Effects Of Various Management Strategies Research Articles

Understanding and Managing Caesarean Scar Ectopic Pregnancy: A Retrospective Analysis of Risk Factors, Strategies, and Outcomes

Objective: Caesarean Scar Ectopic Pregnancies (CSEP) pose distinct diagnostic and management challenges. This study investigates the risk factors, treatment options, and outcomes for CSEP cases treated at Prince Sultan Medical Military City, Riyadh. Methods: Over a two-year period, medical records of 28 patients with CSEP were reviewed, collecting data on patient demographics, obstetric history, and treatment outcomes. This analysis aimed to identify influential risk factors and assess the effectiveness of various management strategies. Results: Treatment success was achieved in 85.7% of cases, with Methotrexate (MTX) proving effective in over half of the cases. The findings suggest significant risk factors and best practices for managing this rare condition. Conclusion: Early detection, risk factor awareness, and tailored treatment strategies are key to optimizing outcomes in patients with CSEP.

Conquering Post-Dural Puncture Headache: A Systematic Review of Effective Treatments

Post-dural puncture headache (PDPH) is a common complication following spinal procedures, particularly lumbar punctures and epidural anesthesia. This systematic review aims to evaluate and compare the effectiveness of various management strategies for PDPH. A comprehensive search was conducted across major databases for relevant articles published up to January 2024. The inclusion criteria comprised studies assessing interventions for post-dural puncture headache (PDPH) management in adult populations. Data extraction and quality evaluation were conducted independently by two reviewers. Analysis involved 34 studies meeting the inclusion criteria. The results indicate that conservative approaches, including bed rest, hydration, caffeine, and analgesics, continue to serve as the fundamental components of PDPH management. Additionally, epidural blood patch (EBP) emerged as the most effective intervention for refractory cases. However, further research is needed to optimize treatment protocols and explore emerging therapies.

Retrospective Analysis of Effective Management Strategies for Primary Amenorrhea of Reproductive Age in Saudi Arabia.

Primary amenorrhea, the absence of menstruation by age 15, can have significant implications for reproductive health and overall well-being. This retrospective study aimed to evaluate the effectiveness of various management strategies for primary amenorrhea among women of reproductive age in Saudi Arabia. Medical records of 63 eligible patients from 2018 to 2023 were analyzed, assessing diagnostic methods, treatment modalities, and associated outcomes. The findings revealed that hormonal therapy was the most commonly employed management strategy (50.0%) and demonstrated the highest rate of achieving menstrual regularity (62.5%). Surgical interventions were utilized in 28.1% of cases, with a 50.0% rate of symptom resolution. Lifestyle modifications were less frequent (21.9%) but showed a moderate rate of symptom resolution (35.7%). Logistic regression analysis identified age, underlying etiology, and management strategy as significant predictors of treatment success. Subgroup analyses highlighted the efficacy of hormonal therapy and lifestyle modifications for genetic etiologies, while surgical interventions were more effective for anatomical causes. The study underscores the importance of a comprehensive diagnostic approach and personalized treatment plans tailored to individual patient characteristics. Despite limitations, the findings contribute to the understanding of optimal management strategies for primary amenorrhea and emphasize the need for multidisciplinary collaboration in addressing this complex condition.

Different modalities of management of liver abscess

Background: Liver abscess is an acute suppurative infectious disease of liver parenchyma which may be pyogenic, amoebic or tubercular. It can occur due to direct blood spread through enterohepatic circulation or due to ascending infection occurring through biliary tree. Aim was to evaluate effectiveness of various management strategies in the management of liver abscess. Methods: It is a prospective study carried out in 100 patients of age 12-80 years between 1st December 2021 to 31st May 2022 who presented to general surgery department and diagnosed with liver abscess. Results: 10% cases were treated conservatively with antibiotics only, 59% cases were treated with percutaneous needle aspiration, 21% patients were treated with percutaneous pigtail catheter drainage, 10% cases were treated with open surgical drainage. Conclusions: Liver abscess with size less than 5 cm or 50 cc can be managed conservatively but liver abscess with size >5 cm need intervention.

