General Principles Of Management Research Articles

Pelvic Nerve Blocks

<h3>Study Objective</h3> To demonstrate nerve block techniques for the obturator nerve, pudendal nerve, and uterine nerves (paracervical block). <h3>Design</h3> Procedural video. <h3>Setting</h3> Academic medical center. <h3>Patients or Participants</h3> Patients with chronic pelvic pain. <h3>Interventions</h3> This video demonstrates how to perform obturator, pudendal, and paracervical nerve blocks. This video highlights the techniques of these pelvic floor nerve blocks and includes general management and follow-up principles for these patients. <h3>Measurements and Main Results</h3> Pain scores, on a scale of 0-10, are measured prior to and after nerve blocks to gauge response. <h3>Conclusion</h3> Determining the source of chronic pelvic pain can be difficult for gynecologists. Nerve blocks can be an effective strategy to help evaluate and possibly treat pelvic pain. Pelvic floor nerve blocks can delineate whether or not pain is originating from the pelvic floor, uterus, or other source. Nerve blocks can also potentially be therapeutic in instances of nerve entrapment, muscle spasms, neuralgia, or myofascial pain. These instructional videos on administering pelvic floor nerve blocks can help gynecologists provide an additional source of therapy for their patients.

Ballistic Injuries to the Foot and Ankle: Antibiotic Administration and Infection Rate

Category: Trauma; Ankle; Hindfoot; Midfoot/Forefoot; Other Introduction/Purpose: Although frequently non-fatal, ballistic injuries to the foot and ankle can lead to significant morbidity and functional impairment. General management principles are often employed, however there is a paucity of data related outcomes following ballistic injury to the foot and ankle. Methods: A retrospective chart review of inpatients who sustained a ballistic injury to the foot and ankle was performed at a single level one trauma institution from 2014 to 2019. A total of 64 patients were identified. Each chart was reviewed for demographics, foot and ankle injury sustained, associated non-orthopaedic injuries, antibiotics received, procedures undergone, and complications documented. Results: The patients were more frequently male (M:F, 11.8:1) with a mean age of 31.2 years (18-75). Fifty-two (81.3%) patients received antibiotics, all of which covered for gram positive organisms. Twelve of these patients also received coverage for gram- negative organisms. Two (3.1%) patients developed a documented infection. One patient who received gram positive antibiotic coverage sustained 1 fracture, underwent bedside bullet removal, and developed a cellulitis that responded to oral antibiotics. The other patient received both gram positive and gram negative coverage, sustained 6 fractures in the foot with extensive soft tissue injury, underwent operative debridement, and ultimately required transmetatarsal amputation due to infection/osteomyelitis. Conclusion: Ballistic injuries to the foot and ankle are common injuries encountered by orthopaedists in an urban setting. The infection rate (3.1%) in our series is low and comparable to infection rates seen after ballistic injury to the hand. Negative outcomes after ballistic injury are associated with multiple fractures and soft tissue compromise. We advocate for early antibiotic administration and a high index of suspicion for infection in these cases.

Russian economic and sociological journals in Scopus: The impact of publication language on the citation rate

Choosing a publishing model is crucial for an academic journal which aims to increase international visibility, cover a wide readership and strengthen its position in international scientometric databases. The article investigates the publishing models of Russian economic and sociological journals indexed in Scopus. The methodological basis of the study is the general principles of scientometric management. The methods of content analysis and citation analysis were used. The information base covers the data retrieved from the Russian Science Citation Index and international scientometric databases Scopus, Scimago Journal &amp; Country Rank. We propose an approach that helps establish a correlation between Russian articles’ citation rate in the international environment and their publication language. In the course of the study, we analyse 30 journals and carry out a quantitative and qualitative assessment of their citations. The paper provides a typology of publication models and categorises them into nine groups according to the share of English-language articles, their publication frequency and specificity in relation to the Russian-language content. Having analysed the journals’ citation indicators, we identify the models that do not impede the journals’ integration into the international environment and are most effective in achieving high citation rates and reaching a wide international readership. Publishing two Russian and English parallel versions of the same journal is recognized as the best practice. The findings can be of use to research institutions and editorial offices in designing journal promotion strategies and strengthening their positions in international scientometric databases.

