal steroid use and various ventilatory settings. Further multivariate analysis revealed only 3 predictors in our patients: grade of RDS (OR = 4.48, p = 0.008), antenatal steroid use (OR = 1.09, p = 0.01) and mean airway pressure (OR = 1.98, p = 0.0001).ConclusionsFailure of early NIV occurred in a small subset of our patients. Predictors of noninvasive ventilation failure may be a useful guide for decisions regarding intubation.

Role of Intraoperative Hemodynamic Factors with Respect to Graft Functioning in Renal Transplant Recipients and Current Trends in Perioperative Hemodynamic Management

Role of Intraoperative Hemodynamic Factors with Respect to Graft Functioning in Renal Transplant Recipients and Current Trends in Perioperative Hemodynamic Management

Current trends in currency risk management by Polish shipbuilding enterprises

Current trends in currency risk management by Polish shipbuilding enterprises

Ebola Virus Disease: Current Trends in Clinical Management

Ebola Virus Disease: Current Trends in Clinical Management

Self- assessment Performance Measurement in Construction Companies: An Application of the EFQM Excellence Model on Processes and Customer Stages

The EFQM Excellence Model was introduced in 1990s as a framework for assessing applications for The UK Excellence Award and it is the most widely-used Business Excellence Framework in Europe, with over 30,000 businesses using the Excellence Model to improve performance and increase their bottom-line.EFQM model focuses on the continuous development idea that all sectors can benefit from. EFQM model enables a company to highlight and develop its strengths in nine main areas for further development. In this study, nine of only 2 areas 1) process and 2) customer areas that are considered to be more effective on companies’ performance will be evaluated regarding a construction company in Turkey.As mentioned, this paper puts EFQM model into practice on a construction company. It is a functional company with an unstable environment. The company has a variable environmental circumstances all over Turkey due to its various construction areas in different cities; and the central office is in Ankara.The aim of this paper is to improve the quality of construction organizations by applying the EFQM excellence model and to show how EFQM model can be applied to advance companies. Furthermore, the paper provides analysis of current quality management trends on construction sector, and describes EFQM model structure to contribute the development of construction companies. This practice allows in a little while to appraise company quality management level and to describe opportunities for constant quality development.

Current trends of diagnosis and management of neurocysticercosis

Cysticercosis occurs in porcine naturally. A human can be infected by cysticercosis if they swallow Taenia solium's egg inadvertently. These eggs can be found in vegetables or unboiled water. These eggs hatch and later will become larva that becomes cysts in muscle or brain, known as cysticercus cellulose. Neurocysticercosis is an infection of the central nervous system caused by Taenia solium at its larval stage. Indonesia is a developing country with a high incidence rate of neurocysticercosis, with the highest amount of cases found in Bali and Papua. Neurocysticercosis boasts a broad array of clinical symptoms, from silent disease to a severe, debilitating illness that leads to death. The diagnosis of neurocysticercosis itself presents a great challenge, due to the unspecific clinical symptoms, in-pathognomonic radiographic findings and serologic studies with low specificity and sensitivity. The management of neurocysticercosis consists of a combination of antiparasitic agents and supportive therapies, ranging from steroid to surgeries that can be done under certain circumstances.

280 Changes and current trends in commodity use and cattle management in commerrcial feedlots in the Great Plains.

280 Changes and current trends in commodity use and cattle management in commerrcial feedlots in the Great Plains.

Green supply chain management in Croatian companies

The scope of this paper is to present current state and trends of Green Supply Chain Management (GSCM) in Croatian companies. Due to the need for reduction of GHG emissions related to the climate change, many standards, directives, concepts, methods and models dealing with sustainability have appeared. The first part of the paper consists of an overview of GSCM where the greening diagram of GSCM is presented. The second part of the paper presents the survey which has been carried out in the Croatian business sector in view of current state and trends, barriers and drivers of the GSCM implementation. According to the results of the survey, barriers and drivers of the GSCM implementation are ranked by its significance and are compared with similar surveys carried out in the European Union (EU) and the United States of America (USA). New categorization of the drivers of the GSCM implementation is presented using the factor analysis.