Estimating the daily nutritive value of bermudagrass for grazing livestock

ABSTRACT Objective Our objective was to develop models to estimate the CP, NDF, lignin, and ash concentrations of bermudagrass [Cynodondactylon (L.) Pers.] forage daily throughout the grazing season and use them to estimate TDN daily. We hypothesized that the CP, NDF, lignin, ash, and TDN concentrations might change daily. Materials and Methods Coastal bermudagrass forage CP, NDF, lignin, and ash concentrations spanning several years were obtained from Overton, Texas. The forage samples used comprised hand-plucked plant parts intended to estimate animal-selected diets. We developed an empirical model for each nutritive variable with the day of the year (DOY) as a predictor. By incorporating these models into a pre-existing summative equation, we estimated the daily values of TDN. These nutritive value models were evaluated using the Willmott index, modeling efficiency, root mean squared error, and R2 as the measures of fit. Results and Discussion Bermudagrass CP concentration had a negative, curvilinear association with DOY, whereas lignin and NDF concentrations were positively, curvilinearly related to DOY. The ash concentration had a negative, linear association with DOY. The likely causal factors for these relationships were plant maturity and weather conditions, especially temperature. The Willmott index, modeling efficiency, and R2 values were greater than 0.87, 0.64, and 0.65, respectively. The root mean squared error and percent error values were less than 3.1 and 11%, respectively. These values indicated that the nutritive value models were reliable. Implications and Applications We showed that the CP, NDF, lignin, ash, and TDN values of bermudagrass forage changed daily. By incorporating these trends into a nutritive value prediction system, accurate estimates of daily TDN could be made. These nutritive value models could be a valuable asset in forage-animal modeling for more accurately studying the effects of various management strategies and environmental factors on forage nutritive value and animal performance.

Linking threat maps with management to guide conservation investment

Stressors to marine ecosystems are increasing, driven by human activities in the sea and on land, and climate change. Cumulative impact maps highlight regions affected by multiple human activities, but efficient conservation investment requires linking dominant pressures to management actions that best address the particular drivers of impacts. We rebuild cumulative impact maps by stressor type (climate change, marine and land) at a global scale to evaluate the expected effectiveness of various management strategies for all coastal territories. Average cumulative impact from non-marine stressors (climate and land) was double those of marine impacts at a national level. The greatest climate impacts by country were in the waters of Pacific Island and Antarctic territories; in the Caspian Sea region and East-Asia for land impacts; and in the waters of European, East-Asian and Caribbean countries for marine impacts. We developed a conservation-effectiveness indicator for the 10 worst-impacted countries in each of the three stressor categories. The indicator considered common management tools for each stressor category: ecosystem-based adaptation and disaster risk reduction (climate), marine protected areas (marine) and integrated coastal management (land). Key disparities were found between broad-scale management of marine ecosystems and the dominant stressors, with existing management in tropical island nations likely insufficient to address intense impacts from climate change. These countries also typically had low performance on governance indicators, suggesting challenges in implementing new mitigation. We highlight trade-offs in making decisions for stressor mitigation and offer strategic guidance on identifying locations to target management of marine, land, or climate impacts.