Ecological and Cultural Understanding as a Basis for Management of a Globally Significant Island Landscape

Islands provide the opportunity to explore management regimes and research issues related to the isolation, uniqueness, and integrity of ecological systems. K’gari (Fraser Island) is an Australian World Heritage property listed based on its outstanding natural value, specifically, the unique wilderness characteristics and the diversity of ecosystem types. Our goal was to draw on an understanding of the natural and cultural environment of K’gari as a foundation on which to build a management model that includes First Nations Peoples in future management and research. Our research involved an analysis of papers in the peer-reviewed scientific literature, original reports, letters, and other manuscripts now housed in the K’gari Fraser Island Research Archive. The objectives of the research were: (1) to review key historical events that form the cultural, social, and environmental narrative; (2) review the major natural features of the island and threats; (3) identify the gaps in research; (4) analyse the management and conservation challenges associated with tourism, biosecurity threats, vegetation management practices, and climate change and discuss whether the requirements for sustaining island ecological integrity can be met in the future; and (5) identify commonalities and general management principles that may apply globally to other island systems and other World Heritage sites listed on the basis of their unique natural and cultural features. We found that the characteristics that contribute to island uniqueness are also constraints for research funding and publication; however, they are important themes that warrant more investment. Our review suggests that K’gari is a contested space between tourist visitation and associated environmental impacts, with an island that has rich First Nations history, extraordinary ecological diversity, and breathtaking aesthetic beauty. This juxtaposition is reflected in disparate views of custodianship and use, and the management strategies are needed to achieve multiple objectives in an environmentally sustainable way whilst creating cultural equity in modern times. We offer a foundation on which to build a co-management model that includes First Nations Peoples in governance, management, research, and monitoring.

Treatment of Gastrointestinal Stromal Tumors (GISTs): A Focus on Younger Patients.

Simple SummaryGastrointestinal stromal tumors (GISTs) are the most common mesenchymal neoplasms of the gastrointestinal tract. GISTs mainly develop in older adults, and the median age of diagnosis is 60–65 years. The incidence of GISTs in young adult patients, defined as adults before 40, is less than 10%. The frequency and type of molecular abnormalities in this group of patients are different from those in older patients. In this publication, we focus on the specificity of GISTs in young people and the principles of therapeutic management and management of the side effects of treatment.Gastrointestinal stromal tumors (GISTs) originate from Cajal’s cells and are the most common mesenchymal neoplasms of the gastrointestinal tract. GISTs in young adults, i.e., patients before the age of 40, are rare and differ from those in older patients and GISTs in children in terms of the molecular and clinical features, including the location and type of mutations. They often harbor other molecular abnormalities than KIT and PDGFRA mutations (wild-type GISTs). The general principles of therapeutic management in young patients are the same as in the elderly. Considering some differences in molecular abnormalities, molecular testing should be the standard procedure to allow appropriate systemic therapy if needed. The optimal treatment strategy should be established by a multidisciplinary team experienced in sarcoma treatment. The impact of treatment on the quality of life and daily activities, including the impact on work, pregnancy, and fertility, in this patient population should be especially taken into consideration.

Ethical Framework of Digital Technology, Artificial Intelligence, and Health Equity

Healthcare is evident in the extensive use of digital technology and artificial intelligence (AI). Although one aim of technological development and application is to promote health equity, it can at the same time increase health disparities. An ethical framework is needed to analyze issues arising in the effort to promote health equity through digital technology and AI. Based on an analysis of ethical principles for the promotion of health equity, this research article aims to synthesize an ethical framework for analyzing issues related to the promotion of health equity through digital technology and AI. Results of the study showed a synthesized framework that comprises two main groups of ethical principles: general principles and principles of management. The latter is meant to serve the implementation of the former. The general principles comprise four core principles: Human Dignity, Justice, Non-maleficence, and Beneficence, covering major principles and minor principles. For example, the core principle of Human Dignity includes three major principles (Non-humanization, Privacy, and Autonomy), and two minor principles (Explicability and Transparency). Other core principles have their relevant major and minor principles. The principles of management can be categorized according to their goals to serve different core principles. An illustration of applying the ethical framework is offered through the analysis and categorization of issues solicited from experts in multidisciplinary workshops on digital technology, AI, and health equity.

Peripartum Severe COVID-19 Pneumonia: Fetal and Neonatal Implications.