Current Trends in Surgical Airway Management of Neonates with Robin Sequence.

Background:Robin sequence is defined by the clinical triad of micrognathia, glossoptosis, and upper airway obstruction, and is frequently associated with cleft palate and failure to thrive. Though the efficacy of certain surgical interventions to relieve airway obstruction has been well established, algorithms dictating decision making and perioperative protocols are poorly defined.Methods:A 22-question survey was sent via e-mail to members of the American Cleft Palate-Craniofacial Association and International Society of Craniofacial Surgeons. Questions were related to surgeon experience in treating neonates with Robin sequence, and specific perioperative protocols.Results:One hundred fifty-one responses were collected. Most respondents were surgeons practicing in North America(82.8%), in a university hospital setting (81.5%) and had completed a fellowship in pediatric plastic surgery or craniofacial surgery (76.2%). Preoperative protocols varied widely by years in training and location of practice. Although 78.8% of respondents always performed direct laryngoscopy, only 49.7% of respondents routinely obtained preoperative polysomnography. Mandibular distraction osteogenesis was the most common primary surgical airway intervention reported by 74.2%, with only 12.6% primarily utilizing tongue-lip adhesion. Slightly less than half of respondents ever performed tongue-lip adhesion. Operative selection was influenced by surgeon experience, with 80% of those in practice 0–5 years primarily utilizing mandibular distraction, compared with 56% of respondents in practice >15 years.Conclusions:This study documents wide variations in preoperative, operative, and postoperative protocols for the surgical airway management of neonates with severe Robin sequence. These results underscore the need to acquire more objective data, to compare different protocols and outcome measures.

Mucoid degenerated anterior cruciate ligament (ACL) managed by arthroscopic ACL reconstruction: A case series

Introduction: Mucoid degeneration of the Anterior Cruciate Ligament is a rare degenerative condition affecting the middle age population (16 to 50 years). The infiltration of glycosaminoglycan into the substance of the ACL causes the ligament to swell up and impinge on the intercondylar notch and Posterior Cruciate Ligament. This results in posterior knee pain and restriction of terminal movements. The current trend of management is debulking the ligament by stripping the degenerated part and preserving the native thin ACL. This poses two problems - 1. Difficulty in identifying the degenerated parts by the arthroscope. Stripping is done with the aid of pre-op MRI; 2. Chances of under stripping (recurrence of the symptoms) or over stripping (laxity and ACL failure). Studies have shown high incidence of grade 1/grade 2 laxity by Lachman test 6 months post-op and a requirement of Secondary ACL reconstruction in many patients. Goal: The goal of this study is to assess the functional outcome of Primary ACL reconstruction with autologous quadrupled hamstring tendon graft after complete excision of the native degenerated ACL. Materials and Methods: This is a prospective study of 13 patient (7 male, 6 female) of average age 41 (25-63) years presenting with posterior knee pain and restriction of flexion for an average period of 6 months (15 days – 36 months) diagnosed with Mucoid degeneration of ACL by MRI, arthroscopy and by histo-pathological examination. They were operated by ACL reconstruction following complete excision of degenerated ACL, as a single stage procedure. Evaluation: The patients were evaluated both pre-operatively and post-operatively by Lysholm knee scoring system and VAS (visual analog score) pain scoring system. Results: Postoperatively, patients were followed up for a minimum of 1 year (average of 14.9 months). There was no evidence of recurrence or instability at the end of follow-up. There was significant improvement in Lysholm score (34.6 to 83.2) and VAS (5.76 to 0.54). Conclusion: Treatment of ACL mucoid degeneration by this modality is effective in preventing recurrence, post-operative laxity and provides better functional outcome compared to the classical partial resection of the degenerated ACL.