Invasive alien palm Pinanga coronata threatens native tree ferns in an oceanic island rainforest

Invasive ornamental plants are a global problem that can have severe impacts on native biodiversity, especially on islands. To determine whether the invasive, ornamental ivory-cane palm Pinanga coronata could be displacing native biodiversity, we investigated its co-distribution with native tree ferns in a Fijian rainforest. We recorded the abundances of P. coronata and tree ferns and related these to environmental variables using linear models and generalised linear mixed-effect models (GLMMs). Distance to an introduction site was the most significant factor predicting the palm’s distribution and abundance, suggesting that its current distribution is limited by insufficient time for wider dispersal. P. coronata cover was strongly and negatively related with the abundance of native tree ferns and the palm may therefore be displacing native tree ferns. This relationship was strongest with tree fern seedlings and weakest with mature tree ferns, implying that the palm is preventing the establishment of native tree ferns. This study thus provides strong circumstantial evidence that P. coronata is progressively displacing native tree ferns by preventing seedling establishment and poses a severe threat to Fiji’s native biodiversity and ecological processes. Therefore, urgent management is required to control and prevent the further spread of P. coronata and its negative impacts on native plant biodiversity. Management should involve an initial feasibility study to determine the effectiveness of various management strategies, followed by targeted control and/or eradication campaigns and long-term monitoring. Ultimately, well implemented legislation to prevent the spread and introduction of P. coronata and other ornamental plants will be crucial to protect native biodiversity in Fiji and elsewhere.

Comparative Effectiveness of Surgery for Traumatic Acute Subdural Hematoma in an Aging Population.

There is uncertainty as to the optimal initial management of patients with traumatic acute subdural hematoma, leading to regional variation in surgical policy. This can be exploited to compare the effect of various management strategies and determine best practices. This article reports such a comparative effectiveness analysis of a retrospective observational cohort of traumatic acute subdural hematoma patients in two geographically distinct neurosurgical departments chosen for their - a-priori defined - diverging treatment preferences. Region A favored a strategy focused on surgical hematoma evacuation, whereas region B employed a more conservative approach, performing primary surgery less often. Region was used as a proxy for preferred treatment strategy to compare outcomes between groups, adjusted for potential confounders using multivariable logistic regression with imputation of missing data. In total, 190 patients were included: 108 from region A and 82 from region B. There were 104 males (54.7%). Matching current epidemiological developments, the median age was relatively high at 68 years (interquartile range [IQR], 54-76). Baseline characteristics were comparable between regions. Primary evacuation was performed in 84% of patients in region A and in 65% of patients in region B (p < 0.01). Mortality was lower in region A (37% vs. 45%, p = 0.29), as was unfavorable outcome (53% vs. 62%, p = 0.23). The strategy favoring surgical evacuation was associated with significantly lower odds of mortality (odds ratio [OR]: 0.43; 95% confidence interval [CI]: 0.21-0.88) and unfavorable outcome (OR: 0.53; 95% CI: 0.27-1.02) 3-9 months post-injury. Therefore, in the aging population of patients with acute subdural hematoma, a treatment strategy favoring emergency hematoma evacuation might be associated with lower odds of mortality and unfavorable outcome.

Risk assessment and management of brucellosis in the southern greater Yellowstone area (I): A citizen-science based risk model for bovine brucellosis transmission from elk to cattle

Livestock producers and state wildlife agencies have used multiple management strategies to control bovine brucellosis in the Greater Yellowstone Area (GYA). However, spillover from elk to domestic bison and cattle herds continues to occur. Although knowledge is increasing about the location and behavior of elk in the SGYA, predicting spatiotemporal overlap between elk and cattle requires locations of livestock operations and observations of elk contact by producers. We queried all producers in a three-county area using a questionnaire designed to determine location of cattle and whether producers saw elk comingle with their animals. This information was used to parameterize a spatially-explicit risk model to estimate the number of elk expected to overlap with cattle during the brucellosis transmission risk period. Elk-cattle overlap was predicted in areas further from roads and forest boundaries in areas with wolf activity, with higher slopes, lower hunter densities, and where the cost-distance to feedgrounds was very low or very high. The model was used to estimate the expected number of years until a cattle reactor will be detected, under alternative management strategies. The model predicted cattle cases every 4.28 years in the highest risk herd unit, a higher prediction than the one case in 26 years we have observed. This difference likely indicates that ongoing management strategies are at least somewhat effective in preventing potential elk-cattle brucellosis transmission in these areas.Using this model, we can infer the expected effectiveness of various management strategies for reducing the risk of brucellosis spillover from elk to cattle.