Peripartum Severe COVID-19 Pneumonia: Fetal and Neonatal Implications.

Umbilical Cord Entanglement.

Umbilical Cord Entanglement.

Immunosuppressive drugs and associated complications in abdominal organ transplantation.

Intensive care management of patients who have undergone organ transplantation of liver, small bowel, pancreas, and/or kidney requires a basic knowledge of immunosuppression principles and the management of immunosuppressive medications. This review highlights the core principles of immunosuppression management in abdominal organ transplantation with a focus on complications arising from immunosuppressive drugs, both in the immediate postoperative period and in long-term usage. The general principles of management of immunosuppression in the abdominal organ transplant population have remained largely unchanged. Improvements in drug monitoring coupled with improvements in knowledge of pathways involved in allograft rejection have further refined immunosuppressive therapy. Infectious and central nervous system complications remain prevalent and are common complications of immunosuppressive drug therapy. For the intensive care professional who cares for abdominal organ transplant recipients, a foundational knowledge of the core principles of immunosuppression management is essential. In addition, an understanding of the common immunosuppressive drug regimens and the complications associated with these regimens is required for optimal management, risk assessment, and outcomes.

An Unexpected Cause of Recurrent Fetal Decelerations

An Unexpected Cause of Recurrent Fetal Decelerations

Acute kidney injury in patients with COVID-19: Epidemiology, pathogenesis and treatment.

Acute kidney injury occurs in about 30% of patients hospitalized with coronavirus disease 2019 (COVID-19) and is one of the most common extrapulmonary complications of this disease. The highest risk of acute kidney injury is found in hospitalized patients who require mechanical ventilation. The pathogenesis of acute kidney injury in COVID-19 is multifactorial and seems to not be fully understood. Both direct and indirect mechanisms of kidney injury caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) should be considered. The histological picture of kidney specimens obtained from patients with acute kidney injury in the course of COVID-19 is dominated by acute tubular necrosis. Some patients also have acute interstitial nephritis, blood clots in the kidney vessels and focal segmental glomerulosclerosis (the variant with collapsing vascular loops). Acute kidney injury in COVID-19 is primarily caused not by direct viral effect, but by indirect pathophysiological mechanisms. The histopathological findings in these patients does not differ from the majority of the other patients with acute kidney injury. The main pathophysiological mechanisms underlying acute kidney injury in COVID-19 are: hemodynamic abnormalities, hypoxia and cytokine storm. The methods of treating the underlying disease, i.e., COVID-19 in patients with acute kidney injury and those without acute kidney injury are similar. However, it should be stressed that in the treatment of COVID-19 accompanied by acute kidney injury, the contraindication to remdesivir is estimated using glomerular filtration rate (eGFR) <30 mL/min/1.73 m2. The general principles of management in patients with both, COVID-19 and acute kidney injury do not differ from the principles of management in patients with acute kidney injury due to the other causes.

ACUTE TUBULOINTERSTITIAL NEPHRITIS WITH UNDERLYING UNDIFFERENTIATED CONNECTIVE TISSUE DISEASE. A CLINICAL CASE STUDY

Acute tubulointerstitial nephritis (ATIN) is an acute kidney disease that can develop under the influence of various exogenous and endogenous factors and is manifested by inflammatory changes in the tubulointerstitial tissue of the kidneys, often accompanied by the development of acute renal kidney damage (AKI). Approximately 3–19% of all AKI cases are due to ATIN nephrobiopsy data, which indicates a difficult non-invasive diagnosis of this disease. Complaints of patients with ATIN are few and are associated with manifestations of acute renal damage: a decrease in urine volume, an increase in blood pressure (BP). Important in the diagnosis of ATIN is urinary syndrome, manifested by proteinuria less than 1 gram per day, erythrocyturia, leukocyturia, including eosinophiluria. In patients with suspected ATIN, a full physical examination is performed, attention is drawn to the appearance of pain on palpation of the kidneys, blood pressure is measured, diuresis, and the presence of edema are assessed. In laboratory diagnostics, it is necessary to investigate the level of creatinine, blood urea, general urine analysis, with instrumental — ultrasound examination of the kidneys, if indicated, a kidney biopsy is performed. Treatment is aimed at immediate cessation of the effect of the etiological factor, maintenance of waterelectrolyte balance and correction of violations of acidbase balance, blood pressure. In this regard, it is possible to use crystalloid solutions, loop diuretics (furosemide, torasemide), antihypertensive drugs in accordance with the general principles of management of patients with AKI, immunosuppressive therapy for ATIN immune genesis, with ATIN drug genesis — glucocorticoids. In the presence of appropriate indications, renal replacement therapy is performed. The prognosis of the disease often depends on timely diagnosis and appropriate treatment. The paper presents the clinical case of a female patient affected with acute tubulointerstitial nephritis.