Survival and harvest of Atlantic Flyway resident population Canada Geese

ABSTRACTResident Population Canada geese (Branta canadensis) are a valuable natural resource, but at high densities they create problems by colliding with vehicles, damaging crops, and fouling parks with feces. Effective management of these geese could be improved with knowledge of demographic rates, especially survival. We used band recovery data from 2005 to 2012 to estimate temporally and spatially explicit survival and recovery rates of Atlantic Flyway Resident Population Canada geese. We analyzed the data in Program MARK and found evidence that survival and recovery varied by age, state of banding, and year. We present state–age–year survival, recovery, and harvest rates from all states. Model‐averaged estimates of adult survival ranged from 0.62 to 0.87 and had high precision for most states. Estimates of survival of juvenile geese were generally higher than those for adult geese, but they were less precise and more variable among states. Based on estimates of survival and recovery rates, the average annual harvest rate of adult geese was 13.5% and ranged from 3.1% in North Carolina to 20.1% in Pennsylvania, USA. Harvest rates of juvenile geese were not significantly different from those of adult geese and averaged 15.3%. The estimated survival and harvest rates can be incorporated into population models to assess potential effectiveness of various management strategies for Resident Population Canada geese. © 2015 The Wildlife Society.

Contribution of shallow groundwater rapid fluctuation to soil salinization under arid and semiarid climate

Rising saline shallow groundwater and associated soil salinization problems are widespread especially in arid and semiarid areas. There have been numerous studies on groundwater-associated salinity, but more information is required on the effects of groundwater frequent and high fluctuations on soil salinization. In the present study, laboratory experiments and numerical simulations using HYDRUS-1D model were carried out for this purpose. The experimental and modeling results showed that groundwater fluctuation caused not only the accumulation of more salt in the soil profile compared to stable groundwater, but also an enhancement of the mechanism. Water table fluctuation induced a much greater spreading of the bromide (Br) tracer within the column than the constant water table. The Br content was on average five orders of magnitude greater under a fluctuating water table than under a constant one. Further, the numerical simulations showed that an increase in the groundwater fluctuation frequency brought about an increase in soil surface salinization under the same evaporation boundary conditions. Additional simulations with HYDRUS-1D were used to study the effects of various management strategies on soil salinization induced by shallow groundwater. Hence, by reducing the evaporation rate through the application of surface mulching, a significant reduction of salt concentration at the soil surface was observed. Moreover, frequent irrigations with small quantities were effective to reduce soil surface salt accumulation induced by saline shallow groundwater.

Management of reported decreased fetal movements for improving pregnancy outcomes

Clinical observations indicate that mothers commonly perceive a reduction in, or absence of, the baby's movements for some days preceding a baby's death. For this reason, fetal movement monitoring is advised by caregivers and used spontaneously by mothers to assess the baby's well-being. However, it is possible that the harmful effects of interventions may outweigh the benefits of such testing. Evidence of effectiveness of fetal movement screening to improve outcomes is limited, though indirect evidence suggests a potential benefit. A secondary question is whether any specific management response to perceived decreased fetal movements (DFM) improves clinical outcome. To determine, from the best available evidence, the effectiveness of various management strategies for DFM. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (28 February 2012) and bibliographies of included studies. Randomised clinical trials comparing various management strategies for DFM, including delivery, expectant management, cardiotocography (visual and computerised), ultrasound examination including Doppler ultrasound, and fetal arousal tests (cardiotocographic or clinical). Two assessors evaluated potentially eligible trials for inclusion, and extracted data onto a purpose-designed form. Where DFM was one among a number of inclusion criteria for the trial, we contacted trial authors for information on outcomes specific to the DFM subgroups. No randomised trials of management of DFM were found. Of 13 randomised trials of management strategies for pregnancies with risk factors for fetal compromise including DFM, data on the DFM subgroups could only be provided by the authors of one trial. The numbers were too small for meaningful analysis (there were 28 cases of DFM). There are insufficient data from randomised trials to guide practice regarding the management of DFM. Based on the results of other systematic reviews of management strategies for women whose babies are thought to be at risk of compromise for various reasons, the following strategies show promise and may be prioritised for further research: Doppler ultrasound studies, computerised cardiotocography, and fetal arousal to facilitate cardiotocography.For settings where electronic fetal assessment methods are not available, clinical fetal arousal tests should be investigated.

A dynamic model for assessing the effects of management strategies on the reduction of construction and demolition waste

During the past few decades, construction and demolition (C&D) waste has received increasing attention from construction practitioners and researchers worldwide. A plethora of research regarding C&D waste management has been published in various academic journals. However, it has been determined that existing studies with respect to C&D waste reduction are mainly carried out from a static perspective, without considering the dynamic and interdependent nature of the whole waste reduction system. This might lead to misunderstanding about the actual effect of implementing any waste reduction strategies. Therefore, this research proposes a model that can serve as a decision support tool for projecting C&D waste reduction in line with the waste management situation of a given construction project, and more importantly, as a platform for simulating effects of various management strategies on C&D waste reduction. The research is conducted using system dynamics methodology, which is a systematic approach that deals with the complexity – interrelationships and dynamics – of any social, economic and managerial system. The dynamic model integrates major variables that affect C&D waste reduction. In this paper, seven causal loop diagrams that can deepen understanding about the feedback relationships underlying C&D waste reduction system are firstly presented. Then a stock-flow diagram is formulated by using software for system dynamics modeling. Finally, a case study is used to illustrate the validation and application of the proposed model. Results of the case study not only built confidence in the model so that it can be used for quantitative analysis, but also assessed and compared the effect of three designed policy scenarios on C&D waste reduction. One major contribution of this study is the development of a dynamic model for evaluating C&D waste reduction strategies under various scenarios, so that best management strategies could be identified before being implemented in practice.

The Integrative Effects of Various Management Strategies in the Performance of MSMES

Abstract: The study of integrative effects of various management strategies in Kenyan MSMEs was an objective in a major study leading to doctoral award. The various management strategies selected were the chief executive (owner manager strategies), human resource, technological, financial, entrepreneurial, marketing as well as interpersonal and environmental factors. Profitability was taken as the measure of performance. A predictive equation was obtained capable of classifying cases into either performance or non performance. Several recommendations were made that would benefit the managers of MSMES. Key words: Integrative effects; MSMEs; Management strategies; Management factors; Performance

The carrot, the stick, or the relationship: what are the effective disciplinary strategies?

The effectiveness of various management strategies has been of central concern in academic and educational debates on the role and nature of classroom discipline. Educational theorists and researchers have put forth a range of different models, each of which incorporates the use of a number of strategies. This article reports on a study that seeks to investigate the gamut of these strategies pragmatically and considers their affects on a range of factors, such as levels of student responsibility, misbehaviour, relationship with teachers, and connection to school. Analysis of the results offered in this article supports the judicious use of a combination of strategies involving the use of hinting, involvement, discussion, and recognition and rewards. The discussion focuses primarily on the benefits that can be achieved through a regulated process of positive discipline strategies, through which teachers and students can develop mutual respect and trust.

Measuring tourism chain performance

The measurement of a destinations' network performance is a complex task due to the diverse actors involved and their complex relationships and there is a need to find simplified and manageable approaches for evaluation. One approach that is frequently used when a situation is too complex or requires a great amount of analysis is to divide the problem in order to conquer it. In this paper, the tourism chain is used to provide a simplified and manageable performance measurement unit for network efficiency. A tourism chain is a pattern in the way tourists interact with a destination. The purpose of this study is to develop a performance index for a tourism chain utilizing fuzzy set theory. The performance measurement model developed was then used to examine the effectiveness of various management strategies. The study found that the performance measurement system may be included in a management information feedback system to help improve decision making processes and the performance of tourism chains.