Functional reconstruction of lower extremity nerve injuries

Peripheral nerve injuries (PNI) in the lower extremity are an uncommon but highly morbid condition. Recent advances in our understanding of nerve physiology and microsurgical techniques have inspired renewed faith in nerve surgery and sparked a creative renaissance in the tools, approaches, and reconstructive schemas available to surgeons in the management of lower extremity PNIs. In this article, we review the literature and provide a principles-based approach for the surgical management of lower extremity PNIs with an emphasis on techniques for functional reconstruction after complete nerve injury. General principles in management include early diagnosis with electrodiagnostics and imaging, early surgical exploration, and opting for nerve and tendon transfers when primary reconstruction of the injured nerve is unfavorable (e.g., delayed reconstruction, unavailability of proximal or distal nerve stumps, or long regenerative distance). The goal of functional reconstruction should be to restore independent gait, so understanding the roles of major neuromuscular units during the gait cycle informs the selection of donor nerves and tendons for transfer. Based on these principles and literature to date, specific algorithms for surgical management are presented for femoral, sciatic, tibial, and common peroneal nerves. We recognize limitations of the current literature, namely the predominance of case series evidence, and call for the accrual of more patient data in surgical management of PNIs.

Management of psychiatric disorders in patients with cancer.

Management of psychiatric disorders in patients with cancer.

Maternal Facial Nerve Palsy and a Perinatal Infection.

Maternal Facial Nerve Palsy and a Perinatal Infection.

Management of Psychiatric Disorders during the Perinatal Period.

Management of Psychiatric Disorders during the Perinatal Period.

General Principles of Contingency Management for Smoking Cessation

General Principles of Contingency Management for Smoking Cessation

Radiological investigation of acute mandibular injury.

This article focuses on the different imaging modalities used to evaluate acute mandibular fractures and explores important concepts relating to their diagnosis, investigation, and treatment. Significant focus will be given to exploring general management principles, considerations regarding first-line imaging, and recent technological advancement. Computed tomography (CT) is the preferred method when attempting to identify acute mandibular fractures, particularly in trauma patients, and has very high specificity and sensitivity. Multidetector CT now represents the standard of care, enabling fast scan times, reduced artifact, accurate reconstructed views, and three-dimensional (3D) reconstructions. Cone-beam CT is a newer advanced imaging modality that is increasingly being used worldwide, particularly in the ambulatory and intraoperative setting. It produces high-resolution images with submillimeter isotropic voxels, 3D and multiplanar reconstruction, and low radiation dose, however is less widely available and more expensive. Ultrasound is a valuable method in identifying a fracture in unstable patients, but is limited in its ability to detect nondisplaced fractures. Magnetic resonance imaging is useful in determining the presence of soft-tissue injury. CT angiography is invaluable in the assessment of potential vascular injury in condylar fracture dislocations.

Principles of strategic financial management and their implementation in the information economy

Subject. This article discusses the general principles of strategic management in relation to strategic financial management. Objectives. The article aims to substantiate and formulate the principles of strategic financial management applicable in the conditions of the Russian version of the information economy, corresponding to the current documents of strategic planning and to the current state of the financial and legal doctrine. Methods. For the study, I used a systems approach, functional and structural analysis, retrospection, forecasting, observation, and classification. Results. The article reveals significant shortcomings of the current strategic planning documents, the lack of doctrinal development, as well as the normative consolidation of general and special principles, which could contribute to solving tasks by strategic financial management effectively. Conclusions. The general principles of strategic management in the economy as a whole are applicable and can be used as the basis for strategic financial management.

Fever after Preterm Prelabor Rupture of Membranes.

Fever after Preterm Prelabor Rupture of Membranes.