Sex, Race and Ethnicity: Providing Quality Care for Elderly Patients Hospitalized with Heart Failure

Heart failure continues to be a major and growing public health problem. Guidelines for heart failure management have been primarily based on clinical trials, in which the elderly, women and minority groups were under-represented. There are major differences between patients enrolled in clinical trials and patients with heart failure at large in the community. Clinicians are faced with the challenge of deciding the best treatment for heart failure patients, in whom clinical guidelines may not fully apply. Much wider representation of minority groups, women and the elderly as well as efforts to include community heart failure patients in future clinical trials will close the gap in our knowledge, with regard to the effects of various management strategies in these patients, and will hopefully contribute to better outcome.

Body wall tears during late pregnancy in mares: 13 cases (1995–2006)

To review management of pregnant mares with body wall defects and assess the effect of various management strategies on the outcome of mares and their foals. Retrospective case series. 13 mares. Medical records of eligible mares were reviewed. Signalment, history, admitting complaint, clinical findings, parity, type of body wall defect, concurrent diagnoses, postpartum complications, outcome of fetus, outcome of mare, and type of clinical case management were recorded. 8 mares received conservative management and 5 mares received interventional management. Survival of mares to discharge was good, and no difference in mare survival was identified on the basis of type of management, type of body wall defect, or presence of hydrops. Foal survival was significantly better in the conservative management group, compared with those managed by interventional management, and was also better without hydrops. Foal survival can be improved in mares with body wall defects that occur during parturition without compromising mare survival by use of conservative management strategies that avoid induction of parturition or elective caesarian section and allow for natural parturition. Potentially, improved fetal readiness for birth may play a role.

MANAGEMENT OF CHAMOIS (RUPICAPRA RUPICAPRA) MOVING BETWEEN A PROTECTED CORE AREA AND A HUNTING AREA

We explored the long-term effect of various management strategies for a mountain ungulate, the chamois (Rupicapra rupicapra), living in a mosaic of protected reserves and hunting areas. The chamois occurs in the French Alps at high densities within protected reserves but is heavily hunted in the surrounding areas. Extensive demographic studies were used for developing a model of the population in the reserve area, as well as for the hunting area. The chamois in the reserve has value for tourism and conservation, whereas the chamois outside the reserve has mainly hunting value. Optimal management of the overall system consisting of reserve and hunting areas depends on the management objective: either a simple maximization of the value of hunted chamois, or the value of hunted chamois together with the value of the chamois in the reserve. We explored how optimal harvesting strategies are affected by the relative hunting values of the sexes and the relative nonconsumptive values of the chamois inside the reserve. A male-biased, sex-specific harvesting rate was generally found to be optimal, a bias which was larger when the value of the chamois in the reserve was included. Movement rates and sex ratio play critical roles in such systems, and should therefore be studied more than they typically are. We suggest experimental approaches to test the critical parameters of the model.

Simulation of Supplemental Irrigation from On‐Farm Ponds

Several researchers have shown that on‐farm runoff collection and supplemental irrigation systems can increase and stabilize crop production in many regions of the world. The objective of this study is to develop simulation capabilities to determine optimum pond size and irrigation strategies for supplemental irrigation systems. A comprehensive basin‐scale soil and water‐resource model is modified to simulate crop yield, supplemental irrigation, furrow diking, and economics. The simulation model is linked with a golden‐section search optimization scheme to optimize farm pond storage with respect to net profits from crop production under supplemental irrigation. The golden section is a direct search method and is applicable to optimization problems where an analytic expression for the objective function is unavailable. The model also produces monetary‐return frequency distributions for various pond sizes and is capable of determining the effects of various management strategies on crop production and water...